Objective: This study aimed to determine the prevalence of restless legs syndrome (RLS) in patients with multiple sclerosis (MS) and to evaluate its effect on sleep quality. Materials and Methods: This cross-sectional study was approved by the Ethics Committee of K & uuml;tahya Health Sciences University. A total of 151 patients with a confirmed diagnosis of MS were included. The Cambridge-Hopkins RLS Questionnaire, RLS Severity Scale, and Pittsburgh Sleep Quality Index (PSQI) were administered. Demographic, clinical, and radiological data were recorded. Patients were divided into two groups according to the presence of RLS, and appropriate parametric and non-parametric statistical tests were used for comparisons. Results: The mean age of the participants was 40.6 +/- 8.6 years, and 68.9% were female. The prevalence of RLS was 37.7%. Patients with RLS were older and had higher Expanded Disability Status Scale scores, a greater proportion of secondary progressive MS and primary progressive MS subtypes, and more frequent spinal lesions (p < 0.05). Poor sleep quality was observed in 63.2% of patients with RLS (p = 0.01). Logistic regression analysis showed that the presence of RLS increased the risk of PSQI by 3.37-fold (p = 0.006), and a family history of RLS was also an independent risk factor (p = 0.01). Conclusion: RLS is common among MS patients and is associated with PSQI. The presence of RLS, spinal lesions, higher disability levels, and older age negatively affect sleep quality. Early recognition and management of RLS in MS patients may improve sleep quality and overall quality of life.
Nocturnal hypoxemia is often attributed to obstructive sleep apnea syndrome (OSAS), but it may also reveal occult cardiopulmonary or thromboembolic disease. A 42-year-old woman with excessive daytime sleepiness and snoring underwent polysomnography, which showed mild OSAS. Despite her normal body mass index and absence of severe respiratory events she had nocturnal desaturation (mean SpO2 88%). V/Q scintigraphy detected subsegmental defects indicating pulmonary embolism, and echocardiography revealed mild pulmonary hypertension. Genetic analysis demonstrated homozygous MTHFR C677T and PAI-1 (4G/4G) mutations. Anticoagulation and vitamin supplementation were initiated, resulting in normalized imaging. Nocturnal hypoxemia may be associated with thrombotic activity, especially in the presence of hereditary thrombophilia.
Objective: This study aimed to compare the relationships between chronotype and nutrition attitudes, mood, and sleep quality among police officers and teachers with different work schedules. Materials and Methods: This cross-sectional, comparative study was conducted with 176 participants (104 teachers and 72 police officers). Participants completed an online survey including demographic data, dietary habits, the Attitude Scale for Healthy Nutrition, Morningness-Eveningness Questionnaire, Depression Anxiety Stress Scale, and Pittsburgh Sleep Quality Index. Results: Police officers' eating habits were more affected by their work schedule than those of teachers (p < 0.05). In terms of chronotype, the majority of police officers were intermediate types, while the majority of teachers were morning types (p < 0.05). Teachers reported better sleep quality than police officers, although the difference did not reach significance (p > 0.05). Evening- and intermediate-type participants had higher depression, anxiety, and stress scores than morning types (2- to 4-fold higher for teachers; 5- to 6-fold higher for police officers). In addition, it has been determined that sleep quality of evening-type police officers had approximately 2-fold poorer than morning-types. Conclusion: These findings suggest that, particularly among police officers working rotating shifts, intermediate and evening chronotypes may have a greater negative impact on mood and sleep quality.
Obstructive sleep apnea (OSA) syndrome is an increasingly prevalent sleep disorder characterized by recurrent upper airway obstructions and associated intermittent episodes of hypoxia. OSA is associated with cardiovascular, metabolic, and neurological morbidity. Recent evidence indicates that the oxidative stress and inflammation caused by intermittent hypoxia play a central role in the pathophysiological consequences of OSA. This review aims to summarize the mechanistic links between OSA and oxidative stress, biomarkers, clinical implications, and treatment approaches. Future research directions are also discussed in light of emerging data from human and animal studies.
