Sleep timing is more important than sleep length or quality for medical school performance

Overwhelming evidence supports the importance of sleep for memory consolidation. Medical students are often deprived of sufficient sleep due to large amounts of clinical duties and university load, we therefore investigated how study and sleep habits influence university performance. We performed a questionnaire-based study with 31 medical students of the University of Munich (second and third clinical semesters; surgery and internal medicine). The students kept a diary (in 30-min bins) on their daily schedules (times when they studied by themselves, attended classes, slept, worked on their thesis, or worked to earn money). The project design involved three 2-wk periods (A: during the semester; B: directly before the exam period—pre-exam; C: during the subsequent semester break). Besides the diaries, students completed once questionnaires about their sleep quality (Pittsburgh Sleep Quality Index [PSQI]), their chronotype (Munich Chronotype Questionnaire [MCTQ]), and their academic history (previous grades, including the previously achieved preclinical board exam [PBE]). Analysis revealed significant correlations between the actual sleep behavior during the semester (MS_diary; mid-sleep point averaged from the sleep diaries) during the pre-exam period and the achieved grade (p = 0.002) as well as between the grades of the currently taken exam and the PBE (p = 0.002). A regression analysis with MS_diary pre-exam and PBE as predictors in a model explained 42.7% of the variance of the exam grade (effect size 0.745). Interestingly, MS_diary—especially during the pre-exam period—was the strongest predictor for the currently achieved grade, along with the preclinical board exam as a covariate, whereas the chronotype did not significantly influence the exam grade.     

Influence of caffeine ingestion on perceived mood states, concentration, and arousal levels during a 75-min university lecture

This investigation aimed to assess the effect of a caffeine supplement on perceived mood state, concentration, and arousal during a 75-min university lecture. Methods. This randomized, blind, cross-over design investigation ran over a course of 2 consecutive weeks. During week 1, 10 third-year Human Movement and Exercise Science students were assigned to either a caffeine- or placebo-supplemented group and were subsequently required to attend a 75-min exercise rehabilitation lecture. Seven days later, students were assigned to the opposite supplementation group before attending a second follow-on lecture, equal in duration to that of week 1. At the conclusion of each lecture, students were required to complete a mood perception questionnaire to assess the perceived level of mood state, concentration, and arousal during the lecture. The results showed that after caffeine consumption, students perceived themselves to be significantly more awake, clear minded, energetic, alert, and anxious (P < 0.05). Additionally, students also felt they were better able to concentrate and had a greater level of arousal than when the placebo was consumed (P < 0.05). In conclusion, the results of this investigation show that university students report enhanced perceptual feelings of behavior and mood state when a low dose of caffeine is consumed 60 min prior to a 75-min academic lecture.     

Morningness–eveningness interferes with perceived health,physical activity,diet and stress levels in working women: A cross-sectional study

Sleep and health are closely interrelated and sleep quality is a well-known contributor to perceived health. However, effects of sleep-timing preference i.e. morningness–eveningness on health has yet to be revealed. In this study, we explored the relationship between morningness–eveningness and perceived health in a sample of female working professionals (N?=?202). Sleep-timing preference was measured using the Composite Scale of Morningness. Perceived health was characterized by Center for Epidemiologic Studies Depression Scale, WHO Well-Being Scale-5 and Patient Health Questionnaire-15 scores. We also investigated possible mechanisms, including stress and health-impairing behaviours. In accordance with previous data, we found more depressive mood, lower well-being and poorer perceived health among evening types. To assess health-impairing behaviours we collected data on smoking habits, alcohol consumption, physical activity and diet. Among the possible mechanism variables, greater stress, less frequent physical activity and less healthy diet were associated with eveningness. Furthermore, stress diminished the strength of the association between morningness–eveningness and depressed mood. Physical activity attenuated the strength of the association between morningness–eveningness and well-being. No effects of alcohol consumption could be identified. Our data show that evening preference behaves as a health risk in terms of associating with poor perceived health. Our findings also suggest that this effect might be mediated by health behaviours and stress.     

