Multifaceted sleep health score is associated with frailty in a national sample of older adults in Taiwan: Sex matters

Although individual sleep characteristics are related to frailty, these characteristics do not occur separately. A multidimensional measure of sleep might provide a better estimation of frailty compared to isolated sleep characteristics. This study investigated the association of a multidimensional measure of sleep health with frailty and examined whether such relationship differed by sex. Data were from the Taiwan Longitudinal Study on Aging (2011), a survey with a nationally representative sample of Taiwanese older adults (N=2,015). Frailty was defined using the Fried-criteria. Self-reported sleep during the past month was used to conceptualize the five sleep health dimensions in the SATED model (satisfaction-alertness-timing-efficiency-duration; higher scores representing better sleep health). Their relationship was estimated using logistic regression analysis adjusting for sociodemographic (age, sex, education), health (chronic conditions, cognitive function, pain, depressive symptoms [excluding items overlapping with frailty and sleep]), and lifestyle (drinking, smoking, exercise) characteristics. The results showed that having a better sleep health composite score was significantly related to lower odds of being frail in both sexes adjusting for sociodemographic information. Such effect remained significant among females but not males after adding health and lifestyle characteristics to the models. Sleep satisfaction and daytime alertness in both sexes and sleep duration among females were significantly associated with frailty adjusting for sociodemographic information. Only alertness among males was significantly related to frailty in model with all covariates. Our findings show that having a better sleep health across multiple dimensions is related to a lower risk of being frail, and the association differs by sex.

Participation in Physical Education Classes, Psychological Well-Being, and Sleep Satisfaction Among South Korean Adolescents

PURPOSE: This study aimed to examine the associations between participation in physical education (PE) classes and the psychological well-being and sleep satisfaction of Korean adolescents.METHODS: Cross-sectional data from 127,804 Korean adolescents (aged 12–18 years) who participated in the 2016 and 2017 Korea Youth Risk Behavior Web-based Surveys (KYRBS) were analyzed. The exploratory variable was the frequency of participation in PE classes every week, while the dependent variables included the psychological well-being and sleep satisfaction, as assessed by the KYRBS questionnaire. Sex- and grade-stratified logistic regression analyses were conducted to generate the odds ratios (ORs) and 95% confidence intervals (CI).RESULTS: Overall 16.9% of adolescents reported that they did not participate in PE classes while 33.0% reported participating for more than three times a week. After adjusting for the academic achievements, family’s economic status, consumption frequency of breakfast and highly caffeinated drinks, and physical activity level, a greater participation in the PE classes was found to be associated with happiness in a dose-response fashion in both sexes and grades (p<.05). As for stress, participation in the PE classes for more than three times a week was associated with less/no stress in boys (OR: 1.16, 95% CI: 1.02–1.31, p<.05) and high school students (OR: 1.22, 95% CI: 1.03–1.44, p<.05). Moreover, greater participation in the PE classes was associated with a lower odds of reporting sleep satisfaction in a linear fashion among high school students.CONCLUSIONS: More frequent participation in PE classes was associated with the psychological well-being and sleep satisfaction in a large sample of Korean adolescents. Increasing the number of mandatory PE sessions is a promising strategy for promoting the psychological well-being of Korean adolescents.

Differences in problem alcohol drinking by military service type among male professional military personnel in South Korea using Military Health Survey data

