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Biggs AT, Seech TR, Johnston SL, Russell DW. Psychological endurance: how grit, resilience, and related factors contribute to sustained effort despite adversity. THE JOURNAL OF GENERAL PSYCHOLOGY 2024; 151:271-313. [PMID: 37697826 DOI: 10.1080/00221309.2023.2253955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/16/2023] [Indexed: 09/13/2023]
Abstract
Many concepts describe how individuals sustain effort despite challenging circumstances. For example, scholars and practitioners may incorporate discussions of grit, hardiness, self-control, and resilience into their ideas of performance under adversity. Although there are nuanced points underlying each construct capable of generating empirically sound propositions, the shared attributes make them difficult to differentiate. As a result, substantial confusion arises when debating how these related factors concomitantly contribute to success, especially when practitioners attempt to communicate these ideas in applied settings. The model proposed here-psychological endurance-is a unified theory to explore how multiple concepts contribute to sustained goal-directed behaviors and individual success. Central to this model is the metaphor of a psychological battery, which potentiates and sustains optimal performance despite adversity. Grit and hardiness are associated with the maximum charge of the psychological battery, or how long an individual could sustain effort. Self-control modulates energy management that augments effort required to sustain endurance, whereas resilience represents the ability to recharge. These factors are constrained by both psychological and physiological stressors in the environment that drain the psychology battery. Taken together, these ideas form a novel framework to discuss related psychological concepts, and ideally, optimize intervention to enhance psychological endurance.
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Schmidt LI, Baetzner AS, Dreisbusch MI, Mertens A, Sieverding M. Postponing sleep after a stressful day: Patterns of stress, bedtime procrastination, and sleep outcomes in a daily diary approach. Stress Health 2024; 40:e3330. [PMID: 37846558 DOI: 10.1002/smi.3330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 08/26/2023] [Accepted: 09/26/2023] [Indexed: 10/18/2023]
Abstract
Sleep problems and stress are common among students and are associated with negative effects on academic performance as well as mental and physical health risks, but studies exploring mediating factors between stress and sleep on a daily basis are scarce. This study aimed to investigate the relationship of daily stress, Bedtime procrastination (BP) (i.e., postponing bedtime without external reasons), and sleep outcomes controlling for trait factors such as self-control. N = 96 students at a German university (M = 22.2 years, SD = 4.0) wore a sleep-tracking wearable (Fitbit Charge HR) for two weeks to assess sleep duration and to calculate the gap between the intended time to go to sleep and the objectively measured time of falling asleep. Stress, intended time to go to sleep, and sleep quality were assessed via daily diaries. Established questionnaires were used to measure trait self-control, trait BP, and smartphone addiction. Multilevel analyses indicated that more stress experienced during the day was associated with more BP (b = 2.32, p = 0.008), shorter sleep duration (b = -3.46, p = 0.003), and lower sleep quality (b = 1.03, p = 0.005) after controlling for several trait factors. The association of daily stress with sleep outcomes (quality and duration) was partly mediated by BP. Our findings indicate that BP might be one factor that contributes to stress-linked decreases in sleep duration and quality. Potential reasons for stress-related later time to fall asleep-like higher physiological arousal or stress-related worries-should be investigated in future studies.
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Affiliation(s)
- Laura I Schmidt
- Institute of Psychology, Heidelberg University, Heidelberg, Germany
| | - Anke S Baetzner
- Institute of Sports and Sports Sciences, Heidelberg University, Heidelberg, Germany
| | - Marina I Dreisbusch
- Institute of Psychology, University of the Bundeswehr Munich, Neubiberg, Germany
| | - Alica Mertens
- School of Social Science, University of Mannheim, Mannheim, Germany
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Qi X, Pan C, Yang J, Liu L, Hao J, Wen Y, Zhang N, Wei W, Cheng B, Cheng S, Zhang F. Disadvantaged social status contributed to sleep disorders: An observational and genome-wide gene-environment interaction analysis. Sleep Health 2024:S2352-7218(24)00059-7. [PMID: 38772848 DOI: 10.1016/j.sleh.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 01/23/2024] [Accepted: 03/13/2024] [Indexed: 05/23/2024]
Abstract
BACKGROUND Sleep is a natural and essential physiological need for individuals. Our study aimed to research the associations between accumulated social risks and sleep disorders. METHODS In this study, we came up with a polysocial risk score (PsRS), which is a cumulative social risk index composed of 13 social determinants of health. This research includes 239,165 individuals with sleep disorders and social determinants of health data from the UK Biobank cohort. First, logistic regression models were performed to examine the associations of social determinants of health and sleep disorders, including chronotype, narcolepsy, insomnia, snoring, short and long sleep duration. Then, PsRS was calculated based on statistically significant social determinants of health for each sleep disorder. Third, a genome-wide gene-environment interaction study was conducted to explore the interactions between single-nucleotide polymorphisms and PsRS in relation to sleep disorders. RESULTS Higher PsRS scores were associated with worse sleep status, with the adjusted odds ratio (OR) ranging from 1.10 (95% Confidence interval [CI]: 1.09-1.11) to 1.29 (95% CI: 1.27-1.30) for sleep disorders. Emotional stress (OR = 1.36, 95% CI: 1.28-1.43) and not in paid employment (OR = 2.62, 95% CI: 2.51-2.74) were found to have significant contributions for sleep disorders. Moreover, multiple single-nucleotide polymorphisms were discovered to have interactions with PsRS, such as FRAS1 (P = 2.57 × 10-14) and CACNA1A (P = 8.62 × 10-14) for narcolepsy, and ACKR3 (P = 1.24 × 10-8) for long sleep. CONCLUSIONS Our findings suggested that cumulative social risks was associated with sleep disorders, while the interactions between genetic susceptibility and disadvantaged social status are risk factors for the development of sleep disorders.
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Affiliation(s)
- Xin Qi
- Precision medicine center, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China
| | - Chuyu Pan
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Jin Yang
- Precision medicine center, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China; Cancer Center, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China; Department of Medical Oncology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China
| | - Li Liu
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Jingcan Hao
- Medical department, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China
| | - Yan Wen
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Na Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Wenming Wei
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Bolun Cheng
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Shiqiang Cheng
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Feng Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China.
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Barret N, Guillaumée T, Rimmelé T, Cortet M, Mazza S, Duclos A, Rode G, Lilot M, Schlatter S. Associations of coping and health-related behaviors with medical students' well-being and performance during objective structured clinical examination. Sci Rep 2024; 14:11298. [PMID: 38760478 PMCID: PMC11101410 DOI: 10.1038/s41598-024-61800-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 05/09/2024] [Indexed: 05/19/2024] Open
Abstract
Objective structured clinical examination (OSCE) is a valid method to evaluate medical students' competencies. The present cross-sectional study aimed at determining how students' coping and health-related behaviors are associated with their psychological well-being and performance on the day of the OSCE. Fourth-year medical students answered a set of standardized questionnaires assessing their coping (BCI) and health-related behaviors before the examination (sleep PSQI, physical activity GPAQ). Immediately before the OSCE, they reported their level of instant psychological well-being on multi-dimensional visual analogue scales. OSCE performance was assessed by examiners blinded to the study. Associations were explored using multivariable linear regression models. A total of 482 students were included. Instant psychological well-being was positively associated with the level of positive thinking and of physical activity. It was negatively associated with the level of avoidance and of sleep disturbance. Furthermore, performance was negatively associated with the level of avoidance. Positive thinking, good sleep quality, and higher level of physical activity were all associated with improved well-being before the OSCE. Conversely, avoidance coping behaviors seem to be detrimental to both well-being and OSCE performance. The recommendation is to pay special attention to students who engage in avoidance and to consider implementing stress management programs.Clinical trial: The study protocol was registered on clinicaltrial.gov NCT05393206, date of registration: 11 June 2022.
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Affiliation(s)
- Noémie Barret
- Lyon Est School of Medicine, Université Lyon 1, Lyon, France
- Department of Anesthesia and Intensive Care, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Théodore Guillaumée
- Lyon Est School of Medicine, Université Lyon 1, Lyon, France
- Department of Anesthesia and Intensive Care, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Thomas Rimmelé
- Lyon Est School of Medicine, Université Lyon 1, Lyon, France
- Department of Anesthesia and Intensive Care, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
- High Fidelity Medical Simulation Center (SIMULYON), Lyon, France
| | - Marion Cortet
- Lyon Est School of Medicine, Université Lyon 1, Lyon, France
- High Fidelity Medical Simulation Center (SIMULYON), Lyon, France
- Department of Obstetrics and Gynecology, Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Stéphanie Mazza
- Centre de Recherche en Neurosciences de Lyon (CRNL), CRNL-U1028, UMR-5292, FORGETTING Team, CNRS, INSERM, Université Lyon 1, 69500, Bron, France
| | - Antoine Duclos
- Lyon Est School of Medicine, Université Lyon 1, Lyon, France
- Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard, Lyon 1, France
- Department of Health Data, Hospices Civils de Lyon, Lyon, France
| | - Gilles Rode
- Lyon Est School of Medicine, Université Lyon 1, Lyon, France
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, TRAJECTOIRES, F-69500, Bron, France
| | - Marc Lilot
- High Fidelity Medical Simulation Center (SIMULYON), Lyon, France
- Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard, Lyon 1, France
- Unit of Pediatric and Congenital Cardio-thoracic Anesthesia and Intensive Care, Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, France
| | - Sophie Schlatter
- Lyon Est School of Medicine, Université Lyon 1, Lyon, France.
- High Fidelity Medical Simulation Center (SIMULYON), Lyon, France.
- Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard, Lyon 1, France.
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Badawy YA, Almakrami AH, Alata AJ, Abujamea EZ, Khaliifa LM. Predictability of Insulin Resistance Based on the Clinical Manifestations Among Male Medical Students of a Private College in Saudi Arabia. Cureus 2024; 16:e60327. [PMID: 38883100 PMCID: PMC11177330 DOI: 10.7759/cureus.60327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2024] [Indexed: 06/18/2024] Open
Abstract
Background Numerous clinical signs and symptoms are thought to be associated with insulin resistance. The purpose of this study was to examine the prevalence of insulin resistance among male medical students attending a private Saudi Arabian institution, based on clinical indications. Methods A convenient non-probability sample consisting of 241 male medical students was used to conduct cross-sectional research. Each participant had an in-person interview as well as anthropometric measurements. The interview consisted of a questionnaire that was used to assess demographic data and clinical manifestations related to insulin resistance. Results The study demonstrated the connection between a few dermatological symptoms and waist circumference as an indicator of insulin resistance. In both the high and normal waist circumference groups, acne was the most common symptom. There was no correlation found between waist circumference and psoriasis, hidradenitis suppurativa, androgenic alopecia, alopecia areata, or vitiligo. Nevertheless, as an indicator of insulin resistance, waist circumference was statistically significantly correlated with both skin tags and acanthosis nigricans. Most students had excessive day sleep, foggy brains, struggled with planning and solving problems, and had a memory that became worse in the past few years. In addition, many students feel hungry even after eating some sweets and usually have extreme thirst. Conclusion Among medical students, skin tags, acanthosis nigricans, and acne were the most prevalent dermatological manifestations. Clinicians need to be aware that skin conditions, sleep difficulties throughout the day, changes in cognition, and food cravings might all be indicators of internal changes and/or illnesses such as diabetes and prediabetes.
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Affiliation(s)
- Yousria A Badawy
- Family Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Ahmed H Almakrami
- Medicine and Surgery, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Abdullah J Alata
- Medicine and Surgery, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Emad Z Abujamea
- Medicine and Surgery, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Louai M Khaliifa
- Pharmacy, Ibn Sina National College for Medical Studies, Jeddah, SAU
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Dagani J, Buizza C, Cela H, Sbravati G, Rainieri G, Ghilardi A. The Interplay of Sleep Quality, Mental Health, and Sociodemographic and Clinical Factors among Italian College Freshmen. J Clin Med 2024; 13:2626. [PMID: 38731154 PMCID: PMC11084360 DOI: 10.3390/jcm13092626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 04/25/2024] [Accepted: 04/27/2024] [Indexed: 05/13/2024] Open
Abstract
Background/Objectives: Sleep and mental health are closely linked, with sleep deprivation increasing the risk of mental health problems in college students. This study aimed to analyze the role of sleep in the mental health status of a sample of Italian freshmen, considering various mental health outcomes and potential interactions between sleep and other relevant factors, such as sociodemographic characteristics, academic experiences, and mental health history. Methods: All freshmen from a medium-sized Italian university were invited to participate in a multidimensional online survey (n = 3756). Sleep quality was assessed through questions on average hours of sleep per night and on satisfaction of perceived sleep quality. Mental health outcomes included psychophysical well-being, psychological distress, substance use, and problematic internet use. Statistical analysis involved multivariate analysis of variance, followed by pairwise comparisons. Results: The sample (n = 721) exhibited low levels of well-being and a high prevalence of psychological distress (52.1%). Approximately one-third of students (n = 258) were dissatisfied with their sleep quality, and one-fourth (n = 186) reported inadequate sleep (less than 7 h per night). More specifically, 24.4% of students slept on average six hours per night, and 1.4% slept five hours or less. Satisfaction with perceived sleep quality significantly influenced well-being, psychological distress, and cannabis use (ηp2 = 0.02). Interaction effects were observed between satisfaction with sleep quality and drop-out intentions (ηp2 = 0.01), as well as between satisfaction with sleep quality and history of mental health diagnosis (ηp2 = 0.02), both of which were significant for psychological distress and cannabis use. Conclusions: This study highlights the influence of perceived sleep quality on academic distress among college freshmen, particularly those with higher intentions of leaving university and with a history of mental health diagnosis.
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Affiliation(s)
- Jessica Dagani
- Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy; (J.D.); (C.B.); (G.S.); (G.R.)
| | - Chiara Buizza
- Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy; (J.D.); (C.B.); (G.S.); (G.R.)
| | - Herald Cela
- Department of Psychology, University of Graz, Universitätsplatz 2, 8010 Graz, Austria
| | - Giulio Sbravati
- Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy; (J.D.); (C.B.); (G.S.); (G.R.)
| | - Giuseppe Rainieri
- Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy; (J.D.); (C.B.); (G.S.); (G.R.)
| | - Alberto Ghilardi
- Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy; (J.D.); (C.B.); (G.S.); (G.R.)
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Kim RH, Paulino YC, Kawabata Y. Validating Constructs of the Depression, Anxiety, and Stress Scale-21 and Exploring Health Indicators to Predict the Psychological Outcomes of Students Enrolled in the Pacific Islands Cohort of College Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:509. [PMID: 38673419 PMCID: PMC11050516 DOI: 10.3390/ijerph21040509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/14/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024]
Abstract
The Depression, Anxiety, and Stress Scale-21 (DASS-21) has been used in various countries to assess the mental states of individuals. The objectives of this study were to validate the DASS-21 for use in Guam, an island that endures a high burden of mental health challenges, such as suicide, and examine the predictive impact of selected health indicators on DASS-21 variables. Three years of data (2017-2019) were pooled from the Pacific Islands Cohort of College Students (PICCS) study conducted annually at the University of Guam. In total, 726 students were included in the secondary data analysis. MPlus statistical software was used to perform a confirmatory factor analysis (CFA) for the validation and structural equation modeling (SEM) for the predictive modeling. The results from the CFA suggested an acceptable model fit (RMSEA: 0.073, CFI: 0.901, TLI: 0.889, RMR: 0.044), while SEM suggested that sleep quality and physical activity were significant predictors of DASS-21 variables. Therefore, the DASS-21 is a valid instrument for measuring depression, anxiety, and stress among emerging adults in Guam.
