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Huang CJ, Hsu NW, Chen HC. Prevalence, dimensions, and correlates of excessive daytime sleepiness in community-dwelling older adults: the Yilan study, Taiwan. Ann Med 2024; 56:2352028. [PMID: 38803075 PMCID: PMC11136468 DOI: 10.1080/07853890.2024.2352028] [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: 01/15/2024] [Accepted: 04/22/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Daytime sleepiness is an important health problem. However, the dimensionality of the Epworth Sleepiness Scale (ESS) in older adults remains unclear. This study aimed to determine the prevalence of ESS-defined excessive daytime sleepiness in older adults. Furthermore, the dimensionality of ESS and its respective correlates were also compared. MATERIALS AND METHODS This is a community-based survey in which community-dwelling older adults aged ≥ 65 years participated. Excessive daytime sleepiness was assessed using the ESS and was defined as an ESS score of > 10. Exploratory factor analysis was performed to identify the ESS factors. Multiple logistic regression analysis was used to examine the independent correlates of the ESS-defined and factor-specific correlates of excessive daytime sleepiness. RESULTS In total, 3978 older adults participated in this study. The mean age was 76.6 ± 6.7 years, with 53.8% ≥ 75 years, and 57.1% were female. The prevalence of ESS-defined excessive daytime sleepiness was 16.0%. An exploratory factor analysis revealed two factors in the ESS, which were designated as 'passive' and 'active' according to the soporific levels of ESS items loaded in each factor. Multiple logistic regression showed that male, illiteracy, depression, disability, short sleep duration and no exposure to hypnotics were risk indicators for ESS-defined excessive daytime sleepiness. However, the correlates for passive and active factor-defined excessive daytime sleepiness differ in pattern, especially in variables related to education, exercise, mental health, and sleep. CONCLUSIONS The prevalence of ESS-defined excessive daytime sleepiness is high, and its correlates vary among older adults. This study also suggests a dual ESS structure in community-dwelling older adults.
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Affiliation(s)
- Chiu-Jui Huang
- Department of Medical Education, National Taiwan University Hospital, Taiwan
| | - Nai-Wei Hsu
- Division of Cardiology, Department of Internal Medicine & Community Medicine Center, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Public Health Bureau, Yilan County, Taiwan
| | - Hsi-Chung Chen
- Department of Psychiatry & Center of Sleep Disorders, National Taiwan University Hospital, Taipei, Taiwan
- School of Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
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Chen C, Hsu NW, Chen HC. The differential pattern of associations between nighttime sleep disturbances with dimensions of daytime sleepiness in community-dwelling older adults, the Yilan study, Taiwan. Psychogeriatrics 2024; 24:212-222. [PMID: 38111149 DOI: 10.1111/psyg.13063] [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: 11/13/2023] [Accepted: 12/04/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND The association between nighttime sleep disturbance and daytime sleepiness remains unclear. This study aimed to examine the relationships between various domains of nighttime sleep disturbance, daytime sleepiness, and their specific dimensions. METHODS This was a community-based cross-sectional study. The participants were adults aged 65 years and older from Yilan City, Taiwan. Daytime sleepiness (DS) was defined using the Epworth Sleepiness Scale (ESS) with scores ≥ 11. The ESS dimensions were further examined using exploratory factor analysis. The highest 15% factor scores for each factor were defined as factor-specific DS. Various domains of nighttime sleep disturbance were assessed using the Pittsburgh Sleep Quality Index. Logistic regression analysis was used to examine the independent relationships among various nighttime sleep disturbances, ESS, and its dimensions. RESULTS Of the 2585 participants, a total of 59.0% were women. Two factors were identified by exploratory factor analysis and were designated as 'passive factor' and 'active factor'. Multiple logistic regression analyses elucidated that short sleep duration was a common risk indicator for ESS-defined (odds ratio (OR): 2.01; 95% confidence interval (CI): 1.43-2.83), passive factor-defined (OR: 2.23, 95% CI: 1.65-3.00), and active factor-defined DS (OR: 1.47, 95% CI: 1.07-2.00). Hypnotic use was associated with a lower risk of both ESS-defined (OR: 0.66, 95% CI: 0.47-0.92) and passive factor-defined DS (OR:0.69, 95% CI: 0.52-0.92). Bathroom use (OR: 1.41, 95% CI: 1.04-1.91), coughing or snoring (OR: 2.14, 95% CI: 1.01-4.56), and sleep efficiency (OR: 0.42; 95% CI: 0.31-0.57) were uniquely associated with active factor-defined DS. CONCLUSION Two factors were identified in the ESS, revealing factor-specific correlates of DS. Specifically, ESS- and passive factor-defined DS shared similar correlates. In contrast, some correlates seem unique to active-factor-defined DS.
