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PubMedDate not supplied

[Colombian validation of the Pittsburgh Sleep Quality Index].

INTRODUCTION: Many studies establish an elevated frequency of sleep disorders. The prevalence during life is of 35%. This situation has lead to develop a great number of instruments with the intention to evaluate better these alterations. Nevertheless, the majority lacks a suitable and national validation. Buysse et al designed the Pittsburgh Sleep Quality Index (PSQI) considered the most able instrument to establish the quality of the sleep. This has been used and validated widely. Nor it exists a version validated to the Castilian for Colombia, nor similar instruments that allow making studies in sleep. AIM: Validation of the Pittsburg Sleep Quality Index in Colombia (ICSP-VC). SUBJECTS AND METHODS: Experts consensus for face validity, pilots studies for evaluating understanding of the questionnaire, with double interview method. Evaluation of internal consistency. RESULTS. Internal consistency was Cronbach's alpha = 0.78. There were different scores between subjects that mentioned some subjective sleep disturbance (U Mann Whitney z = -5.635, p = 0.000), between them that qualify as 'so bad' or not their sleep quality (U Mann Whitney z = -2.90, p = 0.0037), between they that were consuming or not, habitually hypnotics (U Mann Whitney z = -4.289, p = 0.0000) and between they that referred conciliation insomnia or not (U Mann Whitney z = -4.769, p = 0.0000). There were clinical differences in ICSP-VC scores between adult older and younger (U Mann Whitney z = -1.926, p = 0.0542). There were not differences by gender. Subjects with extreme values scores had clinical differences with others. CONCLUSIONS: ICSP-VC is a valid version of PQSI useful for studying sleep disorders.

Adult↗

PubMed2005

Sleep quality deteriorates over a binge--abstinence cycle in chronic smoked cocaine users.

RATIONALE: In cocaine dependent individuals, changes in subjective and objective sleep quality accompany their characteristic binge-abstinence cycle. Preliminary studies suggest that sleep quality may decline with prolonged abstinence. Reported here are results of the most extensive study to date on sleep abnormalities during cocaine binge and confirmed abstinence under controlled conditions. OBJECTIVES: The purpose of the current study was to use an experimental, inpatient model of the cocaine binge and abstinence cycle to examine the course and magnitude of sleep disturbances during cocaine use and abstinence. METHODS: Five inpatient non-treatment seeking cocaine users completed 3 baseline days of drug abstinence followed by 3 days of medically monitored "binge" cocaine use, and then 15 days of drug abstinence. Physiological sleep was recorded with polysomnography and the Nightcap ambulatory monitor, while subjective sleep was assessed by questionnaire. RESULTS: Across 3 days of binge cocaine use and 15 subsequent days of confirmed drug abstinence, mean sleep duration, efficiency and latency changed in the direction of poorer sleep quality. In contrast, subjective reports of sleep quality remained unchanged across the same period. CONCLUSIONS: Physiological sleep quality deteriorated from days when cocaine was used across the first 2 weeks of confirmed drug abstinence. In contrast, subjective reports of sleep quality remained unchanged across the same period. We postulate that this dissociation between objective and subjective sleep quality results from a cocaine-use related disruption of the sleep homeostat. Worsening sleep quality during cocaine abstinence may contribute to the risk of relapse and its treatment may offer novel therapeutic strategies for cocaine dependence.

Adult↗

PubMed2004

Determinants of sleep quality in the healthy aged: the role of physical, psychological, circadian and naturalistic light variables.

Ageing is associated with a decrease in the quality of night-time sleep with 30% of aged persons experiencing chronic insomnia. Treatment of insomnia typically involves the use of hypnotic medications and these have been associated with a range of negative outcomes in this population cohort. The development of age-related insomnia has been linked, in part, to changes in the strength of the circadian regulation of sleep, these changes typically leading to increased fragmentation of the sleep-wake cycle. Management of insomnia may therefore be linked to strengthening of these regulatory control mechanisms. Previous research has indicated that both daily activity levels and ambient light exposure may act as zeitgebers to consolidate sleep-wakefulness cycles. The current study utilised a naturalistic design to explore the relationship between light, activity and night-time sleep quality amongst a sample of 33 healthy aged subjects. Findings demonstrated a significant positive relationship between activity and sleep quality. Ambient light was also shown to have a significant impact on night-time sleep though the study identified a critical exposure threshold of 3000 lux. Factor analysis demonstrated the independent contribution of these two variables to subsequent sleep quality. The findings of the current study identify the potential for the development of non-pharmacological treatment strategies for insomnia in aged people.

