Long-lasting effects of insufficient sleep on neurocognitive development in early adolescence

Importance: Adolescents nowadays often get insufficient sleep. Yet, the long-term adverse effects of sleep loss on developing brain and behavior remains unknown. Objective: To determine whether insufficient sleep leads to long-lasting impacts on mental health, cognition, and brain development in adolescents across two years. Design: This longitudinal study utilized a public dataset, the Adolescent Brain Cognitive Development (ABCD) study, which is an ongoing study starting from 2016. Setting: Data were collected from 21 research sites in the U.S. Participants: 11,875 9-10-year-olds were recruited using stratified sampling in order to reflect the diversity of the U.S. population. Intervention: Individuals with sufficient versus insufficient sleep (< 9 hours per day for adolescents) were compared after controlling for age (months), sex, race, puberty status, and other 7 covariates based on propensity score matching. Main Outcomes and Measures: Behavior problems, cognition, mental health assessments, resting-state functional connectivity, gray matter volume, cortical area, cortical thickness, and structural connectivity (Fractional anisotropy) were collected and preprocessed by the ABCD study. Independent-sample t-tests and meditation analysis were performed to investigate the effects of insufficient sleep. Results: 3021 matched pairs (50.7% male) were identified based on baseline assessment, with mean (SD) age of 119.5 (7.5) months. In baseline, sufficient sleep is associated less behavioral problems on 18 of 20 assessments, e.g. depress (95% CI of mean difference: -0.28 to -0.47, false discovery rate (FDR)-corrected p < .001, Cohen's d = -0.20), better cognitive performance on 7 of 10 assessments, such as crystal cognition (95% CI: 0.81 to 1.50, FDR-corrected p < .001, Cohen's d = 0.17), better functional connection between cortical regions and basal ganglia (all FDR-corrected p < .05, Cohen's d >0.15), and large structure in ACC and temporal pole (all FDR-corrected p < .05, Cohen's d >0.09). Similar patterns of effect of sufficient sleep were found in FL2 (749 pairs remained) e.g. Cohen's d of function connectivity at baseline was correlated with Cohen's d of that at FL2 (r = 0.54, 95% CI: 0.45 to 0.61, p < 1e-10). Mediation and longitudinal mediation analysis revealed that identified brain measures (e.g. gray matter volume of left temporal pole) at baseline mediated the effect of sufficient sleep on behavioral assessments (e.g. crystal cognition) at baseline and at FL2 (95% CI did not encompass 0, p < 0.05 on 100,000 random-generated bootstrapped samples). Conclusions and Relevance: These results provide strong population-level evidence for the long-lasting detrimental effects of insufficient sleep on mental health, cognition, and brain function and structure in adolescents. The current study identified potential neural mechanisms of adverse effect of insufficient sleep in adolescents, which might provide a theoretical grounding for sleep intervention programs to improve the long-term developmental outcomes in adolescents.

How Do People with Late Bedtimes use Social Media?

Background: The use of social media before bedtime usually results in late bedtimes, which is a prevalent cause of insufficient sleep among the general population of most countries. However, it is still unclear how people with late bedtimes use social media, which is crucial for adopting targeted behavior interventions to prevent insufficient sleep. Methods: In this study, we randomly selected 100000 users from Sina Weibo and collected all their posting through web crawling. The posting time was proposed as a proxy to identify nights on which a user stays up late. A text classifier and topic model were developed to identify the emotional states and themes of their posts. We also analyzed their posting/reposting activity, time-use patterns, and geographical distribution. Results: Our analyses show that habitually late sleepers express fewer emotions and use social media more for entertainment and getting information. People who rarely stay up late feel worse when staying up late, and they use social media more for emotional expression. People with late bedtimes mainly live in developed areas and use smartphones more when staying up late. Conclusion: This study depicts the online behavior of people with late bedtimes, which helps understand them and thereby adopt appropriately targeted interventions to avoid insufficient sleep.

