Journal of Sleep sciences

Investigation of the Relationship between Sleep Habits and Sleep Structure by Polysomnography in 3-10 Year-Old Children Referring to the Sleep Department of Qazvin Children's Hospital, Iran

Shabnam Jalilolghadr — 2025-02-17

Background and Objective: Improper sleeping habits can affect children's sleep structure and reduce the quantity and quality of sleep. In this study, we aimed to investigate the relationship between sleep habits and sleep structure in children.

Materials and Methods: The population of this cross-sectional descriptive-analytical study included children aged 3-10 years who were referred to the sleep department of Children's Hospital in Qazvin City, Iran, during 2015-2021 and had undergone standard polysomnography (PSG). The Iranian version of the Children's Sleep Habits Questionnaire (CSHQ) was completed by parents. Sleep structure parameters of PSG were used. Statistical tests included mean, standard deviation (SD), and independent t-test.

Results: Among 163 patients, 102 (62.6%) were boys. The average age of the children was 6.35±3.72 years. According to CSHQ, the average score of "resistance before sleep" was 2.08±0.38 and the highest score was related to "falling asleep in your bed" (2.50±0.81). The highest score of "sleep duration" was related to "sleeping the same amount each day" (2.54±0.75). The comparison of PSG findings showed that the mean score of bedtime resistance had a statistically significant relationship with increased stage N1 and decreased sleep efficiency (SE) (P = 0.01). Moreover, the mean score of "sleep duration" was associated with abnormal Arousal Index (AI) (P = 0.01).

Conclusion: According to the results, children who were reported to be sleep-deprived had a higher percentage of light sleep and frequent night awakenings, and less SE in the PSG. Appropriate health strategies are needed to improve chil- dren's sleep habits

Sleep Disturbance and Anxiety among Nurses after the COVID-19 Pandemic: A Cross-Sectional Study

Marjan Shamspour — 2025-02-17

Background and Objective: The coronavirus disease 2019 (COVID-19) pandemic has had an obvious impact on the mental health of healthcare workers, including nurses who have been at the forefront of managing patients with COVID-19. This study aimed to assess the mental health of nurses who worked at Afzalipour Hospital in Kerman City, Iran, after the pandemic of COVID-19.

Materials and Methods: 400 nurses have been enrolled in a cross-section study. We used a questionnaire to collect demographic and occupational information and the General Health Questionnaire (GHQ) to assess mental health.

Results: 84% of nurses had problems related to mental health, with anxiety being the most common symptom followed by sleep disorder and depression. Social problems were also prevalent among the nurses. There was no statistically sig- nificant difference in mental health between men and women or across different age groups, education levels, or work experience in the COVID-19 ward. However, there was a significant difference in the mental health of nurses with dif- ferent shift intervals and those working more than 15 shifts who had higher mental health scores. There was no statisti- cally significant difference in mental health of night shift nurses and day shift nurses.

Conclusion: These findings highlight the need for interventions to promote mental health among nurses who have worked in the wards related to COVID-19

Investigating the Relationship between Nocturnal Enuresis and Sleep Disordered Breathing Using Polysomnography Data of 5-10 Year-Old Children Referred to Qazvin Children's Hospital, Iran

Shabnam Jalilolghadr — 2025-02-17

Background and Objective: Sleep is a critical biological necessity essential for maintaining both physical and mental health in humans. Given the prevalence of nocturnal enuresis (NE) in children, this study sought to explore its potential link to sleep-disordered breathing (SDB).

Materials and Methods: This cross-sectional study involved children aged 5 to 10 years who visited Qazvin Children's Hospital, Iran, from 2016 to 2021. Data were gathered using the Iranian Children's Sleep Habits Questionnaire (CSHQ) completed by parents, alongside polysomnography (PSG) assessments conducted at the hospital. Children were catego- rized into two groups of with and without enuresis. The PSG data were analyzed to evaluate respiratory parameters in accordance with the American Academy of Sleep Medicine (AASM) guidelines.

Results: Of 124 participants, 64 (51%) were boys, with an average (standard deviation) age of 82.2 (24.4) months. Ap- proximately 39.1% of the children experienced NE. Statistically significant correlations were found between NE and several factors: body mass index (BMI) (P = 0.025), total sleep time (P = 0.026), number of hypopneas (P < 0.001), hypopnea index (P = 0.012), total apnea and hypopnea events (P = 0.004), and the overall apnea-hypopnea index (AHI) (P = 0.005). However, no significant association was established between the oxygen desaturation index, arousal index (AI), and mean oxygen saturation (P > 0.05).

Conclusion: The findings indicate an association between enuresis and obstructive sleep apnea (OSA), suggesting that treating OSA could ameliorate enuresis symptoms. Therefore, it is advisable to evaluate children with enuresis, particu- larly those who are obese, for OSA

Insomnia Phenotype Characterization and Depression among Patients with Obstructive Sleep Apnea

Khosro Sadeghniiat-Haghighi — 2025-02-17

Background and Objective: Over 40% of individuals with obstructive sleep apnea (OSA) have reported experiencing insomnia. The combination of OSA and insomnia results in decreased sleep quality and adherence to continuous positive airway pressure (CPAP) therapy. This study aimed to assess insomnia among patients with OSA.

Materials and Methods: This cross-sectional study involved 1771 participants. Patients with a high suspicion of OSA completed the Insomnia Severity Index (ISI) and the Beck Depression Inventory (BDI-II) questionnaires. All participants underwent overnight polysomnography (PSG).

