1011 Sleep Duration Moderates the Association Between Next-Day Physical Activity and Pain Intensity Among Women with Fibromyalgia

Abstract Introduction Suboptimal sleep has been consistently associated with greater next-day pain intensity among women with fibromyalgia. In contrast, associations between physical activity and same-day pain in this population are contradictory. Given this inconsistency, we aimed to determine whether the daily physical activity-pain association is modified by sleep parameters. Methods This micro-longitudinal study used data collected using wrist-worn triaxial accelerometers over seven consecutive days by 44 adult women with fibromyalgia. Derived variables included sleep duration, sleep onset latency (SOL), wake after sleep onset (WASO), sleep efficiency (SE) and maximum daily physical activity count. Participants also completed digital diaries of refreshed sleep upon awakening (scale 0-100), and pain intensity (5x/day, scale 0-100). Multilevel linear regression models with interaction terms were used to investigate moderating effects of sleep on the next-day person-centered maximum physical activity-average pain intensity association. Results The sample mean age was 44 (SD 14). A total of 304 days of data were available for analysis. Mean sleep duration was 471min(SD 66); mean SOL 10min(SD 10); mean WASO 31min(SD 17), and mean SE 90%(SD 5). Sleep duration moderated the next-day maximum physical activity-pain association (Wald statistic p=0.01). After nights of both shorter (<7 hours) and longer sleep (>8 hours), higher levels of next-day maximum physical activity (compared to the participant’s overall study average) were associated with days of greater average pain. In contrast, after nights of 7-8 hours of sleep, higher levels of next-day maximum physical activity were associated with days of lower average pain. Conclusion An association between higher maximum physical activity and lower levels of pain was only observed after nights of 7-8 hours sleep. Engaging in physical activity is recommended for fibromyalgia-related pain management. Optimizing sleep duration may be useful in minimizing physical activity-related pain in this clinical population. Support DW is supported by a Foundation Fellowship Versus Arthritis. The study that provided data was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health (award number K01AR064275;PI:ALK). The Michigan Institute for Clinical & Health Research provided subject recruitment support through the UMHealthResearch.org website (MICHR:NIH award number UL1TR002240).

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A Comparison of Physical Activity Levels, Sleep Disrupting Behavior, and Stress/Affective Distress as Predictors of Sleep as Indexed by Actigraphy

Journal of Physical Activity and Health ◽

10.1123/jpah.2020-0042 ◽

2021 ◽

pp. 1-12

Author(s):

Shireen W. Eid ◽

Rhonda F. Brown ◽

Carl L. Birmingham ◽

Shane K. Maloney

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Young Children ◽

Ambient Temperature ◽

Sleep Duration ◽

Sleep Onset ◽

Sleep Onset Latency ◽

Onset Latency ◽

Affective Distress ◽

Sleep Impairment

Background: Several behaviors have been reported to interfere with sleep in otherwise healthy adults, including low physical activity (PA) levels. However, few studies have compared low PA with the other behavioral risk factors of objective sleep impairment, despite the behavior tending to cooccur in highly stressed and affectively distressed individuals. Thus, the authors compared objective and subjective measures of PA and other potential sleep disrupting behaviors as predictors of objective sleep (sleep onset latency, actual sleep time, total sleep duration, awake time, and sleep efficacy) at baseline (T1) and 3 months later (T2). Methods: A community-derived sample of 161 people aged 18–65 years were asked about PA, other behavior (ie, night eating, electronic device use, watching television, caffeine and alcohol use), stress, affective distress (ie, anxiety, depression), and demographics including shift work and parenting young children in an online questionnaire at T1 and T2. PA and sleep were also monitored for 24 hours each at T1 and T2 using actigraphy. Results: Multiple regression analyses indicated that sleep at T1 was associated with PA (ie, total number of steps, metabolic equivalents/time, time spent travelling) after controlling mean ambient temperature and relevant demographics. At T2, longer sleep onset latency was predicted by parenting young children and night time television viewing; shorter sleep duration was predicted by female gender; and awake time and sleep efficacy were predicted by alcohol intake after controlling T1 sleep measures, demographics, and mean ambient temperature. Conclusion: The risk factors for objective sleep impairment included parenting young children and watching television at night, whereas better sleep outcomes were associated with greater engagement with PA.

