Long-Term Subjective and Objective Sleep Analysis of Total Sleep Time and Sleep Quality in Real Life Settings

Abstract Purpose To assess the efficacy of tasimelteon to improve sleep in Smith–Magenis syndrome (SMS). Methods A 9-week, double-blind, randomized, two-period crossover study was conducted at four US clinical centers. Genetically confirmed patients with SMS, aged 3 to 39, with sleep complaints participated in the study. Patients were assigned to treatment with tasimelteon or placebo in a 4-week crossover study with a 1-week washout between treatments. Eligible patients participated in an open-label study and were followed for >3 months. Results Improvement of sleep quality (DDSQ50) and total sleep time (DDTST50) on the worst 50% of nights were primary endpoints. Secondary measures included actigraphy and behavioral parameters. Over three years, 52 patients were screened, and 25 patients completed the randomized portion of the study. DDSQ50 significantly improved over placebo (0.4, p = 0.0139), and DDTST50 also improved (18.5 minutes, p = 0.0556). Average sleep quality (0.3, p = 0.0155) and actigraphy-based total sleep time (21.1 minutes, p = 0.0134) improved significantly, consistent with the primary outcomes. Patients treated for ≥90 days in the open-label study showed persistent efficacy. Adverse events were similar between placebo and tasimelteon. Conclusion Tasimelteon safely and effectively improved sleep in SMS.

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Gender differences in BaYaka forager sleep-wake patterns in forest and village contexts

Scientific Reports ◽

10.1038/s41598-021-92816-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Erica Kilius ◽

David R. Samson ◽

Sheina Lew-Levy ◽

Mallika S. Sarma ◽

Ujas A. Patel ◽

...

Keyword(s):

Sleep Quality ◽

Total Sleep Time ◽

Sleep Time ◽

Small Scale ◽

Cultural Variation ◽

Sleep Patterns ◽

Economic Activities ◽

Mixed Effect ◽

Wake Patterns ◽

The Republic

AbstractSleep studies in small-scale subsistence societies have broadened our understanding of cross-cultural sleep patterns, revealing the flexibility of human sleep. We examined sleep biology among BaYaka foragers from the Republic of Congo who move between environmentally similar but socio-ecologically distinct locations to access seasonal resources. We analyzed the sleep–wake patterns of 51 individuals as they resided in a village location (n = 39) and a forest camp (n = 23) (362 nights total). Overall, BaYaka exhibited high sleep fragmentation (50.5) and short total sleep time (5.94 h), suggestive of segmented sleep patterns. Sleep duration did not differ between locations, although poorer sleep quality was exhibited in the village. Linear mixed effect models demonstrated that women’s sleep differed significantly from men’s in the forest, with longer total sleep time (β ± SE = − 0.22 ± 0.09, confidence interval (CI) = [− 0.4, − 0.03]), and higher sleep quality (efficiency; β ± SE = − 0.24 ± 0.09, CI = [− 0.42, − 0.05]). These findings may be due to gender-specific social and economic activities. Circadian rhythms were consistent between locations, with women exhibiting stronger circadian stability. We highlight the importance of considering intra-cultural variation in sleep–wake patterns when taking sleep research into the field.

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Influence of hypothalamic and ambient temperatures on sleep in kangaroo rats

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.1979.237.1.r80 ◽

1979 ◽

Vol 237 (1) ◽

pp. R80-R88 ◽

Cited By ~ 10

Author(s):

S. Sakaguchi ◽

S. F. Glotzbach ◽

H. C. Heller

Keyword(s):