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Affiliation(s)
- Ching Chen
- Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan
| | - Nai-Wei Hsu
- Division of Cardiology, Department of Internal Medicine & Community Medicine Center, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Public Health Bureau, Yilan, Taiwan
| | - Hsi-Chung Chen
- Department of Psychiatry & Center of Sleep Disorders, National Taiwan University Hospital, Taipei, Taiwan
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Hertenstein E, Trinca E, Schneider CL, Fehér KD, Johann AF, Nissen C. Acceptance and Commitment Therapy, Combined with Bedtime Restriction, versus Cognitive Behavioral Therapy for Insomnia: A Randomized Controlled Pilot Trial. PSYCHOTHERAPY AND PSYCHOSOMATICS 2024; 93:114-128. [PMID: 38417415 DOI: 10.1159/000535834] [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: 10/02/2023] [Accepted: 12/08/2023] [Indexed: 03/01/2024]
Abstract
INTRODUCTION Cognitive behavioral therapy for insomnia (CBT-I) is the current first-line treatment for insomnia. However, rates of nonresponse and nonremission are high and effects on quality of life are only small to moderate, indicating a need for novel treatment developments. We propose that Acceptance and Commitment Therapy (ACT) addresses core pathophysiological pathways of insomnia. ACT therefore has the potential to improve treatment efficacy when combined with bedtime restriction, the most effective component of CBT-I. The aim of this study was to compare the efficacy of ACT for insomnia combined with bedtime restriction (ACT-I) and CBT-I in improving insomnia severity and sleep-related quality of life. METHODS Sixty-three patients with insomnia disorder (mean age 52 years, 65% female, 35% male) were randomly assigned to receive either ACT-I or CBT-I in a group format. The primary outcomes were insomnia severity (Insomnia Severity Index) and sleep-related quality of life (Glasgow Sleep Impact Index). Outcomes were assessed before randomization (T0), directly after treatment (T1), and at 6-month follow-up (T2). RESULTS The results indicated significant, large pre-to-post improvements in both groups, for both primary and secondary outcomes. Improvements were maintained at the 6-month follow-up. However, there was no significant group by time interactions in linear mixed models, indicating an absence of differential efficacy. On a subjective treatment satisfaction scale, patients in the ACT-I group indicated significantly greater satisfaction with their improvement of several aspects of health including their energy level and work productivity. CONCLUSIONS The results suggest that ACT-I is feasible and effective, but not more effective than CBT-I for the improvement of insomnia severity and sleep-related quality of life. Future studies are needed to assess whether ACT-I is noninferior to CBT-I and to shed light on mechanisms of change in both treatments.
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Affiliation(s)
- Elisabeth Hertenstein
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Ersilia Trinca
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Carlotta L Schneider
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Kristoffer D Fehér
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Anna F Johann
- Clinic for Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christoph Nissen
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Division of Psychiatric Specialties, Department of Psychiatry, Geneva University Hospitals (HUG), Geneva, Switzerland
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Paschke K, Diestelkamp S, Zapf A, Busch K, Arnaud N, Prehn-Kristensen A, Reis O, Stark M, Cloes JO, Schulz AL, Brauer H, Krömer T, Thomasius R. An app-based training for adolescents with problematic digital-media use and their parents (Res@t digital): protocol for a cluster-randomized clinical trial. Front Psychiatry 2024; 14:1245536. [PMID: 38328520 PMCID: PMC10847547 DOI: 10.3389/fpsyt.2023.1245536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 12/29/2023] [Indexed: 02/09/2024] Open
Abstract
Background Digital media-use disorders (DMUD) in adolescents are a rising phenomenon associated with psychological distress, comorbid mental disorders, and high burden on affected families. Since the ICD-11 introduced criteria for gaming disorder, these can now be transferred to describe additional DMUD associated with social media platforms and streaming services. Most evidence for effective treatments comes from cognitive-behavioral therapy (CBT). However, interventions based on theoretical models for adolescents and their parents are widely missing, leading to a significant clinical gap. Methods Res@t digital (Resource-Strengthening Training for Adolescents with Problematic Digital-Media Use and their Parents) is the app-based translation of the first model-based digital intervention for adolescents with DMUD and their parents based on CBT. It comprises separate but content-related modules for adolescents (Res@t-A) and parents (Res@t-P), applying multimodal techniques. The effectiveness of Res@t will be evaluated within a multicenter cluster-randomized controlled evaluator-blinded pre-post follow-up trial with the waitlist control group (CG). In addition to the Res@t program in the intervention group, both groups will receive treatment as usual within primary child and adolescent psychiatric/psychotherapeutic healthcare. The primary outcome addresses DMUD symptom reduction after 10 weeks. Secondary outcomes are related to a reduction in psychological and family-related problems and an increase in parental self-efficacy. All outcomes will be assessed using standardized self-report measures. A total of 1,334 participating adolescent-parent dyads from a large clinical network throughout Germany are planned to be included in the primary analyses based on an intention-to-treat approach, applying linear mixed models. Discussion Assuming superiority of Res@t over the control condition, the intervention has the potential to provide evidence-based treatment for a significant number of help-seeking families, supporting local healthcare structures and resources. It is a promising program for practicable implementation and flexible use in different settings. Clinical trial registration https://drks.de, DRKS00031043.
