P153 Sleep timing and chronotype in perinatal periods: Longitudinal changes and associations with wellbeing from pregnancy to 2 years postpartum

Abstract Introduction Significant changes to sleep occur during perinatal periods. Existing research focuses on sleep duration and quality, but not sleep timing or chronotype. This study investigated change trajectories of sleep timing and chronotype from late pregnancy to two years postpartum, and examined associations between chronotype and insomnia, sleep-related impairment, and mood at seven different perinatal time-points. Methods Data were from a 2-arm randomised controlled trial testing behavioural sleep and diet interventions. A community sample of nulliparous females without severe sleep/mental health conditions participated. Participants self-reported bedtime, rise-time, chronotype (short Morningness-Eveningness Questionnaire), Insomnia Severity Index, and PROMIS Depression, Anxiety, and Sleep-Related Impairment over seven time points: gestation weeks 30 and 35, and postpartum months 1.5, 3, 6, 12 and 24. Results 163 participants (mean age 33.4±3.4 years) took part. Mixed effects models adjusting for age and group allocation showed that both bed- and rise-times became progressively earlier by approximately 20–30 minutes over time (p<.001); chronotype shifted progressively towards more morningness (p<.01). After adjusting for covariates (sleep duration and efficiency, mental health history, social support, age, group allocation), greater morningness was significantly associated with lower symptoms of insomnia and sleep-related impairment over time (p-values<.001); at each time-point, associations between chronotype and symptoms of depression and anxiety were non-significant (p-values>0.65). Conclusions Sleep timing and chronotype became progressively earlier over the first two postpartum years. Greater morningness was associated with less sleep complaints and sleep-related daytime impairment during the postpartum period. The mechanisms of these findings may be investigated through further research.

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225 Sleep Timing and Chronotype in Mothers: Longitudinal Changes and Associations with Wellbeing from Pregnancy to 2 Years Postpartum

SLEEP ◽

10.1093/sleep/zsab072.224 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A90-A90

Author(s):

Sumedha Verma ◽

Donna Pinnington ◽

Rachel Manber ◽

Bei Bei

Keyword(s):

Mental Health ◽

Sleep Duration ◽

Community Sample ◽

P Values ◽

Longitudinal Changes ◽

Sleep Timing ◽

Longitudinal Associations ◽

Daytime Impairment ◽

Group Allocation ◽

Over Time

Abstract Introduction Women experience significant changes to sleep during perinatal periods. Existing research focuses on sleep duration and quality, but not sleep timing or chronotype (i.e., preferred timing for activity and sleep). This study investigated change trajectories of sleep timing and chronotype from late pregnancy to two years postpartum, and examined longitudinal associations between chronotype and insomnia, sleep-related daytime impairment, and mood. Methods Data were from a 2-arm randomized controlled trial testing behavioral sleep and diet interventions. A community sample of nulliparous women without severe sleep/mental health conditions participated. Women self-reported bedtime, risetime, chronotype (reduced Morningness-Eveningness Questionnaire), Insomnia Severity Index, and PROMIS Depression, Anxiety, and Sleep-Related Impairment over 7 time points: 30 and 35 weeks’ gestation, and postpartum months 1.5, 3, 6, 12 and 24. Results 163 women (mean age 33.35 ± 3.42 years) took part. Mixed effects models controlling for age and group allocation showed that both bed- and risetimes became progressively earlier over time by approximately 20-30 minutes on average (p < .001); chronotype also shifted progressively towards morningness (p < .01). After controlling for covariates (sleep duration and efficiency, mental health history, social support, age, group allocation), greater morningness was significantly associated with lower symptoms of insomnia and sleep-related impairment over time (p-values < .001); longitudinal associations between chronotype and symptoms of depression and anxiety were non-significant (p-values > .65). Conclusion This is one of the first studies to examine longitudinal changes in sleep timing and chronotype from pregnancy to two years postpartum. Sleep timing and chronotype became progressively earlier over the first two postpartum years. The magnitude of changes is beyond what is expected with increasing age. Greater morningness was associated with lower sleep complaints and sleep-related daytime impairment during the postpartum period. The mechanisms underlying these associations require further research. Support (if any) Australasian Sleep Association, Monash University, Australian Government RTP Scholarship and National Health and Medical Research Council.

