Sleep Status and the Associated Factors: A Large Cross-Sectional Study in Shaanxi Province, China

Negative life events, sleep quality, and depression among older adults in Shandong Province, China: A conditional process analysis based on economic income

AIM

Negative life events have been reported as a risk factor for depression. However, the mechanism between negative life events and depression is still unclear. This study aimed to explore the mediating role of sleep quality and the moderating role of economic income in the association between negative life events and depression among older adults aged 60 years and over.

METHODS

A multi-stage stratified sampling method was used to select elderly individuals over 60 years old in Shandong, China, making use of the Household Health Interview Survey (2020). In total, 3868 older adults completed the measures of negative life events, sleep quality, depression, and economic income.

RESULTS

Negative life events positively predicted depression among the elderly (proportion of direct effect, 55.12%), and poor sleep quality could mediate this association (proportion of indirect effect, 44.87%). Economic income played a moderating role in the relationship between negative life events, sleep quality, and depression (the first and second half of the mediating effect, the direct effect of negative life events on depression). Both effects were weaker among the elderly with higher economic incomes.

CONCLUSIONS

Negative life events had positive effects on depression in older adults. Economic income moderated the direct effect of negative life events and the mediating effect (first and second half) of sleep quality on depression. When the elderly experience negative life events, interventions for improving their sleep quality and financial support could effectively prevent depression. Geriatr Gerontol Int 2024; 24: 751-757.

The Relationships between Various Factors and Sleep Status: A Cross-Sectional Study among Healthy Saudi Adults

Impaired sleep can adversely affect daily life. This study assesses the association between different factors and sleep status among apparently healthy Saudi adults. In total, 478 adults were included in this study. Data on anthropometrics, body composition, stress scales, physical activity, and dietary habits were collected. Fasting blood glucose and lipid profile were measured. Sleep quality and duration were assessed using the Pittsburgh Sleep Quality Index. Larger neck circumference (NC) was associated with short sleep duration (odds ratio (OR) 1.23; 95% confidence interval (CI) [1.08, 1.41]; p = 0.002). Higher triglyceride levels were associated with poor sleep quality (OR 1.01; 95% CI [1.002, 1.02]; p = 0.019) and short sleep duration (OR 1.01; 95% CI [1.004, 1.02]; p = 0.005). Stress was a risk factor for poor sleep quality (OR 1.15; 95% CI [1.09, 1.22]; p < 0.001). Being married was significantly associated with good sleep quality (OR 2.97; 95% CI [1.32, 6.71]; p = 0.009), while being single was correlated with longer sleep duration (OR 0.46; 95% CI [0.22, 0.96]; p = 0.039). Other factors such as having a larger waist circumference and more muscle mass were protective factors against poor sleep quality and/or short sleep duration. In conclusion, a larger NC is suggested as a risk factor for short sleep duration and a higher triglyceride level for both short and poor sleep among healthy Saudis. Investigating the factors associated with sleep status may help alleviate sleep disturbances and improve overall health. Further studies are needed to confirm causality using objective sleep measures.

Breakfast Frequency and Sleep Quality in College Students: The Multiple Mediating Effects of Sleep Chronotypes and Depressive Symptoms

Sleep disorders, which are prominent problems among college students, may be associated with skipping breakfast. Therefore, we aimed to explore the role of sleep chronotypes and depressive symptoms as mediators in the relationship between breakfast frequency and sleep quality. A cross-sectional survey enrolling random samples of 712 college students was conducted by the Questionnaire Star online platform. Statistical description and correlation analysis were performed by SPSS 25.0, and a chain mediation test was performed by model 6 in PROCESS 3.5. The result of the article demonstrated that breakfast frequency can affect sleep quality through two mediating pathways: ① sleep chronotypes, with a mediating effect of 32%; and ② depressive symptoms, with a mediating effect of 52.4%. However, the chain mediating effects of sleep chronotypes and depressive symptoms was not significant, and neither was the direct effect of breakfast frequency on sleep quality. Breakfast frequency can indirectly affect sleep quality by adjusting sleep chronotypes and depressive symptoms. Regular breakfast can increase morning and intermediate sleep chronotypes, reduce depressive symptoms, and thus improve sleep quality.

Investigation on sleep-related cognition of Chinese health care workers during the first wave of COVID-19 pandemic

Background

The COVID pandemic has brought tremendous negative effects on the mental health of health care workers, such as anxiety, depression, and sleep disorders. We conducted this study to evaluate the sleep-related cognition of Chinese health care workers (HCWs) during the first wave of COVID-19 pandemic and analyze its association with sleep quality, so as to provide scientific reference for improving sleep of HCWs.

Patients and methods

A total of 404 HCWs from Yijishan Hospital of Wuhu City, China were enrolled in the study, selected by randomized cluster sampling in May 2020. We made a questionnaire to collect the general demographic information of the participants. The Pittsburgh Sleep Quality Index (PSQI) and a brief version of Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS-16) were used to measure sleep quality and sleep-related cognition, respectively.