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Daily Relationships Between Physical Activity and Sleep: Differences Between Subjective and Objective Measures

Innovation in Aging ◽

10.1093/geroni/igaa057.1376 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 426-426

Author(s):

Alycia Bisson ◽

Margie Lachman ◽

Alycia Sullivan Bisson

Keyword(s):

Physical Activity ◽

Sleep Duration ◽

Multilevel Models ◽

Sleep Onset ◽

Negative Relationship ◽

The United States ◽

Objective Measures ◽

Sleep Onset Latency ◽

Subjective Duration ◽

University Of Wisconsin

Abstract Although there is evidence that physical activity (PA) and sleep are related, it is unclear which aspects of these multidimensional constructs are involved. Many have examined differences in PA and sleep between persons, but few have tested daily associations within persons. The present study examined sleep (duration; hours spent asleep, WASO; wake after sleep onset, latency; time to fall asleep) and PA (total and intensity) over 7 days, using both a self-reported diary (subjective) and an ActiWatch (objective). Healthy adults between 34 and 83 came to University of Wisconsin, Madison to participate in the Midlife in the United States (MIDUS) Biomarker study (N=436, Mage: 56.92, SDage: 11.5). Subjective and objective measures showed differential relationships; subjective duration was higher, and latency was lower than objective measures. Some age differences were also found; older adults reported more WASO than middle-aged adults, but their WASO was similar according to actigraphy. Multilevel models revealed that total PA and intensity significantly predicted subjective and objective sleep measures, controlling for age, sex, and other demographic variables. More active participants had shorter sleep durations, WASO, and latency. Within-person analyses revealed that on days one is more active than average, sleep duration is shorter with less WASO across age. Although the negative relationship between PA and sleep duration was unexpected, it is possible that because more active individuals wake less during the night, they may need fewer hours of sleep because their sleep is more restful. Discussion will focus on possible mechanisms involved in linking PA and sleep.

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648 Associations between objective afternoon and evening physical activity and polysomnographic sleep in fibromyalgia

SLEEP ◽

10.1093/sleep/zsab072.646 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A253-A254

Author(s):

Kevin McGovney ◽

Ashley Curtis ◽

Christina S McCrae

Keyword(s):

Physical Activity ◽

Pain Intensity ◽

Sleep Onset ◽

Sleep Architecture ◽

Future Research ◽

Activity Levels ◽

Sleep Onset Latency ◽

Causal Pathways ◽

Time In Bed ◽

Stage 1

Abstract Introduction Patients with fibromyalgia (FM) suffer from pain which limits physical activity and disrupts sleep. Research examining the relationship between pre-bedtime physical activity, pain, and objective sleep is limited. This study examined whether objectively measured activity levels (via actigraphy), pain intensity, or their interaction are associated with polysomnographic sleep outcomes and sleep architecture. Methods Adults with FM (n=158, Mage=52, SD=12, 93% female) completed 14 daily pain ratings, 14 days of actigraphy, and a single night of polysomnography. Activity levels (i.e., magnitude of wrist motion captured per 30 second epoch) were recorded, and average afternoon/evening activity for intervals 12:00-15:00, 15:00-18:00, and 18:00-21:00 was computed, removing days in which participants slept during these periods. Sleep architecture was quantified as the percentage of sleep time in rapid eye movement (%rem) and non-rem (i.e. %stage 1, %stage 2, and %stage 3). Multiple regressions examined whether average afternoon/evening activity, average evening pain [0 (no pain)–100 (most intense pain imaginable)], or their interaction predicted polysomnographic sleep onset latency (SOL), wake after sleep onset (WASO), sleep efficiency (SE), %stage 1, %stage 2, %stage 3, and %rem, controlling for age, body mass index, average individual bedtime, time in bed, and sleep or pain medication usage. Results Greater afternoon activity from 12:00-15:00 was independently associated with lower SE (B= -.08, p=.01), greater WASO (B=.45, p<.001), and greater %stage 1 (B=.04, p<.01). Pain intensity interacted with physical activity from 12:00-15:00 such that the association between physical activity and higher WASO (p=.05) and greater %stage 1 (p<.01) was stronger for individuals with higher pain. Pain intensity and activity from 15:00-18:00, and 18:00-21:00 were not associated with sleep outcomes. Conclusion Our results suggest greater afternoon activity is associated with greater polysomnographic sleep fragmentation and greater %stage 1 sleep in FM, and these relationships are stronger for individuals with higher pain. These relationships are consistent with activity pacing recommendations for chronic pain and suggest pacing in the afternoon may be important for good sleep in FM. However, future research examining causal pathways linking physical activity levels and timing, pain, and sleep is needed. Support (if any) Support: NIAMS (R01AR055160/R01AR005160- S1;PI McCrae). Data collected at University of Florida (Clinical Trial-NCT02001077;PI McCrae).

