xml: <clinical_study>
    <!-- This xml conforms to an XML Schema at:
      https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
    <required_header>
      <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
      <link_text>Link to the current ClinicalTrials.gov record.</link_text>
      <url>https://clinicaltrials.gov/ct2/show/NCT05974709</url>
    </required_header>
    <id_info>
      <org_study_id>0f0534f00fdd44cc</org_study_id>
      <nct_id>NCT05974709</nct_id>
    </id_info>
    <brief_title>Factors Affecting Sleep Quality in Office Workers</brief_title>
    <official_title>Factors Affecting Sleep Quality in Office Workers: A Cross-Sectional Study Investigating Pillow and Mattress Factors and Musculoskeletal Symptoms.</official_title>
    <sponsors>
      <lead_sponsor>
        <agency>Çankırı Karatekin University</agency>
        <agency_class>Other</agency_class>
      </lead_sponsor>
    </sponsors>
    <source>Çankırı Karatekin University</source>
    <oversight_info>
      <has_dmc>No</has_dmc>
      <is_fda_regulated_drug>No</is_fda_regulated_drug>
      <is_fda_regulated_device>No</is_fda_regulated_device>
    </oversight_info>
    <brief_summary>
      <textblock>
        This study will focus on the relationship between pillow and mattress factors,&#xD;
        musculoskeletal disorders and sleep quality in office workers. Sleep is vital to physical and&#xD;
        mental health, and poor sleep can negatively affect cognitive function and workplace&#xD;
        performance. Office workers, who often work in sedentary jobs, are particularly prone to&#xD;
        sleep disorders. Recognizing the factors that contribute to poor sleep in this population is&#xD;
        crucial for developing interventions to improve sleep quality.&#xD;
  &#xD;
        The study used a cross-sectional design and will collect data from an appropriate sample of&#xD;
        office workers (Approximately 600 participants). Various variables will be assessed,&#xD;
        including sociodemographic characteristics, sleep-related factors (to be measured using the&#xD;
        Pittsburgh Sleep Quality Index), pillow characteristics, mattress-related factors,&#xD;
        musculoskeletal symptoms, and physical activity levels (to be measured using the&#xD;
        International Physical Activity Questionnaire).&#xD;
  &#xD;
        Descriptive statistics and multiple regression analysis will be performed to analyze the data&#xD;
        and identify factors affecting sleep quality. Fixed fixes for potential confounders and&#xD;
        modifiers. The study aims to identify specific components of the sleep environment related to&#xD;
        sleep disorders.&#xD;
  &#xD;
        The findings of this study will contribute to the understanding of how pillow and mattress&#xD;
        factors, along with other variables, affect sleep quality in office workers. The results may&#xD;
        provide information for interventions aimed at improving sleep habits, optimizing the sleep&#xD;
        environment, and improving overall well-being in this population. As a result, promoting good&#xD;
        sleep health among office workers can have positive effects on productivity, safety and&#xD;
        overall quality of life.&#xD;
      </textblock>
    </brief_summary>
    <detailed_description>
      <textblock>
        INTRODUCTION&#xD;
  &#xD;
        Sleeping is an important part of human life, but there is still a lot of mystery surrounding&#xD;
        the relationship between the brain and the process of sleeping. Recent research has concluded&#xD;
        that sleeping has much more impact on the brain than previously thought, as it resets itself&#xD;
        and removes toxic waste byproducts which may have accumulated throughout the day. Sleeping&#xD;
        improves memory recall, helps regulate the metabolism in the body, and reduces mental&#xD;
        fatigue. Chronic sleep loss is a serious concern, as it can be constrained by the lack of&#xD;
        sleep.&#xD;
  &#xD;
        Sleep plays a critical role in physical health, regulating immune system functions and&#xD;
        reducing the risk of infections. Poor sleep can weaken immune function, making individuals&#xD;
        more susceptible to illnesses. Over the past decade, research has shown that disturbances of&#xD;
        sleep, including insomnia complaints and extremes of sleep duration, adversely influence the&#xD;
        risk of infectious and inflammatory disease and contribute to all-cause mortality. These&#xD;
        findings have substantial public health implications, as 25% of the population report&#xD;
        insomnia complaints and 10% meet diagnostic criteria for chronic insomnia. Behavioral&#xD;
        treatments have robust efficacy, with remission of insomnia sustained in the long term.&#xD;
        Research on sleep and health has focused on the biological mechanisms underlying these&#xD;
        effects, which could identify those at greatest risk for adverse health consequences or be&#xD;
        targeted to attenuate or even prevent morbidity. Furthermore, sleep is intricately linked to&#xD;
        physical health and vitality. It contributes to the restoration and repair of various bodily&#xD;
        systems, including the cardiovascular, musculoskeletal, and metabolic systems. Sleep loss is&#xD;
        a common condition in developed countries, with people sleeping on average 6.8 hours per&#xD;
        night, 1.5 hours less than a century ago. Recent epidemiological studies have revealed&#xD;
        relationships between sleep deprivation and hypertension, coronary heart disease, and&#xD;
        diabetes mellitus. Sleep loss has been linked to hypertension, coronary heart disease, and&#xD;
        diabetes mellitus.&#xD;
  &#xD;
        Office workers, who typically engage in sedentary work activities and spend a significant&#xD;
        portion of their day in indoor environments, are particularly prone to sleep disturbances.&#xD;
        Sedentary behavior is becoming an important risk factor for poor health and mortality.&#xD;
        Population research has found that as sitting or television viewing time increases, there is&#xD;
        an increased cardiometabolic risk, independent of moderate/vigorous physical activity (MVPA).&#xD;
        High accelerometer-determined sedentary time has been linked to metabolic and cardiovascular&#xD;
        risk factors in healthy adults, and prolonged or uninterrupted sedentary time has been found&#xD;
