bluuebunny/crossref_metadata_2025 huggingface dataset:
0182 Childhood sleep is longitudinally associated with adolescent alcohol and marijuana use
Authors: Krishnan Akshay , Reichenberger David , Strayer Stephen , Master Lindsay , Buxton Orfeu , Hale Lauren , Chang Anne-Marie
Published: May 2022

Introduction

Worse sleep health has been linked with greater substance use among adolescents. However, most studies have only cross-sectionally examined this relationship or examined these longitudinal effects in children with sleep disorders. This study investigates whether childhood sleep is longitudinally associated with adolescent alcohol or marijuana use.

Methods

We analyzed data from the Fragile Families and Child Wellbeing Study, a longitudinal birth cohort. Parents reported their child’s bedtime at ages 3, 5, and 9, and their child’s average sleep duration at ages 5 and 9. At age 15, adolescents self-reported their bedtime, time in bed, whether they ever drank alcohol without parents, and whether they ever tried marijuana. Only participants with complete data were included (N=1,493). Logistic regression analyses for each substance use outcome were adjusted for age, sex, race, family socioeconomic status, family structure, and caregiver education level.

Results

Later bedtime at age 3 was longitudinally associated with lower odds of ever drinking alcohol at age 15 (OR=0.73, CI=0.58, 0.91, p<0.01) whereas later bedtime at age 9 was associated with greater odds (OR=1.44, CI=1.10, 1.89, p<0.01). Later bedtime at age 15 was cross-sectionally associated with greater odds of ever drinking alcohol (OR=1.40, CI=1.23, 1.59, p<0.01). Later bedtime at age 5 was associated with greater odds of ever trying marijuana (OR=1.25, CI=1.00, 1.57, p<0.05), as was later bedtime at age 15 (OR=1.34, CI=1.19, 1.51, p<0.01). Additionally, longer sleep duration at age 9 was longitudinally associated with lower odds of ever trying marijuana (OR=0.84, CI=0.74, 0.97, p<0.02). Adolescents who had longer time in bed at age 15 had lower odds of ever drinking alcohol (OR=0.72, CI=0.63, 0.81, p<0.01) and ever trying marijuana (OR=0.89, CI=0.79, 0.99, p<0.04).

Conclusion

In general, earlier bedtimes and longer sleep duration during childhood and adolescence were associated with lower odds of ever using alcohol or marijuana during adolescence. These results are consistent with current literature indicating that healthy sleep is associated with reduced risk-taking behaviors. Future research should further investigate whether sleep patterns across childhood are linked to decision-making and risk-taking behaviors in adolescence.

Support (If Any)

R01HD073352 (to LH), R01HD36916, R01HD39135, R01HD40421
0183 Daily sleep predicts adolescents’ next-day psychomotor vigilance, sleepiness, and fatigue: Ecological momentary assessment across 28 days of school and vacation
Authors: Shen Lin , Sletten Tracey , Wiley Joshua , Bei Bei
Published: May 2022

Introduction

Few studies have examined the associations between daily sleep and daytime functioning in adolescents during naturalistically-occurring constrained (school term) and unconstrained (vacation) sleep opportunities.

Methods

Adolescents (n = 205; 54.1% females, age M ± SD = 16.9 ± 0.87 years) completed daily measures of sleep and daytime functioning over 28 continuous days (2-week school, and the subsequent 2-week vacation). Total sleep time (TST) and sleep efficiency (SE) were measured using actigraphy and sleep diary. Participants self-reported sleepiness and fatigue every morning and afternoon, and completed the brief, 3.2-minute psychomotor vigilance task (PVT; Joggle Research) on an iPad every afternoon. Using cross-lagged multilevel models, daily TST and SE were examined as predictors of next-day sleepiness, fatigue, and PVT performance. The associations did not differ between school and vacation. The non-significant interaction terms were dropped, and school/vacation status was maintained as a covariate. Previous-day outcome, day of the week, study day, school/vacation and sociodemographics were adjusted. Between-person associations (differences between individuals) and within-person associations (daily deviations from individual’s own mean capturing whether nights with longer- or better-than-average TST or SE respectively, relative to the individual’s average TST/SE, predict next-day outcomes) were tested simultaneously.

Results

Adolescents performed better on the PVT (faster reaction time and fewer lapses) following nights with longer-than-average TST (actigraphy and diary, p-values ≤ .044). Longer-than-average TST (actigraphy and diary) and higher diary SE also predicted lower self-reported sleepiness the next day (morning and afternoon, p-values ≤ .002). Similarly, longer-than-average TST and higher-than-average SE predicted lower self-reported fatigue the next day (morning and afternoon, all p-values ≤ .032). Compared to the vacation, school term was associated with higher self-reported fatigue in the morning and afternoon (p-values ≤ .014), but not higher sleepiness or poorer PVT performance.

Conclusion

Fluctuations in daily sleep were associated with adolescents’ next-day functioning. Importantly, longer- and better-than-average sleep consistently predicted better daytime functioning the next day. Findings were consistent across objective sustained attention and self-reported sleepiness and fatigue, highlighting the short-term effects of sleep restriction on adolescents’ daytime functioning. Protecting adolescents’ sleep duration and promoting good quality sleep on a daily basis could support optimal daytime functioning.