Objective: Dance practice has been linked to eating disorders and sleep-related problems. This study examined the associations between self-perceived sleep quality, healthy eating, and emotional eating among dance students. Materials and Methods: The sample consisted of 114 participants. The instruments used were the Pittsburgh Sleep Quality Index, the composite scale of morningness, the Healthy Eating Index (HEI) for the Spanish population, and the eating and appraisal due to emotions and stress questionnaire. Results: Overall, 80.7% of students reported poor sleep quality, and 72.8% required dietary changes to improve their diet. Participants with poor sleep quality showed significantly higher scores on the emotional eating scale-both total and subscale scores-than those with good sleep quality. Sleep disturbances, daytime dysfunction due to poor sleep, and the presence of nightmares were all associated with emotional eating. Although the number of hours slept was not related to emotional eating, it was associated with healthy eating. No significant differences in the HEI were found based on subjective sleep quality. Finally, students with a morning chronotype exhibited better diet quality than those with an evening chronotype. Conclusion: These findings are discussed in the context of promoting conservatories as potential healthy environments.
Objective: Sleep disorders and insomnia are major health problems that significantly impact mental health, quality of life, and risky behaviors such as self-harm in adolescents. This study aimed to investigate sleep quality, insomnia severity, and demographic and clinical factors affecting sleep quality among adolescents in Kerman, Iran. Materials and Methods: In 2023, 80 adolescents aged 12—20 years with self-harming behaviors were recruited from the psychiatry and counseling centers of Kerman University of Medical Sciences. Data were collected using the Pittsburgh Sleep Quality Index and Insomnia Severity Index questionnaires, structured interviews, and self-report questionnaires. The questionnaires were scored using standardized rules, and various statistical tests were used in the analysis. Results: The mean age of the participants was 16.36, and 56.2% were male. Poor sleep quality was detected in 96.25% of adolescents. Insomnia severity was determined as mild (13.75%), moderate (23.75%), severe (40%), and very severe (22.5%). A significant negative correlation was found between age and insomnia severity, with poorer sleep quality in males. Insomnia severity was higher in those with higher education levels and sleep quality was significantly lower in those with chronic illnesses. Associations were also found between a history of hospitalization and substance abuse. Conclusion: In conclusion, factors such as age, gender, education, chronic illness, and harmful behaviors were shown to play significant roles in sleep quality and insomnia severity in adolescents. The importance of multidimensional interventions (cognitive-behavioral therapy for insomnia, stress management, and sleep hygiene education) is emphasized.
Objective: This study aims to examine the sleep habits of children living in Northern Cyprus and to identify socio-demographic factors that influence these habits. Materials and Methods: Designed as a cross-sectional, descriptive, and comparative study, the research was conducted between September 1, 2023, and April 1, 2024, in a pediatric outpatient clinic. A total of 182 children aged 5-15 and their parents participated. Ethics committee approval and written informed consent were obtained. Data were collected using a Personal Information Form and the Children's Sleep Habits Questionnaire (CSHQ), which demonstrated high internal consistency (Cronbach's alpha = 0.812). Results: Findings revealed that 24.7% of the children had clinically significant sleep problems. A statistically significant difference was found between gender and total CSHQ scores (p < 0.05), with boys scoring higher than girls. However, no significant differences were observed based on age or educational level (p > 0.05). When comparing total and subscale scores based on the presence of clinical sleep problems, all subscales except bedwetting showed statistically significant differences (p < 0.05). These subscales included difficulty waking in the morning, parasomnias related to sleep disruption, morning wake-up behavior, sleep onset delay, sleep duration, need to sleep with others, daytime sleepiness, sleep anxiety, sleep-disordered breathing, and other parasomnias. Conclusion: The findings highlight that sleep problems are prevalent among children and are associated with specific behavioral and demographic factors. Early identification and intervention for childhood sleep issues may contribute positively to children's overall development and well-being.
