174 Discrimination moderates the association of sleep and cognitive function in older Black adults: The Einstein Aging Study

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A71-A71
Author(s):  
Linying Ji ◽  
June Jiao ◽  
Ruixue Zhaoyang ◽  
Carol Derby ◽  
Orfeu Buxton ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Sleep Quality ◽  
Cognitive Functioning ◽  
Skin Color ◽  
Sleep Onset ◽  
Individual Characteristics ◽  
Black Adults ◽  
Memory Binding ◽  
Wrist Actigraphy ◽  
Aging Study

Abstract Introduction Experiences of discrimination attributed to a range of individual characteristics (race, skin color, age, sex, etc.) may influence the extent to which sleep impacts cognitive functioning in order adults, particularly within older minorities. Thus, we investigated the effect of discrimination on the relationship between actigraphic sleep quality and cognitive function in analyses stratified by race. Methods Participants (N=286, mean age=77.4 years, 32% males; 45% white, 41% Black, 14% Hispanic/others) enrolled in The Einstein Aging Study were included. Sleep disturbance, as measured by wake after sleep onset (WASO) (mean=63 min, sd=27 min), was calculated from wrist actigraphy over 15.4±1.4 days. Participants’ mean ambulatory cognitive function was assessed with a validated, memory binding, smartphone-based EMA task (Color Shapes) repeated 4 times daily. A modified version of the Williams’ Everyday Discrimination questionnaire, optimized for older adults, measured participants’ endorsement of discriminated characteristics. Linear regressions, stratified by race (white, Black separately), were conducted with interaction terms to investigate whether discrimination moderated associations between WASO and ambulatory cognitive function. Models controlled for age, education, income, and gender. Regions of significance were also evaluated. Results Race-stratified analysis indicated that the association between mean WASO and cognitive function was significantly moderated by the number of discriminated characteristics among Black adults (n=117), not whites (n=128). Specifically, among Black adults who identified few discriminated characteristics, WASO was not significantly associated with memory binding. However, Black adults who identified discriminated characteristics at +1 SD above the mean (5.5 traits) exhibited a 12% lower average memory binding test score (percent responses correct) with each half-hour greater mean WASO (p=.01). Analysis of the region of significance showed the association is significant when participants endorsed more than three discriminated characteristics. Conclusion These findings emphasize the importance of considering sociocultural factors, such as discrimination, to understand the association between sleep quality and cognitive functioning, particularly for older Blacks. Support (if any) R01AG062622

scholarly journals Associations of loneliness and social isolation with actigraph and self-reported sleep quality in a national sample of older adults

SLEEP ◽  
2020 ◽  
Author(s):  
Jade A Benson ◽  
V Eloesa McSorley ◽  
Louise C Hawkley ◽  
Diane S Lauderdale
Keyword(s):  
Older Adults ◽  
Sleep Quality ◽  
Social Isolation ◽  
Social Life ◽  
Sleep Onset ◽  
Ordinary Least Squares ◽  
Community Dwelling ◽  
Sleep Study ◽  
Time In Bed ◽  
Wrist Actigraphy

Abstract Study Objectives To examine associations of social isolation and loneliness with sleep in older adults and whether associations differ for survey and actigraph sleep measures. Methods This study used data from the National Social Life, Health, and Aging Project (NSHAP), a nationally representative study of community-dwelling older adults born 1920–1947. A random one-third of participants in 2010–2011 were invited to participate in a sleep study (N = 759) that included survey questions, 72 hours of wrist actigraphy, and a sleep log. Perceived loneliness was measured using three questions from the UCLA Loneliness Scale. An index of social isolation was constructed from nine items that queried social network characteristics and social interactions. We used ordinary least squares and ordinal logistic regression to examine whether sleep measures were associated with loneliness and social isolation adjusted for potential sociodemographic confounders. Results Social isolation and loneliness had a low correlation (Spearman’s correlation = 0.20). Both loneliness and social isolation were associated with actigraphy measures of more disrupted sleep: wake after sleep onset and percent sleep. Neither was associated with actigraph total sleep time. Increased loneliness was strongly associated with more insomnia symptoms and with shorter sleep duration assessed by a single question, but social isolation was not. More isolated individuals spent a longer time in bed. Conclusions We found that both loneliness and social isolation were associated with worse actigraph sleep quality, but their associations with self-reported sleep differed. Only loneliness was associated with worse and shorter self-reported sleep.