Support (If Any)

Dr Shen was supported by the Monash International Postgraduate Research Scholarship and Monash Graduate Scholarship.
0185 N2 Sleep Spindle Activity is Associated with Better Next-Day Emotion Regulation in Healthy Children
Authors: Myers Annika , Alfano Candice , Rech Megan , Baran Bengi , Palmer Cara
Published: May 2022

Introduction

Children's day-to-day mental health is dependent on adequate quantity and quality of sleep, but far less is known about the microstructural sleep features that support emotional functioning in children. NREM sleep spindles (rhythmic EEG oscillations between 10 and 15 Hz) are closely linked with intellectual abilities and cognitive processing, and have also been shown to relate to children’s emotional behavior, both concurrently and longitudinally. For example, socially-anxious youth showed reduction in sleep spindle activity compared to healthy controls, which correlated negatively with subjective reports of arousal in response to negative images (Wilhelm et al., 2017). In younger children, greater NREM 2 spindle density was associated with greater prosocial behavior concurrently and fewer behavioral and social problems one year later (Mikoteit et al., 2012; 2013). However, studies in pediatric samples are limited overall and haven’t examined spindles in relation to objective measures of emotion regulation.

Methods

We examined relationships between spindle activity during NREM stage 2 (N2) and next-day subjective and objective emotional responses among N=26 healthy children, 7-11 years old. Children completed a full-night of at-home PSG monitoring (10hr sleep opportunity) followed by two in-lab tasks. In task 1, children rated arousal/reactivity in response to negative images from the International Affective Pictures System (IAPS). In task 2, respiratory sinus arrhythmia (RSA) was measured while children were directed to suppress all facial expressions of emotion (i.e., regulate emotional responses to negative content) while watching negatively-valenced movie clips. All analyses controlled for total sleep time on PSG night and RSA analyses controlled for a resting baseline period.

Results

Greater C3 spindle count (r = .51, p < .05) and density (r = .53, p < .05) were significantly associated with less child-reported arousal towards negative images. Greater F3 peak spindle frequency was positively associated with higher RSA during negative movies (r = .54, p < .05), suggesting better regulatory control of emotional responses to correspond with greater spindle peak frequency.

Conclusion

Together with previous data, our findings suggest that sleep spindle activity may partially reflect children’s capacity to regulate emotional responses in relation to stressful situations, thereby potentially reducing risk of mental health problems.

Support (If Any)
0188 Associations between Preschoolers’ Behavioral Difficulties and Variability in Sleep Duration and Bedtime
Authors: Burkart Sarah , Armstrong Bridget
Published: May 2022

Introduction

Variability in children’s sleep patterns has been linked with health outcomes including obesity, poor mood, and behavioral difficulties. However, much of this evidence stems from parent-reported measures of sleep. Understanding these associations in preschool-age children using device-based measures is important as sleep habits tend to develop and stabilize during this time. The purpose of this study was to examine associations between parent-reported behavioral difficulties and device-measured sleep among preschoolers.

Methods

Ninety-five preschool-aged children (3-5 years, 51% female, 30% Black) with at least two valid nights of sleep were in included in this analysis. Children were asked to wear an Axivity AX3 accelerometer on their non-dominant wrist for 30 days. Parents completed the Strengths and Difficulties Questionnaire which assessed child behaviors over the past 6 months. Raw accelerometry data were processed with GGIR (v2.3). We used MixWild to conduct mixed effects location scale models with a random intercept and scale predicting nocturnal duration variability and bedtime variability. Time invariant behavior subscales (conduct problems, hyperactivity/inattention, peer relationship problems, emotional symptoms, prosocial behavior, and total difficulties) were included as predictors of child sleep duration and bedtime variability.

Results

Children had an average of 13.4 ± 7.4 (range 2-29) nights of valid data. Average nocturnal sleep duration was 9.7 ± 1.4 hours and average bedtime was 9:48 PM. There were no statistically significant associations between any SDQ subscales and variability in children’s sleep duration and bedtime. There was an association between random location and scale such that participants with later average bedtimes also had more variability in their bedtime (p < 0.001).

Conclusion

Variability in nocturnal sleep was not associated with parent reported behavioral difficulties, which is contrary to recent findings. It is unclear if sleep duration and bedtime variability are associated with day-level changes in children’s behavior. Additional work that emphasizes aspects of sleep beyond sleep duration is needed to advance our understanding of preschool-age children’s sleep.

Support (If Any)

This was supported by the National Institute of General Medical Sciences of the NIH for the UofSC Research Center for Child Well-Being (P20GM130420) and by the National Heart, Lung, and Blood Institute (F32HL154530).
0193 Moving While Sleeping: On the Paradoxical Co-occurrence of Muscle Atonia and Twitching
Authors: You Zipeng , Sokoloff Greta , Blumberg Mark
Published: May 2022

Introduction

During active (or REM) sleep, discreet, jerky movements called myoclonic twitches occur against a background of muscle atonia. The neural mechanisms that allow these two seemingly contradictory phenomena to co-occur remain unclear. One view holds that twitches are produced when a large descending motor signal overpowers the inhibition on spinal motor neurons. An alternative view is that atonia and twitching are coordinated by the same brainstem structures that produce and regulate active sleep. One such structure is the sublaterodorsal tegmental nucleus (SLD), which plays a key role in adult rats to the production of atonia, but whose contribution to twitching has not been examined. Here, we investigated the relationship of SLD neurons to atonia and twitching during a period in early development when twitching is abundant.