        to be a risk factor for poor health. With the evolution of the &quot;technology age&quot;, sedentary&#xD;
        time is reported to be increasing due to the shift towards reduced MVPA required in&#xD;
        occupations traditionally requiring MVPA and the increasing percentage of office workers&#xD;
        employed in low-activity occupations. While sedentary office workers may be less exposed to&#xD;
        many of the hazards associated with more physically demanding occupations, they may gain less&#xD;
        of the beneficial MVPA and be exposed to more of the potentially detrimental prolonged and&#xD;
        uninterrupted sedentary behavior.&#xD;
  &#xD;
        Office workers who have sleep issues may face significant effects on their daily functioning&#xD;
        and general quality of life. Insufficient or poor quality sleep can affect cognitive&#xD;
        function, including the ability to pay attention, concentrate, solve problems, and make&#xD;
        decisions. This can lower productivity, increase errors and accidents, and decrease job&#xD;
        performance and satisfaction. Furthermore, it can have a significant impact on mental health,&#xD;
        including an increased risk of anxiety, depression, and emotional instability. Sleep habits&#xD;
        and workplace behaviors have a significant impact on employee performance, safety, and&#xD;
        health, as well as organizational-level success. It is important to understand how sleep&#xD;
        habits and sleepiness impact workers and the organization and to emphasize the impact of good&#xD;
        sleep on productivity and safety.&#xD;
  &#xD;
        Recognizing the importance of sleep and the unique challenges that office employees encounter&#xD;
        is critical for resolving sleep disorders in this demographic. Understanding the factors that&#xD;
        contribute to poor sleep quality among office employees allows for the development of&#xD;
        interventions that encourage good sleep habits, optimize the sleep environment, and improve&#xD;
        overall well-being. Education on sleep hygiene, promotion of physical exercise and mobility&#xD;
        breaks during the workday, ergonomic workstations, and improved lighting conditions in office&#xD;
        environments are some of the targeted measures. Office workers can improve their cognitive&#xD;
        functioning, physical health, and general quality of life by emphasizing sleep health. Sleep&#xD;
        problems are linked to accidents, productivity losses, and increased healthcare utilization,&#xD;
        resulting in $15 billion in healthcare costs each year 15. Poor quality sleep can lead to&#xD;
        accidents, productivity losses, and increased healthcare utilization.&#xD;
  &#xD;
        Sleep disturbances are widespread among office workers, and recognizing the factors that&#xD;
        contribute to these disturbances is critical for devising effective therapies to improve&#xD;
        sleep quality in this population. The sleep environment, including pillow and mattress&#xD;
        features, has a major impact on sleep quality.&#xD;
  &#xD;
        Pillows and mattresses are important sleep environment components that have a direct impact&#xD;
        on sleep posture, comfort, and spinal alignment. The selection of an appropriate pillow and&#xD;
        mattress is critical for supporting the natural curvature of the spine and ensuring optimal&#xD;
        comfort when sleeping. Inadequate pillow and mattress qualities can cause discomfort, pain,&#xD;
        and sleep disruptions. Mattress firmness plays a leading role in reducing pain in individuals&#xD;
        complaining of back pain. Companies are promoting mattresses with therapeutic properties, but&#xD;
        this is not supported by sufficient evidence.&#xD;
  &#xD;
        The height of a pillow is an important aspect that influences head and neck alignment during&#xD;
        sleeping. Increasing the pillow height dramatically raises the cranial and cervical mean and&#xD;
        peak pressures, as well as the extension and lordosis of the cervical spine. An incorrect&#xD;
        pillow height can cause incorrect cervical spine posture, producing tension in the neck&#xD;
        muscles and contributing to sleep-related neck pain. Similarly, the pillow's hardness or&#xD;
        firmness can affect the support supplied to the head and neck. A pillow that is overly soft&#xD;
        or too firm may not give enough support, causing pain and disrupting sleep.&#xD;
  &#xD;
        Another important feature of pillows and mattresses is ergonomic support. Ergonomic pillows&#xD;
        are designed to give ideal head, neck, and spine support and alignment, reducing the risk of&#xD;
        musculoskeletal discomfort and promoting improved sleep posture. Mattresses that possess&#xD;
        suitable firmness and support aid in maintaining spinal alignment and distributing pressure,&#xD;
        thereby promoting a more comfortable and restorative sleep. Studies have indicated that&#xD;
        individuals who utilize pillows and mattresses with inadequate features are at a higher risk&#xD;
        of encountering discomfort, pain, and disruptions in their sleep patterns. The sleep quality&#xD;
        of office workers can be enhanced by choosing pillows and mattresses that provide adequate&#xD;
        support and comfort. This holds particular significance owing to the considerable duration of&#xD;
        time spent in office environments, where sedentary behaviors prevail. Comprehending the&#xD;
        influence of the aforementioned factors and enhancing the sleep environment can facilitate&#xD;
        the advancement of superior sleep and holistic welfare.&#xD;
  &#xD;
        The present research aims to examine the relationship between various pillow and mattress&#xD;
        factors, musculoskeletal discomfort, and sleep quality in individuals working in office&#xD;
        environments. By conducting an examination of various variables including pillow&#xD;
        characteristics, sleep-related factors, musculoskeletal symptoms, physical activity level,&#xD;
        and mattress-related factors, the research can identify the particular components of the&#xD;
        sleeping environment that are most relevant to disturbances.&#xD;
  &#xD;
        METHODS Study Design and Participants The purpose of this cross-sectional study was to look&#xD;