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Affiliation(s)
- Rebecca H. Kim
- College of Natural and Applied Sciences, University of Guam, Mangilao, GU 96923, USA
| | | | - Yoshito Kawabata
- College of Liberal Arts and Social Sciences, University of Guam, Mangilao, GU 96923, USA;
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Garmabi M, Andishmand Z, Naderi F, Sharifnezhad A, Darrudi F, Malekzadeh R, Amini A, Gholami A. The Prevalence of Depression and Anxiety and Its Association with Sleep Quality in the First-Year Medical Science Students. DEPRESSION RESEARCH AND TREATMENT 2024; 2024:7102081. [PMID: 38651016 PMCID: PMC11035008 DOI: 10.1155/2024/7102081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 03/02/2024] [Accepted: 03/17/2024] [Indexed: 04/25/2024]
Abstract
Methods A total number of 471 freshmen students (NUMS) participated in the study, pinpointing that the data are collected in 2019 and 2020. In line with measuring depression, anxiety, and sleep quality, the Persian Beck Depression Inventory-II, Beck Anxiety Inventory, and Pittsburgh Sleep Quality Index were employed. The associations between depression and anxiety with sleep quality were assessed by using the multiple logistic regression model. All statistical analyses were conducted in STATA14, and the significant level was set at P < 0.05. Results The prevalence of depression, anxiety, and poor sleep quality in the study population was 21.4%, 31.9%, and 28%, respectively. Analytical analyses indicated that after adjusting for studied covariates, the odds of poor sleep quality in individuals with depression were 3.5 times higher compared to the counter group (P < 0.001). Moreover, the odds of poor sleep quality in individuals with anxiety were 2.1 times higher compared to the counter group (P < 0.001). Conclusion Noticeable proportion of freshmen students suffer from depression and anxiety; in line with such a critical issue, our study found that depression and anxiety had a statistical association with sleep quality in study population. From this respect, it seems that providing essential interventions and psychological counseling services could be constructive for the freshmen medical students.
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Affiliation(s)
- Maryam Garmabi
- Student Counseling Center, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Zahra Andishmand
- Student Counseling Center, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Fatemeh Naderi
- Student Counseling Center, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Ahmad Sharifnezhad
- Department of Basic Sciences, School of Medicine, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Fatemeh Darrudi
- Noncommunicable Diseases Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Roghayeh Malekzadeh
- Noncommunicable Diseases Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Asieh Amini
- Ph.D. Candidate in English Language Teaching, Razi University, Kermanshah, Iran
| | - Ali Gholami
- Noncommunicable Diseases Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Neyshabur University of Medical Sciences, Neyshabur, Iran
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Hu B, Shen W, Wang Y, Wu Q, Li J, Xu X, Han Y, Xiao L, Yin D. Prevalence and related factors of sleep quality among Chinese undergraduates in Jiangsu Province: multiple models' analysis. Front Psychol 2024; 15:1343186. [PMID: 38659684 PMCID: PMC11040509 DOI: 10.3389/fpsyg.2024.1343186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 03/22/2024] [Indexed: 04/26/2024] Open
Abstract
Background and aims In China, a significant number of undergraduates are experiencing poor sleep quality. This study was designed to investigate the prevalence of poor sleep quality and identify associated factors among undergraduates in Jiangsu Province, China. Methods A total of 8,457 participants were collected in 2022 using whole-group convenience sampling. The factors studied included basic demographics, family and social support, personal lifestyles, physical and mental health, mobile phone addiction index (MPAI), and the Connor-Davidson resilience scale (CD-RISC). The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. Four models, including weighted multiple linear regression, binary logistic regression, weighted linear mixed model, and logistic regression with random effects, were applied to identify associated factors for sleep quality. Results Of the 8,457 participants analyzed, 26.64% (2,253) were classified into the poor sleep quality group with a PSQI score >7. No significant relationship was found between sleep quality and gender, native place, economic level of family, physical exercise, dormitory light, dormitory hygiene, and amativeness matter. Risk factors for sleep quality identified by the four models included lower CD-RISC, higher MPAI, fourth grade or above, smoking, drinking, greater academic pressure, greater employment pressure, roommate sleeping late, noisy dormitory, poorer physical health status, poorer mental health status, and psychological counseling. Conclusions These findings provide valuable insights for university administrators, enabling them to better understand the risk factors associated with poor sleep quality in undergraduates. By identifying these factors, administrators can provide targeted intervention measures and counseling programs to improve students' sleep quality.
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Affiliation(s)
- Bin Hu
- Key Laboratory of Human Genetics and Environmental Medicine, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Wen Shen
- Department of Respiratory Diseases, The Affiliated Huai'an Hospital of Xuzhou Medical University, The Second People's Hospital of Huai'an, Huai'an, Jiangsu, China
| | - Yun Wang
- Department of Dermatology, The Affiliated Huai'an Hospital of Xuzhou Medical University, The Second People's Hospital of Huai'an, Huai'an, Jiangsu, China
| | - Qi Wu
- Key Laboratory of Human Genetics and Environmental Medicine, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Jiali Li
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Xiaozhou Xu
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Yaohui Han
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Lishun Xiao
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, China
- Center for Medical Statistics and Data Analysis, Xuzhou Medical University, Xuzhou, China
| | - Dehui Yin
- Key Laboratory of Human Genetics and Environmental Medicine, School of Public Health, Xuzhou Medical University, Xuzhou, China
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McAlpine T, Mullan B, Clarke PJF. Assessing the daily association of sleep hygiene behaviours with sleep: A between and within persons approach. J Behav Med 2024; 47:255-270. [PMID: 37702911 PMCID: PMC10944446 DOI: 10.1007/s10865-023-00448-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 08/19/2023] [Indexed: 09/14/2023]
Abstract
Sleep hygiene behaviours are recommendations given to both clinical and non-clinical populations with a focus on modifying behaviours to maximise sleep outcomes. However, methodological issues present in sleep hygiene research make it difficult to conclusively determine the impact of each behaviour. This study aimed to address these issues by adopting a two-week, repeated measures design which incorporated objective sleep measures and used linear mixed effect modelling to assess the daily association of a wide range of sleep hygiene behaviours on sleep in a non-clinical, university sample. Between-persons effects revealed that bedtime and frequency of daytime napping, alcohol use, and social media use were negatively related to sleep duration while waketime and frequency of too much water consumption were positively related to sleep duration. Within-person effects revealed that later than usual bedtime, earlier than usual waketime, no sunlight exposure, poor ventilation, having an unpleasant conversation before bed were negatively associated with sleep duration whereas using alcohol to deliberately help full asleep was positively related to sleep duration. In contrast, disproportionately more behaviours were not significantly related to either sleep outcome, only some of which could be explained by individual differences, which suggests that more research is needed to determine the conditions under which these behaviours affect sleep, if at all.
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Affiliation(s)
- Thomas McAlpine
- enAble Institute, Curtin University, Bentley, WA, 6102, Australia
- School of Population Health, Curtin University, Bentley, WA, 6102, Australia
| | - Barbara Mullan
- enAble Institute, Curtin University, Bentley, WA, 6102, Australia.
- School of Population Health, Curtin University, Bentley, WA, 6102, Australia.
| | - Patrick J F Clarke
- enAble Institute, Curtin University, Bentley, WA, 6102, Australia
- School of Population Health, Curtin University, Bentley, WA, 6102, Australia
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Thakre VM, Deshmukh M, Gibbs J. Effectiveness of Brain Gym Exercises Over Cognitive Behavioural Therapy in Improving Sleep Quality Among Healthcare University Students: A Comparative Study. Cureus 2024; 16:e58463. [PMID: 38765356 PMCID: PMC11100550 DOI: 10.7759/cureus.58463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Accepted: 04/17/2024] [Indexed: 05/22/2024] Open
Abstract
Background More than half of healthcare university students are believed to experience inadequate sleep. The application of brain gym exercises is a relatively new concept that has shown potential for addressing a variety of cognitive and perceptual deficits. Nevertheless, its use in managing sleep disorders is still in the early stages. Though cognitive behavioral therapy (CBT) is still the standard treatment for sleep management, recent research suggests that brain gym exercises may help with sleep disorders like insomnia. Independent studies have demonstrated the efficacy of CBT and brain gym activities in treating sleep disorders. Yet, there remains a paucity of studies directly comparing these two methods in treating individuals with sleep disturbances. Aim and objectives To ascertain the effectiveness of brain gym exercises over cognitive behavioral therapy in improving sleep quality among healthcare university students. Method The experimental study comparing brain gym exercises and cognitive behavioral therapy interventions was conducted in Wardha, Maharashtra, India, from March 2023 to December 2023, with 60 subjects selected after considering inclusion and exclusion criteria. The protocol was administered for 4 weeks for 30 minutes per day. The baseline outcome measures were the insomnia severity index (ISI) and the Pittsburgh sleep quality index (PSQI). The outcome measure was used before and after 4 weeks of interventions to evaluate the outcome of the protocol. The software used in the analysis was SPSS 27.0 version and GraphPad Prism 7.0 version, and p<0.05 was considered as the level of significance. Result Post-treatment, evidence was observed for ISI (20.55, P = 0.0001) and PSQI (18.09, P = 0.0001) in Group A. Post-rehabilitation evidence was observed in Group B for ISI (19, P=0.0001) and PSQI (16.64, P=0.0001). The findings revealed a significantly higher mean difference between Group A and Group B, showing a considerable improvement in outcome measure scores within Group A relative to Group B. Conclusion The statistical analysis demonstrates a notable improvement in the pre-and post-scores of the ISI and PSQI following four weeks of brain gym exercises. In comparison, cognitive behavioral therapy showed comparatively less effectiveness in addressing insomnia. The observed improvement in sleep quality among students highlights that brain gym exercises have the potential to be a non-pharmacological alternative for managing mild to moderate insomnia.
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Affiliation(s)
- Vaishnavi M Thakre
- Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Mitushi Deshmukh
- Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Joel Gibbs
- Psychology, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
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Alshehri GD, Almahmoudi AA, Alsaif AA, Shalabi BH, Fatani HZ, Aljassas FH, Alsulami DW, Alhejaili F, Zawawi F. Sleep Patterns and Associated Insomnia in Junior and Senior Medical Students: A Questionnaire-Based Cross-Sectional Study. Int Arch Otorhinolaryngol 2024; 28:e247-e254. [PMID: 38618585 PMCID: PMC11008932 DOI: 10.1055/s-0043-1776731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 06/25/2023] [Indexed: 04/16/2024] Open
Abstract
Introduction Appropriate quality and quantity of sleep are critical for good mental health, optimal body functioning, memory consolidation, and other cognitive processes. Objectives To evaluate the sleeping patterns of medical students in Saudi Arabia and their relationships with psychological distress. Methods This was a cross-sectional, self-administered, questionnaire-based study. The study included medical students from a university in Jeddah, Saudi Arabia. The Pittsburgh Sleep Quality Index (PSQI) and the Athens Insomnia Scale (AIS) were used to evaluate the prevalence and burden of inadequate sleep quality and insomnia in the participants. Results The majority of the participants was women (76.6%). Furthermore, most participants (96.2%) were aged between 18 and 24 years old, while 54.4% of the participants were in their senior year. According to the AIS scores (mean: 15.85 ± 4.52), 98.7% of the participants exhibited insomnia symptoms. The PSQI scores (mean: 9.53 ± 5.67) revealed that 70.5% of the participants had poor sleep quality. Students in their fundamental and junior years had significantly higher percentages of insomnia symptoms and poor sleep quality compared with students in their senior years. Conclusion The prevalence of insomnia and poor sleep quality is high among medical students. Therefore, appropriate strategies for early detection and intervention are warranted.
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Affiliation(s)
- Ghady Dhafer Alshehri
- Department of Otolaryngology-Head & Neck Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahlam Ahmed Almahmoudi
- Department of Otolaryngology-Head & Neck Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Afnan Abdullah Alsaif
- Department of Otolaryngology-Head & Neck Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Bashayer Hassan Shalabi
- Department of Otolaryngology-Head & Neck Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hana Zuhair Fatani
- Department of Otolaryngology-Head & Neck Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Fatima Hassan Aljassas
- Department of Medicine, Division of Sleep Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Dania Wazen Alsulami
- Department of Otolaryngology-Head & Neck Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Faris Alhejaili
- Department of Medicine, Division of Sleep Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Faisal Zawawi
- Department of Otolaryngology-Head & Neck Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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AlMashouk Y, Abu-Saleh SY, Ghazzawi H, Trabelsi K, Jahrami H. Translating and establishing the psychometric properties of the Jenkins Sleep Scale for Arabic-speaking individuals. BMC Psychiatry 2024; 24:236. [PMID: 38549105 PMCID: PMC10976800 DOI: 10.1186/s12888-024-05714-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 03/25/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND The Jenkins Sleep Scale is a widely used self-report questionnaire that assesses sleep quality and disturbances. This study aimed to translate the scale into Arabic and evaluate its psychometric properties in an Arabic-speaking population. METHODS The Jenkins Sleep Scale was translated into Arabic using forward and backward translation procedures. The Arabic version was administered to a convenience sample of 420 adults along with the Pittsburgh Sleep Quality Index (PSQI) and Athens Insomnia Scale (AIS) for validation purposes. Reliability was examined using Cronbach's alpha and McDonald's omega coefficients. Confirmatory factor analysis (CFA) was also conducted to test the unidimensional factor structure. Convergent validity was assessed using correlations with PSQI and AIS scores. RESULTS The Cronbach's alpha and McDonald's omega values for the Arabic Jenkins Sleep Scale were 0.74 and 0.75, respectively, indicating good internal consistency. The 2-week and 4-week test-retest intraclass correlation coefficients were both 0.94 (p < 0.001), indicating excellent test-retest reliability. The CFA results confirmed the unidimensional factor structure (CFI = 0.99, TLI = 0.96, RMSEA = 0.08). The measurement model had an equivalent factor structure, loadings, intercepts, and residuals across sex, age, and marital status. Significant positive correlations were found between the Arabic Jenkins scale score and the PSQI (r = 0.80, p < 0.001) and AIS (r = 0.74, p < 0.001), supporting convergent validity. CONCLUSION The Arabic version of the Jenkins Sleep Scale demonstrated good psychometric properties. The findings support its use as a valid and reliable measure for evaluating sleep quality and disturbances among Arabic-speaking populations.
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Affiliation(s)
| | - Salma Yasser Abu-Saleh
- Department Nutrition and Food Technology, Jordan University of Science and Technology, Irbid, Jordan
| | - Hadeel Ghazzawi
- Nutrition and Food Science Department, Agriculture School, The University of Jordan, Amman, P. O. Box 11942, Jordan
| | - Khaled Trabelsi
- High Institute of Sport and Physical Education of Sfax, University of Sfax, 3000, Sfax, Tunisia
- Research Laboratory: Education, Motricity, Sport and Health, EM2S, LR19JS01, University of Sfax, 3000, Sfax, Tunisia
| | - Haitham Jahrami
- Government Hospitals, Manama, Bahrain.
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain.