Abstract P341: Poor Sleep Patterns Are Associated With Decreased Performance on the Montreal Cognitive Assessment in Both Younger and Older Women

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Brooke Aggarwal ◽  
Adam M Brickman ◽  
Ming Liao ◽  
Molly E Zimmerman
Keyword(s):  
Risk Factors ◽  
Cognitive Function ◽  
Sleep Quality ◽  
Sleep Duration ◽  
Sleep Onset ◽  
Poor Sleep ◽  
Cvd Risk Factors ◽  
Sleep Patterns ◽  
Cvd Risk ◽  
Quality Sleep

Introduction: Poor cardiovascular health has been linked to an increased likelihood of cognitive impairment in older adults. Cognitive impairment has also been identified as an emerging co-morbidity of obstructive sleep apnea, a highly prevalent sleep disorder, particularly in patients with neurological conditions. Whether other aspects of sleep, including sleep duration, sleep quality, sleep onset latency, and insomnia are associated with cognition is not established. Objective: The aim of this study was to evaluate whether specific sleep patterns were associated with cognitive function in a diverse population of both younger and older, neurologically healthy women, and to determine whether this association is mediated by cardiovascular disease (CVD) risk factors. Methods: This was a baseline analysis of 392 women (59% racial/ethnic minority, mean age=39±16.53y, range 20-76y) participating in the ongoing American Heart Association Go Red for Women Strategically Focused Research Network population-based study at Columbia University Medical Center (CUMC). Cognitive function was assessed by the validated Montreal Cognitive Assessment (MoCA) screening instrument. Sleep duration, sleep quality, and time to sleep onset were assessed using the Pittsburgh Sleep Quality Index; insomnia was assessed using the Insomnia Severity Index. Blood lipids and glucose were measured in the biomarker core laboratory at CUMC. Multivariable linear regression models were used to evaluate associations between sleep, CVD risk factors, and MoCA scores, adjusted for age, race/ethnicity, education, health insurance, and tested for interactions between age and sleep. Results: The prevalence of abnormal MoCA (score <26) was 38%; mean scores were lower in adults ≥55y vs. <55y (p<0.0001), and racial/ethnic minorities vs. whites (p<0.0001). Average nightly sleep duration was 6.75±1.29 h, and 50% of women had poor sleep quality. In multivariable models testing for interactions, lower MoCA scores were associated with shorter sleep duration (p=0.007), worse quality sleep (p=0.0005), and higher insomnia level (p=0.04). In stratified analyses, associations between MoCA scores and sleep duration, sleep quality, and insomnia persisted among both younger (<55y) and older (≥55y) groups. Lower MoCA scores were also associated with higher triglycerides (p=0.0001) and lower HDL-cholesterol (p=0.0006); formal tests of mediation suggested that the relation between cognition and insomnia was mediated by triglyceride level. Conclusions: Poor sleep patterns were highly prevalent and associated with lower cognitive function, even in younger women in this diverse population. Sleep patterns should be further investigated as a potential mechanism to identify individuals at risk of cognitive decline. Whether the relation is causal or mediated through traditional CVD risk factors deserves further study.

