Supplemental Material for Individual Differences in Habitual Short Sleep Duration and Dysfunction: Subjective Health Versus Objective Cardiovascular Disease Risk

BACKGROUND Despite the high prevalence of short sleep duration (29.2% of adults sleep <6 hours on weekdays), there are no existing theory-based behavioral interventions to extend sleep duration. The popularity of wearable sleep trackers provides an opportunity to engage users in interventions. OBJECTIVE The objective of this study was to outline the theoretical foundation and iterative process of designing the “Sleep Bunny,” a technology-assisted sleep extension intervention including a mobile phone app, wearable sleep tracker, and brief telephone coaching. We conducted a two-step process in the development of this intervention, which was as follows: (1) user testing of the app and (2) a field trial that was completed by 2 participants with short sleep duration and a cardiovascular disease risk factor linked to short sleep duration (body mass index [BMI] >25). METHODS All participants had habitual sleep duration <6.5 hours verified by 7 days of actigraphy. A total of 6 individuals completed initial user testing in the development phase, and 2 participants completed field testing. Participants in the user testing and field testing responded to open-ended surveys about the design and utility of the app. Participants in the field testing completed the Epworth Sleepiness Scale and also wore an actigraph for a 1-week baseline period and during the 4-week intervention period. RESULTS The feedback suggests that users enjoyed the wearable sleep tracker and found the app visually pleasing, but they suggested improvements to the notification and reminder features of the app. The 2 participants who completed the field test demonstrated significant improvements in sleep duration and daytime sleepiness. CONCLUSIONS Further testing is needed to determine effects of this intervention in populations at risk for the mental and physical consequences of sleep loss.

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Technology-Assisted Behavioral Intervention to Extend Sleep Duration: Development and Design of the Sleep Bunny Mobile App

JMIR Mental Health ◽

10.2196/mental.8634 ◽

2018 ◽

Vol 5 (1) ◽

pp. e3 ◽

Cited By ~ 5

Author(s):

Kelly Glazer Baron ◽

Jennifer Duffecy ◽

Kathryn Reid ◽

Mark Begale ◽

Lauren Caccamo

Keyword(s):

Sleep Duration ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Field Testing ◽

Mobile App ◽

Cardiovascular Disease Risk Factor ◽

User Testing ◽

Short Sleep Duration ◽

Short Sleep ◽

Populations At Risk

Background Despite the high prevalence of short sleep duration (29.2% of adults sleep <6 hours on weekdays), there are no existing theory-based behavioral interventions to extend sleep duration. The popularity of wearable sleep trackers provides an opportunity to engage users in interventions. Objective The objective of this study was to outline the theoretical foundation and iterative process of designing the “Sleep Bunny,” a technology-assisted sleep extension intervention including a mobile phone app, wearable sleep tracker, and brief telephone coaching. We conducted a two-step process in the development of this intervention, which was as follows: (1) user testing of the app and (2) a field trial that was completed by 2 participants with short sleep duration and a cardiovascular disease risk factor linked to short sleep duration (body mass index [BMI] >25). Methods All participants had habitual sleep duration <6.5 hours verified by 7 days of actigraphy. A total of 6 individuals completed initial user testing in the development phase, and 2 participants completed field testing. Participants in the user testing and field testing responded to open-ended surveys about the design and utility of the app. Participants in the field testing completed the Epworth Sleepiness Scale and also wore an actigraph for a 1-week baseline period and during the 4-week intervention period. Results The feedback suggests that users enjoyed the wearable sleep tracker and found the app visually pleasing, but they suggested improvements to the notification and reminder features of the app. The 2 participants who completed the field test demonstrated significant improvements in sleep duration and daytime sleepiness. Conclusions Further testing is needed to determine effects of this intervention in populations at risk for the mental and physical consequences of sleep loss.

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Sleep deprivation and endothelial function: reconciling seminal evidence with recent perspectives

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00607.2020 ◽

2021 ◽

Vol 320 (1) ◽

pp. H29-H35

Author(s):

Joshua M. Cherubini ◽

Jem L. Cheng ◽

Jennifer S. Williams ◽

Maureen J. MacDonald

Keyword(s):

Cardiovascular Disease ◽

Endothelial Dysfunction ◽

Endothelial Function ◽

Sleep Deprivation ◽

Vascular Function ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Health Concern ◽

Short Sleep ◽

Inadequate Sleep

Sleep is critical for the maintenance of physiological homeostasis and, as such, inadequate sleep beckons a myriad of pathologies. Sleep deprivation is a growing health concern in contemporary society since short sleep durations are associated with increased cardiovascular disease risk and atherosclerotic plaque development. Vascular endothelial dysfunction is an antecedent to atherosclerosis and cardiovascular disease. Herein, we review seminal literature indicating that short sleep durations attenuate endothelial function and explore more recent evidence indicating that sleep deprivation perturbs autonomic balance and the circadian rhythmicity of peripheral vascular clock components. We further examine literature that indicates a mechanistic link between short sleep duration and endothelial dysfunction and subsequent morbidity. Understanding the mechanisms that regulate endothelial function in the context of sleep deprivation facilitates the development and optimization of interventions, such as exercise, that mitigate the ramifications of inadequate sleep on vascular function and cardiovascular health. Listen to this article’s corresponding podcast at https://ajpheart.podbean.com/e/sleep-deprivation-and-endothelial-function/

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Sleep Duration and Snoring in Relation to Biomarkers of Cardiovascular Disease Risk Among Women With Type 2 Diabetes