Methods

We recorded extracellular neural activity from the SLD in 8 12-day-old (P12) head-fixed rats as they cycled freely between sleep and wake. To assess the relationship between twitches and neural activity, we also recorded limb movements using high-speed video.

Results

Consistent with the adult literature, the majority of SLD neurons (35/56) were significantly more active during periods of sleep-related atonia. Interestingly, a subgroup of neurons (n=15) was inhibited at the onset of a burst of twitches, whereas another subgroup of neurons (n=26) was excited around the onset of a burst of twitches. Thus, together, the activity of 41 of 56 SLD neurons was modulated by twitches.

Conclusion

These results demonstrate that the activity of SLD neurons is associated with both atonia and twitching. This finding suggests that these two early-developing components of active sleep are coordinated within the brainstem. These initial findings open new avenues for further research into the neural mechanisms that coordinate the co-occurrence of twitching and atonia during active sleep.

Support (If Any)

This research was supported by R37-HD081168 awarded to M.S.B.
0197 Increased Brain Kynurenic Acid Elicits Sex-Dependent Abnormalities in NREM Sleep Spindle Dynamics
Authors: Rentschler Katherine , Tentor Zachary , Fox Julie , Pocivavsek Ana
Published: May 2022

Introduction

Sleep spindles are thalamocortical oscillations which occur during non-rapid eye movement (NREM) sleep. NREM sleep spindle aberrations are a consistent clinical sleep deficiency associated with psychotic disorders and exacerbation of cognitive symptoms. Kynurenic acid (KYNA), a tryptophan metabolite synthesized from kynurenine via kynurenine aminotransferases (KATs) and modulator of glutamatergic and cholinergic neurotransmission, is elevated in the brain of patients with psychotic disorders, including schizophrenia and bipolar disorder. Currently, we sought to understand the neurodevelopmental and transient impacts of brain KYNA elevation on sleep spindle dynamics.

Methods

In Experiment #1, sleep spindles were evaluated in adult offspring, postnatal day (PD) 56 from embryonic kynurenine (EKyn) treated rat dams (Rentschler et al., 2021 Sz Bull) (N=7-9 per group). EKyn KYNA male, but not female, offspring have elevated KYNA during the light phase (Wright et al., 2021 Frontiers in Psychiatry). In Experiment #2, sleep spindles were evaluated in adult rats injected with kynurenine (100 mg/kg; i.p.) to acutely elevate brain KYNA levels at zeitgeber time 0 (N=8-12 per group). Polysomnography was recorded via EEG/EMG telemetry. Sleep spindles were evaluated using a custom-made manual scoring system during the first 4 hr of the light cycle.

Results

Male EKyn, but not female, exhibited a decrease in spindle density compared to ECon (2-wayANOVA: ***P<0.001). FFT spectral power for peak spindle frequency (10-15 Hz) was reduced for all EKyn offspring (3-way ANOVA; frequency x treatment interaction: ****P<0.0001; treatment: *P<0.05). Kynurenine challenge reduced spindle density for both sexes (2-way ANOVA: ***P<0.001; M: **P<0.01; F: *P<0.05). Frequency x treatment interaction for males (2-way ANOVA: ***P<0.001) was observed with lower FFT spectral power for 10-10.5 Hz (*P<0.05) and greater power for 14-14.5 Hz (*P<0.05).

Conclusion

We determined conspicuous sex differences in spindle dynamics in the EKyn paradigm that may be related to brain KYNA levels; only males exhibited a decrease in spindle density, however all EKyn offspring had reduced FFT spectral power. Kynurenine challenge reduced spindle density in both sexes, however only males had changes in FFT spectral power. Future work will consider the efficacy of KYNA synthesis inhibition to prevent NREM sleep spindle abnormalities induced by KYNA elevation.

Support (If Any)

Funding Source: National Institute of Health Grants: NIH RO1 NS102209 & P50 MH103222.
0212 Habitual Heavy Alcohol Drinking in Healthy Adults is Associated With Reduced Circadian Photoreceptor Responsivity to Light
Authors: Burgess Helen , Rizvydeen Muneer , Kikyo Fumitaka , Kebbeh Nema , Tan Michael , Roecklein Kathryn , Hasler Brant , King Andrea , Cao Dingcai
Published: May 2022

Introduction

Habitual alcohol consumption and circadian timing are interconnected. Numerous studies have reported that heavy alcohol use is associated with eveningness. Only two studies have assessed the dim light melatonin onset (DLMO) in the context of habitual alcohol use, and both reported a shorter DLMO-midsleep interval was associated with heavier alcohol consumption. A gap in this research is the potential impact of alcohol use on the primary circadian photoreceptor, the intrinsically photosensitive retinal ganglion cells (ipRGCs), which influence circadian timing. This study aimed to compare sleep, circadian timing, and photoreceptor responsivity between light and heavy alcohol drinkers.

Methods

Participants were healthy (average age 27 years) and included 28 light (average 2.6 drinks/week) and 50 heavy (average 17.9 drinks/week) drinkers. They participated in an 8-day study protocol: 1 week of adlib sleep monitored with wrist actigraphy, followed by a 9-hour laboratory session with a photoreceptor responsivity (post-illumination pupil response, PIPR) and circadian phase assessment. Participants passed a breathalyzer test at the start of the laboratory session.