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Nakie G, Takelle GM, Rtbey G, Andualem F, Tinsae T, Kassa MA, Tadesse G, Fentahun S, Wassie YA, Segon T, Kibralew G, Melkam M. Sleep quality and associated factors among university students in Africa: a systematic review and meta-analysis study. Front Psychiatry 2024; 15:1370757. [PMID: 38559402 PMCID: PMC10979362 DOI: 10.3389/fpsyt.2024.1370757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 02/27/2024] [Indexed: 04/04/2024] Open
Abstract
Background Poor sleep quality significantly impacts academic performance in university students. However, inconsistent and inconclusive results were found in a study on sleep among university students in several African nations. Therefore, this study aimed to estimate the pooled prevalence and associated factors of poor sleep quality among university students in Africa. Methods The databases PubMed, Scopus, Cochrane Library, Science Direct, African Journal Online, and Google Scholar were searched to identify articles. A total of 35 primary articles from 11 African countries were assessed and included in this systematic review and meta-analysis. Data were extracted by using a Microsoft Excel spreadsheet and exported to STATA version 14 for analysis. The I2 test was used to assess the statistical heterogeneity. A random effect meta-analysis model was employed with 95% confidence intervals. Funnel plots analysis and Egger regression tests were used to check the presence of publication bias. A subgroup analysis and a sensitivity analysis were done. Results A total of 16,275 study participants from 35 studies were included in this meta-analysis and systematic review. The overall pooled prevalence of poor sleep quality among university students in Africa was 63.31% (95% CI: 56.91-65.71) I2 = 97.2. The subgroup analysis shows that the combined prevalence of poor sleep quality in East, North, West, and South Africa were 61.31 (95% CI: 56.91-65.71), 62.23 (95% CI: 54.07-70.39), 54.43 (95% CI: 47.39-61.48), and 69.59 (95% CI: 50.39-88.80) respectively. Being stressed (AOR= 2.39; 95% CI: 1.63 to 3.51), second academic year (AOR= 3.10; 95% CI: 2.30 to 4.19), use of the electronic device at bedtime (AOR= 3.97 95% CI: 2.38 to 6.61)) and having a comorbid chronic illness (AOR = 2.71; 95% CI: 1.08, 6.82) were factors significantly associated with poor sleep quality. Conclusion This study shows that there is a high prevalence of poor sleep quality among university students in Africa. Being stressed, in the second year, using electronic devices at bedtime, and having chronic illness were factors associated with poor sleep quality. Therefore, addressing contributing factors and implementing routine screenings are essential to reduce the burden of poor sleep quality. Systematic Review Registration https://www.crd.york.ac.uk/prospero/, identifier CRD42023493140.
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Affiliation(s)
- Girum Nakie
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Girmaw Medfu Takelle
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Gidey Rtbey
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Fantahun Andualem
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Techilo Tinsae
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Mulat Awoke Kassa
- Department of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Gebresilassie Tadesse
- Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Setegn Fentahun
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Yilkal Abebaw Wassie
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Tesfaye Segon
- Department of Psychiatry, College of Health Science, Mettu University, Mettu, Ethiopia
| | - Getasew Kibralew
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Mamaru Melkam
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Mutoh N, Moriya M, Xu C, Kato K, Arai S, Iwabuchi N, Tanaka M, Jinghua Y, Itamura R, Sakatani K, Warisawa S. Bifidobacterium breve M-16V regulates the autonomic nervous system via the intestinal environment: A double-blind, placebo-controlled study. Behav Brain Res 2024; 460:114820. [PMID: 38128887 DOI: 10.1016/j.bbr.2023.114820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 12/11/2023] [Accepted: 12/17/2023] [Indexed: 12/23/2023]
Abstract
We conducted a randomized controlled trial to investigate the potential of Bifidobacterium breve M-16 V to improve mood in humans. In this evaluation, we incorporated the use of near-infrared spectroscopy (NIRS), which has been used to evaluate mood states in studies with small sample sizes. Participants were given B. breve M-16 V (20 billion cells/day) for 6 weeks, and their mood state was assessed before and after ingestion. NIRS data were collected at rest and during a mental arithmetic task (under stress). Intake of B. breve M-16 V decreased the heart rate under stress and increased levels of the GABA-like substance pipecolic acid in stool samples. In addition, B. breve M-16 V improved mood and sleep scores in participants with high anxiety levels. These results suggest that B. breve M-16 V affects the metabolites of the gut microbiota and has the potential to modulate the autonomic nervous system and to improve mood and sleep.
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Affiliation(s)
- Natsumi Mutoh
- Innovative Research Institute, Morinaga Milk Industry Co., Ltd., 1-83, 5-Chome, Higashihara, Zama-city, Kanagawa 252-8583, Japan
| | - Masamichi Moriya
- Graduate School of Frontier Sciences, The University of Tokyo, 5-1-5 Kashiwanoha, Kashiwa-city, Chiba 277-8563, Japan
| | - Chendong Xu
- Innovative Research Institute, Morinaga Milk Industry Co., Ltd., 1-83, 5-Chome, Higashihara, Zama-city, Kanagawa 252-8583, Japan
| | - Kumiko Kato
- Innovative Research Institute, Morinaga Milk Industry Co., Ltd., 1-83, 5-Chome, Higashihara, Zama-city, Kanagawa 252-8583, Japan
| | - Satoshi Arai
- Innovative Research Institute, Morinaga Milk Industry Co., Ltd., 1-83, 5-Chome, Higashihara, Zama-city, Kanagawa 252-8583, Japan
| | - Noriyuki Iwabuchi
- Innovative Research Institute, Morinaga Milk Industry Co., Ltd., 1-83, 5-Chome, Higashihara, Zama-city, Kanagawa 252-8583, Japan.
| | - Miyuki Tanaka
- Innovative Research Institute, Morinaga Milk Industry Co., Ltd., 1-83, 5-Chome, Higashihara, Zama-city, Kanagawa 252-8583, Japan
| | - Yin Jinghua
- Mishuku Hospital, 5-33-12 Kamimeguro, Meguro-ku, Tokyo 153-0051, Japan
| | - Ronko Itamura
- Graduate School of Frontier Sciences, The University of Tokyo, 5-1-5 Kashiwanoha, Kashiwa-city, Chiba 277-8563, Japan
| | - Kaoru Sakatani
- Graduate School of Frontier Sciences, The University of Tokyo, 5-1-5 Kashiwanoha, Kashiwa-city, Chiba 277-8563, Japan
| | - Shinichi Warisawa
- Graduate School of Frontier Sciences, The University of Tokyo, 5-1-5 Kashiwanoha, Kashiwa-city, Chiba 277-8563, Japan
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Khan MSI, Paul T, Al Banna MH, Hamiduzzaman M, Tengan C, Kissi-Abrokwah B, Tetteh JK, Hossain F, Islam MS, Brazendale K. Skipping breakfast and its association with sociodemographic characteristics, night eating syndrome, and sleep quality among university students in Bangladesh. BMC Nutr 2024; 10:46. [PMID: 38439041 PMCID: PMC10913273 DOI: 10.1186/s40795-024-00860-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/27/2024] [Indexed: 03/06/2024] Open
Abstract
INTRODUCTION Skipping breakfast has become more common, and it can significantly affect a person's health, performance, mood, and other physiological and psychological factors. In Bangladesh, university students often encounter unhealthy dietary habits, which raises questions about why many university students choose to skip breakfast. The purpose of this study was to investigate the prevalence of skipping breakfast among university students in Bangladesh and explore the contributing factors. METHODS Patuakhali Science and Technology University, Bangladesh was the location of this cross-sectional study. Breakfast consumption was measured with the single-question item, "How often do you eat breakfast?" (Almost every day, sometimes, rarely, or never). Skipping breakfast was classified as respondents selecting sometimes, rarely, or never having breakfast. Sociodemographic, behavioral, and sleep-related data were collected as key predictor variables. Multiple logistic regression models identified factors associated with skipping breakfast. RESULTS The prevalence of skipping breakfast among study participants (N = 502, 51.6% female and mean age 21.31 years) was 63.5%. Female students were more likely to skip breakfast compared to male students (adjusted odds ratio, AOR = 1.65, 95% CI: 1.06-2.55). Smoker participants had a higher likelihood of skipping breakfast compared to non-smokers (AOR = 3.92, 95% CI: 1.57-9.78). Students with night eating syndrome had a higher likelihood of skipping breakfast compared to their counterparts (AOR = 1.84, 95% CI: 1.06-3.22). Students with poor sleep quality were three times more likely to skip breakfast than their counterparts (AOR = 2.95, 95% CI: 1.93-4.51). Overweight/obese students were less likely to skip breakfast compared to their counterparts (AOR = 0.40, 95% CI: 0.20-0.82). CONCLUSION This study highlights a high prevalence of skipping breakfast among university students in Bangladesh. Specifically, students who are females, smokers, poor sleepers and who have night eating syndrome are more likely to skip breakfast compared to their counterparts. These findings underscore a need for targeted interventions and educational programs to promote healthy breakfast habits. Addressing these modifiable risk factors can have a positive impact on students' nutritional practices and their health and wellbeing.
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Affiliation(s)
- Md Shafiqul Islam Khan
- Department of Food Microbiology, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, 8602, Patuakhali, Bangladesh
| | - Trisha Paul
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, 8602, Patuakhali, Bangladesh
| | - Md Hasan Al Banna
- Department of Food Microbiology, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, 8602, Patuakhali, Bangladesh.
- Nutrition Initiative, Kushtia, Bangladesh.
| | | | - Cornelius Tengan
- Department of Hospitality, Catering and Institutional Management, Bolgatanga Technical University, Sumbrugu, Ghana
| | | | - Justice Kanor Tetteh
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Faria Hossain
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, 8602, Patuakhali, Bangladesh
| | - Md Shajadul Islam
- Department of Food Microbiology, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, 8602, Patuakhali, Bangladesh
| | - Keith Brazendale
- Department of Health Sciences, University of Central Florida, Orlando, FL, USA
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Hahn N, Brzoska P, Kiessling C. On the correlation between gratitude and resilience in medical students. GMS JOURNAL FOR MEDICAL EDUCATION 2024; 41:Doc8. [PMID: 38504862 PMCID: PMC10946207 DOI: 10.3205/zma001663] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/20/2023] [Accepted: 11/14/2023] [Indexed: 03/21/2024]
Abstract
Objective Medical students' health and resilience have increasingly been the subject of current research in recent years. A variety of interventions are recommended to strengthen resilience or its known or suspected influencing factors, although the literature shows that the evidence on the effectiveness of the interventions is inconsistent. The present study investigated whether gratitude is a direct protective factor for resilience in medical students or whether resilience factors (optimism, self-efficacy, social support) and stress mediate the effects of gratitude on resilience. Methods 90 medical students at Witten/Herdecke University took part in the study that determined their gratitude, resilience, optimism, self-efficacy, social support and stress levels using validated questionnaires (GQ-6, RS-25, LOT-R, SWE, F-SozU, PSS). Correlations were analyzed using Pearson correlation coefficients. In addition, a multivariate regression analysis and a path analysis were calculated to determine the direct and indirect effects of gratitude on resilience. Results Multivariate regression analysis showed that only optimism, social support and stress were significantly associated with resilience (B=0.48, 95% CI: 0.31, 0.66; B=0.23, 95% CI: 0.01, 0.44 and B=-0.02, 95% CI: -0.03, -0.001, respectively). The direct effect of gratitude on resilience was minimal and not significant in the path analysis. However, there was an indirect effect of gratitude on resilience (B=0.321; p<0.05). Mediation via the optimism variable was mainly responsible for this effect (indirect effect B=0.197; p<0.05). Conclusion This study shows that gratitude has only a minimal direct influence on resilience. However, results indicate that optimism as a mediating factor strengthens the resilience of medical students. Against this background, it may be useful to integrate interventions that promote an optimistic attitude into medical studies in order to strengthen the mental health of future doctors in the long term.
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Affiliation(s)
- Nicolai Hahn
- Witten/Herdecke University, Faculty of Health, Education of Personal and Interpersonal Competencies in Health Care, Witten, Germany
| | - Patrick Brzoska
- Witten/Herdecke University, Faculty of Health, Health Services Research, Witten, Germany
| | - Claudia Kiessling
- Witten/Herdecke University, Faculty of Health, Education of Personal and Interpersonal Competencies in Health Care, Witten, Germany
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Rawcliffe AJ, Tyson H, Hinde K, Jacka K, Holland R, Chapman S, Roberts AJ. Sleep duration and perceptions of sleep quality in British Army recruits during basic training - an observational analysis. Front Neurol 2024; 15:1321032. [PMID: 38426172 PMCID: PMC10903264 DOI: 10.3389/fneur.2024.1321032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 01/25/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction Sleep is critical to the health, wellbeing and performance of military personnel during basic training. This two-part study evaluated sleep-wake patterns and sleep disturbances in junior soldiers (JS) and infantry recruits in Autumn 2021 (study 1), and non-infantry recruits in spring 2022 (study 2). Methods During studies 1 and 2, validated wearable technology combined with a sleep diary was used to quantify sleep-wake indices, sleep disturbances and perceptions of sleep quality. Sleep diary data was analysed descriptively. A series of repeated-measures ANOVAs examined differences in objective sleep-wake indices. Correlation analysis determined associations between time in bed (TIB) and total sleep time (TST). Results Significant (p < 0.05) differences in most sleep-wake indices were observed between weeks of basic training for all cohorts. Strong positive correlations between TIB and TST were observed for each cohort across basic training (r = 0.681 - 0.970, p < 0.001), with longer TST associated with greater TIB. The mean±SD sleep duration (hours and mins [hm]) for JS (06:22 ± 00:27hm), non-infantry (05:41 ± 00:47hm) and infantry (05:46 ± 00:34hm) recruits across basic training was consistently below national recommendations. The mean±SD bed and wake times for JS (bedtime: 23:01 ± 00:32hm; awake: 05:34 ± 00:10hm), non-infantry (bedtime: 23:38 ± 01:09hm; awake: 04:47 ± 00:58hm), and infantry (bedtime: 23:13 ± 00:29hm; awake: 05:38 ± 00:26hm) recruits varied across weeks of basic training, with over 80% reporting "fairly bad" or "very bad" sleep quality and frequent periods of "dozing off" during daytime activity. The most commonly reported sleep disturbing factors identified during basic training involved: late-night military admin (e.g., ironing, boot cleaning, kit set up etc), early morning wake times, extraneous noise, light and hot room temperatures within the primary sleeping environment, bed/mattress discomfort, muscle soreness and feelings of stress and anxiety. Discussion/Conclusion Our findings contribute to the existing evidence that long-term sleep loss is pervasive during initial military training programmes. The average sleep durations indicate chronic and unrecoverable sleep loss which would be expected to significantly impair physical and cognitive military performance, and increase the risk of injury, illness and attrition rates during basic training. Changes in the design and scheduling of basic training programmes to enable, at the least, minimum sleep recommendations to be met, and to improve sleep hygiene in the primary sleeping environment are warranted.