372 Sleep Hygiene Compliance and Sleep in Young Adult Drinkers with Insomnia: A Daily Analysis

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A148-A148
Author(s):  
Mary Beth Miller ◽  
Ashley Curtis ◽  
Nicole Hall ◽  
Adam Everson ◽  
Chan Jeong Park ◽  
...  
Keyword(s):  
Young Adult ◽  
Sleep Quality ◽  
Stimulus Control ◽  
Sleep Onset ◽  
Heavy Drinking ◽  
Empirical Support ◽  
Sleep Hygiene ◽  
Sleep Efficiency ◽  
Vigorous Exercise ◽  
Wrist Actigraphy

Abstract Introduction Empirical evidence linking sleep hygiene practices to subsequent sleep parameters – and the extent to which those compare to evidence-based practices such as stimulus control – is limited. This study examined the daily impact of recommendation compliance on sleep in a sample of young adult drinkers with insomnia. Methods Young adults (18-30y; N=56, 75% female) who met diagnostic criteria for insomnia and reported past-month binge drinking wore wrist actigraphy and completed online sleep diaries for 7+ days (492 reports). Diaries assessed compliance with nine sleep hygiene recommendations: to limit naps; limit caffeine; avoid caffeine after 12p; avoid tobacco, alcohol, vigorous exercise, and heavy meals within 2 hours of bedtime; avoid bright light within 30 minutes of bedtime; and utilize a bedtime routine. If participants reported wake after sleep onset, diaries also assessed if they had gotten out of bed and returned to bed only when sleepy (partial stimulus control instructions). Multilevel models examined three outcomes: sleep quality, self-reported sleep efficiency, and actigraphy-measured sleep efficiency (α=.05/3≤.017). Covariates included gender; college enrollment; weekday versus weekend; and between-person differences in insomnia severity, hazardous drinking, and average compliance, Results Participants self-reported better sleep efficiency on days that they avoided naps (B=3.64, p=.004; 95% CI=1.20, 6.08). They also self-reported better sleep quality (B=0.40, p&lt;.001; 95% CI=0.19, 0.60) and sleep efficiency (B=3.94, p&lt;.001; 95% CI=1.76; 6.12) on days that they followed stimulus control. Surprisingly, they reported worse sleep quality (B=-0.28, p=.017; 95% CI=-0.51, -0.05) and sleep efficiency (B=-3.74, p=.002; 95% CI=-6.08, -1.40) on days that they avoided alcohol use before bedtime. No variables were significantly associated with actigraphy-based sleep efficiency. At the between-person level, participants reporting more at-risk drinking reported worse sleep quality (B=-0.04, p=.017; 95% CI=-0.08, -0.01). Conclusion Data provide empirical support for recommendations that young adult drinkers with insomnia avoid naps and get out of bed during nighttime awakenings. Although heavier drinkers reported worse sleep quality than lighter drinkers, they also reported better subjective (but not objective) sleep on nights they drank close to bedtime. We speculate that this is due to later bedtimes on heavy-drinking nights. Support (if any) University of Missouri Research Board (PI Miller)

scholarly journals Assessing sleep quality in older adults: A comparison of three measurement approaches

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 882-882
Author(s):  
Amy Berkley ◽  
Patricia Carter
Keyword(s):  
Older Adults ◽  
Sleep Quality ◽  
Assessment Tool ◽  
Sleep Problems ◽  
Adult Population ◽  
Sleep Onset ◽  
Self Report ◽  
Sleep Onset Latency ◽  
Wrist Actigraphy ◽  
Sleep Assessment

Abstract Discrepancies between subjective and objective sleep measures have been reported for some time; however, it is critical to consider the implications of inaccurate or incomplete sleep assessment for frail older adults who are struggling to maintain independence. To compare sleep assessment methods, we collected objective sleep measurements (via wrist actigraphy), subjective measures via self-report sleep surveys (Pittsburgh Sleep Quality Index; Insomnia Severity Index, Sleep Hygiene Index), and qualitative data through semi-structured audio-recorded interviews, from 8 older adults who self-reported sleep problems while living in a retirement community in southwestern US. Participants’ objective sleep (Total Sleep Time, Sleep Onset Latency, Wake After Sleep Onset, and Sleep Efficiency) and qualitative narratives were congruent, but self-report measures failed to capture several unique sleep problems identified in the sample. Disordered sleep in older adults has been linked to increased incidence of falls, depression and anxiety, cognitive impairment, institutionalization, and mortality, but traditional sleep assessment instruments, designed for the general adult population, fail to capture many of the experiences and causes that are unique to older adults. functioning. A sleep assessment tool designed to measure older people’s sleep experiences could provide more accurate and sensitive data.