Results

Both drinking groups were good sleepers with minimal mood disturbance. Consistent with earlier studies, the heavy drinkers had more eveningness (p=0.029), and a trend for a shorter DLMO-midsleep interval (p=0.059) as compared to the light drinkers. The PIPR in the heavy drinkers was significantly smaller than in the light drinkers (p=0.006), suggesting reduced circadian photoreceptor responsivity in the heavy drinkers. In the light drinkers, a larger PIPR in the evening, reflecting greater sensitivity to phase-delaying light, was significantly associated with a later DLMO (r=0.42, p=0.028). However, this relationship was absent in the heavy drinkers (r=-0.07, p=0.68).

Conclusion

The findings replicate previous work examining the relationship between chronotype, DLMO, and habitual alcohol consumption. For the first time, circadian photoreceptor responsivity was examined, and found to be significantly reduced in heavy alcohol drinkers as compared to light alcohol drinkers. This finding is consistent with prior rodent studies that found reduced phase shifts to light with acute or chronic alcohol consumption, and suggests that habitual heavy alcohol use may impair the circadian response to light in humans.

Support (If Any)

Grant awarded from NIAAA R01 AA023839.
0218 N2 and wakefulness drive subjective sleep satisfaction in adults
Authors: Lok Renske , Chawra Dwijen , Hon Flora , Ha Michelle , Kaplan Kate , Zeitzer Jamie
Published: May 2022

Introduction

The measurable aspects of brain function derivable from polysomnography (PSG) that are correlated with sleep satisfaction are poorly understood. Previously, a weak association of PSG measures with subjectively rated sleep depth and restfulness was shown. Using recent developments in automated sleep scoring, which remove the within- and between-rater error associated with human scoring, we revisit whether whole night PSG measurements are associated with sleep satisfaction. Additionally, we investigate if PSG data collected closer to wake time explains the subjective sleep experience better than whole night PSG.

Methods

Random Forest machine learning was used to investigate the relationship between PSG data from the Sleep Heart Health Study (N=3,165, middle-aged and older adults) and self-reported sleep satisfaction (restfulness, depth). PSG were rescored using a novel automated algorithm that generates both a sleep stage for each 15-s epoch as well as a stage matching probability. Data were also parsed into 20 minute-fragments based on time relative to wake.

Results

Models explained 30% of subjective sleep depth and 27% of subjective sleep restfulness, with a similar top four predictors: minutes of N2 and wake after sleep onset (WASO), sleep efficiency, and age, capturing 28% (restfulness) and 26% (depth) of the relative model variance. With increasing subjective sleep quality, there was a progressive increase in N2 and decrease in WASO of similar magnitude, without systematic changes in N1, N3 or REM. In comparing those with the best and worst subjective experience of sleep, there is a range of approximately 30 minutes more N2, 30 minutes less WASO, an improvement of sleep efficiency of 7-8%, and an age span of 3-5 years. Random Forest models derived from PSG fragments closer to the offset of sleep did not provide better explanatory power compared to the whole-night data set.

Conclusion

Approximately one-third of the variance in two measures of self-reported sleep experience can be explained by whole-night PSG variables, notably an increase in N2 and decrease in wake that led to improved sleep efficiency. Interventions that specifically target these may be suitable for improving the self-reported sleep experience.

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0225 An assessment of the information quality, understandability, and actionability of popular YouTube videos on sleep and sleep disorders
Authors: Monten Kristen , Loeb Stacy , Le Colin , Diaby Fatoumata , Fray-Witzer Maya , Van den Bulck Jan , Robbins Rebecca
Published: May 2022

Introduction

The Internet and social media are widely used and surprisingly trusted sources of sleep health information. Despite the tremendous promise as platforms for sharing evidence-based information and supporting decision-making about sleep health and sleep disorders, this may not be the case. Few studies have examined the quality, understandability, and actionability of popular sleep health messages on the Internet and/or social media.

Methods

We identified the most widely viewed videos about “sleep” and “insomnia” on YouTube, which is the most widely used social media platform in the U.S. Two trained coders reviewed each video using two validated assessment tools: (1) DISCERN which rates the quality of information (scores ranging from 1 to 5, with 3 as the threshold for moderate to good quality), and (2) the Patient Education Material Assessment (PEMAT) tool for understandability and actionability (with scores from 0 to 100%, with 70% used as the threshold value). We also documented video reach (the number of times the video was viewed) and likability (the number of times a viewer provided a “thumbs up” after viewing), metrics provided by YouTube.

Results

Our search identified 21 popular videos on sleep and insomnia. The average reach of the videos analyzed was 8.4 million (range: 915,639 to 39,201,665) and average likability was 257,167 (19,000 to 1,600,000). The average DISCERN score was 2.6, below the threshold for information quality. The average PEMAT scores for understandability (67%) and actionability (63%) were below the threshold for understandability and actionability.

Conclusion

The most widely viewed videos about sleep and insomnia on YouTube had generally poor information quality, and were frequently difficult to understand.