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Affiliation(s)
- Alex J. Rawcliffe
- Army Recruit Health and Performance Research, Medical Branch, HQ Army Recruiting and Initial Training Command, Ministry of Defence, Upavon, United Kingdom
- Faculty of Science and Engineering, Anglia Ruskin University, Cambridge, United Kingdom
| | - Hayley Tyson
- Army Recruit Health and Performance Research, Medical Branch, HQ Army Recruiting and Initial Training Command, Ministry of Defence, Upavon, United Kingdom
| | - Katrina Hinde
- Human Sciences Group, Defence Science and Technology Laboratory, Salisbury, United Kingdom
| | - Kimberley Jacka
- Army Recruit Health and Performance Research, Medical Branch, HQ Army Recruiting and Initial Training Command, Ministry of Defence, Upavon, United Kingdom
| | - Rachel Holland
- Army Recruit Health and Performance Research, Medical Branch, HQ Army Recruiting and Initial Training Command, Ministry of Defence, Upavon, United Kingdom
| | - Shaun Chapman
- Army Recruit Health and Performance Research, Medical Branch, HQ Army Recruiting and Initial Training Command, Ministry of Defence, Upavon, United Kingdom
- Cambridge Centre for Sport and Exercise Sciences, School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, United Kingdom
| | - Andrew J. Roberts
- Army Recruit Health and Performance Research, Medical Branch, HQ Army Recruiting and Initial Training Command, Ministry of Defence, Upavon, United Kingdom
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Alsaleem SA, Al-Qahtani AH, Al-Qahtani EH, AlKhaldi YM. Stressors and coping strategies among secondary school male students in Abha City, Saudi Arabia. Front Psychol 2024; 15:1303721. [PMID: 38390407 PMCID: PMC10882712 DOI: 10.3389/fpsyg.2024.1303721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 01/11/2024] [Indexed: 02/24/2024] Open
Abstract
Background Stress is a biological process in which exposure to stressors is associated with bad health effects, decreased ability of disease management, and a higher likelihood for disease-related complications and comorbidities. Stress has been considered the main factor in the etiology of many diseases such as diabetes mellitus, cardiac diseases, and body aches for centuries. Students meet many stressful situations such as the need for success, academic demands, homesickness, and lack of social support. Coping with stress can be a leading cause in preventing psychological distress and a serious illness. Methods A correlational cross-sectional approach was applied to the current research. The research targeted all secondary school male students in Abha city. A multistage cluster sample was applied by selecting schools and students from the Directorate of Education in Abha. Self-administered questionnaire sheets were distributed to students in their classes. The questionnaire covered students' sociodemographic data such as age, grades, parents' education and work, living conditions, and comorbidities. Stressors to which the students were exposed were also enumerated with the degree of stress for each. Stress was assessed using the Holmes-Rahe Stress Inventory for youth. Coping skills were measured using the abbreviated version of the COPE Inventory. Results The study included 324 students whose ages ranged from 15 to 20 years old with a mean age of 17 ± 0.9 years old. Approximately 33% of the students were in first grade; 44.4% of the students had no or minimal level of stress while major stress was recorded among 26.5% of the students. In total, 77.8% of the students had moderate coping and none had high coping ability. Conclusion The study revealed that more than half of the students had significant levels of stress and one out of each four had major stress. The most common stressors were due to the school environment and future planning. Young age, low socioeconomic status, parents' separation, and having chronic health problems were the most important determinants of stress among the students.
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Affiliation(s)
- Safar Abadi Alsaleem
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | | | | | - Yahia Mater AlKhaldi
- Department of Research and Studies, Health Affairs, Aseer Region, Abha, Saudi Arabia
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20
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Zare MJ, Masoumi SJ, Zare M. The association between energy-adjusted dietary inflammatory index and physical activity with sleep quality: a cross-sectional study. BMC Nutr 2024; 10:26. [PMID: 38310318 PMCID: PMC10838418 DOI: 10.1186/s40795-024-00834-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 01/30/2024] [Indexed: 02/05/2024] Open
Abstract
BACKGROUND The study aimed to assess the independent and interactive association of energy-adjusted dietary inflammatory index (E-DII) and physical activity (PA) with sleep quality. METHOD A cross-sectional study was conducted on the 2466 participants (60% women). A 116-item food frequency questionnaire (FFQ) was applied to calculate E-DII, the International Physical Activity Questionnaire (IPAQ) long form for PA, and the Pittsburgh sleep quality index (PSQI) to assess sleep quality were collected via interview. Multivariate logistic regression was applied to assess independent and interactive associations of E-DII and PA with sleep quality. RESULT No significant association was observed between E-DII and sleep quality (OR: 0.96, 95% CI: 0.92_1.01). Also, there was no significant association between the levels of PA and sleep quality. Women had 70% increased odds for poor sleep quality (OR: 1.7, 95% CI: 1.39_2.09) compared with men. No interactive association was observed between E-DII and PA levels with sleep quality. CONCLUSION No significant association was observed between E-DII and PA levels with sleep quality. The study indicates a gender difference in sleep quality. Future prospective studies are required to confirm these findings.
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Affiliation(s)
- Mohammad Javad Zare
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Science, Razi Boulevard, Shiraz, Iran
| | - Seyed Jalil Masoumi
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Science, Razi Boulevard, Shiraz, Iran.
- Center for Cohort Study of SUMS Employees' Health, Shiraz University of Medical Sciences, Shiraz, Iran.
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Morteza Zare
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Science, Razi Boulevard, Shiraz, Iran
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21
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Zekibakhsh Mohammadi N, Kianimoghadam AS, Mikaeili N, Asgharian SS, Jafari M, Masjedi-Arani A. Sleep Disorders and Fatigue among Patients with MS: The Role of Depression, Stress, and Anxiety. Neurol Res Int 2024; 2024:6776758. [PMID: 38322749 PMCID: PMC10843872 DOI: 10.1155/2024/6776758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 01/07/2024] [Accepted: 01/18/2024] [Indexed: 02/08/2024] Open
Abstract
Sleep disorders and fatigue represent prominent symptoms frequently experienced by individuals with multiple sclerosis (MS). Some psychological factors such as depression, stress, and anxiety seem to have a relationship with such problems. This study aimed to examine the role of depression, stress, and anxiety in predicting sleep disorders and fatigue among patients with MS. Employing a cross-sectional descriptive-correlational design, the study involved a sample size of 252 participants selected through purposive sampling based on inclusion and exclusion criteria. We utilized a demographic information questionnaire along with the Mini-Sleep Questionnaire (MSQ), Fatigue Severity Scale (FSS), and Depression, Anxiety, and Stress Scale (DASS-21) to collect data and analyzed them applying SPSS22, incorporating statistical measures including Pearson correlation and regression. The results of the Pearson correlation coefficient showed that sleep disorders had a positive and significant relationship with depression (r = 0.56; P < 0.001), stress (r = 0.40; P < 0.001), and anxiety (r = 0.52; P < 0.001). There was no significant relationship between age and the development of sleep disorders in total score (r = -0.001; P < 0.985), but age had a relationship with insomnia (r = -0.146; P < 0.021) and oversleeping (r = 0.153; P < 0.015). Age and fatigue did not have a significant relationship as well (r = -0.044; P < 0.941). In addition, fatigue had a positive and significant relationship with depression (r = 0.52; P < 0.001), stress (r = 0.48; P < 0.001), and anxiety (r = 0.54; P < 0.001). The results of the regression analysis also showed that depression, stress, and anxiety predict 0.37% of the total variance of sleep disorders (F = 48.34; P < 0.001) and 0.35% of the total variance of fatigue (F = 44.64; P < 0.001). Our findings suggest that depression, stress, and anxiety play a significant role in predicting sleep disorders and fatigue among patients with MS. This study has been reported in accordance with the TREND checklist for nonrandomized trials.
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Affiliation(s)
- Nassim Zekibakhsh Mohammadi
- Department of Psychology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Amir Sam Kianimoghadam
- Department of Clinical Psychology, Religion and Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Niloofar Mikaeili
- Department of Psychology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
| | | | - Mahdieh Jafari
- Department of Psychology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Abbas Masjedi-Arani
- Department of Clinical Psychology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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22
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Ibrahim D, Ahmed RM, Mohammad AZ, Ibrahim B, Mohammed T, Mohamed ME, Abdelgadir T, Mohammed B, Ibrahim M, Shaaban KMA. Prevalence and correlates of generalized anxiety disorder and perceived stress among Sudanese medical students. BMC Psychiatry 2024; 24:68. [PMID: 38263070 PMCID: PMC10807220 DOI: 10.1186/s12888-024-05510-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 01/09/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Generalized Anxiety Disorder (GAD) causes significant disturbance in an individual's well-being and activity. Whereby, interfering with the dynamic progress in life. Also, anxiety is a product of stress and a major predictor of academic performance. This study aimed to assess the prevalence of Generalized Anxiety Disorder (GAD), measure levels of anxiety and perceived stress, evaluate the academic profile, identify lifestyle characteristics, and explore the relationship between these factors. METHODS In this cross-sectional study, 340 Sudanese medical students filled out online questionnaires, composed of the sociodemographic and lifestyle characteristics, academic profile, Generalized Anxiety Disorder-2 scale (GAD-2), and Perceived Stress Scale-10 (PSS-10). Descriptive and inferential statistics were applied using Statistical Package for Social Science (SPSS) Version 20.0 for data analysis. RESULTS Of 340 medical students, 3.8% of them were diagnosed with GAD, while 29.1% scored ≥ 3 in GAD-2, indicating a possible diagnosis. The study found that 9.7% of the participants used addictive substances, with 42% of them having high GAD-2 scores. Moreover, high anxiety levels were associated with high-stress scores (p-value = 0.000). Also, high GAD-2 scores were significantly associated with students who spent less than 10,000 SDG (18 USD) weekly, spent more time on entertainment using smart devices (p-value = 0.004), and had an unhealthy diet (p-value = 0.004). Low anxiety levels were associated with better sleep quality (p-value = 0.00), satisfaction with religious practices (p-value = 0.00), and increased leisure/hobby time (p-value = 0.018). High-stress levels were observed in females (p-value = 0.035), those with lower academic performance satisfaction levels, and increased hours of smart device usage for entertainment (p-value = 0.001). Reduced stress levels were associated with being ≥ 23 years old, increased leisure/hobby time (p-value = 0.002), satisfaction with religious practices [F(3, 166.6) = 10.8, p-value = 0.00)], and having a healthy diet (p-value = 0.006). CONCLUSION The low prevalence of GAD corresponded with previous literature, but 29.1% of medical students had a high probability of having GAD. The study emphasizes on providing accessible mental health services for medical students and interventions addressing modifiable risk factors.
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Affiliation(s)
- Danya Ibrahim
- Faculty of Medicine, University of Khartoum, 11115, Khartoum, P. O Box: 321, Sudan.
| | - Reem Mohamed Ahmed
- Faculty of Medicine, University of Khartoum, 11115, Khartoum, P. O Box: 321, Sudan
| | - Ayman Zuhair Mohammad
- Department of Psychiatry, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Basil Ibrahim
- Department of Surgery, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Tibyan Mohammed
- Faculty of Medicine, University of Khartoum, 11115, Khartoum, P. O Box: 321, Sudan
| | - Mona Elfadl Mohamed
- Faculty of Medicine, University of Khartoum, 11115, Khartoum, P. O Box: 321, Sudan
| | - Tibyan Abdelgadir
- Faculty of Medicine, University of Khartoum, 11115, Khartoum, P. O Box: 321, Sudan
| | - Baraah Mohammed
- Faculty of Medicine, University of Khartoum, 11115, Khartoum, P. O Box: 321, Sudan
| | - Moneib Ibrahim
- Faculty of Medicine, University of Khartoum, 11115, Khartoum, P. O Box: 321, Sudan
| | - Kamil M A Shaaban
- Department of Psychiatry, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
- Department of Community Medicine, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
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23
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Ushikoshi-Nakayama R, Yamazaki T, Omagari D, Matsumoto N, Inoue H, Nukuzuma C, Nishino S, Saito I. Evaluation of the benefits of neutral bicarbonate ionized water baths in an open-label, randomized, crossover trial. Sci Rep 2024; 14:1261. [PMID: 38218992 PMCID: PMC10787754 DOI: 10.1038/s41598-024-51851-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 01/10/2024] [Indexed: 01/15/2024] Open
Abstract
We previously demonstrated that neutral bicarbonate ionized water (NBIW) bathing enhances blood flow by bicarbonate ions and described the underlying mechanism. However, additional clinical investigation was warranted to investigate the efficacy of NBIW bathing. Hence, we performed a randomized, open-label, crossover trial to examine the effects of NBIW bathing on mental stress, sleep, and immune function. Participants who regularly felt stressed were randomly assigned to NBIW or regular bathing for 4 weeks. Mental stress was assessed with the Brief Job Stress Questionnaire (BJSQ) and the Profile of Mood States Second Edition; sleep quality, with the Pittsburgh Sleep Quality Index Japanese version (PSQI-J) and actigraphy; and immune function, with laboratory tests. PSQI-J scores and actigraphy sleep latency and bed out latency improved significantly more with NBIW bathing than with regular bathing (p < 0.05). Furthermore, NBIW bathing reduced both stress-induced fluctuations in CD4+ and CD8+ T cell counts and fluctuations in the naive to memory T cell ratio and neutrophil phagocytosis, indicating improved immune function. These findings suggest that daily NBIW bathing could improve mental stress, sleep quality, and immune function and bring about positive health effects in those who experience stress in their daily lives.
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Affiliation(s)
- Ryoko Ushikoshi-Nakayama
- Department of Pathology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, Kanagawa, 230-8501, Japan
| | - Tomoe Yamazaki
- Department of Pathology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, Kanagawa, 230-8501, Japan
| | - Daisuke Omagari
- Department of Pathology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, Kanagawa, 230-8501, Japan
| | - Naoyuki Matsumoto
- Department of Pathology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, Kanagawa, 230-8501, Japan
| | - Hiroko Inoue
- Department of Pharmaceutical Sciences, Nihon Pharmaceutical University, 10281 Komuro, Ina-machi, Kitaadachi-gun, Saitama, 362-0806, Japan
| | - Chiyoko Nukuzuma
- Bicarbonate Thermotherapy Institute Co., Ltd., Park West Bldg. F7, 6-12-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Seiji Nishino
- Psychiatry and Behavioral Sciences, Sleep and Circadian Neurobiology Laboratory, Stanford University School of Medicine, 3155 Porter Drive, Room 2016, Palo Alto, CA, 94304, USA
| | - Ichiro Saito
- Department of Pathology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, Kanagawa, 230-8501, Japan.
- Cranescience Co., Ltd., 3-9-8 Ginza, Chuo-ku, Tokyo, 104-8139, Japan.
