scholarly journals Transdermal electrical neuromodulation of the trigeminal sensory nuclear complex improves sleep quality and mood.

2016 ◽  
Author(s):  
Alyssa M. Boasso ◽  
Hailey Mortimore ◽  
Rhonda Silva ◽  
Linh Aven ◽  
William J. Tyler
Keyword(s):  
Sleep Quality ◽  
Trigeminal Nerve ◽  
Human Performance ◽  
Acute Stress ◽  
Sleep Onset ◽  
Network Activity ◽  
Physical Work ◽  
Nuclear Complex ◽  
Afferent Inputs ◽  
Electrical Neuromodulation

Achieving optimal human performance that involves cognitive or physical work requires quality sleep and a positive mental attitude. The ascending reticular activating system (RAS) represents a powerful set of endogenous neuromodulatory circuits that gate and tune global brain responses to internal and external cues, thereby regulating consciousness, alertness, and attention. The activity of two major RAS nuclei, the locus coeruleus (LC) and pedunculopontine nucleus (PPN), can be altered by trigeminal nerve modulation. Monosynaptic afferent inputs from the sensory components of trigeminal nerve branches project to the trigeminal sensory nuclear complex (TSNC), which has direct and polysynaptic connections to the LC and PPN. We previously found high-frequency (7 - 11 kHz) transdermal electrical neuromodulation (TEN) of the trigeminal nerve rapidly induces physiological relaxation, dampens sympathetic nervous system responses to acute stress, and suppresses levels of noradrenergic biomarkers. Given the established roles of LC and PPN neuronal activity in sleep regulation, psychophysiological arousal, and stress, we conducted three studies designed to test hypotheses that modulation of the TSNC can improve sleep quality and mood in healthy individuals (n = 99). Across a total of 1,386 days monitored, we observed TEN modulation of trigeminal and cervical nerves prior to sleep onset produced significant improvements in sleep quality and affective states, quantified using clinically validated surveys, overnight actigraph and heart rate recordings, and biochemical analyses compared to baseline or sham controls. Moreover, we observed some frequency dependence in that TEN delivered at lower frequencies (TENLF; 0.50 - 0.75 kHz) was significantly more effective at improving sleep quality and reducing anxiety than higher frequency TEN waveforms. Collectively our results indicate that transdermal electrical neuromodulation of trigeminal and cervical nerve branches can influence TSNC activity in a manner that significantly improves sleep quality and significantly reduces stress. We conclude that biasing RAS network activity to optimize sleep efficiency and enhance mood by electrically modulating TSNC activity through its afferent inputs holds tremendous potential for optimizing mental health and human performance.

The effect of 4-h versus 6-h time restricted feeding on sleep quality, duration, insomnia severity and obstructive sleep apnea in adults with obesity

2021 ◽  
pp. 026010602110023
Author(s):  
Sofia Cienfuegos ◽  
Kelsey Gabel ◽  
Faiza Kalam ◽  
Mark Ezpeleta ◽  
Vicky Pavlou ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Quality ◽  
Sleep Onset ◽  
Control Group ◽  
Sleep Onset Latency ◽  
Restricted Feeding ◽  
Wake Time ◽  
Obstructive Sleep ◽  
Insomnia Severity

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.

scholarly journals 1142 Comprehensive Phenotyping Of Ambulatory Sleep Patterns In Multiple Sclerosis

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A435-A435
Author(s):  
T J Braley ◽  
A L Kratz ◽  
D Whibley ◽  
C Goldstein
Keyword(s):  
Multiple Sclerosis ◽  
Sleep Quality ◽  
Extreme Values ◽  
Sleep Onset ◽  
External Support ◽  
Poor Sleep ◽  
Sleep Patterns ◽  
Poor Sleep Quality ◽  
Historical Cohort ◽  
The Impact

