The Athens Insomnia Scale (AIS) can be regarded as a highly useful instrument in both clinical and research settings, except for when assessing the severity level. This study aims to determine the severity criteria for AIS by using the Insomnia Severity Index (ISI). A total of 1666 government employees aged 20 years or older were evaluated using the AIS and ISI, the Patient Health Questionnaire for depressive symptoms, the Epworth Sleepiness Scale for daytime sleepiness, and the Short Form Health Survey of the Medical Outcomes Study for health-related quality of life (QoL). A significant positive correlation (r) was found between the AIS and the ISI (r = 0.80, p < 0.001). As a result of describing receiver–operator curves, the severity criteria of the AIS are capable of categorizing insomnia severity as follows: absence of insomnia (0–5), mild insomnia (6–9), moderate insomnia (10–15), and severe insomnia (16–24). In addition, compared to all scales across groups categorized by AIS or ISI, it was revealed that similar results could be obtained (all p < 0.05). Therefore, the identification of the severity of AIS in this study is important in linking the findings of epidemiological studies with those of clinical studies.
Lower NAA levels and higher Glx/creatine and Glx/myoinositol ratios in the ACC of CLBP participants compared with controls were revealed. The result suggests the hypothesis that excessive Glx leads to neuronal dysfunction and/or death, which was reflected as a low NAA level in the ACC of individuals with CLBP. Measurement of these metabolites using MRS potentially helps evaluate CLBP patients' condition and psychological status objectively.
We aimed to analyze (a) the changes in depression, sleepiness, insomnia, and sleep habits in relation to the degree of self-isolation and (b) the effects of changes in sleep habits and social interactions on depression, insomnia, and sleepiness during the coronavirus disease 2019 (COVID-19) pandemic. We enrolled 164 patients who visited the sleep outpatient clinic in Shiga University of Medical Science Hospital. We compared the sleep habits, depression (Patient Health Questionnaire-9: PHQ-9), insomnia (Athens Insomnia Scale: AIS), and sleepiness (Epworth Sleepiness Scale: ESS) of patients during the period from April to July 2019 vs. May 2020 (a period of self-isolation due to COVID-19). A Wilcoxon signed-rank test indicated no significant differences in PHQ-9, ESS, and AIS scores between 2019 and 2020 within both the strong self-isolation group and no/little self-isolation group. With respect to sleep habits, earlier bedtime (p = 0.006) and increased sleep duration (p = 0.014) were found in the strong self-isolation group. The former (p = 0.009) was also found in the no/little self-isolation group, but we found significant differences in sleep duration between the no/little self-isolation group and the strong self-isolation group (p = 0.047). Therefore, self-isolation due to COVID-19 had relatively small one-year effects on depression, sleepiness, and insomnia in a clinical population.
A large epidemiological study using oximetry to analyze obstructive sleep apnea (OSA) and metabolic comorbidities was performed in Japan; however, reliability and validity of oximetry in the Japanese population remains poorly understood. In this study, oximetry data from the epidemiological study were compared with data from clinically performed polysomnography (PSG) and out-of-center sleep testing (OCST) in epidemiological study participants who later attended our outpatient units. The oxygen desaturation index (ODI) from oximetry showed a moderate positive relationship (correlation coefficient r = 0.561, p < 0.001) with apnea/hypopnea data from PSG/OCST. The area under the receiver operating characteristic curve showed moderate accuracy of this method in the detection of moderate-to-severe or severe OSA. However, the optimal ODI thresholds to detect moderate-to-severe OSA and severe OSA were the same (ODI > 20.1). Oximetry may be a useful tool for screening moderate-to-severe or severe sleep apnea. However, it may be difficult to set an appropriate threshold to distinguish between moderate and severe sleep apnea by oximetry alone.
Background: Japanese people are known to have the shortest sleep duration in the world. To date, no study has assessed a large Japanese population for insomnia and sleep duration. Methods: We performed an Ιnternet-based survey in association with a national television (TV) program. Questionnaire data were collected not only through personal computers, tablets, and smartphones, but also through the Hybridcast system, which combines broadcasts over airwaves with broadband data provided via the Internet using the TV remote controller. The Athens Insomnia Scale (AIS) was used to assess insomnia. Results: A total of 301,241 subjects participated in the survey. Participants slept for an average of 5.96 ± 1.13 h; the average AIS score was 6.82 ± 3.69. A total of 26.1% of male and 27.1% of female participants had both insomnia (AIS ≥ 6) and short sleep duration (<6 h). Responses were recorded through the Hybridcast system for 76.4% of the elderly (age ≥ 65 years) subjects and through personal computers, tablets, or smartphones for 59.9–82.7% of the younger subjects (age ≤ 65 years). Conclusions: Almost a quarter of the Japanese participants presented short sleep duration and insomnia. Furthermore, the Hybridcast system may be useful for performing large internet-based surveys, especially for elderly individuals.
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