Measure of Atopic Dermatitis Disease Severity Using Actigraphy

2014 ◽  
Vol 18 (1) ◽  
pp. 49-55 ◽  
Author(s):  
Laura F. Sandoval ◽  
Karen Huang ◽  
Jenna L. O'Neill ◽  
Cheryl J. Gustafson ◽  
Emily Hix ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Sleep Quality ◽  
Disease Severity ◽  
Sleep Disturbances ◽  
Sleep Onset ◽  
Sleep Time ◽  
Random Effects Models ◽  
Short Course ◽  
Wrist Actigraphy ◽  
The Impact

Background: Analyzing adherence to treatment and outcomes in atopic dermatitis is limited by methods to assess continual disease severity. Atopic dermatitis significantly impacts sleep quality, and monitoring sleep through actigraphy may capture disease burden. Purpose: To assess if actigraphy monitors provide continuous measures of atopic dermatitis disease severity and to preliminarily evaluate the impact of a short-course, high-potency topical corticosteroid regimen on sleep quality. Methods: Ten patients with mild to moderate atopic dermatitis applied topical fluocinonide 0.1% cream twice daily for 5 days. Sleep data were captured over 14 days using wrist actigraphy monitors. Investigator Global Assessment (IGA) and secondary measures of disease severity were recorded. Changes in quantity of in-bed time sleep were estimated with random effects models. Results: The mean daily in-bed time, total sleep time, and wake after sleep onset (WASO) were 543.7 minutes (SEM 9.4), 466.0 minutes (SEM 7.7), and 75.0 minutes (SEM 3.4), respectively. WASO, a marker of disrupted sleep, correlated with baseline (ρ = .75) and end of treatment IGA (ρ = .70). Most patients did not have marked changes in sleep. IGA scores declined by a median change of 1 point at days 7 ( p = .02) and 14 ( p = .008). Conclusions: Using actigraphy, atopic dermatitis disease severity positively correlated with sleep disturbances. Actigraphy monitors were well tolerated by this cohort of atopic dermatitis subjects.

scholarly journals Actigraphic Measures of Sleep Quality Associated With Ambulatory Cognitive Performance in Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 578-578
Author(s):  
Orfeu Buxton ◽  
Ruixue Zhaoyang ◽  
June Jiao ◽  
Rachel Zimmerman ◽  
Martin Sliwinski ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Response Time ◽  
Cognitive Performance ◽  
Sleep Onset ◽  
Study Cohort ◽  
Learning Effects ◽  
Community Based ◽  
Shape Accuracy ◽  
Error Proportion ◽  
Aging Study

Abstract Few longitudinal studies link objectively assessed sleep and cognitive performance in ecologically-valid environments. Participants enrolled in the community-based Einstein Aging Study cohort (n=224, M[age]=77.17). Wake after sleep onset (WASO) was associated with worse cognitive performance with and without MCI (2-week smartphone-based EMA, six assessments/day). Models include age, gender, ethnicity, education, learning effects, sleep duration, WASO*MCI interaction (p=0.015 for Symbol Match; p=0.002 for Color Shape). Associations were stronger among those with MCI, thirty minutes more nightly WASO predicted a 500ms longer Symbol Match response time (p&lt;0.0001), 5.05% higher Color Dot error proportion (p=0.002), 0.184 points lower Color Shape accuracy (p&lt;0.0001). In those without MCI, WASO was associated with worse cognition: thirty minutes more nightly WASO predicted +166.7ms Symbol Match response time (p=0.03) and -0.06 points Color Shape accuracy (p=0.013). Actigraphic sleep quality associated with ambulatory cognitive performance (and worse with MCI status) suggests targets for prevention/mitigation of cognitive decline. Part of a symposium sponsored by the Sleep, Circadian Rhythms and Aging Interest Group.

