592 Objective vs. Subjective Sleep Data in Early Childhood: Implications for Health Disparities Research

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A233-A233
Author(s):  
Olivia Cicalese ◽  
Ariel Williamson ◽  
Jodi Mindell ◽  
Lisa Meltzer

Abstract Introduction Given limited psychometric research with families of lower socioeconomic status (SES) and/or non-White backgrounds, this study explored the feasibility of and discrepancies between actigraphy and maternal-reported nightly child sleep in preschoolers of lower-SES and primarily Black backgrounds. Methods Twenty-seven children (Mage=3.3 years, SD = 1.2 years; 59.3% girls; 85.2% Black; 100% family income <125% of the US poverty level) were asked to wear an actigraph for 14 days while mothers completed telephone-based sleep diaries. Bedtime, wake time, nighttime sleep duration, nap duration, and 24-hour sleep duration were collected by both measures. Paired t-tests examined actigraphic versus mother-reported child sleep. Results Twenty-six percent of dyads (n=7) were excluded due to insufficient data (1-hour difference between measures on >50% of nights). There were no significant demographic differences between dyads with and without discrepant data. Diary-derived sleep onset was calculated by adding caregiver-reported bedtime and caregiver-reported sleep onset latency. There was no significant difference between actigraphy-derived sleep onset (M=10:20PM, SD=69min) and diary-derived sleep onset (M=9:59PM, SD=51min). Average actigraphy sleep offset (M=7:27 AM, SD=62 min) was 42 minutes earlier than diary-derived wake time (M=8:09 AM, SD=84 min), p<.05. Actigraphy-estimated nighttime (M=8.38 hours, SD=.80) and 24-hour sleep duration (M=9.31 hours, SD=1.13) were 0.92 and 0.85 hours shorter, respectively, than diary-derived nighttime (M=9.30 hours, SD=1.07) and total sleep duration (M=10.16 hours, SD=1.17), p<.005. There were no significant differences in average nap duration. The primary mother-reported barrier in completing diaries was limited awareness of child sleep due to work schedules. Conclusion Study results highlight some of the challenges of collecting and scoring actigraphy and diary data in preschoolers of lower-income backgrounds, in particular missing diary data and discrepancies between actigraphy and diaries. These findings suggest a need to incorporate both subjective parental report and objective measurement of child sleep in clinical and research contexts, as well determine ways to enhance feasibility and scoring procedures. Support (if any) K23HD094905 (AAW)

Author(s):  
Craig Thomas ◽  
Helen Jones ◽  
Craig Whitworth-Turner ◽  
Julien Louis

Purpose: (1) To compare the sleep of female players from a professional soccer team to nonathlete controls across an in-season week and (2) to compare the sleep of core and fringe players from the same team on the night after a match to training nights. Methods: Using an observational design, 18 professional female soccer players and 18 female nonathlete controls were monitored for their sleep via wristwatch actigraphy across 1 week. Independent-sample t tests and Mann–Whitney U tests were performed to compare sleep between groups, while an analysis of variance compared sleep on training nights to the night after a match. Results: Soccer players had significantly greater sleep duration than nonathlete controls (+38 min; P = .009; d: 0.92), which may have resulted from an earlier bedtime (−00:31 h:min; P = .047; d: 0.70). The soccer players also had less intraindividual variation in bedtime than nonathletes (−00:08 h:min; P = .023; r: .38). Despite this, sleep-onset latency was significantly longer among soccer players (+8 min; P = .032; d: 0.78). On the night after a match, sleep duration of core players was significantly lower than on training nights (−49 min; P = .010; d: 0.77). In fringe players, there was no significant difference between nights for any sleep characteristic. Conclusions: During the in-season period, sleep duration of professional female soccer players is greater than nonathlete controls. However, the night after a match challenges the sleep of players with more match involvement and warrants priority of sleep hygiene strategies.


SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A354-A354
Author(s):  
J Potvin ◽  
K Mercier ◽  
A Bérubé ◽  
N Raymond ◽  
G Forest

Abstract Introduction Studies suggest that family intervention programs should consider different sources of parenting stress (PS). Knowing that child sleep has an impact on PS, this study aimed to examine if a child sleep intervention can affect PS in vulnerable families. Methods In a first study, parent and child sleep habits along with PS were assessed using Parenting Stress Index-Short Form, Pittsburgh Sleep Quality Index and homemade questions assessing child sleep. Measures were administered to 138 community mothers (children 3-79 months). Multiple linear regression analyses examined mothers and child sleep associations to PS, controlled by family income. Following results of this first study, 11 vulnerable mothers (children 39-68 months) participated in a child sleep intervention specifically developed for vulnerable families. Measures administered were the same as for study 1, but in this study, the Child Sleep Habits Questionnaire was used to assess the child sleep. Wilcoxon’s t-test compared pre and post-intervention measures. Results In the first study, sleep onset latency (SOL; β= -.25; p= .003), waketime (β= -.28; p= .003) and sleep aids (β= -.19; p= .048) explained 23.6% of PS variance. When child sleep variables were added to the model, only bedtime resistance was significant (β= -.23; p= .023) and increased the explained variance to 30.6%. Following the child sleep intervention, no significant changes in parent sleep were observed. However, results show improvement of child bedtime resistance (Mpre=10.73; Mpost=8.36; p= .027) and PS (Mpre=3.50; Mpost=3.82; p= .05). Conclusion Our results suggest that higher PS is explained by greater struggles in parents sleep (higher SOL, later waketime and higher use of sleep aids) as well as bedtime resistance behaviors in children. Furthermore, PS can be reduced by an intervention improving child bedtime resistance, even if parent sleep is not improved. Support  


2020 ◽  
Vol 4 (2) ◽  
pp. 167-176
Author(s):  
Achim Elfering ◽  
Christin Gerhardt ◽  
Diana Pereira ◽  
Anna Schenker ◽  
Maria U. Kottwitz

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


SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A78-A78
Author(s):  
Zahra Mousavi ◽  
Jocelyn Lai ◽  
Asal Yunusova ◽  
Alexander Rivera ◽  
Sirui Hu ◽  
...  

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


2021 ◽  
pp. 026010602110023
Author(s):  
Sofia Cienfuegos ◽  
Kelsey Gabel ◽  
Faiza Kalam ◽  
Mark Ezpeleta ◽  
Vicky Pavlou ◽  
...  

Background: Time restricted feeding (TRF) involves deliberately restricting the times during which energy is ingested. Preliminary findings suggest that 8–10-h TRF improves sleep. However, the effects of shorter TRF windows (4–6 h) on sleep, remain unknown. Aims: This study compared the effects of 4-h versus 6-h TRF on sleep quality, duration, insomnia severity and the risk of obstructive sleep apnea. Methods: Adults with obesity ( n = 49) were randomized into one of three groups: 4-h TRF (eating only between 3 and 7 p.m.), 6-h TRF (eating only between 1 and 7 p.m.), or a control group (no meal timing restrictions) for 8 weeks. Results: After 8 weeks, body weight decreased ( p < 0.001) similarly by 4-h TRF (–3.9 ± 0.4 kg) and 6-h TRF (–3.4 ± 0.4 kg), versus controls. Sleep quality, measured by the Pittsburgh Sleep Quality Index (PSQI), did not change by 4-h TRF (baseline: 5.9 ± 0.7; week 8: 4.8 ± 0.6) or 6-h TRF (baseline: 6.4 ± 0.8; week 8: 5.3 ± 0.9), versus controls. Wake time, bedtime, sleep duration and sleep onset latency also remained unchanged. Insomnia severity did not change by 4-h TRF (baseline: 4.4 ± 1.0; week 8: 4.7 ± 0.9) or 6-h TRF (baseline: 8.3 ± 1.2; week 8: 5.5 ± 1.1), versus controls. Percent of participants reporting obstructive sleep apnea symptoms did not change by 4-h TRF (baseline: 44%; week 8: 25%) or 6-h TRF (baseline: 47%; week 8: 20%), versus controls. Conclusion: These findings suggest that 4- and 6-h TRF have no effect on sleep quality, duration, insomnia severity, or the risk of obstructive sleep apnea.