Results: In this study, 1242 (68%) of the 1771 participants were men, with a mean age of 47.18 ± 13.65 years. The average Respiratory Disturbance Index (RDI) was 41.53 ± 31.98, the mean ISI score was 12.11 ± 5.99, and the ave r- age BDI score was 12.88 ± 11.22. A total of 639 (36%) participants reported moderate to severe insomnia (ISI score ≥ 15). Those with a normal RDI had mean ISI scores of 13.71 ± 6.32, while patients with mild, moderate, and severe OSA had mean ISI scores of 12.76 ± 5.96, 11.61 ± 5.92, and 11.91 ± 5.95, respectively (P = 0.001). The correlation between RDI and ISI score was 0.006 (P = 0.8). As the severity of insomnia increased, the BDI score also signifi- cantly increased (P < 0.0001).

Conclusion: A notable correlation exists between insomnia and depression; individuals with more severe insomnia re- ported higher depressive symptoms. Given the link between insomnia and OSA, it is advisable to assess insomnia in patients diagnosed with OSA.

Evaluation of Sleep Quality in Patients with COVID-19 after Discharge

Sareh Mohammadi — 2025-02-17

Background and Objective: This study examines sleep quality in patients with coronavirus disease 2019 (COVID-19) after recovery, exploring demographic associations to inform post-discharge management and support.

Materials and Methods: Conducted as a cross-sectional study, sleep quality was assessed in patients with COVID-19 2-4 weeks post-discharge in Iran. A two-part survey was administered via phone, capturing demographics and Pittsburgh Sleep Quality Index (PSQI) scores.

Results: Among 147 patients (109 women and 38 men, mean age: 47.9 years), the average PSQI score was 12.48 ± 7.37, with a mean sleep duration of 6.26 ± 1.69 hours. Poor sleep was notably linked to female gender (P = 0.029), unemployment (P = 0.012), and mental health history (P = 0.021).

Conclusion: Findings underscore the importance of monitoring sleep quality in COVID-19 recovery, with targeted support potentially reducing hospital readmissions

Predicting Pain Perception Based on Psychological Distress in Patients with Rheumatoid Arthritis: The Mediating Role of Sleep Quality

Hosein Etemadi Mehr — 2025-02-17

Background and Objective: Patients with rheumatoid arthritis (RA) often suffer from chronic pain due to the nature of the disease, and in addition to the disease itself, this pain can be aggravated under the influence of psychological fac- tors. The study aimed to predict pain perception based on psychological distress and the mediating role of sleep quality in people with RA.

Materials and Methods: This research was conducted by path analysis, including 202 patients with RA who were se- lected using the convenience sampling method. The study instruments included McGill Pain Questionnaire (MPQ), Pittsburgh Sleep Quality Index (PSQI), and Depression, Anxiety, and Stress Scale (DASS-21). Descriptive statistics reported frequency, mean, standard deviation (SD), and Pearson correlation. In analytical statistics, path analysis was used. Data were analyzed using SPSS and AMOS software.

Results: Psychological distress (anxiety, stress, and depression) had a direct, statistically significant effect on sleep quality. Sleep quality had a direct effect on pain perception. On the other hand, anxiety, stress, and depression, with the mediating role on sleep quality, had a significant influence on pain perception by 0.11, 0.12, and 0.09, respectively. Descriptive statistics showed that a significant correlation existed among independent, mediation, and criteria variables. The proposed predictive model had a good fit.

Conclusion: Along with medical treatments, we need to pay attention to the role of psychological factors such as psychological distress, depression, and sleep quality in patients with RA.

Medical Students “The Night Owls”: Cross-Sectional Analysis of the Sleep Habits of Medical Undergraduates of an Institute in Northern India

Navneet Kumar Kaushik — 2025-03-01

Background and Objective: Sleep is a biological necessity and essential for optimal health. Literature suggests college students are an at-risk population for sleep deprivation; hence, the present research was undertaken to assess the sleep habits of medical student population.

Materials and Methods: The present cross-sectional study was carried out on a convenient sample of apparently healthy medical students at an institute in Northern India. Information pertaining to the usual sleep-wake habits of participants was collected through a structured questionnaire based on the Pittsburgh Sleep Quality Index (PSQI).

Results: The study sample (n = 125) comprising 95 (76%) men and 30 (24%) women had mean age of 20.59 [standard deviation (SD) = 1.21] years. Findings about sleep habits were concerning as over two-thirds (68%) of the students were found to be sleep deprived. Almost half (46%) of the participants usually went to bed past midnight (average bedtime: 1:39 AM). Difficulty in falling asleep was reported by 46% of the sample. Half of the students perceived their sleep quality as poor or fair. Female students reported sleep deprivation more frequently (83% vs. 63%, respectively); female participants had about 3 times greater odds [odds ratio (OR): 2.92, 95% confidence interval (CI): 1.02-8.31] of being sleep deprived than male students.

Conclusion: Sleep deprivation is quite prevalent among medical students with most of them staying up late at night. Difficulty in falling asleep and dissatisfaction with the sleep quality are also common. Female students seem to be more frequently sleep-restricted than male students

Importance of a Control Group in Sleep Research

Shadi Naderyan Fe'li — 2025-03-01

The Article Abstract is not available.