Effect of bitter orange blossom distillate on anxiety and sleep disorder in mothers with infants admitted to neonatal intensive care unit: A Randomized controlled clinical trial

OBJECTIVE

Mothers of neonates admitted to the intensive care unit are prone to sleep disorders due to stress and anxiety. Some herbs have anti-anxiety and sedative properties. This study aimed to investigate the effect of bitter orange blossom distillate on anxiety and sleep disorders in mothers with infants admitted to the neonatal intensive care unit.

METHODS

This randomized controlled clinical trial was conducted from 2021 May 15 to 2022 February 2, on 60 mothers with NICU-admitted infants in one of the medical teaching centers affiliated with Babol University of Medical Sciences, Iran. Permuted block randomization was used to assign the mothers to the experimental (bitter orange blossom distillate syrup) and control groups (syrup prepared from water and sugar). Given the impossibility of blinding the participants, allocation concealment was used to prevent the researcher from predicting the future allocation of the samples to the groups. In addition, the statistical consultant received coded data pertaining to the type of intervention in each group. A demographic questionnaire, the Spielberger State and Trait Anxiety Inventory (STAI), and the General Sleep Disorder Scale were employed to collect data. We assessed the level of anxiety and sleep disorder (in both groups before the intervention and again after the last day of the intervention). Data were analyzed using SPSS V22 software. A P-value less than 0.05 were considered significant.

RESULTS

The mean and standard deviation of the sleep disorder score in the intervention group from (50.26±5.81) to (44.70±6.94) and in the control group from (50.46±6.95) to (48.53±8.62) changed. The covariance test showed that bitter orange blossom distillate syrup has a significant effect on the improvement of sleep disorders (P = 0.01, Effect size = 0.09), but there was no significant difference in the State and Trait anxiety level of mothers (P = 0.122, 0.144 and Effect size = 0.04, 0.03) respectively.

CONCLUSIONS

Due to the positive effect of bitter orange blossom distillate syrup on sleep disorders of mothers with hospitalized babies, this low-cost and low-risk intervention is recommended.

TRIAL REGISTRATION

This study is registered at clinicaltrials.gov as Trial ID = IRCT20201209049666N1.

Risk prediction of sleep disturbance in clinical nurses: a nomogram and artificial neural network model

BACKGROUND

Sleep disturbance occur among nurses at a high incidence.

AIM

To develop a Nomogram and a Artificial Neural Network (ANN) model to predict sleep disturbance in clinical nurses.

METHODS

A total of 434 clinical nurses participated in the questionnaire, a cross-sectional study conducted from August 2021 to June 2022.They were randomly distributed in a 7:3 ratio between training and validation cohorts.Nomogram and ANN model were developed using predictors of sleep disturbance identified by univariate and multivariate analyses in the training cohort; The 1000 bootstrap resampling and receiver operating characteristic curve (ROC) were used to evaluate the predictive accuracy in the training and validation cohorts.

RESULTS

Sleep disturbance was found in 180 of 304 nurses(59.2%) in the training cohort and 80 of 130 nurses (61.5%) in the validation cohort.Age, chronic diseases, anxiety, depression, burnout, and fatigue were identified as risk factors for sleep disturbance. The calibration curves of the two models are well-fitted. The sensitivity and specificity (95% CI) of the models were calculated, resulting in sensitivity of 83.9%(77.5-88.8%)and 88.8% (79.2-94.4%) and specificity of83.1% (75.0-89.0%) and 74.0% (59.4-84.9%) for the training and validation cohorts, respectively.

CONCLUSIONS

The sleep disturbance risk prediction models constructed in this study have good consistency and prediction efficiency, and can effectively predict the occurrence of sleep disturbance in clinical nurses.