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The Monday Effect Revisited: A Diary and Sleep Actigraphy Study

Sleep and Vigilance ◽

10.1007/s41782-020-00105-5 ◽

2020 ◽

Vol 4 (2) ◽

pp. 167-176

Author(s):

Achim Elfering ◽

Christin Gerhardt ◽

Diana Pereira ◽

Anna Schenker ◽

Maria U. Kottwitz

Keyword(s):

Sleep Duration ◽

Sleep Onset ◽

Monday Morning ◽

Sleep Onset Latency ◽

Onset Latency ◽

Social Stressors ◽

Monday Effect ◽

Work Related ◽

Cognitive Failure ◽

Delayed Sleep

Abstract Purpose Accidents are more likely to occur during the morning hours of Mondays (Monday effect). This might be due to a higher level of cognitive failure on Monday morning at work. Methods In a pilot actigraphy study across one working week, we explored this Monday effect and regressed daily self-reported workplace cognitive failure on weekdays (Monday versus other days), background social stressors at work, delayed sleep onset and sleep duration. Diary data were gathered from 40 full-time employees. Results Confirming our assumptions, results revealed work-related cognitive failure and sleep-onset latency on the previous night to be higher on Mondays compared to other workdays. Work-related cognitive failure correlated positively with delayed sleep-onset latency and background social stressors. In multilevel regression analysis, Monday significantly explained variations in workplace cognitive failure. The addition of background social stressors at work and sleep-onset latency to the regression model showed unique contributions to the prediction of workplace cognitive failure. No significant two-way or three-way interactions between working days, sleep-onset latency or sleep duration, and background social stressors were found. Conclusion Peak levels of cognitive failure on Monday morning and the association of cognitive failure with social stressors at work contribute to understanding the mechanisms involved in the increased prevalence of occupational accidents on Monday morning. Occupational safety interventions should address both social stressors at work and individual sleep hygiene.

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193 Sleep Variability and Affect Dynamics Among College Students during COVID-19 Pandemic

SLEEP ◽

10.1093/sleep/zsab072.192 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A78-A78

Author(s):

Zahra Mousavi ◽

Jocelyn Lai ◽

Asal Yunusova ◽

Alexander Rivera ◽

Sirui Hu ◽

...

Keyword(s):

