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

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.

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

Behaviour Change ◽

10.1017/bec.2020.18 ◽

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.

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Delayed Lactogenesis II is Associated With Lower Sleep Efficiency and Greater Variation in Nightly Sleep Duration in the Third Trimester

Journal of Human Lactation ◽

10.1177/0890334419830991 ◽

2019 ◽

Vol 35 (4) ◽

pp. 713-724

Author(s):

Theresa Casey ◽

Hui Sun ◽

Helen J. Burgess ◽

Jennifer Crodian ◽

Shelley Dowden ◽

...

Keyword(s):

Body Mass Index ◽

Blood Glucose ◽

Sleep Duration ◽

Body Mass ◽

Sleep Disturbances ◽

Sleep Onset ◽

Sleep Time ◽

Sleep Efficiency ◽

Delayed Onset ◽

Wrist Actigraphy

Background: Metabolic and hormonal disturbances are associated with sleep disturbances and delayed onset of lactogenesis II. Research aims: The aim of this study was to measure sleep using wrist actigraphy during gestation weeks 22 and 32 to determine if sleep characteristics were associated with blood glucose, body mass index, gestational related disease, delayed onset of lactogenesis II, or work schedule. Methods: Demographic data were collected at study intake from primiparous women who wore a wrist actigraph during gestation weeks 22 ( n = 50) and 32 ( n = 44). Start and end sleep time, total nighttime sleep, sleep efficiency, wake after sleep onset, and sleep fragmentation were measured. Night to night variability was assessed with the root mean square of successive difference. Blood glucose levels, body mass index, and gestational disease data were abstracted from medical charts. Timing of lactogenesis II was determined by survey. Results: Between gestation week 22 and 32, sleep efficiency decreased and fragmentation increased ( p < .05). During gestation week 32, blood glucose was negatively correlated with sleep duration, and positively related to fragmentation ( p < .05). Women who experienced delayed lactogenesis II had lower sleep efficiency and greater fragmentation ( p < .05), and greater night-to-night variability in sleep start and end time, efficiency, and duration during gestation week 32 ( p < .05). Conclusion: Women with better sleep efficiency and more stable nightly sleep time are less likely to experience delayed onset of lactogenesis II. Interventions to improve sleep may improve maternal health and breastfeeding adequacy.

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Nocturnal Sleep–Wake Parameters of Adolescents at Home Following Cancer Chemotherapy

Biological Research For Nursing ◽

10.1177/1099800411408414 ◽

2011 ◽

Vol 14 (3) ◽

pp. 236-241 ◽

Cited By ~ 3

Author(s):

Amy J. Walker ◽

Kyle P. Johnson ◽

Christine Miaskowski ◽

Vivian Gedaly-Duff

Keyword(s):

Sleep Duration ◽

Cancer Chemotherapy ◽

Sleep Onset ◽

Sleep Diary ◽

Nocturnal Sleep ◽

Wake Time ◽

Targeted Interventions ◽

Time In Bed ◽

Wrist Actigraphy ◽

At Home

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.

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Abstract MP90: Association of Sleep Duration and Quality with Incident Diabetes: Coronary Artery Risk Development in Young Adults Sleep Study

Circulation ◽

10.1161/circ.127.suppl_12.amp90 ◽

2013 ◽

Vol 127 (suppl_12) ◽

Author(s):

Mercedes R Carnethon ◽

Peter John D De Chavez ◽

Diane S Lauderdale ◽

April P Carson ◽

Kiang Liu ◽

...

Keyword(s):

