237 Sleep disturbances, online instruction, and learning during COVID-19: evidence from 4148 adolescents in the NESTED study

Abstract Introduction COVID-19 fundamentally altered education in the United States. A variety of in-person, hybrid, and online instruction formats took hold in Fall 2020 as schools reopened. The Nationwide Education and School in TEens During COVID (NESTED) study assessed how these changes impacted sleep. Here we examined how instruction format was associated with sleep disruption and learning outcomes. Methods Data from 4148 grade 6-12 students were included in the current analyses (61% non-male; 34% non-white; 13% middle-school). Each student’s instructional format was categorized as: (i) in-person; (ii) hybrid [≥1 day/week in-person]; (iii) online/synchronous (scheduled classes); (iv) online/asynchronous (unscheduled classes); (v) online-mixed; or (vi) no-school. Sleep disturbances (i.e., difficulty falling/staying asleep) were measured with validated PROMIS t-scores. A bootstrapped structural equation model examined how instructional format and sleep disturbances predict school/learning success (SLS), a latent variable loading onto 3 outcomes: (i) school engagement (ii) likert-rated school stress; and (iii) cognitive function (PROMIS t-scores). The model covaried for gender, race-ethnicity, and school-level Results Our model fit well (RMSEA=.041). Examining total effects (direct + indirect), online and hybrid instruction were associated with lower SLS (b’s:-.06 to -.26; p’s<.01). The three online groups had the strongest effects (synchronous: b=-.15; 95%CI: [-.20, -.11]; asynchronous: b=-.17; [-.23, -.11]; mixed: b=-.14; [-.19, -.098]; p’s<.001). Sleep disturbance was also negatively associated with SLS (b=-.02; [-.02, -.02], p<.001). Monte-carlo simulations confirmed sleep disturbance mediated online instruction’s influence on SLS. The strongest effect was found for asynchronous instruction, with sleep disturbance mediating 24% of its effect (b = -.042; [-0.065, -.019]; p<.001). This sleep-mediated influence of asynchronous instruction propagated down to each SLS measure (p’s<.001), including a near 3-point difference on PROMIS cognitive scores (b = -2.86; [-3.73, -2.00]). Conclusion These analyses from the NESTED study indicate that sleep disruption may be one mechanism through which online instruction impacted learning during the pandemic. Sleep disturbances were unexpectedly influential for unscheduled instruction (i.e., asynchronous). Future analyses will examine specific sleep parameters (e.g., timing) and whether sleep’s influence differs in teens who self-report learning/behavior problems (e.g., ADHD). These nationwide data further underscore the importance of considering sleep as educators and policy makers determine school schedules. Support (if any):

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A-130 An Exploratory Analysis of the Impact PTSD Related Sleep Disturbance has on Language Generativity in Veterans with mTBI

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acaa068.130 ◽

2020 ◽

Vol 35 (6) ◽

pp. 923-923

Author(s):

Walker N ◽

Scott T ◽

Spellman J ◽

Rivera J ◽

Waltzman D ◽

...

Keyword(s):

Sleep Quality ◽

Sleep Disturbance ◽

Verbal Fluency ◽

Sleep Disturbances ◽

Self Report ◽

Analysis Of Covariance ◽

Ptsd Symptoms ◽

History Of ◽

The Impact ◽

The Relationship

Abstract Objective Reviewed literature suggests that individuals with Posttraumatic Stress Disorder (PTSD) demonstrate cognitive deficits in attention, learning/memory, and executive functions. Less is known regarding the relationship between sleep disturbance and language abilities among individuals with PTSD. We hypothesized that subjective perceptions of PTSD-related sleep disturbance would impact language generativity in Veterans with PTSD. Methods 38 individuals (mean age = 46.58, SD = 13.55; 10% female) were administered a brief neurocognitive battery including measures of verbal generativity [i.e., Delis-Kaplan Executive Function System: Verbal fluency subtest], PTSD symptoms (i.e., clinically significant PTSD = > 35 on the PTSD Checklist for DSM-IV), self-report measures of sleep quality (Pittsburgh Sleep Quality Inventory; PSQI), and PTSD-related sleep disturbances (PSQI – Addendum for PTSD). All participants had a history of mild traumatic brain injury (mTBI). An analysis of covariance was used to assess the contribution of PTSD-related sleep disturbance on verbal fluency in Veterans with PTSD. Post-hoc analyses were conducted. Results Those without PTSD performed better on letter fluency than those with PTSD (p=.019). There was no significant effect of PTSD (presence or absence) on letter fluency performance after controlling for subjective sleep quality, F(1, 35) = 1.43, p = .239. Follow up analyses failed to show any associations between PTSD and other cognitive measures. Conclusions PTSD related sleep disturbance accounts for a significant portion of the variance in the relationship between PTSD and verbal generativity. Individuals with a history of mTBI and current PTSD symptoms, may have worse verbal generativity but is partially accounted for by PTSD related sleep disturbance.