        at the variables influencing office workers' sleep quality. Participants were gathered using&#xD;
        a convenience sample technique from diverse workplace environments. To establish the ideal&#xD;
        sample size, a power analysis was performed using G*Power software. The statistical test of&#xD;
        choice was multiple regression analysis, and the computation used an effect size of f2 =&#xD;
        0.15. The power analysis showed that a minimum sample size of 400 participants would be&#xD;
        needed to detect the indicated effect size with a significance level (alpha) of 0.05 and a&#xD;
        target power (1 - β) of 0.80.&#xD;
  &#xD;
        Data Collection Self-report questionnaires and objective assessments were combined to acquire&#xD;
        the data. An extensive questionnaire including sociodemographic details and sleep-related&#xD;
        questions was given to participants.&#xD;
  &#xD;
        Sociodemographic Characteristics The study documented the sociodemographic attributes of the&#xD;
        participants, encompassing variables such as age, gender, height, weight, educational&#xD;
        attainment, marital status, occupation, daily working hours, and professional experience. The&#xD;
        data pertaining to the variables in question were obtained through employment of a structured&#xD;
        questionnaire.&#xD;
  &#xD;
        Sleep-Related Variables The dependent variable will utilize to evaluate the quality of sleep&#xD;
        was the Pittsburgh Sleep Quality Index (PSQI). The PSQI is a frequently employed&#xD;
        self-administered survey that assesses diverse dimensions of sleep quality and disruptions&#xD;
        within a duration of one month. Superior scores are indicative of inferior quality of sleep.&#xD;
        The PSQI was administered to the participants in order to obtain a comprehensive evaluation&#xD;
        of their sleep quality.&#xD;
  &#xD;
        Pillow Characteristics The study will evaluate various pillow-related variables of the&#xD;
        participants, such as pillow height, pillow firmness, pillow composition (e.g., feather,&#xD;
        memory foam), and pillow ergonomics. The variables were acquired via self-report inquiries,&#xD;
        enabling participants to furnish details regarding their individual pillow predilections.&#xD;
  &#xD;
        Mattress-Related Factors. Variables for mattresses include the type of mattress, such as&#xD;
        spring or sponge, the firmness level and the degree of comfort. Participants will provide&#xD;
        self-reported data on the above-mentioned variables to assess their personal perceptions of&#xD;
        mattress-related factors that could potentially affect their sleep quality.&#xD;
  &#xD;
        Musculoskeletal Symptoms The Nordic Musculoskeletal Questionnaire will be used to collect&#xD;
        data on pain experienced by individuals. Specifically, the survey documents the occurrence of&#xD;
        pain at nine different sites over the previous 12 months. Additionally, if there is pain, a&#xD;
        rating of 1 to 10 is given.&#xD;
  &#xD;
        Physical Activity Level:&#xD;
  &#xD;
        Researchers will use the International Physical Activity Questionnaire (IPAQ) to assess the&#xD;
        physical activity levels of study participants. The International Physical Activity&#xD;
        Questionnaire (IPAQ) is a reliable and valid tool used to assess the frequency, duration and&#xD;
        intensity of physical activity in different areas such as work, leisure and transportation.&#xD;
        These data will facilitate capturing the potential impact of physical activity on sleep&#xD;
        quality.&#xD;
      </textblock>
    </detailed_description>
    <overall_status>Not yet recruiting</overall_status>
    <start_date type="Anticipated">August 1, 2023</start_date>
    <completion_date type="Anticipated">October 1, 2023</completion_date>
    <primary_completion_date type="Anticipated">September 15, 2023</primary_completion_date>
    <study_type>Observational</study_type>
    <has_expanded_access>No</has_expanded_access>
    <study_design_info>
      <observational_model>Cohort</observational_model>
      <time_perspective>Cross-Sectional</time_perspective>
    </study_design_info>
    <primary_outcome>
      <measure>Pittsburgh Sleep Quality Index</measure>
      <time_frame>Five minutes</time_frame>
      <description>The Pittsburgh Sleep Quality Index is a comprehensive tool used to assess various aspects of sleep quality. It consists of 19 items, each scored on a 0-3 interval scale. These items are designed to measure subjective sleep quality, sleep latency (time taken to fall asleep), sleep duration, habitual sleep efficiency (the percentage of time spent asleep while in bed), sleep disturbances, use of sleeping medication, and daytime dysfunction.&#xD;
  To determine the overall sleep quality, the scores of these seven components are added together, resulting in a composite score that ranges from 0 to 21. Lower scores indicate better sleep quality.</description>
    </primary_outcome>
    <primary_outcome>
      <measure>Pillow height</measure>
      <time_frame>Two minutes</time_frame>
      <description>The pillow height of the office workers was recorded in cm.</description>
    </primary_outcome>
    <secondary_outcome>
      <measure>Mattress type</measure>
      <time_frame>Two minutes</time_frame>
      <description>The variables pertaining to mattresses encompassed the type of mattress, such as spring or foam.</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Musculoskeletal Symptoms</measure>
      <time_frame>Five minutes</time_frame>
      <description>The Nordic Musculoskeletal Questionnaire was utilized to gather data pertaining to pain experienced by individuals. Specifically, the questionnaire documented the occurrence of pain in nine distinct regions over the course of the previous 12 months. Additionally, if pain was present, a rating on a scale of 1 to 10 was assigned. High scores indicate high pain.</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Physical Activity Level</measure>
      <time_frame>Five minutes</time_frame>
      <description>The researchers utilized the International Physical Activity Questionnaire (IPAQ) to assess the physical activity levels of the study participants. The International Physical Activity Questionnaire (IPAQ) is a reliable and valid tool used to evaluate the frequency, duration, and intensity of physical activity in different domains such as work, leisure, and transportation. This data facilitated the capture of the potential impact of physical activity on the quality of sleep.</description>
