O030 Changes in sleep-wake patterns, circadian timing, and mood in Australian teens during the COVID-19 pandemic

Abstract During the COVID-19 pandemic, schools rapidly transitioned from in-person to remote learning. We examined sleep- and mood-related changes in early adolescents, before and after this transition to assess the impact of in-person vs. remote learning. Sleep-wake timing was measured using wrist-actigraphy and sleep diaries over 1–2 weeks in Year 7 students (age M±SD =12.79±0.42 years) during in-person learning (n=28) and remote learning (n=58; n=27 were studied in both conditions). Circadian timing was measured under a single condition in each individual using salivary melatonin (Dim Light Melatonin Onset; DLMO). Online surveys assessed mood (PROMIS Pediatric Anxiety and Depressive Symptoms) and sleepiness (Epworth Sleepiness Scale – Child and Adolescent) in each condition. During remote vs. in-person learning: (i) on school days, students went to sleep 26 min later and woke 49 min later, resulting in 22 min longer sleep duration (all p<0.0001); (ii) DLMO time did not differ significantly between conditions, although participants woke at a later relative circadian phase (43 minutes, p=0.03) during remote learning; (iii) participants reported significantly lower sleepiness (p=0.048) and lower anxiety symptoms (p=0.006). Depressive symptoms did not differ between conditions. Changes in mood symptoms were not mediated by changes in sleep timing. Although remote learning had the same school start times as in-person learning, removing morning commutes likely enabled adolescents to sleep longer, wake later, and to wake at a later circadian phase. These results indicate that remote learning, or later school start times, may extend sleep duration and improve some subjective symptoms in adolescents.

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Consecutive Days of Racing Does Not Affect Sleep in Professional Road Cyclists

International Journal of Sports Physiology and Performance ◽

10.1123/ijspp.2021-0102 ◽

2021 ◽

pp. 1-4

Author(s):

Charli Sargent ◽

Shona L. Halson ◽

David T. Martin ◽

Gregory D. Roach

Keyword(s):

Sleep Duration ◽

Sleep Onset ◽

Self Report ◽

Activity Monitors ◽

Sleep Diaries ◽

Time In Bed ◽

Road Cycling ◽

Offset Time ◽

The Impact

Purpose: Professional road cycling races are physiologically demanding, involving successive days of racing over 1 to 3 weeks of competition. Anecdotal evidence indicates that cyclists’ sleep duration either increases or deteriorates during these competitions. However, sleep duration in professional cyclists during stage races has not been assessed. This study examined the amount/quality of sleep obtained by 14 professional cyclists competing in the Australian Tour Down Under. Methods: Sleep was assessed using wrist activity monitors and self-report sleep diaries on the night prior to start of the race and on each night during the race. The impact of each day of the race on sleep onset, sleep offset, time in bed, sleep duration, and wake duration was assessed using separate linear mixed effects models. Results: During the race, cyclists obtained an average of 6.8 (0.9) hours of sleep between 23:30 and 07:27 hours and spent 13.9% (4.7%) of time in bed awake. Minor differences in sleep onset (P = .023) and offset times (P ≤.001) were observed during the week of racing, but these did not affect the amount of sleep obtained by cyclists. Interestingly, the 3 best finishers in the general classification obtained more sleep than the 3 worst finishers (7.2 [0.3] vs 6.7 [0.3] h; P = .049). Conclusions: Contrary to anecdotal reports, the amount of sleep obtained by cyclists did not change over the course of the 1-week race and was just below the recommended target of 7 to 9 hours for adults.

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The Impact of Sleep Timing, Sleep Duration, and Sleep Quality on Depressive Symptoms and Suicidal Ideation amongst Japanese Freshmen: The EQUSITE Study

Sleep Disorders ◽

10.1155/2016/8737654 ◽

2016 ◽

Vol 2016 ◽

pp. 1-10 ◽

Cited By ~ 17

Author(s):

Atin Supartini ◽

Takanori Honda ◽

Nadzirah A. Basri ◽

Yuka Haeuchi ◽

Sanmei Chen ◽

...