Slow Wave Sleep ◽

Total Sleep Time ◽

Paradoxical Sleep ◽

Sleep Time ◽

Peripheral Stimulus ◽

Kangaroo Rats ◽

Hypothalamic Temperature ◽

Ambient Temperatures ◽

Thermoregulatory System

Unanesthetized, unrestrained kangaroo rats (Dipodomys) were studied to examine the changes in the frequency and duration of sleep states caused by long-term manipulations of hypothalamic temperature (Thy) at a thermoneutral (30 degrees C) and a low (20 degrees C) ambient temperature (Ta). A cold stimulus present in either the hypothalamus or the skin decreased both the total sleep time (TST) and the ratio of paradoxical sleep (PS) to TST. At a low Ta, TST, but not the PS-to-TST ratio, was increased by raising Thy, indicating that a cold peripheral stimulus could differentially inhibit PS. At a thermoneutral Ta, cooling Thy decreased both TST and the PS/TST. Changes in the amount of PS were due largely to changes in the frequency, but not the duration, of individual episodes of PS, suggesting that the transition to PS is partially dependent on the thermoregulatory conditions existing during slow-wave sleep (SWS). These results are consistent with the recent findings that the thermoregulatory system is functional during SWS but is inhibited or inactivated during PS.

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Personality Traits and Insomnia Symptoms in Shift Workers

Frontiers in Psychology ◽

10.3389/fpsyg.2021.689741 ◽

2021 ◽

Vol 12 ◽

Author(s):

Brigitte Holzinger ◽

Lucille Mayer ◽

Gerhard Klösch

Keyword(s):

Sleep Quality ◽

Personality Traits ◽

Sleep Duration ◽

Total Sleep Time ◽

Sleep Time ◽

Work Schedule ◽

Shift Workers ◽

Time In Bed ◽

Shift Schedules ◽

Insomnia Symptoms

The discrepancy between natural sleep-wake rhythm and actual sleep times in shift workers can cause sleep loss and negative daytime consequences. Irregular shift schedules do not follow a fixed structure and change frequently, which makes them particularly harmful and makes affected individuals more susceptible to insomnia. The present study compares insomnia symptoms of non-shift workers, regular shift workers, and irregular shift workers and takes into account the moderating role of the Big Five personality traits and levels of perfectionism. Employees of an Austrian railway company completed an online survey assessing shift schedules, sleep quality and duration, daytime sleepiness, and personality traits. A total of 305 participants, of whom 111 were non-shift workers, 60 regular shift workers, and 134 irregular shift workers, made up the final sample. Irregular shift workers achieved significantly worse scores than one or both of the other groups in time in bed, total sleep time, sleep efficiency, sleep duration, sleep quality, sleep latency, and the number of awakenings. However, the values of the irregular shifts workers are still in the average range and do not indicate clinical insomnia. Participants working regular shifts reported the best sleep quality and longest sleep duration and showed the least nocturnal awakenings, possibly due to higher conscientiousness- and lower neuroticism scores in this group. Agreeableness increased the effect of work schedule on total sleep time while decreasing its effect on the amount of sleep medication taken. Perfectionism increased the effect of work schedule on time in bed and total sleep time. Generalization of results is limited due to the high percentage of males in the sample and using self-report measures only.

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The Relationships Between Training Load, Type of Sport, and Sleep Among High-Level Adolescent Athletes

International Journal of Sports Physiology and Performance ◽

10.1123/ijspp.2020-0463 ◽

2020 ◽

pp. 1-10

Author(s):

Anis Aloulou ◽

Francois Duforez ◽

Damien Léger ◽

Quentin De Larochelambert ◽

Mathieu Nedelec

Keyword(s):