Objective: Sleep disturbances are a common symptom among patients with multiple sclerosis (MS). The Pittsburgh Sleep Quality Index (PSQI) is a reliable and practical tool for assessing sleep quality. The present study examined the association between sleep quality and clinical and radiologic characteristics in individuals with MS. Materials and Methods: In this retrospective study, 137 patients with MS (PwMS) were included following stringent clinical, radiologic, and psychiatric exclusion criteria. Demographic, clinical, cognitive, and neuroimaging data were extracted from medical records. Sleep quality was assessed using the PSQI, with a global score >= 5 indicating poor sleep quality. Results: Among the 137 PwMS, no significant differences were observed in demographic, clinical, cognitive, or radiologic parameters between those with good and poor sleep quality. However, walking speed was significantly slower in poor sleepers (p = 0.005). Sleep onset latency and subjective sleep quality were strongly correlated with overall PSQI scores. In contrast, lesion location, corpus callosum index, and measures of brainstem or spinal cord atrophy showed no association with sleep quality. Conclusion: Sleep quality is adversely affected in PwMS and correlates with lower-limb physical performance. Patients' self-assessments of sleep quality appear consistent. Prolonged sleep onset latency is an important factor, while the effects of sleep duration and disturbance are less significant.
Objective: Sleep disturbances frequently affect older adults and are linked to geriatric issues such as frailty, cognitive decline, and depression. This study assessed the psychometric properties and diagnostic value of the Turkish version of the Jenkins Sleep Evaluation Scale (JSS-TR) in individuals aged 65 years and above. Materials and Methods: One hundred thirty-two community-dwelling older adults completed the JSS-TR along with the Pittsburgh Sleep Quality Index (PSQI), the Basic Scale on Insomnia Complaints and Quality of Sleep, and a comprehensive geriatric assessment. Analyses included internal consistency, test-retest reliability, correlation with related measures, group comparisons, and receiver operating characteristic (ROC) curve analysis to identify the most appropriate cut-off score for poor sleep quality. Results: The median participant age was 80 years (interquartile range: 9.75). The JSS-TR demonstrated good internal consistency (Cronbach's alpha: 0.68) and excellent stability over time (intraclass correlation coefficients: 0.92). It showed a moderate correlation with PSQI scores (r = 0.62, p < 0.001). ROC analysis indicated an optimal cutoff of >= 15, yielding 54% sensitivity and 87% specificity. Higher JSS-TR scores were significantly associated with frailty and history of falls (p < 0.05), supporting predictive validity. Conclusion: The JSS-TR is a reliable and valid instrument for detecting poor sleep quality among older adults. A population-specific cut-off score of >= 15 improves diagnostic precision in this group.
Objective: Poor sleep quality is common among young adults, and there are many modifiable factors associated with it. The aim of this study is to evaluate the relationship between sleep quality, obesity, the MEDFICTS (meats, eggs, dairy, fried foods, in baked goods, convenience foods, table fats, and snacks) diet, and social media addiction in young adults. Materials and Methods: This descriptive cross-sectional study was conducted with 200 young adults aged 18-25. The study data were collected using the Pittsburgh Sleep Quality Index (PSQI), the MEDFICTS diet assessment questionnaire, and the social media addiction scale (SMAS). A PSQI score of >5 was interpreted as poor sleep quality, while a score of <= 5 was considered good sleep quality. Results: Seventy percent of the young adults participating in the study had poor sleep quality. According to the results of simple linear regression analysis, body mass index (13 = 0.095, p = 0.031), the MEDFICTS diet score (13 = 0.076, p = 0.000), and the SMAS score (13 = 0.076, p = 0.000) were found to have a statistically significant and positive effect on the PSQI score. In the results of multiple linear regression analysis, the MEDFICTS diet score (13 = 0.070, p = 0.000) and SMAS score (13 = 0.053, p = 0.000) were also observed to have a statistically significant and positive effect on the PSQI score. Conclusion: This study demonstrates that obesity, the MEDFICTS diet, and social media addiction are associated with poor sleep quality. Considering the close relationship between sleep and overall health, public health initiatives are needed to reduce obesity and social media use among young adults and to promote healthy eating habits.