Emerging Adults ◽

Sleep Duration ◽

Sleep Onset ◽

Positive And Negative Affect ◽

Sleep Onset Latency ◽

Deep Sleep ◽

Onset Latency ◽

Sleep Patterns ◽

Light Sleep ◽

Affect Dynamics

Abstract Introduction Sleep disturbance is a transdiagnostic risk factor that is so prevalent among emerging adults it is considered to be a public health epidemic. For emerging adults, who are already at greater risk for psychopathology, the COVID-19 pandemic has disrupted daily routines, potentially changing sleep patterns and heightening risk factors for the emergence of affective dysregulation, and consequently mood-related disturbances. This study aimed to determine whether variability in sleep patterns across a 3-month period was associated with next-day positive and negative affect, and affective dynamics, proximal affective predictors of depressive symptoms among young adults during the pandemic. Methods College student participants (N=20, 65% female, Mage=19.80, SDage=1.0) wore non-invasive wearable devices (the Oura ring https://ouraring.com/) continuously for a period of 3-months, measuring sleep onset latency, sleep efficiency, total sleep, and time spent in different stages of sleep (light, deep and rapid eye movement). Participants reported daily PA and NA using the Positive and Negative Affect Schedule on a 0-100 scale to report on their affective state. Results Multilevel models specifying a within-subject process of the relation between sleep and affect revealed that participants with higher sleep onset latency (b= -2.98, p<.01) and sleep duration on the prior day (b= -.35, p=.01) had lower PA the next day. Participants with longer light sleep duration had lower PA (b= -.28, p=.02), whereas participants with longer deep sleep duration had higher PA (b= .36, p=.02) the next day. On days with higher total sleep, participants experienced lower NA compared to their own average (b= -.01, p=.04). Follow-up exploratory bivariate correlations revealed significant associations between light sleep duration instability and higher instability in both PA and NA, whereas higher deep sleep duration was linked with lower instability in both PA and NA (all ps< .05). In the full-length paper these analyses will be probed using linear regressions controlling for relevant covariates (main effects of sleep, sex/age/ethnicity). Conclusion Sleep, an important transdiagnostic health outcome, may contribute to next-day PA and NA. Sleep patterns predict affect dynamics, which may be proximal predictors of mood disturbances. Affect dynamics may be one potential pathway through which sleep has implications for health disparities. Support (if any):

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Association between Physical Activity and Sleep Difficulties among Adolescents in Germany: The Role of Socioeconomic Status

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18189664 ◽

2021 ◽

Vol 18 (18) ◽

pp. 9664

Author(s):

Miriam Blume ◽

Petra Rattay

Keyword(s):

Physical Activity ◽

Socioeconomic Status ◽

Sleep Duration ◽

Adolescent Girls ◽

Daytime Sleepiness ◽

Sleep Onset ◽

Adolescent Girls And Boys ◽

Kiggs Study ◽

Using Data ◽

Sleep Difficulties

We examined sleep difficulties among adolescents in Germany and the association with physical activity (PA). Furthermore, we analyzed whether the association varied with the socioeconomic status (SES) among adolescent girls and boys in Germany. Using data from the German Health Interview Examination Survey for Children and Adolescents (KiGGS) study (Wave 2), 6599 adolescents aged 11 to 17 years were included in the analyses. We conducted sex-stratified logistic regression analyses. Dependent variables were unrecommended sleep duration (defined as a duration of sleep that does not meet the recommended duration), sleep-onset difficulties, trouble sleeping, and daytime sleepiness. Most adolescent girls and boys reported sleep difficulties. While no associations between PA and sleep difficulties were observed, a significant interaction between PA and SES was found for sleep duration in boys and daytime sleepiness in girls. Thus, adolescents with low SES had fewer sleep difficulties if they met the recommendation for PA, compared with those in other SES groups. In Germany, a large proportion of adolescents have sleep difficulties. We found that the experience of sleep difficulties varied according to PA, sex, and the family SES. Future sleep promotion programs should consider these differences.

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Abstract P199: Sleep Health Varies By Immigration Status And Acculturation Level In Women: Results From The American Heart Association Go Red For Women Strategically Focused Research Network

Circulation ◽

10.1161/circ.143.suppl_1.p199 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Ivan A Samayoa ◽

Nour Makarem ◽

Vivian Cao ◽

Moorea Maguire ◽

Huaqing Xi ◽

...

Keyword(s):