Support (If Any)

SL is supported by the NYU Perlmutter Cancer Center Developmental Project Program, which is partially supported by the Cancer Center Support Grant P30CA016087
0228 Using Blue Light Therapy to Facilitate Recovery of Sleep and Psychological Functioning in PTSD
Authors: Killgore William , Pace-Schott Edward , Grandner Michael , Vanuk John , Reign Deva , Dailey Natalie
Published: May 2022

Introduction

Sleep problems are often described as the “hallmark symptoms” of post-traumatic stress disorder (PTSD). Patients with PTSD show numerous disruptions of emotional functioning. Experimental evidence has shown that the ability to retain extinction memories following fear conditioning is impaired in people with PTSD. Because of the key role of sleep in memory consolidation and emotional regulation, we hypothesized that regulating sleep and circadian rhythms with morning blue-wavelength light therapy would facilitate emotional recovery and the ability to retain extinction memories.

Methods

Eighty-four individuals with PTSD (56 female; Age=31.38, SD=8.9) underwent a well-validated fear conditioning and extinction protocol and were then randomly assigned to receive either 6-weeks of BLUE (469 nm; n=44) or placebo AMBER (578 nm; n=40) morning light therapy for 30-minutes daily. Participants returned to undergo post-treatment extinction recall when exposed to the same previously conditioned stimuli, and a functional magnetic resonance imaging (fMRI) while the same images were presented. Participants also completed a variety of emotional and mental health outcome measures and wore an actigraph to measure sleep over the 6-weeks.

Results

There was a significant interaction between light condition and time in bed and total sleep time (p<.05) indicating significant increases in sleep with blue versus amber light over treatment. Additionally, declines in symptoms of PTSD on the Clinician Administered PTSD Scale (CAPS-5) correlated with improvements in sleep for the blue, but not the amber light, group (all p-values <.05). During the fear conditioning and extinction paradigm, blue light was associated with significantly greater extinction recall compared to the amber light condition (p=.05). Finally, blue light resulted in decreased fMRI activation within the right amygdala and increased activation within the ventromedial prefrontal cortex to the previously feared and extinguished stimuli.

Conclusion

Blue light treatment was more effective than amber placebo at increasing sleep quantity, shifting circadian bedtime, reducing PTSD symptom severity, facilitating the retention of extinction memories, and reducing neural fear responses to previously feared stimuli. We suggest that improvements in sleep led to greater consolidation of extinction memories. These findings suggest that blue light treatment may facilitate treatment gains by improving sleep.

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0229 Concerns about the future linked with poor sleep quality in U.S. Army Soldiers withdrawing from Afghanistan
Authors: Mantua Janna , Overman Grace , Huang Kathleen , Eldringhood Hannah , Chaudhury Sidhartha
Published: May 2022

Introduction

A special operations unit of U.S. Soldiers rotated through Afghanistan from October, 2001 to the U.S. drawdown in 2020-2021. For these Soldiers, the drawdown has led to uncertainties about the future of the unit and their careers. Psychological stress resulting from these uncertainties could lead to sleep disturbances. This study assessed the relationship between attitudes about the Afghanistan drawdown and sleep.

Methods

A survey was broadly distributed in July-August 2021. To assess attitudes about the drawdown, participants were asked whether they felt changes in their personal readiness had occurred since the drawdown began. They were asked how they believed the unit should support Afghanistan in the future (remain in Afghanistan, support only through airstrikes, or no further support). Lastly, Soldiers were asked whether the drawdown made them more likely to switch to another unit, get out of the Army, or no change. Subjective sleep quality and duration from the month prior was assessed. Due to the abrupt fall of Kabul, the survey was discontinued earlier than planned, resulting in 35 participants.

Results

Soldiers were 32.80±5.99 years old. They had been in the unit for 8.89±5.71 years and had deployed to Afghanistan 5.14±3.14 times. The average sleep duration was 6.66±0.79 hours, and the average sleep quality was 63.39%±21.63%. There were no relationships between attitudes and sleep duration. However, regression analyses showed those who reported increased stress (B=18.16, p=.01), decreased morale (B=2.97, p=.006), and decreased motivation (B=2.69, p=.01) since the drawdown began had poorer sleep quality. ANOVA tests showed Soldiers who believed the unit should remain in Afghanistan had poorer sleep quality than those endorsing only air support or no involvement (F(2,29)=6.39, p=.005). Further, those who endorsed being more likely to make a career change had poorer sleep quality than those with no changes in career plans (F(2,29)=3.53, p=.04).

Conclusion

These results indicate that psychological distress resulting from the drawdown may be impacting sleep quality in this unit. Continuous monitoring of sleep quality may prove to be a sensitive indicator of elevated stress at the unit level.

Support (If Any)

Support for this study came from the Military Operational Medicine Research Program (MOMRP) of the United States Army Medical Research and Development Command (USAMRDC). Material has been reviewed by the Walter Reed Army Institute of Research. There is no objection to its presentation and/or publication. The opinions or assertions contained herein are the private views of the authors, and are not to be construed as official, or as reflecting true views of the Department of the Army or the Department of Defense. The investigators have adhered to the policies for protection of human subjects as prescribed in AR 70–25. The authors have no conflicts of interest to disclose.
0230 Vaping and Sleep as Predictors of Adolescent Suicidality
Authors: Welty Cody , Nair Uma , Gerald Lynn , Skobic Iva , Morales Mario , Haynes Patricia
Published: May 2022

Introduction

Suicide is a leading cause of death for adolescents aged 14-18. Because of the challenges of suicide prevention interventions (e.g., cost or effectiveness), it is critical to examine potential, modifiable risk factors related to adolescent suicide. This study examined self-reported suicidality, vaping, and sleep quantity among high school students in the U.S. We investigated sleep quantity as a moderator of vaping and multiple aspects of suicidality (thoughts, plans, and attempts). This study is, to our knowledge, the first to examine the effects of both vaping and sleep on suicide outcomes.

