225 Sleep Timing and Chronotype in Mothers: Longitudinal Changes and Associations with Wellbeing from Pregnancy to 2 Years Postpartum

Abstract Introduction Women experience significant changes to sleep during perinatal periods. Existing research focuses on sleep duration and quality, but not sleep timing or chronotype (i.e., preferred timing for activity and sleep). This study investigated change trajectories of sleep timing and chronotype from late pregnancy to two years postpartum, and examined longitudinal associations between chronotype and insomnia, sleep-related daytime impairment, and mood. Methods Data were from a 2-arm randomized controlled trial testing behavioral sleep and diet interventions. A community sample of nulliparous women without severe sleep/mental health conditions participated. Women self-reported bedtime, risetime, chronotype (reduced Morningness-Eveningness Questionnaire), Insomnia Severity Index, and PROMIS Depression, Anxiety, and Sleep-Related Impairment over 7 time points: 30 and 35 weeks’ gestation, and postpartum months 1.5, 3, 6, 12 and 24. Results 163 women (mean age 33.35 ± 3.42 years) took part. Mixed effects models controlling for age and group allocation showed that both bed- and risetimes became progressively earlier over time by approximately 20-30 minutes on average (p < .001); chronotype also shifted progressively towards morningness (p < .01). After controlling for covariates (sleep duration and efficiency, mental health history, social support, age, group allocation), greater morningness was significantly associated with lower symptoms of insomnia and sleep-related impairment over time (p-values < .001); longitudinal associations between chronotype and symptoms of depression and anxiety were non-significant (p-values > .65). Conclusion This is one of the first studies to examine longitudinal changes in sleep timing and chronotype from pregnancy to two years postpartum. Sleep timing and chronotype became progressively earlier over the first two postpartum years. The magnitude of changes is beyond what is expected with increasing age. Greater morningness was associated with lower sleep complaints and sleep-related daytime impairment during the postpartum period. The mechanisms underlying these associations require further research. Support (if any) Australasian Sleep Association, Monash University, Australian Government RTP Scholarship and National Health and Medical Research Council.

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P153 Sleep timing and chronotype in perinatal periods: Longitudinal changes and associations with wellbeing from pregnancy to 2 years postpartum

SLEEP Advances ◽

10.1093/sleepadvances/zpab014.193 ◽

2021 ◽

Vol 2 (Supplement_1) ◽

pp. A71-A71

Author(s):

S Verma ◽

D Pinnington ◽

R Manber ◽

B Bei

Keyword(s):

Mental Health ◽

Sleep Duration ◽

Controlled Trial ◽

Community Sample ◽

P Values ◽

Sleep Complaints ◽

Time Points ◽

Sleep Timing ◽

Group Allocation ◽

Over Time

Abstract Introduction Significant changes to sleep occur during perinatal periods. Existing research focuses on sleep duration and quality, but not sleep timing or chronotype. This study investigated change trajectories of sleep timing and chronotype from late pregnancy to two years postpartum, and examined associations between chronotype and insomnia, sleep-related impairment, and mood at seven different perinatal time-points. Methods Data were from a 2-arm randomised controlled trial testing behavioural sleep and diet interventions. A community sample of nulliparous females without severe sleep/mental health conditions participated. Participants self-reported bedtime, rise-time, chronotype (short Morningness-Eveningness Questionnaire), Insomnia Severity Index, and PROMIS Depression, Anxiety, and Sleep-Related Impairment over seven time points: gestation weeks 30 and 35, and postpartum months 1.5, 3, 6, 12 and 24. Results 163 participants (mean age 33.4±3.4 years) took part. Mixed effects models adjusting for age and group allocation showed that both bed- and rise-times became progressively earlier by approximately 20–30 minutes over time (p<.001); chronotype shifted progressively towards more morningness (p<.01). After adjusting for covariates (sleep duration and efficiency, mental health history, social support, age, group allocation), greater morningness was significantly associated with lower symptoms of insomnia and sleep-related impairment over time (p-values<.001); at each time-point, associations between chronotype and symptoms of depression and anxiety were non-significant (p-values>0.65). Conclusions Sleep timing and chronotype became progressively earlier over the first two postpartum years. Greater morningness was associated with less sleep complaints and sleep-related daytime impairment during the postpartum period. The mechanisms of these findings may be investigated through further research.