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Calibration of the Online Youth Activity Profile Assessment for School-Based Applications

Journal for the Measurement of Physical Behaviour ◽

10.1123/jmpb.2020-0048 ◽

2021 ◽

pp. 1-11

Author(s):

Gregory J. Welk ◽

Pedro F. Saint-Maurice ◽

Philip M. Dixon ◽

Paul R. Hibbing ◽

Yang Bai ◽

...

Keyword(s):

The United States ◽

Self Report ◽

School Level ◽

Online Version ◽

Accelerometer Data ◽

Sedentary Behaviors ◽

Activity Profile ◽

School Based ◽

Calibration Methods ◽

Youth Activity

A balance between the feasibility and validity of measures is an important consideration for physical activity (PA) research—particularly in school-based research with youth. The present study extends previously tested calibration methods to develop and test new equations for an online version of the youth activity profile (YAP) tool, a self-report tool designed for school applications. Data were collected across different regions and seasons to develop more robust, generalizable equations. The study involved a total of 717 youth from 33 schools (374 elementary [ages 9–11 years], 224 middle [ages 11–14 years], and 119 high school [ages 14–18 years]) in two different states in the United States. Participants wore a Sensewear monitor for a full week and then completed the online YAP at school to report PA and sedentary behaviors in school and at home. Accelerometer data were processed using an R-based segmentation program to compute PA and sedentary behavior levels. Quantile regression models were used with half of the sample to develop item-specific YAP calibration equations, and these were cross validated with the remaining half of the sample. Computed values of mean absolute percentage error ranged from 15 to 25% with slightly lower error observed for the middle school sample. The new equations had improved precision compared with the previous versions when tested on the same sample. The online version of the YAP provides an efficient and effective way to capture school level estimates of PA and sedentary behaviors in youth.

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Relationship between Internet addiction and sleep disturbance in high school students: a cross-sectional study

10.21203/rs.2.18949/v4 ◽

2020 ◽

Author(s):

Mikiko Tokiya ◽

Osamu Itani ◽

Yuichiro Otsuka ◽

Yoshitaka Kaneita

Keyword(s):

High School ◽

High School Students ◽

Sleep Disturbance ◽

Internet Addiction ◽

Sleep Disturbances ◽

Multiple Logistic Regression Analysis ◽

Self Report ◽

School Students ◽

Japanese Adolescents ◽

The Relationship

Abstract Background: The increase in the number of Internet users has increased Internet dependence worldwide. In adolescents, this dependence interferes with sleep, which is important for the development of psychophysiological capabilities. However, few large-scale surveys have descriptively examined the relationship between Internet addiction (IA) and sleep disturbance using standardized questionnaires. We conducted this study to determine the relationship between sleep disturbance in adolescents and IA based on the categories of the Young Diagnostic Questionnaire (YDQ) through a complete survey of one prefecture in Japan.Methods: In 2016, a self-report questionnaire was used to survey high school students (n=10,405, age range: 15–16 years) in all 54 day-boarding high schools in the selected prefecture. We defined “sleep disturbance” by scores greater than 5.5 points on the Japanese version of the Pittsburgh Sleep Quality Index. IA was evaluated using the YDQ: “IA,” when five of the eight YDQ items were present; “at-risk,” when three or four YDQ items were reported; and “non-IA,” when two or less YDQ items were positive. Multiple logistic regression analysis was undertaken with sleep disturbance as the dependent variable, IA as the explanatory variable, and adjustments for eight items.Results: High YDQ scores were associated with high prevalence rates of sleep disturbance in boys and girls. These findings persisted after controlling for other factors in the multiple regression model.Conclusions: Among Japanese adolescents, there was a significant independent relationship between IA and sleep disturbances.

