Nocturnal Sleep–Wake Parameters of Adolescents at Home Following Cancer Chemotherapy

2011 ◽  
Vol 14 (3) ◽  
pp. 236-241 ◽  
Author(s):  
Amy J. Walker ◽  
Kyle P. Johnson ◽  
Christine Miaskowski ◽  
Vivian Gedaly-Duff
Keyword(s):  
Sleep Duration ◽  
Cancer Chemotherapy ◽  
Sleep Onset ◽  
Sleep Diary ◽  
Nocturnal Sleep ◽  
Wake Time ◽  
Targeted Interventions ◽  
Time In Bed ◽  
Wrist Actigraphy ◽  
At Home

Purpose: The purpose of this descriptive, longitudinal study was to describe objective nocturnal sleep–wake parameters of adolescents at home after receiving chemotherapy in the hospital or outpatient clinic and explore differences in sleep variables by age, gender, and corticosteroid use. Methods: We collected 7 days of wrist actigraphy and sleep diary data from 48 adolescents (10–19 years) who were receiving cancer chemotherapy for a primary or secondary cancer or a relapse. The actigraphic sleep variables included rest interval (i.e., time in bed), sleep onset, sleep offset, sleep duration, total sleep time (TST), wake after sleep onset (WASO), and %WASO. Results: Of the 48 adolescents, 38 had at least five nights of scored actigraphy and were included in analyses. Older (13–18 years) adolescents went to bed later and had fewer minutes of TST than younger adolescents (10–12 years). Exploratory analyses revealed no differences between adolescents who were taking oral corticosteroids (i.e., prednisone, dexamethasone) and those who were not or between males and females. Conclusion: These adolescents had sleep durations that met or exceeded the recommended sleep duration for their age groups but experienced significant WASO. Further research is needed to estimate sleep needs of adolescents during chemotherapy and determine factors that contribute to nocturnal wake-time so that targeted interventions can be designed to improve sleep quality.

741 Sleep and postpartum depression in healthy fathers: Perceptions of sleep quality predict severity of symptoms

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A289-A289
Author(s):  
Christopher Kalogeropoulos ◽  
Rebecca Burdayron ◽  
Christine Laganière ◽  
Marie-Julie Beliveau ◽  
Karine Dubois-Comtois ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Sleep Quality ◽  
Sleep Duration ◽  
Sleep Onset ◽  
Self Report ◽  
Sleep Diary ◽  
Nocturnal Sleep ◽  
Postpartum Depressive Symptoms ◽  
Paternal Depressive Symptoms ◽  
Perceived Sleep Quality

Abstract Introduction Research on the link between sleep quality and depression in the postpartum period has focused primarily on mothers. Although fathers also experience poorer postpartum sleep and are at risk of developing depressive symptoms, they remain understudied. To date, the limited research focusing on paternal sleep and depression has relied on subjective measures of sleep, without objective verification. The current study implemented a multi-measure approach using subjective and objective indices to explore the relationship between sleep and depressive symptoms in fathers at 6 months postpartum. Methods Fifty-four healthy fathers participated in this cross-sectional study. Paternal sleep was assessed for 2 weeks utilizing: 1) a self-report daily sleep diary, 2) a self-report perceived sleep quality rating, and 3) actigraphy. Subjective indices via the sleep diary measured participants’ perception of their total nocturnal sleep duration and total number of awakenings (self-reported sleep duration and fragmentation). Perceived sleep quality ratings measured participants’ perceptions of how well they thought they slept. Objective sleep variables measured through actigraphy included: total nocturnal sleep duration, number of awakenings, sleep efficiency, and wake after sleep onset (WASO). Paternal depressive symptoms were assessed with the Center for Epidemiologic Studies – Depression Scale (CES-D). Results Regression analyses showed that subjective sleep variables (measured by the sleep diary) and objective sleep variables (measured by actigraphy) did not significantly predict postpartum depressive symptoms in fathers (p > .05). However, self-reported perceived sleep quality significantly predicted postpartum depressive symptom severity in fathers (R2 = .172, p = .034). Conclusion These findings advance our understanding of the link between sleep and depression in fathers. The results highlight the important role of fathers’ perceptions of sleep quality, rather than the actual quality or quantity of their sleep (measured through the sleep diary or actigraphy), in the development of postpartum depressive symptoms. The multi-measure approach to sleep implemented in this study expanded our knowledge about how different facets of sleep relate to depression. These findings have important implications for the development of clinical interventions targeting paternal sleep and mood in the months following childbirth. Support (if any) Social-Science and Humanities Research Council (SSHRC) and Fonds de recherche du Québec – Santé (FRQS)