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Differentiating perinatal Insomnia Disorder and sleep disruption: A longitudinal study from pregnancy to 2 years postpartum

SLEEP ◽

10.1093/sleep/zsab293 ◽

2022 ◽

Author(s):

Nina Quin ◽

Jin Joo Lee ◽

Donna M Pinnington ◽

Louise Newman ◽

Rachel Manber ◽

...

Keyword(s):

Mental Health ◽

Longitudinal Study ◽

Controlled Trial ◽

Structured Interview ◽

Sleep Disruption ◽

Depression And Anxiety ◽

P Values ◽

Sleep Complaints ◽

Insomnia Disorder ◽

Randomised Controlled

Abstract Study Objectives Insomnia Disorder diagnoses require persistent sleep complaints despite “adequate sleep opportunity”. Significant perinatal sleep disruption makes this diagnosis challenging. This longitudinal study distinguished between Insomnia Disorder and Perinatal Sleep Disruption and their sleep and mental health correlates. Methods 163 nulliparous females (age M±SD=33.35±3.42) participating in a randomised-controlled trial repeated the Insomnia Disorder module of the Duke Structured Interview for Sleep Disorders and PROMIS measures for sleep and mental health at 30 and 35 weeks’ gestation, and 1.5, 3, 6, 12, and 24 months postpartum (944 interviews, 1009 questionnaires completed). We compared clinical features when DSM-5 Insomnia Disorder criteria were: (1) met (Insomnia Disorder), (2) not met only because of the sleep opportunity criteria (Perinatal Sleep Disruption), and (3.) not met due to other criteria (Low Complaint). Results Proportions of Insomnia Disorder were 16.0% and 19.8% during early and late third trimester, and ranged 5.3-11.7% postpartum. If the sleep opportunity criteria were not considered, rates of Insomnia would be 2-4 times higher (21.4-40.4%) across time-points. Mixed effects models adjusting for covariates showed that compared to Low Complaint, both Insomnia Disorder and Perinatal Sleep Disruption scored significantly higher on insomnia and sleep disturbance scales, sleep effort, and sleep-related impairments (p-values<.01), but depression and anxiety were comparable (p-values>.12). Conclusion Assessing sleep complaints without considering sleep opportunity can result in over-diagnosis of Insomnia Disorder in the perinatal periods. Insomnia Disorder and perinatal sleep disruption were associated with adverse sleep and mood outcomes, and need to be carefully differentiated and appropriately addressed.

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Levels of physical activity in four domains and affective wellbeing before and during the Covid-19 pandemic

Archives of Public Health ◽

10.1186/s13690-021-00651-y ◽

2021 ◽

Vol 79 (1) ◽

Author(s):

Eliane S. Engels ◽

Michael Mutz ◽

Yolanda Demetriou ◽

Anne K. Reimers

Keyword(s):

Mental Health ◽

Physical Activity ◽

Protective Factor ◽

Total Sample ◽

Poor Mental Health ◽

German Population ◽

Time Points ◽

Sport And Exercise ◽

Over Time ◽

Time Point

Abstract Background Latest studies indicated that the general mental health level is low during the pandemic. Probably, this deterioration of the mental health situation is partly due to declines in physical activity. The aim of this study was to investigate differences in and the association between affective wellbeing and levels of different domains of physical activity at three time points before and during the pandemic. Method We used a nationwide online panel with a trend data design encompassing a total sample of N = 3517, representing the German population (> 14 years). Four different activity domains (sport and exercise, light outdoor activity, housework/gardening, active travel) and affective wellbeing (positive and negative affect) were assessed at three time points before and during the Covid-19 pandemic (October 2019, March 2020, October 2020). Results Multivariate analyses of variance (MANOVA) indicate differences regarding affective wellbeing over the three time points with the lowest values at the second time point. Levels of activity in the four domains differed significantly over time with the strongest decrease for sport and exercise from the first to the second time point. Partial correlations indicated that the relationships between sport and exercise and positive affect were most consistent over time. Conclusions Overall, our findings suggest that physical activity plays a particularly important role in the pandemic period as a protective factor against poor mental health. Especially sports and exercise seem to be supportive and should be encouraged, e.g. by providing additional support in finding adequate outdoor, home-based or digital substitutes.

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T3 Are Burns a Chronic Condition: Examining Physical and Mental Functioning up to 20 Years After Injury

Journal of Burn Care & Research ◽

10.1093/jbcr/irab032.002 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

pp. S2-S3

Author(s):

Callie Abouzeid ◽

Audrey E Wolfe ◽

Gretchen J Carrougher ◽

Nicole S Gibran ◽

Radha K Holavanahalli ◽

...