Influence of circadian typology on drug consumption, hazardous alcohol use, and hangover symptoms

Few studies have focused on the influence of circadian typology on drug use, and none has considered the use of illegal drugs and hazardous alcohol consumption. This study analyzes the influence of circadian typology on several types of drug consumption (habitual or sporadic), hangover symptoms (past 12 mos), and, more specifically, hazardous alcohol consumption of young adults. Five hundred seventeen university students (173 males), between 17 and 30 yrs of age, answered the Composite Scale of Morningness (CSM), the Alcohol Use Disorders Identification Test (AUDIT), and a self-referred questionnaire on drug consumption during the previous month and on the prevalence of different hangover symptoms during the previous year. Our results confirm a higher prevalence of consumption of addictive substances, both legal (nicotine and cola drinks) and illegal (cannabis and ecstasy), in evening- compared to morning- and neither-type subjects (p?相似文献   

Dietary patterns with fresh fruits and vegetables consumption and quality of sleep among older adults in mainland China

With modern society’s increased pressures, problems arise regarding duration and quality of sleep. Many Chinese seniors report poor quality of sleep. With rapid urbanization, Chinese dietary patterns have shifted dramatically, with vegetables consumption declining rapidly. This research focuses on the associations between fruits and vegetables consumption with basic dietary behaviors and sleeping patterns. Using the 2014 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), multinomial logistic regression models predicted older adults’ (age > = 65) quality and duration of sleep. Predictors included fruits and vegetables consumption, types of cooking oil, staple foods, and meat. The mean age of the study sample was around 85 years. Approximately 56% of respondents consumed fresh vegetables daily. A majority of seniors consumed rice as their staple food. Only 14% of seniors consumed fresh fruits daily. Most seniors consumed meat weekly or more frequently. We found that seniors who consumed fruits and vegetables occasionally had lower odds of reporting good quality of sleep [Fruits: AOR (Adjusted odds ratio) = 0.77; Vegetables: AOR = 0.58] compared with daily consumers. Respondents who reported consuming wheat and half rice-half wheat had higher odds of reporting good quality of sleep (Wheat: AOR = 1.52; Half rice-half wheat: AOR = 1.28), compared with seniors who reported rice as their staple food. Chinese public health practitioners and nutritionists should design dietary plans with more frequent consumption of fruits, vegetables, and wheat to help older adults’ overall health including their sleeping patterns.

     

Examining courses of sleep quality and sleepiness in full 2 weeks on/2 weeks off offshore day shift rotations

ABSTRACT

To better understand sleep quality and sleepiness problems offshore, we examined courses of sleep quality and sleepiness in full 2-weeks on/2-weeks off offshore day shift rotations by comparing pre-offshore (1 week), offshore (2 weeks) and post-offshore (1 week) work periods. A longitudinal observational study was conducted among N=42 offshore workers. Sleep quality was measured subjectively with two daily questions and objectively with actigraphy, measuring: time in bed (TIB), total sleep time (TST), sleep latency (SL) and sleep efficiency percentage (SE%). Sleepiness was measured twice a day (morning and evening) with the Karolinska Sleepiness Scale. Changes in sleep and sleepiness parameters during the pre/post and offshore work periods were investigated using (generalized) linear mixed models. In the pre-offshore work period, courses of SE% significantly decreased (p=.038). During offshore work periods, the courses of evening sleepiness scores significantly increased (p<.001) and significantly decreased during post-offshore work periods (p=.004). During offshore work periods, TIB (p<.001) and TST (p<.001) were significantly shorter, SE% was significantly higher (p=.002), perceived sleep quality was significantly lower (p<.001) and level of rest after wake was significantly worse (p<.001) than during the pre- and post-offshore work periods. Morning sleepiness was significantly higher during offshore work periods (p=.015) and evening sleepiness was significantly higher in the post-offshore work period (p=.005) compared to the other periods. No significant changes in SL were observed. Courses of sleep quality and sleepiness parameters significantly changed during full 2-weeks on/2-weeks off offshore day shift rotation periods. These changes should be considered in offshore fatigue risk management programmes.     