Keyword(s):

Depressive Symptoms ◽

Suicidal Ideation ◽

Sleep Quality ◽

Sleep Duration ◽

Sleep Onset ◽

Poor Sleep ◽

Sleep Onset Latency ◽

Onset Latency ◽

Poor Sleep Quality ◽

The Impact

Aim. The aim of this study was to identify the impact of bedtime, wake time, sleep duration, sleep-onset latency, and sleep quality on depressive symptoms and suicidal ideation amongst Japanese freshmen.Methods. This cross-sectional data was derived from the baseline survey of the Enhancement of Q-University Students Intelligence (EQUSITE) study conducted from May to June, 2010. A total of 2,631 participants were recruited and completed the following self-reported questionnaires: the Pittsburgh Sleep Quality Index (PSQI), the Center for Epidemiologic Studies Depression Scale (CES-D), and the original Health Support Questionnaires developed by the EQUSITE study research team.Results. Of 1,992 participants eligible for analysis, 25.5% (n=507) reported depressive symptoms (CES-D total score ≥ 16), and 5.8% (n=115) reported suicidal ideation. The present study showed that late bedtime (later than 01:30), sleep-onset latency (≥30 minutes), and poor sleep quality showed a marginally significant association with depressive symptoms. Poor sleep quality was seen to predict suicidal ideation even after adjusting for depressive symptoms.Conclusion. The current study has important implications for the role of bedtime in the prevention of depressive symptoms. Improving sleep quality may prevent the development of depressive symptoms and reduce the likelihood of suicidal ideation.

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Left prefrontal impact links subthalamic stimulation with depressive symptoms

10.1101/665976 ◽

2019 ◽

Cited By ~ 4

Author(s):

Friederike Irmen ◽

Andreas Horn ◽

Philip Mosley ◽

Alistair Perry ◽

Jan Niklas Petry-Schmelzer ◽

...

Keyword(s):

Depressive Symptoms ◽

Depressive Symptom ◽

Structural Connectivity ◽

Electrode Placement ◽

Validation Dataset ◽

Symptom Change ◽

Test Set ◽

Before And After ◽

The Impact ◽

Stn Dbs

AbstractObjectiveSubthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson’s Disease (PD) not only stimulates focal target structures but also affects distributed brain networks. The impact this network modulation has on non-motor DBS effects is not well characterized. By focusing on the affective domain, we systematically investigate the impact of electrode placement and associated structural connectivity on changes in depressive symptoms following STN-DBS which have been reported to improve, worsen or remain unchanged.MethodsDepressive symptoms before and after STN-DBS surgery were documented in 116 PD patients from three DBS centers (Berlin, Queensland, Cologne). Based on individual electrode reconstructions, the volumes of tissue activated (VTA) were estimated and combined with normative connectome data to identify structural connections passing through VTAs. Berlin and Queensland cohorts formed a training and cross-validation dataset used to identify structural connectivity explaining change in depressive symptoms. The Cologne data served as test-set for which depressive symptom change was predicted.ResultsStructural connectivity was linked to depressive symptom change under STN-DBS. An optimal connectivity map trained on the Berlin cohort could predict changes in depressive symptoms in Queensland patients and vice versa. Furthermore, the joint training-set map predicted changes in depressive symptoms in the independent test-set. Worsening of depressive symptoms was associated with left prefrontal connectivity.InterpretationFibers linking the STN electrode with left prefrontal areas predicted worsening of depressive symptoms. Our results suggest that for the left STN-DBS lead, placement impacting fibers to left prefrontal areas should be avoided to maximize improvement of depressive symptoms.

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Late chronotype predicts more depressive symptoms in bipolar disorder over a 5 year follow-up period

International Journal of Bipolar Disorders ◽

10.1186/s40345-021-00233-5 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Parisa Vidafar ◽

Anastasia K. Yocum ◽

Peisong Han ◽

Melvin G. McInnis ◽

Helen J. Burgess

Keyword(s):