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Affiliation(s)
- Kerstin Paschke
- German Center for Addiction Research in Childhood and Adolescence (DZSKJ), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Silke Diestelkamp
- German Center for Addiction Research in Childhood and Adolescence (DZSKJ), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Antonia Zapf
- Institute of Medical Biometry and Epidemiology (IMBE), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Katharina Busch
- German Center for Addiction Research in Childhood and Adolescence (DZSKJ), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Nicolas Arnaud
- German Center for Addiction Research in Childhood and Adolescence (DZSKJ), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Alexander Prehn-Kristensen
- Institute of Child and Adolescent Psychiatry, Center for Integrative Psychiatry, School of Medicine, Christian-Albrecht University Kiel, Kiel, Germany
| | - Olaf Reis
- Department for Child and Adolescent Psychiatry and Neurology, Rostock University Medical Center, Rostock, Germany
| | - Maria Stark
- Institute of Medical Biometry and Epidemiology (IMBE), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Jan-Ole Cloes
- German Center for Addiction Research in Childhood and Adolescence (DZSKJ), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Anna-Lena Schulz
- German Center for Addiction Research in Childhood and Adolescence (DZSKJ), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Hannah Brauer
- Institute of Child and Adolescent Psychiatry, Center for Integrative Psychiatry, School of Medicine, Christian-Albrecht University Kiel, Kiel, Germany
| | - Thomas Krömer
- Collaborative Practice for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Hamburg, Germany
| | - Rainer Thomasius
- German Center for Addiction Research in Childhood and Adolescence (DZSKJ), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Fernandes GL, Tufik S, Andersen ML. Emergence of different dimensions of sleepiness in a general population sample: An EPISONO study. Sleep Med 2023; 112:46-52. [PMID: 37806035 DOI: 10.1016/j.sleep.2023.09.023] [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: 06/21/2023] [Revised: 09/16/2023] [Accepted: 09/23/2023] [Indexed: 10/10/2023]
Abstract
INTRODUCTION Recent evidence supports the idea that sleepiness has several dimensions, comprising psychophysiological phenomena, such as sleep propensity and sleepiness perception. The Epworth Sleepiness Scale (ESS) is among one of the most used sleepiness assessment tools, but recent data suggest that it might not detect problematic impairments in sleep health. More research is warranted investigating sleepiness dimensions with large sample sizes, using both objective and subjective methods of analyzing sleep. METHODS We used data from the Epidemiological Sleep Study (EPISONO), a major study carried out in Brazil using a representative sample of 1042 participants of the general population of Sao Paulo city, who completed questionnaires and underwent type I polysomnography. Sleepiness was measured by the ESS (sleep propensity) and the UNIFESP Sleep Questionnaire, which asked about the frequency of feeling sleepy during the day (sleepiness perception). The participants were distributed into 4 groups in respect of excessive daytime sleepiness (EDS) according to the following criteria: 1) having an ESS score >10 (ESS group). 2) feeling sleepy ≥3 times per week (Frequent EDS group). 3) the combined criteria (Combined EDS group). 4) having no evidence of EDS (no EDS group). The UNIFESP Sleep Questionnaire was used to obtain self-reported sleep duration, sleep debt, and sleep duration variability. Participants also completed the Pittsburgh Sleep Quality Index, the Insomnia Severity Index, and a pre-polysomnography sleep questionnaire. RESULTS After removing participants with missing data, there were 620 participants with no EDS, 255 individuals in the ESS group, 68 in the Frequent EDS group, and 73 in the Combined EDS group. Compared to the no EDS group, the ESS and Combined EDS groups had significantly increased sleep efficiency, diminished sleep latency, wake after sleep onset, and self-reported weekly sleep duration. The Frequent and Combined EDS groups had significantly higher scores in the Insomnia Severity Index and Pittsburgh Sleep Quality Index. All EDS groups had an increased likelihood of nonrestorative sleep. EDS frequency and the ESS scores were significantly correlated. CONCLUSIONS Participants with a high sleep propensity had a profile suggesting prior sleep deprivation, while high sleepiness perception was associated with impaired sleep quality. These findings indicated that, in the general population, these instruments evaluated separate sleepiness dimensions with different associations, highlighting that screening using a combination of instruments might be more effective in detecting impairments in sleep health.
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Affiliation(s)
- Guilherme Luiz Fernandes
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, São Paulo, 04024-002, Brazil
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, São Paulo, 04024-002, Brazil; Sleep Institute, São Paulo, Brazil
| | - Monica Levy Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, São Paulo, 04024-002, Brazil; Sleep Institute, São Paulo, Brazil.
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Bellofatto M, Gentile L, Bertini A, Tramacere I, Manganelli F, Fabrizi GM, Schenone A, Santoro L, Cavallaro T, Grandis M, Previtali SC, Scarlato M, Allegri I, Padua L, Pazzaglia C, Villani F, Cavalca E, Saveri P, Quattrone A, Valentino P, Tozza S, Russo M, Mazzeo A, Vita G, Piacentini S, Didato G, Pisciotta C, Pareyson D. Daytime sleepiness and sleep quality in Charcot-Marie-Tooth disease. J Neurol 2023; 270:5561-5568. [PMID: 37540277 PMCID: PMC10576706 DOI: 10.1007/s00415-023-11911-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/05/2023] [Accepted: 07/28/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND Sleep abnormalities have been reported in Charcot-Marie-Tooth disease (CMT), but data are scanty. We investigated their presence and correlation in a large CMT patients' series. METHODS Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI) were administered to CMT patients of the Italian registry and controls. ESS score > 10 indicated abnormal daytime somnolence, PSQI score > 5 bad sleep quality. We analyzed correlation with disease severity and characteristics, Hospital Anxiety and Depression Scale (HADS), Modified Fatigue Impact Scale (MFIS), Body Mass Index, drug use. RESULTS ESS and PSQI questionnaires were filled by 257 and 253 CMT patients, respectively, and 58 controls. Median PSQI score was higher in CMT patients than controls (6 vs 4, p = 0.006), with no difference for ESS score. Abnormal somnolence and poor sleep quality occurred in 23% and 56% of patients; such patients had more frequently anxiety/depression, abnormal fatigue, and positive sensory symptoms than those with normal ESS/PSQI. Moreover, patients with PSQI score > 5 had more severe disease (median CMT Examination Score, CMTES, 8 vs 6, p = 0.006) and more frequent use of anxiolytic/antidepressant drugs (29% vs 7%, p < 0.001). CONCLUSIONS Bad sleep quality and daytime sleepiness are frequent in CMT and correlated with anxiety, depression and fatigue, confirming that different components affect sleep. Sleep disorders, such as sleep apnea and restless leg syndrome, not specifically investigated here, are other factors known to impact on sleep quality and somnolence. CMT patients' management must include sleep behavior assessment and evaluation of its correlated factors, including general distress and fatigue.
