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

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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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):

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Objective Assessment of Sleep Patterns among Night-Shift Workers: A Scoping Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182413236 ◽

2021 ◽

Vol 18 (24) ◽

pp. 13236

Author(s):

Seunghwa Shin ◽

Su-Hyun Kim ◽

Bomin Jeon

Keyword(s):

Scoping Review ◽

Objective Assessment ◽

Night Shift ◽

Sleep Onset ◽

Sleep Time ◽

Wearable Devices ◽

Sleep Onset Latency ◽

Sleep Patterns ◽

Shift Workers ◽

Accuracy And Precision

In this scoping review of the literature, we identified the types and the parameters of objective measurements to assess sleep patterns among night-shift workers. We conducted a literature search using electronic databases for studies published from 1991 to 2020 and charted and summarized key information. We included 32 studies in the review. Polysomnography was used in 6 studies and wearable sleep detection devices were utilized in 26 studies. The duration of sleep assessment using the wearable devices ranged from 1 day to > 4 weeks, and more than half of the studies collected data for > 2 weeks. The majority of the studies used subjective questionnaires, such as the Karolinska Sleepiness Scale, Epworth Sleepiness Scale, and Pittsburgh Sleep Quality Index, in addition to objective sleep measurements. Total sleep time was the most common parameter, followed by sleep efficiency, sleep onset latency, and time or frequency of being awake. As the utilization of wearable devices to assess the sleep patterns of night-shift workers is expected to increase, further evaluation of device accuracy and precision, optimal data collection period, and key parameters is warranted.

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0004 TS-142: A Novel and Potent Dual Orexin Receptor Antagonist with Sleep-Promoting Effects in Rats

SLEEP ◽

10.1093/sleep/zsaa056.003 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A2-A2

Author(s):

D Kambe ◽

H Hikichi ◽

Y Tokumaru ◽

M Ohmichi ◽

Y Konno ◽

...

Keyword(s):

Receptor Antagonist ◽

Half Life ◽

Sleep Onset ◽

Sleep Time ◽

Sleep Onset Latency ◽

Orexin A ◽

Pharmacokinetic Profiles ◽

Orexin Receptors ◽

Elimination Half ◽

Emg Electrodes

Abstract Introduction The orexin system plays a pivotal role in regulating sleep and wakefulness, thus, orexin receptors (OX1 and OX2 receptors) have gained much attention as promising therapeutic targets for the treatment of insomnia. We synthesized a novel and potent dual orexin receptor antagonist (DORA), ORN0829 (investigation code name as TS-142), which was designed to have short-acting effects. Here we report pharmacological and pharmacokinetic profiles of ORN0829 in rats. Methods The antagonistic activities of ORN0829 were assessed using calcium mobilization assays. Ala-orexin A-induced [Ca2+]i response was measured with CHO-K1 cells stably expressing human/rat orexin receptor. Rats implanted the EEG/EMG electrodes were orally administrated ORN0829 at doses of 1, 3 or 10 mg/kg at the dark onset and sleep-wake stages were inspected visually. In addition, pharmacokinetic profiles of ORN0829 were investigated in rats. Results ORN0829 inhibited Ala-orexin A-increased [Ca2+]i response with a Kb of 0.67/0.44 nmol/L (for human/rat OX1 receptor), and with a Kb of 0.84/0.80 nmol/L (for human/rat OX2 receptor), respectively, indicating that ORN0829 is a potent DORA with no species differences. ORN0829 dose-dependently increased total sleep time and reduced sleep onset latency at doses of 1, 3 and 10 mg/kg. Importantly, the ORN0829 levels in plasma and cerebrospinal fluid rapidly reached a maximum concentration, and decreased with an elimination half-life of less than 1 h. Conclusion The present study indicates that ORN0829 is a novel and potent DORA with sleep-promoting effects, and that it exhibits ideal pharmacokinetic profiles (rapid absorption and short half-life) in rats. A phase 2a study of TS-142 using patients with insomnia has been completed, which is presented in a separate poster. Support Taisho Pharmaceutical. Co., Ltd.

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1253 Multiple sleep onset REM episodes in middle age woman with excessive daytime sleepiness – Is this automatically assumed narcolepsy?