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24
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Leite CCF, Coutinho MO, Fernandes DV, Souza LHR, Costa LEL, Santos KA, Dos Santos RG, das Mercês MC, Figueiredo MAA, Cavalcante Neto JL. Hours of sleep and associated factors in college students during the COVID-19 pandemic. Work 2024:WOR220648. [PMID: 38189723 DOI: 10.3233/wor-220648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND Sleep alterations are common in college students, particularly during the COVID-19 pandemic. Sociodemographic factors may predict these alterations in this population. OBJECTIVE To identify the sociodemographic factors and health characteristics associated with the number of hours of sleep of college students during the COVID-19 pandemic. METHODS This was a cross-sectional study carried out with 244 university students from a multicampi public university in the State of Bahia, Northeast Brazil. Data collection was performed online and participants answered a specific questionnaire to assess sleep hours, sociodemographic and health variables. RESULTS Significant associations were observed between hours of sleep and older students (odds ratio adjusted -ORaj: 3.75; 95% Confidence Interval -CI: 1.81-7.75; p < 0.01), attending the final semesters (ORaj: 1.85; 95% CI: 1.05-3.25; p < 0.03), and who reported having some disease (ORaj: 2.18; 95% CI: 1.05-4.50; p < 0.03) with greater chances of getting less sleep. However, those who used tobacco (ORaj: 0.08; 95% CI: 0.01-0.45; p < 0.001) were likely to have more hours of sleep per night. CONCLUSION Sleep restriction was common among participating college students, which has likely intensified due to the COVID-19 pandemic and its restrictions. This encourages specific public health actions, contemplating the health and hours of sleep of this population.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Jorge Lopes Cavalcante Neto
- Department of Life Sciences, State University of Bahia, Salvador, Brazil
- Department of Human Sciences, State University of Bahia, Jacobina, Brazil
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25
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Cao Q, Zeng H, Liu F, Wang Y, Zhang P, Yin J, Xu F, Weng X. Changes in brain function and heart sound in acute sleep deprivation individuals. Sleep Med 2024; 113:249-259. [PMID: 38064797 DOI: 10.1016/j.sleep.2023.11.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/29/2023] [Accepted: 11/27/2023] [Indexed: 01/07/2024]
Abstract
AIMS Sleep deprivation (SD) has become a health problem in modern society due to its adverse effects on different aspects. However, the relationship between sleep and cardiovascular system function remains unclear. Here we explored the changes occurring in the brain and the heart sounds after SD. METHODS Ninety healthy adult men were recruited and subjected to 36 h of Sleep Deprivation (SD). They participated in a number of tests, including measurements of the heart sound, blood oxygen, and heart rate every 2 h. By using of principal component analysis to reduced the dimensionality of heart sound data. While the ALFF and ReHo indexes were measured via fMRI before and after SD. Correlation and regression analyses were used to reveal the relationship between fMRI and heart sound changes due to SD. RESULTS In this study, there were no abnormal values in the heart rate and blood oxygen during 36 h of SD, whereas the intensity of heart sounds fluctuated significantly increased and decreased. The ALFF was increased in bilateral pericalcarine(Calcarine), left anterior cuneus, (Precuneus_L), right superior temporal gyrus(Temporal_Sup_R), left supplementary motor area (Supp_Motor_Area_L); However, it was reduced in the right medial superior frontal gyrus (Frontal_Sup_Medial_R), right dorsolateral superior frontal gyrus (Frontal_Sup_R) and left medial frontal gyrus (Frontal_Mid_L). The regression analysis uncovered that the intensity of the heart sound in the systole, s1, and s2 phase could be explained by Calcarine_L changes. CONCLUSION Acute sleep deprivation affects cardiac-brain axis and the specific brain regions. Calcarine_L changes during sleep deprivation are involved in regulating heart contractions.
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Affiliation(s)
- Qiongfang Cao
- Department of Public Health, Chengdu Medical College, Sichuan, 610500, China
| | - Hanrui Zeng
- Department of Clinic Medicine, Chengdu Medical College, Sichuan, 610500, China
| | - Fangfang Liu
- Art College, Southwest Minzu University, Sichuan, 610041, China
| | - Yuhan Wang
- Department of Public Health, Chengdu Medical College, Sichuan, 610500, China
| | - Peng Zhang
- Department of Public Health, Chengdu Medical College, Sichuan, 610500, China
| | - Jie Yin
- Department of Neuroscience, Beijing Institute of Basic Medical Sciences, Beijing, 100850, China
| | - Fan Xu
- Department of Public Health, Chengdu Medical College, Sichuan, 610500, China.
| | - Xiechuan Weng
- Department of Neuroscience, Beijing Institute of Basic Medical Sciences, Beijing, 100850, China.
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26
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Busa F, Csima MP, Márton JA, Rozmann N, Pandur AA, Ferkai LA, Deutsch K, Kovács Á, Sipos D. Sleep Quality and Perceived Stress among Health Science Students during Online Education-A Single Institution Study. Healthcare (Basel) 2023; 12:75. [PMID: 38200981 PMCID: PMC10778774 DOI: 10.3390/healthcare12010075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/14/2023] [Accepted: 12/24/2023] [Indexed: 01/12/2024] Open
Abstract
Recently, online education has been gaining prominence in university life. Our survey aimed to examine sleep quality and perceived stress levels among students at the University of Pécs Faculty of Health Sciences. A cross-sectional, quantitative, descriptive survey was conducted between February and March 2023. The online survey included the Hungarian versions of the internationally validated Athens Insomnia Scale (AIS) and Perceived Stress Scale (PSS). Statistical analysis involved descriptive statistics, independent t-tests, analysis of variance (ANOVA), and Mann-Whitney and Kruskal-Wallis tests (p < 0.05). We analyzed 304 responses, and females dominated (n = 270; 88.8%). Students in a relationship had significantly higher AIS scores (t = -2.470; p = 0.014). Medium average (2.50-3.49) students and those who rarely/never exercise showed significantly higher AIS and PSS (p ≤ 0.05). Students on the phone/watching a series during online education, daily laptop/TV use for more than 2 h, and pre-sleep use of smart devices for more than 60 min also negatively affected AIS and PSS scores (p ≤ 0.05). Nursing, physiotherapy, and radiography students were the most affected regarding insomnia and perceived stress (p ≤ 0.05). Our survey shows that excessive smart device use and lack of exercise are associated with higher stress levels and poorer sleep quality.
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Affiliation(s)
- Flóra Busa
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, Vörösmarty Street 4, 7621 Pẻcs, Hungary; (F.B.); (M.P.C.); (Á.K.)
| | - Melinda Petőné Csima
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, Vörösmarty Street 4, 7621 Pẻcs, Hungary; (F.B.); (M.P.C.); (Á.K.)
- Institute of Education, Hungarian University of Agriculture and Life Sciences, Guba Sándor Street 40, 7400 Kaposvár, Hungary
- Faculty of Health Science, Doctoral School of Health Sciences, University of Pẻcs, Vörösmarty Street 4, 7621 Pẻcs, Hungary; (J.A.M.); (N.R.)
| | - Johanna Andrea Márton
- Faculty of Health Science, Doctoral School of Health Sciences, University of Pẻcs, Vörösmarty Street 4, 7621 Pẻcs, Hungary; (J.A.M.); (N.R.)
| | - Nóra Rozmann
- Faculty of Health Science, Doctoral School of Health Sciences, University of Pẻcs, Vörösmarty Street 4, 7621 Pẻcs, Hungary; (J.A.M.); (N.R.)
- Faculty of Health Sciences, Institute of Emergency Care, Pedagogy of Health and Nursing Sciences, University of Pécs, Vörösmarty Street 4, 7621 Pécs, Hungary; (L.A.F.); (K.D.)
| | - Attila András Pandur
- Department of Oxyology, Faculty of Health Sciences, Emergency Care, University of Pécs, 7621 Pécs, Hungary;
| | - Luca Anna Ferkai
- Faculty of Health Sciences, Institute of Emergency Care, Pedagogy of Health and Nursing Sciences, University of Pécs, Vörösmarty Street 4, 7621 Pécs, Hungary; (L.A.F.); (K.D.)
- Department of Oxyology, Faculty of Health Sciences, Emergency Care, University of Pécs, 7621 Pécs, Hungary;
| | - Krisztina Deutsch
- Faculty of Health Sciences, Institute of Emergency Care, Pedagogy of Health and Nursing Sciences, University of Pécs, Vörösmarty Street 4, 7621 Pécs, Hungary; (L.A.F.); (K.D.)
- Department of Oxyology, Faculty of Health Sciences, Emergency Care, University of Pécs, 7621 Pécs, Hungary;
| | - Árpád Kovács
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, Vörösmarty Street 4, 7621 Pẻcs, Hungary; (F.B.); (M.P.C.); (Á.K.)
- Department of Oncoradiology, Faculty of Medicine, University of Debrecen, Nagyerdei 98, 4032 Debrecen, Hungary
| | - Dávid Sipos
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, Vörösmarty Street 4, 7621 Pẻcs, Hungary; (F.B.); (M.P.C.); (Á.K.)
- Faculty of Health Science, Doctoral School of Health Sciences, University of Pẻcs, Vörösmarty Street 4, 7621 Pẻcs, Hungary; (J.A.M.); (N.R.)
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Getahun GK, Genene A, Tadesse T. Poor sleep quality and associated determinants among textile and garment manufacturing workers in Addis Ababa, Ethiopia. Sleep Med X 2023; 5:100075. [PMID: 37249945 PMCID: PMC10220473 DOI: 10.1016/j.sleepx.2023.100075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 04/22/2023] [Accepted: 05/17/2023] [Indexed: 05/31/2023] Open
Abstract
Background Sleep is a physiological process that is essential to human physical, emotional, and mental health. Sleep difficulties affect an estimated 150 million individuals globally, with roughly 17% of the population in developing countries. As a result, the purpose of this study was to determine the prevalence and associated factors of poor sleep quality among textile and garment manufacturing workers in Addis Ababa, Ethiopia, in 2022. Methods A facility-based cross-sectional study was done from July 15th to August 15th, 2022, using a simple random sample technique. The degree of self-reported poor sleep quality was quantified using a validated, interviewer-administered, standardized Pittsburgh Sleep Quality Index. To determine the relationship between independent variables and poor sleep quality, multivariable logistic regression analysis was carried out with a p-value of less than 0.05 and a 95% confidence interval (CI). Results The prevalence of poor sleep quality was 75.4% (95% CI: 70.8, 80). Working more than 8 h per day (AOR = 2.83, 95% CI: 1.01, 7.94), work dissatisfaction (AOR = 3.27, 95% CI: 1.52-7.05), and using electronic materials before sleeping (AOR = 2.08, 95% CI: 1.01-4.30) were all associated with poor sleep quality. Conclusion Poor sleep quality was common among garment and textile industrial workers. Work dissatisfaction, working hours, and the utilization of electronic materials before bedtime were all substantially related to poor sleep quality, which should be taken into account and addressed early to reduce poor sleep quality.
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Affiliation(s)
- Genanew Kassie Getahun
- Kotebe Metropolitan University, Menelik II Medical and Health Science College, Addis Ababa, Ethiopia
| | - Adisu Genene
- Addis Ababa Medical and Business College, Addis Ababa, Ethiopia
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28
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Oliveira JL, Marques-Vidal P. Sweet dreams are not made of this: no association between diet and sleep quality. J Clin Sleep Med 2023; 19:2005-2014. [PMID: 37489534 PMCID: PMC10692931 DOI: 10.5664/jcsm.10738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 07/21/2023] [Accepted: 07/21/2023] [Indexed: 07/26/2023]
Abstract
STUDY OBJECTIVES Numerous studies have emphasized the significance of nutrition on the quality of sleep, but few have evaluated the effect of various coexisting dietary markers on middle-aged adults. We assessed the association between sleep quality and a large array of dietary markers among middle-aged, community-dwelling participants. METHODS Data from the first, second, and third follow-ups of CoLaus|PsyCoLaus, a population-based study in Lausanne, Switzerland, was used. Sleep quality was assessed by the Pittsburgh Sleep Quality Index. Dietary intake was assessed by a validated food frequency questionnaire. RESULTS Data from 3857 (53% women, 57.2 ± 10.4 years), 2370 (52% women, 60.7 ± 9.5 years), and 1617 (52% women, 63.5 ± 9.0 years) participants from the first, second, and third follow-ups was used. Bivariate correlations showed fish, vegetables, fruit, and cheese intake to be associated with a better sleep quality (lower Pittsburgh Sleep Quality Index), while rusks, sugar, and meat intake were associated with a poorer sleep quality (higher Pittsburgh Sleep Quality Index). After multivariable adjustment, participants reporting poor sleep quality (Pittsburgh Sleep Quality Index > 5) had a lower Mediterranean diet score and a lower likelihood of complying with the meat and fish recommendations, but the results were inconsistent between surveys. No association was found between sleep quality and macro- or micronutrients in the three surveys. CONCLUSIONS No consistent associations were found between a large panel of nutritional markers and sleep quality. Components of the Mediterranean diet such as dairy, fruits, and vegetables might favor good sleep quality, while increased consumption of sugary foods or meat might favor poor sleep quality. CITATION Oliveira JL, Marques-Vidal P. Sweet dreams are not made of this: no association between diet and sleep quality. J Clin Sleep Med. 2023;19(12):2005-2014.
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Affiliation(s)
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Susanu MF, Pop RM. Sleep Patterns and Influencing Factors in Romanian Medical Students During the COVID-19 Pandemic: A Two-Wave Ecological Study. Cureus 2023; 15:e51187. [PMID: 38283431 PMCID: PMC10817762 DOI: 10.7759/cureus.51187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2023] [Indexed: 01/30/2024] Open
Abstract
Introduction Sleep quality among students is variable with sleep disturbances being common worldwide. The coronavirus disease 2019 (COVID-19) pandemic led to major changes, including in the educational system. In this study, we aimed to analyze sleep patterns and screen time of medical students, and the effect of COVID-19. Material and methods We conducted a two-wave questionnaire-based ecological study on Romanian medical students from Târgu Mureș. For data collection, a 43-item questionnaire, structured into six categories, was designed and distributed through social networks and official online teaching platforms. Results Out of 751 answers from both waves, it was seen that most of the responders were female (76.23%, n=571) and in their preclinic years of study (61.33%, n=460). There was a statistically significant association between the form of education and students' general sleep quality (p=0.0010, OR=1.670, 95%CI: 1.228-2.271), their study time (5.5 hours, IQR: 4-7.5 versus five hours, IQR: 2.5-5, p<0.001) and their sleep disturbances (p=0.0008, OR=0.5859, 95%CI: 0.4284-0.8011). Also, there was a statistically significant association between the year of study and their study time (five hours, IQR: 4-7 versus four hours, IQR: 3-6, p<0.001) and their sleep satisfaction (p=0.0027, OR=0.6360, 95%CI: 0.4729-0.8554). Conclusions Students reported better general sleep quality, less trouble sleeping, and less study while studying online full-time. Also, students in clinical years tended to study less and be more satisfied with their sleep compared to students in preclinical years.
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Affiliation(s)
- Maria-Flavia Susanu
- Research Methodology Department, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, Târgu Mureș, ROU
- Endocrinology Department, Mures County Emergency Clinical Hospital, Târgu Mureș, ROU
| | - Raluca-Monica Pop
- Endocrinology Department, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, Târgu Mureș, ROU
- Endocrinology Department, Mures County Emergency Clinical Hospital, Târgu Mureș, ROU
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Kılıç Memur HN, Sezgin O. A coping model for school psychological counsellors: A qualitative study. Stress Health 2023; 39:1082-1092. [PMID: 37040269 DOI: 10.1002/smi.3248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 02/27/2023] [Accepted: 04/02/2023] [Indexed: 04/12/2023]
Abstract
This study analyzed the coping processes of psychological counsellors working in high schools in Turkey in the face of the challenges experienced in counselling sessions. The study used a qualitative research design: grounded theory. Semistructured interviews conducted with 33 high school counsellors were analyzed following Strauss and Corbin's analysis guidelines to create a coping model. The core category in the model was 'coping' while 'actions/reactions' explained what counsellors do to cope. Finally, 'environmental factors' and 'personal factors' influenced their coping processes. The findings are discussed in light of the existing literature to provide suggestions for school counsellors to develop self-care/coping strategies, increase their resilience and decrease their burnout.