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Sleep—an Essential Component of Obesity Screening and Counseling: A Policy Analysis of the Affordable Care Act

INQUIRY The Journal of Health Care Organization Provision and Financing ◽

10.1177/0046958019842001 ◽

2019 ◽

Vol 56 ◽

pp. 004695801984200

Author(s):

Heather Owens

Keyword(s):

Health Care ◽

Policy Analysis ◽

Sleep Disturbance ◽

Affordable Care Act ◽

Health Care Professionals ◽

Access To Health Care ◽

Sleep Disturbances ◽

The United States ◽

Evidence Based ◽

Evidence Based Care

The Patient Protection and Affordable Care Act (PPACA) has provided access to health care for millions of people in the United States. One of the most beneficial aspects of the PPACA is the obesity screening and counseling provision. Currently, it is estimated that over 39% of US adults are obese. Research has linked sleep disturbances to obesity and obesity-related behaviors. The purpose of this article is to advocate for evidence-based care through the inclusion of sleep disturbance screening and management under the PPACA obesity screening and counseling provision. An in-depth policy analysis of the PPACA was conducted to examine the feasibility of adding sleep screenings to the obesity screening and counseling provision available under current law. Findings suggest that the adoption of this policy would require stakeholder advocacy and educational reform. Implementation of the policy would require additional economic investments, but the long-term savings could be significant. A campaign to raise awareness regarding the association between sleep disturbance and obesity among the public and health care professionals would be essential. Policy implementation would require interprofessional collaboration when performing sleep disordered screening and management. Preventative health care for individuals who have not previously accessed the health care system has the potential to socially and economically benefit society if policies provide for evidence-based care. Sleep screening and counseling is essential under the PPACA to adequately address the US obesity crisis.

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“Assessing the Psychometric Properties of the PROMIS Sleep Measures in Persons with Psychosis.”

SLEEP ◽

10.1093/sleep/zsab140 ◽

2021 ◽

Author(s):

Christina L G Savage ◽

Ryan D Orth ◽

Anyela M Jacome ◽

Melanie E Bennett ◽

Jack J Blanchard

Keyword(s):

Sleep Disturbance ◽

Psychometric Properties ◽

Internal Consistency ◽

Convergent Validity ◽

Sleep Disturbances ◽

Psychotic Disorders ◽

Temporal Stability ◽

Self Report ◽

Healthy Controls ◽

Sleep Parameters

Abstract An accumulation of research has indicated that persons with psychotic disorders experience a variety of sleep disturbances. However, few studies have examined the psychometric properties of sleep assessments that are utilized in this population. We conducted two studies to examine the reliability and validity of the PROMISTM Sleep Disturbance and Sleep-Related Impairment scales in outpatient samples of persons with psychosis. In Study 1, we examined the internal consistency and convergent validity of the PROMIS sleep scales in individuals with various psychotic disorders (N = 98) and healthy controls (N = 22). The PROMIS sleep scales showed acceptable internal consistency and convergent validity in both healthy controls and individuals with psychotic disorders. In addition, replicating prior research, the PROMIS scales identified greater sleep disturbance and sleep-related impairment in participants with psychotic disorders compared to healthy controls. In Study 2, we examined the test-retest reliability (M = 358 days) of the PROMIS sleep scales in a subset (N = 37) of persons with psychotic disorders who previously participated in Study 1. We also assessed the relation between these self-report measures and actigraph sleep parameters. The results showed that PROMIS sleep measures demonstrated modest temporal stability in the current sample. Contrary to our hypothesis, there was a lack of correspondence between these scales and actigraph sleep parameters. Overall, these findings indicate that the PROMIS sleep scales are psychometrically sound measures for populations with psychosis and highlight the importance of utilizing a multi-method approach to assess sleep.