scholarly journals Genetic and Environmental Influences on Sleep-Wake Behaviours in Adolescence

2021 ◽  
Author(s):  
Victoria S O'Callaghan ◽  
Narelle K Hansell ◽  
Wei Guo ◽  
Joanne S Carpenter ◽  
Haochang Shou ◽  
...  
Keyword(s):  
Environmental Factors ◽  
Sleep Duration ◽  
Sleep Onset ◽  
Genetic Influences ◽  
Sleep Diary ◽  
Wake Time ◽  
Sleep Timing ◽  
Genetic Source ◽  
Genetic And Environmental Factors ◽  
Restorative Sleep

Abstract Study Objectives To investigate the influence of genetic and environmental factors on sleep-wake behaviours across adolescence. Methods Four hundred and ninety-five participants (aged 9 to 17; 55% females), including 93 monozygotic (MZ) and 117 dizygotic (DZ) twin pairs, and 75 unmatched twins, wore an accelerometry device and completed a sleep diary for two weeks. Results Individual differences in sleep onset, wake time, and sleep midpoint were influenced by both additive genetic (44-50% of total variance) and shared environmental (31-42%) factors, with a predominant genetic influence for sleep duration (62%) and restorative sleep (43%). When stratified into younger (aged 9-14) and older (aged 16-17) subsamples, genetic sources were more prominent in older adolescents. The moderate correlation between sleep duration and midpoint (rP = -.43, rG = .54) was attributable to a common genetic source. Sleep-wake behaviours on school and non-school nights were correlated (rP = .44-.72) and influenced by the same genetic and shared environmental factors. Genetic sources specific to night-type were also identified, for all behaviours except restorative sleep. Conclusions There were strong genetic influences on sleep-wake phenotypes, particularly on sleep timing, in adolescence. Moreover, there may be common genetic influences underlying both sleep and circadian rhythms. The differences in sleep-wake behaviours on school and non-school nights could be attributable to genetic factors involved in reactivity to environmental context.

scholarly journals 0402 Impact of Various Actigraphic Editing Approaches on Sleep/Wake Outputs in Adults with Insomnia and Healthy Sleepers

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 ◽  
...  
Keyword(s):  
Sleep Duration ◽  
Sleep Onset ◽  
Sleep Diary ◽  
Sleep Onset Latency ◽  
Onset Latency ◽  
Linear Mixed Effects ◽  
Automated Algorithm ◽  
Time In Bed ◽  
Patient Status ◽  
Approach Time

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<.0001) and morning out-of-bed time was 13.6±5.7 min later (P=.02) using the AUTO (P<.0001) approach. Time in bed was 42.3±4.7 min longer with AUTO (P<.0001). Sleep onset latency was 11.7±1.4 min and 2.8±1.4 min longer for AUTO (P<.0001) and DIARY (P=.05), respectively. Sleep duration was 22.5±4.4 min longer with AUTO (P<.0001). Wake after sleep onset was 6.8±1.2 min greater with AUTO (P<.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

223 Sleep Duration and Sleep Quality in Chronic Cannabis Users and Non-Users

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A89-A89
Author(s):  
Caroline Tse ◽  
Alicia Stewart ◽  
Omar Ordaz-Johnson ◽  
Maya Herzig ◽  
Jacqueline Gagnon ◽  
...  
Keyword(s):  
Pilot Study ◽  
Sleep Quality ◽  
Sleep Duration ◽  
Sleep Latency ◽  
Sleep Onset ◽  
The United States ◽  
Cannabis Use ◽  
Sleep Diary ◽  
Random Factor ◽  
Time In Bed

