A Comparison of Physical Activity Levels, Sleep Disrupting Behavior, and Stress/Affective Distress as Predictors of Sleep as Indexed by Actigraphy

Author(s):  
Shireen W. Eid ◽  
Rhonda F. Brown ◽  
Carl L. Birmingham ◽  
Shane K. Maloney

Background: Several behaviors have been reported to interfere with sleep in otherwise healthy adults, including low physical activity (PA) levels. However, few studies have compared low PA with the other behavioral risk factors of objective sleep impairment, despite the behavior tending to cooccur in highly stressed and affectively distressed individuals. Thus, the authors compared objective and subjective measures of PA and other potential sleep disrupting behaviors as predictors of objective sleep (sleep onset latency, actual sleep time, total sleep duration, awake time, and sleep efficacy) at baseline (T1) and 3 months later (T2). Methods: A community-derived sample of 161 people aged 18–65 years were asked about PA, other behavior (ie, night eating, electronic device use, watching television, caffeine and alcohol use), stress, affective distress (ie, anxiety, depression), and demographics including shift work and parenting young children in an online questionnaire at T1 and T2. PA and sleep were also monitored for 24 hours each at T1 and T2 using actigraphy. Results: Multiple regression analyses indicated that sleep at T1 was associated with PA (ie, total number of steps, metabolic equivalents/time, time spent travelling) after controlling mean ambient temperature and relevant demographics. At T2, longer sleep onset latency was predicted by parenting young children and night time television viewing; shorter sleep duration was predicted by female gender; and awake time and sleep efficacy were predicted by alcohol intake after controlling T1 sleep measures, demographics, and mean ambient temperature. Conclusion: The risk factors for objective sleep impairment included parenting young children and watching television at night, whereas better sleep outcomes were associated with greater engagement with PA.

2020 ◽  
Vol 4 (2) ◽  
pp. 167-176
Author(s):  
Achim Elfering ◽  
Christin Gerhardt ◽  
Diana Pereira ◽  
Anna Schenker ◽  
Maria U. Kottwitz

Abstract Purpose Accidents are more likely to occur during the morning hours of Mondays (Monday effect). This might be due to a higher level of cognitive failure on Monday morning at work. Methods In a pilot actigraphy study across one working week, we explored this Monday effect and regressed daily self-reported workplace cognitive failure on weekdays (Monday versus other days), background social stressors at work, delayed sleep onset and sleep duration. Diary data were gathered from 40 full-time employees. Results Confirming our assumptions, results revealed work-related cognitive failure and sleep-onset latency on the previous night to be higher on Mondays compared to other workdays. Work-related cognitive failure correlated positively with delayed sleep-onset latency and background social stressors. In multilevel regression analysis, Monday significantly explained variations in workplace cognitive failure. The addition of background social stressors at work and sleep-onset latency to the regression model showed unique contributions to the prediction of workplace cognitive failure. No significant two-way or three-way interactions between working days, sleep-onset latency or sleep duration, and background social stressors were found. Conclusion Peak levels of cognitive failure on Monday morning and the association of cognitive failure with social stressors at work contribute to understanding the mechanisms involved in the increased prevalence of occupational accidents on Monday morning. Occupational safety interventions should address both social stressors at work and individual sleep hygiene.


SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A78-A78
Author(s):  
Zahra Mousavi ◽  
Jocelyn Lai ◽  
Asal Yunusova ◽  
Alexander Rivera ◽  
Sirui Hu ◽  
...  

