Expression of anger in university students according to perceived quality of sleep

Salivary Brain-Derived Neurotrophic Factor and Cortisol Associated with Psychological Alterations in University Students

INTRODUCTION

Recent evidence reported mental health issues in university students such as anxiety and depressive symptoms and poor sleep quality. Decreased plasma brain-derived neurotrophic factor (BDNF) levels have been proposed as a biomarker of depressive symptoms, whereas cortisol levels are an index of energy mobilization and stress and have been linked to sleep quality. Given that salivary biomarkers represent an interesting new field of research, the aim of this cross-sectional study was to evaluate salivary BDNF and cortisol levels in university students to assess whether they have associations with psychological disturbances such as anxiety and depressive symptoms, sleep quality, and stress level.

METHODS

Salivary BDNF and cortisol levels were measured by specific immunoassays in 70 students whose mental health was also evaluated on the same day through the evaluation of anxiety and depression symptoms (Goldberg scale), sleep quality (Pittsburg Sleep Quality Index and Athens Insomnia Scale), and stress (self-perceived stress scale) and healthy lifestyle habits (alcohol consumption, smoking, regular exercise, and body mass index) were also measured. Multivariate regression analyses were performed in order to identify the strengths of associations between psychological alterations and the concentrations of BDNF, cortisol, and other variables.

RESULTS

Salivary BDNF levels were significantly higher in students with more depressive symptoms, whereas no significant differences were found for cortisol levels. When performing the binary logistic regression model, BDNF levels are included as a predictor variable for a high-depressive-symptoms burden (p < 0.05). Students with worse sleep quality on the Pittsburg Scale had higher cortisol levels (p < 0.05). The subdomains of sleep latency and sleep medication were those significantly associated with salivary cortisol levels in logistic regression analyses (OR = 15.150, p = 0.028). Sleep medication only appeared to be related to cortisol levels (OR = 185.142, p = 0.019). Perceived stress levels and anxiety symptoms were not associated with BDNF or cortisol levels.

CONCLUSIONS

BDNF could play a key role in the pathophysiology of mood-related disorders, and elevation of its peripheral levels could contribute to protecting neurons from the development of mental illness. Higher salivary cortisol levels measured in the morning are accompanied by poorer sleep quality. More research is needed, focusing on salivary biomarkers of disorders related to depressive symptoms and poor sleep quality as a potential tool for the diagnosis and prevention of mental illness.

Physical activity and morningness: A helpful combination in improving the sleep quality of active Italian university students

University students are commonly described as having worsened sleep quality, especially when inactive and Evening-type (E-type) subjects. This study aimed to examine the interactions between physical activity and chronotype on sleep quality among a sample of active Sports Science university students. In November 2019, 433 participants (mean age: 19.7 ± 1.56 years; 70% males) completed the Pittsburgh Sleep Quality Index, the Godin-Shepard Leisure-Time Physical Activity Questionnaire (tertiles categorisation), and the Morningness-Eveningness Questionnaire. Females and E-type slept significantly worse than males and Neither-(N-types) and Morning-types (M-types), respectively. However, there were no significant differences in sleep quality based on physical activity levels. The three-way ANOVA revealed that sleep quality in N- and E-types appeared to be independent of physical activity, whereas M-types showed an improvement in sleep classification with increased physical activity. Moderation analysis indicated that physical activity significantly moderated the relationship between chronotypes and sleep quality. Specifically, M-types demonstrated a more pronounced improvement in sleep quality with increasing physical activity compared to the other chronotypes. In conclusion, M-type university students derived the greatest benefits from physical activity in improving sleep quality. Conversely, physical activity seemed to have a limited impact on sleep quality among active E-type university students.

Relationship between free-time physical activity and sleep quality in Brazilian university students

Poor sleep quality and low or no free-time physical activity (FTPA) practice are highly prevalent among university students, but the association between these conditions is still unclear. This cross-sectional study analyzed the relationship between FTPA and sleep quality. An online questionnaire was conducted with university students from a public university in southern Brazil in 2019. The weekly frequency of FTPA was self-reported, and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Logistic regression and ANCOVA models were performed and adjusted for confounders. Among the 2,626 students analyzed, 52.2% did not practice the FTPA, and 75.6% had poor sleep quality (PSQI > 5). In the adjusted analysis, practicing FTPA 4-7 times/week was associated with poor sleep quality (odds ratio = 0.71; 95% confidence interval = 0.52, 0.97) compared with not practicing FTPA. In addition, those who practiced FTPA had significantly lower means of the global PSQI, subjective sleep quality and duration, sleep disturbances, and daytime dysfunction scores than those who did not practice FTPA. In conclusion, the FTPA may contribute to better sleep quality among university students.