SLEEP ◽

10.1093/sleep/zsaa056.1247 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A477-A477

Author(s):

Kamal Patel ◽

Bianca J Lang

Keyword(s):

Daytime Sleepiness ◽

Sleep Latency ◽

Sleep Onset ◽

Sleep Time ◽

Multiple Sleep Latency Test ◽

Sleep Onset Latency ◽

Onset Latency ◽

Obstructive Sleep ◽

Falling Asleep ◽

Multiple Sleep Latency

Abstract Introduction Presence of sleep onset REM episodes often raises concerns of narcolepsy. However other conditions have shown to have presence of sleep on REM episodes which include but not limited to obstructive sleep apnea, sleep wake schedule disturbance, alcoholism, neurodegenerative disorders, depression and anxiety Report of Case Here we present a case of 30 year old female with history of asthma, patent foraman ovale, migraine headache, and anxiety who presented with daytime sleepiness, falling asleep while at work, occasional scheduled naps, non-restorative sleep, sleep paralysis, and hypnopompic hallucination. Pertinent physical exam included; mallampati score of 4/4, retrognathia, high arched hard palate, crowded posterior oropharynx. She had a score of 16 on Epworth sleepiness scale. Patient previously had multiple sleep latency test at outside facility which revealed 4/5 SOREM, with mean sleep onset latency of 11.5 minutes. She however was diagnosed with narcolepsy and tried on modafinil which she failed to tolerate. She was tried on sertraline as well which was discontinued due to lack of benefit. She had repeat multiple sleep latency test work up which revealed 2/5 SOREM, with mean sleep onset latency was 13.1 minutes. Her overnight polysomnogram prior to repeat MSLT showed SOREM with sleep onset latency of 10 minutes. Actigraphy showed consistent sleep pattern overall with sufficient sleep time but was taking hydroxyzine and herbal medication. Patient did not meet criteria for hypersomnolence disorder and sleep disordered breathing. Conclusion There is possibility her medication may have played pivotal role with her daytime symptoms. We also emphasize SOREMs can be present in other disorders such as anxiety in this case and not solely in narcolepsy

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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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Psychotic disorders in young adults with perinatally acquired HIV: a UK case series

Psychological Medicine ◽

10.1017/s0033291720004134 ◽

2020 ◽

pp. 1-7

Author(s):

I. Mallik ◽

T. Pasvol ◽

G. Frize ◽

S. Ayres ◽

A. Barrera ◽

...

Keyword(s):

Mental Health ◽

Young Adults ◽

Young People ◽

Case Series ◽

Psychotic Episode ◽

Published Data ◽

Growing Up ◽

Term Care ◽

Perinatally Acquired

Abstract Background Increasing numbers of children with perinatally acquired HIV (PaHIV) are transitioning into adult care. People living with behaviourally acquired HIV are known to be at more risk of psychosis than uninfected peers. Young adults living with PaHIV face numerous risk factors; biological: lifelong exposure to a neurotrophic virus, antiretroviral medication and immune dysfunction during brain development, and environmental; social deprivation, ethnicity-related discrimination, and migration-related issues. To date, there is little published data on the prevalence of psychotic illness in young people growing up with PaHIV. Methods We conducted a retrospective case note review of all individuals with PaHIV aged over 18 years registered for follow up at a dedicated clinic in the UK (n = 184). Results In total, 12/184 (6.5%), median age 23 years (interquartile range 21–26), had experienced at least one psychotic episode. The presentation and course of the psychotic episodes experienced by our cohort varied from short-lived symptoms to long term illness and nine (75%) appear to have developed a severe and enduring mental illness requiring long term care. Conclusion The prevalence of psychosis in our cohort was clearly above the lifetime prevalence of psychosis in UK individuals aged 16–34 years, which has been reported to be 0.5–1.0%. This highlights the importance of clinical vigilance regarding the mental health of young people growing up with PaHIV and the need to integrate direct access to mental health services within the HIV centres providing medical care.

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507 Clinical Impression of Excessive Daytime Sleepiness (EDS) at initial Sleep Medicine (SM) consultation and its clinical correlates

SLEEP ◽

10.1093/sleep/zsab072.506 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A199-A200

Author(s):

Leon Rosenthal ◽

Raúl Aguilar Roblero

Keyword(s):

