Several issues indicate that the present findings should not be overgeneralized. First, and most importantly, a self- administered questionnaire cannot report actual sleep dura- tion but rather gives an estimate or the subjective opinion of participants in regard to their sleep duration. The same applies to sleep need. Therefore, the current assessed actual sleep duration and sleep need always refers to the subjectivesleep duration and subjectivesleep need, respectively. Second, we assessed only university students, who are not representative of the population of young adults as a whole. Third, only individuals who were willing and able to participate took part in the study, so sampling bias cannot be excluded. Fourth, no data on psychopathology (eg, affective disorders, eating disorders, substance abuse) were collected, and variations in psychopathology might have biased the pattern of associa- tions. In other words, the lack of associations might have been due to further latent but unassessed psychological (eg, symptoms of depression, stress, anxiety) and physiological (eg, cortisol, brain-derived neurotrophic factor) variables.
questionnaire differences in reported sleep duration. Being female was associated with a 7 to 8 min greater difference between diary- and questionnaire-reported sleep duration. It is unclear why sex would predict differences in subjectivesleep duration between diaries and questionnaires. A wealth of clinical, epidemiological, and sociological literature estab- lishes that, on average, women report longer sleep duration than men, 18 but this would not explain discordance between different subjectivesleep duration measures. Perhaps sleep onset latency – the duration between “ lights out ” (the time of ﬁ rst attempted initiation of sleep) and actual sleep onset 19 – provides insight into this difference. Recent literature suggests that women report longer sleep onset latency relative to men. 20 Rather than recording the time at which they fell asleep in their sleep diaries, participants may have recorded the time at which they initiated the ritual of sleep (ie, getting into bed, turning off the lights, etc.). If participants responded to questionnaires in such a way that it did not capture sleep onset latency – that is, Table 3 Demographic predictors of the difference between diary-reported and questionnaire-reported overall sleep duration in the retirement and sleep trajectories study, with dichotomous insomnia exposure (n=1,516)
Even patients with a highly characteristic and convin- cing description of perceived SB, did not always show sleep related symptoms changes in the diary. Therefore, the incongruence between the results from the diary and the questionnaire may further imply that these instru- ments assess different aspects of SB. When discussing SB, it seems necessary to make a distinction between 1) a sub- jective general feeling of improvement after sleep and 2) a specific improvement in actual motor functioning. Both aspects may contribute to the experiences which patients perceive as SB. The latter aspect was mostly assessed by the symptom diary, as we specifically targeted this instru- ment towards changes in motor function. The definition of SB in the questionnaire could be interpreted in a more general way, including non-motor symptoms of PD and/ or a-specific refreshing effects of sleep. Both aspects could for sure be clinically relevant, but the underlying mecha- nisms are possibly different. Therefore, this distinction should be an important point of focus in future research.
Patients with an apnea-hypopnea index (AHI) ≥ 5 per hour and a diagnosis of OSA were enrolled. Those with other concurrent sleep diseases, including periodic limb movement disorder, restless leg syndrome, rapid eye move- ment behavior disorder, and narcolepsy were excluded. Pa- tients with known medical or neurological diseases that might disturb sleep quality (i.e., congestive heart failure, asthma, chronic obstructive pulmonary disease, chronic kidney disease, liver cirrhosis, severe osteoarthritis, malig- nancy, dementia, Parkinsonism, or disabling stroke) were also excluded. All of the patients underwent one over- night full-channel polysomnography (PSG) and com- pleted sleep questionnaire and scales in terms of the Chinese versions of the Epworth sleepiness scale (ESS), the PSQI, the short form-36 (SF-36), and either the Center for Epidemiologic Studies Depression Scale (CES-D) or the Hospital Anxiety and Depression Scale (HADS) before receiving PSG. This study was approved by the Institutional Review Board of Kaohsiung Medical University Hospital (KMUH-IRB-20120136).
Here, we present a retrospective integrated analysis of Studies XP052 and XP053, assessing subjectivesleep outcomes and the tolerability of once-daily GEn 1200 mg using pooled data from the two trials. The objective of such analysis was two fold: first to evaluate – using data pooled according to severity of sleep disturbance at study entry – whether baseline sleep disturbance could have an effect on sleep outcomes, as the interaction between treatment effect and baseline sleep disturbance was not assessed in the original studies; second, to assess how informative two novel sleep endpoints derived from the 24-Hour RLS Symptom Diary were. These were analyzed alongside well-established sub- jective sleep outcomes from the MOS Sleep Scale and the PSQ for exploration and concurrence, and then compared with similar endpoints derived from the PghSD.