    </secondary_outcome>
    <number_of_groups>1</number_of_groups>
    <enrollment type="Anticipated">600</enrollment>
    <condition>Sleep</condition>
    <condition>Work Related Stress</condition>
    <condition>Musculoskeletal Pain</condition>
    <condition>Physical Inactivity</condition>
    <condition>Demographies, Family</condition>
    <arm_group>
      <arm_group_label>Office Workers</arm_group_label>
      <description>The study will document the sociodemographic attributes of the participants, encompassing variables such as age, gender, height, weight, educational attainment, marital status, occupation, daily working hours, and professional experience. The data pertaining to the variables in question were obtained through employment of a structured questionnaire.</description>
    </arm_group>
    <eligibility>
      <study_pop>
        <textblock>
          Office workers from diverse workplace environments, aged 18 years and above, with a minimum&#xD;
          employment duration or professional experience, who are willing to participate in the study&#xD;
          and able to understand and complete the self-report questionnaires accurately.&#xD;
        </textblock>
      </study_pop>
      <sampling_method>Probability Sample</sampling_method>
      <criteria>
        <textblock>
          Inclusion Criteria:&#xD;
  &#xD;
            -  Participants must be office workers.&#xD;
  &#xD;
            -  Participants should be at least 18 years old.&#xD;
  &#xD;
            -  Participants should have a minimum employment duration or professional experience.&#xD;
  &#xD;
            -  Participants should be willing to provide informed consent to participate in the&#xD;
               study.&#xD;
  &#xD;
            -  Participants should be able to understand and complete the self-report questionnaires&#xD;
               accurately.&#xD;
  &#xD;
          Exclusion Criteria:&#xD;
  &#xD;
            -  Individuals who are not office workers (e.g., manual laborers, non-office-based&#xD;
               professionals) would be excluded.&#xD;
  &#xD;
            -  Individuals under the age of 18 would be excluded.&#xD;
  &#xD;
            -  Individuals with cognitive impairments or communication difficulties that prevent them&#xD;
               from accurately completing the self-report questionnaires would be excluded.&#xD;
  &#xD;
            -  Individuals who are unable or unwilling to provide informed consent would be excluded.&#xD;
  &#xD;
            -  Individuals with pre-existing sleep disorders or medical conditions that significantly&#xD;
               impact sleep quality would be excluded, as they may confound the study results.&#xD;
  &#xD;
            -  Pregnant women or individuals with significant health conditions that affect sleep&#xD;
               (e.g., sleep apnea, chronic pain) excluded to minimize confounding variables.&#xD;
        </textblock>
      </criteria>
      <gender>All</gender>
      <minimum_age>18 Years</minimum_age>
      <maximum_age>55 Years</maximum_age>
      <healthy_volunteers>Accepts Healthy Volunteers</healthy_volunteers>
    </eligibility>
    <overall_official>
      <last_name>Ceyhun Türkmen, PhD</last_name>
      <role>Principal Investigator</role>
      <affiliation>Çankırı Karatekin University</affiliation>
    </overall_official>
    <overall_contact>
      <last_name>Ceyhun Türkmen, PhD</last_name>
      <phone>+905311017392</phone>
      <email>ceyhunturkmen@karatekin.edu.tr</email>
    </overall_contact>
    <results_reference>
      <citation>Herculano-Houzel S. Neuroscience. Sleep it out. Science. 2013 Oct 18;342(6156):316-7. doi: 10.1126/science.1245798. No abstract available.</citation>
      <PMID>24136954</PMID>
    </results_reference>
    <results_reference>
      <citation>Morin CM, LeBlanc M, Daley M, Gregoire JP, Merette C. Epidemiology of insomnia: prevalence, self-help treatments, consultations, and determinants of help-seeking behaviors. Sleep Med. 2006 Mar;7(2):123-30. doi: 10.1016/j.sleep.2005.08.008. Epub 2006 Feb 3.</citation>
      <PMID>16459140</PMID>
    </results_reference>
    <results_reference>
      <citation>DeVocht JW, Wilder DG, Bandstra ER, Spratt KF. Biomechanical evaluation of four different mattresses. Appl Ergon. 2006 May;37(3):297-304. doi: 10.1016/j.apergo.2005.07.002. Epub 2005 Sep 19.</citation>
      <PMID>16169512</PMID>
    </results_reference>
    <results_reference>
      <citation>Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989 May;28(2):193-213. doi: 10.1016/0165-1781(89)90047-4.</citation>
      <PMID>2748771</PMID>
    </results_reference>
    <results_reference>
      <citation>Pilcher JJ, Morris DM. Sleep and Organizational Behavior: Implications for Workplace Productivity and Safety. Front Psychol. 2020 Jan 31;11:45. doi: 10.3389/fpsyg.2020.00045. eCollection 2020.</citation>
      <PMID>32082218</PMID>
    </results_reference>
    <verification_date>July 2023</verification_date>
    <study_first_submitted>July 13, 2023</study_first_submitted>
    <study_first_submitted_qc>July 26, 2023</study_first_submitted_qc>
    <study_first_posted type="Actual">August 3, 2023</study_first_posted>
    <last_update_submitted>July 26, 2023</last_update_submitted>
    <last_update_submitted_qc>July 26, 2023</last_update_submitted_qc>
    <last_update_posted type="Actual">August 3, 2023</last_update_posted>
    <responsible_party>
      <responsible_party_type>Principal Investigator</responsible_party_type>
      <investigator_affiliation>Çankırı Karatekin University</investigator_affiliation>
      <investigator_full_name>Ceyhun Türkmen</investigator_full_name>
      <investigator_title>Asst. Prof</investigator_title>
    </responsible_party>
    <keyword>Sleep quality</keyword>
    <keyword>Office workers</keyword>
    <keyword>Sleep environment</keyword>
    <keyword>Physical activity</keyword>
    <keyword>Sociodemographic factors</keyword>
    <condition_browse>
      <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
      <mesh_term>Musculoskeletal Pain</mesh_term>
      <mesh_term>Occupational Stress</mesh_term>
    </condition_browse>
    <patient_data>
      <sharing_ipd>Undecided</sharing_ipd>
    </patient_data>
    <!-- Results have not yet been posted for this study                                          -->
  </clinical_study>
  