ObjectivesAlcohol drinking prevalence in Korea is higher than in other countries and is associated with various social and health problems. Korean culture tends to be tolerant of alcohol drinking and to regard it as an important medium for maintaining good interpersonal relationships in one’s social life. Although alcohol drinking is a means of relieving stress, especially among soldiers, who engage in more binge drinking than civilians, there is lack of research focused on problem drinking among soldiers. Therefore, the purpose of this study was to explore the extent of problem drinking across all military services and to identify factors associated with problem drinking by military service type.DesignSecondary data analysis.SettingDataset of the Military Health Survey in 2015.ParticipantsAltogether, 2252 male professional military personnel were included in this study.Main outcome measureProblem drinking in this study was defined as at-risk drinking and alcohol abuse or dependence with an Alcohol Use Disorders Identification-Korean (AUDIT-K) score of 10 points or higher.ResultsThe average AUDIT-K score was 7.38±4.10 points. The prevalence of problem drinking was 16.4% for the Army, 34.5% for the Navy and 32.1% for the Air Force. Factors associated with problem drinking for each military service type were sleep satisfaction (OR 2.33, 95% CI 1.284 to 4.236) and family support (OR 0.66, 95% CI 0.487 to 0.904) in the Army, smoking status (OR 1.85, 95% CI 1.130 to 3.039) and sleep satisfaction (OR 2.29, 95% CI 1.142 to 4.574) in the Navy and marital status (OR 0.60, 95% CI 0.382 to 0.951), smoking (past smokers and non-smokers OR 2.81, 95% CI 1.593 to 4.973, current smokers and non-smokers OR 1.68, 95% CI 1.114 to 2.544), subjective oral health (OR 1.83, 95% CI 1.011 to 3.297) and family support (OR 0.63, 95% CI 0.45 to 0.88) in the Air Force.ConclusionWhen implementing health projects to address drinking problems, it is necessary to ensure that service-type-specific factors are considered for integrated management.

The Relationship Between Physical Activity and Sleep Status Among Iranian Older Adults: A Cross-Sectional Study

Background: Sleep disorders have a significant impact on physical and mental health among aged population. This study was aimed to determine the relationship between different levels of physical activity (PA) and domains of sleep status in aged population in Birjand, Iran.Methods: This descriptive-analytical study was performed on 1740 individuals ≥60 years in urban and rural regions of Birjand. Longitudinal Ageing Study Amsterdam Physical Activity Questionnaire (LAPAQ), a sociodemographic and a sleep status questionnaire were used to collect data. Analyses of variance (ANOVA), univariate, multiple linear and logistic regressions were used to analyze the data. Results: The mean age of the participants was 69.73±7.56 years. About 54.08% of participants had low PA. People with moderate to high PA had higher sleep quality, sleep satisfaction and sleep efficiency compared to inactive people (p<0.05); but PA was significantly inversely related to sleep duration. According to univariate linear regression model, both low and moderate to high PA were good predictors of sleep quality, sleep efficiency. Moderate to high PA predicted high sleep satisfaction and sleep duration in the participants (p<0.05). Conclusions: Physical activity, particularly at moderate to high levels, results in higher quality, satisfaction and efficiency of sleep in the elderly. The most influential factor on the relationship between PA and sleep is depressed mood. Therefore, in using the PA to improve sleep status of the elderly it is recommended to also focus on reducing the depression.

Association of Vital Exhaustion with Risk Factors for Cardiovascular Diseases, Quality of Life and Lifestyle in 41–44-Year-Old Muscovite Men

