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      Association between physiotherapist sleep duration and working environment during the coronavirus disease 2019 pandemic in Japan: A secondary retrospective analysis study

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          Abstract

          Studies have reported that health care professionals experienced a lack of sleep during the coronavirus disease 2019 (COVID-19) pandemic and that such lack of sleep and working environment affect their performance. However, to the authors’ knowledge, no study has yet investigated the relationship between sleep duration and working environment among Japanese physiotherapists during the COVID-19 pandemic. This study retrospectively investigated the sleep duration of physiotherapists directly providing physiotherapy to patients with COVID-19 within the red zone and analyzed the association between sleep duration and working environment using logistic regression analysis. Among the 565 physiotherapists studied, the average sleep duration was 6 (6–7) h, and 381 (67.4%) had an average sleep duration of ≤6 h. Less experienced physiotherapists were 1.03 times more likely to sleep ≤6 h, and those in charge of patients with COVID-19 as the supervisor ordered were 0.64 times more likely to sleep ≤6 h. Moreover, physiotherapists with a significant increase in the frequency of internal online meetings and those who had been providing physiotherapy to patients with COVID-19 for >6 months were 2.34 and 2.05 times more likely to sleep ≤6 h, respectively. During the COVID-19 pandemic in Japan, two-thirds of the physiotherapists directly providing physiotherapy to patients with COVID-19 slept less than the recommended duration. This study highlights the need for appropriate workload and work hour management for physiotherapists according to their experience and workload, as well as establishing a medical care system that includes work rotation to ensure that the recommended sleep duration is satisfied.

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          Most cited references34

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          The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research

          Despite the prevalence of sleep complaints among psychiatric patients, few questionnaires have been specifically designed to measure sleep quality in clinical populations. The Pittsburgh Sleep Quality Index (PSQI) is a self-rated questionnaire which assesses sleep quality and disturbances over a 1-month time interval. Nineteen individual items generate seven "component" scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. The sum of scores for these seven components yields one global score. Clinical and clinimetric properties of the PSQI were assessed over an 18-month period with "good" sleepers (healthy subjects, n = 52) and "poor" sleepers (depressed patients, n = 54; sleep-disorder patients, n = 62). Acceptable measures of internal homogeneity, consistency (test-retest reliability), and validity were obtained. A global PSQI score greater than 5 yielded a diagnostic sensitivity of 89.6% and specificity of 86.5% (kappa = 0.75, p less than 0.001) in distinguishing good and poor sleepers. The clinimetric and clinical properties of the PSQI suggest its utility both in psychiatric clinical practice and research activities.
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            National Sleep Foundation’s sleep time duration recommendations: methodology and results summary

            The objective was to conduct a scientifically rigorous update to the National Sleep Foundation's sleep duration recommendations.
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              Sleep duration predicts cardiovascular outcomes: a systematic review and meta-analysis of prospective studies.