Methods

Authors utilized responses from adolescents with complete data on the primary outcome of a suicide attempt in the past year in the 2019 Youth Risk Behaviors Survey (n=10,520). Logistic regression was utilized to estimate the main effects of vaping in the past 30 days, sleep hours on school nights, and the interaction of vaping and sleep on suicide attempts (primary outcome), suicidal thoughts (secondary outcome), and suicide plans (secondary outcome).

Results

Students who vaped in the past month had 2.78 (95% CI = [2.171-3.549]) times the odds of a suicide attempt in the last year compared to students who did not vape. Students who slept less than seven hours had 1.93 (95% CI = [1.583-2.352]) times the odds of a suicide attempt in the last year compared to students who slept seven or more hours. Sleep quantity moderated the relationship between vaping and suicidal thoughts in the past year but did not moderate the relationship between vaping and a suicide plan or suicide attempts. Specifically, vaping had a reduced effect on suicidal thoughts among students who slept under seven hours.

Conclusion

Adolescents who vaped in the past month or who reported less than 7 hours of sleep on school nights had significantly higher odds of reporting a suicide attempt in the past year. Students who vape or report low sleep quantity would be ideal participants in suicide prevention interventions as they may be at higher risk for suicidality. Organizations implementing sleep or vaping interventions should incorporate information regarding the higher odds of suicide among students with low sleep quantity or vaping habits.

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0233 Sleep Quality and Disturbances, Emotional Regulation and Resiliency in Adolescents during the COVID-19 Pandemic
Authors: Gauthier-Gagné Gabrielle , Jensen Jana , Somerville Gail , Little Charlotte , West Gwyneth , Daigneault Justine , Risi Nicolette , Gruber Reut
Published: May 2022

Introduction

The COVID-19 pandemic continues to evolve internationally, increasing levels of psychological stress in adolescents around the world, and thereby increasing their risk for emotional disorders associated with chronic stress. This ongoing threat to adolescents’ mental health requires that we identify factors that contribute to their ability to cope with situations shown to carry significant risks, such as the COVID-19 pandemic (i.e., their resiliency).Negative emotions are associated with chronic stress, and factors that reduce levels of negative emotions are associated with improved resiliency. Healthier sleep is associated with lower levels of negative emotions. Cognitive reappraisal (changing the way one thinks about potentially emotion-eliciting events) is an emotional regulation strategy that downregulates negative emotions. However, there is little information about the associations between sleep quality, emotional regulation, and resiliency in adolescents. The present study sought to fill this gap by examining the associations between adolescents’ sleep quality and disturbances, emotional regulation strategies and adolescents’ resiliency during the COVID-19 pandemic.

Methods

Forty-five adolescents (M=13.47, SD=1.7 years) participated in the study during the first wave of the COVID-19 pandemic in Canada (May 15 to June 30, 2020). The Pittsburgh Sleep Quality Index was used to assess adolescents’ self-reported sleep quality and disturbances. The Emotion Regulation Questionnaire was used to assess respondents' tendencies to regulate their emotions using cognitive reappraisal or expressive suppression. The Connor-Davidson Resilience Scale was used to measure resilience. Behavioral/emotional problems were assessed before the pandemic using the Youth Self Report (YSR).

Results

Hierarchical multiple linear regression analyses revealed that lower levels of sleep disturbances and frequent use of cognitive reappraisal to regulate emotions were associated with a higher level of resiliency during the COVID-19 pandemic, above and beyond the contributions of gender or pre-pandemic emotional or behavioral problems.

Conclusion

Better sleep quality and the habitual use of an emotional regulation strategy that is effective in downregulating negative emotions are associated with higher resiliency in adolescents facing the COVID-19 pandemic. The cross-sectional nature of the study does not allow the inference of causation.

Support (If Any)

CIHR 418638 to Reut GruberRGPIN-2015-04467 to Reut Gruber
0234 Salivary α-Amylase Response to Repeated Exposure to Acute Stressors Is Altered by Sleep Deprivation
Authors: Lundholm Kirsie , James Stephen , Honn Kimberly , Hansen Devon , Van Dongen Hans , Satterfield Brieann
Published: May 2022

Introduction

Salivary α-amylase (sAA), a biomarker of autonomic nervous system (ANS) activity, is believed to reflect physiological responsiveness to stressors. Although exposure to stressors often co-occurs with sleep deprivation, little is known about their combined effects. We investigated the sAA response following repeated exposure to acute stressors at well-rested baseline and during total sleep deprivation (TSD).

Methods

As part of a larger study, N=8 healthy subjects (ages 29.0±6.6; 4 females) participated in a 4-day/3-night laboratory-based experiment. Subjects had 38h TSD preceded and followed by 10h sleep opportunities (22:00–08:00). On days 2 (baseline) and 3 (TSD), subjects completed two (A, B) deadly-force decision-making simulations in a high-fidelity shooting simulator with 30min rest between sessions. During each simulation, subjects (who were civilians) acted as police officers while viewing interactive videos depicting stressful law enforcement emergency response scenarios involving deadly-force decision-making. In these scenarios, subjects attempted to de-escalate the situations in the scenarios using verbal commands. If unsuccessful, they were to determine if the use of (simulated) deadly force was necessary and respond accordingly. Saliva samples were collected immediately before the first simulation of the baseline and TSD days, and immediately, 15min, and 30min after each simulation. Samples were assayed in duplicate using a sAA kinetic enzyme assay; results were normalized against the first pre-stressor sample of the baseline day.