Subjective sleep quality in premenstrual syndrome

Premenstrual syndrome (PMS) is a cyclical disorder observed in late luteal phase and presenting with behavioral changes that can affect interpersonal relationships and normal daily activity. Sleep disturbances are also common. The aim of this study is to investigate the relationship between PMS and subjective sleep quality with Pitsburg Sleep Quality Index (PSQI) in the Medical Academy students, whom have considerable information about menstruation. PMS was detected with "Premenstrual Syndrome Scale", and PSQI was used to evaluate subjective sleep quality. Chi-square test and Kendall's rank correlation analysis were used in statistical analysis. p values (p < 0.05) were considered as statistical significant. Poor sleep quality was found in the 75.6% of the participants with PMS, and 58.8% of the participants without PMS (p < 0.05). Only component 5 (sleep disorder component) of the PSQI components revealed statistically significant difference (1.7 ± 0.6 in participants with PMS, and 1.5 ± 0.6 without PMS, p < 0.05). There was a positive correlation between total PSQI score and all of its' components, except component 6 (sleeping pill usage component) (p < 0.05). The strongest association was found to be in the component 5 (r = 0.528; p = 0.0001). Results of our study suggested the poor sleep quality due to sleep disorders in women with PMS.     

Comparison of sleep and chronotype between senior and undergraduate university students

ABSTRACT

The university programs for seniors provide a third age perspective in lifelong learning with classes and recreational facilities, and enable students to share their experiences and knowledge. A good sleep quality promotes better cognitive functioning and serves to protect against age-related cognitive declines. Central nervous system reorganization takes place during sleep, and although the influence of sleep quality on memory is not clear, circadian rhythm disorders affect alertness and individual performance. Physiological change during aging need to be clarified to better understand how university might help students. The aim of the present study was to evaluate for the first time the chronotype, the sleep quality and their relationship in senior university students and to compare them with those of undergraduate students. The Morningness–Eveningness Questionnaire (MEQ) and the Pittsburgh Sleep Quality Index (PSQI) were used. The results indicated that approximately 50% of the participants were good sleepers. This percentage was equal in the senior and undergraduate students. The results showed that undergraduate students tended toward eveningness while senior students tended toward morningness. Among the undergraduate students, evening type chronotypes had a tendency toward higher PSQI scores and this affected their daytime function scores, while it did not in the senior students, in whom worsening sleep quality was associated with disturbances such as going to the bathroom and nocturnal awakening. This information would be useful for designing environmental interventions to optimize sleep/work cycles for decreasing age-associated changes in memory in senior students and for improving the academic achievements of undergraduate students.     

Promoting Sleep in Shiftworkers and Inter Continental Travelers

A number of techniques and treatments can be used to alleviate the sleep disturbance associated with both shiftwork and transmeridian travel. Optimization of the sleeping environment and avoidance of substances such as caffeine and alcohol before sleep are the best initial approach. Timing sleep to coincide with some of the normal sleep period where possible will improve sleep quality in shiftworkers. Similarly, following transmeridian flight, restricting sleep to the nocturnal period in the new time zone will assist adaptation. Hypnotic drugs may be of benefit to alleviate sleep disturbance experienced by shiftworkers or transmeridian travelers. Selection of the most appropriate medication must take into account required duration of action and possible residual effects of the drug on alertness. Hypnotics may be useful, particularly in middle-aged individuals who already have disturbed sleep, on those occasions when poor sleep is anticipated, for example following an eastward flight or after the initial change to night duty. Over-the-counter preparations should be avoided whenever possible unless it is known that they are not associated with residual sequelae. (Chronobiology International, 14(2), 133–143, 1997)     

