Parent-reported early sleep problems and internalising, externalising and dysregulation symptoms in toddlers

BackgroundThe concurrence of sleep and socio-emotional development in children is well accepted. However, the predictive role of sleep problems in infancy and the development of emotional and behavioural problems later in childhood remain still unclear. Therefore, in this study we examined the associations between sleep problems in early childhood and internalising, externalising and dysregulation symptoms in toddlers.Methods1679 families entered the study during pregnancy and 936 children participated at 24 months. Parent-reported sleep duration, sleep-onset latency, night wakings, proportion of daytime sleep and bedtime at 3, 8, 18 and 24 months were assessed with two sleep questionnaires. Externalising, internalising and dysregulation problems at 24 months were examined with the Brief Infant-Toddler Social and Emotional Assessment.ResultsShort sleep duration at 3 and 8 months, more night wakings at 3, 8, 18 and 24 months and greater proportion of daytime sleep at 24 months were associated with internalising symptoms. Shorter sleep duration at 8, 18 and 24 months and longer sleep-onset latency and more night wakings at all time points, in addition to earlier bedtime at 8 months and greater proportion of daytime sleep at 24 months, were related to dysregulation. Finally, more night wakings at 3 and 24 months, and longer sleep-onset latency at 24 months were associated with externalising problems.ConclusionShorter sleep and poorer sleep quality in infancy were prospectively related to emotional and behavioural symptoms in toddlers, and these associations were strongest for internalising and dysregulation symptoms. This study contributes to the recent research on the role of early sleep problems in socio-emotional development, suggesting that shorter sleep duration, longer sleep-onset latency and higher waking frequency are related to internalising, externalising and dysregulation symptoms in toddlers, and thus it might be beneficial to provide early interventions for those infants reporting these sleep problems.

Download Full-text

Abstract P199: Sleep Health Varies By Immigration Status And Acculturation Level In Women: Results From The American Heart Association Go Red For Women Strategically Focused Research Network

Circulation ◽

10.1161/circ.143.suppl_1.p199 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Ivan A Samayoa ◽

Nour Makarem ◽

Vivian Cao ◽

Moorea Maguire ◽

Huaqing Xi ◽

...

Keyword(s):

Sleep Duration ◽

Sleep Problems ◽

Immigrant Women ◽

Sleep Onset ◽

Research Network ◽

Sleep Onset Latency ◽

Onset Latency ◽

Immigration Status ◽

Sleep Health ◽

The Us

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.

Download Full-text

The Monday Effect Revisited: A Diary and Sleep Actigraphy Study

Sleep and Vigilance ◽

10.1007/s41782-020-00105-5 ◽

2020 ◽

Vol 4 (2) ◽

pp. 167-176

Author(s):

Achim Elfering ◽

Christin Gerhardt ◽

Diana Pereira ◽

Anna Schenker ◽

Maria U. Kottwitz

Keyword(s):

Sleep Duration ◽

Sleep Onset ◽

Monday Morning ◽

Sleep Onset Latency ◽

Onset Latency ◽

Social Stressors ◽

Monday Effect ◽

Work Related ◽

Cognitive Failure ◽

Delayed Sleep

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.

Download Full-text

193 Sleep Variability and Affect Dynamics Among College Students during COVID-19 Pandemic

SLEEP ◽

10.1093/sleep/zsab072.192 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A78-A78

Author(s):

Zahra Mousavi ◽

Jocelyn Lai ◽

Asal Yunusova ◽

Alexander Rivera ◽

Sirui Hu ◽

...

Keyword(s):

Emerging Adults ◽

Sleep Duration ◽

Sleep Onset ◽

Positive And Negative Affect ◽

Sleep Onset Latency ◽

Deep Sleep ◽

Onset Latency ◽

Sleep Patterns ◽

Light Sleep ◽

Affect Dynamics

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):

Download Full-text

1144 Actigraphy-defined Sleep And Neurocognitive Decline In Middle-age Hispanic/Latino Adults

SLEEP ◽

10.1093/sleep/zsaa056.1138 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A435-A436

Author(s):

C Agudelo ◽

W Tarraf ◽

B Wu ◽

D M Wallace ◽

S R Patel ◽

...

Keyword(s):

Sleep Duration ◽

Verbal Memory ◽

Middle Age ◽

Verbal Learning ◽

Sleep Onset ◽

Sleep Time ◽

Sleep Onset Latency ◽

Onset Latency ◽

Latino Adults ◽

Neurocognitive Decline

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<0.01), verbal learning (β=-0.0028, p<0.001) and verbal memory (β=-0.036, p<0.05). Increased sleep-time per nap predicted better verbal memory (β=0.0038, p<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).