Results

Post-simulation sAA values normalized to reference were analyzed with mixed-effects ANOVA with fixed effects of day and sample and their interaction and a random effect over subjects on the intercept. There was a significant effect of sample (F[5,76]=3.38, p=0.008) indicating that sAA spiked immediately after each deadly-force decision-making simulation. Planned comparisons revealed significantly blunted sAA during TSD compared to baseline immediately after the second simulation of the day (t[76]=2.09, p=0.040).

Conclusion

In our sample of civilian subjects, the deadly-force decision-making simulations elicited a sAA response, which was blunted after the second simulation on the day subjects were sleep-deprived, suggesting that TSD mediates the biological response to repeated exposure to acute stressors. Whether this result generalizes to police officers and military personnel trained in deadly-force decision-making remains to be determined.

Support (If Any)

ONR grant N00014-13-1-0302
0236 The First Night Effect In Adolescents With And Without Insomnia
Authors: Yuksel Dilara , Arra Nicole , Dulai Teji , Volpe Laila , Camacho Leticia , Obilor Todd , Hsu Carrie , Kiss Orsolya , Prouty Devin , Baker Fiona , de Zambotti Massimiliano
Published: May 2022

Introduction

Insomnia in adolescence is a common and debilitating condition, and vulnerability to stress is known to play a major role its development. In this study, we investigated the effects of sleeping under stress in a sample of adolescents with and without clinically significant insomnia symptoms. The first night in the laboratory was used as an established experimental paradigm for eliciting stress through exposure to an unfamiliar environment.

Methods

Forty-one postpubertal adolescents (18.4 ± 0.7 years) with (n=14, 9 girls) and without (n=27, 16 girls) DSM-5 insomnia symptoms completed two non-consecutive polysomnographic (PSG) nights in the laboratory. Repeated-measures ANOVAs were used to analyze differences in PSG sleep measures between the first and subsequent night, with group (insomnia vs. control) and sex as between-subject factors.

Results

Both groups showed a robust stress effect on the first night, characterized by lower sleep efficiency (↓2.2%) and total sleep time (↓6.4%), and more awakenings (↑12.4%) compared with the subsequent night (p<0.05). Both groups also had less non-rapid-eye-movement (NREM) (↓4.9%) and REM (↓18.8%) sleep on the first night. Girls with insomnia had lower amounts of REM sleep than boys with insomnia on both nights (p<0.05). Both groups perceived higher levels of pre-sleep somatic (↑10.3%) and total (↑7.2%) arousal on the first night compared to the subsequent night (p<0.05). For cognitive arousal, there was a night-group-sex interaction effect: while controls showed no changes between the two nights, boys with insomnia reported significantly lower pre-sleep cognitive arousal levels on the subsequent laboratory night compared to the first night (↓32.9%), whereas cognitive arousal levels remained elevated on the subsequent night in girls with insomnia (p<0.05).

Conclusion

Sleeping for the first time in the laboratory leads to greater pre-sleep arousal and disrupts sleep in adolescents with and without insomnia symptoms. Longitudinal studies are needed to examine the female vulnerability in the manifestation of stress-related hyperarousal, particularly in the context of insomnia development during adolescence.

Support (If Any)

This study was supported by the National Heart, Lung and Blood Institute (NHLBI) grant R01 HL139652 (MdZ). The content is solely the responsibility of the authors and does not necessarily represent the official views the National Institutes of Health.
0237 Sleep Reactivity Prospectively Predicts Distress Reactions to the COVID-19 Pandemic 3-4 Years Later
Authors: Reffi Anthony , Cheng Philip , Kalmbach David , Sultan Zain , Drake Christopher
Published: May 2022

Introduction

The 2019 coronavirus disease (COVID-19) pandemic is a protracted stressor with far-reaching effects on daily life. Although most individuals exhibit resilience in the wake of adversity, it is not clear which characteristics reliably predict resilience versus longstanding distress. It is vital to delineate predictors of pandemic-related distress to highlight modifiable risk factors that can be targeted to enhance psychological resilience. Sleep reactivity may be an important predictor of pandemic reactions because it reflects a vulnerability to experience pronounced sleep disturbances in response to stress, which serve as barriers to healthy adjustment to adversity. Therefore, this study tested sleep reactivity as a prospective predictor of pandemic-related distress.

Methods

Participants were recruited from a previous randomized controlled trial (RCT) comparing self-guided digital CBT-I against a sleep education control in treating insomnia and preventing depression. Participants in the RCT were enrolled between 2016-2017 and were eligible for this follow-up study conducted between April and May 2020 (N = 208; dCBT-I: n = 102; control: n = 106). Pre-treatment sleep reactivity was measured in 2016-2017 (T1) using the Ford Insomnia Response to Stress Test (FIRST). COVID-19 distress was measured in April 2020 (T2) using the Impact of Events Scale (IES) and Quick Inventory of Depressive Symptomatology (QIDS). All analyses controlled for treatment condition and COVID-19 impact.

