Changes in sleep patterns of college students in Israel during COVID-19 lockdown, a sleep diaries study.

Abstract Objective To prevent and reduce the spread of COVID-19, governments around the world apply social restrictions and lockdowns. Such lockdowns significantly alter daily routine and habits. A growing body of research indicates that lockdowns affect sleep and circadian rhythms. The current study further explores that effect using sleep logs for a relatively long duration including lockdown and post-lockdown periods in Israel. Methods For five consecutive weeks, both during lockdown and during post-lockdown periods, from March 13th 2020 to May 12th 2020, Israeli students were asked to fill out daily sleep logs in which they report their sleep and wake times. The participants were also asked to fill out the Morningness-Eveningness Questionnaire (MEQ) in the beginning of the study. Results Data show increase in sleep duration and a later midsleep point during lockdown, compared to post-lockdown periods, both on workdays and on weekends. An interaction between chronotype and lockdown are also observed; Morning types sleep more both during lockdown and during post-lockdown periods. Interestingly, the midsleep point of late chronotypes is later during both workdays and weekends even during lockdown when social constrains on sleep time are in part removed. Discussion Overall, the current results based on detailed and relatively long-term sleep logs analysis confirm previous work using more limited measures such as one-time questionnaires. A lockdown period affects sleep-wake behavior: during lockdown people sleep duration is increased and their sleep onset is delayed. Nevertheless, the circadian preference of individuals is conserved across conditions.

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229 Sleep-wake behavior, meal timings and digital media duration of Indians during COVID-19 Lockdown

SLEEP ◽

10.1093/sleep/zsab072.228 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A91-A92

Author(s):

Babita Pande ◽

Meenakshi Sinha ◽

Ramanjan Sinha

Keyword(s):

Digital Media ◽

Sleep Duration ◽

Sleep Onset ◽

Therapeutic Management ◽

Daily Routine ◽

Age Group ◽

Younger Age ◽

Gender And Age ◽

Delayed Sleep ◽

The Impact

Abstract Introduction Lockdown and stay home order has been imposed on people in many countries including India to prevent the community transmission of COVID-19 pandemic. However this social restriction led to disturbed daily routine and lifestyle behaviour that is needed to be attended for proper therapeutic management of overall health during such crisis. The impact of lockdown on the most apparent behavioral changes viz. sleep-wake behaviour, major meal timings, and digital screen duration of Indians were investigated. In addition the effects of gender and age were explored. Methods After seeking permission from Ethical Institution, an online questionnaire based survey was circulated within India in the first week of May, 2020 for which total 1511 male and female (age ≥18 years) subjects participated. The sleep-wake behavior observed were sleep-wake timings, sleep duration, mid sleep time (MST) as function of lockdown, and social (lockdown) jetlag (SJL = MST before lockdown-MST during lockdown). Results The sleep onset-wakeup and meal times were significantly delayed during lockdown, which was more pronounced in younger age group. The sleep duration increased, specifically in young individuals during lockdown. Females showed more delayed sleep onset-waking times and first meal timing with longer sleep duration during lockdown. Increased digital media duration was observed in all age groups, primarily in males. The younger age group and specifically female reported higher SJL and delayed MST. A positive association was obtained between sleep duration & first meal time, and SJL & major meal timings/screen duration, and a significant negative relationship of sleep duration and SJL with age. Conclusion The study shows delayed sleep-wake schedule, meal timings and increased digital media duration among Indians during COVID-19 lockdown compared to before lockdown. Also, gender and age emerged as important mediating factors for this alteration. The pandemic has given opportunity to sleep more and compensate for the sleep. In spite of that, the higher social jetlag in young age group and female showed the compromised sleep and maladaption with societal timing. These findings have applied implications in sleep health during longer social isolation conditions and for proper therapeutic management. Support (if any) No

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The Cycle of Daily Stress and Sleep: Sleep Measurement Matters

Annals of Behavioral Medicine ◽

10.1093/abm/kaaa053 ◽

2020 ◽

Author(s):

Danica C Slavish ◽

Justin Asbee ◽

Kirti Veeramachaneni ◽

Brett A Messman ◽

Bella Scott ◽

...