Chronotype and sleep duration are associated with stimulant consumption and BMI among Chinese undergraduates

The study sought to identify the association between stimulant consumption and social jetlag, chronotype as well as sleep duration among undergraduate students. A cross-sectional survey was conducted in the university town in Chongqing, China. Data were collected on 977 participants, age 20.06 (SD = 1.25) years old, using the Munich Chronotype Questionnaire (MCTQ) to measure social jetlag, chronotype and average sleep duration. A self-reported questionnaire was used to collect the information: BMI, demographic data, outdoor activity time, smoking status, alcohol consumption, coffee consumption and sugar-sweetened beverage consumption. The positive significant association was found between late chronotype and alcohol consumption (OR = 1.26, 95% CI [1.05–1.52]), being a current smoker (OR = 1.62, 95% CI [1.26–2.07]) and sugar-sweetened beverage consumption (OR = 1.42, 95% CI [1.17–1.72]). Average sleep duration was negatively associated with BMI (OR = 0.84, 95% CI [0.71–0.98]). Social jetlag did not find any association between stimulant consumption and BMI in the adjusted model. The results showed that Chinese undergraduate students had a negative significant association between average sleep duration and BMI, and late chronotype might affect the stimulant consumption among the group. This study may provide some implications for health management of obesity among undergraduate students in China.

     

Association between coffee,tobacco, and alcohol daily consumption and sleep/wake cycle: an actigraphy study in euthymic patients with bipolar disorders

ABSTRACT

Individuals with bipolar disorder (BD) have higher than average rates of coffee, tobacco and alcohol use. These substances may have deleterious effects on sleep quality and quantity, which may destabilize sleep/wake cycles and negatively impact the clinical course and prognosis of BD. The use of these substances may also be perceived as a self-medication attempt, for example, to induce sleep or to increase vigilance during the day. The objective of the current study was to investigate associations between the self-reported daily use of coffee, tobacco, and alcohol, and objective measures of sleep and activity patterns in adult individuals with BD. A sample of 147 euthymic individuals with BD were assessed for daily coffee, tobacco and alcohol consumption and 21 days of actigraphy monitoring. Actigraphic measures of sleep quantity and daytime activity were compared between groups classified as coffee+/coffee-, tobacco+/tobacco- and alcohol+/alcohol-, defined according to their current daily use. Then, we examined potential correlations between sleep/wake cycle parameters and the amount of daily consumption of each substance. Multivariable analyses identified associations between the use of coffee, tobacco, and alcohol and several sleep and activity parameters, such as between coffee, alcohol, and the relative amplitude of activity (respectively, p = .003 and p = .005), between alcohol and M10 onset (onset time of the 10 most active hours during the 24-h cycle) (p = .003), and between coffee and sleep duration (p = .047). This study supports the hypothesis that there is a relationship, whose direction would be bidirectional, between the daily use of these substances and the sleep/wake cycle in euthymic individuals with BD. These preliminary results require replications in other retrospective and prospective samples. They may have a clinical impact on psycho-education strategies to be proposed to individuals with BD.     

Influence of Circadian Typology on Drug Consumption,Hazardous Alcohol use,and Hangover Symptoms

