SAMMANFATTNING   Bakgrund: Sömn är grundläggande för att människor ska uppleva hälsa och välbefinnande. Syftet: Att undersöka sömnrutiners och omgivande faktorers betydelse för god sömn hos patienter på rehabiliteringsklinik.                                                                                       Metod: En kvantitativ deskriptiv tvärsnittsstudie genomfördes med hjälp av en enkätundersökning på två rehabiliteringskliniker i Stockholm. Patienterna (n=33) togs ut enligt konsekutiv ordning utifrån att de bedömdes kunna fylla i enkäten (adekvata, orienterade till tid och rum, förstod svenska språket). Enkäten, ett validerat och reliabelt redan befintligt frågeformulär, Karolinska Sleep Questionaire (KSQ) användes efter omarbetning.      Resultat: Den sammanlagda bedömningen av sömnen utifrån de fyra indexen, sömnkvalitetsindex, uppvaknandebesvärsindex, snarkbesvärsindex och sömnighets/trötthetsindex visade att det var 76 % som ansåg sig ha dålig sömn. Sömnrutinernas betydelse bedömdes med hjälp av VAS- skalan. 63 % av patienterna skattade sömnrutinernas betydelse från medel till mycket viktig. I denna studie uppgav 42 % att de blev störda i sin sömn på grund av omgivande faktorer. Ljud var det som upplevdes som mest störande faktorn.                                                                                                                           Slutsats: En sömnanamnes tydliggör patientens sömnrutin och underlättar en god sömnkvalitet för patienten.   Nyckelord: sömnrutiner, sömnkvalitet, patienter, rehabilitering / ABSRACT Background: Sleep is essential to enable people to experience the health and welfare. Aim: To examine sleep routines and surrounding factors relevant for a good sleep in patients in rehabilitation clinic.                                                                                                       Method: A quantitative descriptive cross-sectional survey was carried out by means of a questionnaire survey in two rehabilitation clinics in Stockholm. The patients (n=33) were taken out in consecutive order, on the basis that they were able to complete the questionnaire (adequate, oriented in space and time, understood the Swedish language). The questionnaire was designed based on a validated and reliable questionnaire, Karolinska Sleep Questionaire (KSQ).                                                                                                                                 Result:The overall assessment of sleep based on the four indexes, sleep quality index, awakeningindex, snoringindex and sleepiness/fatigue index showed that it was 76% who believed they had poor sleep. Sleep routine significance was assessed based on the VAS scale. 63% of patients estimated sleep routine the importance of medium to very important. In this study 42 % stated that they were disturbed in their sleep because of the surrounding factors. The sound was seen as the most disruptive factor.                                                            Conclusion: A sleep history clarifies the patient's sleep routine, and facilitate a good sleep quality for the patient.     Keywords: sleep routines, sleep quality, patients, rehabilitation

The population of the world is aging. In Sweden alone, almost 20% of the population is 65 years or older. As people get older, problems with sleep disturbances and sleep quality tends to increase, as do the risks of falling injuries. In this thesis, methods for calculating sleep quality and if a person is about to leave a bed were devised. A bed sensor, measuring ballistocardiographical signals, was used to measure activity in bed and vital signs of the occupant. The Cole-Kripke algorithm, used to calculate sleep quality based on activity from a wrist worn sensor, was adapted to the bed sensor system and compared to results from the ActiGraph wGT3X-BT activity monitor, which is frequently used in research. The bed sensor systems sleep quality estimations showed strong correlation with the ActiGraph, with a Pearson correlation coefficient of 0.946. Two approaches were made to estimate if a subject was about to leave the bed, one by training a neural network on labeled night data, and one using a linear equation with each term consisting of activity data, optimized by linear regression. The neural network approach suffered from limited data, but the linear method showed more promise, with accuracy, specificity and sensitivity all over 70%.