Keyword(s):

Sleep Disturbances ◽

Multilevel Models ◽

Single Channel ◽

Sleep Onset ◽

Sleep Time ◽

Sleep Diary ◽

Sleep Onset Latency ◽

Daily Stress ◽

Sleep Diaries ◽

Sleep Measurement

Abstract Background Disturbed sleep can be a cause and a consequence of elevated stress. Yet intensive longitudinal studies have revealed that sleep assessed via diaries and actigraphy is inconsistently associated with daily stress. Purpose We expanded this research by examining daily associations between sleep and stress using a threefold approach to assess sleep: sleep diaries, actigraphy, and ambulatory single-channel electroencephalography (EEG). Methods Participants were 80 adults (mean age = 32.65 years, 63% female) who completed 7 days of stressor and sleep assessments. Multilevel models were used to examine bidirectional associations between occurrence and severity of daily stress with diary-, actigraphy-, and EEG-determined sleep parameters (e.g., total sleep time [TST], sleep efficiency, and sleep onset latency, and wake after sleep onset [WASO]). Results Participants reported at least one stressor 37% of days. Days with a stressor were associated with a 14.4-min reduction in actigraphy-determined TST (β = −0.24, p = 0.030), but not with other actigraphy, diary, or EEG sleep measures. Nights with greater sleep diary-determined WASO were associated with greater next-day stressor severity (β = 0.01, p = 0.026); no other diary, actigraphy, or EEG sleep measures were associated with next-day stressor occurrence or severity. Conclusions Daily stress and sleep disturbances occurred in a bidirectional fashion, though specific results varied by sleep measurement technique and sleep parameter. Together, our results highlight that the type of sleep measurement matters for examining associations with daily stress. We urge future researchers to treat sleep diaries, actigraphy, and EEG as complementary—not redundant—sleep measurement approaches.

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

Journal of Human Lactation ◽

10.1177/0890334419830991 ◽

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.

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A Sleep Laboratory Evaluation of the Long-Term Efficacy of Zopiclone

The Canadian Journal of Psychiatry ◽

10.1177/070674378803300206 ◽

1988 ◽

Vol 33 (2) ◽

pp. 103-107 ◽

Cited By ~ 22

Author(s):

Jonathan A.E. Fleming ◽

Jean Bourgouin ◽

Peter Hamilton

Keyword(s):

Sleep Onset ◽

Sleep Time ◽

Sleep Efficiency ◽

Laboratory Evaluation ◽

Sleep Study ◽

Sleep Studies ◽

Metallic Taste ◽

Hypnotic Medication ◽

Drug Free

Six patients between the ages of 25 and 59, with chronic, primary insomnia received the new, non-benzodiazepine, hypnotic zopiclone continuously for 17 weeks after a drug free interval of 12 nights. To qualify for the study, sleep efficiency, determined by a sleep study on two, consecutive, placebo-controlled nights, had to be less than 75%. Patients evaluated their sleep by questionnaire and had sleep studies completed throughout active treatment. Zopiclone (7.5 mg) increased sleep efficiency by decreasing sleep latency, wakefulness after sleep onset and increasing total sleep time. Sleep architecture was minimally affected by zopiclone treatment; no significant changes in delta or REM sleep were observed. The commonest side effect was a bitter or metallic taste. No significant changes in biological functioning were noted throughout the study period. These findings indicate that zopiclone is a safe and effective hypnotic medication which maintains its effectiveness with protracted use.

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P062 Sleep parameter validation of a home-based ballistocardiograph sleep tracker

SLEEP Advances ◽

10.1093/sleepadvances/zpab014.108 ◽

2021 ◽

Vol 2 (Supplement_1) ◽

pp. A41-A42

Author(s):

M Kholghi ◽

I Szollosi ◽

M Hollamby ◽

D Bradford ◽

Q Zhang

Keyword(s):