  
text: download date: ClinicalTrials.gov processed this data on September 20, 2023
  link text: Link to the current ClinicalTrials.gov record.
  url: https://clinicaltrials.gov/ct2/show/NCT05974709
  org study id: 0f0534f00fdd44cc
  nct id: NCT05974709
  lead sponsor: 
  has dmc: No
  is fda regulated drug: No
  is fda regulated device: No
  This study will focus on the relationship between pillow and mattress factors,
        musculoskeletal disorders and sleep quality in office workers. Sleep is vital to physical and
        mental health, and poor sleep can negatively affect cognitive function and workplace
        performance. Office workers, who often work in sedentary jobs, are particularly prone to
        sleep disorders. Recognizing the factors that contribute to poor sleep in this population is
        crucial for developing interventions to improve sleep quality.
  
        The study used a cross-sectional design and will collect data from an appropriate sample of
        office workers (Approximately 600 participants). Various variables will be assessed,
        including sociodemographic characteristics, sleep-related factors (to be measured using the
        Pittsburgh Sleep Quality Index), pillow characteristics, mattress-related factors,
        musculoskeletal symptoms, and physical activity levels (to be measured using the
        International Physical Activity Questionnaire).
  
        Descriptive statistics and multiple regression analysis will be performed to analyze the data
        and identify factors affecting sleep quality. Fixed fixes for potential confounders and
        modifiers. The study aims to identify specific components of the sleep environment related to
        sleep disorders.
  