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Accelerometry-assessed sleep duration and timing in late childhood and adolescence in Scottish schoolchildren: a feasibility study

10.1101/2020.04.06.20055434 ◽

2020 ◽

Author(s):

Laura M. Lyall ◽

Natasha Sangha ◽

Cathy Wyse ◽

Elaine Hindle ◽

Dawn Haughton ◽

...

Keyword(s):

Mental Health ◽

Depressive Symptoms ◽

Sleep Duration ◽

Activity Patterns ◽

School Setting ◽

Childhood And Adolescence ◽

Developmental Phase ◽

Health And Wellbeing ◽

Sleep Timing ◽

Primary School Pupils

AbstractChildren and adolescents commonly suffer from sleep and circadian rhythm disturbances, which may contribute to poorer mental health and wellbeing during this critical developmental phase. Many studies however rely on self-reported sleep measures. This study assessed whether accelerometry data collection was feasible within the school setting as a method for investigating the extent of sleep and circadian disruption, and associations with subjective wellbeing, in Scotland. Fourteen days of wrist-worn accelerometry data were collected from 69 pupils, aged 10-14 years. Objective measures of sleep timing, sleep duration and circadian rest-activity patterns were derived. Questionnaires assessed subjective sleep timing, depressive symptoms, and experiences of wearing the accelerometer. Pupils slept on average less than 8 hours per night, failing to meet standard age-specific recommendations. Sleep timing was later and duration longer on weekends compared to weekdays (B = 0.87, 95% confidence interval (CI) 0.70, 1.04; B = 0.49, 95% CI 0.29, 0.69), indicating social jetlag. Lower daytime activity was correlated with higher depressive symptoms (r = -0.84, p = 0.008). Compared to primary school pupils, secondary pupils had shorter sleep window duration and lower circadian relative amplitude. Over half of participants reported some discomfort/inconvenience wearing the accelerometer. These data highlight that inadequate sleep is prevalent in this sample of schoolchildren. Future, larger scale investigations will examine in more detail the associations between sleep, circadian function and physical activity with mental health and wellbeing.

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Accelerometry-assessed sleep duration and timing in late childhood and adolescence in Scottish schoolchildren: A feasibility study

PLoS ONE ◽

10.1371/journal.pone.0242080 ◽

2020 ◽

Vol 15 (12) ◽

pp. e0242080

Author(s):

Laura M. Lyall ◽

Natasha Sangha ◽

Cathy Wyse ◽

Elaine Hindle ◽

Dawn Haughton ◽

...

Keyword(s):

Mental Health ◽

Depressive Symptoms ◽

Sleep Duration ◽

Activity Patterns ◽

School Setting ◽

Childhood And Adolescence ◽

Developmental Phase ◽

Health And Wellbeing ◽

Sleep Timing ◽

Primary School Pupils

Children and adolescents commonly suffer from sleep and circadian rhythm disturbances, which may contribute to poorer mental health and wellbeing during this critical developmental phase. Many studies however rely on self-reported sleep measures. This study assessed whether accelerometry data collection was feasible within the school setting as a method for investigating the extent of sleep and circadian disruption, and associations with subjective wellbeing, in Scotland. Fourteen days of wrist-worn accelerometry data were collected from 69 pupils, aged 10–14 years. Objective measures of sleep timing, sleep duration and circadian rest-activity patterns were derived. Questionnaires assessed subjective sleep timing, depressive symptoms, and experiences of wearing the accelerometer. Pupils slept on average less than 8 hours per night, failing to meet standard age-specific recommendations. Sleep timing was later and duration longer on weekends compared to weekdays (B = 0.87, 95% confidence interval (CI) 0.70, 1.04; B = 0.49, 95% CI 0.29, 0.69), indicating social jetlag. Lower daytime activity was correlated with higher depressive symptoms (r = -0.84, p = 0.008). Compared to primary school pupils, secondary pupils had shorter sleep window duration and lower circadian relative amplitude. Over half of participants reported some discomfort/inconvenience wearing the accelerometer. These data highlight that inadequate sleep is prevalent in this sample of schoolchildren. Future, larger scale investigations will examine in more detail the associations between sleep, circadian function and physical activity with mental health and wellbeing.