Results

The results showed that 312 HCWs (77.2%) had false beliefs and attitudes about sleep, while only 92 HCWs (22.8%) had correct beliefs about sleep. In addition, we found that those HCWs who were older, married, with a bachelor’s degree or higher, nurses, more daily working hours (&gt; 8 h) and monthly night shifts (≥ 5 times), had higher DBAS-16 scores (all p &lt; 0.05). However, we did not find significant differences between men and women in DBAS-16 scores. According to the definition of PSQI, a total of 1/4 of the HCWs are poor sleepers and their DBAS-16 score was higher than good sleepers (t = 7.622, p &lt; 0.001). In the end, we confirmed a positive correlation between sleep cognition and sleep quality (r = 0.392, p &lt; 0.01).

Conclusion

Our study revealed false beliefs and attitudes about sleep were prevalent among HCWs during the first wave of COVID-19 pandemic, and these false beliefs about sleep were closely correlated to sleep quality. We recommend fighting against these false beliefs about sleep.

Sleep state of the elderly population in Korea: Nationwide cross-sectional population-based study

Objective

Interest in sleep disorders among the elderly, especially those in Korea, has increased. We aimed to describe the overall sleep status of the elderly population in Korea using survey data and to determine the risk factors concerning different aspects of sleep status.

Methods

We conducted a cross-sectional survey on 271 respondents aged 65-86 years old. We performed multistage clustered random sampling according to the population and socioeconomic distribution of all Korean territories. The survey questionnaire was used to perform a structural assessment of sociodemographic characteristics; medical comorbidities; psychiatric comorbidities; and sleep status, including sleep duration, sleep quality, presence of insomnia, excessive daytime sleepiness, sleep apnea, and restless legs syndrome.

Results

Approximately 12.5, 22.%, and 51.3% of the elderly population had poor sleep quality, excessive daytime sleepiness, and insomnia, respectively. Hypertension, dyslipidemia, insomnia, anxiety, and depression predicted poor sleep quality. Female sex, insomnia, and sleep apnea predicted excessive daytime sleepiness. Poor sleep quality and depression predicted insomnia.

Conclusion

A substantial proportion of the elderly Korean population have sleep problems, including poor sleep quality, excessive daytime sleepiness, and insomnia. Sleep status is influenced by various factors, including age, sex, and metabolic and psychiatric comorbidities.

Sleep quality and its associated factors among patients with tuberculosis: A cross-sectional study

Background

Tuberculosis (TB) patients commonly suffer from sleep issues owing to various adverse drug reactions (ADRs), disease symptoms, and the contagious nature of their disease. These sleep issues negatively affect the treatment outcome and quality of life. However, the prevalence of sleep disturbance and its associated factors among TB patients have rarely been reported.

Methods

A total of 497 inpatients with TB from three hospitals in China were enrolled in this cross-sectional study to investigate their sleep quality using the Pittsburgh sleep quality index (PSQI). Clinical data, including demographic information, TB-related stigma, perceived stress, and nutrition- and immunity-related indicators, were also collected to explore the factors associated with sleep disturbance among the recruited patients.

Results

Approximately 70% of the recruited patients reported a sleep disturbance to varying degrees, presenting poorer global and subjective sleep qualities, longer sleep latency, shorter sleep duration, lower sleep efficiency, more frequent sleep disturbances, greater use of sleeping medication, and more severe daytime dysfunction. Furthermore, the body mass index (BMI), hemoglobin levels, albumin levels, and T lymphocyte count of the patients in the poor sleep quality group were significantly lower than those in the good sleep quality group (p < 0.05). Increasing age, higher income, drug resistance, higher stigma or stress perception, lower albumin levels, and lower CD4 levels were significantly associated with sleep disturbance among TB patients (p < 0.05).

Conclusion

Three-quarters of the participants were found to suffer from a probable sleep disturbance. And sleep problems are linked to biological traits that interact with psychological, cultural, and social factors in complex ways. It is therefore important to pay attention to the sleep quality of TB patients, especially those with the identified risk factors. Besides, taking care of these risk factors may prove to be an effective sleep management strategy.

The significance of sleep quality in euthymic bipolar patients from Nigeria

Background

Bipolar disorder is highly under-researched in Africa. Existing studies show that racial/ethnic disparities exist for sleep quality. Poor sleep quality in bipolar disorder causes significant morbidity and mortality even during periods of euthymia.

Aim

This study aimed to assess sleep quality and its correlates amongst euthymic patients with bipolar I disorder from Nigeria.

Setting

The study was carried out in a teaching hospital, and state hospital, in Ibadan, Nigeria.

Method

This cross-sectional study was conducted amongst 76 euthymic bipolar patients aged between 18 and 60 years, meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnostic criteria for bipolar disorder. Euthymia was defined as having a score of ≤ 5 on the Young Mania Rating Scale and < 8 on the Hamilton Depression Rating Scale. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI).

Results

A total of 37 (48.7%) participants had poor quality sleep. Sleep quality was associated with marital status (p = 0.013) and suicide plan (p = 0.047). Participants with good sleep quality had higher total sleep duration, lower time to fall asleep (sleep latency), better subjective quality of sleep, were less likely to use sleep medications and had less daytime dysfunction than participants with poor sleep quality. All p-values were < 0.05. Subjective quality of sleep, ongoing use of sleep medication, daytime dysfunction were independently associated with poor sleep quality.

Conclusion

Poor sleep quality frequently persists during euthymic periods in patients with bipolar disorder. The correlates identified can be targeted for intervention during treatment.