Abstract Introduction The majority of sleep research in persons with multiple sclerosis (PwMS) has been siloed, restricted to evaluation of one or a few sleep measures in isolation. To fully characterize the impact of sleep disturbances in MS, multifaceted phenotyping of sleep is required. The objective of this study was to more comprehensively quantify sleep in PwMS, using a recently developed multi-domain framework of duration, continuity, regularity, sleepiness/alertness, and quality. Methods Data were derived from a parent study that examined associations between actigraphy and polysomnography-based measures of sleep and cognitive function in MS. Actigraphy was recorded in n=55 PwMS for 7-12 days (Actiwatch2®, Philips Respironics). Sleep metrics included: duration=mean total sleep time (TST, minutes); continuity=mean wake time after sleep onset (minutes), and regularity=stddev wake-up time (hours). ‘Extreme’ values for continuity/regularity were defined as the most extreme third of the distributions. ‘Extreme’ TST values were defined as the lowest or highest sixth of the distributions. Sleepiness (Epworth Sleepiness Scale score) and sleep quality [Pittsburgh Sleep Quality Index (PSQI) sleep quality item] were dichotomized by accepted cutoffs (&gt;10 and &gt;1, respectively). Results Sleep was recorded for a mean of 8.2 days (stddev=0.95). Median (1st, 3rd quartile) values were as follows: duration 459.79 (430.75, 490.60), continuity 37.00 (23.44, 52.57), regularity 1.02 (0.75, 1.32), sleepiness/alertness 8 (4, 12), and sleep quality 1.00 (1.00, 2.00). Extreme values based on data distributions were: short sleep &lt;=426.25 minutes (18%), long sleep &gt;515.5 minutes (16%), poor sleep continuity ≥45 minutes (33%), and poor sleep regularity ≥1.17 hours (33%). Sleepiness and poor sleep quality were present in 36% and 40% respectively. For comparison, in a historical cohort of non-MS patients, the extreme third of sleep regularity was a stddev of 0.75 hours, 13% had ESS of &gt;10, and 16% had poor sleep quality. Conclusion In this study of ambulatory sleep patterns in PwMS, we found greater irregularity of sleep-wake timing, and higher prevalence of sleepiness and poor sleep quality than published normative data. Efforts should be made to include these measures in the assessment of sleep-related contributions to MS outcomes. Support The authors received no external support for this work.

scholarly journals Non-pharmacological sleep interventions for pediatric cancer patients and survivors: a systematic review protocol

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Peter L. Stavinoha ◽  
Ineke M. Olsthoorn ◽  
Maria C. Swartz ◽  
Sara Nowakowski ◽  
Stephanie J. Wells ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sleep Quality ◽  
Cancer Patients ◽  
Pediatric Cancer ◽  
Sleep Disturbances ◽  
Sleep Onset ◽  
Standard Of Care ◽  
Sleep Diary ◽  
Pharmacological Interventions ◽  
Pediatric Cancer Patients

Abstract Background Sleep disturbances constitute a common complication in pediatric cancer patients and survivors and are frequently severe enough to warrant treatment. Suboptimal sleep has been associated with decreased emotional well-being and cognitive functioning and increased behavioral problems. Standardized guidelines for non-pharmacological sleep interventions for adults with cancer exist, but no standard of care intervention or standard guidelines are available to guide such intervention in pediatric cancer patients and survivors. Therefore, effective behavioral interventions for improving sleep quality need to be identified. The objective of the review is to evaluate the effect of non-pharmacological sleep interventions on sleep quality in pediatric cancer patients and survivors. Methods The review will consider studies that include children and adolescents between 0 and 18 years diagnosed with cancer or who have a history of cancer who have non-respiratory sleep disturbance. We will include experimental and quasi-experimental studies evaluating non-pharmacological interventions such as psychological interventions, technical/device interventions, interventions targeting physical activity, and complementary and alternative medicine interventions (e.g., yoga, massage, music). Interventions involving medications, ingestible supplements, products purported to work through absorption, and medical devices will be excluded. Primary outcome will be sleep quality as measured by methods including retrospective ratings, daily sleep diary, and validated questionnaires. Secondary outcomes will include total sleep time, sleep onset latency, wake after sleep onset, daytime sleepiness, and daytime sleep duration (naps) as measured by retrospective ratings, daily sleep diary, validated questionnaires, and/or actigraphy. Databases will include MEDLINE (Ovid), EMBASE (Ovid), Cochrane Library, CINAHL (Ebsco), and PsycINFO (Ovid) and will be queried from database inception to present. Two reviewers will independently screen all citations, full-text articles, and extract data. The study methodological quality will be assessed using Joanna Briggs Institute (JBI) critical appraisal tools. Data will be extracted and findings pooled and synthesized using a meta-aggregation approach via the JBI System for the Unified Management, Assessment, and Review of Information (SUMARI). If feasible, we will conduct random effects meta-analysis. Additional analyses will be conducted to explore the potential sources of heterogeneity (e.g., methodological quality, study design, outcome measures). Discussion This systematic review will synthesize and consolidate evidence on existing non-pharmacological interventions to improve sleep in pediatric cancer patients and survivors. Findings may help inform practitioners working with pediatric cancer patients and survivors experiencing sleep disturbances and is intended to identify gaps and opportunities to improve methodical quality of further non-pharmacological sleep intervention research in this population toward developing an eventual standard of care. Systematic review registration PROSPERO CRD42020200397.