Abstract Introduction Sleep disturbance is a transdiagnostic risk factor that is so prevalent among emerging adults it is considered to be a public health epidemic. For emerging adults, who are already at greater risk for psychopathology, the COVID-19 pandemic has disrupted daily routines, potentially changing sleep patterns and heightening risk factors for the emergence of affective dysregulation, and consequently mood-related disturbances. This study aimed to determine whether variability in sleep patterns across a 3-month period was associated with next-day positive and negative affect, and affective dynamics, proximal affective predictors of depressive symptoms among young adults during the pandemic. Methods College student participants (N=20, 65% female, Mage=19.80, SDage=1.0) wore non-invasive wearable devices (the Oura ring https://ouraring.com/) continuously for a period of 3-months, measuring sleep onset latency, sleep efficiency, total sleep, and time spent in different stages of sleep (light, deep and rapid eye movement). Participants reported daily PA and NA using the Positive and Negative Affect Schedule on a 0-100 scale to report on their affective state. Results Multilevel models specifying a within-subject process of the relation between sleep and affect revealed that participants with higher sleep onset latency (b= -2.98, p<.01) and sleep duration on the prior day (b= -.35, p=.01) had lower PA the next day. Participants with longer light sleep duration had lower PA (b= -.28, p=.02), whereas participants with longer deep sleep duration had higher PA (b= .36, p=.02) the next day. On days with higher total sleep, participants experienced lower NA compared to their own average (b= -.01, p=.04). Follow-up exploratory bivariate correlations revealed significant associations between light sleep duration instability and higher instability in both PA and NA, whereas higher deep sleep duration was linked with lower instability in both PA and NA (all ps< .05). In the full-length paper these analyses will be probed using linear regressions controlling for relevant covariates (main effects of sleep, sex/age/ethnicity). Conclusion Sleep, an important transdiagnostic health outcome, may contribute to next-day PA and NA. Sleep patterns predict affect dynamics, which may be proximal predictors of mood disturbances. Affect dynamics may be one potential pathway through which sleep has implications for health disparities. Support (if any):


Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Ivan A Samayoa ◽  
Nour Makarem ◽  
Vivian Cao ◽  
Moorea Maguire ◽  
Huaqing Xi ◽  
...  

Introduction: The Healthy Immigrant Effect refers to the phenomenon that recent immigrants are on average healthier than their native-born counterparts. Greater immigrant acculturation to the US has been linked to increased risk of cardiovascular disease (CVD), frequently attributed to factors including the adoption of Western diets and decreased physical activity. While immigrants may have healthier habits than US adults, which may confer protection from CVD, there is little research on sleep health, particularly in immigrant women. Hypothesis: We hypothesized that immigrants, particularly those with greater acculturation, would have more sleep problems. Methods: Baseline data from a 1-y, community-based cohort of 506 women (61% racial/ethnic minority, mean age=37±16y) was used to evaluate cross-sectional associations between acculturation and sleep. Women self-reported their immigration status and national origin. Acculturation was measured from responses to questions regarding language preference, nativity (sorted by regions: Asia, Caribbean, Latin America, other), length of residency in the US, and age at immigration. Sleep duration, sleep quality, risk of obstructive sleep apnea (OSA) and insomnia were assessed using validated questionnaires. Logistic regression models adjusted for age, health insurance, education and BMI were used to evaluate associations between acculturation measures and sleep characteristics. Results: Women who were immigrants (n=176) reported lower mean sleep duration (6.60 ± 1.25 vs. 6.85 ± 1.22 h, p=0.02) compared to non-immigrants (n=323); non-immigrants were more likely than immigrants to sleep ≥7h/night (OR: 1.50, CI: 1.01-2.22, p=0.04). Women who immigrated to the US before vs. after age 25 y had lower odds of having sleep onset latency ≥26 min (OR:0.97, CI:0.95-1.00, p=0.03). Immigrant women living in the US >10y vs. <10y had more than 2-fold higher odds of having longer sleep onset latency (≥26 min) (OR:2.43, CI:1.09-5.41, p=0.03). Immigrants from the Caribbean were more likely than immigrants from other regions to be at a high risk for OSA (OR:2.65, CI:1.07-6.55, p=0.04). Conclusions: Compared to non-immigrants, immigrant women exhibit shorter habitual sleep duration. Sleep problems may vary by age of immigration, years lived in the US, and region of origin, as those who immigrated when they were older and those who had lived in the US>10 y required more time to fall asleep and Caribbean immigrants had higher OSA risk.


2017 ◽  
Vol 14 (6) ◽  
pp. 465-473 ◽  
Author(s):  
Anette Harris ◽  
Hilde Gundersen ◽  
Pia Mørk Andreassen ◽  
Eirunn Thun ◽  
Bjørn Bjorvatn ◽  
...  