The current study aimed to specifically explore sleep timing and circadian preferences in Arabic speaking Egyptian patients with hepatic cirrhosis. Consistent with the literature, [4-6, 8, 12, 13] sleep-timing and circadian preferences were more disturbed in hepatic patients as compared to healthy controls. Our study is the second study to use the Pittsburgh Sleep Quality Index (PSQI) in the assessment of hepatic population. We agreed with the previous study  which used the widely know scale in differences in total score and in subscores for sleep latency and disturbances, which both came with significantly higher scores in hepatic group, and subscore for sleep duration, which indicated no significant difference between hepatic patients and control groups in both studies.. On the other hand, the two studies disagreed about four subscores, namely subjectivesleep quality, habitual sleep efficiency, use of sleep medications, and daytime sleep dysfunction. These differences could be explained by diffeent etiological factors behind hepatic disease in Egypt and USA.
Methods/Design: Participants, aged 65 years or older (n = 150), who have sleep disorders will be randomized for treatment with either acetaminophen 1000 mg or placebo, once daily at bedtime in a double-blind design. Eligible patients should be able to give informed consent, should not be cognitively impaired (Minimal Mental State Examination (MMSE) score ≥ 20), should not have pain, and should not use acetaminophen on a regular basis because of pain complaints. The study will take three weeks to complete. During these three weeks, the participants register their sleep behavior in a sleep diary. The participants will use the study medication during the second and third week. The primary endpoint will be the self-reported sleep disorders at the end of week three, as measured by means of the Insomnia Severity Index (ISI). To validate these subjectivesleep parameters against objectively measured indices of the sleep-wake pattern, we will measure the periods of wakefulness and sleep in a subgroup of participants, using an actigraph worn on the wrist during the entire study period.
Participants and methods: Eighty-three individuals aged 18–65 years with no history of sleep disorders, chronic physical or psychiatric illnesses, or substance misuse were recruited from the North of England. Secondary analysis of a series of standardized studies, which included psychometrics, actigraphy, and an in-lab polysomnography (PSG) component, was undertaken. Questions from several psychometric sleep scales were combined to create an aggregate measure of sleep health status. Subjectivesleep continuity was assessed by 2-week sleep diary. Objec- tive measures comprised two continuous weeks of actigraphy and two nights of in-lab PSG. Results: Significant negative correlations were evident between sleep health scores and both diary-derived subjectivesleep latency (SL; diary) and actigraphy-derived SL (actigraphy). This was reflected by independent samples t-test between high and low sleep health groups. No relationships between sleep health and PSG parameters were observed. Regression analyses indicated sleep latencies from both the sleep diary and actigraphy as significant predictors, explaining 28.2% of the variance in sleep health.
Sleep disturbances were measured with the Polish version of the Pittsburgh Sleep Quality Questionnaire (PSQI). The PSQI has internal consistency and a reliability coefficient (Cronbach’s alpha) of 0.83 for its 7 components. The PSQI is a 19-item self-rated questionnaire used for evaluating subjectivesleep quality during the previous month. The PSQI is a questionnaire designed to evaluate the following: overall sleep quality, sleep quality, sleep latency, sleep dura- tion, sleep efficiency, sleep disturbance, medication use, and daytime dysfunction. 12 Each answer was scored on a scale
The authors analyzed quality of sleep according to the time of the experiment and the type of refuge space using the OSA sleep inventory and calculating the average score of the two subjects. Subjectivesleep quality by type of refuge space for the summer experiment is summarized in Figure 6. As for the “refreshing” and “initiation and maintenance of sleep” factors, which are important in maintaining strength and stamina for day-to-day living, the score for the corrugated cardboard temporary shelter and subjects’ homes reached fifty points, showing that quality of sleep was maintained in these environments. Although the “frequent dreaming and anxiety” factor was rated low for subjects’ homes, it is possible that the subjects were affected because the evaluation was made one day before the experiment commenced. As for the tent, the score was around forty points for most factors. The rating for