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Relationship between Internet addiction and sleep disturbance in high school students: a cross-sectional study

10.21203/rs.2.18949/v2 ◽

2020 ◽

Author(s):

Mikiko Tokiya ◽

Osamu Itani ◽

Yuichiro Otsuka ◽

Yoshitaka Kaneita

Keyword(s):

High School ◽

High School Students ◽

Sleep Disturbance ◽

Internet Addiction ◽

Sleep Disturbances ◽

Multiple Logistic Regression Analysis ◽

Self Report ◽

School Students ◽

Japanese Adolescents ◽

The Relationship

Abstract Background: Worldwide, the increase in the number of Internet users has increased Internet dependence. In adolescents, this dependence interferes with sleep, which is important for the development of psychophysiological capabilities. However, few large-scale surveys have descriptively examined the relationship between Internet addiction (IA) and sleep disturbance using standardized questionnaires. We conducted this study to determine the relationship between sleep disturbance in adolescents and IA based on the categories of the Young Diagnostic Questionnaire (YDQ) through a complete survey of one prefecture in Japan. Methods: In 2016, a self-report questionnaire was used to survey high school students (n=10,405, age range: 15–16 years) in all 54 day-boarding high schools in the selected prefecture. We defined “sleep disturbance” by scores greater than 5.5 points on the Japanese version of the Pittsburgh Sleep Quality Index. IA was evaluated using the YDQ: “IA,” when 5 of the 8 YDQ items were present; “at-risk,” when either 3 or 4 YDQ items were reported; and “non-IA,” when less than 2 YDQ items were positive. Multiple logistic regression analysis was undertaken with sleep disturbance as the dependent variable, IA as the explanatory variable, and adjustments for 8 items. Results: High YDQ scores were associated with high prevalence rates of sleep disturbance in both male and female participants. These findings persisted after controlling for other factors in the multiple regression model. Conclusions: Among Japanese adolescents, there exists a significant independent relationship between IA and sleep disturbances.

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Treatment of Sleep Disturbance in Patients with Traumatic Brain Injury

European Psychiatry ◽

10.1016/s0924-9338(09)71455-5 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1

Author(s):

A. Alao ◽

C. Chung

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Sleep Disturbance ◽

Sleep Disturbances ◽

Behavioral Therapy ◽

The United States ◽

Early Morning ◽

Duration Of Treatment ◽

Veterans Hospitals ◽

Restorative Sleep

Aims:Traumatic brain injury (TBI) affects nearly 1.5 million individuals in the United States each year. During peacetime, over 7,000 Americans with a diagnosis of TBI are admitted to military and veterans hospitals every year; this number increases significantly during combat, during which TBI may comprise up to 20% of survivor casualties. Pain and discomfort relating to injuries are frequent causes of sleep disturbance in TBI patients. Sleep disturbances can manifest as difficulty falling or staying asleep, early morning wakening and non-restorative sleep, and affects up to 30% of individuals with TBI. Because there are few studies on pharmacotherapy for sleep disturbances in TBI, many physicians base their intervention on experience with the general population. in this poster, we will consider the unique features of the patient with TBI and make recommendations for psychoactive medications that are appropriate to treat insomnia in this population.Methodology:A literature review was performed and recommendations for treatment of sleep disturbances in patients with TBI are summarized here based on published findings.Conclusion:Non-pharmacological means should be the first-line treatment for sleep disturbances in patients with TBI. These include sleep hygiene and cognitive behavioral therapy. Physicians and other clinicians should pay attention to the specific sleep complaint, adverse effect profile of the medication as well as the anticipated duration of treatment before deciding upon a sleep agent for patients with TBI.

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Relationship between Internet addiction and sleep disturbance in high school students: a cross-sectional study

10.21203/rs.2.18949/v3 ◽

2020 ◽

Author(s):

Mikiko Tokiya ◽

Osamu Itani ◽

Yuichiro Otsuka ◽

Yoshitaka Kaneita

Keyword(s):

High School ◽

High School Students ◽

Sleep Disturbance ◽

Internet Addiction ◽

Sleep Disturbances ◽

Multiple Logistic Regression Analysis ◽

Self Report ◽

School Students ◽

Japanese Adolescents ◽

The Relationship

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727 Impact of Washington State COVID-19 Lockdown on Sleep

SLEEP ◽

10.1093/sleep/zsab072.724 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A283-A284

Author(s):