The association between cotinine-measured smoking intensity and sleep quality

INTRODUCTION

METHODS

RESULTS

CONCLUSIONS

Factors Affecting Turnover Intention among New Graduate Nurses: Focusing on Job Stress and Sleep Disturbance

Despite the high prevalence of nurses’ turnover and the turnover intention of new nurses, there are insufficient studies examining turnover intention at the time when job orientation is completed and independent nursing commences. Thus, this study examined turnover intention levels and identified the factors affecting turnover intention of new Generation Z nurses, focusing on job stress and sleep disturbance, at the eighth week after completing job orientation. This was a cross-sectional descriptive correlational study. Using a convenient sampling method, 133 new nurses were recruited. Data were collected using a structured questionnaire consisting of demographic and occupational characteristics, job stress, sleep disturbance, and turnover intention. Descriptive statistics were computed to describe the sample and interest variables. Logistic regression analysis was performed to examine the association of job stress and sleep disturbance with turnover intention. Most nurses were women (91.7%) and approximately two-thirds worked in the surgical ward (n = 61, 45.9%). Turnover intention was 12.8%, average job stress was 40.11 ± 90.7, and average sleep disturbance was 42.39 ± 15.27. New graduate nurses’ turnover intention was associated with job stress (OR = 1.07, 95% CI = 1.02–1.12) and sleep disturbance (OR = 1.19, 95% CI = 1.05–1.35), and this model explained 47.7% of the variance. Study findings determine that job stress and sleep disturbance were significant predictors of turnover intention in new nurses at the eighth week after joining the hospital. Therefore, nursing administrators should focus on new nurses’ job stress and sleep disturbance, and provide them with timely assessment and management to reduce turnover intention.

The Effect of Improving Preoperative Sleep Quality on Perioperative Pain by Zolpidem in Patients Undergoing Laparoscopic Colorectal Surgery: A Prospective, Randomized Study

Methods

A prospective, randomized study was conducted with 88 patients undergoing laparoscopic colorectal surgery. The experimental group (S group, n = 44) was given 10 mg of zolpidem tartrate one night before the surgical procedure, while no medication was given to the control group (C group, n = 44). The primary outcome was the intraoperative remifentanil consumption. Sufentanil consumption, average patient-controlled analgesia (PCA) effective press times, the visual analog scale (VAS) scores, and incidences of postoperative nausea and vomiting (PONV) were recorded at 6 h (T1), 12 h (T2), and 24 h (T3) postoperatively.

Results

The intraoperative remifentanil consumption was significantly lower in the S group than that in the C group (p < 0.01). Sufentanil consumption at 6 h and 12 h postoperatively was significantly lower in the S group than that in the C group (p < 0.05); average PCA effective press times and VAS scores, at 6 h and 12 h postoperatively, were significantly lower in the S group than those in the C group (p < 0.01); differences between groups 24 h postoperatively were not significant. No significant between-group difference was noted in the incidence of nausea and vomiting.

Conclusion

Improving patients' sleep quality the night before surgical procedure by zolpidem can decrease the usage of intraoperative analgesics and reduce postoperative pain.

Association between sedentary time and sleep quality based on the Pittsburgh Sleep Quality Index among South Korean adults

Background

Sleep problems increase the risk of premature illness and death. We evaluated the association between sedentary time and sleep quality among South Korean adults.

Methods

The data of adults (aged ≥ 19 years) from the 2018 Korea Community Health Survey were analyzed. Sedentary time, which included hours spent sitting or lying down daily, was categorized into four standardized groups. Poor sleep quality was defined using the global cutoff point (> 5 points) of the Pittsburg Sleep Quality Index. Multiple logistic regression analyses were performed to identify the association between sedentary time (≤ 3.9, 4.0–5.9, 6.0–7.9, and ≥ 8 hours /day) and sleep quality, by sex.