        The findings of this study will contribute to the understanding of how pillow and mattress
        factors, along with other variables, affect sleep quality in office workers. The results may
        provide information for interventions aimed at improving sleep habits, optimizing the sleep
        environment, and improving overall well-being in this population. As a result, promoting good
        sleep health among office workers can have positive effects on productivity, safety and
        overall quality of life.
  INTRODUCTION
  
        Sleeping is an important part of human life, but there is still a lot of mystery surrounding
        the relationship between the brain and the process of sleeping. Recent research has concluded
        that sleeping has much more impact on the brain than previously thought, as it resets itself
        and removes toxic waste byproducts which may have accumulated throughout the day. Sleeping
        improves memory recall, helps regulate the metabolism in the body, and reduces mental
        fatigue. Chronic sleep loss is a serious concern, as it can be constrained by the lack of
        sleep.
  
        Sleep plays a critical role in physical health, regulating immune system functions and
        reducing the risk of infections. Poor sleep can weaken immune function, making individuals
        more susceptible to illnesses. Over the past decade, research has shown that disturbances of
        sleep, including insomnia complaints and extremes of sleep duration, adversely influence the
        risk of infectious and inflammatory disease and contribute to all-cause mortality. These
        findings have substantial public health implications, as 25% of the population report
        insomnia complaints and 10% meet diagnostic criteria for chronic insomnia. Behavioral
        treatments have robust efficacy, with remission of insomnia sustained in the long term.
        Research on sleep and health has focused on the biological mechanisms underlying these
        effects, which could identify those at greatest risk for adverse health consequences or be
        targeted to attenuate or even prevent morbidity. Furthermore, sleep is intricately linked to
        physical health and vitality. It contributes to the restoration and repair of various bodily
        systems, including the cardiovascular, musculoskeletal, and metabolic systems. Sleep loss is
        a common condition in developed countries, with people sleeping on average 6.8 hours per
        night, 1.5 hours less than a century ago. Recent epidemiological studies have revealed
        relationships between sleep deprivation and hypertension, coronary heart disease, and
        diabetes mellitus. Sleep loss has been linked to hypertension, coronary heart disease, and
        diabetes mellitus.
  
        Office workers, who typically engage in sedentary work activities and spend a significant
        portion of their day in indoor environments, are particularly prone to sleep disturbances.
        Sedentary behavior is becoming an important risk factor for poor health and mortality.
        Population research has found that as sitting or television viewing time increases, there is
        an increased cardiometabolic risk, independent of moderate/vigorous physical activity (MVPA).
        High accelerometer-determined sedentary time has been linked to metabolic and cardiovascular
        risk factors in healthy adults, and prolonged or uninterrupted sedentary time has been found
        to be a risk factor for poor health. With the evolution of the "technology age", sedentary
        time is reported to be increasing due to the shift towards reduced MVPA required in
        occupations traditionally requiring MVPA and the increasing percentage of office workers
        employed in low-activity occupations. While sedentary office workers may be less exposed to
        many of the hazards associated with more physically demanding occupations, they may gain less
        of the beneficial MVPA and be exposed to more of the potentially detrimental prolonged and
        uninterrupted sedentary behavior.
  
        Office workers who have sleep issues may face significant effects on their daily functioning
        and general quality of life. Insufficient or poor quality sleep can affect cognitive
        function, including the ability to pay attention, concentrate, solve problems, and make
        decisions. This can lower productivity, increase errors and accidents, and decrease job
        performance and satisfaction. Furthermore, it can have a significant impact on mental health,
        including an increased risk of anxiety, depression, and emotional instability. Sleep habits
        and workplace behaviors have a significant impact on employee performance, safety, and
        health, as well as organizational-level success. It is important to understand how sleep
        habits and sleepiness impact workers and the organization and to emphasize the impact of good
        sleep on productivity and safety.
  
        Recognizing the importance of sleep and the unique challenges that office employees encounter
        is critical for resolving sleep disorders in this demographic. Understanding the factors that
        contribute to poor sleep quality among office employees allows for the development of
        interventions that encourage good sleep habits, optimize the sleep environment, and improve
        overall well-being. Education on sleep hygiene, promotion of physical exercise and mobility
        breaks during the workday, ergonomic workstations, and improved lighting conditions in office
        environments are some of the targeted measures. Office workers can improve their cognitive
        functioning, physical health, and general quality of life by emphasizing sleep health. Sleep
        problems are linked to accidents, productivity losses, and increased healthcare utilization,
        resulting in $15 billion in healthcare costs each year 15. Poor quality sleep can lead to
        accidents, productivity losses, and increased healthcare utilization.
  