Sleep Duration ◽

Sleep Problems ◽

Immigrant Women ◽

Sleep Onset ◽

Research Network ◽

Sleep Onset Latency ◽

Onset Latency ◽

Immigration Status ◽

Sleep Health ◽

The Us

Introduction: The Healthy Immigrant Effect refers to the phenomenon that recent immigrants are on average healthier than their native-born counterparts. Greater immigrant acculturation to the US has been linked to increased risk of cardiovascular disease (CVD), frequently attributed to factors including the adoption of Western diets and decreased physical activity. While immigrants may have healthier habits than US adults, which may confer protection from CVD, there is little research on sleep health, particularly in immigrant women. Hypothesis: We hypothesized that immigrants, particularly those with greater acculturation, would have more sleep problems. Methods: Baseline data from a 1-y, community-based cohort of 506 women (61% racial/ethnic minority, mean age=37±16y) was used to evaluate cross-sectional associations between acculturation and sleep. Women self-reported their immigration status and national origin. Acculturation was measured from responses to questions regarding language preference, nativity (sorted by regions: Asia, Caribbean, Latin America, other), length of residency in the US, and age at immigration. Sleep duration, sleep quality, risk of obstructive sleep apnea (OSA) and insomnia were assessed using validated questionnaires. Logistic regression models adjusted for age, health insurance, education and BMI were used to evaluate associations between acculturation measures and sleep characteristics. Results: Women who were immigrants (n=176) reported lower mean sleep duration (6.60 ± 1.25 vs. 6.85 ± 1.22 h, p=0.02) compared to non-immigrants (n=323); non-immigrants were more likely than immigrants to sleep ≥7h/night (OR: 1.50, CI: 1.01-2.22, p=0.04). Women who immigrated to the US before vs. after age 25 y had lower odds of having sleep onset latency ≥26 min (OR:0.97, CI:0.95-1.00, p=0.03). Immigrant women living in the US >10y vs. <10y had more than 2-fold higher odds of having longer sleep onset latency (≥26 min) (OR:2.43, CI:1.09-5.41, p=0.03). Immigrants from the Caribbean were more likely than immigrants from other regions to be at a high risk for OSA (OR:2.65, CI:1.07-6.55, p=0.04). Conclusions: Compared to non-immigrants, immigrant women exhibit shorter habitual sleep duration. Sleep problems may vary by age of immigration, years lived in the US, and region of origin, as those who immigrated when they were older and those who had lived in the US>10 y required more time to fall asleep and Caribbean immigrants had higher OSA risk.

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Sleep misestimation among older adults suffering from insomnia with short and normal objective sleep duration and the effects of cognitive behavior therapy

SLEEP ◽

10.1093/sleep/zsaa250 ◽

2020 ◽

Author(s):

Nicole Lovato ◽

Gorica Micic ◽

Leon Lack

Keyword(s):

Older Adults ◽

Sleep Duration ◽

Behavior Therapy ◽

Cognitive Behavior Therapy ◽

Sleep Onset ◽

Sleep Diary ◽

Cognitive Behavior ◽

Sleep Onset Latency ◽

Normal Sleep

Abstract Study Objectives Compare the degree of sleep misestimation in older adults with insomnia presenting with objectively short relative to normal sleep duration, and investigate the differential therapeutic response on sleep misestimation between the proposed sleep duration phenotypes to cognitive-behavior therapy for insomnia (CBTi). Methods Ninety-one adults (male = 43, mean age = 63.34, SD = 6.41) with sleep maintenance insomnia were classified as short sleepers (SS; <6 h total sleep time [TST]) or normal sleepers (NS; ≥6 h TST) based on one night of home-based polysomnography. Participants were randomly allocated to CBTi (N = 30 SS, N = 33 NS) or to a wait-list control condition (N = 9 SS, N = 19 NS). Sleep misestimation was calculated as the difference scores of subjective (sleep diary reported) and objective (derived from actigraphy) sleep onset latency (SOL), wake after sleep onset (WASO), and TST at pre- and post-treatment, and 3-month follow-up. Results Prior to treatment, perception of SOL, WASO, and TST did not differ between patients with objectively short sleep duration relative to those with objectively normal sleep duration. Patients’ perception of WASO and TST, improved immediately following treatment and at 3-month follow-up relative to the waitlist group. These improvements did not differ significantly between those with short or normal objective sleep duration prior to treatment. Conclusions The degree of sleep misestimation is similar for older adults suffering from chronic insomnia with short or normal objective sleep duration. Irrespective of objective sleep duration prior to treatment, CBTi produces significant improvements in sleep perception. Clinical Trial Registration Number ACTRN12620000883910

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A Comparative Study of Sleep and Mood Between Young Elite Athletes and Age-Matched Controls

Journal of Physical Activity and Health ◽

10.1123/jpah.2016-0513 ◽

2017 ◽

Vol 14 (6) ◽

pp. 465-473 ◽

Cited By ~ 6

Author(s):

Anette Harris ◽

Hilde Gundersen ◽

Pia Mørk Andreassen ◽

Eirunn Thun ◽

Bjørn Bjorvatn ◽

...