Results

Of the 224,118 participants, 35,784/100,454 men (35.6%) and 58,271/123,664 women (47.1%) had poor sleep quality. Compared with ≤ 3.9 h/day, sedentary times 4.0–5.9, 6.0–7.9, and ≥ 8 h/day were associated with worse sleep quality among men (odds ratio [OR]: 1.12, 95% confidence interval [CI]: 1.08–1.16; OR: 1.19, 95% CI: 1.14–1.25; OR: 1.30, 95% CI: 1.25–1.34, respectively) and women (OR: 1.06, 95% CI: 1.03–1.10; OR: 1.12, 95% CI: 1.08–1.16; OR: 1.22, 95% CI: 1.18–1.26, respectively). In subgroup analyses of sleep quality, subjective sleep quality, latency, disturbance, use of sleeping medication, and daytime dysfunction showed a strong dose-response relationship with increasing sedentary time in both sexes.

Conclusions

Regardless of sex, the longer the sedentary time, the stronger the association with poor sleep quality. Nationwide efforts are required to recommend standards for sedentary time and develop evidenced-based healthy behavior guidelines.

Association Between Sleep Quality and Falls: A Nationwide Population-Based Study from South Korea

Purpose

There are few large studies evaluating the association between sleep quality and the risk of falls. We aimed to determine the independent effect of poor sleep quality on an increased risk of falls using a large-sample dataset.

Methods

We conducted a retrospective, cross-sectional study using population-based data from the 2018 Korean Community Health Survey on 201,700 participants. Sociodemographic, mental health-related, and physical health-related variables as well as sleep quality evaluated by the Pittsburgh Sleep Quality Index (PSQI) were compared between 2499 fallers who have experienced at least one fall during the past 12 months and 199,201 non-fallers. Multivariable logistic regression was performed to identify sleep quality variables significantly associated with an increased risk of falls.

Results

Fallers had poorer sleep quality (PSQI score >5) and higher scores for global PSQI and individual PSQI components than did non-fallers (all p < 0.001). Multivariable logistic regression adjusted for potential confounders including socioeconomic, physical health-related, and mental health-related variables showed that an increased risk of falls was associated with poor sleep quality (odds ratio [OR] 1.30, 95% confidence interval [CI] 1.19–1.42). Subgroup analyses by age revealed that poor sleep quality was significantly associated with an increased risk of falls in all three adult age groups. Multivariable logistic regression using the seven PSQI components revealed that an increased risk of falls was associated with short sleep duration (OR 1.14, CI 1.09–1.20), increased sleep disturbances (OR 1.30, CI 1.16–1.46), and increased daytime dysfunctions (OR 1.21, CI 1.08–1.13).

Conclusion

Poor sleep quality caused by short sleep duration may be a principal risk factor of falls in adult populations. Increased sleep disturbances and daytime dysfunctions may also contribute to an increased risk of falls. Our results have clinical and public health perspectives that increasing sleep duration and reducing daytime dysfunctions and sleep disturbances could mitigate unintentional falls.

Association Between Cohabitation Status and Sleep Quality in Families of Persons With Dementia in Korea: A Cross-sectional Study

Objectives

The aim of this study was to identify the association between cohabitation status and sleep quality in family members of people with dementia (PwDs).

Methods

Data of 190 365 participants aged ≥19 years from the 2018 Korea Community Health Survey were analyzed. Participants were categorized according to their cohabitation status with PwDs. Multiple logistic regression and ordinal logistic regression analyses were performed to evaluate the relationship between the cohabitation status of PwDs’ relatives and sleep quality measured using the Pittsburgh Sleep Quality Index (PSQI) and PSQI subscales.

Results

Compared to participants without PwDs in their families, both cohabitation and non-cohabitation with PwDs were associated with poor sleep quality (cohabitation, male: odds ratio [OR],1.28; 95% confidence interval [CI], 1.08 to 1.52; female: OR, 1.40; 95% CI, 1.20 to 1.64; non-cohabitation, male: OR, 1.14; 95% CI, 1.05 to 1.24; female: OR, 1.23; 95% CI, 1.14 to 1.33). In a subgroup analysis, non-cohabiting family members showed the highest odds of experiencing poor sleep quality when the PwD lived alone (male: OR, 1.48; 95% CI, 1.14 to 1.91; female: OR, 1.58; 95% CI, 1.24 to 2.01). Cohabiting male and female participants had higher odds of poor subjective sleep quality and use of sleeping medications than non-cohabiting male and female participants, respectively.