        Sleep disturbances are widespread among office workers, and recognizing the factors that
        contribute to these disturbances is critical for devising effective therapies to improve
        sleep quality in this population. The sleep environment, including pillow and mattress
        features, has a major impact on sleep quality.
  
        Pillows and mattresses are important sleep environment components that have a direct impact
        on sleep posture, comfort, and spinal alignment. The selection of an appropriate pillow and
        mattress is critical for supporting the natural curvature of the spine and ensuring optimal
        comfort when sleeping. Inadequate pillow and mattress qualities can cause discomfort, pain,
        and sleep disruptions. Mattress firmness plays a leading role in reducing pain in individuals
        complaining of back pain. Companies are promoting mattresses with therapeutic properties, but
        this is not supported by sufficient evidence.
  
        The height of a pillow is an important aspect that influences head and neck alignment during
        sleeping. Increasing the pillow height dramatically raises the cranial and cervical mean and
        peak pressures, as well as the extension and lordosis of the cervical spine. An incorrect
        pillow height can cause incorrect cervical spine posture, producing tension in the neck
        muscles and contributing to sleep-related neck pain. Similarly, the pillow's hardness or
        firmness can affect the support supplied to the head and neck. A pillow that is overly soft
        or too firm may not give enough support, causing pain and disrupting sleep.
  
        Another important feature of pillows and mattresses is ergonomic support. Ergonomic pillows
        are designed to give ideal head, neck, and spine support and alignment, reducing the risk of
        musculoskeletal discomfort and promoting improved sleep posture. Mattresses that possess
        suitable firmness and support aid in maintaining spinal alignment and distributing pressure,
        thereby promoting a more comfortable and restorative sleep. Studies have indicated that
        individuals who utilize pillows and mattresses with inadequate features are at a higher risk
        of encountering discomfort, pain, and disruptions in their sleep patterns. The sleep quality
        of office workers can be enhanced by choosing pillows and mattresses that provide adequate
        support and comfort. This holds particular significance owing to the considerable duration of
        time spent in office environments, where sedentary behaviors prevail. Comprehending the
        influence of the aforementioned factors and enhancing the sleep environment can facilitate
        the advancement of superior sleep and holistic welfare.
  
        The present research aims to examine the relationship between various pillow and mattress
        factors, musculoskeletal discomfort, and sleep quality in individuals working in office
        environments. By conducting an examination of various variables including pillow
        characteristics, sleep-related factors, musculoskeletal symptoms, physical activity level,
        and mattress-related factors, the research can identify the particular components of the
        sleeping environment that are most relevant to disturbances.
  
        METHODS Study Design and Participants The purpose of this cross-sectional study was to look
        at the variables influencing office workers' sleep quality. Participants were gathered using
        a convenience sample technique from diverse workplace environments. To establish the ideal
        sample size, a power analysis was performed using G*Power software. The statistical test of
        choice was multiple regression analysis, and the computation used an effect size of f2 =
        0.15. The power analysis showed that a minimum sample size of 400 participants would be
        needed to detect the indicated effect size with a significance level (alpha) of 0.05 and a
        target power (1 - β) of 0.80.
  
        Data Collection Self-report questionnaires and objective assessments were combined to acquire
        the data. An extensive questionnaire including sociodemographic details and sleep-related
        questions was given to participants.
  
        Sociodemographic Characteristics The study documented the sociodemographic attributes of the
        participants, encompassing variables such as age, gender, height, weight, educational
        attainment, marital status, occupation, daily working hours, and professional experience. The
        data pertaining to the variables in question were obtained through employment of a structured
        questionnaire.
  
        Sleep-Related Variables The dependent variable will utilize to evaluate the quality of sleep
        was the Pittsburgh Sleep Quality Index (PSQI). The PSQI is a frequently employed
        self-administered survey that assesses diverse dimensions of sleep quality and disruptions
        within a duration of one month. Superior scores are indicative of inferior quality of sleep.
        The PSQI was administered to the participants in order to obtain a comprehensive evaluation
        of their sleep quality.
  
        Pillow Characteristics The study will evaluate various pillow-related variables of the
        participants, such as pillow height, pillow firmness, pillow composition (e.g., feather,
        memory foam), and pillow ergonomics. The variables were acquired via self-report inquiries,
        enabling participants to furnish details regarding their individual pillow predilections.
  
        Mattress-Related Factors. Variables for mattresses include the type of mattress, such as
        spring or sponge, the firmness level and the degree of comfort. Participants will provide
        self-reported data on the above-mentioned variables to assess their personal perceptions of
        mattress-related factors that could potentially affect their sleep quality.
  
