Indian Journal of Sleep Medicine

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2023 | January-March | Volume 18 | Issue 1

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Original Article

Kshirod K Mishra, Ahmed Mushtaq Reshamvala, Harshal Sathe, Vrushti Bharat Patil

Effects of Lockdown on Sleep Pattern in the General Population during COVID-19 Pandemic

[Year:2023] [Month:January-March] [Volume:18] [Number:1] [Pages:6] [Pages No:1 - 6]

Keywords: COVID-19, Lockdown, Sleep

   DOI: 10.5005/jp-journals-10069-0110  |  Open Access |  How to cite  | 


Background and aim: COVID-19 pandemic hit India in January 2020. To curb the spread of the virus, a nationwide lockdown was instated on March 24. The lockdown has had an adverse psychological impact on the general population. Sleep is essential because of its many benefits for mental and physical health. Lack of sleep can impair both mental and physical functioning like decision-making, mood changes, anxiety symptoms, jeopardize immune response, increase accidents and increase medical expenditures. The current study was aimed at assessing sleep patterns during the pandemic in the general public. Materials and methods: This was a cross-sectional, observational descriptive survey study conducted through social media platforms. Sociodemographic data such as age, gender, marital status, etc. along with sleep schedules, and working routine was assessed using a semi-structured pro forma. Insomnia severity index (ISI) and patient health questionnaire-4 (PHQ-4) were tools used to assess insomnia; depression and anxiety respectively. Results: A total of 124 subjects were included in the study. Sleep patterns revealed a delay in routine bedtimes, with a reduction in sleep quality and an increase in total sleep duration. Moderate to severe insomnia was seen in 9% of patients and 29% had subthreshold insomnia. Anxiety was found in 19 and 22% had depressive symptoms. Conclusion: Lockdown due to the COVID-19 pandemic was associated with changes in sleep patterns, quantity, and quality of night-time sleep and had also led to the manifestation of emotional symptoms in the general population.



Aliza Reshi

Sleep Paralysis: Prevalence in Indian College Students, Locus of Control and Susceptibility to Stress

[Year:2023] [Month:January-March] [Volume:18] [Number:1] [Pages:4] [Pages No:7 - 10]

Keywords: Indian college students, Locus of control, Sleep paralysis, Stress proneness, Stress susceptibility

   DOI: 10.5005/jp-journals-10069-0111  |  Open Access |  How to cite  | 


Sleep paralysis (SP) is a sleep disorder characterized by a waking state and an inability to move (paralysis) occurring suddenly during sleep. Although the prevalence rate in the general population is usually around 7.6%, it is elevated in the college student population to around 28.3%. Furthermore, research has linked the experience of SP episodes to the cultural background and paranormal beliefs of an individual. Aims: The present study hence aims to determine: (1) the prevalence of SP in the Indian college population, (2) the relationship between the locus of control (LOC) of an individual with the frequency and intensity of SP episodes based on a hypothesized pathway of an individual experiencing less fear with an increased sense of control, and (3) the relationship between proneness to stress of an individual and the experience of SP episodes. The study also incorporates an exploratory analysis to investigate relationships between the proneness of stress, LOC and the experience of SP including intensity and frequency of the first episode, and of the latest episode. Materials and methods: An online survey method is used with voluntary response sampling. A total of 150 participants responded to the survey, measuring SP experience, intensity and frequency, LOC, and proneness to stress. Results: No significant differences were found in the intensity and frequency of SP episodes among the three LOCs (external chance, external powerful others, and internal), or in people with high proneness to stress and in people with low proneness to stress. A significant relationship was found between the external LOC and the presence of the intruder hallucination, and between the fear intensity of the first episode and the number of lifetime episodes. Conclusion: The experience of SP is not related to LOCs, but the frequency of episodes is related to the fear felt during the first episode. Clinical significance: Sleep paralysis interventions can target fear associated with SP to bring down the frequency of episodes.


