Objectives

We aimed to compare three variants of the Pittsburgh Sleep Quality Index (PSQI usual, work- and work-free days: PSQI_u, PSQI_w, PSQI_f) and to assess whether chronotype (MSF_sc)/social jetlag (SJL) are associated with sleep quality in patients with sleep disorders (SD).

Methods

In sum, 431 SD patients and 338 subjects from the general population (GP) were included. Participants filled in three variants of the PSQI and the Munich ChronoType Questionnaire (MCTQ). We used Generalized Estimating Equations (GEE) to investigate effects of group (GP, SD), PSQI (usual, work or free) and their interaction (group∗PSQI) on scores. To investigate associations between MSF_sc/SJL and the difference between PSQI_w and PSQI_f (PSQI_diff) in patients with SD we used linear regressions (N = 352). We used Sobel to test whether there was a mediation effect of SJL on the association between MSF_sc and PSQI_diff.

Results

PSQI scores differed between groups (p < 0.001). Post-hoc analysis revealed a significant difference between PSQI_u vs. PSQI_f and PSQI_w vs. PSQI_f with PSQI_f presenting lower scores, while PSQI_u vs. PSQI_w did not differ in any group. In line with previous findings, SJL was associated to PSQI_diff in SD patients.

Conclusions

PSQI_u mainly represents sleep quality on workdays also in SD patients. Being a late chronotype seems to be associated with higher differences in sleep quality on work-vs. free days mostly when it coincides with societal time constraints. Since sleep quality is poorer on workdays even in SD patients, we suggest that treatment strategies should address social aspects affecting sleep, including ways of minimizing SJL.

中文翻译：

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社交时间会影响睡眠障碍患者的睡眠质量。

目标

我们旨在比较匹兹堡睡眠质量指数的三种变体（PSQI的平时，无工作日和无工作日：PSQI _u，PSQI _w，PSQI _f），并评估表型（MSF _sc）/社会时差（SJL）是否相关睡眠障碍（SD）患者的睡眠质量。

方法

总共包括431名SD患者和338名来自普通人群（GP）的受试者。参与者填写了PSQI和慕尼黑计时型问卷（MCTQ）的三种变体。我们使用广义估计方程（GEE）来研究组（GP，SD），PSQI（正常，工作或自由）及其相互作用（组* PSQI）对分数的影响。为了研究SD患者的MSF _sc / SJL与PSQI _w和PSQI _f之间的差异（PSQI _diff），我们使用线性回归（N = 352）。我们用Sobel检验了SJL对MSF _sc和PSQI _diff之间的关联是否有中介作用。

结果

两组之间的PSQI分数有所不同（p <0.001）。事后分析显示PSQI _u与PSQI _f和PSQI _w与PSQI _f之间存在显着差异，其中PSQI _f得分较低，而在任何组中PSQI _u与PSQI _w均无差异。与先前的发现一致，SD患者中SJL与PSQI_差异相关。

结论

PSQI _u主要代表SD患者在工作日的睡眠质量。迟发性表型似乎与工作与睡眠质量的较高差异有关。空闲时间主要是在社会时间紧迫的情况下。由于即使在SD患者中，工作日的睡眠质量也较差，因此我们建议治疗策略应针对影响睡眠的社会方面，包括最大程度降低SJL的方法。