Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Archana Dambal

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Department of General Medicine,
Belgaum Institute of Medical Sciences,Belgaum, Karnataka,INDIA,
On 30 Nov 2018




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Super Speciality Paediatric Hospital and Post Graduate Teaching Institute, Noida
On Sep 2018




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Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




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"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



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Professor and Head
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Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




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I wish JCDR a great success and I hope that journal will soar higher with the passing time."



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Professor and Head
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Saraswati Dental College
Lucknow
On Sep 2018




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Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
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Best regards,
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Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011

Important Notice

Original article / research
Year : 2010 | Month : February | Volume : 4 | Issue : 1 | Page : 2036 - 2040

A Study Of Sleeping Habits And Disorders Among School Students Of Pondicherry

PATIL R *, MITTAL A ** , RAGHAVIA M *** , MALHOTRA V*** , SRINIVASARAGAVAN ****, NIKHIL M*****, HARISH******

*,**Assistant Professor,Department of Community Medicine,A V Medical College,Pondicherry,***Prof. and Head, Department of Community Medicine,A V Medical College,Pondicherry ***Associate Professor,Department of Physiology,Vinayaka Mission’s Medical College,Salem,Tamilnadu,****Assistant Professor,Department of Community Medicine, Vinayaka Missions Medical College Salem,*****,******Interns,Department of Community Medicine,A V Medical College,Pondicherry

Correspondence Address :
Dr.Varun Malhotra,Vinayaka Missions Medical College. Salem (India)Email:dr_varun@yahoo.com

How to cite this article :

PATIL R , MITTAL A , RAGHAVIA M , MALHOTRA V, SRINIVASARAGAVAN , NIKHIL M , et al.. A STUDY OF SLEEPING HABITS AND DISORDERS AMONG SCHOOL STUDENTS OF PONDICHERRY. Journal of Clinical and Diagnostic Research [serial online] 2010 February [cited: 2019 Aug 19 ]; 4:2036-2040. Available from
http://www.jcdr.net/back_issues.asp?issn=0973-709x&year=2010&month=February&volume=4&issue=1&page=2036-2040&id=632

Introduction
Human beings spend nearly 20-25 years of their life in sleep. Although 25 years of sleep sound a bit odd in first look, it is a fact that every human being is a miniature form of the giant Kumbhakarna (A character of Indian epic Ramayana) who was considered as the doyen of the art of sleep.

Life of a human being can be divided into two, the time he is asleep and the time he is awake. The two phases are so closely interlinked that the quality of time he is asleep, affects the quality of his wakefulness and productivity, and likewise the various factors and events when he is awake affects the sleep also. There are two phases of sleep; the non rapid eye movement sleep (NREM) and the rapid eye movement sleep (REM),the initial NREM is the calm and restful sleep which is present after hours of wakefulness during the day. REM is not a very relaxing phase and sleep is not usually deep and is also associated with episodes of dreams.

Sleep has been known to influence the physical and emotional well being of adolescents by causing substantial biological and psychosocial changes (1).Adolescence is a period when the individual faces various types of stresses and transitions; both physiological and psychological. Adolescents and young adults (12-25 years) are at high risk for problem sleepiness with particularly serious consequences (2) so we selected this age group for the study of sleep habits and problems. Since sleep disorders are more prevalent in urban area as compared to villages, we planned the study in urban schools.

In our study we wanted to know about the various sleep habits, sleep problems and the various factors which can influence the sleep. Various disorders like somnambulism, bruxism, sleep apnoea, nocturnal enuresis etc. were chosen to study in our research.

Material and Methods

The study was conducted during August-September 2008.It was a cross sectional study conducted among higher secondary school students of urban Pondicherry. Multistage random sampling method was used to select the sample. All the private higher secondary schools were enlisted. Total 6 schools were selected randomly. Permissions prior to study were taken from the school authorities. From each school 5 sections were selected randomly for the study. Self administered questionnaire was prepared and pretested. After making necessary corrections questionnaire was used for the study.