Keyword(s):

Physical Activity ◽

Total Sleep Time ◽

Elite Athletes ◽

Sleep Onset ◽

Sleep Time ◽

Sleep Diary ◽

Sleep Onset Latency ◽

Onset Latency ◽

Social Jetlag ◽

Weekly Training

Background:Sleep and mood have seldom been compared between elite athletes and nonelite athletes, although potential differences suggest that physical activity may affect these parameters. This study aims to explore whether adolescent elite athletes differ from controls in terms of sleep, positive affect (PA) and negative affect (NA).Methods:Forty-eight elite athletes and 26 controls participating in organized and nonorganized sport completed a questionnaire, and a 7-day sleep diary.Results:On school days, the athletes and the controls who participated in organized and nonorganized sport differed in bedtime (22:46, 23:14, 23:42, P < .01), sleep onset (23:03, 23:27, 00:12, P < .01), and total sleep time (7:52, 8:00, 6:50, P < 01). During weekend, the athletes, the controls who participated in organized and nonorganized sport differed in bedtime (23:30, 00:04, 00:49, P < .01), sleep onset (23.42, 00:18, 01:13, P < .01), rise time (9:15, 9:47, 10:55, P < .01), sleep efficiency (95.0%, 94.2%, 90.0%, P < 05), and sleep onset latency (11.8, 18.0, 28.0 minutes, P < .01). Furthermore, the athletes reported less social jetlag (0:53) and higher score for PA (34.3) compared with the controls who participated in nonorganized sport (jetlag: 1:25, P < .05, PA: 29.8, P < .05).Conclusions:An almost dose-response association was found between weekly training hours, sleep, social jetlag and mood in adolescents.

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Effect of exercise on sleep and bi-directional associations with accelerometer-assessed physical activity in men with obesity

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2020-0361 ◽

2020 ◽

Author(s):

Tatiana Plekhanova ◽

Alex V. Rowlands ◽

Melanie Davies ◽

Charlotte L. Edwardson ◽

Andrew Hall ◽

...

Keyword(s):

Physical Activity ◽

Sleep Quality ◽

Aerobic Exercise ◽

Sleep Duration ◽

Exercise Intervention ◽

Vigorous Physical Activity ◽

Sleep Onset ◽

Onset Time ◽

Post Intervention

This study examined the effect of exercise training on sleep duration and quality and bidirectional day-to-day relationships between physical activity (PA) and sleep. Fourteen inactive men with obesity (49.2±7.9 years, BMI 34.9±2.8 kg/m²) completed a baseline visit, eight-week aerobic exercise intervention, and one-month post-intervention follow-up. PA and sleep were assessed continuously throughout the study duration using wrist-worn accelerometry. Generalised estimating equations (GEE) were used to examine associations between PA and sleep. Sleep duration increased from 5.2h at baseline to 6.6h during the intervention period and 6.5h at one-month post-intervention follow-up (p<0.001). Bi-directional associations showed that higher overall activity volume and moderate-to-vigorous physical activity (MVPA) were associated with earlier sleep onset time (p<0.05). Later timing of sleep onset was associated with lower overall volume of activity, most active continuous 30 minutes (M30CONT), and MVPA (p<0.05). Higher overall activity volume, M30CONT, and MVPA predicted more wake after sleep onset (WASO) (p<0.001), whereas greater WASO was associated with higher overall volume of activity, M30CONT, and MVPA (p<0.001). An aerobic exercise intervention increased usual sleep duration. Day-to-day, more PA predicted earlier sleep onset, but worse sleep quality and vice versa. Novelty: • Greater levels of physical activity in the day were associated with an earlier sleep onset time that night, whereas a later timing of sleep onset was associated with lower physical activity the next day in men with obesity • Higher physical activity levels were associated with worse sleep quality, and vice versa

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