313 Sleep Obtained by Cabin Crewmembers During a Long-haul Flight

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A125-A125
Author(s):  
Lucia Arsintescu ◽  
Cassie Hilditch ◽  
Zachary Glaros ◽  
Kenji Kato ◽  
Kevin Gregory ◽  
...  
Keyword(s):  
Sleep Latency ◽  
Sleep Onset ◽  
Significant Risk ◽  
Sleep Efficiency ◽  
Sleep Diary ◽  
Start Time ◽  
Flight Duration ◽  
Entire Study ◽  
Subsequent Performance ◽  
And Performance

Abstract Introduction Sleep loss and circadian disruption pose a significant risk in safety-sensitive occupations. In aviation, many studies have demonstrated how inflight rest locations influence alertness and performance among pilots, but few studies have evaluated cabin crew. The purpose of the present study was to evaluate sleep outcomes among cabin crewmembers sleeping in a bunk compared to a jump seat during one long-haul route. Methods Thirty-one (6 male) cabin crewmembers (age M = 30, SD = +/-13) flew the same long-haul route (outbound and return) with a flight duration of 10:41 (± 0:14) hours. Participants were randomly assigned to fly on an aircraft with a bunk or a jump seat for their sleep opportunity. Participants wore an Actiwatch (Phillips-Respironics Spectrum) throughout the entire study and completed a sleep diary at bedtime and upon waking. During flight they completed a nap diary entering the start time of the inflight sleep (if any) and the duration. Results Sixty-five flights (32 outbound and 33 return) were included in the analyses. Seventy-seven percent of the flights had a bunk and 23% had a jump seat. Crewmembers obtained M = 146.46 (± 67.20) minutes of rest out of which they slept M = 125.33 (± 64.91) minutes in the bunk. While using the jump seat, crewmembers obtained M = 169.53 (± 133.30) minutes of rest out of which they slept M = 142.92 (± 149.72) minutes. When crewmembers slept in the bunk, sleep latency was shorter (M = 13.69 ± 12.64 minutes) and efficiency was better (M = 76.16 ± 16.09 %) compared to the jump seat (sleep onset: M = 16.77 ± 13.89 minutes; sleep efficiency: M = 60.64 ± 17.42 %). Conclusion We found that cabin crewmembers slept for longer time when they used the jump seat. They fell asleep faster and their sleep efficiency was better when using the bunk compared to the jump seat. Further research is needed to understand how sleep quality and subsequent performance are influenced by sleep opportunity in a bunk compared to a jump seat. Support (if any) NASA Airspace Operations and Safety Program, System-Wide Safety Project.

scholarly journals Nighttime Variability in Wrist Actigraphy

2011 ◽  
Vol 19 (2) ◽  
pp. 105-114 ◽  
Author(s):  
Julie L. Otte ◽  
Judith K. Payne ◽  
Janet S. Carpenter
Keyword(s):  
Repeated Measures ◽  
Sleep Disturbances ◽  
Breast Cancer Survivors ◽  
Sleep Latency ◽  
Sleep Onset ◽  
Sleep Time ◽  
Sleep Efficiency ◽  
Sleep Diary ◽  
Repeated Measures Design ◽  
Wrist Actigraphy

Wrist actigraphy measures sleep activity and circadian rhythm. This study examined nighttime variability in Actiwatch parameters in a sample of breast cancer survivors (BCSs) to determine a minimum number of nights needed to obtain an accurate picture of objective sleep. A descriptive, quantitative, and repeated measures design was used. Consenting participants wore an actigraph and completed a sleep diary across 7 nights. There were no significant differences in wake after sleep onset (WASO), total sleep time (TST), sleep latency, or sleep disturbances across nights of week (Monday to Sunday) or monitoring nights (1st to 7th). Sleep efficiency was significantly better at Night 6 compared with Night 7. The coefficients of variation (CVs) for WASO ranged from 46% to 86%, TST 23%–34%, sleep latency 154%–246%, sleep efficiency 12%–22%, and sleep disturbances 33%–41%. Although the CVs indicated high variability across women, there was little internight variability in WASO or TST during across 7 nights of sleep. This suggests that in BCSs, Actiwatch data could be collected and evaluated from any single night for an accurate measure of usual sleep.