        Musculoskeletal Symptoms The Nordic Musculoskeletal Questionnaire will be used to collect
        data on pain experienced by individuals. Specifically, the survey documents the occurrence of
        pain at nine different sites over the previous 12 months. Additionally, if there is pain, a
        rating of 1 to 10 is given.
  
        Physical Activity Level:
  
        Researchers will use the International Physical Activity Questionnaire (IPAQ) to assess the
        physical activity levels of study participants. The International Physical Activity
        Questionnaire (IPAQ) is a reliable and valid tool used to assess the frequency, duration and
        intensity of physical activity in different areas such as work, leisure and transportation.
        These data will facilitate capturing the potential impact of physical activity on sleep
        quality.
  observational model: Cohort
  time perspective: Cross-Sectional
  measure: Pittsburgh Sleep Quality Index
  time frame: Five minutes
  description: The Pittsburgh Sleep Quality Index is a comprehensive tool used to assess various aspects of sleep quality. It consists of 19 items, each scored on a 0-3 interval scale. These items are designed to measure subjective sleep quality, sleep latency (time taken to fall asleep), sleep duration, habitual sleep efficiency (the percentage of time spent asleep while in bed), sleep disturbances, use of sleeping medication, and daytime dysfunction.
  To determine the overall sleep quality, the scores of these seven components are added together, resulting in a composite score that ranges from 0 to 21. Lower scores indicate better sleep quality.
  measure: Pillow height
  time frame: Two minutes
  description: The pillow height of the office workers was recorded in cm.
  measure: Mattress type
  time frame: Two minutes
  description: The variables pertaining to mattresses encompassed the type of mattress, such as spring or foam.
  measure: Musculoskeletal Symptoms
  time frame: Five minutes
  description: The Nordic Musculoskeletal Questionnaire was utilized to gather data pertaining to pain experienced by individuals. Specifically, the questionnaire documented the occurrence of pain in nine distinct regions over the course of the previous 12 months. Additionally, if pain was present, a rating on a scale of 1 to 10 was assigned. High scores indicate high pain.
  measure: Physical Activity Level
  time frame: Five minutes
  description: The researchers utilized the International Physical Activity Questionnaire (IPAQ) to assess the physical activity levels of the study participants. The International Physical Activity Questionnaire (IPAQ) is a reliable and valid tool used to evaluate the frequency, duration, and intensity of physical activity in different domains such as work, leisure, and transportation. This data facilitated the capture of the potential impact of physical activity on the quality of sleep.
  arm group label: Office Workers
  description: The study will document the sociodemographic attributes of the participants, encompassing variables such as age, gender, height, weight, educational attainment, marital status, occupation, daily working hours, and professional experience. The data pertaining to the variables in question were obtained through employment of a structured questionnaire.
  study pop: 
  sampling method: Probability Sample
  criteria: 
  gender: All
  minimum age: 18 Years
  maximum age: 55 Years
  healthy volunteers: Accepts Healthy Volunteers
  last name: Ceyhun Türkmen, PhD
  role: Principal Investigator
  affiliation: Çankırı Karatekin University
  last name: Ceyhun Türkmen, PhD
  phone: +905311017392
  email: ceyhunturkmen@karatekin.edu.tr
  citation: Herculano-Houzel S. Neuroscience. Sleep it out. Science. 2013 Oct 18;342(6156):316-7. doi: 10.1126/science.1245798. No abstract available.
  PMID: 24136954
  citation: Morin CM, LeBlanc M, Daley M, Gregoire JP, Merette C. Epidemiology of insomnia: prevalence, self-help treatments, consultations, and determinants of help-seeking behaviors. Sleep Med. 2006 Mar;7(2):123-30. doi: 10.1016/j.sleep.2005.08.008. Epub 2006 Feb 3.
  PMID: 16459140
  citation: DeVocht JW, Wilder DG, Bandstra ER, Spratt KF. Biomechanical evaluation of four different mattresses. Appl Ergon. 2006 May;37(3):297-304. doi: 10.1016/j.apergo.2005.07.002. Epub 2005 Sep 19.
  PMID: 16169512
  citation: Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989 May;28(2):193-213. doi: 10.1016/0165-1781(89)90047-4.
  PMID: 2748771
  citation: Pilcher JJ, Morris DM. Sleep and Organizational Behavior: Implications for Workplace Productivity and Safety. Front Psychol. 2020 Jan 31;11:45. doi: 10.3389/fpsyg.2020.00045. eCollection 2020.
  PMID: 32082218
  responsible party type: Principal Investigator
  investigator affiliation: Çankırı Karatekin University
  investigator full name: Ceyhun Türkmen
  investigator title: Asst. Prof
  mesh term: Musculoskeletal Pain
  mesh term: Occupational Stress
  sharing ipd: Undecided