Lower Energy ◽

Energy Levels ◽

Sleep Onset ◽

Sleep Time ◽

Clinical Impression ◽

Sleep Onset Latency ◽

Convenience Sample ◽

Time In Bed ◽

Number Of Patients ◽

Cardinal Symptom

Abstract Introduction EDS represents a cardinal symptom in SM. Use of subjective scales are prevalent, which have a modest correlation with the MSLT. While the Clinical Global Impression has been used in research, reports of clinical impression (CI) in medical practice are lacking. We report on the CI of EDS in a convenience sample of patients undergoing initial consultation. Methods Patients reported primary, secondary symptoms and completed the Sleep Wake Activity Inventory (SWAI) prior to Tele-Medicine consultation. A SM physician completed the assessment which included ascertainment of CI of EDS (presence S+ / absence S-). Results There were 39 ♂and 13 ♀. The CI identified 26 patients in each group (S+/S-). Age (52 [14]), BMI (33 [7]), reported time in bed, sleep time, sleep onset latency and # of awakenings did not differ. All identified a primary symptom (S-: 21, S+: 19 reported snoring or a previous Dx of OSA). Sleepiness as a 1ry or 2ry symptom was identified by 0 in the S- and by 13 in the S+ groups. Refreshing quality of sleep differed (χ2 <0.05): un-refreshing sleep was reported by 7 (S-) and by 13 (S+). Naps/week: 0.7 [1.5] and 1.57 [1.5] for the S-, S+ groups respectively (p<0.05). A main effect (p<0.01) was documented on the SWAI. We report on the Sleepiness [SS] and Energy Level [EL] scales (lower scores on the SS reflect higher sleepiness while lower scores on EL denote higher energy). Higher sleepiness (p<0.01) 43 [12] and lower energy levels 24 [6] (p<0.05) were documented on the S+ group (S- 61 [17], and 18 [6] respectively). Available spouse’s Epworth score on 29 patients: S- patients 5.8 [4] and S+ 10.2 [6] (p<0.05). Dx of OSA was identified among all but 1 in the S+ group. Also, Insomnia was diagnosed among 11 (S-) and 19 (S+) patients (p<0.05) despite only 3 and 7 (respectively) identifying it as a presenting symptom. Conclusion While snoring or previous Dx of OSA were prevalent motivations for consultation, sleepiness and insomnia were clinically relevant among a substantial number of patients. Unrefreshing sleep, daytime naps, lower energy, and higher sleepiness were ubiquitous among S+ patients. Support (if any):

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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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O043 “My Fitbit tells me I don’t sleep” – Validation of a consumer-wearable device (Fitbit Charge 3TM) using gold standard in-laboratory polysomnography to assess sleep in adults presenting for medical evaluation in a sleep laboratory

SLEEP Advances ◽

10.1093/sleepadvances/zpab014.042 ◽

2021 ◽

Vol 2 (Supplement_1) ◽

pp. A19-A19

Author(s):

M Munsif ◽

R Jumabhoy ◽

K Rangamuwa ◽

D Mansfield ◽

S Drummond ◽

...

Keyword(s):

Sleep Disorders ◽

Sleep Onset ◽

Sleep Time ◽

Sleep Onset Latency ◽

Medical Evaluation ◽

Insomnia Disorder ◽

Epoch Analysis ◽

A Prospective Study ◽

Screening Device ◽

Wake State

Abstract Background There has been a rapid growth in wearable devices marketed for sleep. Trackers such as the Fitbit collect data through an accelerometer and use heart rate variability to estimate the sleep-wake state. Currently, Fitbit validation studies have only been with “healthy” adults and Insomnia Disorder. Aims The purpose of this study is to evaluate the accuracy of Fitbit Charge3TM compared to in-lab polysomnography (PSG) in patients with sleep disorders. Our hypothesis is that Fitbit Charge 3TM will perform with less sensitivity and specificity relative to PSG in the presence of sleep disorders. Methods A prospective study of patients attending a PSG through Epworth Camberwell Sleep Lab between 2019–2021 will be conducted. Fitbit Charge3TM will be worn on the wrist with concurrent PSG monitoring. Parameters measured with both PSG and Fitbit Charge3TM will include total sleep time, Sleep onset latency, wake after sleep onset and time spent in N1, N2, N3 and REM sleep (min). Standard PSG data will be evaluated to diagnose sleep-disordered breathing. Progress to date:Ethics approval has been obtained, and 110 participants have been recruited. 30-second epoch-by-epoch analysis will now be conducted. Bland-Altman analyses will be performed to assess agreement between the Fitbit and PSG. Intended outcome and impact: Our novel study findings will provide evidence to address queries regarding the accuracy of the Fitbit trackers to evaluate sleep and may support the use of Fitbit Charge3TM as an initial screening device to assess sleep duration and sleep architecture in select patients.

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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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