Abdullah Khalid Asiri is medical student in King Khalid University. He is pursuing his MBBS from King Khalid University. Also Sami Fayez Alshehri is medical student in King Khalid University.

Introduction: Excessive use of Twitter and WhatsApp is potentially harmful to the quality of sleep of medical students which in turn infl uences their health and academic performance. Th is study is aimed to assess the use of Twitter and WhatsApp and its eff ects on the quality of sleep among medical student of King Khalid University, Kingdom of Saudi Arabia. Methodology: A sample of 286 medical college students was chosen by simple random selection. An online data collection was performed by using a Pittsburg’s questionnaire (PSQI). Results: Among the total sample of 286 medical students only three students (1%) do not use any of the communication applications, 218 students use both twitter and whatsapp and 62(21%) use whatsapp only. Th irty six (12%) had suff ered bad sleep quality. Alarmingly, forty nine students (17%) had used medicine at least once a week to sleep and fourteen (4.5%) of them had used such medication three times a week. Students who use both applications more than three hours a day have a higher chance to suff er poor sleep quality score compared to those who use less than one hour a day. Conclusion: Based on these fi ndings students are at high risk of sleep disturbance which in turn could have negative consequences on their health and academic performance. Health education programs should be instituted to tackle such problem.

Yong Won Cho completed his PhD at the age of 35 from Keimyung University. He is the Director of Neurology, Keimyung University. He has published more than 50 papers in reputed journals and has been serving as an Editorial Board Member of the Journal of Clinical Neurology.

Although the relationship between insomnia and restless legs syndrome (RLS/WED) has been reported in lots of research, the impact of insomnia severity in RLS patients on depressive moods and the quality of life (QOL) was unclear. Our aim is to examine insomnia symptomatology and the impact of insomnia on QOL and depression through the comparison among RLS subjects, primary insomnia subjects and normal subjects. We assessed and compared depressive symptoms and QOL among 148 RLS patients, 115 primary insomnia subjects and 117 normal healthy subjects based on the Korean versions of the Beck Depression Inventory (K-BDI) and the SF-36. Severities of RLS and insomnia were assessed with the Korean version of the International RLS Study Group rating scale (K-IRLS) and Insomnia Severity Index (K-ISI). Th e prevalence of insomnia in RLS according to ISI cut off was 62.2% and the prevalence of moderate-severe depression was 37.8% in RLS and 37.4% in insomniacs. Th ere were no signifi cant diff erences in depression and QOL between RLS patients and primary insomniacs although RLS patients had signifi cantly lower scores on the K-ISI (16.40±6.34 vs. 20.96±4.97, p<0.001) and K-PSQI (11.32±4.29 vs. 14.30±3.22, p<0.001). In multivariate stepwise regression, the most eff ective factor to the K-BDI in the RLS group was the K-IRLS (r2=0.15) while in the insomnia group it was the K-ISI (r2=0.19). Insomnia symptoms is not as strongly associated with depression and QOL in the RLS group as in the PI group although RLS patients have considerable depressed moods similar to that of primary insomniacs.

Woo Kyung Bae is a professor at Health Promotion Center, Seoul National University. He has published more than 50 papers in reputed journals and has been serving as an Editorial Board Member of the Korean Journal of Family Medicine.

Aim: In this study, we aimed to determine the factors related to chronic fatigue in patients without other general medical conditions. In particular, we tried to determine the relationship between sleep quality and chronic fatigue severity aff ected by several explanatory factors such as anxiety, depression and emotional stress. Materials & Methods: We used the data collected from the out-patient fatigue clinic in Seoul National Bundang Hospital. Th e study was conducted from March 3, 2010 to March 2, 2014 and the participants were all fi rst-visit patients at the clinic. We measured body mass index (BMI) of each patient and evaluated variables including lifestyle (smoking, alcohol consumption, regular exercise), past medical history, past medication history, quality of sleep, anxiety, depression, stress severity and fatigue severity using a questionnaire. A total of 214 participants who complained chronic fatigue for more than last 6 months, were evaluated. Results: Th e factors that showed statistically signifi cant relationship with fatigue severity were regular exercise, anxiety, emotional stress and global sleep quality. Especially, subjective sleep quality, sleep latency, sleep disturbances, daytime dysfunction in sleep quality components were signifi cantly related to high fatigue severity, whereas sleep duration, habitual sleep effi ciency, use of sleeping medication had no relationship with fatigue severity. Conclusion: Poor quality of sleep was associated with high fatigue severity. Th e major factors that infl uenced fatigue severity were subjective sleep quality, sleep latency, sleep disturbances and daytime dysfunction.