Diabetes Care ◽

10.2337/dc06-2107 ◽

2007 ◽

Vol 30 (5) ◽

pp. 1233-1240 ◽

Cited By ~ 98

Author(s):

C. J. Williams ◽

F. B. Hu ◽

S. R. Patel ◽

C. S. Mantzoros

Keyword(s):

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Sleep Duration ◽

Disease Risk ◽

Cardiovascular Disease Risk

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Contribution of short sleep duration to ethnic differences in cardiovascular disease: results from a cohort study in the Netherlands

BMJ Open ◽

10.1136/bmjopen-2017-017645 ◽

2017 ◽

Vol 7 (11) ◽

pp. e017645 ◽

Cited By ~ 5

Author(s):

Kenneth Anujuo ◽

Charles Agyemang ◽

Marieke B Snijder ◽

Girardin Jean-Louis ◽

Bert-Jan van den Born ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

The Netherlands ◽

Sleep Duration ◽

Ethnic Differences ◽

Urban Setting ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Short Sleep Duration ◽

Short Sleep

ObjectivesWe analysed association between short sleep duration and prevalence of cardiovascular disease (CVD) in a multiethnic population living in the Netherlands, and the contribution of short sleep to the observed ethnic differences in the prevalence of CVD, independent of CVD risk factors.Methods20 730 participants (aged 18–71 years) of the HELIUS (Healthy Life in an Urban Setting) Study were investigated. Self-reported sleep duration was classified as: short (<7 hours/night) and healthy (7–9 hours/night). Prevalence of CVD was assessed using the Rose Questionnaire on angina pectoris, intermittent claudication and possible myocardial infarction. Association of short sleep duration with prevalent CVD and the contribution of short sleep to the observed ethnic differences in the prevalence of CVD were analysed using adjusted prevalence ratio(s) (PRs) with 95% CI.ResultsResults indicate that short sleep was associated with CVD among all ethnic groups with PRs ranging from 1.41 (95% CI 1.21 to 1.65) in Moroccans to 1.62 (95% CI 1.20 to 2.18) in Dutch after adjustment for age, sex and conventional CVD risk factors. The independent contributions of short sleep (in percentage) to ethnic differences in CVD compared with Dutch were 10%, 15%, 15%, 5% and 5% in South-Asian Surinamese, African-Surinamese, Ghanaian, Turkish and Moroccan, respectively.ConclusionShort sleep contributed to ethnic differences in CVD independent of well-known CVD risk factors particularly in Surinamese and Ghanaian groups. Reducing sleep deprivation may be a relevant entry point for reducing increased CVD risks among the various ethnic minority groups.

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Modeling Sleep and Adiposity-Associated Cardiometabolic Disease Risk Factors: Protocol for the SLUMBRx Study (Preprint)

10.2196/preprints.27139 ◽

2021 ◽

Author(s):

Adam Knowlden ◽

John Higginbotham ◽

Michael Grandner ◽

John Allegrante

Keyword(s):

Risk Factors ◽

Sleep Duration ◽

Disease Risk ◽

Cardiometabolic Disease ◽

Health Issues ◽

Short Sleep Duration ◽

Short Sleep ◽

Adiposity Indices ◽

The Relationship ◽

Cardiometabolic Disease Risk

BACKGROUND Obesity and short sleep duration are significant public health issues. Current evidence suggests these conditions are associated with cardiovascular disease, metabolic syndrome, inflammation, and premature mortality. Increased interest in the potential link between obesity and short sleep duration, and its health consequences, has been driven by: 1) the apparent parallel increase in prevalence of both conditions in recent decades; 2) their overlapping association with cardiometabolic outcomes; and 3) the potential causal connection between the two health issues. The Short Sleep Undermines Cardiometabolic Health (SLUMBRx) Study seeks to contribute to the development of a comprehensive adiposity-sleep model, while laying the groundwork for a future program of research that will be designed to prevent and treat adiposity and sleep-related cardiometabolic disease risk factors. OBJECTIVE SLUMBRx addresses four topics pertinent to the adiposity-sleep hypothesis: 1) the relationship between adiposity and sleep duration; 2) sex-based differences in the relationship between adiposity and sleep duration; 3) influence of adiposity indices and sleep duration on cardiometabolic outcomes; and 4) the role of socioecological factors as effect modifiers in the relationship between adiposity indices, sleep, and cardiometabolic outcomes. METHODS SLUMBRx will employ a large-scale survey (n=1,000) that recruits 159 participants (53 normal weight, 53 overweight, and 53 obese) to be assessed in two phases. RESULTS Phase 1, a lab-based study, will gather objective adiposity indices (air displacement plethysmography and anthropometrics) and cardiometabolic data (blood pressure, pulse wave velocity and pulse wave analysis, and blood-based biomarker). Phase 2, a one-week, home-based study, will gather sleep-related data (home sleep testing/sleep apnea, actigraphy, sleep diaries). During Phase 2, detailed demographic and socioecological data will be collected to contextualize hypothesized adiposity and sleep-associated cardiometabolic disease risk factors. Collection and analyses of these data will yield information necessary to customize future observational and intervention research. CONCLUSIONS Precise implementation of the SLUMBRx protocol promises to provide objective, empirical data on the interaction between body composition and sleep duration. The hypotheses that will be tested by SLUMBRx are important for understanding the pathogenesis of cardiometabolic disease and for developing future public health interventions to prevent its conception and treat its consequences. CLINICALTRIAL https://projectreporter.nih.gov/project_info_description.cfm?aid=9822114&icde=45818775

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