Keyword(s):

Mental Health ◽

Hospital Stay ◽

National Database ◽

Time Points ◽

Patient Reported ◽

Burn Survivors ◽

Population Demographic ◽

The Impact ◽

Over Time

Abstract Introduction Burn survivors often face many long-term physical and psychological symptoms associated with their injury. To date, however, few studies have examined the impact of burn injuries on quality of life beyond 2 years post-injury. The purpose of this study is to examine the physical and mental well-being of burn survivors up to 20 years after injury. Methods Data from the Burn Model System National Database (1997–2020) were analyzed. Patient-reported outcome measures were collected at discharge with a recall of preinjury status, and then at 5, 10, 15, and 20 years after injury. Outcomes examined were the Physical Component Summary (PCS) and Mental Component Summary (MCS) of the Short Form-12. Trajectories were developed using linear mixed methods model with repeated measures of PCS and MCS scores over time and controlling for demographic and clinical variables. The model fitted score trajectory was generated with 95% confidence intervals to demonstrate score changes over time and associations with covariates. Results The study population included 420 adult burn survivors with a mean age of 42.4 years. The population was mainly male (66%) and white (76.4%) with a mean burn size of 21.5% and length of hospital stay of 31.3 days. Higher PCS scores were associated with follow-up time points closer to injury, shorter hospital stay, and younger age. Similarly, higher MCS scores were associated with earlier follow-up time points, shorter hospital stay, female gender, and non-perineal burns. MCS trajectories are demonstrated in the Figure. Conclusions Burn survivors’ physical and mental health worsened over time. Such a trend is different from previous reported results for mental health in the general population. Demographic and clinical predictors of recovery over time are identified.

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Testing the Effects of the Shamiri Intervention and its Components on Anxiety, Depression, Wellbeing, and Academic Functioning in Kenyan Adolescents: Study Protocol for a Five-Arm Randomized Controlled Trial

10.31234/osf.io/6xdka ◽

2021 ◽

Author(s):

Katherine E. Venturo-Conerly ◽

Tom L Osborn ◽

Akash R Wasil ◽

Huong Le ◽

Emily Corrigan ◽

...

Keyword(s):

Mental Health ◽

Academic Performance ◽

Controlled Trial ◽

Growth Mindset ◽

Anxiety Symptoms ◽

Control Group ◽

Randomized Controlled ◽

Multi Level ◽

Secondary Outcomes ◽

Over Time

Background: Treatments for youth mental disorders are a public health priority, especially in sub-Saharan Africa (SSA), where treatment options remain limited due to high cost, elevated stigma, and lack of trained mental health professionals. Brief, accessible, and non-stigmatizing community-based interventions delivered by lay-providers may help address treatment needs in SSA. One such intervention, the Shamiri Intervention, consisting of three elements (growth mindset, gratitude, and value affirmation) has been tested in randomized controlled trials with school-going Kenyan adolescents. This three-element Shamiri Intervention has been shown to significantly reduce depression and anxiety symptoms and improve social support and academic performance relative to a control group. In this trial, we aim to investigate the effects of each element of the Shamiri Intervention.Methods: In this five-arm randomized controlled trial, we will test each of the intervention components (growth mindset, gratitude, and value affirmation) against the full Shamiri Intervention and against a study-skills control intervention. Students (Nplanned=1288) at participating secondary schools who are interested in participating in this universal intervention will be randomized in equal numbers into the five groups. The students will meet in groups of 8-15 students led by local high school graduate lay-providers. These lay-providers will receive 10 hours of training, plus expert supervision once a week throughout the intervention delivery. Multi-level models will be used to compare trajectories over time of the primary outcomes (depressive symptoms, anxiety symptoms, academic performance, and wellness) and secondary outcomes in each intervention group to the control group. Multi-level models will also be used to compare trajectories over time of the primary outcomes (depressive symptoms, anxiety symptoms, academic performance, and wellness) and secondary outcomes of those in the single-element interventions compared to the full Shamiri Intervention. Finally, effect sizes (calculated as mean gain scores) will be used to compare all groups on all measures. Discussion: This trial will shed light on the mechanisms and outcomes targeted by each individual intervention, helping prioritize which mental health interventions are most important to disseminate.