Mindfulness and Behaviour Therapy for Insomnia: An Assessment of Treatment Effect in a Sleep Disorders Clinic Population with Insomnia

2020 ◽  
pp. 1-15
Author(s):  
Allie Peters ◽  
John Reece ◽  
Hailey Meaklim ◽  
Moira Junge ◽  
David Cunnington ◽  
...  
Keyword(s):  
Sleep Disorders ◽  
Treatment Effect ◽  
Sleep Onset ◽  
Sleep Efficiency ◽  
Health Concern ◽  
Sleep Diary ◽  
Sleep Onset Latency ◽  
Subjective Sleep ◽  
Sleep Parameters

Abstract Insomnia is a common major health concern, which causes significant distress and disruption in a person's life. The objective of this paper was to evaluate a 6-week version of Mindfulness-Based Therapy for Insomnia (MBTI) in a sample of people attending a sleep disorders clinic with insomnia, including those with comorbidities. Thirty participants who met the DSM-IV-TR diagnosis of insomnia participated in a 6-week group intervention. Outcome measures were a daily sleep diary and actigraphy during pre-treatment and follow-up, along with subjective sleep outcomes collected at baseline, end-of-treatment, and 3-month follow-up. Trend analyses showed that MBTI was associated with a large decrease in insomnia severity (p < .001), with indications of maintenance of treatment effect. There were significant improvements in objective sleep parameters, including sleep onset latency (p = .005), sleep efficiency (p = .033), and wake after sleep onset (p = .018). Significant improvements in subjective sleep parameters were also observed for sleep efficiency (p = .005) and wake after sleep onset (p < .001). Overall, this study indicated that MBTI can be successfully delivered in a sleep disorders clinic environment, with evidence of treatment effect for both objective and subjective measures of sleep.

scholarly journals 0127 Relationship Between Sleep Metrics with Free-Living Glucose Concentrations and Glycemic Variability in Non-Diabetic Adults

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A50-A50
Author(s):  
J R Sparks ◽  
E E Kishman ◽  
X Wang
Keyword(s):  
South Carolina ◽  
Glucose Metabolism ◽  
Sleep Onset ◽  
Glycemic Variability ◽  
Sleep Efficiency ◽  
Sleep Diary ◽  
Poor Sleep ◽  
Free Living ◽  
Experimental Conditions ◽  
Time In Bed

Abstract Introduction Insufficient sleep and poor sleep quality have been associated with impaired glucose metabolism at fasting and under experimental conditions. Continuous glucose monitoring (CGM) measures glucose concentrations over an extended, free-living period that can be used to assess glycemic health. Relationships between CGM-assessed glucose concentrations and glycemic variability, an emerging glycemic health marker, with sleep metrics have yet to be elucidated. The purpose of this study was to examine the relationships between sleep metrics with glucose concentrations and glycemic variability in non-diabetic adults. Methods Twenty-four non-diabetic adults (age=46.0±5.8 years; BMI=32.2±5.7 kg/m2) completed actigraphy, sleep diary, and CGM over 7 consecutive days. Time-in-bed (TIB), total sleep time (TST), wake duration after sleep onset, and sleep efficiency [(TST÷TIB)×100%] were determined using actigraphy assisted with sleep diary input. Nightly variability of each sleep metric was calculated as standard deviation (SD) across all nights. Glucose concentrations at waking in the morning, and 1, 2, and 3 hours prior to waking, and diurnal, nocturnal, and 24-hour means were determined. Intra-day glycemic variability, including mean amplitude of glycemic excursions and continuous overlapping of net glycemic action of 1, 2, and 4 hours, and inter-day glycemic variability, mean of daily differences, were calculated. Pearson product correlations between sleep metrics with glucose concentrations and glycemic variability were performed. Results Average TIB and TST were 462.6±61.7 minutes and 403.3±59.7 minutes, respectively. TIB negatively correlated with glucose concentrations at 2 and 3 hours prior to waking (r=-0.42, p=0.04 and r=-0.42, p=0.04, respectively). Nightly variability in sleep efficiency positively correlated with waking, and 1, 2, and 3 hours prior to waking glucose concentrations (0.44≤r≤0.48, p≤0.03 for all). No sleep metrics correlated with glycemic variability measures (p≥0.10 for all). Conclusion Findings suggest a longer amount of sleep opportunity and more consistent sleep efficiency relate to better glucose metabolism in non-diabetic adults. Support American Heart Association 14BGIA20380706 and University of South Carolina Support to Promote Advancement of Research and Creativity Grant #11530-17-43917.