Background:Sleep and mood have seldom been compared between elite athletes and nonelite athletes, although potential differences suggest that physical activity may affect these parameters. This study aims to explore whether adolescent elite athletes differ from controls in terms of sleep, positive affect (PA) and negative affect (NA).Methods:Forty-eight elite athletes and 26 controls participating in organized and nonorganized sport completed a questionnaire, and a 7-day sleep diary.Results:On school days, the athletes and the controls who participated in organized and nonorganized sport differed in bedtime (22:46, 23:14, 23:42, P < .01), sleep onset (23:03, 23:27, 00:12, P < .01), and total sleep time (7:52, 8:00, 6:50, P < 01). During weekend, the athletes, the controls who participated in organized and nonorganized sport differed in bedtime (23:30, 00:04, 00:49, P < .01), sleep onset (23.42, 00:18, 01:13, P < .01), rise time (9:15, 9:47, 10:55, P < .01), sleep efficiency (95.0%, 94.2%, 90.0%, P < 05), and sleep onset latency (11.8, 18.0, 28.0 minutes, P < .01). Furthermore, the athletes reported less social jetlag (0:53) and higher score for PA (34.3) compared with the controls who participated in nonorganized sport (jetlag: 1:25, P < .05, PA: 29.8, P < .05).Conclusions:An almost dose-response association was found between weekly training hours, sleep, social jetlag and mood in adolescents.


SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A435-A436
Author(s):  
C Agudelo ◽  
W Tarraf ◽  
B Wu ◽  
D M Wallace ◽  
S R Patel ◽  
...  

Abstract Introduction Few studies have evaluated objective sleep measures and longitudinal neurocognitive decline, particularly in middle-age or Hispanic/Latino adults. We evaluated prospective associations between actigraphy-defined sleep and 7-year neurocognitive change among Hispanic/Latino adults. We hypothesized that sleep duration would be associated with neurocognitive decline. Methods We analyzed data from 1,036 adults 45-64 years of age from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a multi-center prospective cohort study of diverse community-dwelling Hispanic/Latino adults. At Visit 1 (2008-2011), participants underwent neurocognitive assessments, 7-days of actigraphy, home sleep testing, and sleep questionnaires (including the Insomnia Severity Index). Seven years later, participants repeated neurocognitive assessments. The neurocognitive battery included the Six-Item Screener, Brief Spanish-English Verbal Learning Test, phonemic word fluency test, and Digit Symbol Subtest. Survey linear regression was used to evaluate prospective associations between actigraphy-defined or self-reported sleep variables and neurocognitive change. Final models adjusted for objectively-defined variables (age, body-mass index, Field Center, and time between neurocognitive assessments), and self-reported variables (sex, education, Hispanic/Latino background, alcohol consumption, physical activity, heart failure, cerebrovascular events, depression and anxiety symptoms, and antidepressant use). Results At Visit 1, the sample was 55% female and mean age was 54.9±2.2 years. The mean sleep duration was 402.6±27.6 minutes, mean sleep-onset latency was 11.3±9.7 minutes, mean number of days with naps of ≥ 15 minutes duration was 1.1±0.7, and mean sleep-time per nap was 51±14.1 minutes. Increased sleep-onset latency was associated with 7-year declines in global neurocognitive function (β=-0.0026, p&lt;0.01), verbal learning (β=-0.0028, p&lt;0.001) and verbal memory (β=-0.036, p&lt;0.05). Increased sleep-time per nap predicted better verbal memory (β=0.0038, p&lt;0.05). In contrast, sleep duration, sleep fragmentation, and self-reported sleep measures were not associated with neurocognitive change. Conclusion Among middle-age adults, sleep-onset latency and nap duration were associated with neurocognitive change. These findings may serve as targets for intervention of neurocognitive decline. Support This work is supported by the National Institute on Aging: R01AG048642, RF1AG054548, R01AG061022, R21AG056952, and R21HL140437 (AR).


SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A371-A371
Author(s):  
A K Johnson ◽  
A A Santos ◽  
L G Araujo ◽  
V S Gonsalves ◽  
B L Walker ◽  
...  