778 Poor Sleep Quality is Associated with Reduced Myelination in Patients with Psychotic Disorders

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A303-A303
Author(s):  
Cagri Yuksel ◽  
Xi Chen ◽  
Lauren Watford ◽  
Margaret Gardner ◽  
Kathryn Lewandowski ◽  
...  
Keyword(s):  
White Matter ◽  
Sleep Quality ◽  
Psychotic Disorders ◽  
Sleep Onset ◽  
Sleep Loss ◽  
Magnetization Transfer Ratio ◽  
Poor Sleep ◽  
Sleep Onset Latency ◽  
Healthy Controls ◽  
Poor Sleep Quality

Abstract Introduction Recent studies show that sleep favors oligodendrocyte proliferation and myelination, and sleep loss is associated with alterations in white matter structure and decreased myelination. Psychotic disorders are characterized by disrupted white matter integrity, and abnormal axon and myelin structure. Despite common sleep disturbances in these disorders, little is known about the relationship between sleep quality and white matter findings. A novel in vivo neuroimaging technique that combines diffusion tensor spectroscopy (DTS) and magnetization transfer ratio (MTR) allows separately examining the axon structure and glial function, and myelin content, respectively. Using this method, we examined the association of sleep quality with white matter biology in a sample of patients with psychotic disorders and matched healthy controls. Methods Participants included patients diagnosed with bipolar disorder with psychotic features (euthymic or depressed, n=12) and schizophrenia spectrum disorders (n=9), and age and sex matched healthy controls (n=20). DTS and MTR data was collected from the right prefrontal white matter at 4T. DTS measures included apparent diffusion coefficients of water, NAA, creatine and choline. Sleep quality was measured using Pittsburgh Sleep Quality Index (PSQI). Results PSQI total score was significantly higher in patients. and patient sample included a higher percentage of poor sleepers (PSQI total score&gt;5). In patients, total PSQI score and sleep onset latency were significantly and negatively associated with MTR (F=6.9, p=0.02 and F=9.7, p=0.007, respectively). There was no difference in any DTS measures between groups. Conclusion Our preliminary results show that poor sleep quality is associated with decreased myelin content in the frontal lobe, in patients with psychotic disorders. This finding suggests that sleep loss may be a mediator of white matter alterations in psychosis. Support (if any) This work is supported by National Institute of Mental Health K23MH119322 to Cagri Yuksel

142 Prenatal Sleep Quality and Infant Sleep: A Longitudinal Study

SLEEP ◽  
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 &gt; .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 &lt; .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)

scholarly journals Moderate Exercise Plus Sleep Education Improves Self-Reported Sleep Quality, Daytime Mood, and Vitality in Adults with Chronic Sleep Complaints: A Waiting List-Controlled Trial

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Carmen Gebhart ◽  
Daniel Erlacher ◽  
Michael Schredl
Keyword(s):  
Physical Exercise ◽  
Sleep Quality ◽  
Controlled Trial ◽  
Sleep Onset ◽  
Intervention Group ◽  
Waiting List ◽  
Control Group ◽  
Sleep Education ◽  
Sleep Complaints ◽  
Chronic Sleep

Research indicates that physical exercise can contribute to better sleep quality. This study investigates the six-week influence of a combined intervention on self-rated sleep quality, daytime mood, and quality of life. A nonclinical sample of 114 adults with chronic initiating and the maintaining of sleep complaints participated in the study. The intervention group of 70 adults underwent moderate physical exercise, conducted weekly, plus sleep education sessions. Improvements among participants assigned to the intervention group relative to the waiting-list control group (n=44) were noted for subjective sleep quality, daytime mood, depressive symptoms and vitality. Derived from PSQI subscores, the intervention group reported increased sleep duration, shortened sleep latency, fewer awakenings after sleep onset, and overall better sleep efficiency compared to controls. The attained scores were well sustained and enhanced over a time that lasted through to the follow-up 18 weeks later. These findings have implications in treatment programs concerning healthy lifestyle approaches for adults with chronic sleep complaints.