Numerous studies have shown the relationship between sleep and overall health. A common measure of sleep is sleep quality which has been shown to be influenced by a variety of factors such as physical activity, diet, stress, social engagement, cognitive stimulating, and sleep hygiene behaviors. Data was analyzed from a previous study to determine whether trying to change one’s sleep would improve sleep quality and if this was more effective than physical exercise. A group of 104 individuals, randomized to the treatment group, were asked to log their daily activities, via smartphone app, within these six behavioral domains for six months. Behavioral change scores were computed as the difference between six-month behavioral level and baseline behavioral level, for each of the six domains. Factor analysis that revealed that two latent factors explained the majority of the variance in behavioral change, with a "Physical Body Related behavior change” factor ("Physical") and a "Mental/Emotional" behavior change factor ("Mental"). In linear regression models, Physical significantly predicted sleep quality improvement over the six months (p=.029), but Mental did not (p=.606). In the middle aged adults in this study, the behavioral change pattern of increasing diet quality and physical activity, significantly predicted improvements in sleep quality. While efforts to improve one's cognitive and emotional well-being were not found to predict to sleep improvement, they still may be important for cognitive health overall. This information can prove useful as different interventions and programs are implemented to improve sleep in the population.

Bakgrund: Fysisk träning har observerats vara en faktor som påverkar sömnkvaliteten. På grund av tidskrävande universitetsstudier har det visats att såväl fysisk träning som sömn kan komma att bortprioriteras hos studenter. Studier kring hur Sveriges fysioterapeutstudenters träningsmängd korrelerar med sömnkvaliteten saknas.  Syfte: Att undersöka svenska fysioterapeutstudenters mängd fysiska träning och upplevda sömnkvalitet samt om det förelåg några skillnader mellan kvinnor och män. Syftet var dessutom att undersöka sambandet mellan fysisk träning och dålig sömnkvalitet. Metod: En kvantitativ tvärsnittsstudie med deskriptiv, komparativ och korrelerande design. Den fysiska träningen mättes med hjälp av Socialstyrelsens indikatorfråga för mängd fysisk träning en vanlig vecka och sömnkvaliteten bedömdes med Pittsburgh Sleep Quality Index (PSQI).  Resultat: Sammanlagt deltog 241 fysioterapeutstudenter. Totalt 58% tränade mer än 2 timmar per vecka. Majoriteten av deltagarna upplevde att de inte hade en dålig sömnkvalitet (PSQI= 4). Det fanns ingen signifikant skillnad mellan könen gällande fysisk träning (p= 0.83) och dålig sömnkvalitet (p= 0.14). Det fanns ett signifikant men mycket svagt samband mellan mängd fysisk träning och dålig sömnkvalitet, r= -0.14 (p= 0.04). Slutsats: Studien indikerar en överlag bra fysisk träningsnivå hos Sveriges fysioterapeutstudenter. Majoriteten upplevde att de inte hade en dålig sömnkvalitet. Det förelåg ingen könsskillnad gällande träningsmängd och sömnkvalitet. Korrelationen mellan mängd fysisk träning och dålig sömnkvalitet var mycket svag. / Background: Physical exercise has been observed to be a factor that impacts on sleep quality. As a result of time-consuming university studies, it has been shown that students do not prioritise physical exercise or sleep. Studies on how Sweden’s physiotherapy students’ amount of physical exercise correlate with sleep quality are lacking.  Objective: To examine Sweden’s physiotherapy students' physical exercise and sleep quality, as well as whether there were any differences between women and men. The purpose was also to examine the correlation between physical exercise and poor sleep quality.  Methods: A quantitative cross-sectional study with descriptive, comparative and correlational design. Physical exercise was measured using the National Board of Health and Welfare’s indicator question and sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI).  Results: Altogether, 241 physiotherapy students participated. A total of 58% physical exercised more than 2 hours per week. The majority of the participants did not have a pore sleep quality (PSQI md= 4). There was no significant difference between the sexes regarding physical exercise (p= 0.83) and sleep quality (p= 0.14).  There was a very weak correlation between the amount of physical exercise and poor sleep quality, r= -0.14 (p= 0.04). Conclusion: The study indicates an overall good physical exercise level among Sweden’s physiotherapy students. The majority did not report poor sleep quality. There was no difference between the sexes in the amount of physical exercise or sleep quality. The correlation between physical exercise and poor sleep quality was very weak.