Few studies have focused on the influence of circadian typology on drug use, and none has considered the use of illegal drugs and hazardous alcohol consumption. This study analyzes the influence of circadian typology on several types of drug consumption (habitual or sporadic), hangover symptoms (past 12 mos), and, more specifically, hazardous alcohol consumption of young adults. Five hundred seventeen university students (173 males), between 17 and 30 yrs of age, answered the Composite Scale of Morningness (CSM), the Alcohol Use Disorders Identification Test (AUDIT), and a self-referred questionnaire on drug consumption during the previous month and on the prevalence of different hangover symptoms during the previous year. Our results confirm a higher prevalence of consumption of addictive substances, both legal (nicotine and cola drinks) and illegal (cannabis and ecstasy), in evening- compared to morning- and neither-type subjects (p?<?.001 in all cases). Evening-type subjects also obtained a higher total score on the AUDIT (p?<?.001) and showed a greater prevalence in the subscales of potential alcohol problems (p?<?.02), as well as more frequent different hangover symptoms (learning difficulties, thirst, tiredness, headaches, sensorial hypersensitivity, anxiety, and irritability; p?<?.04 in all cases) compared with morning- and neither-type subjects, except for sensorial hypersensitivity and anxiety, for which the evening-type did not differ from the neither-type. Our results provide substantial evidence that the evening circadian typology is a risk factor for the development of drug consumption and that it should be taken into account both in preventive and treatment approaches. Moreover, the data regarding hazardous alcohol use and hangover symptoms emphasize the need to include circadian typology in future studies on the pattern of heavy episodic drinking. (Author correspondence: gprat@ub.edu)     

Cyberbullying perpetration among undergraduates: evidence of the roles of chronotype and sleep quality

Cyberbullying is one of the important negative issues among adolescents and youngsters. Victims of cyberbullying perpetration have been reported to suffer many psychological and emotional problems that can lead them as far to suicide. The purpose of the present study was to investigate the associations of cyberbullying perpetration with gender, personality traits, chronotype, and sleep quality. Three hundred and fifty-three freshman and sophomore university students from Turkey (45.9% (n = 162) female and 54.1% (n = 191) male) completed a questionnaire that included Cyberbullying Scale, Big-5 Inventory, Composite Scale of Morningness, and Sleep Quality Scale. The most conspicuous result of the study was that chronotype and sleep quality were significant predictors of cyberbullying perpetration. Evening-type students had significantly higher scores on cyberbullying scale than neither-type students and morning-type students, and also neither-type students had higher scores on cyberbullying scale than morning-type students. Further, poorer sleep quality, being male, higher extraversion, higher neuroticism, and lower conscientiousness were related to higher cyberbullying perpetration.     

Young inhabitants of the North with late chronotype and social jetlag consume more high-calorie foods and alcohol

Previous research has shown a high prevalence of late chronotype and social jetlag (SJL) among young northerners. These traits are also associated with unhealthy food preferences and greater alcohol consumption. The aim of this study was to analyze the relationships among characteristics of the sleep–wake rhythm and dietary preferences of young residents of the North. The study involved 282 participants from the Komi Republic (53.2% female) aged 18.9 ± 2.8 years old. Participants were asked to provide personal data and to complete two questionnaires: the Munich Chronotype Questionnaire and the Food Frequency Questionnaire. Females reported consuming 1.3 times more oils and fats than boys. Rural residents reported consuming 1.7 times more alcohol than urban residents. University students reported consuming 5.4 times more alcohol than secondary school students, but secondary school students consumed 1.6 and 1.5 times more meat and fruits, respectively. Participants with late chronotype reported consuming more alcohol, and those with a shorter duration of sleep reported consuming more tea and coffee. Respondents with SJL consumed more fats, oils, meat, and alcohol. The results indicate that unhealthy dietary habits of young northerners are more closely associated with SJL than with chronotype or the duration of sleep.     

Sleep after a Bedtime Beverage

Sleep after an inert capsule was compared with sleep after a hot, bedtime, milk-cereal drink (Horlicks). All-night electrophysiological recordings were made with 18 persons on 10 nights each.Restlessness during sleep at the end of the night was diminished after Horlicks in a group of 10 young adults. In an older group of eight adults, mean age 55 years, sleep after Horlicks was of longer total duration and was less broken by periods of wakefulness. In the latter group the improvement associated with Horlicks was most apparent late in the night and it increased with repeated administration.     

