bluuebunny/crossref_metadata_2025 huggingface dataset:
0093 Chronotypic characteristics of sleep, mental health, and daily life of Japanese university of health sciences students
Authors: Sato Toshiaki , Kawakatsu Yuki , Takahata Miki , Muraoka Shuhei , Kudo Daisuke , Satake Shinji , Eakman Aaron
Published: May 2023

Introduction

Students’ lifestyles change after entering the university negatively impacting effective sleep regulation, daytime alertness, motivation to learn, and mental health. An evening chronotype has been increasingly associated with negative impacts upon performance and well-being. Greater understanding of chronotype differences in sleep-related, mental health, and daily life characteristics is needed to develop a sleep health promoting intervention.

Methods

Cross-sectional descriptive design among health sciences students (nursing, occupational therapy and physical therapy) in a Japanese university. The Japanese version of the Morningness-Eveningness Questionnaire (MEQ-J) was used to create morning (M), intermediate (I), and evening (E) chronotype groups. One-way analysis of variance was used to investigate differences among chronotype groups by sleep, mental health, and daily life characteristics. We assessed insomnia severity (ISI-J), sleep quality (PSQI-J), sleep hygiene (SHPS-J), daytime sleepiness and dysfunctional sleep beliefs; depression (JCES-D) and anxiety; and time use in club, commuting, sleep, and work, as well as engagement in meaningful day-to-day activities (EMAS-J), significant group differences were explored post-hoc.

Results

Of 369 students there were 21% classified as M chronotype, 63% as I, and 16 % as E; an approximate 1:3:1 ratio. Sleep quality was progressively better as chronotype advanced from E, to I, to M (PSQI-J: d range 0.41-1.07); along with sleep problems being less likely (ISI-J: d range 0.45-1.16). Sleep hygiene practices were most effective for the M chronotype, followed by I then E (SHPS-J: d range 0.49-1.14). No group differences were found in daytime sleepiness or dysfunctional sleep beliefs. Depression symptoms were greater in the E chronotype compared to I and M (JCES-D: d range 0.52-0.84). M chronotypes reported the longest commuting times (d range 0.45-0.55). No differences were found in sleep duration or time spent in other activity types. Lastly, M chronotypes reported engaging in more meaningful activities compared to E (EMAS-J: d = 0.47).

Conclusion

Sleep health lifestyle intervention should target chronotype preference to be less evening-like, thereby promoting sleep quality and mental health. Intervention could tailor sleep hygiene beliefs and skills to address sleep timing, pre-sleep arousal and environment regulation according to individuals’ daily life characteristics and chronotype differences.

Support (if any)
0095 Magnitude of Temperature Drop Prior to Sleep Onset May Predict Increase in Slow Wave Sleep
Authors: Kim Jong , Valencia Daphne , Parekh Ankit , Blessing Esther , Osorio Ricardo
Published: May 2023

Introduction

Neural circuitry implicated in thermoregulation is known to be interdependent with that implicated in regulation of sleep-wake state. In addition, previous studies in both rodent and human have shown that the sleep-associated decline in core body temperature (CBT) is associated with subsequent slow wave sleep. We sought to replicate this association in cognitively normal older adults, and extend upon previous studies by using automated telemetric methods to measure CBT.

Methods

Thirty-one cognitively normal and mildly cognitively impaired (MCI) older adults (age 68 ± 6 years, 18 female, 3 MCI) underwent measurement of CBT for two consecutive nights with a telemetric sensor, during which lab nocturnal polysomnography was simultaneously performed. Data from the second night were used. A validated algorithm was used to preprocess CBT to exclude and fill artifactual data outliers and small gaps, respectively. The sleep-associated CBT was calculated with an automated procedure by identifying the CBT decrease between the first peak in CBT identified prior to ‘Lights Out’ and the lowest value following Lights Out. Slow wave activity (SWA) increase was calculated as increase relative to baseline in the relative spectral power (0.5-4.0 Hz, F3-M2) in the first 5 second epoch following lights out.