Results

T1 FIRST predicted T2 IES (b = 0.29, + 0.14 SE, p < .05) and QIDS (b = 0.16, + 0.04 SE, p < .001), such that higher sleep reactivity pre-pandemic predicted more severe stress responses and depressive symptoms during the pandemic 3-4 years later. Exploratory analyses revealed T1 FIRST was a predictor of the IES subscales arousal and intrusions (bs = 0.02, + 0.01 SEs, ps < .05), but not avoidance.

Conclusion

These findings build on evidence that sleep reactivity prospectively predicts reactions to trauma and demonstrate its predictive utility generalizes to pandemic responses. Sleep reactivity is a modifiable risk factor that may be targeted using cognitive-behavioral or mindfulness-based approaches, and thus may offer a new pathway to resilience.

Support (If Any)

Support for P.C. was provided from the National Heart Lung and Blood Institute (K23HL138166).
0246 Sleep Hygiene Mediates The Relationship Between Depression And Sleep Quality In College Freshman
Authors: Hirsch Sophie , Zendels Philip , Peach Hannah , Gaultney Jane
Published: May 2022

Introduction

A variety of attitudes, behaviors, and health attributes can influence sleep quality. Depression and sleep quality interact bidirectionally, with depressed individuals often sleeping worse. College freshman may be prone to worse sleep and depression due to significant lifestyle changes, including sleep hygiene (a set of behaviors and conditions promoting sleep). This study sought to examine the relationship between sleep hygiene and depression in predicting sleep quality in first-year college students.

Methods

165 participants were recruited to investigate sleep behaviors associated with stress, mental health, physical activity and eating as they entered college. Data were recorded using the Pittsburgh Sleep Quality Index (PSQI; Buysse et al., 1989), the Sleep Hygiene Practice Scale (SHPS; Lin et al., 2007; Yang et al., 2010) and the Center for Epidemiological Studies-Depression (CESD; Radloff, 1977). A simple mediation analysis was run using the PROCESS macro for SPSS (Model 4; Hayes, 2018) with age and gender as covariates to examine direct and indirect associations of depression on sleep quality via sleep hygiene practices.

Results

In the model predicting sleep hygiene (R2 = .33, p < .001), depression had a significant effect (b = 1.90, p < .001), suggesting individuals scoring higher for depression engaged in more unhealthy sleep hygiene behaviors. The model predicting sleep quality (R2 = .47, p < .001) had significant effects from depression (b = .11, p = .005) and sleep hygiene (b = .09, p < .001) suggesting both higher depression scores and poor sleep hygiene behaviors associate with worse sleep quality. The indirect pathway was also significant (b = .17, CI: .11 - .24), suggesting depression’s impact on sleep hygiene behaviors also contributes to sleep quality.

Conclusion

One connection between depression and reduced sleep quality may be indirect via maladaptive sleep hygiene. Future research should look at addressing mental health with incoming students and promoting healthy lifestyle behaviors.

Support (If Any)

NA
0252 Sleep Hygiene Education Intervention: Psychological and Physiological Associations with Sleep in College Students
Authors: Horton Alexis , Gibson Matelyn , Anderson Noah , Mullins Kayla , Reynolds Alexandria
Published: May 2022

Introduction

College students tend to struggle with managing healthy sleep habits; these unhealthy behaviors can lead to poor sleep and impact their overall mental and physical health. More specifically, sleep is intimately connected to psychological and physiological factors such as anxiety, depression, and blood pressure. The focus of the current study was to examine habitual sleep habits in college students, provide a brief educational intervention, and investigate potential changes in psychological and physiological health.

Methods

Participants included 14 undergraduate students (6 men, average age M=20.64 years, SD=2.13) who wore wrist actigraphs to measure their typical sleep habits. After one week, participants completed questionnaires about sleep (Pittsburgh Sleep Quality Index, PSQI), sleepiness (Epworth Sleepiness Scale, ESS), fatigue (Multidimensional Assessment of Fatigue Scale, MAF), and psychological symptoms (i.e., depression, anxiety, and stress; Depression Anxiety Stress Scales, DASS-21). Blood pressure and heart rate were measured using a wrist device. Subjects participated in a short lecture about healthy sleep hygiene habits and the importance of sleep and then repeated the one-week observational study.

Results

Paired sample t-tests revealed a significant increase from baseline average sleep duration (M=5.83 hours) to post-intervention sleep duration (6.64 hours; t(13)=-2.532, p=.013). Sleep efficiency (actigraphy) and quality (PSQI) did not improve significantly. ESS scores decreased significantly (t(13)=3.76, p=.002 (pre M=9.29; post M=5.43) and MAF scores decreased significantly (t(13)=2.19, p=.047 (pre M=20.48; post M=15.60). No significant differences were found in depressive, anxiety, or stress symptoms when comparing DASS-21 scores pre- vs post-intervention. Baseline systolic blood pressure (M=114.88) significantly decreased compared to post-intervention recordings (M=108.21). Diastolic blood pressure and heart rate did not differ significantly.

Conclusion

The results of this study suggest that one educational lecture about sleep hygiene may be a start to improving sleep in college students. Even a 48-minute increase resulted in decreased sleepiness and fatigue. However, no improvements were found in sleep quality or efficiency. Although a slight improvement was found in systolic blood pressure, no other physiological or psychological benefits were noted. More research should be conducted on how to improve sleep habits in college students beyond an educational approach.

Support (If Any)

None.