B-24 Objective and Subjective Sleep Measures are Associated with Neurocognition in Middle-Aged and Older Adults With and Without HIV

2019 ◽  
Vol 34 (6) ◽  
pp. 970-970
Author(s):  
L Campbell ◽  
M Kohli ◽  
A Heaton ◽  
M Higgins ◽  
E Lee ◽  
...  
Keyword(s):  
Working Memory ◽  
Sleep Quality ◽  
Neuropsychological Testing ◽  
Sleep Onset ◽  
Sleep Fragmentation ◽  
Self Report ◽  
People Living With Hiv ◽  
Subjective Sleep Quality ◽  
Subjective Sleep ◽  
Wrist Actigraphy

Abstract Objective Poorer sleep quality is related to worse cognitive functioning in the general population and people living with HIV; however, many studies use self-report sleep questionnaires that rely on retrospective recall. This study aimed to examine the relationship between objective (wrist actigraphy) and subjective sleep quality with neurocognitive functioning. Method Eighty-five adults aged 50-74 years with and without HIV (HIV+ n = 53, HIV- n = 32) were recruited from the community and ongoing studies at UC San Diego. Participants completed comprehensive neuropsychological testing assessing global and domain-specific cognition. Participants wore actigraphy watches for 14 nights after neuropsychological testing to objectively assess sleep quality (i.e., total sleep time (TST), efficiency, wake after sleep onset, and sleep fragmentation). The Pittsburgh Sleep Quality Index assessed subjective sleep quality. Results After adjusting for demographic variables and use of sleep medications, there were no differences in any sleep quality measures by HIV status (p’s>0.05). In separate adjusted linear regression models, lower sleep efficiency (p = 0.02; 95% CI: -9.5, -1.1) and greater sleep fragmentation (p = 0.02; 95% CI: -0.82, -0.09) were associated with worse learning. Less TST was associated with worse working memory (p = 0.02; 95% CI: -9.2, -0.8). In contrast, worse subjective sleep quality was associated with worse executive function (p < 0.01; 95% CI: -1.18, -0.23) and working memory (p = 0.03; 95% CI: -1.22, -0.07). Conclusion Both objective and subjective sleep quality were associated with cognition in both persons with and without HIV; however, subjective and objective sleep quality were associated with different cognitive domains. Therefore, both objective and subjective sleep quality are important health behaviors to assess.

scholarly journals Loneliness, Sleep Quality, and Cognitive Function in Community-Dwelling Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 173-173
Author(s):  
Kexin Yu ◽  
Bernadette Fausto
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Sleep Quality ◽  
Social Life ◽  
Sleep Onset ◽  
Sleep Time ◽  
Community Dwelling ◽  
Sleep Fragmentation ◽  
Mediating Effect ◽  
Analysis Model

Abstract Loneliness is a risk factor for cognitive decline in older adults, however, the underlying mechanisms are less understood. Individuals who experience frequent loneliness tend to have poorer sleep quality. Empirical evidence supports the influence of sleep on cognitive health. This study examined the possible mediating effect of sleep characteristics on the relationship between loneliness and cognition. The study sample included 557 participants from wave 2 of the National Social Life, Health, and Aging Project who had actigraphy sleep measures (mean age = 73.17, 52.6% female). Loneliness was assessed with the 3-item UCLA Loneliness Scale. Cognitive function was measured with the Montreal Cognitive Assessment. Five sleep quality indicators were objectively recorded with wearable devices: assumed sleep time; actigraphy sleep time; time spent awake after sleep onset (WASO); sleep fragmentation; and sleep percentage (actigraphy sleep/(assumed sleep + WASO)). Path analysis model results show that WASO, fragmentation, and sleep percentage mediate the link between loneliness and cognitive function. Loneliness was positively related to WASO, and WASO was negatively associated with cognition. Loneliness correlated with increased sleep fragmentation which was associated with worse cognitive function. Individuals who had more frequent loneliness had a lower sleep percentage, and sleep percentage was positively associated with cognitive function. Nonetheless, the path from loneliness to these three sleep characteristics became insignificant after controlling for depressive symposiums. Depressive symptoms and fragmentation were found to double mediate the association between loneliness and cognitive function. Sleep and depression could be underlying pathways for the association between loneliness and cognition.