Conclusions

The residence of PwDs and cohabitation status may contribute to poor sleep quality among PwDs’ family members. The circumstances faced by cohabiting and non-cohabiting family members should be considered when evaluating sleep quality in family members of PwDs, and appropriate interventions may be needed to improve sleep quality in both cohabiting and non-cohabiting family members.

Association between quality and duration of sleep and subjective cognitive decline: a cross-sectional study in South Korea

Sleep is being emphasized as a factor that improves mental health and quality of life. Here, we aimed to investigate the association between the quality and duration of sleep and subjective cognitive decline in the Korean population. We used the 2018 Korean Community Health Survey data that are nationwide representative data collected by the Korea Centers for Disease Control and Prevention. Sleep quality was measured using the Korean version of Pittsburgh Sleep Quality Index. The study population comprised 206,719 individuals aged 19 years and over. We used multiple logistic regression for the analysis. Individuals of both sexes with poor sleep quality were more likely to experience subjective cognitive decline compared with the reference group (good sleep quality) (men, odds ratio (OR) = 1.97 [95% confidence interval (CI) 1.86-2.09]; women, OR = 1.75 [95% CI 1.67-1.84]). U-shape associations were found between sleep duration and subjective cognitive decline. Additionally, the presence of depressive symptom or stress and health-related behaviors, including smoking, drinking, and not walking, were high-risk factors for subjective cognitive decline. Our results indicate that poor sleep quality might contribute to subjective cognitive decline in the Korean population. We suggest the implementation of intervention measures for poor sleep behaviors to prevent cognitive decline.

Association Between Recent Experience of Childbirth and Sleep Quality in South Korean Women: Results from a Nationwide Study

INTRODUCTION

Although women commonly report deterioration of sleep quality postpartum, this relationship has been less studied in East Asian countries. This study investigated the association between recent experience of childbirth and sleep quality in South Korean women and additionally examined how healthy practice behavior interplays in the stated relationship.

METHODS

Data from the 2018 Community Health Survey were used. Sleep quality was measured using the Pittsburgh sleep quality index (PSQI). Women who responded to have given birth in the past year were categorized as having a recent experience of childbirth. The general characteristics of the study population were investigated using chi-square test. The association between the dependent and independent variables was analyzed using multivariate logistic regression analysis.

RESULTS

Of a total of 41,708 study participants, 16,877 (40.5%) individuals reported poor sleep quality. Poor sleep quality was more common in women with a recent experience of childbirth (48.4%) than those without (40.0%). Compared to individuals without a recent experience of childbirth, those with such an experience were more likely to show poor sleep quality (OR 1.50, 95% CI 1.34-1.68). Such differences were reduced in individuals with a healthy lifestyle.

CONCLUSION

Recent experience of childbirth was associated with higher likelihoods of poor sleep quality in women. The degree of risks found was reduced in individuals practicing a healthy lifestyle habit. The findings infer the need to monitor and address sleep-related disturbances commonly reported among postpartum women.

Factors associated with poor sleep quality in the Korean general population: Providing information from the Korean version of the Pittsburgh Sleep Quality Index

BACKGROUND

Recently, studies have been conducted to address the research gap in the understanding of poor-quality sleep and its relationship to health outcomes, through the evaluation of sleep quality. The aim of this study was to provide information regarding poor sleep quality based on a nationwide general population sample in Korea.

METHODS

We conducted a cross-sectional study using data from a nationwide sample of 165,193 individuals (males: 44%) aged 19 years or older from the 2018 Korea Community Health Survey. The age range of the participants was 19-107 years (mean: 55.3 ± 17.5). The Korean version of the Pittsburgh Sleep Quality Index (PSQI) was used for assessing sleep quality. Poor sleep quality was defined as a total PSQI score of >5.