Abstract Introduction Cannabis use is on the rise in the United States, with 10% of adults reporting cannabis use in the past 30 days. Users commonly report consuming cannabis to improve sleep despite the lack of research that supports an association between cannabis use and sleep. In this pilot study we sought to examine objective measures of sleep duration and sleep quality among non- and chronic-cannabis users, and any patterns in relation to the time since consumption of cannabis. Methods Chronic cannabis users (cannabis used 2 or more times/week) and non-users provided up to 2-weeks of actigraphy (ActiGraph wGT3X-BT), worn on the wrist and verified by sleep diary. Chronic cannabis users also reported the date, time, amount, and route of their cannabis use. Mixed-effects models with participant as a random factor were used to examine: 1) the relationship between daily sleep parameters in cannabis non-users vs. users; and 2) the elapsed time between cannabis use and time in bed in chronic cannabis users. Results Chronic cannabis users (n=6) and non-users (n=7) collectively provided 151 nights of sleep. Participant characteristics (38.5% female; age, 25.8 years ± 4 years; BMI, 23.4 kg/m2 ± 3.4 kg/m2) did not significantly differ between groups. Cannabis use was associated with decreased total sleep time (measured in hours, ß=-0.58, p<0.001) and increased wake after sleep onset (WASO, ß=32.79, p=0.005), but not with the number of awakenings (ß=6.02, p=0.068). Among chronic cannabis users, cannabis use within two hours of bed was associated with increased sleep latency compared to use greater than two hours (ß=6.66, p=0.026). There was no association between time of cannabis use and WASO (p=0.621) or the number of awakenings (p=0.617). Conclusion In this pilot study of objectively measured sleep, we found that chronic cannabis use compared to non-use is associated with decreased sleep duration of otherwise healthy adults. Cannabis used closer to bedtime is associated with increased sleep latency. Additional studies that are able to assess the mode and dosage of use are needed to further understand the effects of cannabis and its components on sleep. Support (if any) KL2TR002370, AASM, Oregon Institute of Occupational Health Sciences

scholarly journals Evening intake of alcohol, caffeine, and nicotine: night-to-night associations with sleep duration and continuity among African Americans in the Jackson Heart Sleep Study

SLEEP ◽  
2019 ◽  
Vol 42 (11) ◽  
Author(s):  
Christine E Spadola ◽  
Na Guo ◽  
Dayna A Johnson ◽  
Tamar Sofer ◽  
Suzanne M Bertisch ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Sleep Duration ◽  
Sleep Onset ◽  
Sleep Efficiency ◽  
Sleep Diary ◽  
Sleep Study ◽  
Mixed Effect ◽  
Wrist Actigraphy ◽  
Sleep Parameters ◽  
Predominantly Female

Abstract Study Objectives We examined the night-to-night associations of evening use of alcohol, caffeine, and nicotine with actigraphically estimated sleep duration, sleep efficiency, and wake after sleep onset (WASO) among a large cohort of African American adults. Methods Participants in the Jackson Heart Sleep Study underwent wrist actigraphy for an average of 6.7 nights and completed concurrent daily sleep diary assessments to record any consumption of alcohol, caffeine, and nicotine within 4 hours of bedtime. Linear mixed-effect models were fit and adjusted for age, sex, educational attainment, body mass index, depression, anxiety, stress, and having work/school the next day. Results Eligible participants (n = 785) were an average of 63.7 years (SD: 10.6), and were predominantly female (67.9%). There were 5164 days of concurrent actigraphy and sleep diary data. Evening alcohol use was associated with that night’s lower sleep efficiency (−0.98% [95% CI: −1.67% to −0.29%], p = 0.005), but not with WASO or sleep duration. Evening nicotine use was associated with that night’s lower sleep efficiency [1.74% (95% CI: −2.79 to −0.68), p = 0.001] and 6.09 minutes higher WASO ([95% CI: 0.82 to 11.35], p = 0.02), but was not associated with sleep duration. Evening caffeine use was not associated with any of the sleep parameters. Conclusion Nicotine and alcohol use within 4 hours of bedtime were associated with increased sleep fragmentation in the associated night, even after controlling for multiple potential confounders. These findings support the importance of sleep health recommendations that promote the restriction of evening alcohol and nicotine use to improve sleep continuity.

