SummaryEmerging longitudinal research has highlighted poor sleep as a risk factor of a range of adverse health outcomes, including disabling pain conditions. In establishing the causal role of sleep in pain, it remains to be clarified whether sleep deterioration over time is a driver of pain and whether sleep improvement can mitigate pain-related outcomes. A systematic literature search was performed using PubMed MEDLINE, Ovid EMBASE, and Proquest PsycINFO, to identify 16 longitudinal studies involving 61,000 participants. The studies evaluated the effect of sleep changes (simulating sleep deterioration, sleep stability, and sleep improvement) on subsequent pain-related outcomes in the general population. A decline in sleep quality and sleep quantity was associated with a two- to three-fold increase in risk of developing a pain condition, small elevations in levels of inflammatory markers, and a decline in self-reported physical health status. An exploratory meta-analysis further revealed that deterioration in sleep was associated with worse self-reported physical functioning (medium effect size), whilst improvement in sleep was associated with better physical functioning (small effect size). The review consolidates evidence that changes in sleep are prospectively associated with pain-related outcomes and highlights the need for further longitudinal investigations on the long-term impact of sleep improvements.

Study objectives:We conceptualized sleep quality judgment as a decision-making process and examined the relative importance of 17 parameters of sleep quality using a choice-based conjoint analysis.Methods:One hundred participants (50 good sleepers; 50 poor sleepers) were asked to choose between 2 written scenarios to answer 1 of 2 questions: “Which describes a better (or worse) night of sleep?”. Each scenario described a self-reported experience of sleep, stringing together 17 possible determinants of sleep quality that occur at different times of the day (day before, pre-sleep, during sleep, upon waking, day after). Each participant answered 48 questions. Logistic regression models were fit to their choice data.Results:Eleven of the 17 sleep quality parameters had a significant impact on the participants’ choices. The top 3 determinants of sleep quality were: Total sleep time, feeling refreshed (upon waking), and mood (day after). Sleep quality judgments were most influenced by factors that occur during sleep, followed by feelings and activities upon waking and the day after. There was a significant interaction between wake after sleep onset and feeling refreshed (upon waking) and between feeling refreshed (upon waking) and question type (better or worse night of sleep). Type of sleeper (good vs poor sleepers) did not significantly influence the judgments.Conclusions:Sleep quality judgments appear to be determined by not only what happened during sleep, but also what happened after the sleep period. Interventions that improve mood and functioning during the day may inadvertently also improve people’s self-reported evaluation of sleep quality.

Background: The COVID- 19 virus is not only effecting physical health, but immensely effecting on psychological health. Objective: To evaluate the psychological health issues, stress, anxiety and depression, among the adult population during the movement control period of COVID-19. Design: Research study is cross-section design, online data collection through social media and internet. Methods and Material: Online cross-sectional survey was conduct (n=716) using Depression, Anxiety and Stress scale (DASS). Statistical analysis used: descriptive statistical analyses, to highlight the prevalence rate of psychological issues and coping response using SPSS. Results: The prevalence in score of Stress 70% (Mean=2.02), Anxiety 67% (Mean=1.71) and Depression 42.3% (Mean=2.28). Conclusions: There is significant prevalence of psychological health issues among adults during the adverse unavoidable circumstance due to COVID-19 Pandemic movement control order.

Pain-related sleep beliefs appear to be an integral part of chronic pain patients' insomnia experience. The PBAS is a valid and reliable instrument for evaluating the role of these beliefs in chronic pain patients.

39People with chronic pain often report sleep of "poor quality".

, pandemic effected the global health, physically, socially and mentally. Currently the pandemic in Malaysia observed to be in control with movement strict precaution and preventions. This study is cross-sectional survey study to evaluate the responses of Malaysian Adults during the COVID-19 pandemic in Malaysia. To evaluate the Malaysian responses and effects on their psychological health and coping response, a cross sectional online survey was conduct on (N=716) adult participants age range 20 to 75 years (Mean 33.34), male (193) female (523) from various background and all district of Malaysia. Questionnaire Depression, Anxiety, and Stress Scale (DASS), and Brief Coping Response Inventory (BCRI) was administer to evaluate the response through online Google form. Results revealed that there is significant gender differences in the score of psychological health related to, depression, anxiety and stress with coping response. Results, A Mann-Whitney U analysis indicated that there was a difference (Z = -2.013, p < .05) indicated that male stress score higher than female during the COVID-19 movement control period. Coping response showed higher significance with male as compared to females. Our findings revealed high levels of depression, anxiety, and stress symptoms among both gender, with the differences in coping response towards the pandemic phase of COVID-19, during movement control period. As Mental health practitioner, there is great needs to address the mental health status and coping responses, for the wellbeing of adults during the unprecedented phase of COVID-19 pandemic.

In Education sectors many researchers have focused student's life style and effects on mental health. Currently there are many factors which are contributing to develop depressive symptoms among University Students. Study was conduct to investigate the relationship between skipping breakfast and lack of physical exercise are contributing risk factor of depression among University students. To conduct this survey research, sample (N=350) students participated from different faculties, of Sultan Idris Education University (UPSI), Malaysia. Students (178% male, 172% female), age (19-27 years) were selected by using convenience sampling. This survey was conduct by administering the structured questionnaire of Breakfast information and Habitual physical exercise questionnaire, level of depression was measured by Beck Depression Inventory (Beck, et al., 1996). Results revealed that there was strongly negative correlation between the scores of having breakfast, Habitual physical activity and depression. Multiple regression shows that skipping breakfast and lack of physical activities were significant, F(2,347=87.99, p<.000), R 2 33%, which revealed skipping breakfast and physical activity are significant at (p<.000). Result indicate that skipping breakfast and lack of physical activity can predict depression. Student's life style behavior of skipping meal and lack of physical are significant for mental and emotional health. Present research predict that skipping breakfast, lack of physical exercise are risk factors toward depression among students. This study is important to learn about the contributing factors of mental health, we can encourage students to take healthy and timely meal and participate regularly in exercise to increase mental health.

Pain and sleeplessness are two of the commonest reasons for primary care appointments. The prevalence of each problem alone is high, and to add to the complexity, pain and insomnia frequently co-occur, with pain interrupting sleep and pain being further aggravated following a poor night’s sleep. Sleep and pain management are increasingly recognized as important to public health. In particular, insomnia and chronic pain are long-term conditions that actively contribute to morbidity, disability, economic burden to society, and suffering to the individual and immediate family. This chapter examines the interrelationship between the two at the population level. Specifically, evidence from population-based studies regarding the co-occurrence and temporal link of pain and sleep is reviewed, with moderators and mediators of the relationship highlighted. Possible directions for future research and treatment development are also outlined.