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Affiliation(s)
- Marta Bellofatto
- SC Malattie Neurologiche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
| | - Luca Gentile
- Unità di Neurologia e Malattie Neuromuscolari, Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, 98124, Messina, Italy
| | - Alessandro Bertini
- SC Malattie Neurologiche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
| | - Irene Tramacere
- Dipartimento Gestionale di Ricerca e Sviluppo Clinico, Direzione Scientifica, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133, Milan, Italy
| | - Fiore Manganelli
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, Università Federico II di Napoli, 80131, Naples, Italy
| | - Gian Maria Fabrizi
- Dipartimento di Neuroscienze, Biomedicina e Movimento, Università di Verona, 37126, Verona, Italy
| | - Angelo Schenone
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili, Università di Genova, 16132, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy
| | - Lucio Santoro
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, Università Federico II di Napoli, 80131, Naples, Italy
| | - Tiziana Cavallaro
- Dipartimento di Neuroscienze, Biomedicina e Movimento, Università di Verona, 37126, Verona, Italy
| | - Marina Grandis
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili, Università di Genova, 16132, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy
| | - Stefano C Previtali
- INSPE and Division of Neuroscience, IRCCS Ospedale San Raffaele, 20132, Milan, Italy
| | - Marina Scarlato
- INSPE and Division of Neuroscience, IRCCS Ospedale San Raffaele, 20132, Milan, Italy
| | | | - Luca Padua
- Università Cattolica del Sacro Cuore, 00168, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy
| | - Costanza Pazzaglia
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy
| | - Flavio Villani
- Unità di U.O. Neurofisiopatologia, IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy
| | - Eleonora Cavalca
- SC Malattie Neurologiche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
| | - Paola Saveri
- SC Malattie Neurologiche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
| | - Aldo Quattrone
- Dipartimento di Scienze Mediche, Università Magna Grecia, 88100, Catanzaro, Italy
| | - Paola Valentino
- Dipartimento di Scienze Mediche, Università Magna Grecia, 88100, Catanzaro, Italy
| | - Stefano Tozza
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, Università Federico II di Napoli, 80131, Naples, Italy
| | - Massimo Russo
- Unità di Neurologia e Malattie Neuromuscolari, Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, 98124, Messina, Italy
| | - Anna Mazzeo
- Unità di Neurologia e Malattie Neuromuscolari, Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, 98124, Messina, Italy
| | - Giuseppe Vita
- Unità di Neurologia e Malattie Neuromuscolari, Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, 98124, Messina, Italy
| | - Sylvie Piacentini
- Unità di Neuropsicologia, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta di Milano, 20133, Milan, Italy
| | - Giuseppe Didato
- Unità di Epilettologia Clinica e Sperimentale, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133, Milan, Italy
| | - Chiara Pisciotta
- SC Malattie Neurologiche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
| | - Davide Pareyson
- SC Malattie Neurologiche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy.
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Campelo CL, Batista RFL, Silveira VNDC, Figueiredo KNDRS, Machado PMA, Borgatto AF, dos Santos AM. Assessment of the Brazilian Version of the Epworth Sleepiness Scale Using Item Response Theory: A Psychometric Study. Clocks Sleep 2023; 5:581-589. [PMID: 37873839 PMCID: PMC10594512 DOI: 10.3390/clockssleep5040038] [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: 07/22/2023] [Revised: 08/30/2023] [Accepted: 09/11/2023] [Indexed: 10/25/2023] Open
Abstract
There seems to be a consensus that adolescents worldwide are not getting enough sleep. This study aimed to evaluate the psychometric properties of the Epworth Sleepiness Scale (ESS) in adolescents using the item response theory. A psychometric study was conducted with 2206 adolescents aged 18 and 19 years in the city of São Luís, Maranhão, Brazil. The dimensionality of the ESS was assessed by principal component analysis. A Samejima's graded response model (SGRM) was fitted to it. The findings of this study showed a good internal consistency and the unidimensionality of the ESS. Considering the latent trait continuum, we obtained three levels, with anchor items. For the item 'Sitting still in a public place', the adolescents presented a small possibility of dozing in level 1, and a medium and great possibility in level 2. The item 'Sitting around talking to someone' presented small, medium, and great possibilities of dozing in level 3. The ESS with five items showed satisfactory psychometric properties. In addition, the results from the SGRM showed that adolescents with high levels of sleepiness are likely to nod off or sleep sitting up while talking to someone. This study allows us to understand excessive daytime sleepiness in adolescents.
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Affiliation(s)
- Cleber Lopes Campelo
- Department of Public Health, Postgraduate Program in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (R.F.L.B.); (V.N.d.C.S.); (K.N.d.R.S.F.); (A.M.d.S.)
- Higher School of Health Sciences, State University of Amazonas, Manaus 69065-001, AM, Brazil
| | - Rosângela Fernandes Lucena Batista
- Department of Public Health, Postgraduate Program in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (R.F.L.B.); (V.N.d.C.S.); (K.N.d.R.S.F.); (A.M.d.S.)
| | - Victor Nogueira da Cruz Silveira
- Department of Public Health, Postgraduate Program in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (R.F.L.B.); (V.N.d.C.S.); (K.N.d.R.S.F.); (A.M.d.S.)
| | - Kely Nayara dos Reis Silva Figueiredo
- Department of Public Health, Postgraduate Program in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (R.F.L.B.); (V.N.d.C.S.); (K.N.d.R.S.F.); (A.M.d.S.)
| | - Patrícia Maria Abreu Machado
- Department of Medicine I, Directorate of Technologies in Education, Federal University of Maranhão, São Luís 65020-240, MA, Brazil;
| | - Adriano Ferreti Borgatto
- Department of IT and Statistics, Postgraduate Program in Physical Education, Federal University of Santa Catarina, Florianópolis 88040-970, SC, Brazil;
| | - Alcione Miranda dos Santos
- Department of Public Health, Postgraduate Program in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (R.F.L.B.); (V.N.d.C.S.); (K.N.d.R.S.F.); (A.M.d.S.)