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Habitual Sleep, Sleep Duration Differential, and Weight Change Among Adults

Innovation in Aging ◽

10.1093/geroni/igab046.129 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 35-35

Author(s):

Yin Liu ◽

Mari Palta ◽

Jodi Barnet ◽

Max Roberts ◽

Erika Hagen ◽

...

Keyword(s):

Body Mass Index ◽

Cohort Study ◽

Data Collection ◽

Sleep Duration ◽

Men And Women ◽

Longitudinal Associations ◽

The Difference ◽

Nighttime Sleep ◽

Inadequate Sleep ◽

Over Time

Abstract We assessed longitudinal associations between diary-measured sleep duration and clinically assessed body mass index (BMI) among 784 men and women enrolled in the Wisconsin Sleep Cohort Study (mean [SD] age = 51.1 [8.0] years at baseline). The outcome was BMI (kg/m2). Key predictors were habitual sleep duration (defined as average weekday nighttime sleep duration) and sleep duration differential (defined as the difference between average weekday and average weekend nighttime sleep duration) at each data collection wave. Men with shorter habitual sleep duration on weekdays had higher BMI than men with longer habitual sleep duration on weekdays. Participants with larger differentials between weekday and weekend sleep duration experienced more rapid BMI gain over time for both men and women. Inadequate sleep, characterized as shorter habitual sleep during weekdays and larger weekday-weekend sleep differential, is positively associated with BMI levels and trajectories among men and women in mid-to-late life.

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Interpretation Bias and Anxiety in Childhood: Stability, Specificity and Longitudinal Associations

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465810000494 ◽

2010 ◽

Vol 39 (2) ◽

pp. 191-204 ◽

Cited By ~ 23

Author(s):

Cathy Creswell ◽

Thomas G. O'Connor

Keyword(s):

Cognitive Processes ◽

Community Sample ◽

Anxiety Symptoms ◽

Longitudinal Associations ◽

One Year ◽

The Stability ◽

Anxiety Depression ◽

The Relationship ◽

Over Time ◽

Prospective Investigation

Background: Biases in the interpretation of ambiguous material are central to cognitive models of anxiety; however, understanding of the association between interpretation and anxiety in childhood is limited. To address this, a prospective investigation of the stability and specificity of anxious cognitions and anxiety and the relationship between these factors was conducted. Method: Sixty-five children (10–11 years) from a community sample completed measures of self-reported anxiety, depression, and conduct problems, and responded to ambiguous stories at three time points over one-year. Results: Individual differences in biases in interpretation of ambiguity (specifically “anticipated distress” and “threat interpretation”) were stable over time. Furthermore, anticipated distress and threat interpretation were specifically associated with anxiety symptoms. Distress anticipation predicted change in anxiety symptoms over time. In contrast, anxiety scores predicted change in threat interpretation over time. Conclusions: The results suggest that different cognitive constructs may show different longitudinal links with anxiety. These preliminary findings extend research and theory on anxious cognitions and their link with anxiety in children, and suggest that these cognitive processes may be valuable targets for assessment and intervention.

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0829 Sleep, Chronic Pain, and Global Health in Adults Ages 65 or Older

SLEEP ◽

10.1093/sleep/zsaa056.825 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A316-A316

Author(s):

