Availability of Data and Material
The datasets generated or analyzed during the study are available from the corresponding author on reasonable request.
Conflicts of Interest
Seockhoon Chung, a contributing editor of the Psychiatry Investigation, was not involved in the editorial evaluation or decision to publish this article. All remaining authors have declared no conflicts of interest.
Author Contributions
Conceptualization: Seockhoon Chung, In-Young Yoon. Data curation: Hyuk Joo Lee, Hayun Choi. Formal analysis: Hyuk Joo Lee. Funding acquisition: In-Young Yoon. Investigation: Hyuk Joo Lee, Jung Kyung Hong, Hayun Choi. Methodology: Hyuk Joo Lee, Hayun Choi, In-Young Yoon. Project administration: Hyuk Joo Lee. Resources: In-Young Yoon. Software: Hyuk Joo Lee. Supervision: Seockhoon Chung, In-Young Yoon. Validation: In-Young Yoon. Visualization: Hyuk Joo Lee. Writing—original draft: Hyuk Joo Lee, In-Young Yoon. Writing—review & editing: all authors.
Funding Statement
This work was supported by the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (grant number HI17C0203).
Data are presented as mean±standard deviation for numerical data and number (%) for categorized data. Independent t-test and chi-square test were performed to examine inter-group differences. BMI, body mass index; PSQI, Pittsburgh Sleep Quality Index; ESS, Epworth Sleepiness Scale; BDI, Beck’s Depression Inventory; BAI, Beck’s Anxiety Inventory; NRS, Numeric Rating Scale; AHI, apnea-hypopnea index; PLMI, periodic limb movement index
Characteristics |
Experimental group (N=81) |
Control group (N=79) |
p-value† | |||||
---|---|---|---|---|---|---|---|---|
Pre-intervention | Post-intervention | p-value* | Pre-intervention | Post-intervention | p-value* | |||
Questionnaires (score) | ||||||||
PSQI | 12.47±2.72 | 10.30±3.36 | <0.001 | 11.91±2.65 | 10.44±3.09 | <0.001 | 0.118 | |
ESS | 7.52±4.73 | 7.16±4.31 | 0.457 | 8.47±5.27 | 7.63±4.40 | 0.101 | 0.442 | |
BDI | 15.84±9.37 | 13.06±8.31 | <0.001 | 15.34±8.28 | 13.77±7.91 | 0.006 | 0.263 | |
BAI | 11.51±7.68 | 9.48±7.28 | <0.001 | 11.16±9.70 | 9.22±8.65 | <0.001 | 1.000 | |
NRS | 3.10±2.42 | 2.79±2.32 | 0.176 | 3.06±2.51 | 2.71±2.37 | 0.181 | 0.917 | |
Sleep diary‡ | N=71 | N=66 | ||||||
SL (min) | 64.26±41.86 | 39.85±30.82 | <0.001 | 56.53±38.39 | 42.88±40.68 | 0.004 | 0.138 | |
WASO (min) | 94.53±73.71 | 59.98±53.94 | <0.001 | 93.60±81.18 | 67.37±69.40 | <0.001 | 0.383 | |
TST (min) | 258.39±81.59 | 315.51±67.70 | <0.001 | 258.49±77.85 | 304.82±76.96 | <0.001 | 0.637 | |
SE (%) | 62.68±17.90 | 76.62±14.76 | <0.001 | 64.56±18.91 | 74.68±17.98 | <0.001 | 0.221 | |
Actigraphy§ | N=72 | N=69 | ||||||
SL (min) | 5.83±6.13 | 6.71±7.03 | 0.410 | 6.79±8.62 | 7.51±8.71 | 0.654 | 0.957 | |
WASO (min) | 76.54±40.76 | 78.15±43.67 | 0.742 | 69.55±32.90 | 69.26±33.44 | 0.924 | 0.957 | |
TST (min) | 337.74±57.49 | 331.31±55.35 | 0.217 | 330.14±78.32 | 336.00±61.08 | 0.480 | 0.299 | |
SE (%) | 80.82±7.90 | 80.19±9.10 | 0.506 | 81.62±7.63 | 81.68±7.58 | 0.925 | 0.847 | |
Blood test | ||||||||