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Gonçalves MT, Malafaia S, Moutinho Dos Santos J, Roth T, Marques DR. Epworth sleepiness scale: A meta-analytic study on the internal consistency. Sleep Med 2023; 109:261-269. [PMID: 37487279 DOI: 10.1016/j.sleep.2023.07.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 07/26/2023]
Abstract
OBJECTIVE/BACKGROUND The Epworth Sleepiness Scale (ESS) is one of the most used self-reported instruments to assess sleepiness. Thus, several adaptations into different Languages have been performed worldwide over the years. The scale has produced disparate psychometric properties when applied in different settings. In the current study, our aim was to perform a Reliability Generalization meta-analysis of the Cronbach᾽s alphas of all published studies on ESS, specifically with a psychometric focus. PATIENTS/METHODS Three reference databases (Scopus, PubMed and Web of Science) were searched since 1991 to October 2022 and all the records on psychometric or validation studies that reported Cronbach's alphas, from clinical and nonclinical groups, were included. In total, data from 46 publications (63 estimates) were extracted, comprising 92,503 participants. RESULTS Using a Random-Effects Model, the cumulative Cronbach's alpha for the 63 estimates was about 0.82 (CI: 0.798, 0.832) which can be considered as a good measure. However, and as expected, it was observed a high level of heterogeneity (I2 = 98.96%). Moderation analyses considering setting, date, continent, risk of bias, sex, age and language were performed in order to account for the heterogeneity. Even so, only the variables study setting and continent were significant, and had little importance in explaining the heterogeneity. CONCLUSIONS The ESS is a reliable tool to measure sleepiness; however, further studies are needed to investigate what variables might explain the observed variability. Moreover, it will be important to include empirical studies beyond psychometric ones.
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Affiliation(s)
- Maria Teresa Gonçalves
- University of Aveiro, Department of Education and Psychology, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal
| | - Simone Malafaia
- University of Aveiro, Department of Education and Psychology, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal
| | | | - Thomas Roth
- Sleep Disorders and Research Center, Henry Ford Hospital, Detroit, MI, USA
| | - Daniel Ruivo Marques
- University of Aveiro, Department of Education and Psychology, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal; CINEICC - Centre for Research in Neuropsychology and Cognitive Behavioural Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal.
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Berge AHZ, Kellmann M, Loch F, Ferrauti A, Meyer T, Pfeiffer M, Jakowski S. Validierung des Fragebogens zum Schlafverhalten von Sportlerinnen und Sportlern (FSVS). ZEITSCHRIFT FUR SPORTPSYCHOLOGIE 2022. [DOI: 10.1026/1612-5010/a000367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Zusammenfassung. Der Athlete Sleep Behavior Questionnaire ist ein englischsprachiger Fragebogen zur Erhebung des individuellen Schlafverhaltens von Sportler_innen. Ziel dieser Studie war die Übersetzung des Athlete Sleep Behavior Questionnaire ins Deutsche sowie die wissenschaftliche Validierung dieser deutschen 18-Item-Version, dem Fragebogen zum Schlafverhalten von Sportlerinnen und Sportlern (FSVS). Die Validierungsstichprobe umfasste 450 Teilnehmende. Mittels eines dichotomen Items zur regelmäßigen Wettkampfteilnahme (ja/nein) wurde in Wettkampfsportler_innen ( n = 209) und Kontrollgruppe ( n = 241) unterteilt. Cronbach-α des FSVS-Gesamtwerts ergab .66. Die Pearson-Produkt-Moment-Korrelationsanalysen ergaben moderate Korrelationen zwischen FSVS-Gesamtwert, der Epworth-Sleepiness-Scale ( r = .33) und dem Pittsburgh-Sleep-Quality-Index ( r = .30). Es wurden signifikante Gruppenunterschiede für den FSVS-Gesamtwert gefunden, t(448) = 4.47, p < .001, d = 0.42, bei deskriptiv höheren Werten der Gruppe der Wettkampfsportler_innen. In einer separaten Stichprobe, die 13 Ruderer_innen der deutschen Junioren-Nationalmannschaft umfasste, wurden die Fragebogenwerte anschließend mit objektiven Schlafparametern korreliert. Dabei ließ sich eine hohe Korrelation zwischen FSVS-Gesamtwert und Einschlaflatenz ( rs = .68, p = .011) erkennen. Zusammenfassend ist der FSVS ein schnelles und valides Werkzeug, um dysfunktionale Schlafverhaltensweisen bei Wettkampfsportler_innen zu identifizieren. In Anlehnung an die Originalversion wird die Ableitung von Interventionen anhand einzelner Items empfohlen.