Sleep Duration ◽

Daytime Sleepiness ◽

Population Sample ◽

Sleep Onset ◽

Demographic Characteristics ◽

Incident Diabetes ◽

Diabetes Incidence ◽

Sleep Study ◽

Sleep Maintenance ◽

Sleep Parameters

Background: Most prior longitudinal studies investigating the association of sleep characteristics with incident diabetes are based on self-reported sleep duration and quality. However, self-reported sleep is prone to differential error that is based on the amount of actual sleep that a person gets. Objective: To test whether objectively-measured sleep duration and quality or self-reported sleepiness were associated with the development of diabetes in a population sample. Methods: Participants from the Chicago, IL center of the CARDIA study who wore wrist actigraphs (Actiwatch TM ) twice between 2003-2005 and who were free from diabetes in 2000-2001 were included in the analysis (n=594). The following sleep parameters were averaged over 6 days: sleep duration, sleep maintenance (percentage of sleep period actually sleeping) and minutes of wake after sleep onset (WASO). The Epworth Sleepiness Scale (ESS) assessed daytime sleepiness; higher scores reflect more sleepiness. Diabetes was determined based on fasting glucose >126 mg/dL, medication use, post-load glucose >200 mg/dL or Hemoglobin A1c >6.5% during examinations in 2005-2006 and 2010-2011. Results: Participants were 40.1 years old (SD=3.6), average sleep duration was 365.8 min (SD=64.3), sleep maintenance was 88.9% (SD=5.4), WASO was 46.0 min (SD=24.0) and the ESS was 7.5 (SD=4.3). Over ~10 years, 68 participants (11.4%) developed diabetes. Each sleep measure was associated with diabetes incidence in unadjusted models; however, only the association with daytime sleepiness remained significant following adjustment for demographic characteristics and diabetes risk factors. Conclusions: Self-reported daytime sleepiness is a straightforward measurement of sleep quality that can identify adults at risk for diabetes. Although objective measures of sleep duration and quality are associated with incident diabetes, the association is entirely explained by demographic characteristics.

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346 Semi-Individualized Acupuncture for Insomnia Disorder: A Randomized Sham-Controlled Trial

SLEEP ◽

10.1093/sleep/zsab072.345 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A138-A138

Author(s):

Jerry Wing-Fai Yeung ◽

Branda Yee-Man Yu ◽

John Yuen ◽

Janice Ho ◽

Ka-Fai Chung ◽

...

Keyword(s):

Total Sleep Time ◽

Sleep Time ◽

Sleep Diary ◽

Linear Mixed Effect Model ◽

Mixed Effect ◽

Insomnia Symptom ◽

Insomnia Disorder ◽

Wrist Actigraphy ◽

Significant Difference ◽

Sleep Parameters

Abstract Introduction Acupuncture is an alternative treatment for improving sleep quality and the effectiveness is thought to be optimized with an individualized approach resembling real practice. However, existing evidence is limited by methodological shortcomings due to blinding issues, standardized measures, and diagnostic procedures. It was of the present study’s interest to examine the efficacy and safety of semi-individualized acupuncture treatment on insomnia. Methods Adults with DSM-5 insomnia disorder (n = 140) were randomized with 1:1 allocation to a 4-week intervention traditional acupuncture (TA) or validated non-invasive sham acupuncture (SA). The selection of acupoints was semi-individualized by the acupuncturist. As the primary outcome, the sleep efficiency (SE) by sleep diary was assessed at baseline, 1-week posttreatment, and 5-week posttreatment. Other sleep parameters derived from sleep diary, the wrist-actigraphy-derived sleep parameters, insomnia symptom severity, anxiety, and depressive symptoms, as well as the health-related quality of life, were also evaluated. Results Although linear mixed-effect model revealed both groups did not attain significant difference in sleep-diary-derived SE and other outcome measures (all P > 0.05), TA promising effect on improving insomnia symptom (within-group effect size, d = 1.13 & 1.30 at 1-week & 5-week posttreatment respectively) and also a higher proportion of subjects achieved SE ≥ 85% compared with SA (55.6% versus 36.4% at week 9, P = 0.03). Besides, subjects in TA group reported significantly greater improvement in both the total sleep time (TST) derived from sleep diary and actigraph than those in the SA group at 1-week posttreatment (difference in mean changes from baseline: sleep diary = 22.0 min, p = 0.01; actigraphy =18.8 min, P = 0.02) but not 5-week posttreatment. Conclusion This study is the first to evaluate the effect of the TCM-theory-based individualized acupuncture on sleep using a sham-control design. A 4-week semi-individualized acupuncture is able to significantly increase total sleep time with few adverse events. Support (if any) Research Grants Council of Hong Kong, Early Career Scheme (Project no.: 25101017)

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Nighttime Variability in Wrist Actigraphy

Journal of Nursing Measurement ◽

10.1891/1061-3749.19.2.105 ◽

2011 ◽

Vol 19 (2) ◽

pp. 105-114 ◽

Cited By ~ 9

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.