Bipolar Disorder ◽

Depressive Symptoms ◽

Depressive Mood ◽

Self Report ◽

Circadian Timing ◽

Clinical Interviews ◽

Circadian Phase ◽

Patients At Risk ◽

Larger Sample

Abstract Background There is increasing evidence that bipolar disorder is influenced by circadian timing, including the timing of sleep and waking activities. Previous studies in bipolar disorder have shown that people with later timed daily activities, also known as late chronotypes, are at higher risk for subsequent mood episodes over the following 12–18 months. However, these studies were limited to euthymic patients and smaller sample sizes. The aim of the current study was to further examine baseline chronotype as a potentially important predictor of mood-related outcomes in a larger sample of individuals with bipolar disorder and over the longest follow up period to date, of 5 years. Participants included 318 adults diagnosed with bipolar I and II (19–86 years) who were enrolled in the Prechter Longitudinal Study of Bipolar Disorder. Results Participants with a late chronotype were found to be more likely to have mild to more severe depressive symptoms (PHQ-9 ≥ 5) as captured with PHQ-9 assessments every 2 months over the 5 year follow up period. This higher risk for depressive symptoms remained even after adjusting for age, sex and mood at baseline. Additionally, late chronotypes reported fewer hypomania/mania episodes during the 5 year follow up, as derived from clinical interviews every two years. Conclusions These results highlight the potential clinical usefulness of a single self-report question, in identifying patients at risk for a more depressive mood course. The results also suggest that circadian phase advancing treatments, that can shift circadian timing earlier, should be explored as a means to reduce depressive symptoms in late chronotypes with bipolar disorder.

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The Impact of Multidisciplinary Rehabilitation on Depressive Symptoms in Hemodialysis Patients

Western Journal of Nursing Research ◽

10.1177/0193945916685091 ◽

2017 ◽

Vol 40 (5) ◽

pp. 738-752

Author(s):

Shirin Mohammadi-Kalaveh ◽

Tahereh Toulabi ◽

Shirin Hasanvand ◽

Mohammad Gholami ◽

Fatemeh Ghasemi

Keyword(s):

Depressive Symptoms ◽

Depressive Symptom ◽

Psychological Problem ◽

Hemodialysis Patients ◽

Rehabilitation Program ◽

Multidisciplinary Rehabilitation ◽

Significant Difference ◽

Before And After ◽

Quasi Experimental ◽

The Impact

Depressive symptom is the most frequent psychological problem reported among chronic kidney disease (CKD) patients being treated by hemodialysis. This article evaluates the effectiveness of multidisciplinary rehabilitation on depressive symptoms in hemodialysis patients and clarifies the role of nurses. This quasi-experimental study was done on 30 patients in the hemodialysis center (educational hospital) in 2013. Eight rehabilitation plans were conducted by nurses. Beck Depression Inventory (BDI) was used before and after intervention. Our data were analyzed using descriptive and inferential statistics. Result of this study shows that there was a significant difference between mean depressive symptom score before (36.4 ± 10.9) and after (10.5 ± 3.1) rehabilitation ( p < .001). It is recommended that rehabilitation program be implemented in all hemodialysis centers with the participation of specialists in different fields.

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Abstract MP19: Impact of Change in Bedtime Variability on Body Composition: Secondary Findings From the Go Red for Women Strategically Focused Research Network

Circulation ◽

10.1161/circ.141.suppl_1.mp19 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Cited By ~ 1

Author(s):

Marie-Pierre St-Onge ◽

Ayanna Campbell ◽

Faris M Zuraikat ◽

Bin Cheng

Keyword(s):