Results

Of the 31 participants, 21 had both good quality EEG and CBT data, with an average total sleep time of 7.5 ± 1.5 hours, and an average duration 46.6 ± 18.5 hours of CBT data collected. There was a strong positive correlation between the magnitude of CBT decline and subsequent SWA (rho = 0.70, p < 0.001 Spearman’s Rank correlation), supporting previous results.

Conclusion

This is one of the first studies to obtain simultaneous CBT and NPSG data in older adults using an ingestible telemetric sensor. Our results support the previous research that there is a significant relationship between sleep-associated body cooling prior to sleep onset and increase in SWA. This highlights the potential for future therapeutic thermal intervention in older adults to improve sleep and sleep mediated health conditions. Further research with a bigger sample size will be necessary to control for variables such as obstructive sleep apnea and cognition status.

Support (if any)

NIH R01AG070866, R21AG055002, K25HL151912,
0096 Short sleep duration and poor sleep quality associated with elevated serum NfL and mild cognitive impairment in older Veterans
Authors: Weiss Carleara , Lorenz Rebecca
Published: May 2023

Introduction

Ten percent of adults aged ≥ 65 and 50% of adults ≥ 85 years exhibit cognitive impairment. In addition, 50% of older adults experience poor sleep quality. Veterans are more vulnerable to sleep disturbances and potential cognitive impairment as long-term consequences of on-duty responsibilities, co-morbidities, and conditions such as post-traumatic stress disorder. Previous studies demonstrated a relationship between sleep and cognitive impairment through impaired glymphatic function and neurodegeneration. Biomarkers such as neurofilament light (NfL) are elevated in neurodegeneration and dementia. Here, we sought to investigate NfL levels in cognitive-intact older Veterans exhibiting poor sleep quality.

Methods

A cross-sectional study with eighteen Veterans aged 65-86 without a clinical diagnosis of dementia. Self-reported sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI), while time in bed (TIB), and total sleep time (TST) were retrieved from Fitbit Charge. Cognitive function was evaluated with the St. Louis University Mental Status Exam (VA-SLUMS). We used an automated multiplex immunoassay system to identify dementia biomarkers using an enzyme-linked lectin assay. T-tests, one-way or two-way ANOVAs with Tukey’s post-hoc (with or without repeated measures) were used for the analysis.

Results

Participants were classified as good sleepers (PSQI>5) and poor sleepers (PSQI< 5). Poor sleepers spent less TIB (Fitbit 5.3h vs. 7.7h, p =0.001) and slept fewer hours (Fitbit 4.7h vs. 7.2h, p =0.001) when compared to good sleepers. Additionally, poor sleepers exhibited mild cognitive impairment (VA SLUMS 26.9, p, =0.01). Lastly, poor sleepers exhibited higher serum NfL (mean 66.7, p=0.04).

Conclusion

Poor sleep quality was associated with short sleep duration, mild cognitive impairment, and higher serum levels of NfL in older Veterans without a dementia diagnosis. Results may contribute to the early identification of dementia and sleep-centered treatment guidance. Further studies with more extensive and diverse samples are warranted before clinical recommendations.

Support (if any)

Carleara Weiss, Ph.D., MS, RN. 1K99AG079117-01 (PI), National Institute on Aging.
0099 Circadian Rest-Activity Rhythm Development is associated with Weight Gain in Early Infancy
Authors: Petrov Megan , Jiao Nana , Shu Jingmin , Liu Li , Gross Tav , Reifsnider Elizabeth , Coonrod Dean , Whisner Corrie
Published: May 2023

Introduction

In early childhood, irregular sleep schedules that may promote circadian rhythm misalignment predict greater weight gain. However, circadian rest-activity (CRA) rhythmicity in infancy in relation to growth is understudied. The aim of the present study was to investigate the association between newborn circadian rest-activity rhythmicity and change in weight-for-age from birth to three months.