Can People Sleep Too Much? Effects of Extended Sleep Opportunity on Sleep Duration and Timing

Many people are concerned about whether they are getting “enough” sleep, and if they can “sleep too much.” These concerns can be approached scientifically using experiments probing long-term (i.e., multi-night) sleep homeostatic processes, since homeostatic processes move the system toward its physiological setpoint (i.e., between “not enough” and “too much”). We analyzed sleep data from two human studies with sleep opportunities much longer than people usually stay in bed (i.e., conditions in which sleep homeostatic responses could be documented): sleep opportunities were 14–16 h per day for 3–28 days. Across the nights of the extended sleep opportunities, total sleep duration, Rapid Eye Movement (REM) sleep duration and non-REM sleep durations decreased and sleep latency increased. Multiple nights were required to reach approximately steady-state values. These results suggest a multi-day homeostatic sleep process responding to self-selected insufficient sleep duration prior to the study. Once steady state-values were reached, there were large night-to-night variations in total sleep time and other sleep metrics. Our results therefore answer these concerns about sleep amount and are important for understanding the basic physiology of sleep and for two sleep-related topics: (i) the inter-individual and intra-individual variability are relevant to understanding “normal” sleep patterns and for people with insomnia and (ii) the multiple nights of sleep required for recovery from insufficient sleep from self-selected sleep loss is important for public health and other efforts for reducing the adverse effects of sleep loss on multiple areas of physiology.

Association between pesticide exposure and sleep health among a representative sample of US adults: evidence from NHANES 2009–2014

Background Data suggest that pesticides interact with the melatonin receptor, which may influence sleep. However, the link between pesticides and sleep remains unexplored among the general adult population. This study evaluated unstratified and sex-stratified associations between urinary pesticide exposure (N = 4,478) and self-reported acute household pesticide exposure (N = 14,956), with sleep health outcomes within a nationally representative sample of US adults. Methods Data from the National Health and Nutrition Examination Surveys (NHANES) 2009–2014 were combined for analysis of aim 1 and aim 2. Urinary pesticide metabolite concentrations served as biomarkers of pesticide exposure. Acute household pesticide exposure (if any chemical products were used in the home in the past seven days to control pests) was self-reported (yes/no). Insufficient sleep duration (< 7 h/night) and trouble sleeping (yes/no) were self-reported. Log-binomial regression models that accounted for complex survey weights and adjusted for confounders were used to compute prevalence ratios and 95% CI. Results Log urinary 3-phenoxybenzoic acid (3-PBA) was related to a higher probability of insufficient sleep [1.09 (95% CI: 1.00, 1.20), p = 0.04] and trouble sleeping [1.14 (95% CI: 1.02, 1.27), p = 0.02] among males. Self-reported acute household pesticide exposure was associated with a higher probability of insufficient sleep duration [1.16 (95% CI: 1.02, 1.32), p = 0.03] and trouble sleeping [1.20 (95% CI: 1.01, 1.44), p = 0.04] in the unstratified sample. Sex-stratified findings showed that associations between acute household pesticide exposure and trouble sleeping only persisted among males [1.69 (95% CI: 1.27, 2.24), p < .001]. Conclusions In summary, acute pesticide exposure may be detrimental to adult sleep health, particularly among US males.

Pileup of Insufficient Sleep and Day-to-Day Trajectories of Affective and Physical Well-Being

This study examined whether and how pileup of insufficient sleep is associated with day-to-day trajectories of affective and physical well-being. Participants from the Midlife in the United States Study (N=1,795) provided diary data for eight days. Pileup of insufficient sleep was operationalized as the number of consecutive nights with &lt;6 hours of sleep. Multilevel models evaluated the linear, quadratic, and cubic effects of pileup of insufficient sleep on daily well-being, adjusting for sociodemographic covariates. Daily negative affect increased and positive affect decreased in curvilinear fashion as the pileup of insufficient sleep increased. For example, daily negative affect increased, but the rate of increase decelerated as the pileup of insufficient sleep increased. In the days most distal to baseline, the rate of increase in negative affect accelerated again. Results were consistent for physical symptoms. Findings suggest that making efforts to break the vicious cycle of insufficient sleep may protect daily well-being.