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Affiliation(s)
| | - Michael Kellmann
- Fakultät für Sportwissenschaft, Ruhr-Universität Bochum, Deutschland
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Fabian Loch
- Fakultät für Sportwissenschaft, Ruhr-Universität Bochum, Deutschland
| | | | - Tim Meyer
- Institut für Sport und Präventivmedizin, Universität des Saarlandes, Deutschland
| | - Mark Pfeiffer
- Institut für Sportwissenschaft, Johannes-Gutenberg-Universität Mainz, Deutschland
| | - Sarah Jakowski
- Fakultät für Sportwissenschaft, Ruhr-Universität Bochum, Deutschland
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10
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Faulkner KM, Jurgens CY, Denfeld QE, Chien CV, Thompson JH, Gelow JM, Grady KL, Lee CS. Patterns and predictors of dyspnoea following left ventricular assist device implantation. Eur J Cardiovasc Nurs 2022; 21:724-731. [PMID: 35138359 PMCID: PMC9564114 DOI: 10.1093/eurjcn/zvac007] [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: 06/28/2021] [Revised: 11/30/2021] [Accepted: 01/24/2022] [Indexed: 11/14/2022]
Abstract
AIMS Dyspnoea is a common symptom of heart failure (HF) that often prompts patients to seek treatment. Implantation of a left ventricular assist device (LVAD) has been associated with reduced dyspnoea but it is unclear if all patients experience similar improvements in dyspnoea over time following LVAD implantation. Our aim was to identify distinct trajectories of dyspnoea symptoms over time following LVAD implantation and predictors of dyspnoea trajectory. We hypothesized that at least two, distinct trajectories of dyspnoea would be observed following LVAD implantation. METHODS AND RESULTS This was a secondary analysis of data from the Profiling Biobehavioral Responses to Mechanical Support in Advanced Heart Failure study. In the parent study, sociodemographic and clinical data were collected prior to LVAD implantation and at 1, 3, and 6 months following LVAD implantation from a sample (n = 101) of patients with advanced HF. Latent growth mixture modelling was performed to identify distinct trajectories of dyspnoea symptoms. Backwards stepwise logistic regression was used to identify predictors of dyspnoea trajectory. Two, distinct trajectories of dyspnoea symptoms were identified: sustained improvement and unsustained improvement. Participants who experienced sustained improvement (86.7% of sample) demonstrated large, significant improvement in dyspnoea from pre-implantation to 3 months post-implant followed by smaller, non-significant improvement from 3 to 6 months. Participants who experienced unsustained improvement (13.3% of sample) demonstrated initial improvement from pre-implantation to 3 months post-implantation followed by worsening of dyspnoea from 3 to 6 months. Greater depressive symptoms at baseline and living alone were significant predictors of unsustained improvement. CONCLUSION Patients experience different patterns of dyspnoea over time following LVAD implantation. Clinicians should inquire about living arrangements and depressive symptoms at each visit to determine risk of unsustained improvement in dyspnoea.
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Affiliation(s)
- Kenneth M Faulkner
- Corresponding author. Tel: +1 631 444 3006, ; Present address. Stony Brook University School of Nursing, 101 Nicolls Road, Health Sciences Center Level 2, Stony Brook, NY 11794, USA
| | - Corrine Y Jurgens
- William F. Connell School of Nursing, Boston College, 140 Commonwealth Avenue, Maloney Hall, Chestnut Hill, MA 02467, USA
| | - Quin E Denfeld
- Oregon Health & Science University School of Nursing, 3455 SW U.S. Veterans Hospital Road, Mailcode: SN-ORD, Portland, OR 97239, USA
| | - Christopher V Chien
- University of North Carolina REX Healthcare, 2800 Blue Ridge Road, Suite 204, Raleigh, NC 27607, USA
| | - Jessica Harman Thompson
- William F. Connell School of Nursing, Boston College, 140 Commonwealth Avenue, Maloney Hall, Chestnut Hill, MA 02467, USA,University of Kentucky College of Nursing, 751 Rose Street, Lexington, KY 40536-0232, USA
| | - Jill M Gelow
- Providence Health, 9427 Southwest Barnes Road, Suite 599, Portland, OR 97225, USA
| | - Kathleen L Grady
- Northwestern University, 675 North Saint Clair Street, Arkes Pavilion, Suite 730, Chicago, IL 60611-3056, USA
| | - Christopher S Lee
- William F. Connell School of Nursing, Boston College, 140 Commonwealth Avenue, Maloney Hall, Chestnut Hill, MA 02467, USA
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11
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Current Management of Residual Excessive Daytime Sleepiness Due to Obstructive Sleep Apnea: Insights for Optimizing Patient Outcomes. Neurol Ther 2021; 10:651-672. [PMID: 34658002 PMCID: PMC8520824 DOI: 10.1007/s40120-021-00289-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 10/01/2021] [Indexed: 02/04/2023] Open
Abstract
Although excessive daytime sleepiness (EDS) attributable to obstructive sleep apnea (OSA) can be resolved by consistent usage of and effective treatment (often with the use of continuous positive airway pressure therapy), 12–58% of patients report residual EDS (REDS). While REDS is difficult to treat, a proportion of cases are possibly due to reversible issues, and wake-promoting medications can prove useful for the remaining cases. Given the challenges associated with effective management of REDS and its relationship to multiple comorbidities, multidisciplinary management of patients with REDS is often recommended. Here we aim to bridge the knowledge gap on the burden, risk factors, prevalence, and potential pathophysiologic mechanisms of REDS in patients with OSA after first-line treatment. The roles of primary care physicians and sleep specialists, as well as the importance of the use of objective assessment tools for the evaluation of REDS and the effective management of comorbidities, are discussed. An update of approved treatments and emerging candidate treatments is also presented.
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12
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Nature-Based Therapies for Sleep Disorders in People Living with Human Immunodeficiency Virus. Nurs Clin North Am 2021; 56:189-202. [PMID: 34023115 DOI: 10.1016/j.cnur.2021.02.002] [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: 11/23/2022]
Abstract
Following diagnosis of human immunodeficiency virus (HIV), getting adequate sleep may be the farthest thing from the mind of patients or providers. Even further from mind are the potential benefits on both sleep and HIV from nature-based therapy. In developing and developed countries, access to high-quality natural spaces has the potential to support physical and mental health. This article provides a review of sleep disorders, conventional and nature-based therapies, and the potential of nature-based therapy to support the health of people living with HIV through increased restorative sleep and immune function.