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Affiliation(s)
- Hale Nur Kılıç Memur
- Department of Guidance and Psychological Counselling, Marmara University, Istanbul, Turkey
| | - Osman Sezgin
- Department of Guidance and Psychological Counselling, Marmara University, Istanbul, Turkey
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Memarian A, Shahrbabaki PM, Zakeri MA, Ahmadinejad M. The relationship between depressive symptoms and sleep quality in medical staff after their infection with COVID-19. Front Psychiatry 2023; 14:1269402. [PMID: 38098629 PMCID: PMC10720747 DOI: 10.3389/fpsyt.2023.1269402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 11/13/2023] [Indexed: 12/17/2023] Open
Abstract
Background Healthcare workers (HCWs) play a crucial role in managing infectious diseases like COVID-19. However, the demanding working conditions during the pandemic have led to an increased risk of depression and sleep disorders among these dedicated professionals. Therefore, this study aimed to examine the relationship between depressive symptoms and sleep quality in medical staff who had contracted COVID-19. Methods This descriptive study involved a sample of 203 HCWs who had contracted COVID-19. These HCWs were employed at a hospital affiliated with Kerman University of Medical Sciences in 2020. The data for this study were collected using a demographic information form, the Pittsburgh Sleep Quality Index (PSQI), and the Beck Depression Inventory (BDI). Statistical analysis was conducted using SPSS22, with a significance level set at less than 0.05. Results The study found that the mean score for depressive symptoms among the participants was 11.67 ± 2.68, while the mean score for sleep quality was 5.47 ± 3.02. It was observed that 18.2% of the participants experienced moderate depression, 10.3% had severe depression, and 59.6% had poor sleep quality. Furthermore, a significant and positive correlation was identified between sleep quality and depression (r = 0.54; p = 0.001). Multiple regression models indicated that the harmful pattern and sleep quality together could predict 34% of the variance in depression. Additionally, the use of sedatives and depression were found to predict 33% of the variance in sleep quality. Conclusion The findings of our study indicated a high prevalence of depressive symptoms and insomnia among medical staff who had contracted COVID-19. These results provide valuable insights for health managers, highlighting the need for implementing interventions in epidemic environments to reduce the vulnerability of HCWs.
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Affiliation(s)
| | | | - Mohammad Ali Zakeri
- Pistachio Safety Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Clinical Research Development Unit, Ali-Ibn Abi-Talib Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Mehdi Ahmadinejad
- Department of Anesthesiology, School of Medicine, Shahid Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran
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Wang S, Luo G, Zhang X, Jing Y, Zaimina, Yao C, Li M, Chen H, Li J. Prevalence and influencing factors of sleep disturbance among medical students under the COVID-19 pandemic. Eur Arch Psychiatry Clin Neurosci 2023:10.1007/s00406-023-01707-6. [PMID: 38007404 DOI: 10.1007/s00406-023-01707-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 10/15/2023] [Indexed: 11/27/2023]
Abstract
BACKGROUND Medical students may feel severe psychological stress during COVID-19, which might impair their ability to sleep. This research aimed to look at the risk factors for sleep disturbance and the prevalence of sleep disturbance among medical students. METHODS 538 medical students in total were recruited for this research. Anxiety, depression, and sleep disturbance were assessed using the Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), and Pittsburgh Sleep Quality Index (PSQI). To evaluate the possible risk variables, we computed descriptive statistics for each assessment item and ran univariate and logistic regression analyses. RESULTS Medical students had a 63.6% prevalence of sleep disturbance (n = 342). According to logistic regression, introverted students are 1.77 times more likely than extroverted students to have sleep disturbance (OR = 1.77, 95% CI 1.08-2.91). Medical students with depression had a 5.6-times higher risk of sleep disturbance than those without depression (OR = 5.60, 95% CI 3.43-9.15). Additionally, medical students with anxiety were 3.95 times more likely than those without anxiety to have sleep disturbance (OR = 3.95, 95% CI 2.04-7.64). CONCLUSIONS According to this research, the COVID-19 pandemic caused significant sleep disturbance among medical students. Additionally, among medical students, introversion, anxiety, and depression were risk factors for sleep disturbance.
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Affiliation(s)
- Shuo Wang
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Tianjin, 300222, China
| | - Guoshuai Luo
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Tianjin, 300222, China
| | - Xue Zhang
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Tianjin, 300222, China
| | - Yifan Jing
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Tianjin, 300222, China
| | - Zaimina
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Tianjin, 300222, China
| | - Cong Yao
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Tianjin, 300222, China
| | - Meijuan Li
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Tianjin, 300222, China
| | - Hongli Chen
- State Key Laboratory of Separation Membrane and Membrane Process, Tiangong University, Tianjin, 300387, China
| | - Jie Li
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Tianjin, 300222, China.
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Varghese N, Buergin D, Boonmann C, Stadler C, Schmid M, Eckert A, Unternaehrer E. Interplay between stress, sleep, and BDNF in a high-risk sample of young adults. Sci Rep 2023; 13:20524. [PMID: 37993570 PMCID: PMC10665413 DOI: 10.1038/s41598-023-47726-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 11/17/2023] [Indexed: 11/24/2023] Open
Abstract
Children in institutional care have a high risk to experience childhood adversities (CAs), with consequences for physical and mental well-being. The long-term effects of CAs on the brain, including consequences for neuronal plasticity and sleep, are poorly understood. This study examined the interplay between stress (including CAs), sleep, and brain-derived neurotrophic factor (BDNF), a prominent marker for neuronal plasticity. Participants (N = 131, mean age = 26.3±3.4 years, 40 females) with residential youth-care history completed questionnaires measuring CAs (Childhood Trauma Questionnaire, CTQ), psychological well-being (World Health Organization-Five Well-Being Index, WHO-5), and sleep disturbances (Pittsburgh Sleep Quality Inventory, PSQI). Hair cortisol and serum BDNF concentration were measured using enzyme-linked immunosorbent assays. The analyses were conducted by using bootstrap regression models. There was no association of stress parameters or sleep with BDNF concentration. However, we found a significant association of CAs and well-being with sleep disturbances. Last, we found an association between CAs and BDNF in sleep-healthy but not sleep-disturbed participants. Our findings indicated a role of sleep disturbance in the association between stress and BDNF. Still, further studies are warranted using vulnerable groups at-risk to understand long-term effects on mental health and sleep.
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Affiliation(s)
- Nimmy Varghese
- Research Cluster, Molecular & Cognitive Neuroscience, Division of Neurobiology, University of Basel, 4002, Basel, Switzerland
- Neurobiology Lab for Brain Aging and Mental Health, Medical Faculty, Psychiatric University Clinics Basel, University of Basel, 4002, Basel, Switzerland
| | - David Buergin
- Child and Adolescent Research Department, University Psychiatric Clinics Basel (UPK), University of Basel, Wilhelm Klein-Strasse 27, 4002, Basel, Switzerland
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
| | - Cyril Boonmann
- Child and Adolescent Research Department, University Psychiatric Clinics Basel (UPK), University of Basel, Wilhelm Klein-Strasse 27, 4002, Basel, Switzerland
- LUMC-Curium - Department of Child of Adolescent Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Christina Stadler
- Child and Adolescent Research Department, University Psychiatric Clinics Basel (UPK), University of Basel, Wilhelm Klein-Strasse 27, 4002, Basel, Switzerland
| | - Marc Schmid
- Child and Adolescent Research Department, University Psychiatric Clinics Basel (UPK), University of Basel, Wilhelm Klein-Strasse 27, 4002, Basel, Switzerland
| | - Anne Eckert
- Research Cluster, Molecular & Cognitive Neuroscience, Division of Neurobiology, University of Basel, 4002, Basel, Switzerland
- Neurobiology Lab for Brain Aging and Mental Health, Medical Faculty, Psychiatric University Clinics Basel, University of Basel, 4002, Basel, Switzerland
| | - Eva Unternaehrer
- Child and Adolescent Research Department, University Psychiatric Clinics Basel (UPK), University of Basel, Wilhelm Klein-Strasse 27, 4002, Basel, Switzerland.
- Department of Psychology, University of Konstanz, Konstanz, Germany.
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Redding A, Santarossa S, Sagong C, Kalmbach DA, Drake CL, Casement MD, Cheng P. "Life will never be the same": a qualitative analysis of the impact of COVID-19 on adults with a history of insomnia. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2023; 4:zpad046. [PMID: 38093801 PMCID: PMC10718814 DOI: 10.1093/sleepadvances/zpad046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/07/2023] [Indexed: 06/14/2024]
Abstract
Study Objectives To utilize qualitative data analysis to enrich our understanding of the impact of coronavirus (COVID-19) on those with a pre-pandemic history of insomnia. Methods The sample included 208 participants who completed the Coronavirus Impact Scale in April and May 2020. A content analysis was used to analyze responses to a free-response item "Please tell us about any other ways the coronavirus has impacted your life" (n = 175), using a combination of inductive and deductive coding. Results Both negative and positive themes emerged, including altered access to health care, negative financial impacts, and various emotions surrounding COVID-19. Some shared "silver linings" such as having more time for physical activity and deepening familial connections. Conclusions This analysis provides novel insight into the shared concerns and lived experiences of those with a history of insomnia. Understanding these unique stressors can enable healthcare professionals to better anticipate the needs of this population, as well as learn to navigate future stressful events.
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Affiliation(s)
- Ashley Redding
- Public Health Sciences, Henry Ford Health, Detroit, MI, USA
| | - Sara Santarossa
- Public Health Sciences, Henry Ford Health, Detroit, MI, USA
- Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Chaewon Sagong
- Sleep Disorders and Research Center, Henry Ford Health, Detroit, MI, USA
| | - David A Kalmbach
- Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, East Lansing, MI, USA
- Sleep Disorders and Research Center, Henry Ford Health, Detroit, MI, USA
| | | | | | - Philip Cheng
- Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, East Lansing, MI, USA
- Sleep Disorders and Research Center, Henry Ford Health, Detroit, MI, USA
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Boyd A, Mealand K, Briggs Early K, Oestreich E. Perceived Stress, Grit, and Self-Care Behaviors in First-Year Medical Students. Am J Lifestyle Med 2023; 17:803-812. [PMID: 38511119 PMCID: PMC10948928 DOI: 10.1177/15598276221124576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024] Open
Abstract
Medical students experience more stress than the general population, which over time can cause mental and physical disease, including burnout. Identifying factors impacting stress during early medical training could inform strategies to minimize its impacts throughout training and in clinical practice. This study surveyed 238 first-year osteopathic medical students to assess stress (Perceived Stress Scale; PSS), grit, sleep quality (Pittsburgh Sleep Quality Index; PSQI), physical activity (Godin-Shephard Leisure-Time Physical Activity Score; LTPA), and nutrition habits (Rapid Eating Assessment for Participants; REAP) within the first 2 weeks of starting medical school and again 10 weeks later. Incomplete responses were removed, leaving 204 study participants. We observed statistically significant decreases in grittiness (∆grit = -2.230%, P = .002) and physical activity (∆LTPA = -22.147%, P < .0001), while perceived stress (∆PSS = 34.548%, P < .0001) and poor sleep quality (∆PSQI% = 19.853, P < .0001) increased. Correlation analyses identified the strongest relationships were between ∆PSS vs ∆PSQI (r = .47, P < .0001) and ∆PSS vs ∆LTPA (r = -.20, P < .01). Multivariable linear regression analysis isolated ∆PSQI (P < .0001) and ∆LTPA (P = .012) as statistically significant predictors of ∆PSS. These results suggest early, repeated curricular interventions focused on physical activity and sleep hygiene may help students better manage stress during medical education.
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Affiliation(s)
- Alan Boyd
- College of Osteopathic Medicine, Pacific Northwest University of Health Sciences, Yakima, WA, USA (AB, KM, KBE, EO)
| | - Kyle Mealand
- College of Osteopathic Medicine, Pacific Northwest University of Health Sciences, Yakima, WA, USA (AB, KM, KBE, EO)
| | - Kathaleen Briggs Early
- College of Osteopathic Medicine, Pacific Northwest University of Health Sciences, Yakima, WA, USA (AB, KM, KBE, EO)
| | - Emily Oestreich
- College of Osteopathic Medicine, Pacific Northwest University of Health Sciences, Yakima, WA, USA (AB, KM, KBE, EO)
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Rasmussen AH, Petersen LK, Kaasgaard Sperling M, Bertelsen MM, Rathleff MS, Petersen KKS. The potential effect of walking on quantitative sensory testing, pain catastrophizing, and perceived stress: an exploratory study. Scand J Pain 2023; 23:751-758. [PMID: 37694875 DOI: 10.1515/sjpain-2023-0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 08/22/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVES Studies suggest that a range of pain mechanisms, such as poor quality of sleep, perceived stress, pain catastrophizing or pain sensitivity, are likely to enhance clinical pain. Animal studies suggest that these pain mechanisms can be modulated by increasing physical activity, but human data are needed to support this hypothesis. This exploratory study aimed to investigate the changes in pain mechanisms after a simple self-directed walking program of 8-weeks. Additionally, this exploratory study investigated the interaction between changes over time in assessments of poor quality of sleep, perceived stress, pain catastrophizing or pain sensitivity and how these changes interacted with each other. METHODS This prospective cohort study included 30 healthy subjects who were assessed at baseline and 4- and 8-weeks after initiating the walking program (30 min walking/day for 8 weeks). Self-report outcomes included: Pain Catastrophizing Scale (PCS), the Perceived Stress Scale (PSS) and Pittsburgh Sleep Quality Index. Pressure pain thresholds, temporal summation of pain and conditioned pain modulation (CPM) were assessed using cuff algometry. RESULTS Twenty-four subjects completed all the visits (age: 42.2, SD: 14.9, 16 females). PCS and PSS significantly decreased at the 8-week's visit compared to baseline (p<0.05). No significant differences were seen for an improvement in quality of sleep (p=0.071) and pain sensitivity (p>0.075) when comparing the 8-week's visit to the baseline visit. Changes in pain mechanisms comparing baseline and 8-weeks data were calculated and regression analyses found that an improvement in PCS was associated with an improvement in CPM (R2=0.197, p=0.017) and that a higher adherence to the walking program was associated with a larger improvement in PCS (R2=0.216, p=0.013). CONCLUSIONS The current exploratory study indicates that a simple self-directed walking program of 8-weeks can improve pain catastrophizing thoughts, perceived stress. Higher adherence to the walking program were associated with an improvement in pain catastrophizing and an improvement in pain catastrophizing was associated with an increase in conditioned pain modulation.
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Affiliation(s)
- Anna Houmøller Rasmussen
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Lærke Kjeldgaard Petersen
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Mette Kaasgaard Sperling
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Maria Møller Bertelsen
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Michael Skovdal Rathleff
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
- Department of Clinical Medicine, Center for General Practice, Aalborg University, Aalborg, Denmark
| | - Kristian Kjær-Staal Petersen
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
- Department of Health Science and Technology, Faculty of Medicine, Center for Neuroplasticity and Pain, Aalborg University, Aalborg, Denmark
- Center for Mathematical Modeling of Knee Osteoarthritis (MathKOA), Aalborg University, Aalborg, Denmark
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Sakhelashvili I, Spruyt K. The interaction between stress and sleep disorders among foreign medical students in Georgia. Sleep Med 2023; 110:225-230. [PMID: 37647713 DOI: 10.1016/j.sleep.2023.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVES This study aimed to: a. Investigate daytime sleepiness, stress, and pre-sleep arousal prevalence among foreign medical students in Georgia. b. Explore gender-based associations between sleep and stress parameters. METHODS Mental health was assessed in 207 foreign medical students in Georgia using the Epworth Sleepiness Scale (ESS), Pre-Sleep Arousal Scale (PSAS), and Student-Life Stress Inventory (SLSI). RESULTS Most participants reported elevated stress levels and excessive daytime sleepiness (EDS). EDS affected 25.1% of students, with slightly higher prevalence in males. PSAS was prevalent in 97.1% of students. Stress was widely reported, with 78% experiencing it, with a higher prevalence in females. Significant correlations were observed between sleepiness and arousal, including somatic (r = 0.41) and total scores (r = 0.28). Sleepiness was also linked to stressors like pressure, changes, self-imposed stress, and overall self-evaluation stress (r = 0.45). Strong correlations existed between ESS, Total PSAS, and overall self-evaluation SLSI scores for both genders. Gender differences were observed in the associations with Cohen's d within the small to moderate size. Men showed significant associations between ESS and stressors: conflict, pressure, chances, all stress reaction categories, and total SLSI scores (p < 0.001). In women, ESS correlated significantly only with overall self-evaluation (p < 0.001). Excessive daytime sleepiness, especially with somatic and total PSAS, predicted total SLSI scores for the entire sample and both genders, with stronger predictive values for total PSAS. CONCLUSION The study reveals a high prevalence of clinical sleepiness and its significant correlation with pre-sleep arousal and stress among foreign medical students, with females experiencing more difficulties than males.