Aged↗

PubMed2006

Impairments in health functioning and sleep quality in older adults with a history of depression.

OBJECTIVES: To determine whether older adults with a history of depression show impairments in health functioning and sleep quality at a gradient between older adults with no history of depression and those with current major depression and to examine whether poor sleep quality contributes to declines in health functioning in addition to the contribution of depressive symptoms. DESIGN: Cross-sectional. SETTING: Three urban communities: Denver, Colorado, and Los Angeles and San Diego, California. PARTICIPANTS: Two hundred community-dwelling adults aged 60 and older who were never mentally ill, 143 with a history of major or minor depressive disorder in remission, and 67 with a current depressive disorder. MEASUREMENTS: Diagnosis, Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; health functioning (Medical Outcomes Study 36-item Short-Form Health Survey); depressive symptom severity (Beck Depression Inventory); and sleep quality (Pittsburgh Sleep Quality Index). RESULTS: Older adults with a history of depression showed impairments in sleep quality and had lower levels of health functioning than controls; these impairments were at a gradient with declines in those with current depression. Poor sleep quality was independently associated with declines in health perception in older adults with and without depression. CONCLUSION: These findings have important health implications for older people who have a lifetime history of depression, given evidence that poor health functioning is a risk factor for depression recurrence as well as mortality. Moreover, in view of the association between sleep quality and health status, testing of interventions that target sleep quality might identify strategies to improve health functioning in older adults.

Aged↗

PubMedDate not supplied

Correlates of sleep quality in persons with HIV disease.

This study used the Symptom Experience dimension of the revised UCSF Symptom Management Conceptual model to examine correlates of sleep quality in HIV-infected persons. According to this model, person, health/illness, and environment categories influence perception of a symptom. The average person in the sample (N = 58) reported being HIV-infected for 8.5 years and was 46 years old, not working, and a person of color. Depending on the level of data, either chi square or Pearson correlations were computed between the person, health/illness, and environment categories and the dependent variable, sleep quality, as measured by the Pittsburgh Sleep Quality Index. Person variables significantly related to sleep quality were employment status, trait anxiety, and general well-being. Health/illness variables significantly related to sleep quality were length of time living with HIV disease and five health status measures (depressive symptoms, state anxiety, symptom severity, daytime sleepiness, and functional status). The environmental variables associated with sleep quality were sleeping alone, having a separate bedroom, and sleeping in a noisy room. Correlates of better sleep quality are positive general well-being, less anxious personality trait and emotional state, less daytime sleepiness, less depressive symptoms, and less symptom severity. Correlates of worse sleep quality are impaired functional status and longer duration of living with HIV disease.

Adult↗

PubMed2004

Sleep quality and blood pressure dipping in normal adults.

OBJECTIVES: To investigate the relationship between sleep quality and nocturnal blood pressure dipping in normal subjects. We hypothesized that sleep quality correlates with dipping. DESIGN: Cross-sectional study. SETTING: Unattended polysomnography in the home followed by a 24-hour ambulatory blood pressure measurement. PATIENTS: Eighty-eight self-described normal subjects were evaluated; 26 were excluded due to an apnea-hypopnea index > or = 10. None were taking antihypertensive medications. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: Subjects were divided into dippers and nondippers based on > or = 10% drop in nocturnal mean arterial pressure (MAP). Sleep-quality variables included total sleep time; sleep latency; percentage of stages 1, 2, 3, 4, and rapid-eye-movement sleep; percentage of wake time after sleep onset (WASO); total arousal index; and sleep efficiency. Of the remaining 62 subjects, 17.7% were nondippers, and 7 were hypertensive. There was no difference in age, body mass index, apnea-hypopnea index, blood pressure, or sleep quality between groups. Stage 4 sleep correlated significantly with dipping of diastolic blood pressure and MAP (r = 0.410 and 0.378, respectively, P < or = .002), and percentage of WASO was negatively correlated with dipping of diastolic blood pressure (r = -0.360, P = .004), suggesting that greater dipping was associated with better sleep quality. On multivariate analyses, Stage 4 sleep was independently associated with dipping of diastolic blood pressure (P = .034) after adjusting for screening MAP, percentage of WASO, total arousal index, and Stage 1 sleep. The same link was found between Stage 4 sleep and dipping of MAP (P = .05) after adjusting for screening MAP, age, sex, and body mass index. Repeat analyses excluding hypertensives yielded similar findings. CONCLUSION: Our data suggest that deeper and less-fragmented sleep is associated with more blood pressure dipping in normal subjects.