RESULTS

The overall prevalence of poor sleepers was 41.0% (males: 35.6%; females: 46.2%). Poor sociodemographic status (illiteracy, low income, and unemployment), poor health behaviors (smoking, high-risk drinking, diabetes, hypertension, non-participation in walking, and obesity), and poor mental health (perceived poor health status, stress, depressive symptoms, and subjective cognitive decline) were all associated with poor sleep quality in both males and females.

LIMITATIONS

As this study relies on self-reported and cross-sectional data, causal inferences cannot be made.

CONCLUSIONS

Poor sleep quality is highly prevalent in females. In addition, poor socio-demographic status, poor health behaviors, and poor mental health were associated with poor sleep quality. The mechanisms underlying sex differences in sleep quality remain to be elucidated, and further studies are required to address this.

Validation of the Korean Version of the Mini-Sleep Questionnaire-Insomnia in Korean College Students

PURPOSE

This study aimed to evaluate the reliability and validity of the Korean version of the Mini-Sleep Questionnaire-Insomnia in Korean college students.

METHODS

A total of 470 students from six nursing colleges in South Korea participated in the study. The translation and linguistic validation of the Mini-Sleep Questionnaire-Insomnia was performed based on guidelines. The Pittsburgh Sleep Quality Index and the Perceived Stress Scale were used to validate the measure. Cronbach α, item-total correlation for internal consistency reliability and intraclass correlation coefficient for test-retest reliability were evaluated. Exploratory factor analysis for construct validity, Pearson's correlation with the Pittsburgh Sleep Quality Index and the Perceived Stress Scale for concurrent validity, and the receiver operating character curve for predictive validity were assessed.

RESULTS

The 4-item Mini-Sleep Questionnaire-Insomnia had a Cronbach α of .69 and the item-total correlations were higher than .30. Cronbach α increased to .73 if the item assessing the use of sleeping pills and tranquilizers was deleted. This item had marked skewness and kurtosis issues. Factor analysis indicated unidimensionality, explaining 53.0% of the total variance. The measure showed high test-retest reliability (i.e., intraclass correlation coefficient = .84), acceptable concurrent validity (r with the Pittsburg Sleep Quality Index = .69; r with the Perceived Stress Scale = .31) and predictive validity [area under curve = .85; 95% confidence interval (0.81, 0.90)].

CONCLUSION

The Mini-Sleep Questionnaire-Insomnia showed acceptable reliability and validity. Yet, the limited distribution in sleep medications warrants further evaluations in the clinical population.

Comparative Effectiveness of Three Occupational Therapy Sleep Interventions

Although sleep intervention is within the domain of occupational therapy, few studies exist supporting practice. Effectiveness of three sleep interventions was compared: Dreampad Pillow®, iRest® meditation, and sleep hygiene. Twenty-nine participants were randomly assigned to the Dreampad Pillow® ( n = 10), iRest® meditation ( n = 9), and sleep hygiene ( n = 10) groups. In Phase 1, all participants used a 7-day sleep hygiene regimen to reduce poor sleep habits. In Phase 2 (14 days), 10 participants used the Dreampad Pillow® and sleep hygiene, nine used the iRest meditation and sleep hygiene, and 10 continued sleep hygiene only. At intervention-end, the iRest meditation group experienced statistically greater time asleep than both the Dreampad Pillow® ( p < .006, d = 1.87) and sleep hygiene groups ( p < .03, d = 1.80). The Dreampad Pillow® group experienced statistically fewer nighttime awakenings than the iRest® meditation ( p < .04, d = −1.53) and sleep hygiene ( p < .004, d = −1.43) groups. No differences were found between groups in perceived sleep quality, length of time needed to fall asleep, and fatigue level next day. This study provides support for sleep interventions within occupational therapy’s domain.