Mary Peterson ◽

Kirsie Lundholm ◽

Lillian Skeiky ◽

Hans Van Dongen ◽

Devon Hansen

Keyword(s):

Sleep Disturbances ◽

Sleep Onset ◽

Washington State ◽

Self Report ◽

Sleep Disruption ◽

Before And After ◽

Report Data ◽

Delayed Sleep ◽

Self Report Data ◽

At Home

Abstract Introduction The COVID-19 pandemic caused a global disruption to daily routines. Studies using surveys and sleep-related applications on mobile devices suggest that the pandemic has contributed to increases in sleep disruption or onset of new sleep disturbances. We present results from a naturalistic at-home study in which objective sleep measurements were made using both a wrist actigraph (Actiwatch-2, Philips Respironics) and a non-contact monitoring device (SleepScore Max, SleepScore Labs), comparing sleep measurements obtained immediately before and after the start of the first mandatory COVID-19 stay-at-home order in Washington State. Methods As part of a larger study, nine Washington State residents (ages 22–48, 5 female, 4 male; 6 insomniacs, 3 normal sleeper) were enrolled in a 10-week at-home sleep monitoring study, which involved 1 week of actigraphy, 8 weeks of non-contact monitoring (data available for 6 subjects), and 1 week of actigraphy. During the study, the Washington State governor issued a stay-at-home order, effective March 15, 2020. We compared sleep measurements obtained before this date (mean ± SD: 25.0 ± 15.0 nights) and after this date (25.2 ± 13.9 nights) using mixed-effects ANOVA. Results Non-contact monitoring measurements indicated that after the start of the lockdown, participants woke up later by 63.2 ± 12.1 min (mean ± SE; F[1,299]=27.40, p<0.001) without significant change in bedtime (F[1,299]=0.29, p=0.59). Sleep latency lengthened by 4.0 ± 2.3 min (F[1,295]=4.92, p=0.027), and there were increases in number of awakenings (F[1,295]=6.22, p=0.013) and wake after sleep onset (F[1,295]=12.58, p<0.001). Actigraphy data complemented these results, showing delayed sleep onset by 53.4 ± 15.1 min (F[1,101]=12.46, p<0.001) and delayed final awakening by 104.3 ± 19.6 min (F[1,101]=28.43, p<0.001), with longer sleep duration (F[1,101]=6.06, p=0.016), increased number of awakenings (F[1,101]=13.00, p<0.001), and a trend for increased intermittent wakefulness (F[1,101]=3.88, p=0.052) post-lockdown. Conclusion In this sample, we found evidence of increased sleep disruption following the first Washington State stay-at-home order related to COVID-19. Our findings are consistent with previous studies based on self-report data, which observed later wake times and decreases in sleep quality post-lockdown. Support (if any) NIH grant KL2TR002317. Non-contact monitoring devices provided by SleepScore Labs.

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An International Cooperative Model of Online Chinese Courses

International Journal of Humanities and Arts Computing ◽

10.3366/ijhac.2014.0101 ◽

2014 ◽

Vol 8 (supplement) ◽

pp. 95-106

Author(s):

Shih-Chang Hsin ◽

Ching-Wei Wang ◽

Yu-Hui Huang

Keyword(s):

School Districts ◽

Language Learning ◽

Online Instruction ◽

Implementation Process ◽

The United States ◽

School Level ◽

Teaching Resources ◽

Cooperative Model ◽

Learning Platform ◽

Cooperative Agreements

This research project attempts to build a new cooperative model with the superintendents of school districts of various states in the United States. The idea behind the project is based on the urgent need of Mandarin Chinese courses in middle school level in the US. Since most school districts encounter the problem of not having enough Chinese teachers or teaching resources, offering Chinese courses through internet videoconferencing from Taiwan could be a feasible solution. This project involved some aspects including teaching materials design specifically for online instruction, communication with schools and their teachers/students, teacher's training for synchronized online instruction, e-learning platform and facilities arrangement, and problem solving along the implementation process. The program has been implemented during the year of 2012. We have cooperative agreements with five schools districts in different states and have established a workable operation model for this international cooperation. Through this cooperative model, American students gain the benefit of learning resources through internet, and Mandarin educators and researchers in Taiwan also gain new insights on how to promote the Chinese language learning in the global community.

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