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13
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Sap-Anan N, Pascoe M, Wang L, Grigg-Damberger MM, Andrews ND, Foldvary-Schaefer N. The Epworth Sleepiness Scale in epilepsy: Internal consistency and disease-related associations. Epilepsy Behav 2021; 121:108099. [PMID: 34102473 DOI: 10.1016/j.yebeh.2021.108099] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/24/2021] [Accepted: 05/24/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Epworth Sleepiness Scale (ESS) is the most common instrument for measuring subjective sleep propensity in people with epilepsy but has not yet been validated in this population. STUDY OBJECTIVES We aimed to systematically assess the validity, performance, and internal consistency of the ESS, as well as correlations between the ESS and disease-specific variables and patient-reported outcome measures in a cohort of adults with epilepsy (AWE). METHODS Ninety-five AWE completed sleep and seizure diaries, in-laboratory polysomnography (PSG) and patient-reported outcome measures, including the ESS, Insomnia Severity Index (ISI), and the Beck Depression Inventory (BDI). Demographic information and data from 95 matched controls referred for PSG for suspected obstructive sleep apnea (OSA) was taken from the electronic medical record. Frequencies of high ESS item ratings (item score ≥2) were calculated for each group. Cronbach's α and factor analysis were performed to assess the internal consistency and validity of the ESS within cases and controls. Multivariable linear models were used to assess the association between ESS and predictors of interest, adjusting for demographic and disease-specific variables, including seizure type, frequency, and anti-seizure medication (ASM) therapy. RESULTS While suspected OSA controls had significantly greater mean ESS total scores (9.9 vs 7.9, p = 0.004) and proportion with ESS >10 (42% vs 25%, p = 0.014), there were no significant differences in the severity of item responses, with the exception of "lying down to rest in the afternoon when circumstances permit," for which more controls rated as likely/very likely (79% vs 64%), p = 0.024). AWE with ESS >10 had higher mean standardized ASM dose (2.5 vs 1.7, p = 0.026). All ESS items were significantly correlated with the total score within each group. Cronbach's α was 0.75 for cases and 0.85 for controls, indicating good internal consistency of the ESS for both groups. After adjusting for demographic and sleep characteristics, higher ESS scores were associated with greater insomnia scores on the ISI (p = 0.024) and depressive symptoms on the BDI (p = 0.018). CONCLUSIONS This study provides validity for the use of the ESS in adult populations with epilepsy.
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Affiliation(s)
| | - Maeve Pascoe
- Sleep Disorders Center, Cleveland Clinic, Cleveland, OH, USA.
| | - Lu Wang
- Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA.
| | | | - Noah D Andrews
- Sleep Disorders Center, Cleveland Clinic, Cleveland, OH, USA.
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14
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Hof zum Berge A, Loch F, Schwarzenbrunner K, Ferrauti A, Meyer T, Pfeiffer M, Kellmann M. Assessment of sleep quality and daytime sleepiness in German national ice hockey players preparing for the world championship. GERMAN JOURNAL OF EXERCISE AND SPORT RESEARCH 2021. [DOI: 10.1007/s12662-020-00693-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Abstract
Objectives
Objectives were to examine subjective sleep quality and daytime sleepiness of the German ice hockey junior national team prior to the world championship to identify athletes of concern and areas of optimization with the intention of equally preventing injury and enhancing performance.
Methods
Twenty-one athletes (Mage = 18.5 ± 0.6 years, Mheight = 181.7 ± 4.3 cm, Mweight = 81.4 ± 7.1 kg), playing for national (n = 13) and international (n = 8) home clubs, answered the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) before training camp (T1, day 1) and prior to tournament (T2, day 11).
Results
Overall, 9 players at T1 and 7 at T2 were identified as bad sleepers (PSQI > 5), while high sleepiness (ESS > 10) was found for 6 athletes at each measurement time. Group means and standard deviations reduced descriptively for PSQI (T1 = 5.38 ± 2.31, T2 = 4.57 ± 2.36) and ESS (T1 = 9.24 ± 3.74, T2 = 8.48 ± 3.28). Tendential differences were visible for PSQI in international-based players (Z = −1.7, p = 0.09) and ESS in first-national-league players (Z = −1.73, p = 0.08) over time. Higher PSQI values for international-based players (6.25 ± 2.6) were found compared to first-national-league (5.83 ± 1.60) and lower-league players (4.00 ± 2.08), with large effect sizes for lower-league compared to international (d = 0.95) and national players (d = 0.98) at T1 and small effect sizes compared to first-league players (d = 0.24) at T2.
Conclusion
Findings emphasize great vulnerability and individuality and underline the importance of intraindividual sleep monitoring to meet the requirements needed to equally obtain health and enhance overall performance.
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15
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Manzar MD, Hameed UA, Alqahtani M, Albougami A, Salahuddin M, Morgan P, Bahammam AS, Pandi-Perumal SR. Obstructive sleep apnea screening in young people: Psychometric validation of a shortened version of the STOP-BANG questionnaire using categorical data methods. Ann Thorac Med 2021; 15:215-222. [PMID: 33381236 PMCID: PMC7720742 DOI: 10.4103/atm.atm_389_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Accepted: 03/06/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND: The STOP-BANG is an easily administrable questionnaire for the screening of obstructive sleep apnea in adults, which may be adapted for use by young people. Here, we assessed the psychometric properties of the STOP-BN, a shortened version of the STOP-BANG questionnaire, using categorical data methods. METHODS: Four hundred and three young people (age 20.71 ± 1.93 years) were selected by random sampling to participate in this cross-sectional study. Participants completed the STOP-BN, a tool for recording social and demographic characteristics, and the Epworth Sleepiness Scale (ESS), a measure of daytime sleepiness. The obtained data were analyzed using categorical data methods. RESULTS: A two-factor model was identified for the STOP-BN, using the Kaiser's criteria (eigenvalue >1) and the screen test. However, the parallel analysis based on minimum rank, and the cumulative variance criteria (>40%) identified an one-factor model. Factor loadings ranged from 0.364 to 0.745. The identified two-factor model showed acceptable fit as the reported goodness of fit index and weighted root mean square residual were in the ideal range, and the comparative fit index was close to the ideal range. Greatest lower bound to reliability for two factors of the STOP-BN was 0.67 and 0.67, indicating an acceptable internal consistency. A weak to a nonsignificant correlation between the ESS and the STOP-BN score was demonstrated, favoring STOP-BN's divergent validity. CONCLUSION: Categorical methods support the psychometric validity of the STOP-BN in the study population.