Abstract: Sleep disturbances very common in children with autism. That is why it requires instruments that facilitate its evaluation. Goals: Perform the evaluation of sleep from a subjective prospect in a group of children with primary autism and compare to a control group, using the Sleep Habits in Children Survey (CSHQ), In order to determine sleep disturbances, according to the sub-scales results. Method: A prospective cross-sectional study of the sample was carried out. A group with primary Autism n = 21 was selected. For the assessment of the dream we chose (CSHQ). The differences between independent groups were calculated by applying a Mann Whitney U test (p <0.05). Results: The group of children with autism showed the highest values of the total scale (mean = 48.00) wish is congruent with a greate disfuntion of sleep, compared to the control group (mean = 36.47) for p = 0.00. Significant differences were found for all sub scales p = 0.00, with the exception of sub-scale number 7. Conclusions: There is a high presence of sleep disturbances in children with primary autism, which are related to multifactorial causes, with the exception of sleep breathing disorders that did not show statistically significant differences between groups. Keywords: Subjectivesleep assessment; Autism spectrum disorder; REM sleep; NREM sleep
An integrated questionnaire was administered to 467 people aged 38 - 92 (mean age: 64.8 years) in Hyogo Prefecture (35 ˚ N), Japan in August 2011, with responses received from 223 people (females: 142, males: 78, unknown: 3) which were all usable for analysis. The questionnaire consisted of basic questions about attributes such as age and sex, questions on sleep habits and sleep quality (SubjectiveSleep Quality Scale), the Torsvall-Åkerstedt Diurnal Type Scale (1980) and a Japa- nese version (Kasugai, 1998) of the Impact of Event Scale- Revised (IES-R) which has been usually used as PTSD scores (Wilson & Keane, 2004) composed of 22 questions, 8 questions related to intrusion, 6 on hyper-arousal and 8 on avoidance- numbing (Table 1). The original questions on sleep habits which Harada et al. (1998) originally constructed have been used in several papers (Takeuchi et al., 2001a; Takeuchi et al., 2001b; Harada et al., 2002; Takeuchi et al., 2003; Harada et al., 2004; Shinomiya et al., 2004; Harada et al., 2007).
Subjectivesleep quality as well as depressiveness was assessed by different questionnaires including the Landecker Inventar zur Erfassung von Schlafstörungen LISST , Schlaffragebogen-A (SF-A) and Schlaffrage bogen-B (SF-B) , Epworth Sleepiness Scale (ESS)  and Beck Depression Inventory (BDI) , all German versions. The SF-B questionnaire measures composite scores including sleep quality, feeling of being refreshed in the morning, feeling balanced/relaxed in the evening, feeling exhausted in the evening and psychosomatic symptoms in the sleeping period over the last two weeks. The SF-A yields the same composite scores pro- spectively for each night the questionnaire was com- pleted. The LISST results in composite scores to detect different symptom classes of sleep disorders including problems with sleep/wake rhythm, insomnia symptoms, sleep quality, parasomnias and tiredness during the day. Nightmare frequency was measured on an eight-point rating scale  (‘How often do you experience night- mares?’ 0 = never, 1 = less than once a month, 2 = about once a month, 3 = twice or three times a month, 4 = about once a week, 5 = several times a week and 6 = al- most every morning). In order to obtain mornings with dream recall per week, the scale was recoded using the class means (0 → 0, 1 → 0.125, 2 → 0.25, 3 → 0.625, 4 → 1.0, 5 → 3.5, 6 → 6.5).
The study instrument comprised two parts including a demographic questionnaire and the Pittsburgh sleep quality index (PSQI). The demographic questionnaire consisted of questions about participants’ demographic and clinical data including age, gender, marriage, em- ployment, education level, history of hospitalizations, and medical diagnosis. The PSQI is a self-report question- naire developed for evaluating sleep quality (14, 15). The PSQI consists of 7 components subjectivesleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medications, and day- time dysfunction. The score for each component ranges from 0 to 3, resulting in a total PSQI score of 0-21. Higher scores represent lower sleep quality (16, 17). In this study we used Farsi version of PSQI, which has yielded satisfac- tory validity and reliability. Cronbach’s alpha coefficient was 0.77 and corrected item-total correlations ranged from 0.30 to 0.7 for the seven components of the PSQI (14).