Methods

Data were captured as a secondary data analysis from the Snuggle Bug / Acurrucadito Study (see Support). English or Spanish speaking mothers (n=41, age M±SD=33.1±4.6y, 31.7% Hispanic/Latina) and their full-term (≥37wk) infants of normal weight (2.5-4kg; 58.5% female; 25.6% WIC enrolled) were recruited from Phoenix, Arizona. CRA rhythmicity was measured at eight weeks with ankle-worn Micro Motionloggers (Ambulatory Monitoring Inc.) for five 24hr periods at one-minute epochs. CRA metrics assessed included 24hr autocorrelation, mesor, magnitude, acrophase, goodness-of-fit R2, interdaily stability, intradaily variability, and relative amplitude. Birthweight was mother-reported and 3mon infant weight was measured with a Seca scale. Weight-for-age Z-scores (WAZ) by infant sex were computed based upon World Health Organization growth charts and the change difference between timepoints was the primary outcome. Regression models adjusting for birth WAZ examined the relationships between CRA metrics at eight weeks with change in WAZ from birth to 3mo.

Results

At eight weeks, mean±SD CRA metrics were as follows: 24hr autocorrelation of 0.25±0.03, mesor of 115.6±14.7, amplitude of 68.1±18.3, goodness-of-fit R2 of 0.42±0.10, acrophase of 14:12±1:42, interdaily stability of 0.57±0.12, intradaily variability of 0.93±0.19, and relative amplitude of 0.61±0.11. Mean birth WAZ and change in WAZ from birth to 3mon were 0.39±0.73 and -0.57±0.77, respectively. After adjusting for birth WAZ, in separate models, greater mesor (R2 Change=0.10, β=-0.32, p=0.03), amplitude (R2 Change=0.11, β=-0.34, p=0.03), and goodness-of-fit R2 (R2 Change=0.10, β=-0.32, p=0.04) were significantly associated with less change in WAZ from birth to 3mon.

Conclusion

Among relatively healthy, full-term infants born of normal weight, greater 24hr circadian rest-activity rhythmicity achieved by 8 weeks was associated with slower rate of weight gain across the newborn stage. Promoting behaviors and environmental cues from parents that strengthen early circadian rhythmicity in their infants may promote healthy weight trajectories.

Support (if any)

NIH/NHLBI R01HL147931
0101 Greater Variability in Sleep Health is Associated with Obesogenic Appetitive Traits in 6-Year-Olds in the INSIGHT Study
Authors: Hohman Emily , Hernandez Erika , Dadzie Adwoa , Master Lindsay , Anzman-Frasca Stephanie , Paul Ian , Savage Jennifer , Buxton Orfeu
Published: May 2023

Introduction

Poor sleep health is associated with increased risk for childhood obesity, but the underlying mechanisms are unclear. Eating behaviors may play a role. We examined the association between appetitive traits and objectively-measured sleep variables in 6-year-old children. We hypothesized that poorer or more variable sleep health measures would be associated with higher levels of food approach traits (food responsiveness, enjoyment of food, emotional overeating, and desire to drink), and lower levels of satiety responsiveness.

Methods

Participants were from an observational long-term follow-up of INSIGHT, an RCT of a responsive parenting intervention for first-time mothers compared to a safety control intervention. At age 6 years, children wore wrist actigraphy (Spectrum Plus) for 7 days to assess sleep. Children with ≥3 valid days were included in analyses (n=167). Mothers completed the Children’s Eating Behavior Questionnaire to assess appetitive traits. Separate regression models examined the association between appetitive traits and sleep variables (M/SD of nighttime total sleep time (TST), onset, offset, and midpoint of sleep timing, and sleep maintenance efficiency), controlling for intervention group, child age, sex, and overweight status.

Results

Mean TST was unrelated to appetitive traits; greater variability (SD) in TST was associated with higher food responsiveness (B=0.008, p=0.03) and desire to drink (B=0.010, p=0.04). Mean sleep onset time was unrelated to appetitive traits, but greater variability in sleep onset time was associated with higher desire to drink (B=0.686, p=0.004). Higher mean sleep maintenance efficiency was associated with higher satiety responsiveness (B=0.035, p=0.04) and lower enjoyment of food (B=-0.053, p=0.008). Greater variability in sleep maintenance efficiency was associated with higher enjoyment of food (B=0.092, p=0.03) and lower satiety responsiveness (B=-0.089, p=0.01). Emotional overeating was unrelated to sleep variables, and sleep offset and midpoint were unrelated to appetitive traits.

