The impact of rotating work schedules, chronotype, and restless legs syndrome/Willis-Ekbom disease on sleep quality among female hospital nurses and midwives: A cross-sectional survey

Background: Decreases in subjective sleep quality are prevalent among nurses and midwives engaged in rotating shift work. Objectives: The present study aimed to examine the relationship between differences in work schedules and subjective sleep quality among female nursing staff. Design: A cross-sectional survey design was used for descriptive and logistic regression analyses. Data collection was conducted from December 2016 to September 2017. Settings: Participants were recruited from five regional core hospitals in Japan. Participants: A total of 1253 nurses and midwives were included in the final analysis. Methods: Subjective sleep quality was assessed using the Japanese version of the Pittsburgh Sleep Quality Index. Chronotype and social jet lag were calculated for both work day and work-free day. Symptoms related to restless legs syndrome/Willis-Ekbom disease were assessed using the Japanese version of the Cambridge-Hopkins questionnaire short form 13. Participants with the urge to move their legs, though not fulfilling the restless legs syndrome/Willis-Ekbom disease criteria, were classified as having leg motor restlessness. Logistic regression analyses for poor sleep were adjusted for age, body mass index, smoking, drinking, menstruation status, the presence of premenstrual syndrome, and the presence of a spouse. Results: Rates of poor sleep (Pittsburgh Sleep Quality Index score ?6) among those working, day shifts, rotating 12.5 hour night shifts, rotating 16 hour night shifts, and three-shift rotations were 41.2%, 51.1%, 44.5%, and 60.4%, respectively. Approximately 40% of three-shift rotation workers experienced difficulty initiating sleep. Shift workers tended to exhibit evening chronotype, delayed sleep phase, and high social jet lag. The prevalence of restless legs syndrome/Willis-Ekbom disease was 2.5%. Leg motor restlessness was observed in. 15.5% of participants. The adjusted odds ratios (95% confidence interval) of three-shift work (vs. day shift), evening chronotype (vs. morning chronotype), and the presence of leg motor restlessness (vs. no leg motor restlessness) for those with poor sleep were 2.20 (1.47?3.30), 1.95 (1.29?2.94),and 1.66 (1.15?2.39), respectively. Conclusions: Regardless of the working schedules, rates of poor sleep were high among female hospital nurses and midwives. Our findings suggest that poor sleep quality is influenced by three-shift rotation, the evening chronotype, and leg motor restlessness

The impact of sleep–wake problems on health-related quality of life among Japanese nursing college students: a cross sectional survey

Aim: This study was conducted to examine the impact of sleep–wake problems on health-related quality of life of Japanese nursing college students.Methods: This cross-sectional study was conducted in 2019 on 150 third and fourth-year nursing college students from two locations in Japan. Insomnia severity was assessed using the Insomnia Severity Index (ISI) and health-related quality of life using the SF-8 questionnaire. The total sleep time (TST) was divided into 3 groups: < 6 h, 6–7 h (reference), and ≥ 7 h. The total ISI score was divided into 2 groups: ≥ 8 points and < 8 points (reference). Logistic regression analysis was performed to evaluate sleep–wake problems related to decline in mental health.Results: The median mental health indicated in the SF-8 questionnaire was divided into two groups, and the factors causing decline in mental health were investigated. The odds ratios (95% confidence interval) for adjusted ISI ≥ 8 and TST on weekdays < 6 h was 6.51 (2.96–14.30) and 3.38 (1.40–8.17), respectively. Mental health status was significantly lower when ISI ≥ 8 and even lower when TST < 6 h.Conclusion: Insomnia and short sleep duration are associated with decreased mental health status in nursing college students. Many tended to lack sleep on weekdays. Sleep–wake problems identified while in university should be comprehensively dealt with

Effects of psychotherapy for middle-aged individuals with anxiety disorders in a general medicine practice

Background: Anxiety disorders are mental disorders that cause somatic symptoms for which patients may seek care from generalmedicine departments. We focused on anxiety disorders in middle-aged patients and examined the effect of a psychotherapeuticintervention.Materials and Methods: The participants were 14 middle-aged patients diagnosed with an anxiety disorder. Patients receivedpretreatment assessments and were randomly assigned to a pharmacotherapy group (n = 8) or a pharmacotherapy and psychotherapygroup (n = 6). The duration of the study was three months. Pre-and post-treatment, the Medical Outcomes Study 36-ItemShort-Form Health Survey (SF-36), State-Trait Anxiety Inventory (STAI), and a visual analog scale (VAS) were administered. Inthe pharmacotherapy and psychotherapy group, salivary cortisol was collected pre- and post-psychotherapy at the first and finalpsychotherapy sessions.Result: Four patients in the pharmacotherapy group withdrew from the study. There were no significant differences in the totalscores of the SF-36 or STAI between groups. Improvement was seen in the pharmacotherapy and psychotherapy group pre- andpost- treatment. SF-36 subscales of bodily pain (p = 0.02) and mental health (p = 0.04) were significantly higher than posttreatment.The state anxiety score on the STAI improved post-treatment (p = 0.03). On the VAS, the pharmacotherapy and psychotherapygroup’s symptoms were significantly improved (p = 0.02).Conclusion: This suggests that psychotherapy for middle-aged individuals contributes to the improvement of anxiety states andHRQoL in general medicine departments. It promotes the recognition of curative effects and prevents doctor shopping