Total Sleep Time ◽

Sleep Onset ◽

Sleep Time ◽

Daily Routine ◽

Sleep Onset Latency ◽

Onset Latency ◽

Sleep Monitoring ◽

Significant Discrepancy ◽

Home Based ◽

Wake Detection

Abstract Introduction Consumer home sleep trackers are gaining popularity for objective sleep monitoring. Amongst them, non-wearable devices have little disruption in daily routine and need little maintenance. However, the validity of their sleep outcomes needs further investigation. In this study, the accuracy of the sleep outcomes of EMFIT Quantified Sleep (QS), an unobtrusive and non-wearable ballistocardiograph sleep tracker, was evaluated by comparing it with polysomnography (PSG). Methods 62 sleep lab patients underwent a single clinical PSG and their sleep measures were simultaneously collected through PSG and EMFIT QS. Total Sleep Time (TST), Wake After Sleep Onset (WASO), Sleep Onset Latency (SOL) and average Heart Rate (HR) were compared using paired t-tests and agreement analysed using Bland-Altman plots. Results EMFIT QS data loss occurred in 47% of participants. In the remaining 33 participants (15 females, with mean age of 53.7±16.5), EMFIT QS overestimated TST by 177.5±119.4 minutes (p<0.001) and underestimated WASO by 44.74±68.81 minutes (p<0.001). It accurately measured average resting HR and was able to distinguish SOL with some accuracy. However, the agreement between EMFIT QS and PSG on sleep-wake detection was very low (kappa=0.13, p<0.001). Discussion A consensus between PSG and EMFIT QS was found in SOL and average HR. There was a significant discrepancy and lack of consensus between the two devices in other sleep outcomes. These findings indicate that while EMFIT QS is not a credible alternative to PSG for sleep monitoring in clinical and research settings, consumers may find some benefit from longitudinal monitoring of SOL and HR.

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Sleep Patterns and Affect Dynamics Among College Students during COVID-19 Pandemic (Preprint)

10.2196/preprints.33964 ◽

2021 ◽

Author(s):

Zahra Mousavi ◽

Jocelyn Lai ◽

Katharine Simon ◽

Alexander P. Rivera ◽

Asal Yunusova ◽

...

Keyword(s):

Mental Health ◽

Young Adults ◽

Longitudinal Design ◽

Sleep Onset ◽

Sleep Time ◽

Sleep Onset Latency ◽

Sleep Patterns ◽

Daily Lives ◽

Affect Dynamics

BACKGROUND Sleep disturbance is a transdiagnostic risk factor so prevalent among young adults it is considered a public health epidemic, exacerbated by the COVID-19 pandemic. Sleep may contribute to mental health via affect dynamics. Prior literature on contribution of sleep to affect is largely based on correlational studies or experiments that do not generalize to the daily lives of young adults. Furthermore, the literature examining the associations between sleep variability and affect dynamics remains scant. OBJECTIVE In an ecologically valid context, using an intensive longitudinal design, we aimed to assess the daily and long-term associations between sleep patterns and affect dynamics among young adults during the COVID-19 pandemic. METHODS College student participants (N=20, 65% female) wore an Oura ring continuously for 3-months to measure sleep patterns, such as average and variability in total sleep time (TST), wake after sleep onset (WASO), sleep efficiency (SE), and sleep onset latency (SOL), resulting in 1173 unique observations. We administered a daily ecological momentary assessment (EMA) using a mobile health app to evaluate positive (PA) and negative affect (NA), and COVID-worry once per day. RESULTS Participants with higher SOL and TST on the prior day had lower PA the next day. Further, higher average TST across the 3-month period predicted lower average PA. TST variability predicted higher affect variability across all affect domains. CONCLUSIONS Fluctuating sleep patterns are associated with affect dynamics at daily and long-term scales. Low PA and affect variability may be potential pathways through which sleep has implications for mental health.

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

International Journal of Sports Physiology and Performance ◽

10.1123/ijspp.2021-0102 ◽

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.

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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).

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Live Fast, Die Young, and Sleep Later: Life History Strategy and Human Sleep Behavior

Evolution Medicine and Public Health ◽

10.1093/emph/eoaa048 ◽

2020 ◽

Author(s):

Vahe Dishakjian ◽

Daniel M T Fessler ◽

Adam Maxwell Sparks

Keyword(s):