Conclusion

Other than sleep efficiency, mean levels of sleep health appear unrelated to appetitive traits, but greater variability in sleep health measures were associated with higher levels of potentially obesogenic traits and lower levels of protective traits. Future studies should examine whether promotion of sleep regularity can improve regulation of eating behavior and reduce childhood obesity risk.

Support (if any)

R01DK088244, KL2TR002015
0106 Prospective Sleep Patterns in Infants Later Diagnosed with ASD: A Case Series
Authors: Abel Emily , Schwichtenberg A J
Published: May 2023

Introduction

Sleep problems among individuals with autism spectrum disorder (ASD) are pervasive across the lifespan. However, little is known about the emergence of sleep patterns in the months preceding a child’s diagnosis. It is unclear whether sleep problems precede diagnoses and the emergence of core diagnostic features, or whether they simply co-emerge with early behavioral markers across the first three years of life. Thus, our study examined prospective patterns of sleep and development from 6-36 months among children at high familial likelihood for ASD, beginning prior to features of ASD/atypical development.

Methods

Using a case series approach, participants included 9 children at high familial likelihood for ASD—3 who developed ASD, 3 who had early ASD concerns but did not develop ASD (ASD-C), and 3 who were typically developing (TD). Sleep was assessed using actigraphy. Developmental competence and ASD features were monitored using standardized assessments (ASOS-2 and MSEL) and parent reports (VABS, M-CHAT).

Results

All children with ASD experienced sleep difficulties in early development (e.g., extended night wakings). However, different patterns emerged for each child: adequate sleep at six months, followed by less severe but persistent sleep problems across development (case 1); low levels of sleep problems during early infancy, followed by improved sleep from 9-15 months and a sharp increase in sleep problems at 24 months (case 2); sleep problems at 9 and 12 months, followed by a decrease in sleep problems across the remainder of early development (case 3). In general, sleep problems emerged prior to ASD diagnoses and did not appear to covary with ASD symptoms. However, sleep problems for case 2 intensified in line with a significant regression in skills and the onset of ASD features at 24 months.

Conclusion

Sleep problems are a normative part of infancy for most children—including those with TD. However, sleep may begin to distinguish some children with ASD from their peers around 12 months of age. Although sleep problems appear most severe and persistent for children with ASD, patterns are variable and sleep intervention efforts should be individualized to meet the heterogeneity in ASD.

Support (if any)

R00 MH092431; PI Schwichtenberg.
0109 The Impact of Pubertal Development on Children’s Chronotype, Sleep and Changes in Mental Health
Authors: Peltz Jack , Magzoub Muram , Brew Nathanael
Published: May 2023

Introduction

Approximately 70% of adolescents do not obtain the required amount or quality of sleep expected for healthy functioning (Wheaton et al., 2018). Deficient sleep is so pervasive for adolescents that it could be considered an epidemic due to its adverse impact on mental and physical health (Shochat et al., 2014). Pubertal development tends to result in children’s delayed sleep phase, which has been linked to deficient sleep and greater psychosocial problems (Crowley et al., 2018; Owens et al., 2014). However, there is a paucity of research that has longitudinally examined these inter-related constructs. Accordingly, this study examined the longitudinal role of children’s pubertal development on their subsequent chronotype, sleep, and well-being.

Methods

Data were collected through the Adolescent Brain & Cognitive Development study (2021, release 4.0) and included waves 2 (48.7% female; Mchild_age=10.95 years, SD=.67) and 3 (Mchild_age=12.02, SD=.67). A total of 5949 children had their sleep duration and variability recorded at wave 3 with Fitbit watches, which were worn across an average of 13.8 nights (SD=9.9). At waves 2 and 3, parents reported on their child’s mental health with the Child Behavioral Checklist (Achenbach & Rescorla, 2001). Children self-reported on their pubertal development (Peterson et al., 1988) at wave 2 and their chronotype at wave 3 (Roenneberg et al., 2003). Most participants identified as white (52.4%), with another 24.0% identifying as Hispanic/Latinx, 13.4% identifying as Black, 5.9% American Indian/Alaska Native/Native Hawaiian/Pacific Islander, and 4.2% as multi-race. The families were economically diverse with 21.5% reporting family incomes of <$25,000 and 6.8% with incomes of >$200,000.