Sleep Quality ◽

Muscle Soreness ◽

Total Sleep Time ◽

Sleep Time ◽

Training Load ◽

Academic Environment ◽

Adolescent Athletes ◽

Daily Training ◽

High Level ◽

Age And Sex

Purpose: To evaluate the effects of sporting activities, training loads, and athletes’ characteristics on sleep among high-level adolescent athletes, in a controlled training and academic environment. Methods: A total of 128 high-level adolescent athletes (age = 15.2 [2.0] y), across 9 different sports, completed common sleep questionnaires and were monitored daily (7.3 [2.7] d) during a typical in-season training period. Sleep was analyzed using actigraphy and sleep diaries, whereas training load was evaluated using the session rating of perceived exertion, and muscle soreness and general fatigue were reported with the aid of visual analog scales. Separate linear mixed-effects models were fitted, including the athlete as a random effect and the following variables as fixed effects: the sport practiced (categorical predictor), daily training load, age, and sex. Different models were used to compare sleep variables among sports and to assess the influence of training load, age, and sex. Results: The mean total sleep time was 7.1 (0.7) hours. Swimmers presented increased sleep fragmentation, training loads, perceived muscle soreness, and general fatigue compared with athletes who engaged in other sports. Independent of any sport-specific effects, a higher daily training load induced an earlier bedtime and reduced total sleep time and perceived sleep quality, with higher sleep fragmentation. Moreover, female athletes experienced increased total sleep time and worse sleep quality in response to stress compared with those in males. Conclusion: In a controlled training and academic environment, high-level adolescent athletes did not achieve the recommended sleep duration. Impaired sleep quality and quantity could be partially explained by increased training loads.

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1092 Attention-deficit/hyperactivity Disorder Symptoms And Sleep Characteristics Within A Seasonal Affective Disorder Spectrum

SLEEP ◽

10.1093/sleep/zsaa056.1087 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A415-A416

Author(s):

K N Kim ◽

D L Wescott ◽

P L Franzen ◽

B P Hasler ◽

K A Roecklein

Keyword(s):

Sleep Quality ◽

Sleep Duration ◽

Adhd Symptom ◽

Symptom Severity ◽

Daytime Sleepiness ◽

Total Sleep Time ◽

Sleep Time ◽

Sleep Onset Latency ◽

Adhd Symptoms ◽

Depression Severity

Abstract Introduction Seasonal affective disorder (SAD) increases risk for attention-deficit/hyperactivity disorder (ADHD), although the mechanism linking SAD and ADHD is unknown. Prior research has identified insomnia and delayed sleep phase in both ADHD and SAD. We hypothesized that sleep duration and timing in SAD would be associated with the severity of ADHD symptoms. Methods Adults with SAD (n = 45) and subsyndromal SAD (S-SAD; n = 18) aged 19-66 years from Pittsburgh, PA., were assessed for ADHD symptoms, self-report sleep quality, depression severity, and daytime sleepiness in the Winter. Participants wore an Actiwatch for 4-14 days, from which we calculated sleep-onset latency, total sleep time, sleep midpoint, and sleep efficiency. We conducted a hierarchical multivariate linear regression to determine if sleep characteristics predict ADHD symptom severity in our sample while controlling for depressive symptoms. Age and gender were added in Step 1, seasonal depression severity in Step 2, actigraphy-based total sleep time, sleep onset latency, midpoint, and efficiency in Step 3, and self-reported sleep quality and daytime sleepiness in Step 4. Results Participants mostly scored in the “likely” or “highly likely” ADHD range (87.30%, n=55), higher than the national prevalence rate (4.4%). When controlling for age, gender, and depression severity, only shorter actigraphy-based total sleep time was associated with higher ADHD symptom severity (β=-0.30, p<0.05). However, when self-reported sleep quality and daytime sleepiness were added as predictors, total sleep time was no longer a statistically-significant predictor of ADHD symptom severity and only daytime sleepiness predicted ADHD symptom severity (β=0.31, p<0.05). Conclusion Our results suggest that individuals with SAD who experience daytime sleepiness and/or possibly shorter actigraphy-based sleep duration experience higher ADHD symptom severity. Treatments like Trans-C or CBT-I to improve daytime sleepiness and sleep duration may be indicated for SAD patients who present with comorbid ADHD symptoms. Support NIMH K.A.R. MH103303

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Testing the contiguity of the sleep and fatigue relationship: a daily diary study

SLEEP ◽

10.1093/sleep/zsaa252 ◽

2020 ◽

Author(s):

Andrea L Harris ◽

Nicole E Carmona ◽

Taryn G Moss ◽

Colleen E Carney

Keyword(s):