L Tran ◽

B Jeon ◽

E Chasens

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Chronic Pain ◽

Global Health ◽

Pain Intensity ◽

Sleep Duration ◽

General Health ◽

P Values ◽

Significant Difference

Abstract Introduction Understanding the association of sleep and pain in older adults can help improve their global health. The purpose of the study was to describe the associations between sleep, chronic pain, and global health in adults ages 65 or older. Methods This study was a secondary analysis of data from adults over 65 years in the 2015 Sleep in America Poll - Sleep and Pain by the National Sleep Foundation (NSF). The survey included demographics (age, race, marital status, education), sleep (duration, quality, insomnia symptoms), and pain (type [none, chronic, fleeting], intensity, location). Global health derived from general health, physical health, mental health, and quality of life with a potential range of 4-20; higher score=better health. The survey also queried fatigue and stress. Results The sample (N=248) was 65-91 years (mean age=72.8±5.9), male (53.6%), White (82.7%), married (65.7%), and with post-highschool education (54.4%). Average sleep duration was 425±74 minutes. “No pain” was reported by 38.7% of the sample (n=96), “fleeting pain” by 32.7% (n= 81), and “chronic pain” by 28.6% (n=71). The most common locations for chronic pain were shoulder or neck (63.2%) and back (69.4%). Average global health score was 9.8±2.9. There was no significant difference in time in bed, sleep duration, bedtime, or wake-up time between groups. Persons with chronic pain had higher average pain intensity, worst pain intensity, and current pain; they reported significantly lower sleep quality with significantly more restlessness, trouble staying asleep, and worry about getting a good night sleep (all p-values<.02), there was no significant difference in difficulty falling asleep compared to persons with no pain. Persons with chronic pain had significantly worse general health, physical health, mental health, global health, fatigue, and stress (all p-values<.02); but no significant difference in quality of life compared to persons with no pain. Conclusion We conclude that chronic pain has a significant negative impact on sleep and global health in the sample of adults ages 65 or older from the 2015 Sleep in America Poll - Sleep and Pain by the NSF. Support Undergraduate Research Mentoring Program, University of Pittsburgh School of Nursing.

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Longitudinal associations of sleep problems with alcohol and cannabis use from adolescence to emerging adulthood

SLEEP ◽

10.1093/sleep/zsab102 ◽

2021 ◽

Author(s):

Wendy M Troxel ◽

Anthony Rodriguez ◽

Rachana Seelam ◽

Joan S Tucker ◽

Regina A Shih ◽

...

Keyword(s):

Mental Health ◽

Alcohol Use ◽

Emerging Adulthood ◽

Sleep Problems ◽

Cannabis Use ◽

Sleep Health ◽

Time In Bed ◽

Social Jetlag ◽

Longitudinal Associations ◽

Over Time

Abstract Study Objectives This study examined longitudinal associations of sleep problems with alcohol and cannabis use across six annual waves of data from adolescence to emerging adulthood. Methods Participants were 3,265 youth from California (ages 16 to 22 across waves). At each wave, past-month alcohol use and cannabis use, mental health, and several dimensions of sleep health (i.e., social jetlag, bedtimes, time in bed, trouble sleeping) were assessed via questionnaire. Parallel process latent growth models examined the association between sleep and alcohol or cannabis use trajectories and the role of mental health in contributing to such trajectories. Results Smaller declines in social jetlag (r = .11, p = .04), increases in trouble sleeping (r = .18, p < .01), and later weekday (r = .16, p < .01) and weekend bedtimes (r = .25, p < .01) were associated with increases in likelihood of alcohol use over time. Declines in weekend TIB (r = -.13, p = .03), as well as increases in weekday TIB (r = 0.11, p = 0.04) and later weekday (r = .18, p < .01) and weekend bedtime (r = .24, p < .01), were associated with increases in likelihood of cannabis use over time. Most associations remained significant after controlling for time-varying mental health symptoms. Conclusions Trajectories of sleep health were associated with trajectories of alcohol and cannabis use during late adolescence to emerging adulthood. Improving sleep is an important target for intervention efforts to reduce the risk of substance use during this critical developmental transition.

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Disentangling Within- and Between-Person Effects of Shared Risk Factors on E-cigarette and Cigarette Use Trajectories From Late Adolescence to Young Adulthood

Nicotine & Tobacco Research ◽

10.1093/ntr/nty179 ◽

2018 ◽

Vol 21 (10) ◽

pp. 1414-1422 ◽

Cited By ~ 12

Author(s):

Michael S Dunbar ◽

Jordan P Davis ◽

Anthony Rodriguez ◽

Joan S Tucker ◽

Rachana Seelam ◽

...