Adult↗

PubMed2004

Sleep hygiene and sleep quality in Italian and American adolescents.

This study investigated cross-cultural differences in adolescent sleep hygiene and sleep quality. Participants were 1348 students (655 males; 693 females) aged 12-17 years from public school systems in Rome, Italy (n = 776) and Southern Mississippi (n = 572). Participants completed the Adolescent Sleep-Wake Scale and the Adolescent Sleep Hygiene Scale. Reported sleep hygiene and sleep quality were significantly better for Italian than American adolescents. A moderate linear relationship was observed between sleep hygiene and sleep quality in both samples (Italians: R =.40; Americans: R =.46). Separate hierarchical multiple regression analyses showed that sleep hygiene accounted for significant variance in sleep quality, even after controlling for demographic and health variables (Italians: R(2) =.38; Americans: R(2) =.44). The results of this study suggest that there are cultural differences in sleep quality and sleep hygiene practices, and that sleep hygiene practices are importantly related to adolescent sleep quality.

Activities of Daily Living↗

PubMedDate not supplied

Comparison of subjective sleep quality in patients with cancer and healthy subjects.

PURPOSE/OBJECTIVES: To compare the subjective sleep quality of a group of patients with cancer undergoing treatment and a normative sample of healthy comparison subjects. DESIGN: Secondary analysis of data from a single time point in a repeated measures descriptive-correlational study. SAMPLE/SETTING: Convenience sample of 15 patients with cancer receiving antineoplastic therapy and admitted to a tertiary university medical center for fever or neutropenia and 52 healthy comparison subjects without sleep disturbances. Although both groups were of similar age, a higher percentage of men comprised the comparison group. METHODS: Patients completed the Pittsburgh Sleep Quality Index (PSQI) on the first day of hospitalization to reflect their perceptions of sleep for the month prior to hospitalization. Healthy comparison subject scores on the PSQI were obtained from a published report outlining psychometric properties of the PSQI (Buysse, Reynolds, Monk, Berman, & Kupfer, 1989). MAIN RESEARCH VARIABLES: Sleep latency, sleep duration, sleep efficiency, sleep disturbances, medication use, daytime dysfunction, and global sleep quality. FINDINGS: Patients with cancer reported significantly poorer overall sleep quality accompanied by more daytime dysfunction. The incidence of specific sleep disturbances, such as snoring and dyspnea, was not different between the groups. CONCLUSIONS: This small sample of patients reported significantly poorer sleep quality than an historical comparison group. Specific sleep disturbances commonly seen in the general population were not problematic for the patients with cancer. Limited sample size and use of an historical comparison group need to be considered in interpreting and applying these findings. Additional research is needed to further characterize the nature of sleep problems in patients with cancer. IMPLICATIONS FOR NURSING PRACTICE: Nurses need to assess sleep in their patients, including its impact on quality of life and functional status.

Adult↗

PubMed2005

Partial sleep deprivation therapy combined with sertraline affects subjective sleep quality in major depressive disorder.