scholarly journals 0497 Rebound Insomnia During Discontinuation of Chronic Hypnotic Use

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A190-A190
Author(s):  
G Koshorek ◽  
J Verkler ◽  
T Roth ◽  
T Roehrs
Keyword(s):  
Clinical Trial ◽  
Sleep Latency ◽  
Sleep Onset ◽  
Sleep Efficiency ◽  
Study Medication ◽  
Rebound Insomnia ◽  
Dsm V ◽  
Hypnotic Medication ◽  
Choice Period ◽  
Trial Participants

Abstract Introduction Rebound insomnia refers to worsened sleep relative to baseline on 1-2 nights after discontinuation of active hypnotic medication. Rebound is typically assessed using a placebo substitution. We assessed rebound in an on-going “blinded” clinical trial in which people with insomnia are instructed to discontinue their study medication (i.e., no-pill) after 6 months of nightly use. Methods DSM-V diagnosed people with insomnia (n=31, 26 females), aged 26-61 yrs, with a polysomnographic sleep efficiency of ≤85%, no other sleep disorders, unstable medical or psychiatric diseases or drug dependency completed the clinical trial. Participants were randomized to zolpidem XR (12.5 mg), eszopiclone (3 mg) or placebo nightly for 6 months (blinded groups A: n=11, B: n=9, C: n=11). After 6 months, over a 2-week choice period, they were given the instruction to discontinue their nightly hypnotic use with an opportunity, if necessary, to self-administer either 1, 2, or 3 capsules of their assigned medication (zolpidem XR 6.25 mg, 6.25 mg, placebo; eszopiclone 2 mg, 1 mg, placebo as capsules 1, 2 and 3 respectively; or 3 placebos). On baseline and the14 discontinuation nights, sleep was recorded and scored by actigraphy for sleep efficiency (SE), sleep latency (LAT) and wake after sleep onset (WASO). Results Relative to the baseline night, on the first discontinuation night there was no difference in SE, LAT, and WASO. Fifteen subjects stopped taking study medication when told to discontinue and 16 subjects took study medication on one night or more. While not differing on baseline or night 1, on night 14 the last study night the medication users had a lower SE (75.9 vs 87.7 %, p&lt;.0.004) and a longer LAT (61.5 vs 14.5 min, p&lt;0.05). Conclusion Difficulty discontinuing hypnotic use is not specifically related to rebound insomnia. We reported in a companion abstract those with insomnia and hyperarousal, defined by MSLT, are those with difficulty discontinuing hypnotic use and as shown here slept poorly on the last study night. Support NIDA, grant#: R01DA038177 awarded to Dr. Roehrs

803 Sleep Disturbances in Patients with Frontotemporal Dementia

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A312-A314
Author(s):  
Nathan Walker ◽  
Bradley Vaughn
Keyword(s):  
Sleep Apnea ◽  
Frontotemporal Dementia ◽  
Rem Sleep ◽  
Sleep Disturbances ◽  
Sleep Latency ◽  
Sleep Onset ◽  
Retrospective Chart Review ◽  
Sleep Efficiency ◽  
Periodic Limb Movements ◽  
Apnea Hypopnea Index