The Effect of Uncoupled Sleep and Dysfunctional Sleep Beliefs on Sleep Outcomes in Older Adults following Online Cognitive Behavioral Therapy for Insomnia: A Single-Group Non-randomized Trial (Preprint)

2021 ◽  
Author(s):  
Yvonne Kutzer ◽  
Lisa Whitehead ◽  
Eimear Quigley ◽  
Shih Ching Fu ◽  
Mandy Stanley
Keyword(s):  
Older Adults ◽  
Cognitive Behavioral Therapy ◽  
Sleep Quality ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Behavioral Therapy ◽  
Sleep Onset ◽  
Poor Sleep ◽  
Subjective Sleep Quality ◽  
Subjective Sleep

BACKGROUND The current Covid-19 pandemic has brought about a marked interest in sleep health, as well as an increased demand for telehealth services, such as online Cognitive Behavioral Therapy for insomnia (CBT-I). Older adults in particular report a high rate of sleep problems. Recent studies have suggested that dysfunctional sleep beliefs could contribute to the high rates of self-reported insomnia in this age group. In addition, older adults have an increased rate of uncoupled sleep, e.g. displaying an insomnia complaint in the absence of objectively measured poor sleep. It is essential to determine the prevalence of coupled and uncoupled sleep in older adults and to examine the efficacy of online CBT-I to improve sleep outcomes. OBJECTIVE This study aims to assess objective and subjective sleep quality and dysfunctional sleep beliefs in a sample of community-dwelling older adults aged 60-80 years with and without uncoupled sleep in Western Australia following digitally delivered CBT-I. METHODS Objective sleep was measured using wrist actigraphy, and subjective sleep quality via sleep diaries and the Pittsburgh Sleep Quality Index (PSQI). Dysfunctional sleep beliefs were assessed by the Dysfunctional Beliefs and Attitudes about Sleep scale (DBAS-16) prior to and following a four-week online CBT-I programme. Linear mixed model and generalised linear mixed model analyses were conducted to examine objective and subjective sleep onset latency, total sleep time, wake after sleep onset and number of awakenings as well as PSQI and DBAS16 scores, respectively. RESULTS 62 participants (55 females; 88.7%) completed the study. CBT-I effectively reduced dysfunctional sleep beliefs and PSQI scores across all sleep classifications, even in good sleepers without a sleep complaint. Objective and self-reported changes in sleep parameters were mainly demonstrated in complaining poor sleepers. Complaining good sleepers reported a decrease in the number of subjective sleep awakenings only. CONCLUSIONS Online CBT-I was effective in improving the sleep outcomes of individuals who had both subjective and objective poor sleep. However, as the online CBT-I reduced dysfunctional sleep beliefs in all sleep groups, further examination of dysfunctional sleep beliefs and whether they mediate the outcomes of digital CBT-I in older adults will need to be conducted. CLINICALTRIAL Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN 12619001509156; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378451 INTERNATIONAL REGISTERED REPORT RR2-32705

Abstract 037: History Of Weight Cycling Is Prospectively Associated With Shorter And Poorer Quality Sleep, And Higher Sleep Apnea Risk In Diverse Us Women: Results From The AHA Go Red For Women Strategically Focused Research Network

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Vivian Cao ◽  
Nour Makarem ◽  
Moorea Maguire ◽  
Ivan Samayoa ◽  
Huaqing Xi ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Sleep Onset ◽  
Research Network ◽  
Poor Sleep ◽  
Sleep Onset Latency ◽  
Weight Cycling ◽  
Onset Latency ◽  
Cross Sectional ◽  
History Of ◽  
Insomnia Severity