Abstract Introduction Unidentified sleep disorders can affect emotional, cognitive and social development in children. Screening for sleep disorders within the pediatric population is not common practice during medical visits. The objective of this study is to identify specific questions related to behavioral and physiological factors having potential to screen and detect those at risk for sleep disorders in a general pediatric clinic. Methods A retrospective archive from electronic medical records was analyzed from 1,361 children patients, 0-18 years old, that visited a pediatric clinic from March-November of 2019. Children or their parents reported on the presence of eight objective behavioral and physiological factors on the Kids Sleep Screener Questionnaire (KSSQ), which were used as potential risk factors for sleep disorders. Propensity of daytime sleepiness was measured through the Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD). Scores higher than 11 were considered a positive indicator of potential sleep disorders because of excessive daytime sleepiness. Positive scores from the ESS-CHAD were used for comparison with the KSSQ factors using chi-square test of SAS software. Results Among the eight factors, snoring was the strongest risk factor and increased sleep duration was the weakest risk factor associated with a positive ESS-CHAD. Relationships among risk factors and the increased likelihood for developing sleep disorders were statistically significant (p&lt;0.05-p&lt;0.0001) and identified as following: snoring by 2.46 times, restless sleeper by 2.03 times, behavioral or learning difficulties by 1.43 times, nocturnal awakenings by 1.16 times, excessive sleepiness during the day by 1.10 times. Sleep onset latency and increased sleep duration were weak indicators due to a likeliness of less than one time (p&lt;0.05) to be associated with a positive ESS-CHAD. Abnormal sleep behavior was not a statistically significant risk factor (p≥0.05) for potential sleep disorders in children. Conclusion There were associations between seven behavioral and physiological risk factors with overall sleep propensity in children. These results exhibit that the KSSQ is an important tool to identify potential sleep disorders in children and the need for follow up with a sleep specialist. The KSSQ is under validation for becoming a standard sleep screener in pediatrics. Support N/A


2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Atin Supartini ◽  
Takanori Honda ◽  
Nadzirah A. Basri ◽  
Yuka Haeuchi ◽  
Sanmei Chen ◽  
...  

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.


2021 ◽  
Vol 12 ◽  
Author(s):  
Bente S. M. Haugland ◽  
Mari Hysing ◽  
Valborg Baste ◽  
Gro Janne Wergeland ◽  
Ronald M. Rapee ◽  
...  

There is limited knowledge about sleep in adolescents with elevated levels of anxiety treated within primary health care settings, potentially resulting in sleep problems not being sufficiently addressed by primary health care workers. In the current study self-reported anxiety, insomnia, sleep onset latency, sleep duration, and depressive symptoms were assessed in 313 adolescents (12–16 years; mean age 14.0, SD = 0.84, 84.0% girls) referred to treatment for anxiety within primary health care. Results showed that 38.1% of the adolescents met criteria for insomnia, 34.8% reported short sleep duration (&lt;7 h), and 83.1% reported long sleep onset latency (≥30 min). Total anxiety symptoms were related to all sleep variables after controlling for age and sex. Furthermore, all anxiety symptom sub-types were associated with insomnia and sleep onset latency, whereas most anxiety subtypes were associated with sleep duration. Adolescents’ depressive symptoms accounted for most of the anxiety-sleep associations, emphasizing the importance of depressive symptoms for sleep. However, anxiety was associated with insomnia and sleep onset latency also among youth with low levels of depressive symptoms. The findings suggests that primary health care workers should assess sleep duration, sleep onset latency, and insomnia in help-seeking adolescents with anxiety.


SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A154-A154
Author(s):  
C E Kline ◽  
M E Egeler ◽  
A G Kubala ◽  
S R Patel ◽  
H M Lehrer ◽  
...  