Metabolic Syndrome ◽

Body Composition ◽

Standard Deviation ◽

Sleep Duration ◽

Research Network ◽

Sleep Restriction ◽

Study Phase ◽

Sleep Phase ◽

Wrist Actigraphy ◽

The Impact

Variability in daily sleep duration and unstable bedtimes are emerging sleep-related factors that have been linked to metabolic syndrome. For example, in longitudinal studies, the odds of developing metabolic syndrome over 6.3 y median follow-up are 1.36 for every 1 h increase in sleep onset variability (standard deviation of bedtimes measured over 7 nights of actigraphy) in fully adjusted models. However, whether reducing bedtime variability improves markers of disease risk has not been tested. Here, we assessed whether body composition was impacted by changes in bedtime variability over a 6-wk period during which women were instructed to maintain healthy, habitual sleep patterns. This was a single arm of a randomized trial originally designed to test the impact of sleep restriction on cardiometabolic risk factors. Women, aged 20 y and older and with body mass index 20-33 kg/m 2 were recruited. All women were required to have adequate sleep duration of 7-9 h/night, determined over 2 wk using wrist-worn actigraphy. Upon randomization, women were given bed and wake time prescriptions aligned with their average screening bed and wake times in order to ensure maintenance of adequate sleep duration over the 6 wk study phase. The alternate phase required women to delay their bedtimes to achieve sleep restriction. Only data from the adequate sleep phase were used for the present analyses. Bedtime variability and body composition data were available for 37 women (age 34.9±12.4 y, BMI 24.7±2.9 kg/m 2 , screening sleep duration 7.58±0.49 h/night). Body composition was measured at baseline (0 wk) and endpoint (6 wk) using magnetic resonance imaging. Bedtime and sleep data were collected weekly using wrist actigraphy. Change in bedtime variability was calculated as the difference in the standard deviation of bedtimes measured during the 2-wk screening period and the 6-wk study phase. Sleep duration did not differ between screening and the average of 6 wk of the sleep phase (-4.8±24.7min, P=0.24). Average percent change in bedtime SD was 24.4±25.2% in those who increased their bedtime variability and -39.9±23.5% in those who reduced their bedtime variability. Results showed that, compared to women who increased or did not change (n=8) bedtime variability, women who reduced their bedtime variability (n=29) during the intervention had significant reductions in total (reduced: -0.52±0.98 vs increase/no change: 0.63±0.41 L, P<0.001) and subcutaneous adipose tissue (reduced: -0.48±0.86 vs increase/no change: 0.56±0.31 L, P<0.001). Thus, results provide novel preliminary information showing that reducing bedtime variability can improve body composition over time. Given that bedtimes are highly individualized, this may provide an easy public health message to maintain healthy sleep hygiene, particularly stable bedtime routine, to achieve better weight management and reduced CVD risk.

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Parents still matter: the influence of parental enforcement of bedtime on adolescents’ depressive symptoms

SLEEP ◽

10.1093/sleep/zsz287 ◽

2019 ◽

Vol 43 (5) ◽

Author(s):

Jack S Peltz ◽

Ronald D Rogge ◽

Heidi Connolly

Keyword(s):

Depressive Symptoms ◽

Sleep Duration ◽

Energy Levels ◽

Well Being ◽

Mediation Model ◽

Caffeine Consumption ◽

Limit Setting ◽

Adolescent Sleep ◽

School Start Times ◽

Collaborative Autonomy

Abstract Study Objectives The aim of the current study was to test a multilevel mediation model that examined how adolescent sleep duration might be linked to depressive symptoms via their daytime energy levels. Furthermore, the study examined how parents’ enforcement of various types of bedtime rules predicted the duration of adolescent sleep. Methods A total of 193 adolescent (ages 14–17; Mage = 15.7 years old, SD = .94; 54.4% female; 71% Caucasian) and parent dyads completed baseline, online surveys, and adolescents also completed online 7-day, twice-daily (i.e. morning and evening) reports of their sleep duration (morning diary) and their energy levels and depressive symptoms throughout the day (evening diary). Parents (Mage = 47.6 years old, SD = 5.4; 80% female) completed assessments of enforcement of bedtime-related rules (i.e. bedtime, cessation of electronic media usage, prohibiting afternoon/evening caffeine consumption). Multilevel modeling enabled the testing of the mediation model both at the between-person level and within individuals. Results Results suggested that adolescents’ energy levels mediated the association between adolescents’ sleep duration and depressive symptoms. Furthermore, both greater enforcement of bedtimes and later school start times predicted longer sleep durations for adolescents, and were indirectly associated with adolescents’ depressive symptoms. Conclusions These findings underscore the importance of adolescents obtaining sufficient sleep to support their mental health and suggest a critical point of intervention for preventing or decreasing insufficient sleep. Given the diverse threats to adolescents’ sleep as well as adolescents’ desire for greater independence, collaborative, autonomy-promoting bedtime limit-setting is recommended to support adolescents’ well-being.