Sleep Quality ◽

Hierarchical Linear Modeling ◽

Total Sleep Time ◽

Sleep Time ◽

Cognitive Factors ◽

Sleep Diary ◽

Poor Sleep ◽

Daily Diary Study ◽

Insomnia Disorder ◽

The Relationship

Abstract Study Objectives There is mixed evidence for the relationship between poor sleep and daytime fatigue, and some have suggested that fatigue is simply caused by lack of sleep. Although retrospective measures of insomnia and fatigue tend to correlate, other studies fail to demonstrate a link between objectively disturbed sleep and fatigue. The current study prospectively explored the relationship between sleep and fatigue among those with and without insomnia disorder. Methods Participants meeting Research Diagnostic Criteria for insomnia disorder (n = 33) or normal sleepers (n = 32) completed the Consensus Sleep Diary (CSD) and daily fatigue ratings for 2 weeks. Baseline questionnaires evaluated cognitive factors including unhelpful beliefs about sleep and rumination about fatigue. Hierarchical linear modeling tested the within- and between-participant relationships between sleep quality, total sleep time, and daily fatigue ratings. Mediation analyses tested if cognitive factors mediated the relationship between insomnia and fatigue. Results Self-reported nightly sleep quality significantly predicted subsequent daily fatigue ratings. Total sleep time was a significant predictor of fatigue within, but not between, participants. Unhelpful sleep beliefs and rumination about fatigue mediated the relationship between insomnia and fatigue reporting. Conclusions The results suggest that perception of sleep plays an important role in predicting reports of daytime fatigue. These findings could be used in treatment to help shift the focus away from total sleep times, and instead, focus on challenging maladaptive sleep-related cognitions to change fatigue perception.

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Sleep and Psychological Abuse Among Cohabiting Couples: A Pilot Study

Partner Abuse ◽

10.1891/1946-6560.8.4.347 ◽

2017 ◽

Vol 8 (4) ◽

pp. 347-360

Author(s):

Sharon Rose ◽

Linda Berg-Cross ◽

Nancy A. Crowell

Keyword(s):

Sleep Quality ◽

Relationship Satisfaction ◽

Sleep Deprivation ◽

Daytime Sleepiness ◽

Psychological Abuse ◽

Total Sleep Time ◽

Sleep Time ◽

Cohabiting Couples ◽

Survey Results ◽

The Relationship

This study explored the relationship between psychological abuse and sleep deprivation among nonclinical cohabiting couples. Thirty-one couples participated in completing a variety of sleep measures, a psychological abuse scale, and a relationship satisfaction survey. Results indicated a persistent relationship between everyday sleep deficits (sleep quality, daytime sleepiness, and self-reported total sleep time) and the perceived perpetration and felt victimization of psychological abuse. Overall, results were as hypothesized, but there were gender differences. Male psychological abuse victimization and perpetration were significantly related to sleep quality and daytime sleepiness, but for women, only sleep duration was predictive of felt victimization. The sleep variables were significantly related to women’s—but not men’s—reported relationship satisfaction. Overall, minimal sleep deprivation appears to be related to increased psychological abuse perpetration and victimization even among a normative population scoring outside the clinical range on these measures. Implications for prevention and treatment are discussed.

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1034 Should We Recommend More Sleep To Prevent Obesity?

SLEEP ◽

10.1093/sleep/zsaa056.1030 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A393-A393

Author(s):

D S Kim ◽

B E Foster ◽

J F Collen ◽

A H Eliasson

Keyword(s):