scholarly journals Palmitoylethanolamide for sleep disturbance. A double-blind, randomised, placebo-controlled interventional study

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Amanda Rao ◽  
Phillippa Ebelt ◽  
Alistair Mallard ◽  
David Briskey
Keyword(s):  
Sleep Quality ◽  
Sleep Disturbance ◽  
Acid Amide ◽  
Sleep Onset ◽  
Trial Registration ◽  
Sleep Onset Latency ◽  
Double Blind ◽  
Endogenous Fatty Acid ◽  
Wrist Actigraphy ◽  
Wide Range

Abstract Background Sleep is essential for wellbeing, yet sleep disturbance is a common problem linked to a wide range of health conditions. Palmitoylethanolamide (PEA) is an endogenous fatty acid amide proposed to promote better sleep via potential interaction with the endocannabinoid system. Methods This double-blind, randomised study on 103 adults compared the efficacy and tolerability of 8 weeks of daily supplemented PEA formulation (350 mg Levagen + ®) to a placebo. Sleep quality and quantity were measured using wrist actigraphy, a sleep diary and questionnaires. Results At week 8, PEA supplementation reduced sleep onset latency, time to feel completely awake and improved cognition on waking. After 8 weeks, both groups improved their sleep quality and quantity scores similarly. There was no difference between groups at baseline or week 8 for sleep quantity or quality as measured from actigraphy or sleep diaries. Conclusion These findings support PEA as a potential sleeping aid capable of reducing sleep onset time and improving cognition on waking. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12618001339246. Registered 9th August 2018.

scholarly journals Palmitoylethanolamide for Sleep Disturbance. A Double-blind, Randomised, Placebo-controlled Interventional Study

2021 ◽  
Author(s):  
Amanda Rao ◽  
Phillippa Ebelt ◽  
Alistair Mallard ◽  
David Briskey
Keyword(s):  
Sleep Quality ◽  
Sleep Disturbance ◽  
Acid Amide ◽  
Sleep Onset ◽  
Trial Registration ◽  
Sleep Onset Latency ◽  
Double Blind ◽  
Endogenous Fatty Acid ◽  
Wrist Actigraphy ◽  
Wide Range

Abstract Background: Sleep is essential for wellbeing, yet sleep disturbance is a common problem linked to a wide range of health conditions. Palmitoylethanolamide (PEA) is an endogenous fatty acid amide proposed to promote better sleep via potential interaction with the endocannabinoid system.Methods: This double-blind, randomized study on 103 adults compared the efficacy and tolerability of 8 weeks of daily supplemented PEA formulation (350 mg Levagen+TM) to a placebo. Sleep quality and quantity were measured using wrist actigraphy, a sleep diary and questionnaires. Results: At week 8, PEA supplementation reduced sleep onset latency, time to feel completely awake and improved cognition on waking. After 8 weeks, both groups improved their sleep quality and quantity scores similarly. There was no difference between groups at baseline or week 8 for sleep quantity or quality as measured from actigraphy or sleep diaries. Conclusion: These findings support PEA as a potential sleeping aid capable of reducing sleep onset time and improving cognition on waking. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12618001339246. Registered 9th August 2018, http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375493&isReview=true

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