Results

Mediation analyses, conducted using Mplus (v.8.8, Muthén & Muthén, 2022), examined if pubertal development at wave 2 predicted residual change in children’s mental health via the mediating variables of chronotype and both sleep duration and variability. Children’s age, sex, body mass index, and socio-economic status were included as covariates. Model fit was excellent. Results suggested greater pubertal development indirectly predicted increases in children’s mental health problems via chronotype (i.e., greater eveningness) and longer sleep duration and greater sleep variability.

Conclusion

Given typical changes to children’s sleep during puberty, findings highlight the critical connections to their mental health.

Support (if any)
0110 The Influence of Changing School Start Times on Frequency and Timing of Nurse’s Visits for Sleep and Nutrition
Authors: Doudell Kelly , Gunn Heather , Meltzer Lisa
Published: May 2023

Introduction

Healthy school start times are important for ensuring students obtain sufficient sleep, which may impact other health outcomes. Previous studies have not examined the impact of changing school start times on nurses’ visits related to sleep and nutrition in students in grades K-12 after district-wide changes to delay start times in middle and high school and advance start times in elementary school.

Methods

Electronic medical record data (reason for student visit and time of visit) were retrieved from nursing offices for elementary (n=44), middle (n=14), and high (n=6) schools. For this study, we included sleep and nutrition visits within the first two hours of the school day in April/May for the year prior (pre-change) and two years after (post-change, follow-up) implementing new school start times. Within each school level (i.e., elementary, middle, high), descriptive statistics examined the number of visits by health category.

Results

In elementary school, nurse visits increased in the first two hours when school start times were moved from 9:00am to 8:00 am for both sleep (pre-change n=45; post-change n=78; follow-up n=58) and nutrition (pre-change n=30; post-change n=63; follow-up n=48). For middle school, nurse visits slightly decreased in the first two hours of school when start times were moved from 8:00am to 8:50am for both sleep (pre-change n=14; post-change n=11; follow-up n=11) and nutrition (pre-change n=47; post-change n=42; follow-up n=6). High school nurse visits also slightly decreased in the first two hours of school when start times moved from 7:10am to 8:20am for both sleep (pre-change n=16; post-change n=7; follow-up n=7) and nutrition (pre-change n=5; post-change n=5; follow-up n=2).

Conclusion

While not unexpected, elementary school nurse visits for sleep and nutrition increased when start times were moved earlier. However, at follow-up, visit frequency notably decreased, suggesting that it may take time for families to adjust to the new start times. For both middle and high school students, nurse visits for sleep and nutrition slightly decreased with later start times. More research is needed to determine optimal start times for elementary school students, as healthy start times are essential for adolescent health and well-being.

Support (if any)

RWJF Evidence for Action (#75277)
0112 Acute Sleep Restriction and Circadian Misalignment Impairs Attention in High School Students
Authors: Lafeber Connor , Monterastelli Allison , Misiunaite Ieva , Eastman Charmane , Crowley Stephanie
Published: May 2023

Introduction

We examined the impact of acute sleep restriction and circadian misalignment on reaction times in adolescents.