Download Full-text

An Examination of Anxiety Sensitivity as a Moderator of the Relation Between Sleep Anticipatory Anxiety and Sleep Onset Latency

Journal of Cognitive Psychotherapy ◽

10.1891/0889-8391.22.3.258 ◽

2008 ◽

Vol 22 (3) ◽

pp. 258-270 ◽

Cited By ~ 27

Author(s):

Kimberly A. Babson ◽

Casey D. Trainor ◽

Liviu Bunaciu ◽

Matthew T. Feldner

Keyword(s):

Anxiety Sensitivity ◽

Sleep Onset ◽

Sleep Onset Latency ◽

Onset Latency ◽

Anticipatory Anxiety ◽

Future Directions ◽

Cognitive Component ◽

Cognitive Components ◽

Body Of Knowledge

Evidence suggests that advancing currently limited knowledge about self-reported sleep onset latency is important for better understanding insomnia. Relatively little research has been conducted to understand factors that affect sleep onset latency. The current study tested a hypothesized role of factors of the global anxiety sensitivity (AS) construct as moderators of the relation between sleep onset latency and physical and cognitive components of sleep anticipatory anxiety. As hypothesized, AS-Physical Concerns moderated the relation between the physical component of sleep anticipatory anxiety and sleep onset latency, even after controlling for age, gender, negative affect, and substance use variables. However, in contrast to prediction, AS-Mental Incapacitation Concerns did not appear to moderate the relation between sleep onset latency and the cognitive component of sleep anticipatory anxiety. These findings are discussed in terms of extant research on sleep onset latency, and future directions for research to advance this body of knowledge are considered.

Download Full-text

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

Sleep Disorders ◽

10.1155/2016/8737654 ◽

2016 ◽

Vol 2016 ◽

pp. 1-10 ◽

Cited By ~ 17

Author(s):

Atin Supartini ◽

Takanori Honda ◽

Nadzirah A. Basri ◽

Yuka Haeuchi ◽

Sanmei Chen ◽

...

Keyword(s):

Depressive Symptoms ◽

Suicidal Ideation ◽

Sleep Quality ◽

Sleep Duration ◽

Sleep Onset ◽

Poor Sleep ◽

Sleep Onset Latency ◽

Onset Latency ◽

Poor Sleep Quality ◽

The Impact

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

Download Full-text

0007 Daytime Sleep in Night Shift Workers: Quantifying the Role of Circadian Misalignment

SLEEP ◽

10.1093/sleep/zsaa056.006 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A3-A3

Author(s):

E Mann ◽

C Sagong ◽

A Cuamatzi Castelan ◽

M Singh ◽

T Roth ◽

...

Keyword(s):

Sleep Duration ◽

Sleep Disturbances ◽

Night Shift ◽

Sleep Onset ◽

Sleep Onset Latency ◽

Shift Workers ◽

Circadian Misalignment ◽

Daytime Sleep ◽

Falling Asleep ◽

Dim Light

Abstract Introduction Circadian misalignment is commonly cited as a culprit of daytime sleep disturbances in night shift workers; however, the specific impact and magnitude that circadian misalignment has on daytime sleep has not been well-characterized in larger samples of night shift workers. Methods Participants included fixed-night shift workers (n=52, ages 18–50) who completed an 8-hour daytime polysomnography (PSG) in the lab following a night shift. Measures of sleep disturbances included: difficulty falling asleep (sleep onset latency [SOL], latency to persistent sleep [LPS]), difficulty staying asleep (sleep efficiency [SE], wake after sleep onset [WASO]), and sleep duration (total sleep time [TST]). Melatonin samples were collected hourly for 24 hours under dim light (<10 lux) and used to determine dim light melatonin offset (DLMOff). Circadian misalignment (CM) was calculated as the time difference between bedtime and DLMOff (higher values represented sleeping after DLMOff), and correlated with PSG sleep variables. Results CM was significantly associated with difficulty staying asleep (WASO: r=0.48, p<0.001; SE: r=-0.45, p<0.001), and sleep duration (TST: r=-0.38, p<0.01). Specifically, every 3 hours of CM on average added 19.2 minutes of WASO and reduced TST by 15 minutes. In contrast, CM was not significantly correlated with sleep onset difficulties (SOL: r=-0.27; LPS: r=-0.02). Conclusion These data suggest that circadian misalignment in shift workers may be a better predictor of difficulties staying asleep and sleep duration during the day relative to difficulties falling asleep. Because longer work hours (10–12 hours) are common in night shift worker, it may be that sleep initiation difficulties associated with circadian misalignment is masked by elevated fatigue or an increased homeostatic drive from prolonged wakefulness. These results may help guide decisions about the magnitude of phase shifts required (e.g., with light therapy) for the desired improvement in daytime sleep. Support Support for this study was provided to PC by the NHLBI (K23HL138166)