Prader-Willi syndrome (PWS) is a rare genetic disorder that is frequently associated with sleep-disordered breathing, particularly obstructive sleep apnea syndrome (OSAS). We present a case series of five Turkish children with PWS who underwent overnight polysomnography. OSAS was identified in three patients (60%), one of whom had severe disease. Ear, nose, and throat evaluations revealed adenoid hypertrophy in two patients and tonsillar hypertrophy in one child. These findings suggest that OSAS is clinically relevant in PWS, and underscore the importance of routine polysomnographic assessment before and during growth hormone therapy.
The primary objective of this study was to analyze self-reported sleep perception in relation to psychological inflexibility traits in adults. A total of 705 adults (65.2% women) participated, with a mean age of 27.21 years standard deviation = 10.67. The instruments used were the and the Acceptance and Action Questionnaire. Results showed that participants with high psychological inflexibility had a significantly greater risk of reporting poor sleep quality [odds ratio (OR) = 2.632] and identifying with an evening chronotype (OR = 2.825) than those with lower inflexibility scores. Higher inflexibility scores were positively associated with sleep disturbances, daily dysfunction due to poor sleep quality, use of sleep medication, and other sleep-related issues. Targeting behaviors associated with psychological inflexibility could help improve sleep-related outcomes.
Objective: In this study, the prevalence of insomnia and the effects of factors such as depression, anxiety, and fatigue on sleep and quality of life in patients with relapsing-remitting multiple sclerosis (RRMS) were investigated. Materials and Methods: One hundred and five RRMS patients and 105 healthy control groups were examined. Insomnia, depression, anxiety, sleep and life qualities and fatigue were evaluated with scales. Results: The insomnia prevalence was higher in MS patients than in the control group (31.7% vs. 17.1%, p = 0.014). Fatigue, anxiety and depression levels increased in MS patients, and sleep and life qualities were significantly impaired (p < 0.001). Fatigue, anxiety and depression levels were higher in female patients than in males, while quality of life was lower (p < 0.001). It has shown an increasing effect on depression and anxiety levels, insomnia and deterioration in sleep quality. Conclusion: Factors that adversely affect sleep and quality of life, especially depression, anxiety and fatigue, should be carefully evaluated in RRMS patients. This emphasizes the importance of individual approaches in clinical management.
Objective: Insomnia is a common psychiatric condition characterized by persistent difficulties falling or staying asleep despite having adequate opportunities and conditions. Seven core parameters, as measured by the Insomnia Severity Index, determine the risk of insomnia. A cubic polynomial regression model was developed based on the baseline parameters to forecast insomnia severity. Materials and Methods: The model incorporates quadratic and cubic terms to enhance accuracy by capturing nonlinear dependencies between variables. Least squares regression and ridge regularization improve stability and avoid overfitting. Results: The model’s performance was evaluated using mean squared error (MSE) and coefficient of determination R-squared (R2), achieving an accuracy that effectively represents trends in insomnia severity. The results indicate that the cubic polynomial model significantly enhances prediction reliability, reducing the MSE value from simpler polynomial approaches to 0.0018 and increasing the R2 value to 0.98. Conclusion: The performance results demonstrate that the model's prediction of insomnia severity largely aligns with the actual observation data. This demonstrates that the model can accurately analyze sleep disorders and make dependable predictions. These findings suggest that advanced polynomial regression may be a valuable tool in sleep analysis, enabling the prediction of insomnia severity.