(1) Background: Vital exhaustion (VE) is no less of an important risk factor (RF) for cardiovascular diseases (CVD) and cardiovascular events than the well-known RFs. Insufficient knowledge of the relationship between VE and CVD RF, quality of life, and lifestyle was the rationale for this study. (2) Methods: We examined 301 Muscovite men 41–44 years of age. The categorization of RFs for CVD was carried out in accordance with conventionally considered criteria. In order to evaluate the lifestyle and quality of life in study participants, we were offering them a self-filling questionnaire developed by I.A. Gundarov. The presence of VE signs was assessed using a 14-item short version of the Maastricht Vital Exhaustion Questionnaire scale (MVEQ). All study subjects were classified into three ordered groups depending on the distribution of VE indicators by tertiles: Group 1 consisted of men with a low VE (0–2 points), Group 2 included males with a medium VE score (3–5 points), and Group 3 comprised subjects with high VE scores (6–14 points). To analyze the obtained data, we used one-way analysis of variance (ANOVA), Pearson’s chi-squaredtest (χ2), Goodman and Kruskal’s gamma, and linear regression analysis. (3) Results: We established that every third male (36.8%) had VE signs, while 10.6% of men had high VE levels. With an increase of VE in men, the frequency of arterial hypertension (AH) was increasing as well, and it was significantly higher in men with a high VE compared to their peers with a low VE (48.4% versus 33%; p = 0.03). A significant linear relationship was discovered between VE levels and excessive alcohol consumption (p = 0.001). The strongest linear associations were found between the VE level, and both psychosocial stress indicator and the amount of consumed ethanol. Self-assessment of personal happiness, job and sleep satisfaction, residential living conditions, and spiritual needs, as well as psychosocial stress indicator, total amount of consumed ethanol, and muscle strength (hand-grip dynamometry), were independent determinants of the VE level, and, collectively, they explained 46.6% of its variability. The greatest contribution to VE was made by the personal happiness level, explaining 25.5% of its variability. The proportions of the VE variance uniquely explained by various factors were as follows: 9.3% by the psychosocial stress, 4.9% by job satisfaction, 2.8% by sleep satisfaction, 2.3% by total consumption of ethanol, 1.6% by muscle strength, 1.1% by living conditions in the residential neighborhood, and just 0.8% by spiritual needs. (4) Conclusion: High VE levels in 41–44-year-old men are associated with AH, sedentary behavior, excessive alcohol consumption, and lower values of most indicators of both lifestyle and quality of life.

Exploring the Effect of Nightly Infusion Pump Alarms on Sleep in the Hospital

Purpose Optimal sleep helps parents and children cope with life-threatening disease. However, hospital-surroundings are noisy, negatively affecting sleep quality and quantity. We aimed to determine sleep quantity; sleep satisfaction; their relation to infusionpump alarms in pediatric cancer patients and parents; and sleep quality and daytime impairment in parents. Methods Patients (2–18 years), admitted for scheduled anti-cancer therapy were eligible, as were inrooming parents. Frequency and duration of nightly infusion pump alarms were recorded. Patients and parents wore an accelerometer to assess sleep quantity (sleep efficiency, wake after sleep onset, night awakenings), additionally daily sleep satisfaction was assessed. Parents filled out questionnaires on sleep quality (PROMIS Sleep Disturbance, Insomnia Severity Index) and daytime impairment (PROMIS Sleep-Related Impairment, PROMIS Fatigue). Sleep quality scores were compared to norms. In children and parents the relation between alarms and sleep was assessed using multilevel analyses. Results Nineteen children (age 8.8 ± 4.9 years, 40 nights) and 30 parents (age 41.1 ± 6.3, 46 nights) participated (response 78%). Nightly alarms sounded median 3 times / 6 minutes in parents and 5 times / 10 minutes in children. Parents scored worse than the norm on sleep disturbances (P .01), but not on daytime impairment, 16% experienced clinical insomnia. There was no relation between alarms and sleep quantity or satisfaction for children and parents. Conclusions This explorative study showed that alarms sound frequently at night and parents sleep poorly during admissions. However, sleep of children and parents and alarms were not significantly related here. Future research should identify and improve (other) disrupting factors in the hospital.

Monitoring Internal Load with a Mobile App in Professional Soccer Players after the COVID-19 Lockdown (Readiness Soccer): Observational Study (Preprint)