Abstract Introduction Frontotemporal dementia (FTD) is a degenerative process and,as the name implies, involves the frontal and temporal lobes of the brain. Patients with FTD make up 10–15% of all cases of dementia and 20% diagnosed before age 65, however not much is reported about sleep disturbances in these patients. Given the area of neuronal loss one would expect that sleep may be influenced early and by issues in arousal mechanisms and in breathing pattern. This study examined the polysomnography (PSG) reports of patients with a diagnosis FTD. Methods A retrospective chart review was performed to identify patients with both a diagnosis of FTD and having undergone a PSG. 23 patients were identified as fulfilling both requirements. Data recorded included, diagnosis, age at time of PSG, Epworth sleepiness scale (ESS), total sleep time (TST), wake after sleep onset (WASO), sleep latency (SL), REM sleep latency, sleep efficiency (SE), percentage of stage N1, N2, N3, and REM sleep, apnea-hypopnea index (AHI), presence of Cheyne-Stoke breathing, periodic limb movement index, and presence of REM without atonia. Results Patient age ranged from 57–85 years. Average ESS was 8.8 with only 5 patients reported excessive daytime sleepiness(as assessed by ESS). The average TST was 290 minutes, average SL was 37.9 minutes, average WASO was 147.5 minutes, and average sleep efficiency was 60.3%. Patients spent the majority of time in N2 sleep with an average of 68.3% of the time spent in N2. The average time spent in N3 was 9.6% of sleep. 8.9% of sleep was spent in REM. 83% of patients were diagnosed with sleep apnea (as defined by an AHI &gt; 5), with an average AHI of 20.2 events/hour. Cheyne-Stokes breathing was only noted in 4 of the 23 patients, or 17%. Periodic limb movements of sleep were noted in 48% of the patients (n=11). REM without atonia or RBD was not noted for any patients. Conclusion This study shows that patients with FTD suffer from typical sleep disturbances, however there is a high prevalence of sleep apnea as well as PLMS. In addition, patients with FTD have decreased sleep efficiency with increased WASO. Support (if any):

scholarly journals 0210 Evaluating the Sensitivity of Sleep Measures for Monitoring Pilot Fatigue in Operational Settings

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A82-A82
Author(s):  
M J van den Berg ◽  
L J Wu ◽  
P H Gander ◽  
E Santos-Fernandez ◽  
L Signal
Keyword(s):  
Los Angeles ◽  
Response Speed ◽  
Vigilance Task ◽  
Individual Variability ◽  
Civil Aviation ◽  
Sleep Diary ◽  
Start Time ◽  
Flight Duration ◽  
Time Awake ◽  
Pilot Fatigue

Abstract Introduction Previously, combined data analyses of four pilot fatigue monitoring studies including 237 pilots flying long-haul and ultra-long range (ULR) flights found no association between pilots’ actigraphic sleep in flight and psychomotor vigilance task (PVT) performance at top-of-descent (TOD; beginning of the landing phase of flight). The present study aimed to determine whether measures of in-flight sleep recorded with polysomnography (PSG) are more sensitive predictors of pilots’ PVT performance near TOD than actigraphic measures. Methods Data were re-analysed from 41 Singapore Airlines A340-500 pilots (median age 47, range 29–58 years) monitored on a ULR trip between Singapore and Los Angeles (average flight duration outbound = 15.6 hrs; inbound = 17.2 hrs). In-flight sleep was recorded simultaneously with PSG (scored in 30-second epochs) and actigraphy (recorded in 30-second epochs and scored in conjunction with sleep diary information). PSG- and actigraphy-determined time awake were calculated as the duration between the end of the last epoch scored as sleep (PSG) or software-scored sleep interval (actigraphy) and the start time of the 10-minute PVT completed near TOD. Results Linear mixed modelling indicated that after controlling for flight sector and intra- and inter-individual variability, neither PSG-derived total in-flight sleep (F (1, 44.4) = 0.006, p= 0.941) and time awake (F (1, 34.3) = 0.431, p= 0.516), nor actigraphic total in-flight sleep (F (1, 51.1) = 0.161, p= 0.69) and time awake (F (1, 34.9) = 0.23, p= 0.634) were associated with PVT response speed at TOD. Conclusion In this context, actigraphy produced identical findings to polysomnography and remains a valid alternative for monitoring in-flight sleep of groups of pilots during ULR flights. Further research is needed to determine whether PVT performance is a discriminatory measure of fatigue-related impairment in pilots. Support This analysis was supported by the Massey University College of Health Research Fund. The Singapore Airlines study was funded by the Singapore Civil Aviation Authority. We thank Dr Jarnail Singh for permission to use these data.