BACKGROUND AND PURPOSE: Earlier studies have shown an association between mood disorders and sleep regulation. Total or partial sleep deprivation was demonstrated to have rapid antidepressive effects in depression. Depressive symptoms recur after one night of recovery sleep, but relapse is less when patients are receiving medication. In this study, we examined the subjective sleep quality changes with the antidepressive therapy using partial sleep deprivation plus sertraline and sertraline monotherapy in patients with major depressive disorder. PATIENTS AND METHODS: Thirteen patients received six partial sleep deprivation therapies in addition to sertraline; the sleep schedule on deprivation nights started at 11:00 p.m. and ended at 3:00 a.m. Eleven patients were treated with sertraline monotherapy as a control group. Six nights of partial sleep deprivation were completed in the first two weeks. Subjective sleep quality was evaluated with the Pittsburgh Sleep Quality Index (PSQI); depression and the accompanying anxiety were also assessed at baseline and at the end of the fourth week. RESULTS: The late partial sleep deprivation (LPSD) group showed less increase in estimated sleep duration and less significant improvement in subjective sleep quality than the control group. Although decreased sleep latency and increased sleep efficiency are associated with the sleep deprivation, contrary results were found in our study. CONCLUSIONS: In conclusion, changes in subjective sleep quality could occur relative to the combined partial sleep deprivation therapy and to pharmacotherapy and must be differentiated from the rapid effects of sleep deprivation therapy and objective polysomnographic measures.

Adult↗

PubMed2002

Self-reported sleep quality, strain and health in relation to perceived working conditions in females.

Self-reported sleep quality, strain and health in relation to perceived working conditions in females The aims of this study were to examine self-reported sleep quality, perceived strain and health in relation to working conditions; the prevalence and severity of sleep disturbances and daytime distress arising from poor sleep in women on different work shifts. Furthermore, to see whether females with gastrointestinal symptoms, joint-, back- or muscle-pain and who are dissatisfied with working hours differ with regard to the above aspects. Finally, degree of strain-related symptoms and sleep difficulties were tested as predictors of sleep quality and general health outcome. Important research questions are whether registered nurses and those on rotating work shifts have greater sleep problems than others. A total of 156 females, aged 20-59 years, working at three different casualty departments, answered structured questionnaires. The results showed a persistently high rate of psycho-physiological long-term effects of stress related to working conditions. Thirty-four per cent were dissatisfied with their working hours, and exhibited significantly more mental strain, fatigue/excessive tiredness and inability to relax after work because of involuntary thoughts, in relation to working conditions than others did. Sixty-two females (39.7%) complained of insufficient sleep. The sleep quality outcome was significantly predicted by difficulty falling asleep (odds ratio 8.4), difficulty in falling asleep after nocturnal awakening (odds ratio 3.4) and perceived exhaustion (odds ratio 2.6). Females suffering from gastrointestinal symptoms and joint-, back- and muscle symptoms for several days in a week or even everyday were especially sensitive to worse sleep quality. Independent of work shifts, registered nurses exhibited a higher degree of mental strain and prolonged recovery in comparison with others. In conclusions, sleep initiation difficulties, troubled sleep and exhaustion significantly predicted reduced sleep quality outcome with decreased resilience to stress and vulnerability to psycho-physiological disorders in females working within the health care system.

Adult↗

PubMedDate not supplied

[Studies on sleep quality in old age].

A survey of 480 randomly chosen men and women over 65 years of age observed complaints concerning the quality of sleep in 26%, the use of sleeping drugs in 33%; complaints and/or drugs were found in 45% of cases. On the average complaints were more often made by women. The percentage of men complaining increased from 65 to 90+ years. In the group over 90 years of age both sexes showed the same frequency. The quality of sleep was correlated with self-rated health-status, mobility and impairment especially of the cardiovascular system. No correlations were found with contentment, place of residence, noise, outdoor exercise and socioeconome status. Sleeping drugs were most effective in subjects with cerebral impairment and of least effect when subjects suffered from cardiovascular trouble.

Age Factors↗

PubMed2006

Sleep in overweight adolescents: shorter sleep, poorer sleep quality, sleepiness, and sleep-disordered breathing.

