• 0909
• Sleep Hygiene Practices And Sleep Quality In Depressed And
• Anxious Outpatients
• Jimenez-Genchi A, Monteverde E, Nenclares-Portocarrero A, Esquivel-
• Adame G
• Instituto Nacional de Psiquiatria Ramon de la Fuente, Mexico, Mexico

• Introduction: Sleep hygiene (SH) consists of a series of recommendations
• aimed at reducing behaviors that produce increased arousal and/or
• behaviors that are inconsistent with sleep organization. Rather than a primary
• cause of insomnia, poor sleep hygiene contributes to insomnia of
• other types, mainly that associated with mental disorders. However, as far
• as we know, specific SH rules, which may be contributing to poor sleep
• of patients with depressive and/or anxiety disorders, have not been
• described. Therefore, the aim of this retrospective study was the comparison
• of sleep quality between patients who practiced SH and those who
• did not.

• Methods: Psychiatric outpatients with a primary diagnosis of Major
• Depression (n=31), Anxiety Disorder (n=15), and comorbid Major
• Depression and Anxiety Disorder (n=16) were included. Subjects with
• pharmacological and/or no pharmacological treatment in the last month,
• psychotic and substance related disorders were excluded. All patients
• filled two questionnaires: the Pittsburgh Sleep Quality Index (PSQI) and
• a self-rated instrument that assessed the practice of 22 SH rules during the
• previous month. PSQI scores were compared between subjects who practiced
• and those who did not practice each one of the SH rules.

• Results: Sixty-two patients were studied (age 33.5, ± 14.4; female
• 77.5%). There were no significant differences in age, gender or PSQI
• scores between diagnostic groups. Significantly lower PSQI scores were
• observed just in patients who practiced one of the following SH rules: a)
• Regular arising time in the morning (10.1 ± 3.6 vs 12.6 ± 3.4, t 2.6); b)
• Morning exercise (9.2 ± 2.9 vs 12.1 ± 3.4, t 2.8); c) Avoid coca cola drinks
• (10.5 ± 4.2 vs 12.6 ± 2.9, t 2.2); d) Not going to bed with hunger or thirst
• (11.1 ± 3.5 vs 13.1 ± 3.9, t 1.9); e) Not staying in bed if not sleeping or
• sleepy (8.9 ± 3.3 vs 12.4 ± 3.5, t 3.3) (all p<0.05). Furthermore, the sum
• of the scores of these items showed a significant negative relation with
• PSQI scores (r= -.53, p<0.01).

• Conclusion: These results support previous observations with respect to
• the participation of inadequate sleep hygiene in the poor sleep of patients
• with major depression or anxiety disorders. In addition, they suggest the
• existence of "active ingredients" in SH. The next step is testing the efficacy
• of the voluntary practice of these rules.