              Aims To assess the relationship between duration of sleep and morbidity and mortality from coronary heart disease (CHD), stroke, and total cardiovascular disease (CVD). Methods and results We performed a systematic search of publications using MEDLINE (1966-2009), EMBASE (from 1980), the Cochrane Library, and manual searches without language restrictions. Studies were included if they were prospective, follow-up >3 years, had duration of sleep at baseline, and incident cases of CHD, stroke, or CVD. Relative risks (RR) and 95% confidence interval (CI) were pooled using a random-effect model. Overall, 15 studies (24 cohort samples) included 474 684 male and female participants (follow-up 6.9-25 years), and 16 067 events (4169 for CHD, 3478 for stroke, and 8420 for total CVD). Sleep duration was assessed by questionnaire and incident cases through certification and event registers. Short duration of sleep was associated with a greater risk of developing or dying of CHD (RR 1.48, 95% CI 1.22-1.80, P < 0.0001), stroke (1.15, 1.00-1.31, P = 0.047), but not total CVD (1.03, 0.93-1.15, P = 0.52) with no evidence of publication bias (P = 0.95, P = 0.30, and P = 0.46, respectively). Long duration of sleep was also associated with a greater risk of CHD (1.38, 1.15-1.66, P = 0.0005), stroke (1.65, 1.45-1.87, P < 0.0001), and total CVD (1.41, 1.19-1.68, P < 0.0001) with no evidence of publication bias (P = 0.92, P = 0.96, and P = 0.79, respectively). Conclusion Both short and long duration of sleep are predictors, or markers, of cardiovascular outcomes.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Formal analysisRole: InvestigationRole: Project administrationRole: ResourcesRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: InvestigationRole: Project administrationRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: InvestigationRole: ResourcesRole: Writing – review & editing
                Role: SupervisionRole: Writing – review & editing
                Role: SupervisionRole: Writing – review & editing
                Role: Data curationRole: Funding acquisitionRole: InvestigationRole: ResourcesRole: SupervisionRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                PLOS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                9 July 2024
                2024
                : 19
                : 7
                : e0306822
                Affiliations
                [1 ] Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
                [2 ] Medical Japan, Pfizer Japan Inc., Tokyo, Japan
                [3 ] Division of Medical Education, Juntendo University School of Medicine, Tokyo, Japan
                [4 ] Medical Technology Innovation Center, Juntendo University, Tokyo, Japan
                [5 ] Clinical Research and Trial Center, Juntendo University, Tokyo, Japan
                [6 ] Faculty of Health Science, Juntendo University, Tokyo, Japan
                [7 ] Department of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo, Japan
                University of Pretoria, SOUTH AFRICA
                Author notes

                Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: [Fumito Morisawa is employed by Pfizer Japan Inc. However, Pfizer Japan Inc. did not fund and had no involvement in conducting this study. The remaining authors have declared that no competing interests exist. The competing interests do not alter our adherence to PLOS ONE policies on sharing data and materials].

                Author information
                https://orcid.org/0000-0002-6964-6702
                https://orcid.org/0000-0003-1627-6151
                Article
                PONE-D-24-01710
                10.1371/journal.pone.0306822
                11233007
                38980861
                1788ecbe-ca10-4a96-b1fa-6cad3d8bd36c
                © 2024 Morisawa et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 22 January 2024
                : 24 June 2024
                Page count
                Figures: 1, Tables: 2, Pages: 13
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/501100003478, Ministry of Health, Labour and Welfare;
                Award ID: 20CA2047
                Award Recipient :
                There was no additional external funding received for this study. However, our previously conducted study was supported by a Health and Labor Sciences Research Grant from the Ministry of Health, Labour and Welfare ( https://www.mhlw.go.jp/english/) under grant number 20CA2047 to T.T. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. F. M is employed by Pfizer Japan Inc. Pfizer Japan Inc. only provided support in the form of salaries for the author (F.M), but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of the author (F.M) are articulated in the ‘author contributions’ section.
                Categories
                Research Article
                Medicine and Health Sciences
                Medical Conditions
                Infectious Diseases
                Viral Diseases
                Covid 19
                Biology and Life Sciences
                Physiology
                Physiological Processes
                Sleep
                Medicine and Health Sciences
                Health Care
                Physiotherapy
                Medicine and Health Sciences
                Epidemiology
                Pandemics
                Medicine and Health Sciences
                Health Care
                Health Care Facilities
                People and Places
                Population Groupings
                Professions
                Supervisors
                Medicine and Health Sciences
                Critical Care and Emergency Medicine
                Research and Analysis Methods
                Research Design
                Survey Research
                Custom metadata
                Data cannot be shared publicly because the participants did not obtain consent for their data to be shared publicly and ethical restrictions on sharing the data publicly are imposed by the Research Ethics Committee of the Faculty of Health Sciences, Juntendo University. Data are available from the independent data administrator of this study group (contact via email: k.taniguchi.ax@ 123456juntendo.ac.jp ) for researchers who meet the criteria for access to confidential data.
                COVID-19

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