Keyword(s):

Mental Health ◽

Risk Factors ◽

Young People ◽

Marijuana Use ◽

Cigarette Use ◽

Health Symptoms ◽

Growing Body ◽

Longitudinal Associations ◽

Shared Risk ◽

Over Time

Abstract Background Longitudinal studies report associations between use of electronic cigarettes (ECs) and cigarettes over time among young people, but do not distinguish within- from between-person effects, which complicates interpretation of findings. Further, the role of shared risk factors, such as substance use and mental health, in explaining longitudinal associations between EC and cigarette use remains unclear. This study used within- and between-person analyses to assess longitudinal associations between youths’ EC and cigarette use and shared risk factors. Methods Between 2015 and 2017, 2039 youths completed three Web-based surveys, allowing us to model EC and cigarette use from ages 16 to 20. Auto-regressive latent growth models with structured residuals (ALT-SR) examined both between-person and within-person associations between past-month frequency of EC use, cigarette use, and third variables (alcohol and marijuana use, mental health symptoms) over time. Results Models revealed robust reciprocal associations between EC and cigarette use, such that more frequent EC use at one time predicted more frequent cigarette use at the subsequent time, and vice versa. Between-person analyses showed associations between shared risk factors and both EC and cigarette use. However, shared risk factors did not predict frequency of subsequent EC and cigarette use in within-person analyses. Conclusions Findings add to a growing body of research suggesting that EC use among youth is prospectively associated with progression toward greater cigarette use. Shared risk factors may help explain differences in EC and cigarette use patterns between young people, but do not appear to influence longitudinal trajectories of EC and cigarette use within individuals. Implications This study examined within- and between-person associations between e-cigarette use, cigarette use, and shared risk factors (alcohol use, marijuana use, mental health symptoms) in a longitudinal cohort of youths. Within- and between-person analyses revealed reciprocal prospective associations between e-cigarette and cigarette use, suggesting a progression toward more frequent use of both products over time. The shared risk factors examined here did not affect escalations in e-cigarette or cigarette use over time within individuals, but likely influence which youths use these products. Findings add to a growing body of evidence suggesting that e-cigarette use increases subsequent cigarette use in young people.

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Prior sleep-wake behavior predicts mental health resilience among adults in the United States during the COVID-19 pandemic

10.1101/2021.06.15.21258983 ◽

2021 ◽

Author(s):

Mark É Czeisler ◽

Emily R Capodilupo ◽

Matthew D Weaver ◽

Charles A Czeisler ◽

Mark E Howard ◽

...

Keyword(s):