In our sample, online surveys revealed significantly more sleep disruption and suicidal ideology in the POTS group than in the control group. More than 50% of our POTS par- ticipants reported poor sleep, nighttime wakefulness, sleep onset latency > 30 minutes, and sleep disruption due to pain. Further, people with POTS took more medications to help them sleep than controls. Those in the POTS group were also more likely to consider suicide. Particularly associated with suicidal ideation among those with POTS were increased frequency of bad dreams, pain that disrupted sleep, poor subjectivesleep efficiency, sleep onset latency > 30 minutes, difficulty staying awake during the day, self-ratings of worse sleep quality, and keeping up enthusiasm to get things done. Significant predictors of suicidal ideation in this study were sleep quality, having POTS, and age. Overall, the POTS group had a significantly higher risk for suicidal ideation as well as past and future attempts than the control group.
Chinese version of the Pittsburgh Sleep Quality Index (C-PSQI): We used the translated (Chinese) version of the Pittsburgh Sleep Quality Index of Chiang , originally developed by Buysse, Reynolds III, Monk et al. . This is a self-rated questionnaire which assesses sleep quality and disturbances over a 1-month time inter- val. Nineteen individual items generated seven “component” scores: subjectivesleep quality, sleep latency, sleep duration, habitual sleep efficient, sleep disturbances, use of sleeping medication, and daytime dysfunction. The seven components were scored from 0 to 3 points, with each component weighted equally. A score of “0” indicated no difficulty, while a score of “3” represented severe difficulty. The possible total scores of the seven components ranged from 0 to 21. A higher score signified worse sleep quality. “Poor sleep” was defined as a PSQI score of greater than 5 . The Cronbach’s α value for this study was 0.83.
A trend towards significance was observable for the association between affiliation and disorders in initiating or maintaining sleep. A possible explanation might be that oxytocin is an important factor in the association between affiliation and sleep (Blagrove et al., 2012). Oxytocin has anxiolytic (anxiety reducing) and sedating effects and is secreted in the paraventricular nucleus of the hypothalamus, the part of the brain that is involved in regulating sleep and arousal, so it may play an important role in sleep-wake behavior. Furthermore, oxytocin is also involved in affiliative behaviors, which might explain the link between sleep and affiliation. Moore et al. (2010) also found that affiliation/sociability was an important factor in predicting sleep in (pre)adolescents. The authors argued that due to the developmental importance of social relationships during (pre)adolescence and the availability of cell phones and social media, it is not surprising that socially active (pre)adolescents have more sleep problems than those who have a less vivacious social life.. Affiliation did turn out to also be a moderately strong predictor of the mean hours of sleep a child gets each night during the week and subjectivesleep quality. So, more affiliation was related to less sleep problems.
The purpose of this study was to assess factors associated with subjectivesleep evaluation, chiefly excessive daytime sleepiness (EDS) in obstructive sleep apnea syndrome (OSAS) adult outpatients under continuous positive airway pres- sure (CPAP) treatment. One thousand and forty-eight OSAS outpatients (mean age: 51.4% male: 90.5%) who were treated by CPAP were consecutively collected. Age, sex, CPAP compliance (CPAP usage as their device of nights with application-time of at least 4 hours per night objectively; %usage ≥ 4 h/d), and Japanese version of the Pittsburgh Sleep Quality Index (PSQI-J) of the patients showing EDS (Japanese version of the Epworth Sleepiness Scale; JESS ≥ 11) were compared cross-sectionally with those of the patients who did not show EDS (JESS < 11). Nineteen point two % of all patients showed EDS subjectively. Two hundred one patients were classified to an EDS(+) group and an 847 pa- tients were classified to EDS(–) group. Age and global PSQI-J scores were significantly different between the two groups. Logistic regression showed that EDS was significantly associated with global PSQI-J scores, but not with age. Among PSQI-J components, overall sleep quality, duration of sleep, sleep disturbance, and day dysfunction due to sleepiness were significantly higher in the EDS(+) group. Especially, 19.4% of patient in the EDS(+) group reported actual sleep time during the past month to be less than 5 hours/day. Although functional relationship should be further evaluated, insufficient sleep is the main factor associated with EDS in the OSAS patients under CPAP treatment.
Background: Medical residency programs are traditionally supposed to be having long working hours, which can be associated with a poor quality of sleep and resultant daytime sleepiness. This poses threat to both physician and patient. This study has an alarming importance in recent scenario, where India is witnessing growing incidents of assaults against resident doctors. We evaluated the subjectivesleep quality, day time sleepiness, satisfaction with life, stress, anxiety and depression and their association with subjectivesleep quality amongst the residents on their off- duty days and also compared these findings amongst various departments of our institution.