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142 Prenatal Sleep Quality and Infant Sleep: A Longitudinal Study

SLEEP ◽

10.1093/sleep/zsab072.141 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A58-A59

Author(s):

Rebecca Burdayron ◽

Marie-Helene Pennestri ◽

Elizabeth Keys ◽

Lianne Tomfohr-Madsen ◽

Gerald Giesbrecht

Keyword(s):

Sleep Quality ◽

Sleep Duration ◽

Gestational Age ◽

Sleep Onset ◽

Depression Scale ◽

Future Research ◽

Poor Sleep ◽

Infant Sleep ◽

Maternal Sleep ◽

Sleep Parameters

Abstract Introduction Poor sleep quality is common during pregnancy and can increase the risk of adverse obstetric and fetal outcomes. Existing research on the association between prenatal sleep and infant sleep is scarce and has focused on other aspects of prenatal sleep such as sleep duration, chronotype, and insomnia symptoms. To our knowledge, no studies have examined the association between prenatal sleep quality and infant sleep outcomes. Thus, this study aimed to investigate whether maternal sleep quality during pregnancy was prospectively associated with infant sleep dimensions, independent of relevant covariates. Methods Participants were a subset of 272 mother-infant dyads enrolled in an ongoing cohort study. Maternal prenatal sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI) in early to mid- (M gestational age = 15.12 ± 3.56 weeks) and late- (M gestational age = 32.44 ± 0.99 weeks) pregnancy. Mothers completed the Brief Infant Sleep Questionnaire (BISQ) at 3, 6, and 12 months postpartum. The following infant sleep parameters were assessed: sleep duration (day, night, 24-hour), number of night awakenings, and wake after sleep onset. Prenatal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS) at both pregnancy time points. Other covariates included maternal age at enrollment, infant age, parity, and co-sleeping status. Results Generalized estimating equations (GEE) models revealed that poorer maternal sleep quality during early-to-mid pregnancy did not significantly predict infant sleep parameters after adjustment for covariates (p > .05). However, in late pregnancy, poorer maternal sleep quality significantly predicted shorter 24-hour sleep duration and longer wake after sleep onset, but not daytime sleep duration, nighttime sleep duration, and number of night awakenings (p < .05). Conclusion Study findings advance our understanding of the prospective link between maternal prenatal sleep quality and infant sleep. Results indicate that maternal sleep quality during late gestation may play a role in the development of infant sleep patterns. These findings have important implications for intervention efforts targeting maternal sleep quality during pregnancy. Future research should use objective measures of sleep, such as actigraphy, to better elucidate the effects of prenatal sleep quality on infant sleep outcomes. Support (if any) The Canadian Institutes of Health Research (CIHR)

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A Sleep Laboratory Evaluation of the Long-Term Efficacy of Zopiclone

The Canadian Journal of Psychiatry ◽

10.1177/070674378803300206 ◽

1988 ◽

Vol 33 (2) ◽

pp. 103-107 ◽

Cited By ~ 22

Author(s):

Jonathan A.E. Fleming ◽

Jean Bourgouin ◽

Peter Hamilton

Keyword(s):

Sleep Onset ◽

Sleep Time ◽

Sleep Efficiency ◽

Laboratory Evaluation ◽

Sleep Study ◽

Sleep Studies ◽

Metallic Taste ◽

Hypnotic Medication ◽

Drug Free

Six patients between the ages of 25 and 59, with chronic, primary insomnia received the new, non-benzodiazepine, hypnotic zopiclone continuously for 17 weeks after a drug free interval of 12 nights. To qualify for the study, sleep efficiency, determined by a sleep study on two, consecutive, placebo-controlled nights, had to be less than 75%. Patients evaluated their sleep by questionnaire and had sleep studies completed throughout active treatment. Zopiclone (7.5 mg) increased sleep efficiency by decreasing sleep latency, wakefulness after sleep onset and increasing total sleep time. Sleep architecture was minimally affected by zopiclone treatment; no significant changes in delta or REM sleep were observed. The commonest side effect was a bitter or metallic taste. No significant changes in biological functioning were noted throughout the study period. These findings indicate that zopiclone is a safe and effective hypnotic medication which maintains its effectiveness with protracted use.

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Influence of the menopausal transition on polysomnographic sleep characteristics: A longitudinal analysis

SLEEP ◽

10.1093/sleep/zsab139 ◽

2021 ◽

Author(s):

Karen A Matthews ◽

Laize Lee ◽

Howard M Kravitz ◽

Hadine Joffe ◽

Genevieve Neal-Perry ◽

...