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Accelerometry-assessed sleep duration and timing in late childhood and adolescence in Scottish schoolchildren: a feasibility study

10.1101/2020.04.06.20055434 ◽

2020 ◽

Author(s):

Laura M. Lyall ◽

Natasha Sangha ◽

Cathy Wyse ◽

Elaine Hindle ◽

Dawn Haughton ◽

...

Keyword(s):

Mental Health ◽

Depressive Symptoms ◽

Sleep Duration ◽

Activity Patterns ◽

School Setting ◽

Childhood And Adolescence ◽

Developmental Phase ◽

Health And Wellbeing ◽

Sleep Timing ◽

Primary School Pupils

AbstractChildren and adolescents commonly suffer from sleep and circadian rhythm disturbances, which may contribute to poorer mental health and wellbeing during this critical developmental phase. Many studies however rely on self-reported sleep measures. This study assessed whether accelerometry data collection was feasible within the school setting as a method for investigating the extent of sleep and circadian disruption, and associations with subjective wellbeing, in Scotland. Fourteen days of wrist-worn accelerometry data were collected from 69 pupils, aged 10-14 years. Objective measures of sleep timing, sleep duration and circadian rest-activity patterns were derived. Questionnaires assessed subjective sleep timing, depressive symptoms, and experiences of wearing the accelerometer. Pupils slept on average less than 8 hours per night, failing to meet standard age-specific recommendations. Sleep timing was later and duration longer on weekends compared to weekdays (B = 0.87, 95% confidence interval (CI) 0.70, 1.04; B = 0.49, 95% CI 0.29, 0.69), indicating social jetlag. Lower daytime activity was correlated with higher depressive symptoms (r = -0.84, p = 0.008). Compared to primary school pupils, secondary pupils had shorter sleep window duration and lower circadian relative amplitude. Over half of participants reported some discomfort/inconvenience wearing the accelerometer. These data highlight that inadequate sleep is prevalent in this sample of schoolchildren. Future, larger scale investigations will examine in more detail the associations between sleep, circadian function and physical activity with mental health and wellbeing.

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Accelerometry-assessed sleep duration and timing in late childhood and adolescence in Scottish schoolchildren: A feasibility study

PLoS ONE ◽

10.1371/journal.pone.0242080 ◽

2020 ◽

Vol 15 (12) ◽

pp. e0242080

Author(s):

Laura M. Lyall ◽

Natasha Sangha ◽

Cathy Wyse ◽

Elaine Hindle ◽

Dawn Haughton ◽

...

Keyword(s):

Mental Health ◽

Depressive Symptoms ◽

Sleep Duration ◽

Activity Patterns ◽

School Setting ◽

Childhood And Adolescence ◽

Developmental Phase ◽

Health And Wellbeing ◽

Sleep Timing ◽

Primary School Pupils

Children and adolescents commonly suffer from sleep and circadian rhythm disturbances, which may contribute to poorer mental health and wellbeing during this critical developmental phase. Many studies however rely on self-reported sleep measures. This study assessed whether accelerometry data collection was feasible within the school setting as a method for investigating the extent of sleep and circadian disruption, and associations with subjective wellbeing, in Scotland. Fourteen days of wrist-worn accelerometry data were collected from 69 pupils, aged 10–14 years. Objective measures of sleep timing, sleep duration and circadian rest-activity patterns were derived. Questionnaires assessed subjective sleep timing, depressive symptoms, and experiences of wearing the accelerometer. Pupils slept on average less than 8 hours per night, failing to meet standard age-specific recommendations. Sleep timing was later and duration longer on weekends compared to weekdays (B = 0.87, 95% confidence interval (CI) 0.70, 1.04; B = 0.49, 95% CI 0.29, 0.69), indicating social jetlag. Lower daytime activity was correlated with higher depressive symptoms (r = -0.84, p = 0.008). Compared to primary school pupils, secondary pupils had shorter sleep window duration and lower circadian relative amplitude. Over half of participants reported some discomfort/inconvenience wearing the accelerometer. These data highlight that inadequate sleep is prevalent in this sample of schoolchildren. Future, larger scale investigations will examine in more detail the associations between sleep, circadian function and physical activity with mental health and wellbeing.