Mental Health ◽

United States ◽

Substance Use ◽

Sleep Duration ◽

Large Scale ◽

Sleep Onset ◽

The United States ◽

Lifestyle Changes ◽

Depression Symptoms ◽

Sleep Timing

Rigorous nonpharmaceutical interventions (e.g., stay-at-home orders, remote-work directives) were implemented in early 2020 for coronavirus disease 2019 (COVID-19) pandemic containment in the U.S. During this time, increased sleep duration and delayed sleep timing were reported through surveys (Leone et al., 2021) and wearable data (Rezaei and Grandner, 2021), as were elevated adverse mental health symptom (Czeisler et al., 2020). Inter-relationships between sleep and mental health have not been examined using longitudinal objective sleep-wake data, during these abruptly imposed lifestyle changes. We examined objective sleep-wake data and surveyed mental health data collected among 4,912 U.S. adult users of a validated sleep wearable (WHOOP, Boston, Massachusetts) before and during the COVID-19 pandemic. Comparing the pre-pandemic (January 1 to March 12, 2020) and acute pandemic-onset intervals (March 13 to April 12, 2020), participants exhibited increased mean sleep duration (0.25h [95% CI = 0.237-0.270]), later sleep onset (18m [17.378-20.045]) and offset (36m [35.111-38.106]), and increased consistency of sleep timing (3.51 [3.295-3.728] out of 100); all P < 0.0001. Generally, participants with persistent sleep deficiency and low sleep consistency had higher odds of symptoms of anxiety or depression, burnout, and new or increased substance use during the pandemic. Decreases in sleep duration (adjusted odds ratio [aOR] = 1.30, 95% CI = 1.03-1.65, P = 0.025) and sleep consistency (2.05 [1.17-3.67], P = 0.009) were associated with increased anxiety and depression symptoms during the pandemic. We suggest that sleep duration and consistency may be important predictors of risk of adverse mental health outcomes during a pandemic. M.J. Leone, M. Sigman, D.A. Golombek. Effects of lockdown on human sleep and chronotype during the COVID-19 pandemic. Curr Biol 30(16), R930-R931 (2020). N. Rezaei N, M.A. Grandner. Changes in sleep duration, timing, and variability during the COVID-19 pandemic: Large-scale Fitbit data from 6 major US cities. Sleep Health 10.1016/j.sleh.2021.02.008. (2021). M.É. Czeisler, R.I. Lane, E. Petrosky, et al., Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic - United States, June 24-30, 2020. MMWR Morb Mortal Wkly Rep 69(32), 1049-1057 (2020).

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661 Chronotype, Mood, and Diabetes-Related Distress in Adults with Type 2 Diabetes

SLEEP ◽

10.1093/sleep/zsab072.659 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A258-A259

Author(s):

Bomin Jeon ◽

Eileen Chasens

Keyword(s):

Type 2 Diabetes ◽

Sleep Duration ◽

Daytime Sleepiness ◽

Apnea Hypopnea Index ◽

P Values ◽

Sleep Timing ◽

Obstructive Sleep ◽

Significant Difference ◽

Normal Sleep

Abstract Introduction Chronotype refers to an individual’s preferred timing of sleep and wakefulness, which can be classified as ‘normal’ or ‘late’ chronotypes. The purpose of this study was to examine whether late sleep timing was associated with impaired mood and diabetes-related distress in persons with type 2 diabetes (T2D). Methods The study is a secondary analysis of pooled cross-sectional baseline data from two studies of treatment of obstructive sleep apnea (R01-DK96028) and insomnia (K24-NR016685) in persons with T2D. Sleep timing was measured by the bedtime from a 7-day sleep diary. “Normal” sleep timing was defined as bedtime between 9PM to 12AM ≥ 85% per week. “Late” sleep timing as bedtime after 12AM with normal sleep timing < 85% per week. Other sleep variables evaluated were sleep duration, daytime sleepiness (Epworth Sleepiness Scale [ESS]), and OSA severity (apnea-hypopnea index [AHI]). The Profiles of Mood States measured Total Mood Disturbance (TMD) and the subscales of Tension-Anxiety (T-A), Depression-Dejection (D-D), Anger-Hostility (A-H), Vigor-Activity (V-A), Fatigue-Inertia (F-I), and Confusion-Bewilderment (C-B). Diabetes-related distress was measured by the Problem Areas in Diabetes (PAID). Hierarchical multiple regression was performed to determine whether sleep timing was associated with mood and diabetes-related distress. Results The sample (N=296) had 61% with late sleep timing (n=181). Persons with normal vs late sleep timing were similar in age, sex, race, and education (p >.05). Persons with late sleep timing were less likely to be partnered, had shorter sleep duration and greater mood impairment (TMD and T-A, D-D, A-H, C-B subscales) than those with normal timing (all p values <.05); there was no significant difference by sleep timing in PAID scores (p=.256). Hierarchical regression analyses adjusting for demographics (age, sex, race, marital status, education level), clinical (HbA1c, BMI), and sleep variables (sleep duration, ESS, AHI) revealed that late sleep timing was not significantly associated with impaired mood (TMD and subscales) or PAID. However, ESS was statistically significant in predicting greater TMD (β=.310, p <.001), mood subscales (all p-values <.05) and PAID (β =.222, p <.001). Conclusion Daytime sleepiness, not late sleep timing, is a significant sleep-related symptom for increased mood impairment and diabetes-related distress in persons with T2D. Support (if any):

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