OBJECTIVE: To document the sleep of overweight adolescents and to explore the degree to which weight-related sleep pathology might account for diminished psychosocial outcome. METHODS: Sixty children aged 10-16.9 from a weight-management clinic were compared to 22 healthy controls using comprehensive actigraphic, polysomnographic, and parent- and self-report questionnaire assessments. RESULTS: Overweight participants averaged more symptoms of sleep-disordered breathing, later sleep onset, shorter sleep time, and more disrupted sleep than controls. Although the groups did not differ in self-reported sleep habits, multiple concerns were reported by parents of overweight participants, including daytime sleepiness, parasomnias, and inadequate sleep. Group differences in academic grades and depressive symptoms were at least partially accounted for by short sleep and daytime sleepiness. CONCLUSIONS: Excessive weight is associated with an increased risk of sleep problems. There is a need for further research in this area and for clinicians who work with overweight children to evaluate their sleep.

Adolescent↗

PubMed1998

Time of day effects in, and the relationship between, sleep quality and movement.

The study aimed to measure the effects of a 27-h 'day' sleep-wake regime on actigraphic and subjective sleep variables, and to examine the relationships between these variables. Nine subjects spent 30 days and nights in the laboratory. After sleeping 8 h for each of 8 nights, the subjects had an imposed 27-h 'day', for 18 'days', remaining in bed for 9 h on each sleep period. Sleep periods therefore started 3 h later each day, although subjects' circadian rhythms stayed entrained to 24 h, because subjects were not isolated from the natural light-dark cycle. Time asleep, subjective sleep efficiency and subjective sleep quality, but not movement during sleep, were found to be significantly affected by time of going to bed. There were significant decreases in movement during recovery sleeps following each of two episodes of 26 h sleep deprivation. Over the study there were significant within-subject correlations between subjective sleep quality and subjective sleep efficiency (rav = 0.65), movement during sleep and subjective sleep efficiency (rav = -0.48), and movement during sleep and subjective sleep quality (rav = -0.26). We conclude that sleep movement, despite its low within- and between-subjects variability, is nevertheless a statistically reliable, but weak, indicator of subjective sleep efficiency and quality.

Adult↗

PubMed2005

Hormone therapy and sleep quality in women around menopause.

OBJECTIVE: To obtain data on sleep quality in women attending menopause clinics in Italy. DESIGN: A cross-sectional study was conducted on the sleep quality of postmenopausal women attending a network of first-level outpatient menopause clinics in Italy for general counseling about menopause or treatment of its symptoms. Eligible for the study were women observed consecutively during the study period with natural or spontaneous menopause. All participating centers enrolled women into the study who had never used hormone therapy (HT) (group 1, 819 women), current users of transdermal estrogens with or without progestins (group 2, 819 women), and current users of oral estrogens with or without progestins (group 3, 790 women). The women were asked about their quality of sleep using the Basic Nordic Sleep Questionnaire, their quality of life using the Short Form-12 questionnaire, and the intensity of hot flushes using a visual analogue scale. RESULTS: Women in groups 2 and 3 tended to report difficulties in sleeping less often than those in group 1. For example, never users of HT more frequently reported sleeping poorly and needed more time to sleep or had problems falling asleep; these differences were significant (P < 0.05). Otherwise, no difference emerged from the Basic Nordic Sleep Questionnaire between women in groups 2 and 3. CONCLUSIONS: This study gives support to the suggestion that HT improves the quality of sleep. The effect was similar in women taking oral or transdermal therapy with or without progestins.

Cross-Sectional Studies↗

PubMedDate not supplied

Subjective sleep quality and suicidality in patients with major depression.

The purpose of this study was to examine the association between sleep quality and suicidality in major depressive disorder. We evaluated 41 patients with major depression by using the Pittsburgh Sleep Quality Index (PSQI) and the Schedule for Affective Disorders and Schizophrenia (SADS) suicide subscale. We found that suicidal depressive patients had significantly higher scores of subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency and PSQI global scores than nonsuicidal patients. We also found significant correlations between the SADS suicide subscale scores and most measures of the PSQI. These data suggest that there is an association between poor subjective sleep quality and suicidal behavior in patients with major depressive disorder.

Adult↗

PubMed2003

Impact and correlates of poor sleep quality in Japanese white-collar employees.