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0267 School Night Sleep Duration Effect on Risk for In-and-Out of School Suspensions: An Investigation in a Middle-School Aged Sample

SLEEP ◽

10.1093/sleep/zsaa056.265 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A102-A102

Author(s):

J D Cook ◽

P E Peppard ◽

E E Blair ◽

K M Tran ◽

D T Plante

Keyword(s):

Middle School ◽

Sleep Duration ◽

Full Model ◽

Aged Sample ◽

School Suspension ◽

Final Sample ◽

Increased Risk ◽

School Start Times ◽

The Impact ◽

Out Of School

Abstract Introduction Sleep plays an important role in adolescent education and development. Sleep impacts student school attendance, academic performance, and daytime behaviors. There has been limited investigation into the impact on sleep duration (SD) on school suspension risk. Given the growing public health and policy focus on altering school start times to increase SD, this study assessed SD association with school suspension risk using a middle-school aged sample from the Madison (Wisconsin) Metropolitan School District (MMSD), prior to implementation of a planned district-wide delay in middle school start times. Methods 4,175 middle-school aged students from 12 MMSD schools completed a sleep survey, which included school-night SD (SNSD). Self-reported SNSD between 4-and-12 hours served as criterion for inclusion in final sample. Mixed effects modeling was employed with students nested within school. Logistic regression determined SNSD association with in-school (ISS) and out-of-school (OSS) suspensions. ISS and OSS were dichotomized (No ISS/OSS = 0; nonzero ISS/OSS = 1) to serve as outcome variables. Full model covariates included age, sex, race, circadian preference, parent educational level, homelessness, free and reduced lunch, and special education status. Results Final sample included 3,860 students. Shorter SNSD associated with greater likelihood of OSS [OR = 0.83, 95% CI (-0.28, -0.09), X2 = 16.1, p < 0.0001], but not ISS [OR = 0.97, 95% CI (-0.14, -0.070), X2 = 0.44, p = 0.51]. Significance between SNSD and OSS was maintained in the full model [OR = 0.84, 95% CI (-0.27, -0.08), X2 = 13.2, p = 0.0003]. Each additional hour of sleep associated with 16% lower risk of OSS. Conclusion These results suggest that students with shorter SD are at increased risk for OSS, which further highlights the potential deleterious impact of short SD on adolescent educational experience. Support This research was generously supported by a grant from the Madison Education Partnership (MEP).

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063 Differential Impact of Sleep Duration on Nocturnal Blood Pressure Dipping Between Men and Women

SLEEP ◽

10.1093/sleep/zsab072.062 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A26-A26

Author(s):

Jeremy Bigalke ◽

Ian Greenlund ◽

Jennifer Nicevski ◽

Neha John-Henderson ◽

Jason Carter

Keyword(s):

Blood Pressure ◽

Sleep Duration ◽

Significant Relationship ◽

Sleep Time ◽

Cardiovascular Complications ◽

Poor Sleep ◽

Sample Population ◽

Wrist Actigraphy ◽

Nocturnal Blood Pressure Dipping ◽

The Impact

Abstract Introduction There is growing evidence that poor sleep may have a greater impact on the development of cardiovascular complications in women compared to men. However, most studies that have evaluated the impact of sex on sleep insufficiencies and blood pressure (BP) have not utilized ambulatory BP, and often rely more heavily on subjective sleep diaries as opposed to objective sleep assessment. The purpose of this study was to examine the impact of sex on the relationship between objectively measured sleep and nocturnal BP dipping. We hypothesized that poor sleep would be associated with decreased nocturnal BP dipping, and that this association would be stronger in women. Methods Total sleep time (TST) and sleep efficiency (SE) were monitored in fifty adults (31 men, 19 women; 36±3 years; 26±1 kg/m2) utilizing wrist actigraphy monitoring over the course of 5–14 days (Avg: 10±0 days). On a separate occasion, participants underwent a 24-hour ambulatory BP recording session. Independent samples T-tests were used to compare characteristics between sexes. Partial correlations controlling for age and BMI were utilized to probe relationships between sleep and nocturnal BP dipping. Results TST and SE were not different between sexes. However, women exhibited reduced mean arterial pressure (MAP: 86±1 vs. 90±1 mmHg, P=0.026) compared to men. Partial correlation revealed a significant relationship between TST and the magnitude of nocturnal MAP dipping in the sample population (R = 0.460, P<0.001). When stratified by sex, this significant relationship persisted in men (R = 0.610, P<0.001), but not women (R = 0.108, P>0.05). In contrast, no relationship was observed between SE and nocturnal MAP dipping (R = -0.052, P>0.05) for the sample population. Similarly, SE did not correlate with nocturnal MAP dipping in men (R = -0.080, P>0.05) or women (R = 0.045, P>0.05). Conclusion Contrary to our initial hypothesis, our results demonstrate that actigraphy-based TST is associated with nocturnal BP dipping in healthy men, but not women. This suggests a relation between impaired nocturnal BP regulation and habitual sleep duration, potentially predisposing men to an increased overall risk for cardiovascular complications. Support (if any) National Institutes of Health (HL-098676 and HL-122919)