Depressive symptoms and sleep are both strongly associated with deficits in emotional functioning (Durmer & Dinges, 2005; van der Helm & Walker, 2010). Although sleep and depression are tightly intertwined, understanding their independent and conjoint impact on emotional functioning is imperative. Given the limitations of previous designs, the primary goal of this study was to examine the separate impact of poor sleep quality and depressive symptoms on emotion regulation. In order to accomplish this goal, we preselected groups on the basis of their sleep and depression profiles: individuals with mainly sleep problems (N = 30), individuals with mainly depressive symptoms (N = 10), individuals who scored highly on both problems (N = 37), as well as individuals who are low on both problems (N = 33). Main predictions were that sleep would be uniquely associated with poor trait and laboratory emotion regulation. Results were contrary to hypotheses in that we found main effects of depression on all self-reported measures of emotion regulation and a main effect of sleep on rumination alone. Sleep and depression both predicted affective consequences of laboratory emotion regulation but in the opposite of the expected direction: greater severity scores predicted more benefit from instructed emotion regulation strategy use in the laboratory. Further discussion centers on the complexity of sleep problems and future directions for a greater understanding of sleep within emotion regulation.

Poor sleep quality is an important symptom of many medical or psychiatric disorders. However, the impact of cooking oil fumes (COFs) on sleep quality has not been studied. This population-based cross-sectional study was conducted to examine the association between COFs of Chinese household cooking and sleep quality. Individual sleep quality assessment was completed in 2197 participants with an average age of 37.52 years, through Pittsburgh Sleep Quality Index (PSQI). Information about their cooking practice were also collected by self-reported questionnaire. As an internal biomarker of COFs, urinary 1-hydroxypyrene (1-HOP) (n = 562) was further measured using high-performance liquid chromatography. Binary logistic regression models were performed to evaluate the association between exposure to COFs and individual sleep quality. We found that, subjective poor kitchen ventilation, preheating oil to smoking, and cooking for over 30 minutes were positively associated with overall poor sleep quality (global PSQI score >5) [odds ratio (OR) = 1.75, 95% confidence interval (CI) = 1.43–2.16; 1.25, (1.03–1.52); 1.42, (1.15–1.76), respectively]. After adjusting for potential confounders, subjective poor kitchen ventilation still tend to increase the risk of long sleep latency, sleep disturbances, and daytime dysfunction [OR = 1.37, 95% CI = 1.09–1.73; 1.91, (1.39–2.61); 1.54, (1.23–1.93), respectively]. Similar results were observed in participants who preheated oil to smoking [OR = 1.36, 95% CI = 1.08–1.72; 1.55, (1.14–2.14); 1.25, (1.02–1.55), respectively] and cooked for over 30 minutes [OR = 1.34, 95% CI = 1.05–1.72; 1.46, (1.03–2.06); 1.36, (1.08–1.72), respectively]. Furthermore, high urinary 1-HOP level was also positively associated with overall poor sleep quality (OR = 2.30, 95% CI = 1.31–4.05). The results indicated that exposure to COFs from Chinese household cooking may be a risk factor for poor sleep quality among middle-aged Chinese population.

Objective: People living with HIV (PLWH) commonly report sleep disturbances which are associated with long-term health consequences, including disease progression. PLWH also experience internalised stigma as a result of their HIV status, which can be associated with increased loneliness and depression. Little attention focuses on the impact of these factors on sleep. Therefore, we examined whether internalised HIV-stigma was indirectly related to poorer sleep quality through higher levels of loneliness and depressive symptoms. Design: 181 PLWH from across the United States completed an online survey. Main Study Measures: Internalised HIV-stigma was assessed using the HIV-Stigma Scale, loneliness was assessed using the UCLA-Loneliness Scale-Short Form, depressive symptoms were assessed with the Center for Epidemiologic Studies–Depression Index, and Sleep Quality was assessed using the Pittsburgh Sleep Quality Index. Results: Internalised HIV-stigma was indirectly associated with poorer global sleep quality and daytime sleep dysfunction through both loneliness and depressive symptoms. Conclusions: PLWH who experience HIV-related stigma may experience greater feelings of loneliness, which are related to increased depressive symptoms and poorer sleep quality. Interventions focused on improving sleep in PLWH should focus on multiple factors that influence sleep, including psychosocial factors such as stigma, social isolation and depressive symptoms.