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Affiliation(s)
- Md Dilshad Manzar
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Majmaah, 11952, Saudi Arabia
| | - Unaise Abdul Hameed
- Department of Physiotherapy, Fatima College of Health Sciences, Al Mafraq, Abu Dhabi City, United Arab Emirates.,Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia
| | - Mazen Alqahtani
- Department of Physiotherapy, College of Applied Medical Sciences, Majmaah University, Majmaah, 11952, Saudi Arabia
| | - Abdulrhman Albougami
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Majmaah, 11952, Saudi Arabia
| | - Mohammed Salahuddin
- Department of Pharmacy, College of Medicine and Health Sciences, Mizan-Tepi University (Mizan Campus), Mizan-Aman, Ethiopia
| | - Prue Morgan
- Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia
| | - Ahmed S Bahammam
- The University Sleep Disorders Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,The Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation, King Saud University, Saudi Arabia
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Lee JL, Chung Y, Waters E, Vedam H. The Epworth sleepiness scale: Reliably unreliable in a sleep clinic population. J Sleep Res 2020; 29:e13019. [DOI: 10.1111/jsr.13019] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 01/28/2020] [Accepted: 02/10/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Jessica Louise Lee
- School of Medicine The University of Notre Dame Australia Sydney NSW Australia
- Department of Respiratory and Sleep Medicine Liverpool Hospital Sydney NSW Australia
| | - Yewon Chung
- Department of Respiratory and Sleep Medicine Liverpool Hospital Sydney NSW Australia
| | - Edward Waters
- School of Medicine The University of Notre Dame Australia Sydney NSW Australia
| | - Hima Vedam
- Department of Respiratory and Sleep Medicine Liverpool Hospital Sydney NSW Australia
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Pilcher JJ, Morris DM. Sleep and Organizational Behavior: Implications for Workplace Productivity and Safety. Front Psychol 2020; 11:45. [PMID: 32082218 PMCID: PMC7005570 DOI: 10.3389/fpsyg.2020.00045] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 01/08/2020] [Indexed: 12/19/2022] Open
Abstract
The interaction between sleep and work-related behaviors influence many aspects of employee performance, safety, and health as well as organizational-level success. Although it is well established that quantity and quality of sleep can affect different types of task performance and personal health, the interactions between sleep habits and organizational behaviors have received much less attention. It is important to examine how sleep habits and workplace behaviors relate and the role of the underlying circadian rhythm on the potential impact of sleep and sleepiness in the workplace. Developing a deeper understanding of how sleep habits and sleepiness impact workers and the organization can help provide the necessary background for human resource management to develop more progressive support networks for employees that benefit both the worker and the organization. Human resources and employees should emphasize the impact of good sleep and sleep habits on organizational and individual productivity and safety.
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Affiliation(s)
- June J Pilcher
- Department of Psychology, Clemson University, Clemson, SC, United States
| | - Drew M Morris
- Department of Psychology, Clemson University, Clemson, SC, United States
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Manzar MD, Salahuddin M, Alamri M, Albougami A, Khan MYA, Nureye D, Spence DW, Pandi-Perumal SR. Psychometric properties of the Epworth sleepiness scale in Ethiopian university students. Health Qual Life Outcomes 2019; 17:30. [PMID: 30732633 PMCID: PMC6367806 DOI: 10.1186/s12955-019-1098-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 01/24/2019] [Indexed: 11/18/2022] Open
Abstract
Background Daytime sleepiness is highly prevalent across the globe. The Epworth sleepiness scale (ESS) is the most widely used tool for screening daytime sleepiness. The psychometric properties of the ESS have not been comprehensively examined in African populations. Material and methods A cross-sectional design with simple random sampling was used in the present study. The study recruited 600 students from Mizan-Tepi University, Ethiopia, of which 329 (age = 18–28 years and body mass index = 21.19 ± 3.17 kg/m2) completed the study. ESS, a semi-structured socio-demographics questionnaire and a clinical interview to diagnose insomnia according to the International Classification of Sleep Disorders were employed. Results All except one item of the ESS showed a floor effect, while only one item score showed ceiling effect. However, no ceiling/floor effect was observed in the ESS total score. The Cronbach’s alpha (0.75) and composite reliability (0.75), indicated good internal consistency, while a moderate item-total score correlation (r = 0.55–0.67) implied favorable internal homogeneity. The known-group validity was established by significantly higher scores for all the ESS item scores and the ESS total scores among those with symptoms of insomnia than among non-symptomatic students. Fit indices along with the consideration of inter-factor correlation coefficient, measures of item retention favored the unidimensional structure of the ESS. Conclusion The ESS has excellent psychometric validity for screening daytime sleepiness in Ethiopian university students. Electronic supplementary material The online version of this article (10.1186/s12955-019-1098-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Md Dilshad Manzar
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Majmaah, 11952, Saudi Arabia
| | - Mohammed Salahuddin
- Department of Pharmacy, College of Medicine and Health Sciences, Mizan-Tepi University (Mizan Campus), Mizan-Aman, Ethiopia.
| | - Majed Alamri
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Majmaah, 11952, Saudi Arabia
| | - Abdulrhman Albougami
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Majmaah, 11952, Saudi Arabia
| | - Mohammad Yunus Ali Khan
- Biomedical Sciences, College of Medicine and Health Sciences, Mizan-Tepi University (Mizan Campus), Mizan-Aman, Ethiopia
| | - Dejen Nureye
- Department of Pharmacy, College of Medicine and Health Sciences, Mizan-Tepi University (Mizan Campus), Mizan-Aman, Ethiopia
| | - D Warren Spence
- Independent researcher, 652 Dufferin Street, Toronto, ON, M6K 2B4, Canada
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