Objective: Restless legs syndrome (RLS) is a prevalent neurological disorder characterized by an irresistible urge to move the legs. Mostly, the condition is associated with other health problems such as sleep disorders or any other health problems, thus making it an underdiagnosed condition among general population in a developing country like Pakistan including its local regions. Materials and Methods: The study consisted of 350 participants from different regions of Quetta to evaluate the prevalence of RLS in the region. To achieve the desired aim, a well-designed questionnaire was made using Google Form which was distributed through different social media platforms from March 2023 to October 2023. The international diagnostic criteria for diagnosis of RLS was used. Results: The prevalence of RLS among 350 individuals was calculated to be 43 (12.1%). According to the Epworth Sleepiness Scale, 20 (46.5%) of the 43 participants with an RLS diagnosis had severe sleepiness, followed by moderate (23.3%), very severe (20.9%), and mild (9.3%). Age, gender, sleeping difficulties, and other health conditions were not substantially correlated with RLS (p > 0.05), however smoking was (p = 0.036). Neither the severity of RLS nor the degree of sleepiness were significantly correlated with gender (p = 0.683 and p = 0.858, respectively). Conclusion: The RLS prevalence found in our study was less than that of another prevalence study in Pakistan. To have a better understanding of the variables of RLS in distinct populations, it is imperative that additional prevalence studies be conducted in various regions of the country.
Objective: Quality sleep, which plays an important role in the physical, cognitive, immunological, and psychosocial functions of patients, is imperative, especially for patients hospitalised in intensive care units (ICU) to recover from their critical illnesses. The aim of this study was to investigate the effect of earplugs (EP) and eye mask (EM) on sleep quality in ICU patients. Materials and Methods: The sample of the study consisted of 120 patients hospitalised in the general ICU of Siirt State Hospital between July 2021-May 2022. Patients were divided into four groups as EP, EM, EP + EM and control group. Each patient in the related group wore EP, EM, and EP in combination with EM between 22:00-06:00 and was allowed to sleep in this way. Data were collected using the "patient description form" and "Richards Campbell Sleep Questionnaire (RCSQ)". Results: According to that the dependent samples t-test performed for intragroup comparison, there was a statistically significant increase between pretest and post-test RCSQ mean scores of the patients in the EP, EM, and EP + EM groups (tEP=7,899, tEM=17,268, tEP + EM=9,381, p<0.001); whereas, there was no significant difference between pretest and post-test RCSQ mean scores of the patients in the control group (tC=1,084, p>0.05). Also, the first three factors that negatively affected the sleep quality of ICU patients were noise (71.6%), light (60.8%) and nursing interventions (49.1%). Conclusion: The application of EM only was found to be the most effective nursing practice in enhancing the sleep quality of patients hospitalised in the ICU.
Objective: The aim of this study was to evaluate sleep quality in nurses and to investigate the relationship between poor sleep quality and occupational accidents. Materials and Methods: This cross-sectional study was conducted with nurses (n=164) who had been working in different clinics of a university hospital for at least one year and who had not previously been diagnosed with sleep disorders and who agreed to participate in the research. In the data collection form, sociodemographic characteristics, medical history, information about sleep and working conditions, and hospital employee health and safety unit records were questioned. Pittsburgh Sleep Quality Index was used to evaluate sleep quality. Results: It was found that 77.4% of nurses had poor sleep quality. It was determined that 66.9% of nurses with poor sleep quality and 45.9% of nurses with good sleep quality worked day and night in shifts. It was observed that 38% of the nurses who participated in the study had an occupational accident in the last year, and it was found that all occupational accidents occurred in the group with impaired sleep quality and a significant difference was found between the two groups in terms of the frequency of occupational accidents. Conclusion: It was found that nurses had poor sleep quality. Individuals with impaired sleep quality have a high frequency of working alternating day and night shifts and continuous night shifts.