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Ethnicity Differences in Sleep Changes Among Prehypertensive Adults Using a Smartphone Meditation App: Dose-Response Trial

JMIR Formative Research ◽

10.2196/20501 ◽

2020 ◽

Vol 4 (10) ◽

pp. e20501

Author(s):

John C Sieverdes ◽

Frank A Treiber ◽

Christopher E Kline ◽

Martina Mueller ◽

Brenda Brunner-Jackson ◽

...

Keyword(s):

Sleep Quality ◽

Sleep Duration ◽

Dose Response ◽

Dose Effect ◽

Feasibility Trial ◽

Sleep Complaints ◽

Wrist Actigraphy ◽

Multimethod Assessment ◽

The Impact

Background African Americans (AAs) experience greater sleep quality problems than non-Hispanic Whites (NHWs). Meditation may aid in addressing this disparity, although the dosage levels needed to achieve such benefits have not been adequately studied. Smartphone apps present a novel modality for delivering, monitoring, and measuring adherence to meditation protocols. Objective This 6-month dose-response feasibility trial investigated the effects of a breathing awareness meditation (BAM) app, Tension Tamer, on the secondary outcomes of self-reported and actigraphy measures of sleep quality and the modulating effects of ethnicity of AAs and NHWs. Methods A total of 64 prehypertensive adults (systolic blood pressure <139 mm Hg; 31 AAs and 33 NHWs) were randomized into 3 different Tension Tamer dosage conditions (5,10, or 15 min twice daily). Sleep quality was assessed at baseline and at 1, 3, and 6 months using the Pittsburgh Sleep Quality Index (PSQI) and 1-week bouts of continuous wrist actigraphy monitoring. The study was conducted between August 2014 and October 2016 (IRB #Pro00020894). Results At baseline, PSQI and actigraphy data indicated that AAs had shorter sleep duration, greater sleep disturbance, poorer efficiency, and worse quality of sleep (range P=.03 to P<.001). Longitudinal generalized linear mixed modeling revealed a dose effect modulated by ethnicity (P=.01). Multimethod assessment showed a consistent pattern of NHWs exhibiting the most favorable responses to the 5-min dose; they reported greater improvements in sleep efficiency and quality as well as the PSQI global value than with the 10-min and 15-min doses (range P=.04 to P<.001). Actigraphy findings revealed a consistent, but not statistically significant, pattern in the 5-min group, showing lower fragmentation, longer sleep duration, and higher efficiency than the other 2 dosage conditions. Among AAs, actigraphy indicated lower sleep fragmentation with the 5-min dose compared with the 10-min and 15-min doses (P=.03 and P<.001, respectively). The 10-min dose showed longer sleep duration than the 5-min and 15-min doses (P=.02 and P<.001, respectively). The 5-min dose also exhibited significantly longer average sleep than the 15-min dose (P=.03). Conclusions These findings indicate the need for further study of the potential modulating influence of ethnicity on the impact of BAM on sleep indices and user-centered exploration to ascertain the potential merits of refining the Tension Tamer app with attention to cultural tailoring among AAs and NHWs with pre-existing sleep complaints.

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