Download Full-text

Sleep problems and self-harm in adolescence

The British Journal of Psychiatry ◽

10.1192/bjp.bp.114.146514 ◽

2015 ◽

Vol 207 (4) ◽

pp. 306-312 ◽

Cited By ~ 45

Author(s):

Mari Hysing ◽

Børge Sivertsen ◽

Kjell Morten Stormark ◽

Rory C. O'Connor

Keyword(s):

Sleep Problems ◽

Large Population ◽

Sleep Onset ◽

Strong Relationship ◽

Population Based ◽

Sleep Onset Latency ◽

Short Sleep Duration ◽

Detailed Assessment ◽

Self Harm ◽

The Relationship

BackgroundAlthough self-harm and sleep problems are major public health problems in adolescence, detailed epidemiological assessment is essential to understand the nature of this relationship.AimsTo conduct a detailed assessment of the relationship between sleep and self-harm in adolescence.MethodA large population-based study in Norway surveyed 10 220 adolescents aged 16–19 years on mental health, including a comprehensive assessment of sleep and self-harm.ResultsAdolescents with sleep problems were significantly more likely to report self-harm than those without sleep problems. Insomnia, short sleep duration, long sleep onset latency, wake after sleep on set as well as large differences between weekdays versus weekends, yielded higher odds of self-harm consistent with a dose–response relationship. Depressive symptoms accounted for some, but not all, of this association.ConclusionsThe findings highlight a strong relationship between sleep problems and self-harm. Interventions to reduce adolescent self-harm ought to incorporate sleep problems as a treatment target.

Download Full-text

Home-Based Sleep Sensor Measurements in an Older Australian Population: Before and during a Pandemic

Sensors ◽

10.3390/s21185993 ◽

2021 ◽

Vol 21 (18) ◽

pp. 5993

Author(s):

Mahnoosh Kholghi ◽

Claire M. Ellender ◽

Qing Zhang ◽

Yang Gao ◽

Liesel Higgins ◽

...

Keyword(s):

Older Adults ◽

Time Course ◽

Total Sleep Time ◽

Sleep Onset ◽

Sleep Time ◽

Community Dwelling ◽

Sleep Efficiency ◽

Sleep Onset Latency ◽

Onset Latency ◽

Short Sleep Duration

Older adults are susceptible to poor night-time sleep, characterized by short sleep duration and high sleep disruptions (i.e., more frequent and longer awakenings). This study aimed to longitudinally and objectively assess the changes in sleep patterns of older Australians during the 2020 pandemic lockdown. A non-invasive mattress-based device, known as the EMFIT QS, was used to continuously monitor sleep in 31 older adults with an average age of 84 years old before (November 2019–February 2020) and during (March–May 2020) the COVID-19, a disease caused by a form of coronavirus, lockdown. Total sleep time, sleep onset latency, wake after sleep onset, sleep efficiency, time to bed, and time out of bed were measured across these two periods. Overall, there was no significant change in total sleep time; however, women had a significant increase in total sleep time (36 min), with a more than 30-min earlier bedtime. There was also no increase in wake after sleep onset and sleep onset latency. Sleep efficiency remained stable across the pandemic time course between 84–85%. While this sample size is small, these data provide reassurance that objective sleep measurement did not deteriorate through the pandemic in older community-dwelling Australians.

Download Full-text

Sleep Duration and Insomnia in Adolescents Seeking Treatment for Anxiety in Primary Health Care

Frontiers in Psychology ◽

10.3389/fpsyg.2021.638879 ◽

2021 ◽

Vol 12 ◽

Author(s):

Bente S. M. Haugland ◽

Mari Hysing ◽

Valborg Baste ◽

Gro Janne Wergeland ◽

Ronald M. Rapee ◽

...

Keyword(s):

Health Care ◽

Primary Health Care ◽

Depressive Symptoms ◽

Sleep Duration ◽

Health Care Workers ◽

Sleep Onset ◽

Sleep Onset Latency ◽

Onset Latency ◽

Primary Health ◽

Care Workers

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 (<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.

Download Full-text