Sleep of Wheelchair Rugby Athletes: Training, Rest and Competition

2020 ◽  
Author(s):  
Victor Sanz-Milone ◽  
Fernanda V. Narciso ◽  
Andressa da Silva ◽  
Milton Misuta ◽  
Marco Túlio de Mello ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Sleep Onset ◽  
Sleep Efficiency ◽  
Sleep Diary ◽  
Poor Sleep ◽  
Subjective Sleep Quality ◽  
Wheelchair Rugby ◽  
Rest Periods ◽  
Rugby Players

AbstractThe aim of this study was to evaluate the sleep-wake cycle of wheelchair rugby athletes during the pre-season compared to in-season. Wheelchair Rugby athletes wore an actigraph monitor during two respective 10-day periods: 1) pre-season and 2) in-season, each of which comprised three training days, three rest days, and four competition days, respectively. In addition, the players completed questionnaires regarding sleepiness, subjective quality of sleep, and chronotype, as well as the use of the sleep diary along with the actigraph measurements (20 days). The wheelchair rugby athletes had poor subjective sleep quality in both stages observed by sleep efficiency below 85% (ES 0.31) and high score in the Pittsburgh questionnaire (effect size-ES 0.55), the actigraphy results presented an increase of sleep latency (ES 0.47), and wake after sleep onset (ES 0.42). When comparing the athlete’s routine, the competition days, demonstrated a reduction in the total time of sleep and the sleep efficiency, in addition to an increase in wakefulness after sleep onset when compared with the training and rest periods. As a result, the wheelchair rugby players did not describe a pattern of sleep-wake cycle during different training phases, as well as poor sleep quality.

scholarly journals P121 Comparison of Actigraphy versus PSG and Perception of Sleep in Patients with Excessive Daytime Sleepiness

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A60-A61
Author(s):  
T Roebuck ◽  
E McDermott ◽  
R Cuesta ◽  
R Nguy ◽  
M Spiteri ◽  
...  
Keyword(s):  
Sleep Latency ◽  
Sleep Onset ◽  
Sleep Time ◽  
Sleep Diary ◽  
Sleep Onset Latency ◽  
Onset Latency ◽  
Activity Data ◽  
Significant Difference ◽  
Sleep Parameters ◽  
Perception Of Sleep

Abstract Actigraphy is used as a validated measure of rest and sleep, however, there are reported differences in WASO in healthy individuals (Chinoy, 2021). Methods This study compares the sleep parameters from PSG with simultaneous overnight actigraphy on patients the night prior to MSLT. We also compare the actigraphy data collected on the week prior to the PSG with the patient’s sleep diary. 22 subjects, age 38.7 ± 3.1 years, BMI 23.5 ± 1.4 kg/m2, 40.1% male, 4 participants were treated with CPAP. Results WASO was found to be under estimated by actigraphy versus PSG (y=-0.957x+18.014, R2=0.51), there is an increase in underestimation beyond 18minutes. Our data also show on overestimation of sleep onset latency by actigraphy versus PSG when sleep latency is longer than 12 minutes (y=0.27x-12.04, R2=0.08). Total sleep time was perceived to be longer on the PSG night than the PSG data shows (y=0.68x-4.65, R2=0.21). Data demonstrated participants to overestimate their sleep period in their sleep diary compared to the actigraphy data (y=-0.87x+6.58, R2=0.21). T-tests showed a significant difference between WASO (minutes) detected by PSG and the actigraphy data (67.4 ± 8.9 vs 33.3 ± 3.9 p=0.0007). There were no other significant differences in the datasets. Conclusion Actigraphy uses activity data and light detection to estimate rest and sleep periods in wearers. Our data reflects expected differences reported in the literature of actigraphy data versus PSG due to the limitation of actigraphy being able to differentiate between sleep and motionless wakefulness.

223 Sleep Duration and Sleep Quality in Chronic Cannabis Users and Non-Users

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A89-A89
Author(s):  
Caroline Tse ◽  
Alicia Stewart ◽  
Omar Ordaz-Johnson ◽  
Maya Herzig ◽  
Jacqueline Gagnon ◽  
...  
Keyword(s):  
Pilot Study ◽  
Sleep Quality ◽  
Sleep Duration ◽  
Sleep Latency ◽  
Sleep Onset ◽  
The United States ◽  
Cannabis Use ◽  
Sleep Diary ◽  
Random Factor ◽  
Time In Bed