IL-6 (pg/mL) | 2.10±3.74 | 1.73±3.10 | 0.214 | 1.53±1.40 | 2.62±8.33 | 0.246 | 0.140 | |
TNF-alpha (pg/mL) | 0.83±0.30 | 0.80±0.30 | 0.170 | 0.80±0.29 | 0.82±0.33 | 0.453 | 0.121 | |
Glucose (mg/dL) | 96.21±23.79 | 95.25±16.64 | 0.631 | 95.91±14.92 | 96.49±17.27 | 0.655 | 0.647 | |
CRP (mg/L) | 2.14±12.51 | 0.70±1.16 | 0.306 | 1.18±3.96 | 1.46±4.64 | 0.528 | 0.248 | |
Cortisol (µg/dL) | 10.70±3.03 | 9.66±3.93 | 0.020 | 11.03±3.29 | 10.07±3.63 | 0.034 | 0.484 | |
Insulin (mIU/L) | 5.20±6.15 | 6.16±8.05 | 0.395 | 4.67±2.53 | 5.83±4.97 | 0.029 | 0.978 |
† analysis of covariance was performed to examine between-group differences after controlling for age, sex, and baseline body mass index;
PSQI, Pittsburgh Sleep Quality Index; ESS, Epworth Sleepiness Scale; BDI, Beck’s Depression Inventory; BAI, Beck’s Anxiety Inventory; NRS, Numeric Rating Scale; SL, sleep latency; WASO, wake after sleep onset; TST, total sleep time; SE, sleep efficiency; IL-6, interleukin-6; TNF-alpha, tumor necrosis factor-alpha; CRP, C-reactive protein
Characteristics |
Experimental group (N=40) |
Control group (N=41) |
p-value† | |||||
---|---|---|---|---|---|---|---|---|
Pre-intervention | Post-intervention | p-value* | Pre-intervention | Post-intervention | p-value* | |||
Questionnaires (score) | ||||||||
PSQI | 13.00±2.21 | 10.37±3.04 | <0.001 | 12.15±2.59 | 10.95±2.70 | 0.002 | 0.039 | |
ESS | 7.80±4.54 | 6.78±4.19 | 0.124 | 7.51±5.34 | 6.85±4.50 | 0.250 | 0.957 | |
BDI | 17.90±11.03 | 14.25±8.53 | 0.006 | 15.68±9.36 | 14.00±8.37 | 0.029 | 0.287 | |
BAI | 11.82±7.73 | 9.72±6.50 | 0.002 | 11.34±11.26 | 9.56±10.15 | 0.048 | 0.903 | |
NRS | 3.05±2.56 | 2.68±2.33 | 0.223 | 3.10±2.60 | 2.78±2.48 | 0.358 | 0.789 | |
Sleep diary‡ | N=34 | N=34 | ||||||
SL (min) | 65.17±41.44 | 37.60±30.65 | <0.001 | 57.92±41.12 | 44.92±37.03 | 0.028 | 0.127 | |
WASO (min) | 98.18±70.67 | 57.07±59.72 | <0.001 | 91.36±64.08 | 69.46±63.35 | 0.013 | 0.128 | |
TST (min) | 249.90±78.81 | 324.32±72.85 | <0.001 | 254.13±72.26 | 303.98±73.53 | 0.001 | 0.247 | |
SE (%) | 61.50±17.21 | 78.32±14.76 | <0.001 | 64.01±17.88 | 74.09±17.72 | 0.001 | 0.073 | |
Actigraphy§ | N=35 | N=35 | ||||||
SL (min) | 6.30±7.04 | 7.87±8.42 | 0.402 | 5.73±5.51 | 8.30±8.87 | 0.179 | 0.677 | |
WASO (min) | 85.21±43.51 | 88.54±49.15 | 0.688 | 72.02±33.92 | 74.87±30.82 | 0.448 | 0.884 | |
TST (min) | 332.29±56.17 | 327.36±55.71 | 0.471 | 326.36±67.07 | 331.04±64.83 | 0.565 | 0.656 | |
SE (%) | 78.80±8.47 | 78.03±9.82 | 0.590 | 80.86±7.44 | 79.82±7.32 | 0.236 | 0.584 | |
Blood test | ||||||||
IL-6 (pg/mL) | 2.00±2.91 | 1.49±1.36 | 0.334 | 1.57±1.53 | 1.99±2.84 | 0.267 | 0.282 | |
TNF-alpha (pg/mL) | 0.92±0.32 | 0.85±0.31 | 0.073 | 0.82±0.28 | 0.88±0.39 | 0.131 | 0.007 | |
Glucose (mg/dL) | 102.55±31.77 | 98.88±20.69 | 0.343 | 97.27±13.19 | 95.00±11.93 | 0.171 | 0.698 | |
CRP (mg/L) | 3.84±17.74 | 0.62±0.60 | 0.258 | 1.70±5.44 | 1.41±3.99 | 0.401 | 0.320 | |
Cortisol (µg/dL) | 10.51±2.90 | 8.87±2.94 | 0.004 | 10.58±2.66 | 10.42±3.52 | 0.775 | 0.007 | |
Insulin (mIU/L) | 6.39±8.35 | 6.96±9.85 | 0.793 | 4.55±2.23 | 4.97±3.46 | 0.374 | 0.897 |