Association between high psychological distress and poor oral health-related quality of life (OHQoL) in Japanese community-dwelling people: the Nagasaki Islands Study

Background: We investigated the association between psychological distress and oral health status/oral health-related quality of life (OHQoL) in Japanese community-dwelling people. Methods: We conducted a cross-sectional study using data from the Nagasaki Islands Study. A total of 1183 (455 men and 728 women)has been analyzed in this study. Psychological distress was measured using the Kessler Psychological Distress Scale (K6). Oral health status was measured by dental examination. The OHQoL was measured using the General Oral Health Assessment Index (GOHAI). We defined the total score of ?5 points on the K6 as high psychological distress (high-K6 group). Results: The multiple linear regression analysis to identify the GOHAI showed that gender, K6, the total number of teeth, the number of dental caries, and visiting a dental clinic within the past 6 months significantly associated with the GOHAI. Among all of these variables, high-K6 (? 5)was a substantial contributing factor of the GOHAI (β = ? 0.23, 95% Cl ? 2.31 to ?1.41, p < 0.0001).Conclusions: It is likely that the individual with high psychological distress was strongly related to poor OHQoL even in the general population

Associations between alkaline phosphatase and hypertension in relation to circulating CD34-positive cell levels pertaining to elderly Japanese men

Serum alkaline phosphatase (ALP) could be an indicator of osteoblastic activity, which initiates hematopoietic stem cell (CD34-positive cell) production in bone marrow. Since chronic inflammation, which is a known risk factor for hypertension and endothelium dysfunction, stimulates bone marrow activity, ALP could be positively associated with hypertension. To clarify those associations, we conducted a cross-sectional study of 479 elderly Japanese men aged 60-69. Circulating CD34-positive cell levels could influence associations between serum ALP and hypertension because CD34-positive cell production is also a factor known to contribute to endothelial repair. Therefore, participants were stratified by the median value of circulating CD34-positive cell levels (1.00 cells/μL). A low level of circulating CD34-positive cells was identified in 240 members of the study population. A significantly positive association of ALP with hypertension was detected among participants with low circulating CD34-positive cell levels (multivariable-OR (odds ratio) for hypertension resulting from a 1 standard deviation (SD) increment in serum ALP (58.3 IU/L) = 1.44 (1.06, 1.95)) but not among those with high CD34-positive cell levels (multivariable-OR=0.91 (0.67, 1.23)). We also observed a significant effect of the interaction of circulating CD34-positive cell levels on the association between serum ALP and hypertension (multivariable p=0.011). Serum ALP was found to be positively associated with hypertension among elderly participants with low but not with high circulating CD34-positive cell levels. Since CD34-positive cells are a factor known to contribute to endothelial repair, capability for endothelial repair can be expected to have an effect on the association between serum ALP and hypertension

Associations between alkaline phosphatase and hypertension in relation to circulating CD34-positive cell levels pertaining to elderly Japanese men

Serum alkaline phosphatase (ALP) could be an indicator of osteoblastic activity, which initiates hematopoietic stem cell (CD34-positive cell) production in bone marrow. Since chronic inflammation, which is a known risk factor for hypertension and endothelium dysfunction, stimulates bone marrow activity, ALP could be positively associated with hypertension. To clarify those associations, we conducted a cross-sectional study of 479 elderly Japanese men aged 60-69. Circulating CD34-positive cell levels could influence associations between serum ALP and hypertension because CD34-positive cell production is also a factor known to contribute to endothelial repair. Therefore, participants were stratified by the median value of circulating CD34-positive cell levels (1.00 cells/μL). A low level of circulating CD34-positive cells was identified in 240 members of the study population. A significantly positive association of ALP with hypertension was detected among participants with low circulating CD34-positive cell levels (multivariable-OR (odds ratio) for hypertension resulting from a 1 standard deviation (SD) increment in serum ALP (58.3 IU/L) = 1.44 (1.06, 1.95)) but not among those with high CD34-positive cell levels (multivariable-OR=0.91 (0.67, 1.23)). We also observed a significant effect of the interaction of circulating CD34-positive cell levels on the association between serum ALP and hypertension (multivariable p=0.011). Serum ALP was found to be positively associated with hypertension among elderly participants with low but not with high circulating CD34-positive cell levels. Since CD34-positive cells are a factor known to contribute to endothelial repair, capability for endothelial repair can be expected to have an effect on the association between serum ALP and hypertension