Epworth sleepiness scale (ESS) (3) was incorporated in the questionnaire.ESS is used to measure daytime sleepiness. This can be helpful in diagnosing sleep disorders. In ESS, numbers are given for different situations where a person can fall asleep.

Following numbers are given: 0 = no chance of dozing,1 = slight chance of dozing,2 = moderate chance of dozing,3 = high chance of dozing.

Following situations are used:
1. Sitting and reading,
2. Watching TV,
3. Sitting inactive in a public place (e.g. a theater or a meeting),
4. As a passenger in a car for an hour without a break,
5. Lying down to rest in the afternoon when circumstances permit ,
6. Sitting and talking to someone,
7. Sitting quietly after a lunch without alcohol,
8. In a car, while stopped for a few minutes in traffic

The score obtained by adding the numbers leads to a total. Below 10 score is considered as normal while 10 or above is abnormal and needs advice from sleep specialist.

Information regarding age, sex, height, weight, sleeping time, wake up time, difficulty to fall asleep or staying asleep, medications for sleep, naps, day time sleepiness, habits and problems during sleep and after waking up etc. were included. Purpose of the study and the questions were explained to the students before administering it. Collected data were compiled and analyzed using Microsoft excel software. Proportions were used to see any difference between boys and girls.

Results

Results and Discussion
Total 1545 students in age group 14-20 years participated in the study.Mean age of the participants was 15.93 years(SD: 0.75 yr).Number of boys and girls were approximately equal(48.7% males,51.3% females) (Table/Fig 1).Mean BMI was 21.49 kg/m2(SD:4.61kg/ m2). Average night sleep duration was 7.0 hours (SD: 1.07 hr).

Most common sleep problem was fearful dreams in morning (M 12.6%, F 15.5%) followed by kicking. It was found that sleep problems are more in girls as compared to boys (Table/Fig 2).

In a study among 13-19 years age group school students in France (4) it was observed that nightmares were significantly more common in girls. Similar finding is reported in our study also.In a study by Suri in Delhi (5) it was found that 5.8% school going children suffered from night terrors. About 12% of the entire population (13.3% males and 10.4% females) were seen to suffer from bruxism. Approximately 7.7% of the overall population was observed to suffer from bedwetting.The overall prevalence of snoring was found to be 12.7% (Males=12.8%, Females=12.6%).In our study we found lesser number of problems during sleep as compared to delhi study.

Most common problem after waking up was dry mouth in males (19.8%) and headache (17.4%) in females. Nearly 50% students had some problem in morning (Table/Fig 3) .

Family type didn’t affect the sleep onset latency. Females had a greater sleep onset latency time (Table/Fig 4).

As the study was done in urban area, 85% belonged to nuclear family. Nearly one third students were in habit of taking naps during day time. Boys and girls both had similar tendency to take naps (Table/Fig 5).

The complaint of excessive daytime sleepiness includes inappropriate and undesirable sleep during waking hours; reduced motor and cognitive performance (6). Approximately 16% students feel that it is difficult to stay asleep. Daytime sleepiness was same in boys and girls.

It was found that day time sleepiness is not related to difficulty in staying asleep (Table/Fig 6).


Nocturnal awakenings were reported by approximately 16% students Boys wake up frequently in night as compared to girls (Table/Fig 7) .

More number of boys (68.5%) were taking naps compared to girls( 44.3%) (Table/Fig 8).

Similar findings were reported by Gupta R et al (7) also.

Sleep was disturbed by stress in one fourth of the boys as well as one fourth of the girls. There was no significant difference between boys and girls regarding disturbance of sleep by stress (Table/Fig 9).


The study tried to obscure the sleep habits and problems among adolescents of both sexes. Sleeping habits and an inability to fall asleep varied significantly between countries as well as between age groups, but only slightly between the sexes (8). In a study conducted among students with the higher education system (average age of 20 years), 21% reported that they experienced sleep difficulties. In another study, 36% of the sample reported that they were completely free of any sleep disturbance (9). Apart from excluding other well-known factors affecting sleep, if sleep cannot cycle normally through REM and NREM, one may feel tired, fatigued, or sleepy, and may have trouble concentrating or paying attention while awake (10).

