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Fulltext Effects of Internet Cognitive Behavioral Therapy for Insomnia and Internet Sleep Hygiene Education on Sleep Quality and Executive Function Among Medical Students in Malaysia: Protocol for a Randomized Controlled Trial

Mariappan V, Mukhtar F

JMIR Res Protoc, 2024 Dec 11;13:e59288.
PMID: 39661437 DOI: 10.2196/59288

BACKGROUND: Medical students are frequently affected by poor sleep quality. Since poor sleep quality has negative physiological and psychological consequences such as on executive function, there is an opportunity to improve sleep quality and executive functions using non-pharmacological intervention such as cognitive behavioural therapy.
OBJECTIVE: The aim of this study therefore is to determine if improving sleep quality could improve executive functions in medical students with poor sleep quality by comparing cognitive behavioural therapy for insomnia (CBT-I) with sleep hygiene education (SHE) in a randomized controlled trial (RCT).
METHODS: A parallel group, RCT with a target sample of 120 medical students recruited from government-based medical universities in Malaysia. Eligible participants will be randomized to internet group CBT-I or internet group SHE in a 1:1 ratio. Assessments will be performed at baseline, post-intervention, 1 month, 3-months, and 6-months. The primary outcome is between-group differences in sleep quality and executive function post-baseline. The secondary outcomes include pre-sleep worry, attitude about sleep, sleep hygiene and sleep parameters.
RESULTS: This study received approval from the Research Ethics Committee in Universiti Putra Malaysia (JKEUPM-2023-1446) and Universiti Kebangsaan Malaysia (JEP-2024-669). The clinical trial was also registered in Australian New Zealand Clinical Trial Registry (ACTRN1264000243516). As of June 2024, the recruitment process is ongoing and a total of 48 and 49 students have been enrolled from the universities into the CBT-I and ISHE groups, respectively. All the participants provided signed and informed consent to participate in the study. Data collection has been completed for the baseline (pre-treatment assessment), and follow-up assessments for T1 and T2 for all the participants in both groups, while T3 and T4 assessments will be completed by July 2025. Data analysis will be performed by August 2025 and the research will be completed by December 2025.
CONCLUSIONS: This study is the first attempt to design a CBT intervention to ameliorate poor sleep quality and its related negative effects among medical students. This research is also the first large-scale exploring the relationship between health status and CBT-mediated sleep improvement among medical students.
TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12624000243516; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=387030.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/59288.

Matched MeSH terms: Sleep Hygiene*
Fulltext Relations of Bedtime Mobile Phone Use to Cognitive Functioning, Academic Performance, and Sleep Quality in Undergraduate Students

Ragupathi D, Ibrahim N, Tan KA, Andrew BN

Int J Environ Res Public Health, 2020 09 29;17(19).
PMID: 33003445 DOI: 10.3390/ijerph17197131

The present cross-sectional study examined the relations of bedtime mobile phone use to cognitive functioning, academic performance, and sleep quality in a sample of undergraduate students. Three hundred eighty-five undergraduate students completed a self-administered questionnaire containing sociodemographic variables, bedtime mobile phone use, the Pittsburgh Sleep Quality Index, and the Cambridge Neuropsychological Test Automated Battery (attention and verbal memory). At bivariate level, increased scores in bedtime mobile phone use were significantly correlated with decreased scores in academic performance and sleep quality. Our multivariate findings show that increased scores in bedtime mobile phone use uniquely predicted decreased scores in academic performance and sleep quality, while controlling for gender, age, and ethnicity. Further untangling the relations of bedtime mobile phone use to academic performance and sleep quality may prove complex. Future studies with longitudinal data are needed to examine the bidirectional effect that bedtime mobile phone use may have on academic performance and sleep quality.

Matched MeSH terms: Sleep Hygiene
Fulltext Sleep belief factors among Diploma students in UiTM Sabah

Nowyannie Willie D. Tamsin, Norah Tuah, Mazalan Sarahintu, Herniza Roxanne Marcus