scholarly journals Sleep maturation influences cognitive development of preterm toddlers

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Akiko Ando ◽  
Hidenobu Ohta ◽  
Yuko Yoshimura ◽  
Machiko Nakagawa ◽  
Yoko Asaka ◽  
...  
Keyword(s):  
Cognitive Development ◽  
Sleep Duration ◽  
Sleep Time ◽  
Brain Maturation ◽  
Sleep Diary ◽  
Sleep Regulation ◽  
Wake Time ◽  
Daytime Nap ◽  
Nighttime Sleep ◽  
The Relationship

AbstractOur recent study on full-term toddlers demonstrated that daytime nap properties affect the distribution ratio between nap and nighttime sleep duration in total sleep time but does not affect the overall total amount of daily sleep time. However, there is still no clear scientific consensus as to whether the ratio between naps and nighttime sleep or just daily total sleep duration itself is more important for healthy child development. In the current study, to gain an answer to this question, we examined the relationship between the sleep properties and the cognitive development of toddlers born prematurely using actigraphy and the Kyoto scale of psychological development (KSPD) test. 101 premature toddlers of approximately 1.5 years of age were recruited for the study. Actigraphy units were attached to their waist with an adjustable elastic belt for 7 consecutive days and a child sleep diary was completed by their parents. In the study, we found no significant correlation between either nap or nighttime sleep duration and cognitive development of the preterm toddlers. In contrast, we found that stable daily wake time was significantly associated with better cognitive development, suggesting that sleep regulation may contribute to the brain maturation of preterm toddlers.

scholarly journals Delayed Lactogenesis II is Associated With Lower Sleep Efficiency and Greater Variation in Nightly Sleep Duration in the Third Trimester

2019 ◽  
Vol 35 (4) ◽  
pp. 713-724
Author(s):  
Theresa Casey ◽  
Hui Sun ◽  
Helen J. Burgess ◽  
Jennifer Crodian ◽  
Shelley Dowden ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Blood Glucose ◽  
Sleep Duration ◽  
Body Mass ◽  
Sleep Disturbances ◽  
Sleep Onset ◽  
Sleep Time ◽  
Sleep Efficiency ◽  
Delayed Onset ◽  
Wrist Actigraphy

Background: Metabolic and hormonal disturbances are associated with sleep disturbances and delayed onset of lactogenesis II. Research aims: The aim of this study was to measure sleep using wrist actigraphy during gestation weeks 22 and 32 to determine if sleep characteristics were associated with blood glucose, body mass index, gestational related disease, delayed onset of lactogenesis II, or work schedule. Methods: Demographic data were collected at study intake from primiparous women who wore a wrist actigraph during gestation weeks 22 ( n = 50) and 32 ( n = 44). Start and end sleep time, total nighttime sleep, sleep efficiency, wake after sleep onset, and sleep fragmentation were measured. Night to night variability was assessed with the root mean square of successive difference. Blood glucose levels, body mass index, and gestational disease data were abstracted from medical charts. Timing of lactogenesis II was determined by survey. Results: Between gestation week 22 and 32, sleep efficiency decreased and fragmentation increased ( p < .05). During gestation week 32, blood glucose was negatively correlated with sleep duration, and positively related to fragmentation ( p < .05). Women who experienced delayed lactogenesis II had lower sleep efficiency and greater fragmentation ( p < .05), and greater night-to-night variability in sleep start and end time, efficiency, and duration during gestation week 32 ( p < .05). Conclusion: Women with better sleep efficiency and more stable nightly sleep time are less likely to experience delayed onset of lactogenesis II. Interventions to improve sleep may improve maternal health and breastfeeding adequacy.