Abstract Introduction Cannabis use is on the rise in the United States, with 10% of adults reporting cannabis use in the past 30 days. Users commonly report consuming cannabis to improve sleep despite the lack of research that supports an association between cannabis use and sleep. In this pilot study we sought to examine objective measures of sleep duration and sleep quality among non- and chronic-cannabis users, and any patterns in relation to the time since consumption of cannabis. Methods Chronic cannabis users (cannabis used 2 or more times/week) and non-users provided up to 2-weeks of actigraphy (ActiGraph wGT3X-BT), worn on the wrist and verified by sleep diary. Chronic cannabis users also reported the date, time, amount, and route of their cannabis use. Mixed-effects models with participant as a random factor were used to examine: 1) the relationship between daily sleep parameters in cannabis non-users vs. users; and 2) the elapsed time between cannabis use and time in bed in chronic cannabis users. Results Chronic cannabis users (n=6) and non-users (n=7) collectively provided 151 nights of sleep. Participant characteristics (38.5% female; age, 25.8 years ± 4 years; BMI, 23.4 kg/m2 ± 3.4 kg/m2) did not significantly differ between groups. Cannabis use was associated with decreased total sleep time (measured in hours, ß=-0.58, p&lt;0.001) and increased wake after sleep onset (WASO, ß=32.79, p=0.005), but not with the number of awakenings (ß=6.02, p=0.068). Among chronic cannabis users, cannabis use within two hours of bed was associated with increased sleep latency compared to use greater than two hours (ß=6.66, p=0.026). There was no association between time of cannabis use and WASO (p=0.621) or the number of awakenings (p=0.617). Conclusion In this pilot study of objectively measured sleep, we found that chronic cannabis use compared to non-use is associated with decreased sleep duration of otherwise healthy adults. Cannabis used closer to bedtime is associated with increased sleep latency. Additional studies that are able to assess the mode and dosage of use are needed to further understand the effects of cannabis and its components on sleep. Support (if any) KL2TR002370, AASM, Oregon Institute of Occupational Health Sciences

scholarly journals Evening intake of alcohol, caffeine, and nicotine: night-to-night associations with sleep duration and continuity among African Americans in the Jackson Heart Sleep Study

SLEEP ◽  
2019 ◽  
Vol 42 (11) ◽  
Author(s):  
Christine E Spadola ◽  
Na Guo ◽  
Dayna A Johnson ◽  
Tamar Sofer ◽  
Suzanne M Bertisch ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Sleep Duration ◽  
Sleep Onset ◽  
Sleep Efficiency ◽  
Sleep Diary ◽  
Sleep Study ◽  
Mixed Effect ◽  
Wrist Actigraphy ◽  
Sleep Parameters ◽  
Predominantly Female

Abstract Study Objectives We examined the night-to-night associations of evening use of alcohol, caffeine, and nicotine with actigraphically estimated sleep duration, sleep efficiency, and wake after sleep onset (WASO) among a large cohort of African American adults. Methods Participants in the Jackson Heart Sleep Study underwent wrist actigraphy for an average of 6.7 nights and completed concurrent daily sleep diary assessments to record any consumption of alcohol, caffeine, and nicotine within 4 hours of bedtime. Linear mixed-effect models were fit and adjusted for age, sex, educational attainment, body mass index, depression, anxiety, stress, and having work/school the next day. Results Eligible participants (n = 785) were an average of 63.7 years (SD: 10.6), and were predominantly female (67.9%). There were 5164 days of concurrent actigraphy and sleep diary data. Evening alcohol use was associated with that night’s lower sleep efficiency (−0.98% [95% CI: −1.67% to −0.29%], p = 0.005), but not with WASO or sleep duration. Evening nicotine use was associated with that night’s lower sleep efficiency [1.74% (95% CI: −2.79 to −0.68), p = 0.001] and 6.09 minutes higher WASO ([95% CI: 0.82 to 11.35], p = 0.02), but was not associated with sleep duration. Evening caffeine use was not associated with any of the sleep parameters. Conclusion Nicotine and alcohol use within 4 hours of bedtime were associated with increased sleep fragmentation in the associated night, even after controlling for multiple potential confounders. These findings support the importance of sleep health recommendations that promote the restriction of evening alcohol and nicotine use to improve sleep continuity.

Sign in / Sign up

Export Citation Format

Share Document