STUDY OBJECTIVES: This study estimated the prevalence, examined associated impacts, and identified correlated factors of poor sleep quality among Japanese white-collar employees who were working in a labor market that included extensive downsizing and restructuring. DESIGN: A cross-sectional self-administered questionnaire survey was conducted as part of 2 consecutive studies on sleep. Sleep quality was measured with the Pittsburgh Sleep Quality Index. SETTING: A telecommunications company in the Tokyo metropolitan area. PARTICIPANTS: Of 5,924 workers, 5,090 responded (85.9%). Results from 4,868 daytime employees were analyzed. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: The 1-month point prevalence of poor sleep quality was approximately 30% to 45% across age and gender and was significantly higher than in the general population of Japanese adults. The overall prevalence of absenteeism, poor physical and psychological health, problems in work performance and personal relationships, and accidents were 16.5%, 18.3%, 17.3%, 2.5%, 2.1%, and 1.8%, respectively. Poor sleepers were more likely to take sick leave, suffer from poor physical and psychological health, and have problems in occupational activities and personal relationships. The most strongly associated factor underlying poor sleep quality was perceived stress, followed by job dissatisfaction, being unmarried, poor bedroom environment, lower academic attainment, younger age, and hypertension. CONCLUSIONS: This study suggests that the cost related to poor sleep quality is extremely high. Comprehensive countermeasures against poor sleep quality at not only the individual, but also the organizational and societal levels, need to be considered for both employees and employers in order that health, safety, and productivity are ensured.

Adult↗

PubMed2005

Effect of esomeprazole on nighttime heartburn and sleep quality in patients with GERD: a randomized, placebo-controlled trial.

OBJECTIVES: Sleep disturbances are common in patients with gastroesophageal reflux disease (GERD). This study examined the effects of esomeprazole on nighttime heartburn, GERD-related sleep disturbances, sleep quality, work productivity, and regular activities. METHODS: This multicenter, randomized, double-blind, placebo-controlled trial included adults with GERD-associated sleep disturbances and moderate-to-severe nighttime heartburn (recorded by patient diary during screening). Patients received oral esomeprazole 40 mg (n = 220) or 20 mg (n = 226) or placebo (n = 229) once daily for 4 wk. The primary outcome was relief of nighttime heartburn. Secondary outcomes included resolution of sleep disturbances, sleep quality measured by the Pittsburgh Sleep Quality Index (PSQI) questionnaire, and work productivity measured by the Work Productivity and Activity Impairment Questionnaire. RESULTS: Nighttime heartburn was relieved in 53.1% (111/209), 50.5% (111/220), and 12.7% (28/221) of patients who received esomeprazole 40 mg, esomeprazole 20 mg, and placebo, respectively. Differences (95% CI) versus placebo were 40.5% (32.4%, 48.5%) and 37.8% (29.9%, 45.7%) and were highly significant (p < 0.0001). GERD-related sleep disturbances resolved in significantly more (p < 0.0001) patients who received esomeprazole 40 (73.7%) or 20 mg (73.2%) than in those who received placebo (41.2%). Both esomeprazole groups had greater PSQI global score changes from baseline (p < 0.0001 vs placebo) and more (p < 0.0001 vs placebo) work hours saved per week per patient compared with baseline (esomeprazole 40 mg, 11.6 h; esomeprazole 20 mg, 12.3 h; placebo, 6.2 h). CONCLUSIONS: Esomeprazole reduced nighttime heartburn and GERD-related sleep disturbances and improved sleep quality and work productivity.

Administration, Oral↗

PubMed2005

[Auto sleep staging and sleep quality estimation based on BP neural network].

To estimate the sleep quality, a 3-layer BP neural network was studied. The EEG complexity and the power spectrum of sleep-multigraph served as the input vector of the network . All-night sleep-stage scoring was performed. Then several parameters (sleep period, shallow sleep period, deep sleep period, REM period, ratio of the wakeful period and sleep one) were defined to estimate the sleep quality. The experiments revealed that the estimated sleep condition was the same as the subjects' impression. The data on six cases of all-night sleep show that this method is available to estimate the sleep quality.

Electroencephalography↗