Keyword(s):

Sleep Duration ◽

Menopausal Status ◽

Hot Flashes ◽

Sleep Onset ◽

Menopausal Transition ◽

Apnea Hypopnea Index ◽

Cross Sectional ◽

Sleep Study ◽

Beta Power ◽

Eeg Power

Abstract Study Objectives To evaluate how change in menopausal status related to spectral analysis and polysomnographic measures of sleep characteristics. Methods The Study of Women’s Health Across the Nation (SWAN) Ancillary Sleep Study evaluated sleep characteristics of 159 women who were initially pre- or early perimenopausal and repeated the assessment about 3 ½ years later when 38 were pre- or early perimenopausal, 31 late perimenopausal, and 90 postmenopausal. Participants underwent in-home ambulatory polysomnography for 2 to 3 nights. Average EEG power in the delta and beta frequency bands was calculated during NREM and REM sleep, and sleep duration, wake after sleep onset (WASO), and apnea hypopnea index (AHI) were based on visually-scored sleep. Results The women who transitioned to postmenopause had increased beta NREM EEG power at the second assessment, compared to women who remained pre-or early premenopausal; no other sleep measures varied by change in menopausal status. In multivariate models the associations remained; statistical controls for self-reported hot flashes did not explain findings. In secondary analysis, NREM beta power at the second assessment was greater among women who transitioned into the postmenopause after adjustments for initial NREM beta power. Conclusions Sleep duration and WASO did not vary by menopause transition group across assessments. Consistent with prior cross-sectional analysis, elevated beta EEG power in NREM sleep was apparent among women who transitioned to postmenopause, suggesting that independent of self-reported hot flashes, the menopausal transition is associated with physiological hyperarousal during sleep.

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Abstract MP081: Association between Sleep Characteristics and Cardiovascular Disease Risk Factors in a Population Sample: Chicago Area Sleep Study

Circulation ◽

10.1161/circ.125.suppl_10.amp081 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Mercedes Carnethon ◽

Kristen L Knutson ◽

Peter J de Chavez ◽

Kwang-Youn Kim ◽

Jason Ng ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Waist Circumference ◽

Sleep Duration ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Sleep Study ◽

Chicago Area ◽

Wrist Actigraphy ◽

Apnea Detection

Introduction: Shortened sleep duration and poor quality sleep are each associated with cardiovascular disease (CVD) risk factors (e.g., hypertension, obesity, diabetes) in prior cross-sectional and longitudinal studies. However, prior studies have often relied on self-reports of sleep duration, which commonly overestimate actual sleep time. Despite known associations of sleep disordered breathing (e.g., obstructive sleep apnea [OSA]) with CVD, prior studies have not excluded people with sleep disorders before testing these associations. Objective: We tested whether sleep duration and quality, measured objectively using wrist actigraphy, was associated with fasting glucose, blood pressure, and anthropometric characteristics in adults without a history of OSA and with apnea hypopnea index (AHI)<15 based on one night using in-home apnea detection equipment. Methods: The Chicago Area Sleep Study (CASS) recruited 531 participants (56% female) ages 35-64 years (mean= 47.5) via commercially available telephone listings. Participants underwent 1 night of screening using in-home apnea detection equipment (ApneaLink TM ) and 411 had AHI<15. Participants wore wrist actigraphs for 7 days (Actiwatch TM ) to determine sleep duration, sleep % (% of time during the sleep interval spent sleeping), and minutes of wake after sleep onset (WASO). The Epworth Sleepiness Scale (ESS) was used to determine daytime sleepiness. Height, weight and waist circumference were measured, hypertension and diabetes were determined according to JNC-VII and American Diabetes Association 2010 criteria, respectively. Results: On average, participants slept for 7 hours (SD=1.2), sleep percentage was 83.2% (SD=20.1), WASO was 41.2 min (SD=21), the ESS score was 6.8 (SD=4.1) and 44% of the sample slept for <7 hours/night. SBP and DBP were 114.5 (SD=13.6) and 70.9 mmHg (SD=9.8), respectively, fasting blood glucose was 92.5 mg/dL (SD=19.6), BMI was 26.2 kg/m 2 (SD=4.5) and waist circumference was 87.4 cm (SD=12.7). The prevalence of obesity (BMI>30), hypertension and diabetes was 21%, 14% and 6.1%, respectively. Sleep duration was the only measure to demonstrate statistically significant (p<0.05) associations with metabolic markers, namely inverse associations with SBP, DBP, BMI, waist circumference and the odds of obesity. Following adjustment for age, race, sex, education, physical activity, depressive symptoms, alcohol intake, smoking and sugared beverage intake, sleep duration (<7 hrs. vs. >7hrs) only remained significantly associated with BMI (β= -1.1 kg/m2, SE=0.42) and waist circumference (β= -3.8 cm, SE=1.2). Conclusions: Sleep duration is associated with CVD risk factors in adults with a low likelihood of OSA. The presence of other adverse health behaviors accounts for much of the observed association.

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