Consecutive Days of Racing Does Not Affect Sleep in Professional Road Cyclists

2021 ◽  
pp. 1-4
Author(s):  
Charli Sargent ◽  
Shona L. Halson ◽  
David T. Martin ◽  
Gregory D. Roach
Keyword(s):  
Sleep Duration ◽  
Sleep Onset ◽  
Self Report ◽  
Activity Monitors ◽  
Sleep Diaries ◽  
Time In Bed ◽  
Road Cycling ◽  
Offset Time ◽  
The Impact

Purpose: Professional road cycling races are physiologically demanding, involving successive days of racing over 1 to 3 weeks of competition. Anecdotal evidence indicates that cyclists’ sleep duration either increases or deteriorates during these competitions. However, sleep duration in professional cyclists during stage races has not been assessed. This study examined the amount/quality of sleep obtained by 14 professional cyclists competing in the Australian Tour Down Under. Methods: Sleep was assessed using wrist activity monitors and self-report sleep diaries on the night prior to start of the race and on each night during the race. The impact of each day of the race on sleep onset, sleep offset, time in bed, sleep duration, and wake duration was assessed using separate linear mixed effects models. Results: During the race, cyclists obtained an average of 6.8 (0.9) hours of sleep between 23:30 and 07:27 hours and spent 13.9% (4.7%) of time in bed awake. Minor differences in sleep onset (P = .023) and offset times (P ≤.001) were observed during the week of racing, but these did not affect the amount of sleep obtained by cyclists. Interestingly, the 3 best finishers in the general classification obtained more sleep than the 3 worst finishers (7.2 [0.3] vs 6.7 [0.3] h; P = .049). Conclusions: Contrary to anecdotal reports, the amount of sleep obtained by cyclists did not change over the course of the 1-week race and was just below the recommended target of 7 to 9 hours for adults.

scholarly journals 0127 Relationship Between Sleep Metrics with Free-Living Glucose Concentrations and Glycemic Variability in Non-Diabetic Adults

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A50-A50
Author(s):  
J R Sparks ◽  
E E Kishman ◽  
X Wang
Keyword(s):  
South Carolina ◽  
Glucose Metabolism ◽  
Sleep Onset ◽  
Glycemic Variability ◽  
Sleep Efficiency ◽  
Sleep Diary ◽  
Poor Sleep ◽  
Free Living ◽  
Experimental Conditions ◽  
Time In Bed

Abstract Introduction Insufficient sleep and poor sleep quality have been associated with impaired glucose metabolism at fasting and under experimental conditions. Continuous glucose monitoring (CGM) measures glucose concentrations over an extended, free-living period that can be used to assess glycemic health. Relationships between CGM-assessed glucose concentrations and glycemic variability, an emerging glycemic health marker, with sleep metrics have yet to be elucidated. The purpose of this study was to examine the relationships between sleep metrics with glucose concentrations and glycemic variability in non-diabetic adults. Methods Twenty-four non-diabetic adults (age=46.0±5.8 years; BMI=32.2±5.7 kg/m2) completed actigraphy, sleep diary, and CGM over 7 consecutive days. Time-in-bed (TIB), total sleep time (TST), wake duration after sleep onset, and sleep efficiency [(TST÷TIB)×100%] were determined using actigraphy assisted with sleep diary input. Nightly variability of each sleep metric was calculated as standard deviation (SD) across all nights. Glucose concentrations at waking in the morning, and 1, 2, and 3 hours prior to waking, and diurnal, nocturnal, and 24-hour means were determined. Intra-day glycemic variability, including mean amplitude of glycemic excursions and continuous overlapping of net glycemic action of 1, 2, and 4 hours, and inter-day glycemic variability, mean of daily differences, were calculated. Pearson product correlations between sleep metrics with glucose concentrations and glycemic variability were performed. Results Average TIB and TST were 462.6±61.7 minutes and 403.3±59.7 minutes, respectively. TIB negatively correlated with glucose concentrations at 2 and 3 hours prior to waking (r=-0.42, p=0.04 and r=-0.42, p=0.04, respectively). Nightly variability in sleep efficiency positively correlated with waking, and 1, 2, and 3 hours prior to waking glucose concentrations (0.44≤r≤0.48, p≤0.03 for all). No sleep metrics correlated with glycemic variability measures (p≥0.10 for all). Conclusion Findings suggest a longer amount of sleep opportunity and more consistent sleep efficiency relate to better glucose metabolism in non-diabetic adults. Support American Heart Association 14BGIA20380706 and University of South Carolina Support to Promote Advancement of Research and Creativity Grant #11530-17-43917.