† analysis of covariance was performed to examine between-group differences after controlling for age, sex, and baseline body mass index;
PSQI, Pittsburgh Sleep Quality Index; ESS, Epworth Sleepiness Scale; BDI, Beck’s Depression Inventory; BAI, Beck’s Anxiety Inventory; NRS, Numeric Rating Scale; SL, sleep latency; WASO, wake after sleep onset; TST, total sleep time; SE, sleep efficiency; IL-6, interleukin-6; TNF-alpha, tumor necrosis factor-alpha; CRP, C-reactive protein
Characteristics |
Experimental group (N=41) |
Control group (N=38) |
p-value† | |||||
---|---|---|---|---|---|---|---|---|
Pre-intervention | Post-intervention | p-value* | Pre-intervention | Post-intervention | p-value* | |||
Questionnaires (score) | ||||||||
PSQI | 11.95±3.07 | 10.22±3.69 | 0.001 | 11.66±2.72 | 9.89±3.42 | 0.001 | 0.888 | |
ESS | 7.24±4.95 | 7.54±4.45 | 0.675 | 9.50±5.07 | 8.47±4.18 | 0.239 | 0.343 | |
BDI | 13.83±6.97 | 11.90±8.02 | 0.044 | 14.97±7.04 | 13.53±7.48 | 0.097 | 0.723 | |
BAI | 11.20±7.71 | 9.24±8.05 | 0.017 | 10.97±7.81 | 8.84±6.79 | 0.003 | 0.942 | |
NRS | 3.15±2.33 | 2.90±2.43 | 0.475 | 3.03±2.46 | 2.63±2.27 | 0.339 | 0.865 | |
Sleep diary‡ | N=37 | N=32 | ||||||
SL (min) | 63.42±42.79 | 41.92±31.25 | 0.004 | 55.06±35.87 | 40.71±44.73 | 0.058 | 0.734 | |
WASO (min) | 91.18±77.21 | 62.65±48.71 | 0.004 | 95.98±97.14 | 65.16±76.27 | 0.018 | 0.619 | |
TST (min) | 266.19±84.38 | 307.42±62.51 | 0.002 | 263.13±84.29 | 305.72±81.61 | 0.010 | 0.591 | |
SE (%) | 63.76±18.69 | 75.06±14.78 | <0.001 | 65.14±20.22 | 75.30±18.52 | 0.004 | 0.866 | |
Actigraphy§ | N=37 | N=34 | ||||||
SL (min) | 5.39±5.18 | 5.61±5.30 | 0.841 | 7.87±10.93 | 6.50±8.57 | 0.500 | 0.631 | |
WASO (min) | 68.35±36.68 | 68.30±35.73 | 0.996 | 67.00±32.12 | 63.48±35.46 | 0.455 | 0.972 | |
TST (min) | 342.90±59.01 | 335.04±55.51 | 0.322 | 334.02±89.29 | 341.09±57.48 | 0.833 | 0.627 | |
SE (%) | 82.74±6.90 | 82.24±7.96 | 0.697 | 82.39±7.85 | 83.60±7.46 | 0.304 | 0.726 | |
Blood test | ||||||||
IL-6 (pg/mL) | 2.19±4.44 | 1.96±4.16 | 0.127 | 1.53±1.26 | 3.30±11.69 | 0.357 | 0.262 | |
TNF-alpha (pg/mL) | 0.75±0.27 | 0.76±0.28 | 0.652 | 0.79±0.30 | 0.76±0.23 | 0.434 | 0.262 | |
Glucose (mg/dL) | 90.02±8.27 | 91.71±10.51 | 0.179 | 94.45±16.64 | 98.11±21.68 | 0.068 | 0.455 | |
CRP (mg/L) | 0.48±0.51 | 0.77±1.53 | 0.194 | 0.61±0.61 | 1.53±5.31 | 0.293 | 0.564 | |
Cortisol (µg/dL) | 10.89±3.18 | 10.43±4.61 | 0.508 | 11.52±3.83 | 9.69±3.75 | 0.012 | 0.316 | |
Insulin (mIU/L) | 4.04±2.21 | 5.38±5.81 | 0.087 | 4.81±2.85 | 6.77±6.11 | 0.047 | 0.625 |
† analysis of covariance was performed to examine between-group differences after controlling for age, sex, and baseline body mass index;
PSQI, Pittsburgh Sleep Quality Index; ESS, Epworth Sleepiness Scale; BDI, Beck’s Depression Inventory; BAI, Beck’s Anxiety Inventory; NRS, Numeric Rating Scale; SL, sleep latency; WASO, wake after sleep onset; TST, total sleep time; SE, sleep efficiency; IL-6, interleukin-6; TNF-alpha, tumor necrosis factor-alpha; CRP, C-reactive protein