Introduction: Poor sleep and history of weight cycling (HWC) are associated with worse cardiovascular health, yet limited research has evaluated the association between HWC and poor sleep patterns. Hypothesis: We hypothesized that HWC would be associated with poor sleep in US women. Methods: The AHA Go Red for Women Strategically Focused Research Network cohort at Columbia University (n=506, mean age 37 ± 15.7y, 61% racial/ethnic minority) was used to evaluate cross-sectional associations of HWC and sleep characteristics at baseline, and prospective associations of HWC from baseline with sleep measures at 1-yr. HWC, defined as losing and gaining ≥ 10 lbs at least once (excluding pregnancy), and number of WC episodes were self-reported. Sleep duration, measures of sleep quality, insomnia severity, and obstructive sleep apnea (OSA) risk were assessed using the validated Pittsburgh Sleep Quality Index, Insomnia Severity Index, and Berlin questionnaire. Linear and logistic regression models, adjusted for age, race/ethnicity, education, health insurance status, pregnancy history, and menopausal status, were used to evaluate the relation of HWC with sleep. Results: Most women reported ≥1episode of weight cycling (72%). In linear models of cross-sectional and prospective data, each additional weight cycling episode was related to shorter sleep duration, poorer sleep quality, longer sleep onset latency, greater insomnia severity, more sleep disturbances and daytime dysfunction, lower sleep efficiency, and higher sleep medication use frequency. In logistic models, HWC (≥1 vs. 0 episodes) was associated with greater odds for short sleep, poor sleep quality, long sleep onset latency ≥26 min, high OSA risk, and sleep efficiency<85% ( Table ). Conclusion: HWC predicted poor sleep among women, suggesting that weight maintenance may represent an important strategy to promote sleep health. Long-term studies are needed to disentangle the complex relations between weight fluctuations and sleep across the life course.

scholarly journals 0342 Self-Silencing within Intimate Relationships, Sleep, and Subclinical Atherosclerosis in Midlife Women

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A129-A130
Author(s):  
K P Jakubowski ◽  
Y Chang ◽  
E Barinas-Mitchell ◽  
K A Matthews ◽  
P M Maki ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Carotid Plaque ◽  
Subclinical Atherosclerosis ◽  
Sleep Onset ◽  
Sleep Time ◽  
Physical Symptoms ◽  
Midlife Women ◽  
Poor Sleep ◽  
Multinomial Regression ◽  
Health Indices

Abstract Introduction Social relationships are important for health. In some relationships, women learn to self-silence, or to inhibit self-expression to avoid conflict or loss. Self-silencing is associated with reported psychiatric and physical symptoms, but no studies have examined whether self-silencing is related to worse sleep or cardiovascular (CV) health. We tested relationships of self-silencing to sleep and carotid plaque in midlife women; secondary analyses examined whether sleep mediated or moderated relationships between self-silencing and plaque. Methods In an ongoing community-based study of nonsmoking women, 304 women aged 40-60 were assessed at baseline; 157 of these women have been assessed 5 years later. At baseline, women reported on self-expression in their current/last intimate relationship via the Silencing the Self Scale. At both visits, women provided self-reports (demographics, medical history, CESD depression, PSQI sleep quality), physical measures, actigraphy (total sleep time [TST], wake after sleep onset [WASO], and efficiency), and carotid artery ultrasound to quantify plaque. Relationships of self-silencing and subscales to sleep (subjective and actigraphic sleep at baseline and averaged across visits) and carotid plaque (0, 1, ≥2) were tested in linear regression and multinomial regression models, respectively, adjusted for demographic and health indices, including depressive symptoms and snoring. Results At baseline, women (72% White) were on average 54 years old; 44% reported poor sleep quality, 46% had plaque (24% score ≥2), and average TST, WASO, and efficiency were 6.2 hrs, 46 min, and 84%, respectively. At baseline, self-silencing (particularly the tendency to judge oneself by external standards) was related to worse sleep quality (p=.001), but better actigraphic WASO (p=.02) and efficiency (p=.02). Self-silencing was related to worse average sleep quality across visits (p=.001). Self-silencing related to higher odds of baseline plaque ≥2 [OR(95% CI)=1.14 (1.02,1.28), p=.02], yet sleep did not explain or moderate this relationship. Conclusion Self-silencing was associated with worse subjective, but better actigraphic sleep at baseline, and with poorer sleep quality over 5 years. Self-silencing related to carotid atherosclerosis, yet sleep did not appear to impact this relationship. Emotional expression is relevant to midlife women’s sleep and CV health. Support R01HL105647, K24123565 (RCT); RF1AG053504 (RCT & PM); T32MH018269 (KPJ)

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