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Affiliation(s)
- Irine Sakhelashvili
- Georgian -American University, Medical School, M. Aleksidze Str, Tbilisi, 0160, Georgia.
| | - Karen Spruyt
- INSERM UMR 1141 NeuroDiderot, Hôpital Robert Debré, Bâtiment Bingen, Point Jaune-3ème et 4ème Etages, 48, boulevard Sérurier, 75019, Paris, France.
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Dougherty EN, Johnson NK, Badillo K, Haedt-Matt AA. Sleep reactivity is associated with social anxiety and disordered-eating behaviors in college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2280-2285. [PMID: 34469257 DOI: 10.1080/07448481.2021.1967359] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 07/17/2021] [Accepted: 08/06/2021] [Indexed: 06/13/2023]
Abstract
Objective: Investigate whether sleep reactivity was associated with social anxiety and disordered-eating behaviors in a college population. Participants: One hundred ninety-eight college-age men and women. Methods: Participants completed self-report measures of social anxiety, disordered-eating behaviors and sleep reactivity. Results: Sleep reactivity was associated with greater dietary restriction and purging, controlling for social anxiety but it was not associated with binge eating. Sleep reactivity was associated with elevated symptoms of social anxiety, controlling for disordered-eating behaviors. Conclusions: The results suggest that sleep reactivity represents a shared correlate of disordered-eating behaviors and social anxiety that may partially explain their co-occurrence. Interventions to help college students high in sleep reactivity effectively manage stress and regulate their sleep may aid in the prevention and treatment of social anxiety and disordered-eating behaviors.
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Affiliation(s)
| | - Nicole K Johnson
- Department of Psychology, Illinois Institute of Technology, Chicago, Illinois, USA
| | - Krystal Badillo
- Department of Psychology, Illinois Institute of Technology, Chicago, Illinois, USA
| | - Alissa A Haedt-Matt
- Department of Psychology, Illinois Institute of Technology, Chicago, Illinois, USA
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Nema J, Mankova D, Bures M, Novak J. Sleep quality and duration: A key to life satisfaction among military students. MILITARY PSYCHOLOGY 2023:1-11. [PMID: 37725691 DOI: 10.1080/08995605.2023.2259778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 08/30/2023] [Indexed: 09/21/2023]
Abstract
Military service is a demanding profession that requires high physical preparedness and mental endurance. At the same time, the demands of military duties often require early rising and shortened sleep duration. Such a reduction in sleep can reduce physical and mental performance, and these changes can be reflected in life satisfaction. For this reason, soldiers' life satisfaction is a crucial variable for their success and long-term service. This study examined the relationship between sleep quality, sleep duration, and life satisfaction in military medical students. The results on 35 military students showed that greater sleep quality corresponded to greater life satisfaction; this relationship was moderate and significant (r = -460, p = .005). Notably, participants (n = 17) who began to wake up without the use of an alarm clock reported an average of 11% higher life satisfaction than the participants who woke to an alarm clock; this difference between participants was statistically significant (p = .011, Cohen's d = .911). Pre- and post-intervention showed that sleep hygiene education could be a suitable solution to prevent sleep deprivation and positively impact life satisfaction. Our findings emphasize the importance of increased sleep hygiene education, especially in preparing future military officers and during military exercises. Prioritizing sleep hygiene in these ways can significantly increase soldiers' life satisfaction.
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Affiliation(s)
- Jiri Nema
- Department of Military Medical Service Organisation and Management, Faculty of Military Health Sciences, University of Defence, Hradec Kralove, Czech Republic
| | - Denisa Mankova
- Department of Psychology, Faculty of Arts, Palacky University, Olomouc, Czech Republic
| | - Miroslav Bures
- Department of Computer Science, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic
| | - Jan Novak
- Department of Anthropology and Human Genetics, Faculty of Science, Charles University, Prague, Czech Republic
- Department of Neurology, General University Hospital, Prague, Czech Republic
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Guo C, Piao S, Wang C, Yu L, Wang K, Qu Q, Zhang C, Yu X. The prevalence and associated factors of sleep deprivation among healthy college students in China: a cross-sectional survey. PeerJ 2023; 11:e16009. [PMID: 37744238 PMCID: PMC10512935 DOI: 10.7717/peerj.16009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 08/09/2023] [Indexed: 09/26/2023] Open
Abstract
Background The prevalence of sleep deprivation among college students is increasing and has a few associated factors. Methods The present study analyzed 2,142 college students from 28 provinces in China. The Chinese version of the Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep duration. Binary logistic regression was conducted to explore the sleep deprivation related factors. Age and gender were controlled as covariates. Results Among the 2,142 college students (27.7% male, 72.3% female), 1,620 (75.6%) reported the average sleep duration was below 7 h per day for one month, 49.3% (1,055/2,142) slept 6∼7 h (contains 6 h), 21.0% (449/2,142) slept 5∼6 h (contains 5 h), and 5.4% (116/2,142) slept <5 h. Age increased the risk of sleep deprivation, the adjusted odds ratio = 1.05 (95% CI [1.01∼1.10]). The adjusted odds ratio (A-OR) for sleep deprivation was higher for students of more than 60 min nap duration per day (A-OR = 2.35, 95% CI [1.45∼3.80]), and age growth (A-OR = 1.05, 95% CI [1.01∼1.10]). In contrast, A-ORs were lower among sleeping inconsistency between work and rest days (A-OR = 0.61, 95% CI [0.49∼0.75]), accustomed to staying up late (A-OR = 0.45, 95% CI [0.36∼0.57]), staying up late to work or study (A-OR = 0.62, 95% CI [0.49∼0.78]), stress (A-OR = 0.75, 95% CI [0.58∼0.98]), and repeated thoughts in bed had (A-OR = 0.79, 95% CI [0.62∼0.99]). Conclusions Sleep deprivation is extremely common among healthy college students in China. It is necessary to perform methods maintaining enough sleep due to the current high incidence of sleep deprivation. Controlling the nap duration and getting enough sleep on rest days to replace missing hours of sleep on workdays might improve college students' sleep.
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Affiliation(s)
- Congcong Guo
- School of Integrated Traditional Chinese and Western Medicine, Binzhou Medical University, Yantai, Shandong, China
| | - Songzhe Piao
- Department of Urology, Taizhou Hospital of Zhejiang Province Affiliated with Wenzhou Medical University, Linhai, Zhejiang, China
| | - Chenyu Wang
- School of Integrated Traditional Chinese and Western Medicine, Binzhou Medical University, Yantai, Shandong, China
| | - Lili Yu
- Faculty of Chinese Medicine, Macau University of Science and Technology, Macao, China
| | - Kejun Wang
- School of Integrated Traditional Chinese and Western Medicine, Binzhou Medical University, Yantai, Shandong, China
| | - Qian Qu
- School of Integrated Traditional Chinese and Western Medicine, Binzhou Medical University, Yantai, Shandong, China
| | - Cuiting Zhang
- School of Integrated Traditional Chinese and Western Medicine, Binzhou Medical University, Yantai, Shandong, China
| | - Xiaofei Yu
- School of Integrated Traditional Chinese and Western Medicine, Binzhou Medical University, Yantai, Shandong, China
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Leow MQH, Chiang J, Chua TJX, Wang S, Tan NC. The relationship between smartphone addiction and sleep among medical students: A systematic review and meta-analysis. PLoS One 2023; 18:e0290724. [PMID: 37713408 PMCID: PMC10503710 DOI: 10.1371/journal.pone.0290724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 08/14/2023] [Indexed: 09/17/2023] Open
Abstract
OBJECTIVES This systematic review aimed to evaluate the association between smartphone addiction and sleep in medical students. The secondary outcomes included the prevalence of smartphone addiction, duration and purpose of its use, prevalence of poor sleep, duration and quality of sleep. METHODS The authors searched PubMed, Cochrane Library, Embase, PsycINFO and CINAHL databases, from inception of each database to October 2022. Quantitative studies in the English language on smartphone addiction and sleep in students studying Western Medicine were included. The Rayyan application was used for title-abstract screening, and Joanna Briggs Institute (JBI) critical appraisal checklist to assess the risk of bias. Heterogeneity tests and meta-synthesis of data were performed using the meta-package in R software. Data on the activities used on the smartphone was synthesized qualitatively. RESULTS A total of 298 abstracts were initially assessed for inclusion eligibility: 16 of them were eventually appraised, covering 9466 medical students comprising 3781 (39.9%) males and 5161 (54.5%) females. Meta-correlation between the Smartphone Addiction Scale Short Version (SAS-SV) and Pittsburgh Sleep Quality Index (PSQI) was 0.30 (95%CI = 0.24-0.36), and 0.27 (95% CI = 0.18-0.36) for SAS-SV and sleep duration. The meta-analytic estimation of smartphone addiction prevalence was 39% (95%CI = 0.30-0.50), and score using SAS-SV was 31.11 (95%CI = 29.50-32.72). The mean duration of smartphone daily used was 4.90 hours (95%CI = 3.72-6.08). The meta-analytic estimation on prevalence of poor sleep was 57% (95%CI = 0.48-0.66), and the meta-mean of PSQI and duration of sleep was 5.95 (95%CI = 4.90-7.00) and 5.62h (95%CI = 4.87-6.36) respectively. Medical students used their smartphones mostly for text messaging, followed by photo-sharing or social networking. Its usage for medical education remains unclear. CONCLUSION The prevalence of poor sleep and smartphone addiction in medical students was 57% and 39% respectively, with a correlation index of 0.30. Medical students commonly used the smartphone for text-messaging, photo-sharing or social networking, averaging 4.9 hours daily.
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Affiliation(s)
| | - Joelle Chiang
- Lee Kong Chian School of Medicine, National Technological University of Singapore, Singapore, Singapore
| | - Tiffany Jia Xuan Chua
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Sean Wang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ngiap Chuan Tan
- Singhealth Polyclinics, Singapore, Singapore
- SingHealth Duke-NUS Family Medicine Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
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Liu Y, Chen J, Chen K, Liu J, Wang W. The associations between academic stress and depression among college students: A moderated chain mediation model of negative affect, sleep quality, and social support. Acta Psychol (Amst) 2023; 239:104014. [PMID: 37633175 DOI: 10.1016/j.actpsy.2023.104014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/08/2023] [Accepted: 08/22/2023] [Indexed: 08/28/2023] Open
Abstract
BACKGROUND Growing competition in tight job market and academic excellence as a social norm in Asian culture have made Chinese college students burdened with immense academic stress. OBJECTIVES This study aimed to explore the associations between academic stress and depression, and the mediating roles of negative affect and sleep quality, as well as the moderating role of social support in the relationship between negative affect and sleep quality. METHODOLOGY A convenience sample of 221 male and 479 female college students aged between 17 and 25 completed questionnaires on academic stress, depression, negative affect, sleep quality and social support. RESULTS Results indicated that academic stress could not only directly affect depression (b = 0.31, p < 001), but also affect depression through the mediation role of negative affect and sleep quality. The chain mediating effects includes three paths, namely, the mediating role of negative affect (indirect effect = 0.21, percentage of total effect = 69.58 %), the mediating role of sleep quality (indirect effect = 0.06, percentage of total effect = 21.03 %), and the chain mediating role of negative affect and sleep quality (indirect effect = 0.06, percentage of total effect = 19.86 %). Social support moderated the adverse influence of negative affect on sleep quality. Social support decreases the impact of negative affect on sleep quality. Specifically, the association between negative affect and sleep quality was stronger for college students with low (bsimple = 0.44, p < 0.001) social support than those with high (bsimple = 0.32, p < 0.001) social support. IMPLICATIONS The results advanced our understanding of how academic stress affects college students' depression. These findings provide implications on the cultivation of stress coping strategies, promotion of emotion regulation skills, exaltation of sleep quality, and improvement of the social support level aiming for future depression preventions and interventions. Specific measures include setting up psychological health courses, teaching emotion management strategies, and establishing web-based programme steming from acceptance and commitment therapy. It should be noted that the cross-sectional design means the causal associations among the variables could not be determined.
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Affiliation(s)
- Yongli Liu
- Department of Education Policy and Leadership, The Education University of Hong Kong, Hong Kong, China; Department of Educational, Shanxi Datong University, Datong, China
| | - Junjun Chen
- Department of Education Policy and Leadership, The Education University of Hong Kong, Hong Kong, China
| | - Kun Chen
- Department of Educational Technology, Shanxi Datong University, Datong, China
| | - Jing Liu
- School of Journalism, Shanxi Datong University, Datong 037009, China
| | - Wei Wang
- Department of Psychology, Shanxi Datong University, Datong, China.
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Yaghmour KA, Alhmyri SM, Alhmyri BM, Sharaf R, Alasmari MA, Almilabi MM. The Effect of Sleep Quality and Mental Health on Academic Performance Among the Medical Students of King Abdulaziz University. Cureus 2023; 15:e44951. [PMID: 37818494 PMCID: PMC10561659 DOI: 10.7759/cureus.44951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Sleep quality has an important role in brain functioning and development. Affected sleep quality and mental health can negatively affect the academic performance of college students. OBJECTIVE To assess the effect of sleep quality and mental health on the academic performance of medical students at King Abdulaziz University, Jeddah, Saudi Arabia. METHODS We conducted a cross-sectional study among medical students at King Abdulaziz University. The dependent variable was the current grade point average (GPA). For the independent variables, two validated tools were used in the study: the Pittsburgh Sleep Quality Index (PSQI) for sleep assessment; and the Depression, Anxiety and Stress Scale (DASS-21) for mental health assessment. RESULTS A total of 382 responses were analyzed. The majority of students (86.6%) had GPAs greater than 3.75/5, while only 1% of the sample had a GPA lower than 2.75/5. The PSQI showed a median and interquartile range of (9, 6-11). Normal DASS-21 represented the majority as follows: depression at 67%, anxiety at 63.1%, and stress at 82.2%. In the statistical analyses, sleep quality, depression, anxiety, and stress were not statistically significant with the student's GPA. CONCLUSION Low levels of sleep quality were found among medical students in our study. While sleep quality and mental health status did not show an effect on the GPA of the medical students, lower sleep quality was significantly correlated with increased scores of depression, anxiety, and stress. Our findings mandate interventions directed at improving sleep quality among medical students.