A diagnosis of Autism Spectrum Disorder (ASD) can impact the entire family. Parents of children with ASD reportedly have greater stress levels, family conflict, financial concerns, and poor health habits than parents of neurotypical (NT) children. While many parent-focused interventions have been developed, these interventions focus on parent training and child behavior outcomes rather than the health and well-being of the parents. Therefore, this study aimed to examine the effects of a 15-week family judo program on physical and psychosocial health in parents of children with ASD. A total of 18 parents of children with ASD participated in a weekly judo program, with each session lasting 45 minutes. Parents completed online surveys that asked about sociodemographic information and parental stress and wore wrist accelerometers that measured their physical activity and sleep quality. Paired samples t-tests were used to examine parental stress, physical activity, and sleep quality differences in parents of children with ASD pre- and post-judo program. Both a decrease in parental stress (47.77 vs. 41.61, p High-stress levels can also negatively impact physical health and have been linked to poor sleep and low physical activity levels. This is particularly concerning as research suggests that parents of children with neurodevelopmental disorders already report worse sleep quality and lower levels of physical activity than parents of NT children. Furthermore, the treatment of sleep disorders in children with ASD has been related to reductions in parental stress. Additionally, child engagement in health behaviors has been correlated with parent behaviors. The majority of these studies, however, have utilized self-report measures of sleep and physical activity, which are prone to bias. Furthermore, while there are several components that make up sleep quality, the majority of studies have primarily focused on sleep duration rather than other aspects of sleep, such as sleep efficiency. Parental stress can also spill over into the parent-child relationship, resulting in diminished communication quality and decreased optimism about the future. Furthermore, evidence suggests a bidirectional relationship exists between parent/caregiver stress and child ASD symptoms. In other words, increased stress levels of the parent/caregiver may exacerbate the child's ASD symptoms, further worsening parent/caregiver stress. The immediate need for interventions to ease parents' stress and improve the quality of life for both parents and children is apparent. Physical activity has been deemed an intervention to reduce stress and is associated with improved well-being and mental health for both neurotypical and ASD populations. Several studies have demonstrated the benefits of physical activity interventions incorporating mind-body interaction, such as yoga or martial arts, for children with ASD. Martial arts training, such as judo, benefits participants and their families by encompassing mindfulness, balance, strength, and coordination, emphasizing social interaction. Despite the increasing prevalence of ASD, the reported stress on families of children with ASD, and the negative effects of parent stress on both parents and their children with ASD, there are no studies that have examined the benefits of a family-based, mind-body physical activity program on stress and health behaviors in parents of children with ASD. The current study will address this gap by examining the effects of a family judo intervention on parent stress and sleep patterns of parents of children with ASD. There is a significant decrease in parent-reported stress post-judo program. Parents also have increased levels of physical activity. Finally, we see parents reporting decreased stress and improved self-confidence with their children during the semi-structured interviews at the end of the program. These findings may be used to explore further whether a family judo program may lead to better parent and family outcomes, such as increased parental efficacy, improved parent-child bonding, and strengthened family resiliency.

No description available.

Cerebrovascular burden (CVB) is a significant factor among the aging population. Age-related cognitive decline is an important social and economic issue, and understanding the mechanisms has clinical implications, both in selecting potential therapies and in choosing specific modifiers for their evaluation. In summary, past work suggests that high CVB is one source of variance in neurovascular functioning among older adults. High CVB and associated brain-changes have been identified as causes of age-related changes and it may be that high CVB is a correlate of age-related changes in sleep quality. The primary hypothesis to be tested is that cerebrovascular burden measured using an index variable reflecting blood pressure, resting heart rate, and blood oxygen saturation, will predict subjective sleep quality in a sample of adults over age 70. Sleep quality was measured using the Pittsburgh Sleep Quality Index. A sample of 8 dementia-free, community dwelling participants over the age of 70 completed the study. Though individual cerebrovascular risk factors (blood pressure, resting heart rate) had moderate but non-significant correlations with sleep quality, only the CVB index variable significantly related (1-tailed) to sleep quality. Findings support the hypothesized relationship. Future research should seek to replicate these findings with a larger sample, and to identify mechanisms by which this relationship may function.