scholarly journals 0039 The Clinical Utility of Dim Light Melatonin Onset in Treatment of Delayed Sleep-Wake Phase Disorder: Preliminary Findings

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A16-A16
Author(s):  
L Swanson ◽  
J Arnedt ◽  
K DuBuc ◽  
T de Sibour ◽  
H Burgess
Keyword(s):  
Sleep Onset ◽  
Onset Time ◽  
Sleep Diary ◽  
Double Blind ◽  
Exogenous Melatonin ◽  
Research Award ◽  
Dim Light Melatonin Onset ◽  
Wrist Actigraphy ◽  
Dim Light ◽  
Delayed Sleep

Abstract Introduction Delayed sleep-wake phase disorder (DSWPD) is common, debilitating, and challenging to treat. In an ongoing randomized trial, we are comparing exogenous melatonin treatment outcomes in DSWPD participants for whom dim light melatonin onset (DLMO) is measured objectively vs. estimated. Methods Thus far, 13 participants (27±6 years old, 67% female) have completed a randomized, controlled, double-blind 4-week trial of 0.5 mg of exogenous melatonin timed to either 3 h before measured DLMO (M-DLMO, n = 6) or 3 h before DLMO estimated at 2 h before average sleep onset time based on at least 7 days of wrist actigraphy and sleep diary (E-DLMO, n = 7). All participants met International Classification of Sleep Disorders-3 diagnostic criteria for DSWPD and were otherwise healthy. Participants completed 4 weekly treatment sessions with a blinded psychologist; time of melatonin administration and bed-rise schedule were advanced up to 1 h/week. A validated home saliva collection kit measured DLMO in all participants. Between-group t-tests and Hedges’ g effect sizes (ES) were calculated at post-treatment for the following outcomes: DLMO; Pittsburgh Sleep Quality Index (PSQI) global score; Morningness-Eveningness Questionnaire (MEQ); and the actigraphy parameters sleep efficiency (SE) and clock time of sleep onset and offset. A paired-sample t-test compared the measured vs. estimated DLMO at baseline. Results The M-DLMO group had a 65±88 mins DLMO advance vs. 27±30 mins in the E-DLMO group (ES=0.51 p=.381). PSQI scores were similar between groups (M-DLMO=6.67±2.06, E-DLMO=7.1± 1.57, ES=-0.24, p=.646), as were MEQ scores (M-DLMO=43±4.98, E-DLMO=48±12.72, ES=-0.47, p=.387). Sleep onset time (M-DLMO=0:32±1:02, E-DLMO=0:31±1:38, ES=0.01, p=.98) and offset time (M-DLMO=8:05±1:03, E-DLMO=8:08±2:14, ES=-0.02, p=.968) were similar between the groups, although sleep was more efficient in M-DLMO vs. E-DLMO (84%±3% vs. 76%±10%, ES=0.94, p=.096). On average, baseline measured DLMO occurred 123±83 mins earlier than estimated DLMO (p=.001). Conclusion We are continuing to enroll participants in this trial. Preliminary results suggest some potential benefit of measuring the DLMO, but results will need to be clarified in a larger sample. Support American Sleep Medicine Foundation Strategic Research Award

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