Abstract Introduction Actigraphy data can be edited using a variety of approaches. However, whether time-intensive manual editing provides different sleep/wake estimates compared to other approaches is unknown. The purpose of this study was to compare sleep/wake data obtained from a standardized editing approach that incorporates multiple inputs versus three other common approaches. Methods 72 adults (33.8±11.1 y, 74% female, 71% white) provided 1022 nights of data for analysis; 45 were healthy sleepers (678 nights) and 27 met DSM-5 criteria for insomnia. Participants wore an Actiwatch Spectrum on their nondominant wrist and completed a sleep diary for 3-24 nights. Each night’s rest interval was set using four different approaches: (1) a standardized process based upon published guidelines (Patel et al., Sleep 2015) that incorporates a hierarchical order of multiple inputs (event marker, light, diary, activity; STANDARD); (2) software-provided automated algorithm (AUTO); (3) automated algorithm with incorporation of event markers (AUTOE); and (4) sleep diary (DIARY). We used linear mixed-effects models to evaluate whether sleep/wake parameters differed between the STANDARD and other editing approaches, accounting for patient status (healthy sleeper, insomnia) and the possibility that differences among editing approaches may be dependent on patient status. Results All results are expressed relative to the STANDARD approach. Bedtime was 36.1±5.1 min earlier (P&lt;.0001) and morning out-of-bed time was 13.6±5.7 min later (P=.02) using the AUTO (P&lt;.0001) approach. Time in bed was 42.3±4.7 min longer with AUTO (P&lt;.0001). Sleep onset latency was 11.7±1.4 min and 2.8±1.4 min longer for AUTO (P&lt;.0001) and DIARY (P=.05), respectively. Sleep duration was 22.5±4.4 min longer with AUTO (P&lt;.0001). Wake after sleep onset was 6.8±1.2 min greater with AUTO (P&lt;.0001). Similar patterns were observed for all sleep/wake measures among healthy sleepers and adults with insomnia. Conclusion A standardized approach to editing actigraphy data leads to different sleep/wake estimates compared to other common approaches, though the differences were often small in magnitude and not dependent upon sleep status. Most notably, reliance upon the automated algorithm yielded longer time in bed, sleep duration, sleep onset latency, and wake after sleep onset compared to the standardized approach. Support NIH K23HL118318


SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A126-A127
Author(s):  
S Wong ◽  
L E Hartstein ◽  
M K LeBourgeois

Abstract Introduction Recent surveys estimate that electronic media use among young children is increasing and that behavioral sleep problems are prevalent. In this study, we employed assessments of sleep and media use and tested the hypothesis that poor sleeping children would be more likely to engage with media than good sleeping children. Methods Participants were 44 children from two different cohorts: (1) Healthy, good sleepers (n=26, 13 males, 4.3±0.4 years) who reportedly obtained ≥10.5 hours per night and had no behavioral sleep problems and (2) Poor sleepers (n=18, 9 males, 5.5±0.7 years) who reportedly obtained chronic insufficient sleep ≤9 hours per night and/or had behavioral sleep problems for ≥6 months. Sleep duration and sleep onset latency (SOL) were quantified through 7 nights of actigraphy and verified with sleep diaries. Media use, defined as any electronic device involving screen time that engages children, was assessed across 2 weekdays and 2 weekend days through a parental media diary. Independent t-tests compared the duration of media use and actigraphy variables between groups. Results Poor sleeping children on average had longer SOL (28.6±17.9 vs. 17.3±8.66 minutes, t=-2.5, p&lt;0.05) and shorter sleep duration (589.6±37.5 vs. 627.4±27.4 minutes, t=3.7, p&lt;0.01) compared to good sleeping children. Additionally, average daily media use (125.1±88.5 vs. 66.5±48.3 minutes, t=-2.6, p&lt;0.05), evening media use (22.0±21.3 vs. 4.2±10.4 minutes, t=-3.3, p&lt;0.01), and weekend media use (154.4±105.9 vs. 79.8±55.6 minutes, t=-2.7, p&lt;0.05) duration was higher in poor than good sleepers. Conclusion Our findings indicate that media use duration and timing likely play an important role in early childhood sleep health. Young children who use more evening media are more likely to take longer to fall asleep and have shorter sleep duration overall. Time displacement (time spent using media instead of sleeping), psychological stimulation, and the effects of screen light on circadian timing are potential mechanisms underlying these associations. Support NIH R01-MH086566 and R21-MH110765 to MKL


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