2007 ◽  
Vol 1 (4) ◽  
pp. 274-282 ◽  
Author(s):  
Ann M. Lynch ◽  
Courtney I. Jarvis ◽  
Ronald J. DeBellis ◽  
Anna K. Morin

Insomnia is a common condition resulting in significant clinical and economic consequences. This review discusses the efficacy of nonpharmacologic treatment options commonly recommended for sleep onset and sleep maintenance insomnia. In addition, the efficacy of these approaches as part of a multifaceted intervention and in comparison to that of pharmacologic options is reviewed. The primary literature and review articles on the nonpharmacologic treatment of insomnia were identified through a MEDLINE search between 1966 and August 2006. Articles on the nonpharmacologic treatment of primary insomnia, including clinical trials on the efficacy of individual and combination treatment options, were reviewed. The nonpharmacologic treatment options for insomnia include stimulus control, sleep hygiene educations, sleep restriction, paradoxical intention, relaxation therapy, biofeedback, and cognitive-behavioral therapy. These treatment strategies produce significant changes in several sleep parameters of chronic insomniacs, including sleep-onset latency, wake time after sleep onset, sleep duration, and sleep quality. Many therapeutic options are available to treat insomnia, including nonpharmacologic strategies. Treatment recommendations, both pharmacologic and nonpharmacologic, should be made based on patient-specific insomnia symptoms, treatment history, and medical history.


2013 ◽  
Vol 44 (7) ◽  
pp. 1521-1532 ◽  
Author(s):  
A. van Straten ◽  
J. Emmelkamp ◽  
J. de Wit ◽  
J. Lancee ◽  
G. Andersson ◽  
...  

BackgroundInsomnia is a prevalent problem with a high burden of disease (e.g. reduced quality of life, reduced work capacity) and a high co-morbidity with other mental and somatic disorders. Cognitive behavioural therapy (CBT) is effective in the treatment of insomnia but is seldom offered. CBT delivered through the Internet might be a more accessible alternative. In this study we examined the effectiveness of a guided Internet-delivered CBT for adults with insomnia using a randomized controlled trial (RCT).MethodA total of 118 patients, recruited from the general population, were randomized to the 6-week guided Internet intervention (n = 59) or to a wait-list control group (n = 59). Patients filled out an online questionnaire and a 7-day sleep diary before (T0) and after (T1) the 6-week period. The intervention group received a follow-up questionnaire 3 months after baseline (T2).ResultsAlmost three-quarters (72.9%) of the patients completed the whole intervention. Intention-to-treat (ITT) analysis showed that the treatment had statistically significant medium to large effects (p < 0.05; Cohen's d between 0.40 and 1.06), and resulted more often in clinically relevant changes, on all sleep and secondary outcomes with the exception of sleep onset latency (SOL) and number of awakenings (NA). There was a non-significant difference in the reduction in sleep medication between the intervention (a decrease of 6.8%) and control (an increase of 1.8%) groups (p = 0.20). Data on longer-term effects were inconclusive.ConclusionsThis study adds to the growing body of literature that indicates that guided CBT for insomnia can be delivered through the Internet. Patients accept the format and their sleep improves.


2011 ◽  
Vol 14 (3) ◽  
pp. 236-241 ◽  
Author(s):  
Amy J. Walker ◽  
Kyle P. Johnson ◽  
Christine Miaskowski ◽  
Vivian Gedaly-Duff

Purpose: The purpose of this descriptive, longitudinal study was to describe objective nocturnal sleep–wake parameters of adolescents at home after receiving chemotherapy in the hospital or outpatient clinic and explore differences in sleep variables by age, gender, and corticosteroid use. Methods: We collected 7 days of wrist actigraphy and sleep diary data from 48 adolescents (10–19 years) who were receiving cancer chemotherapy for a primary or secondary cancer or a relapse. The actigraphic sleep variables included rest interval (i.e., time in bed), sleep onset, sleep offset, sleep duration, total sleep time (TST), wake after sleep onset (WASO), and %WASO. Results: Of the 48 adolescents, 38 had at least five nights of scored actigraphy and were included in analyses. Older (13–18 years) adolescents went to bed later and had fewer minutes of TST than younger adolescents (10–12 years). Exploratory analyses revealed no differences between adolescents who were taking oral corticosteroids (i.e., prednisone, dexamethasone) and those who were not or between males and females. Conclusion: These adolescents had sleep durations that met or exceeded the recommended sleep duration for their age groups but experienced significant WASO. Further research is needed to estimate sleep needs of adolescents during chemotherapy and determine factors that contribute to nocturnal wake-time so that targeted interventions can be designed to improve sleep quality.


Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Ivan A Samayoa ◽  
Nour Makarem ◽  
Vivian Cao ◽  
Moorea Maguire ◽  
Huaqing Xi ◽  
...  

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


SLEEP ◽  
2020 ◽  
Author(s):  
Nicole Lovato ◽  
Gorica Micic ◽  
Leon Lack

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


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