Anxious and Angry: Early Emotional Adaptation of Medical Students in a Situational Crisis on the Example of the COVID-19 Pandemic

BACKGROUND

The COVID-19 pandemic is an example of a situational crisis resulting in emotional destabilization. The aim of the study was to analyze changes in the level of anxiety and anger in medical students during the early adaptation to the situational crisis, and to estimate the risk factors for fear and anger in this group.

METHODS

Participants were 949 medical students (M = 22.88, SD = 4.10) in the first stage on March 2020, and 748 (M = 22.57, SD = 3.79) in the second stage on June 2020. The STAI, STAXI-2, and our own questionnaire were used.

RESULTS

First vs the second stage: anxiety state (p < 0.001), anger state (p = 0.326), and feeling angry (p < 0.05). The regression model (F(14.1681) = 79.01, p < 0.001) for the level of anxiety state explains 39% of the dependent variable variance (r² = 0.39). The model for the anger-state level (F(6.1689) = 68.04, p < 0.001)-19% (r² = 0.19).

CONCLUSIONS

During the early adaptation to the situational crisis, the general level of anxiety decreased, but anger was at the same level. The anxiety was explained by contact with potentially or objective infected persons, and the level of anger was based on the need for greater social support.

Multilevel analysis of sleep quality and anger in emergency medical service workers

OBJECTIVE

Poor sleep quality characterizes the emergency medical service (EMS) profession. Anger is particularly affected by sleep disturbance and may be related to sleep quality at both between- and within-person levels, yet this has never been examined. The current study performed a multilevel analysis of the relationship between sleep quality and anger among EMS workers.

DESIGN

Ecological momentary assessment PARTICIPANTS: Seventy-nine EMS workers employed at an emergency medical service provider in Central New York.

MEASUREMENTS

Participants completed 8 daily assessments that inquired about sleep quality and anger.

RESULTS

EMS workers who typically experienced poorer sleep quality reported greater anger levels; for instance, workers who routinely experienced poor sleep quality reported anger levels that were 18%-35% higher compared to workers receiving fair sleep quality. Regardless of their typical sleep quality, days when workers experienced poorer sleep than usual was characterized by higher levels of anger: on a day when a worker experienced poorer sleep quality than usual for them, their anger levels were 5% higher on that day regardless of their typical sleep quality.

CONCLUSIONS

EMS workers regularly experiencing poor sleep quality experience more anger. However, even workers who typically have better sleep quality experience anger elevations following poor sleep. These findings suggest that interventions targeting both between- and within-person factors impacting sleep may be important for addressing sleep quality's influence on anger in the EMS profession.

Skipping breakfast and mood: The role of sleep

BACKGROUND

Breakfast skipping has been related to poor mood, but the role of sleep in this relationship remains unclear.

AIM

To evaluate whether breakfast skipping associated with mood independently of sleep, and whether sleep interacted with breakfast skipping.

METHODS

During an in-person research visit, a sample of 329 adults completed questionnaires regarding last night's sleep, current morning breakfast intake, and mid-morning mood states. Sex-stratified linear regression models examined associations between breakfast skipping and mood and interactions with sleep.

RESULTS

Among males, those who did not consume breakfast had less vigor independent of sleep (β=-2.72 with 95% CI -4.91, -0.53). Among females, those who did not consume breakfast had higher feelings of anxiety (β=1.21 with 95% CI -0.04, 2.47). Interaction analyses revealed that males with longer time to fall asleep and longer night-time awake time had higher depression scores in the presence of breakfast skipping, and females with more night-time awake time and shorter duration had higher fatigue and less vigor if they were also breakfast skippers.

CONCLUSION

Breakfast skipping and poor sleep may jointly affect mood.

The association of sleep quality and aggression: A systematic review and meta-analysis of observational studies

Poor sleep quality is closely related to aggression, but despite the promise of new therapeutic possibilities, a systematic synthesis of observational research on the association between sleep quality and aggression is lacking. This systematic review and meta-analysis examined the association between sleep quality and aggression, using the academic databases PubMed and PsycINFO. Subjective and objective measures of sleep quality were included, as well as multiple measures of aggression, assessing aggressive and externalizing behavior, anger, hostility and irritability. Ninety-two observational articles, containing 96 studies, encompassing a total of 58.154 children, adolescents and adults were sourced out of 7161 references identified. Methodological quality was moderate or strong in 76% of studies. Data for meta-analysis was available from 74 studies. Poorer sleep quality was associated with higher aggression in 80.8% of studies. Pooled results showed a correlation of 0.28 (95%CI 0.25-0.31; I² = 90.1%) and odds ratio of 3.61 (95%CI 1.13-11.51; I² = 88.3%). Effect estimates and heterogeneity varied according to population type and measurement instruments, but not according to article quality or age group. Our findings confirm that poor sleep quality is consistently associated with higher aggression. As most evidence is cross-sectional, more prospective and high-quality experimental evidence is required to elucidate cause-effect and optimize prevention and treatment of aggression.