Sleep affects physical growth, behavior and emotional development besides determining cognitive functioning, learning and attention (11).For many sleep disorders there is an associated increase in daytime sleepiness and an increase in road traffic accidents. Sleep disorders such as sleep apnoea, particularly when associated with other medical diseases, are associated with increased mortality. Sleep walking is a condition in which sleep and arousal mechanisms seem to have locked in an unresolved conflict. Sleepwalking not infrequently leads to accidents but occasionally leads to death, and rarely sleep related homicide is reported (12).

Dreams only occur in the few moments before you wake up. Dreaming sleep is commonly accompanied by flaccid or relaxed paralysis. Preventing people from dreaming drives them mad. Sleep is necessary and provides rest from exertion and perhaps has some restorative functions as well. Night terrors consist of a frightening dream concerning some anxiety-laden topic and occur during REM sleep. Waking up from an anxiety, nightmare can be just as frightening but reassurance is possible. It must be admitted that the function of sleep remains a mystery, and its evolution remains a matter of conjecture. The state of sleep is unconscious pranayama, or the unconscious process of switching the life force from the five sense telephones. In sleep one practices the mortal posture or savasana. In this posture the body is still, the muscles have stopped working, venous blood is reduced, the heart slows down, and the energy from the five senses is switched off. Then the mind attains conscious pratyahara, or unconsciously returns within and becomes absorbed in an unconscious state of peace (13).Problem sleepiness in adolescents is most commonly associated with problem sleep patterns. A number of factors affect sleep patterns of adolescents and young adults. These factors include the adolescent’s biological status and behavioral preferences, parent-child negotiations, and changing school schedules.2There is a compelling need to educate the students about the normal and abnormal sleep. This study suggests that there are no differences in majority of the factors and habits related to sleep between males and females.

Acknowledgement

We would like to thank the schools and students especially Nishant,Chinnadurai,Sathya,Madhumita,Santhanagopal LD ,Sarala
for participating in our study. We are also thankful to the Dean, A V Medical College,Pondicherry for giving us permission to conduct the study.

References

1.
Dahl RE,Lewin DS. Pathway to Adolescent Health-Sleep Regulation and Behaviour.J Adolesc Health 2002;31:175-84.
2.
National Center on Sleep Disorders Research and Office of Prevention, Education, and Control. Working Group Report on Problem Sleepiness. August 1997. Available at: http://www.nhlbi.nih.gov/health/prof/sleep/pslp_wg.pdf.
3.
Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14:540–5. [PubMed].
4.
Bailly D, Bailly-Lambin I, Querleu D, Beuscart R, Collinet C.Sleep in adolescents and its disorders. A survey in schools. Encephale 2004;30(4):352-9.
5.
Suri JC,Sen MK,Adhikari Tulasi.Epidemiology of sleep disorders in school children of Delhi: A questionnaire based study. The Indian J of Sleep Med 2008;3(2):42-50.
6.
Parkes J D,ABC of sleep disorders-Daytime Sleepiness. BMJ 1993 March 20;306:772-5.
7.
Gupta R, Bhatia MS,Chhabra V, Sharma S,Dahiya D, Semalti K,Sapra R and Dua RPS. Sleep patterns of urban school-going adolescents. Indian pediatr 2008 ;45(3 )183-9.
8.
Tynjala J, Kannas L, Valimaa R.How young Europeans sleep. Health Educ Res. 1993;8:69-80. [PubMed].
9.
Coren S. The prevalence of self-reported sleep disturbances in young adults. Int J Neurosci. [PubMed ].
10.
Smith M. Understanding sleep problems - the basics. Available at: http://www.medscape.com/viewarticle/474122.
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11.Liu X, Liu L, Owens JA, Kaplan DL. Sleep patterns and sleep problems among schoolchildren in the United States and China. Pediatrics 2005; 115 (1 Suppl): 241-9.
12.
Colin m shapiro, William c dement. Impact and epidemiology of sleep disorders. BMJ 1993 Jun 12;306:1604-7
13.
Sri Sri Paramhansa Yogananda Autobiography of Yogi Science of Kriya Yoga

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