The Napping Behaviour of Australian University Students

The purpose of this study was to evaluate the self-reported sleep and napping behaviour of Australian university students and the relationship between napping and daytime functioning. A sample of 280 university first-year psychology students (median age  = 19.00 years) completed a 6-item napping behaviour questionnaire, a 12-item Daytime Feelings and Functioning Scale, the Pittsburg Sleep Quality Index and the Epworth Sleepiness Scale. Results indicated that 53.6% of students reported napping with 34% napping at least 1–2 times per week, and 17% napping three or more occasions per week. Long naps, those over 30 minutes, were taken by 77% of the napping students. Sixty-one percent of students reported they took long naps during the post-lunch dip period, from 2–4pm. Students who nap at least once per week reported significantly more problems organizing their thoughts, gaining motivation, concentrating, and finishing tasks than students who did not nap. Students who napped also felt significantly more sleepy and depressed when compared to students who did not nap. The results also indicated that nap frequency increased with daytime sleepiness. The majority of students (51%) reported sleeping 6–7 hours per night or less. Overall, the results from this study suggest that among this population of Australian first-year university students habitual napping is common and may be used in an attempt to compensate for the detrimental effects of excessive sleepiness.     

Fibromyalgia syndrome and chronotype: late chronotypes are more affected

Sleep has strong links to the symptomology of fibromyalgia syndrome (FMS), a diffuse musculoskeletal pain disorder. Information about the involvement of the circadian clock is, however, sparse. In this study, 1548 individuals with FMS completed an online survey containing questions on demographics, stimulant consumption, sleep quality, well-being and subjective pain, chronotype (assessed by the Munich ChronoType Questionnaire, MCTQ), and FMS impact. Chronotype (expressed as the mid-sleep-point on free days, corrected for sleep deficit on workdays, MSF(sc)) significantly correlated with stress-ratings, so-called "memory failures in everyday life," fatigue, FMS impact, and depression but not with anxiety. When chronotypes were categorized into 3 groups (early, intermediate, late), significant group differences were found for sum scores of perceived stress, memory failures in everyday life, fatigue, FMS impact, and depression but not anxiety, with late chronotypes being more affected than early chronotypes. Sleepiness ratings were highest in early chronotypes. Challenges of sleep quality and subjective pain were significantly increased in both early and late chronotypes. The results show that according to their reports, late chronotypes are more affected by fibromyalgia.     

An Experimental Trial Exploring the Impact of Continuous Transdermal Alcohol Monitoring upon Alcohol Consumption in a Cohort of Male Students

Objective

To examine the impact of continuous transdermal alcohol monitoring upon alcohol consumption in male students at a Scottish university.

Method

Using a within-subject mixed-methods design, 60 male university students were randomly allocated into three experimental conditions using AUDIT score stratified sampling. Participants in Conditions A and B were asked not to consume alcohol for a 14-day period, with those in Condition A additionally being required to wear a continuous transdermal alcohol monitoring anklet. Condition C participants wore an anklet and were asked to continue consuming alcohol as normal. Alcohol consumption was measured through alcohol timeline follow-back, and using data collected from the anklets where available. Diaries and focus groups explored participants’ experiences of the trial.

Results

Alcohol consumption during the 14-day trial decreased significantly for participants in Conditions A and B, but not in C. There was no significant relative difference in units of alcohol consumed between Conditions A and B, but significantly fewer participants in Condition A drank alcohol than in Condition B. Possible reasons for this difference identified from the focus groups and diaries included the anklet acting as a reminder of commitment to the study (and the agreement to sobriety), participants feeling under surveillance, and the use of the anklet as a tool to resist social pressure to consume alcohol.

Conclusions

The study provided experience in using continuous transdermal alcohol monitors in an experimental context, and demonstrated ways in which the technology may be supportive in facilitating sobriety. Results from the study have been used to design a research project using continuous transdermal alcohol monitors with ex-offenders who recognise a link between their alcohol consumption and offending behaviour.