Original Article

Nithya Haridas, Nidhi Sudhakar, Aditya Ashok, Akhilesh Kunoor, Renjitha Bhaskaran

Prevalence and Clinical Features of Rapid Eye Movement-related Obstructive Sleep Apnea: A Cross-sectional Analysis of Clinical Population from South India

[Year:2023] [Month:January-March] [Volume:18] [Number:1] [Pages:4] [Pages No:11 - 14]

Keywords: Gender, Obstructive sleep apnea, Rapid eye movement

   DOI: 10.5005/jp-journals-10069-0112  |  Open Access |  How to cite  | 


Introduction: Rapid eye movement (REM)-related obstructive sleep apnea (OSA) is a condition where apneas and hypopneas occur predominately during REM sleep. There is limited data on the prevalence of REM-related breathing disorders in the Indian population. Aim of the study: To estimate the prevalence of REM-related OSA in a clinic-based population in South India. Methodology: This cross-sectional observational study was done in a tertiary care center in South India from January 2017 to December 2019. Consecutive adult patients who underwent level-I polysomnography were enrolled. Apnea–Hypopnea Index (AHI) was computed as the total number of apneas and hypopneas per hour of total sleep time. Sleep-state-dependent indices were also determined by dividing the number of events in nonrapid eye movement (NREM) and REM sleep by the amount of NREM and REM time, respectively. Patients with an AHI greater than five were diagnosed with OSA and included in this study. Rapid eye movement-related obstructive sleep apnea was defined as overall AHI ≥5 and AHI REM/AHI NREM ≥2. Nonrapid eye movement-related OSA was defined as overall AHI ≥5 and AHI REM/AHI NREM ≥2. Statistical analysis was performed using IBM SPSS version 21.0. Results: One hundred ninety-nine patients diagnosed with OSA were included in the study. Rapid eye movement OSA has a prevalence of 24.12% in this population. Age >50 years and female sex were the factors associated with REM-predominant OSA, while T88% >20% was associated with NREM OSA. Conclusion: Rapid eye movement-related OSA is prevalent in South Indian patients referred for evaluation of sleepiness.



KR Bharath K Reddy, Barnali Bhattacharya

Knowledge, Attitude, Practices, and Training of Pediatricians in India Regarding Sleep Disorders in Children: A Need to Wake Up!

[Year:2023] [Month:January-March] [Volume:18] [Number:1] [Pages:3] [Pages No:15 - 17]

Keywords: Education, Healthcare, Pediatric, Sleep, Sleep lab

   DOI: 10.5005/jp-journals-10069-0113  |  Open Access |  How to cite  | 


Introduction: Sleep disorders are prevalent in children. Pediatricians being the first point of contact for parents need adequate knowledge in the management of sleep disorders. This study was undertaken to understand the knowledge, attitude, practices, and training of pediatricians in India regarding sleep in children. Methodology: About 510 pediatricians across India completed a 24-item web-based survey. The domains assessed included sleep physiology, infant sleep, obstructive sleep apnea (OSA), and parasomnias. The respondents consisted of general pediatricians (85.42%), pediatric pulmonologists (4.40%), and pediatric neurologists (1.39%). Results: The mean knowledge score of the respondents was 54% (±17%). Pediatric pulmonologists scored above 90% in all questions compared with others. Only 203 (39.8%) respondents routinely asked questions regarding sleep patterns and sleep-related problems. About 22 (4.3%) respondents used a screening tool or sleep questionnaire in clinical practice, and 51 (10%) respondents were confident about managing sleep problems. About 19 (3.7%) respondents had referred a child for polysomnography (PSG). About 474 (93%) respondents said they did not receive any formal training in pediatric sleep medicine. Conclusion: The knowledge and practices among pediatricians in India on pediatric sleep disorders were found to be poor, similar to studies in other countries. This study hence highlights the increased need for awareness and education among pediatricians in India in pediatric sleep medicine.


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