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Affiliation(s)
| | | | | | - Renad Sharaf
- Medicine, King Abdulaziz University, Jeddah, SAU
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Prokeš M. Sleep quality and sleep routines as mediators of stressors and life satisfaction in Czech university students: a structural equation model. Front Psychol 2023; 14:1231773. [PMID: 37727748 PMCID: PMC10505808 DOI: 10.3389/fpsyg.2023.1231773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/08/2023] [Indexed: 09/21/2023] Open
Abstract
Introduction Sleep is especially important to overall well-being. Some aspects of sleep have been well documented, for example sleep quantity and its effect on well-being, but the value of a consistent sleep routine remains poorly studied. University students are a population group especially susceptible to stress, mental health problems and poor sleep quality and experience changing daily schedules. Investigating the protective power of sleep in this population group is therefore an important avenue of research. Methods Applying a structural equation model, the current study surveyed a large sample of Czech university students during the COVID-19 pandemic in late spring, 2021, and observed the mediation effects of sleep on this group. Results and Discussion The study found that working, maintaining social contact and attending lectures in person had a strong effect on satisfaction with life. Increased personal study time indirectly supported consistent sleep routines and mediated perceptions of life satisfaction. As expected, the results indicated the importance of high-quality sleep. The results also verified partial mediation, directly and indirectly, through sleep quality, highlighting the significance of a consistent sleep routine in students on their self-reported satisfaction with life.
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Ekici Ö. Association of stress, anxiety, and depression levels with sleep quality in patients with temporomandibular disorders. Cranio 2023; 41:407-415. [PMID: 33345727 DOI: 10.1080/08869634.2020.1861886] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To examine the psychological symptoms of TMD and their effects on sleep quality in patients with temporomandibular disorders. METHODS The study was carried out with 425 consecutive TMD patients who sought care at the oral and maxillofacial surgery clinic of a faculty of dentistry. Perceived Stress Scale-14, Beck Anxiety Scale, and Beck Depression Scale were used to evaluate the psychological state. Sleep quality was evaluated with the Pittsburgh Sleep Quality Index. RESULTS The mean sleep score of all participants was 6.52. As the level of anxiety and depression increased, the scores of both total sleep quality and sleep quality components increased significantly p < 0.01. On the other hand, those with poor sleep quality had significantly higher stress, anxiety, and depression levels than those with good sleep quality p < 0.01. CONCLUSION Negative emotional situations such as stress, anxiety, and depression seriously impair sleep quality in TMD patients.
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Affiliation(s)
- Ömer Ekici
- Department of Oral and Maxillofacial Surgery, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
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Harding AB, Ramirez MR, Ryan AD, Xiong BN, Rosebush CE, Woods-Jaeger B. Impacts of COVID-19 on Stress in Middle School Teachers and Staff in Minnesota: An Exploratory Study Using Random Forest Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6698. [PMID: 37681838 PMCID: PMC10487626 DOI: 10.3390/ijerph20176698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/26/2023] [Accepted: 08/29/2023] [Indexed: 09/09/2023]
Abstract
While the COVID-19 pandemic has negatively impacted many occupations, teachers and school staff have faced unique challenges related to remote and hybrid teaching, less contact with students, and general uncertainty. This study aimed to measure the associations between specific impacts of the COVID-19 pandemic and stress levels in Minnesota educators. A total of 296 teachers and staff members from eight middle schools completed online surveys between May and July of 2020. The Epidemic Pandemic Impacts Inventory (EPII) measured the effects of the COVID-19 pandemic according to nine domains (i.e., Economic, Home Life). The Kessler-6 scale measured non-specific stress (range: 0-24), with higher scores indicating greater levels of stress. Random forest analysis determined which items of the EPII were predictive of stress. The average Kessler-6 score was 6.8, indicating moderate stress. Three EPII items explained the largest amount of variation in the Kessler-6 score: increase in mental health problems or symptoms, hard time making the transition to working from home, and increase in sleep problems or poor sleep quality. These findings indicate potential areas for intervention to reduce employee stress in the event of future disruptions to in-person teaching or other major transitions during dynamic times.
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Affiliation(s)
- Alyson B. Harding
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA; (M.R.R.); (A.D.R.); (B.N.X.)
| | - Marizen R. Ramirez
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA; (M.R.R.); (A.D.R.); (B.N.X.)
- Department of Environmental and Occupational Health, Program of Public Health, University of California at Irvine, Irvina, CA 92697, USA
| | - Andrew D. Ryan
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA; (M.R.R.); (A.D.R.); (B.N.X.)
| | - Bao Nhia Xiong
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA; (M.R.R.); (A.D.R.); (B.N.X.)
| | - Christina E. Rosebush
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA; (M.R.R.); (A.D.R.); (B.N.X.)
| | - Briana Woods-Jaeger
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA;
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Yared L, Rodrigues K, Mangal R, Stead TS, Ganti L. Sleep Hygiene, Daytime Sleepiness, and Coping Mechanisms Amongst US Adults. Cureus 2023; 15:e45608. [PMID: 37868531 PMCID: PMC10588676 DOI: 10.7759/cureus.45608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2023] [Indexed: 10/24/2023] Open
Abstract
Background Excessive daytime sleepiness (EDS) can be measured by the Epworth Sleepiness Scale (ESS) and has been shown to be prevalent in the United States. This study aimed to survey the levels of EDS in US adults and explore factors related to sleep hygiene. Methods An anonymous web-based survey was conducted, polling the frequency of hypersomnia symptoms, sleep quality, and time spent in their occupation. Respondents were at least 21 years of age and United States residents. Participants reported information related to age, gender, education, income, and race in addition to their responses to the survey questions. All data were analyzed using JMP 16.0. Results In our cohort of 200 adults, the median age was 40, with an interquartile range of 34-50 years. 48% were female. More than half of the cohort (53%) had severe or higher-normal EDS. Race (p=0.112), sex (p=0.426), age (p=0.063) shift work/shift timing (p=0.260), and screen time before bed (p=0.785) were not statistically significant for excessive daytime sleepiness. However, the length of participants' workdays (p=0.001) and their income levels (p=0.008) were found to be significantly associated with EDS. In other words, longer workdays and lower income levels were associated with an increased likelihood of falling asleep during inactive periods of the day. Conclusion Sleep deprivation and excessive daytime sleepiness are intertwined with sleep hygiene. This study highlights some of the possible issues that could lead to potential solutions.
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Affiliation(s)
- Lindsey Yared
- Biology, Trinity Preparatory School, Winter Park, USA
| | | | - Rohan Mangal
- Medicine, University of Miami Miller School of Medicine, Miami, USA
| | - Thor S Stead
- Medicine, The Warren Alpert Medical School of Brown University, Providence, USA
| | - Latha Ganti
- Medical Sciences, The Warren Alpert Medical School of Brown University, Providence, USA
- Emergency Medicine and Neurology, University of Central Florida College of Medicine, Orlando, USA
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Shimamoto H, Suwa M, Adachi H, Adachi M, Mizuno K. Better Mental Health and Sleep under Behavioral Restrictions Due to COVID-19 in Japanese University Students: A Cross-Sectional Survey. Clocks Sleep 2023; 5:373-383. [PMID: 37489437 PMCID: PMC10366772 DOI: 10.3390/clockssleep5030028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 06/09/2023] [Accepted: 06/20/2023] [Indexed: 07/26/2023] Open
Abstract
Coronavirus disease (COVID-19) is a global pandemic, which is not only a severe public health issue but also significantly impacts the physical activity, sleep habits, and mental health of university students. Thus, we examined the association between behavioral restrictions due to COVID-19 and sleep patterns and mental health in first-year Japanese university students. Four hundred and twenty-two students (253 males and 169 females; age, 18.7 ± 1.0 years) participated in our questionnaire study. Under the behavioral restrictions due to COVID-19, 193 students (127 males and 66 females) responded to the questionnaire online from home. The participants did not visit the university during the survey period. The data acquired the year before the COVID-19 pandemic (2018 and 2019) were used as control data (126 males and 103 females). The questionnaire consisted of four sections: (1) demographic and lifestyle variables, (2) the Pittsburgh Sleep Quality Index, (3) the Japanese version of the Epworth Sleepiness Scale, and (4) the Patient Health Questionnaire-9. Our data revealed that self-restraint due to COVID-19 was associated with better sleep and mental health. In addition, mental health was independent of sleep, while sleep was related to mental health. These differences were more pronounced in male than in female students. This finding could be due to physical activity at night, part-time work, and long commuting times during the pre-pandemic period.
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Affiliation(s)
- Hideki Shimamoto
- Center for Education in Liberal Arts and Sciences, Osaka University, Toyonaka 560-0043, Japan
| | - Masataka Suwa
- Department of Food and Nutrition, Koriyama Women's University, Koriyama 963-8503, Japan
| | - Hiroyoshi Adachi
- Campus Life Health Support/Consultation Center, Osaka University, Toyonaka 560-0043, Japan
| | - Manabu Adachi
- Faculty of Human Health, Sonoda Women's University, Amagasaki 661-8520, Japan
| | - Koh Mizuno
- Faculty of Education, Tohoku Fukushi University, Sendai 981-8522, Japan
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Nabhan EM, Jaafar K, Daoud R, Nasser Z. Sleep Quality and Nicotine Dependence Among Lebanese University Residents and Fellows: A Cross-Sectional Study. Cureus 2023; 15:e42364. [PMID: 37621823 PMCID: PMC10445409 DOI: 10.7759/cureus.42364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 08/26/2023] Open
Abstract
Background and objectives Sleep quality and nicotine addiction are important public health issues with significant negative impacts on individual well-being and the performance of healthcare professionals. This study aims to determine the prevalence and association of nicotine dependence and poor sleep quality among residents and fellows enrolled in the Lebanese University. Methods A cross-sectional study using the snowball-sampling technique was conducted in Lebanon between January and March 2023. Data were collected through an online survey that included information on socio-demographic characteristics, nicotine dependence, and sleep quality. A total of 350 residents and fellows were included in the study. Bivariate analysis and multivariable logistic regression were carried out to identify the factors associated with sleep quality. Adjusted odds ratio and 95% confidence intervals were reported. Results One quarter (25.1%) of the residents and fellows were smokers; among them, 44.3% smoked I Quit Ordinary Smoking (IQOS), 14.8% smoked cigarettes, 10.2% smoked waterpipe (WP), 12.5% smoked cigarettes and WP, and 18.2% smoked IQOS and WP. According to the Pittsburgh Sleep Quality Index (PSQI), 34.3% of participants had poor sleep quality. Smokers had 12.5 times higher odds of experiencing poor sleep quality compared to non-smokers (adjusted odds ratio ORadj = 12.58 with 95% confidence interval [CI] of 7.07-22.36; p-value <0.001). In addition, smoking a combination of two types of tobacco products (cigarettes with WP or IQOS with WP) posed the highest risk of poor sleep quality, with an adjusted odds ratio of 31.54 (95% CI of 9.15-45.74, p-value <0.001). Elevated Fagerström Test for Nicotine Dependence (FTND) and Lebanon Waterpipe Dependence Scale (LWDS-11) scores indicated an increased risk of poor sleep quality (adjusted odds ratio ORadj = 4.69 with 95% CI of 2.179-10.10; p-value <0.001; and adjusted odds ratio ORadj =1.27 with 95% CI of 1.04-1.55; p-value 0.019, respectively). Conclusion Our study found a significant association between nicotine dependence and poor sleep quality among medical residents and fellows, with smokers being more susceptible to sleep disturbances. The high prevalence of IQOS smoking among medical residents and fellows in Lebanon highlights the urgent need for comprehensive research investigating the effects of heated tobacco products. Furthermore, our study reveals a critical insight into the potential additive effects of nicotine, suggesting that the concurrent use of multiple tobacco products may further elevate the risk of poor sleep quality. Recognizing the implications of our findings, it is imperative to develop targeted interventions and educational programs that promote healthier sleep habits and facilitate smoking cessation among medical residents and fellows.
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Affiliation(s)
- Elias M Nabhan
- Internal Medicine, Lebanese University Faculty of Medicine, Beirut, LBN
- Cardiology, University of Balamand, Beirut, LBN
| | - Kamel Jaafar
- Obstetrics and Gynaecology, Lebanese University Faculty of Medicine, Beirut, LBN
| | - Rama Daoud
- General Medicine, Lebanese University Faculty of Medicine, Beirut, LBN
| | - Zeina Nasser
- Faculty of Medical Sciences, Neuroscience Research Center (NRC), Lebanese University, Hadath, LBN
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Albinsaleh AA, Al Wael WM, Nouri MM, Alfayez AM, Alnasser MH, Alramadan MJ. Prevalence and Factors Associated With Poor Sleep Quality Among Visitors of Primary Healthcare Centers in Al-Ahsa, Kingdom of Saudi Arabia: An Analytical Cross-Sectional Study. Cureus 2023; 15:e42653. [PMID: 37644931 PMCID: PMC10461694 DOI: 10.7759/cureus.42653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2023] [Indexed: 08/31/2023] Open
Abstract
Introduction Poor sleep quality can predict poor health and is associated with mortality risk. Many factors are associated with sleep quality such as gender, health, education, socioeconomic status, and stress. The objective of this study was to estimate the magnitude of poor sleep quality among visitors of Primary Healthcare Centers (PHCCs) in Al-Ahsa and to identify factors associated with poor sleep quality. Methods This is an analytical cross-sectional study. A multistage cluster sampling technique was used to recruit 461 visitors to PHCCs in Al-Ahsa Governorate in the Eastern Province of Saudi Arabia. A structured questionnaire was administered through face-to-face interviews. The questionnaire includes demographics, a validated Arabic version of the Pittsburgh Sleep Quality Index (PSQI), the Arabic version of the International Physical Activity Questionnaire (IPAQ), the Arabic version of the Patient Health Questionnaire-2 (PHQ-2), the Arabic version of the Generalized Anxiety Disorder-2 (GAD-2), the Arabic version of Perceived Stress Scale-10 (PSS-10), and a translated Mobile Related Sleep Risk Factors (MRSRF). Univariate analysis was performed using the Mann-Whitney U test for continuous data, the chi-square test (χ²) or Fishers's exact test (as appropriate) for categorical data, and logistic regression for multivariable analysis. A P-value of less than or equal to 0.05 was considered significant. Results The study included 433 participants, with 72.5% of them being poor sleepers (PSQI global score of over 5). The highest percentage of poor sleepers was found among those aged 18 - 28 years (81.7%), with no significant difference between genders (p = 0.676). The study's multivariable logistic regression analysis revealed that poor sleep is associated with smoking four hours before bedtime (OR = 2.9, CI = 1.2 - 6.7), consuming caffeine (drinks or pills) three hours before sleep (OR = 2.3, CI = 1.23 - 4.12) or immediately before bedtime (OR = 3.2, CI = 1.02 - 9.9), using mobile phones right before bedtime (OR = 2.6, CI = 1.5 - 4.5), having anxiety (OR = 5.8, CI = 1.3 - 26.2), and depression symptoms (OR = 6.5, CI = 2.9 - 14.5), among other risk factors. Conclusion The prevalence of poor sleep quality in our sample was notably high at 72.5%. Many factors are strongly associated with poor sleep quality including experiencing symptoms of anxiety and depression. Longitudinal studies are needed to explore this crucial health issue further. Healthcare providers in Al-Ahsa should pay particular attention while assessing patients who suffer from sleep disturbance by screening them for depression and anxiety and raising public awareness of the importance of good quality sleep and the factors that affect it.
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