Life History ◽

Individual Differences ◽

Sleep Duration ◽

Sleep Onset ◽

Life History Strategy ◽

The Body ◽

Equation Modeling ◽

Sleep Onset Latency ◽

Sleep Behaviors

Abstract Background and objectives Life History Theory (LHT) describes trade-offs that organisms make with regard to three investment pathways: growth, maintenance, and reproduction. In light of the reparative functions of sleep, we examine sleep behaviors and corresponding attitudes as proximate manifestations of an individual’s underlying relative prioritization of short-term reproduction versus long-term maintenance. Methodology We collected survey data from 568 participants across two online studies having different participant pools. We use a mixture of segmented and hierarchical regression models, structural equation modeling, and machine learning to infer relationships between sleep duration/quality, attitudes about sleep, and biodemographic/psychometric measures of life history strategy (LHS). Results An age-mediated U- or V-shaped relationship appears when LHS is plotted against habitual sleep duration, with the fastest strategies occupying the sections of the curve with the highest mortality risk: < 6.5 hours (short sleep) and > 8.5 hours (long sleep). LH “fastness” is associated with increased sleepiness and worse overall sleep quality: delayed sleep onset latency, more wakefulness after sleep onset, higher sleep-wake instability, and greater sleep duration variability. Hedonic valuations of sleep may mediate the effects of LHS on certain sleep parameters. Conclusions and implications The costs of deprioritizing maintenance can be parameterized in the domain of sleep, where “life history fastness” corresponds with sleep patterns associated with greater senescence and mortality. Individual differences in sleep having significant health implications can thus be understood as components of lifelong trajectories likely stemming from calibration to developmental circumstances. Relatedly, hedonic valuations of sleep may constitute useful avenues for non-pharmacological management of chronic sleep disorders. LAY Summary Sleep is essential because it allows the body to repair and maintain itself. But time spent sleeping is time that cannot be spent doing other things. People differ in how much they prioritize immediate rewards, including sociosexual opportunities, versus long-term goals. In this research, we show that individual differences in sleep behaviors, and attitudes toward sleep, correspond with psychological and behavioral differences reflecting such differing priorities. Orientation toward sleep can thus be understood as part of the overall lifetime strategies that people pursue.

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P084 Is Cognitive Behaviour Therapy for insomnia (CBTi) responsiveness a function of objective sleep efficiency rather than objective sleep duration?

SLEEP Advances ◽

10.1093/sleepadvances/zpab014.128 ◽

2021 ◽

Vol 2 (Supplement_1) ◽

pp. A48-A48

Author(s):

N Lovato ◽

G Micic ◽

L Lack

Keyword(s):

Sleep Duration ◽

Cognitive Behaviour Therapy ◽

Sleep Onset ◽

Past Research ◽

Severity Index ◽

Sleep Time ◽

Sleep Efficiency ◽

Behaviour Therapy ◽

Cognitive Behaviour ◽

Pre Treatment

Abstract Introduction Past research and our own has not shown a differential response to Cognitive Behaviour Therapy for insomnia (CBTi) based on objective sleep duration. It is valuable to investigate CBTi responsiveness is a function of objective sleep efficiency (SE) instead of objective sleep duration. This study is a secondary exploratory analysis of our earlier clinical trial to assess the differential therapeutic response to CBTi for older insomniacs based on SE prior to treatment. Method Seventy-nine adults (male=34, mean age=63.38, SD=6.25) with sleep maintenance insomnia were selected. Participants were grouped into 3 ordinal groups; the top 50% of participants (above the median percent sleep time-normal SE), the 25% of participants in the third quartile (moderately low SE), and the bottom 25% of participants (severely low SE) based on 1-night of home-based polysomnography. Participants were randomly allocated to CBTi or wait-list control. One-week sleep diaries, actigraphy and a battery of questionnaires evaluated the efficacy of CBTi for each SE group. Outcome measures were taken at pre-treatment, post-treatment, and 3-month follow-up. Results CBTi produced robust improvements in sleep quality including reduced wake after sleep onset, and improved sleep efficiency. Participants reported a reduction of scores on the Insomnia Severity Index, Flinders Fatigue Scale, Epworth Sleepiness Scale, Daytime Feeling and Functioning Scale, Sleep Anticipatory Anxiety Questionnaire, Dysfunctional Beliefs and Attitudes Scale, and increased Sleep Self-Efficacy Scale. All improvements were significant relative to waitlist and comparable regardless of objective SE at pre-treatment. Discussion CBTi responsiveness did not differ as a function of objective SE.

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