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Affection deprivation during the COVID-19 pandemic: A panel study

Journal of Social and Personal Relationships ◽

10.1177/02654075211046587 ◽

2021 ◽

pp. 026540752110465

Author(s):

Colin Hesse ◽

Alan Mikkelson ◽

Xi Tian

Keyword(s):

Mental Health ◽

Life Satisfaction ◽

Panel Study ◽

Exchange Theory ◽

Future Research ◽

Relational Communication ◽

Time Points ◽

The Relationship ◽

Practical Implications ◽

Over Time

This study examined the longer-term effects of the COVID-19 lockdowns on relational communication and mental health. Specifically, the study used the theoretic premises of Affection Exchange Theory (AET: Floyd, 2006 ) to hypothesize connections between affection deprivation and several indices of mental health, including loneliness and depression. The study used a panel design to recruit participants at different time points during the COVID-19 lockdowns. We employed growth modeling to examine how affection deprivation influenced mental health outcomes over time. As predicted, affection deprivation was associated with stress, loneliness, and depression. Contrary to our hypotheses, affection deprivation was not associated with life satisfaction and happiness. In addition, the results showed that sex moderated the relationship between affection deprivation and depression. These findings are discussed in detail, including both theoretical and practical implications as well as directions for future research.

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Double-blinding of an acupuncture randomized controlled trial optimized with clinical translational science award resources

Clinical Trials ◽

10.1177/1740774520934910 ◽

2020 ◽

Vol 17 (5) ◽

pp. 545-551

Author(s):

Alana D Steffen ◽

Larisa A Burke ◽

Heather A Pauls ◽

Marie L Suarez ◽

Yingwei Yao ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Systematic Approach ◽

Controlled Trial ◽

Phase 2 ◽

Double Blind ◽

Randomized Controlled ◽

Group Assignment ◽

Trial Testing ◽

Group Allocation ◽

Over Time

Background Clinical trial articles often lack detailed descriptions of the methods used to randomize participants, conceal allocation, and blind subjects and investigators to group assignment. We describe our systematic approach to implement and measure blinding success in a double-blind phase 2 randomized controlled trial testing the efficacy of acupuncture for the treatment of vulvodynia. Methods Randomization stratified by vulvodynia subtype is managed by Research Electronic Data Capture software’s randomization module adapted to achieve complete masking of group allocation. Subject and acupuncturist blinding assessments are conducted multiple times to identify possible correlates of unblinding. Results At present, 48 subjects have been randomized and completed the protocol resulting in 87 subject and 206 acupuncturist blinding assessments. Discussion Our approach to blinding and blinding assessment has the potential to improve our understanding of unblinding over time in the presence of possible clinical improvement.

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Influence of an increased number of physical education lessons on the motor performance of adolescents–A non-interventional cohort study

PLoS ONE ◽

10.1371/journal.pone.0258305 ◽

2021 ◽

Vol 16 (10) ◽

pp. e0258305

Author(s):

Astrid Reif ◽

Christoph Triska ◽

Michael Nader ◽

Jürgen Scharhag ◽

Harald Tschan ◽

...

Keyword(s):

Cohort Study ◽

Physical Education ◽

Motor Performance ◽

Control Group ◽

Observation Group ◽

Time Points ◽

Sports Club ◽

Group Allocation ◽

Over Time ◽

Observation Period

Increasing the amount of regular physical education lessons in school is currently discussed in many countries in order to increase physical activity in youth. The purpose of this study was to compare the motor performance of pupils from an observation group participating in a school trial of two additional physical education lessons (5 lessons of each 50 min/week) without a specific intervention program to a control group with a regular amount of three physical education lessons (3 lessons of each 50 min/week) as indicated by the standard Austrian school curriculum. In this cohort study motor performance of 140 adolescents (12.7±0.5 years) was assessed by means of the German Motor Performance Test 6–18 over a period of 1.5 years with measurement time points before (T1), after eight months (T2) and at the end of the observation period (T3). Two- and three-way mixed analysis of variance were used to detect time, group and interaction effects. Although the observation group demonstrated a higher total motor performance score at all time points (P = 0.005), the improvement over time in total motor performance (P < 0.001) was more pronounced in the control group. Girls and boys developed differently over time (time*gender interaction: P = 0.001), whereby group allocation did not affect this interaction (time*gender*group: P = 0.167). Anyway, girls of control group tend to benefit most of additional physical education lessons. Sports club members scored significantly higher in motor performance across the observation period (P = 0.018) irrespective of group allocation. These findings indicate that there could be a ceiling effect in what the pupils could achieve in terms of motor performance as the pupils of the observation group might have reached this point earlier than their counterparts in the control group. Nevertheless, sports club membership seems to reveal some benefits. Whether improving quality and specificity of the single physical lessons might be superior to merely adding additional ones needs to be confirmed in future studies.

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