Insufficient Sleep and Health Care Utilization: A Scoping Review

Insufficient sleep is a common problem among older adults with 26% over the age of 65 reporting less than seven hours sleep in a 24 hour time period. Evidence indicates that untreated sleep disorders are associated with osteoarthritis, heart disease, hypertension, diabetes, obesity, falls, decreased cognitive performance, and decreased health related quality of life in older adults. A scoping review was undertaken to determine what is known about the association between insufficient sleep or insomnia and health care utilization. The Joanna Briggs Institute, Methodology for JBI Scoping Reviews was used to guide the review. Searches were conducted in PubMed, HINARI, Google Scholar and Cochrane databases. Twenty nine studies were included. Overall, the review indicates that reduced sleep is associated with a greater odds of difficulties in daily activities, higher rates of health care utilization and costs, and poly pharmacy. Findings also reveal sociodemographic and geographic variations in prevalence of healthy sleep duration. Although the majority of studies focused on the causes and consequences of insomnia and recommended clinical and behavioral health promotion interventions, there is a gap in studies related to the public health or economic impact of insufficient sleep. Research in this area will provide perspectives on the need to raise awareness of the importance of sleep and to incorporate the awareness into policies that improve sleep health.

The Prevalence of Insufficient Sleep and Bedtime Delay Among Kindergarten Children Aged 3 to 6 Years in a Rural Area of Shanghai: A Cross-Sectional Study

Introduction: Sleep deprivation in children is a global public health problem that affects the physical and mental development of children. Bedtime delay induced by longer screen time and heavy study load is a common cause of sleep deprivation in children. However, the prevalence of insufficient sleep and bedtime delay and related influencing factors among kindergarten children is limited in Shanghai, China.Methods: In 2018, we selected 8,586 children aged 3 to 6 years and their parents in Songjiang District, Shanghai. Data was collected among parents by face-to-face questionnaire interview with signed informed consent. We defined insufficient sleep as those who slept for &lt; 10 h in children aged 3–5 years or 9 h in children aged 6 years within 24 h, and we define bedtime delay as children with bedtime after 21:00. SAS 9.1.3 software was used to calculate the prevalence of bedtime delay and insufficient sleep, and logistic regression was used to explore potential influencing factors.Results: The prevalence of insufficient sleep and bedtime delay among children aged 3 to 6 years was 11.67 and 56.85%, respectively. The prevalence of insufficient sleep among boys was slightly higher than among girls [odds ratio (OR) = 1.18, 95% confidence interval (CI): 1.04–1.35]. With the increase of the age of children, the prevalence of insufficient sleep increased gradually (P &lt; 0.05). The prevalence of insufficient sleep was higher among the only child in the family (OR = 1.18, 95% CI: 1.02–1.36) and those with longer hours of TV watching (OR = 109, 95% CI: 1.02–1.16). Meanwhile, the prevalence of bedtime delay was also higher among the only child in the family (OR = 1.17, 95% CI: 1.06–1.79), among those with parents accompanying for sleep (OR = 1.21, 95% CI: 1.10-1.34), and those with longer TV watching time (OR = 1.13, 95% CI: 1.07–1.18).Conclusions: Insufficient sleep and bedtime delay were prevalent in Chinese children aged 3 to 6 years, especially in boys and older children. TV watching as well as parents accompanying for sleep were associated with insufficient sleep and bedtime delay. We recommend that parents should limit the screen time of children, advocate earlier bedtime and later morning wake-up among children, as well as make their children sleep in separate beds or rooms in younger age.

Impact of Body Mass Index, Socioeconomic Status, and Bedtime Technology Use on Sleep Duration in Adolescents

Factors related to adolescents and sleep are understudied. We evaluate the relationship between bedtime technology use (TU), TV in bedroom, weight, and socioeconomic status in seventh graders (N = 3956) enrolled in a school-based wellness intervention. Sleep quantity was dichotomized to insufficient (<8 hours) or sufficient (≥8 hours); high TU before sleep was defined by use “a few nights each week” or “every, or almost every night.” Insufficient sleep (38.7%), having TV in bedroom (72.9%), and high TU (83.1%) were commonly reported. The likelihood of sufficient sleep was lower for those with high TU (odds ratio [OR] = 0.529 [0.463-0.605]), obese students (OR = 0.815 [0.700-0.949]), and those with a TV in the bedroom (OR = 0.817 [0.703-0.950]). Also, attending a school with higher percent low socioeconomic status students was also associated with insufficient sleep ( P = .026). Interventions to reduce TU may be important for improving sleep quantity, especially for some vulnerable populations.