Sleep Quality ◽

Cardiovascular Health ◽

Total Sleep Time ◽

Sleep Time ◽

Adult Obesity ◽

Insufficient Sleep ◽

Obesity Epidemic ◽

Health And Nutrition ◽

Management Plans ◽

Health Registry

Abstract Introduction According to the 2015-2016 National Health and Nutrition Examination Survey (NHANES), the national adult obesity rate was 40% with the incidence of adult obesity having increased by 70% over the last 30 years. Paralleling the obesity epidemic have been worsening sleep deprivation and eroding sleep quality. We analyzed data from a Cardiovascular Health Registry to explore a link between total sleep time and obesity. Methods Registry participants underwent anthropometrics and completed validated questionnaires assessing health behaviors and symptoms including total sleep time (TST), Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), Pittsburgh Sleep Quality Index (PSQI), Perceived Stress Scale (PSS), and exercise time. Differences between subjects with sufficient (≥7 hours) and insufficient (<7 hours) sleep were analyzed using T-tests. Results Registry participants (n=630) had mean age 55.3±9.9 years (45% men, 391W, 182B, 26H, 12A, 19O). The subgroup with sufficient sleep (n=261, 48% men), had mean BMI 29.3±5.6 while the subgroup with insufficient sleep (n=369, 44% men) had mean BMI of 30.5±5.3, p=0.008. The insufficient sleep group was noted to be sleepier (ESS 9.7±4.9 vs 7.4±4.6, p<0.001), more fatigued (FSS 4.9±2.3 vs 3.5±2.4, p<0.001) and have worse sleep quality (PSQI 8.6±3.7 vs 4.7±2.8, p<0.001). Insufficient sleepers also perceived greater stress levels (PSS 22.2±8.4 vs 18.9±6.2, p<0.001), and showed a trend toward less exercise per week (143±134 vs 163±106 minutes, p=0.13). Conclusion Participants with insufficient sleep were significantly more overweight on average and were more symptomatic for insufficient sleep. While current approaches to weight management focus largely on diet and physical activity, the data from this study suggest that insufficient sleep should also be considered as a risk factor for obesity and should be incorporated into management plans for obesity. Support

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The Association between Sleep Duration and Quality with Readmissions: An Exploratory Pilot-Study among Cardiology Inpatients

Clocks & Sleep ◽

10.3390/clockssleep2020011 ◽

2020 ◽

Vol 2 (2) ◽

pp. 120-142

Author(s):

Clementine Labrosciano ◽

Rosanna Tavella ◽

Amy Reynolds ◽

Tracy Air ◽

John F. Beltrame ◽

...

Keyword(s):

Sleep Quality ◽

Total Sleep Time ◽

Sleep Time ◽

Unplanned Readmission ◽

Post Discharge ◽

Increased Risk ◽

Observational Cohort ◽

Patient’S Perception ◽

Study Participants

Background: Readmissions within 30 days of discharge are prominent among patients with cardiovascular disease. Post hospital syndrome hypothesizes that sleep disturbance during the index admission contributes to an acquired transient vulnerability, leading to increased risk of readmission. This study evaluated the association of in-hospital sleep (a) duration and (b) quality with 30-day all-cause unplanned readmission. Methods: This prospective observational cohort study included patients admitted to the coronary care unit of a South Australian hospital between 2016–2018. Study participants were invited to wear an ActiGraph GT3X+ for the duration of their admission and for two weeks post-discharge. Validated sleep and quality of life questionnaires, including the Pittsburgh Sleep Quality Index (PSQI), were administered. Readmission status and questionnaires were assessed at 30 days post-discharge via patient telephone interview and a review of hospital records. Results: The final cohort consisted of 75 patients (readmitted: n = 15, non-readmitted: n = 60), of which 72% were male with a mean age 66.9 ± 13.1 years. Total sleep time (TST), both in hospital (6.9 ± 1.3 vs. 6.8 ± 2.9 h, p = 0.96) and post-discharge (7.4 ± 1.3 h vs. 8.9 ± 12.6 h, p = 0.76), was similar in all patients. Patient’s perception of sleep, reflected by PSQI scores, was poorer in readmitted patients (9.13 ± 3.6 vs. 6.4 ± 4.1, p = 0.02). Conclusions: Although an association between total sleep time and 30-day readmission was not found, patients who reported poorer sleep quality were more likely to be readmitted within 30 days. This study also highlighted the importance of improving sleep, both in and out of the hospital, to improve the outcomes of cardiology inpatients.

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