BACKGROUND Heavy physical and mental loads are typical for professional soccer players during the competitive season. COVID-19 lockdowns had recently forced competitions to be interrupted and later disputed in a shrunken calendar. Wearable sensors and mobile phones could be potentially useful in monitoring players’ training load in such highly demanding environments. OBJECTIVE The aim of this study was to explore whether remote heart rate variability (HRV) monitoring and self-reported wellness of professional soccer players could be useful to monitor players’ internal training load and to estimate their performance during the continuation of the 2020 season after the COVID-19 lockdown in Spain. METHODS A total of 21 professional soccer players participated in a 6-week study. Participants used an Android or iOS-based smartphone and a Polar H10 wearable ECG monitor for the duration of the study. Every morning they recorded their HRV and answered a questionnaire about their perceived recovery, muscle soreness, stress and sleep satisfaction. Smallest worthwhile change (SWC) and coefficient of variation (CV) were calculated for the logarithm of the root mean square of the successives differences (LnRMSSD) of the HRV. Players’ in-game performance was evaluated subjectively by independent observers and classified as high, normal and low. In order to find which variables could be potentially linked to performance, we studied their correlation and tested for significant differences among distributions. We also trained random forest models with cross-validation and bootstrapping to find the wellness and HRV features with best predictive ability for performance. RESULTS We found the usability of Readiness Soccer in a real scenario to be very good, with 81.36 points in the System Usability Scale. A total of 241 measurements of HRV and self-reported wellness were recorded. For a entire training microcycle (ie, time in between matches), self-reported high recovery (Mann-Whitney U, P=.003), low muscle soreness (P=.002), high sleep satisfaction (P=.02), low stress (Anderson-Darling, P=.03), and not needing more than 30 minutes to sleep since going to bed (Chi-Squared, P=.02), were found significant to differentiate high from normal match performance. Performance estimation models achieved the highest accuracy (73.4%) when combining self-reported wellness and HRV features. CONCLUSIONS HRV and self-reported wellness data were useful to monitor the evolution of professional soccer players’ internal load and to predict match performance levels out of measures in a training microcycle. Despite the limitations, these findings highlight opportunities for long-term monitoring of soccer players during the competitive season as well as real-time interventions aimed at early management of overtraining and boosting individual performance.

240 Habitual Sleep Changes Following COVID-19 Outbreak

Introduction The ongoing COVID-19 pandemic emerges as one of the most impressive and strenuous events of the century, with unthinkably huge global effects. We aimed at analyzing if and how does the pandemic affect sleep and related behaviors. Methods We reviewed 48,047 nights recorded in the US with the Sleeprate application by 3,381 users during a period of 2 years, December 2018-November 2020. Nightly data included perceived and measured sleep parameters. In addition, users reported their perceived daytime stress and sleepiness. We analyzed the monthly variability of the studied parameters and compared their values during the COVID-19 period of March-November 2020 (CP) with those in the previous corresponding period in 2019, the pre-COVID-19 period (PCP). Results Starting March 2020, wake-up time (WUT) was significantly delayed relative to PCP. WUT in April 2020 was the latest (8:06AM±2:12hours, mean±SD, p&lt;.000), being an hour later than in April 2019. This delay started to diminish in June 2020, reaching 7:27AM±2:10 hours by November 2020, which was not significantly higher than during PCP. Bedtime (BT) exhibited similar behavior, yet it returned to PCP times faster. Delayed BT and WUT on weekends were observed during CP as well as PCP. No consistent differences in sleep duration or sleep efficiency were detected between CP and PCP. Subjective sleep satisfaction was higher in CP relative to PCP. However, daytime sleepiness and daytime stress were also higher during most of CP compared to PCP. Conclusion Our data, based on digital in-app sleep diaries coupled with perceived sleep parameters, demonstrate the pandemic’s effects on sleep behavior in the US. Users in this study adapted to the new circumstances with delayed sleep schedule, while not reducing the sleep opportunity. The higher sleep satisfaction may be connected to later sleep schedules, allowing a wake-up time that fits better human biological clocks. The reported increased stress and sleepiness further portray the uncertainty and turbulence characterizing the pandemic’s effects on populations life during the pandemic. As good sleep is linked with immune response efficacy, higher quality of life, and improved mood, the importance of sleep must not be overlooked, especially during the pandemic. Support (if any):