Borneo Akademika, 2019;3(1):20-29.
MyJurnal

University students are known to have different sleeping schedules. Students’ sleep difficulties will affect their health and their performances in studies. Sleep hygiene is a collection of healthy sleep habits that can improve one’s ability to fall asleep and stay asleep. It is considered to be imperative to treat sleep disturbance especially among university students. The aim of this study is to examine the sleep beliefs among the students of UiTM Sabah based on gender and academic performance. This study was conducted on Diploma students between March and July 2018. The respondents were randomly selected from Diploma students of all faculties in UiTM Sabah: Accounting, Business Management, Public Administration, Science, Planting Industry Management, Hotel Management, and Tourism Management. This paper is based on the Sleep Belief Scale questionnaire to assess the sleep hygiene awareness. Questionnaires were distributed using online survey. Findings of this study were analyzed using SPSS statistical software. The result of findings showed that the Sleep Incompatible Behaviours (drinking coffee, taking sleep medication, smoking before sleep) is the highest contributor of the students’ sleep hygiene and therefore it affects the sleep quality. While the Sleep Wake Cycle Behaviours (going to bed & waking up always at the same hour, going to bed two hours earlier than the habitual hour) and Thoughts and Attitude to Sleep (over thinking before sleep, trying to fall asleep without having a sleep sensation)also contributed to the sleep hygiene of the students but not as high as the Sleep Incompatible Behaviours. Based on the results of the findings, the counseling department of UiTM Sabah may organise an education program to create awareness among students about the intervention and prevention strategies as well as the incorrect beliefs about sleep.

Matched MeSH terms: Sleep Hygiene
Fulltext Parent’s knowledge on healthy lifestyle for children under-5 years [Abstract]

Mohamed Nasir AD, Mohd Kassim AB

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):68.
MyJurnal

ABSTRACTS FOR INTERNATIONAL FAMILY HEALTH CONFERENCE 2019 (I-FaH 2019). Health Intervention Towards Community Wellness, Held at Oriental Crystal Hotel, Kajang, Selangor, Malaysia .4-5th September, 2019
Introduction: Obesity, a major risk factor for chronic disease, is a growing problem in Malaysia. Current data from the National Health Morbidity Survey (NHMS) shows that prevalence of overweight for children under five years has increased from 6.5% (NHMS 2011) to 7.6 % (NHMS 2015). Childhood obesity needs to be addressed as studies also have shown that childhood obesity contributes to adult chronic disease. Increase in chronic diseases will cause an increase in health care cost. Intervention programmes are available and currently target schoolchildren and adults. No programme yet targeting at children under five years. This survey was conducted to understand parents level of knowledge with regards to healthy lifestyle among children under-5 years.
Methods: Parents attending Health Clinics in the state of Perak were given self-administered questionnaire.
Results: Twenty two (22) Health Clinics from 11 districts in Perak were involved in the survey. A total of 600 parents or care givers participated. Majority were unaware of good sleep hygiene and screen time limitation.
Conclusion: Awareness of healthy lifestyle for children under 5 years has not been given due attention. Health intervention via promotion is needed for prevention of obesity.

Matched MeSH terms: Sleep Hygiene
Fulltext Type 2 Diabetes Patients' Perspectives, Experiences, and Barriers Toward Diabetes-Related Self-Care: A Qualitative Study From Pakistan

Bukhsh A, Goh BH, Zimbudzi E, Lo C, Zoungas S, Chan KG, et al.

Front Endocrinol (Lausanne), 2020;11:534873.
PMID: 33329377 DOI: 10.3389/fendo.2020.534873

Objective: This study aimed to qualitatively explore perspectives, practices, and barriers to self-care practices (eating habits, physical activity, self-monitoring of blood glucose, and medicine intake behavior) in urban Pakistani adults with type 2 diabetes mellitus (T2DM). Methods: Pakistani adults with T2DM were recruited from the outpatient departments of two hospitals in Lahore. Semistructured interviews were conducted and audiorecorded until thematic saturation was reached. Two researchers thematically analyzed the data independently using NVivo® software with differences resolved by a third researcher. Results: Thirty-two Pakistani adults (aged 35-75 years, 62% female) participated in the study. Six themes were identified from qualitative analysis: role of family and friends, role of doctors and healthcare, patients' understanding about diabetes, complication of diabetes and other comorbidities, burden of self care, and life circumstances. A variable experience was observed with education and healthcare. Counseling by healthcare providers, family support, and fear of diabetes-associated complications are the key enablers that encourage study participants to adhere to diabetes-related self-care practices. Major barriers to self care are financial constraints, physical limitations, extreme weather conditions, social gatherings, loving food, forgetfulness, needle phobia, and a hectic job. Conclusion: Respondents identified many barriers to diabetes self care, particularly related to life situations and diabetes knowledge. Family support and education by healthcare providers were key influencers to self-care practices among Pakistani people with diabetes.

Matched MeSH terms: Sleep Hygiene