Methods

Adolescents (n=38, 21 girls) aged 14.1-18.0 years completed a 14-day protocol. On days 1-7, participants slept at home on individualized 10-h sleep/dark schedules. On days 8-14, they lived in the laboratory. On day 8, Dim Light Melatonin Onset (DLMO) was measured. On Days 9-13, sleep opportunity was restricted to 8.5h (n=9), 7h (n=12), or 5.5h (n=8). A fourth group was not sleep restricted a had a 10-h sleep opportunity (control; n=9). On days 11-13, sleep/dark gradually shifted earlier with morning bright light to advance circadian rhythms. Final DLMO was measured on day 14. Participants completed simple reaction time tasks on days 5 (baseline), 11 (after 2 sleep restriction (SR) nights = post-SR), and 13 (after 2 shifted sleep/dark nights = post-shift). Testing began 2.5h, 5.5h, 8.5h, and 11.5h after wake. Daily difference from baseline scores for post-SR lapses, median reaction time (MedRT), mean 1/RT (responses/sec), fastest 10% RT (F10), and slowest 10% 1/RT (S10) were compared between sleep opportunity groups. Final temperature minimum (Tmin) was estimated post-hoc (Final DLMO+7h). Tmin 2-4h before wake defined an aligned subgroup (N=16) and Tmin after wake defined a misaligned subgroup (N=10). Post-SR scores (day 11) were subtracted from post-shift scores (day 13) at corresponding times relative to wake. Aligned and misaligned subgroups were compared to determine the of impact circadian misalignment.

Results

Lapses [F(3,34)=3.8,p=.02] and MedRT [F(3,34=3.3,p=.03] increased from baseline in a SR-dose-dependent manner. Lapses and MedRT increased more with 7hSR (lapsesΔ=19.4±9.1; MedRTΔ=80.7±51.4 msec) and 5.5hSR (lapsesΔ=25.8±18.6; MedRTΔ=99.5±74.6 msec) compared to Control (lapsesΔ=5.4±4.8; MedRTΔ=20.8±21.7 msec). Mean 1/RT, F10, and S10 showed similar trends (p’s≤0.1). MedRT slowed [t(24)=2.24,p=0.04] and response rate decreased (Mean 1/RT: t(24)=2.06,p=.05; S10: t(24)=2.16,p=.04) in the misaligned compared to the aligned group 2.5h after wake.

Conclusion

Attention decrements occurred when sleep was restricted to 5.5h or 7h, the latter being a typical sleep opportunity for high school students. Circadian misalignment also contributed to decrements in morning attention, which has major implications for safety during the school commute and academics.

Support (if any)

R01 HL146772 (Crowley)
0116 A theory-driven, meta-analytical approach to evaluating optimal parenting behaviors and adolescent sleep
Authors: Ewing Emily , Poole Elaine , Mackaronis Julia , Critchfield Kenneth , Gunn Heather
Published: May 2023

Introduction

For adolescents, affiliative parenting behaviors (e.g., warm) are generally associated with better sleep and non-affiliative parenting behaviors (e.g., hostile) are associated with deficient sleep. However, specificity of interpersonal behaviors is unknown. We applied an interpersonal theoretical framework and conducted a meta-analysis to test and operationalize the theory that safety and security are necessary for good sleep.

Methods

Included in the meta-analysis were 41 studies on adolescent (10-19 years) sleep health and parenting behaviors. Studies included a total of 57,549, primarily female (52%), participants (Mage = 14.92, SDage = 2.00). Race/ethnicity was 76.7% White, 5.9% Black, 6.5% Hispanic, 1.5% Asian, and 9.4% Other. Structural analysis of social behavior (SASB) was applied to define and operationalize optimal (e.g., affiliative and autonomy granting/taking) and sub-optimal (e.g., non-affiliative and autonomy granting/taking) parenting behaviors (independent variable). Dependent variables were sleep regularity, duration, efficiency, latency, timing, quality, alertness/sleepiness, and disturbance. The final effect size of interest for analysis was a correlation efficient r.

Results

Optimal parenting behaviors were associated with longer sleep duration (r = 0.11, p = .02), decreased latency (r = -0.16, p < .001), less daytime sleepiness (r = -0.28, p < .001), and less sleep disturbances (r = -0.22, p < .001). Suboptimal parenting behaviors were associated with decreased sleep duration (r = -0.04, p = .05), increased latency (r = 0.12, p < .01), and more sleep disturbances (r = 0.38, p < .001).

Conclusion

This study applied interpersonal theory to define and operationalize parenting behaviors and their association with adolescent sleep. Findings support anthropological theory that parental interpersonal warmth is important for adolescent sleep and further indicate that security likely includes appropriate use of structure and autonomy granting behaviors. SASB analysis additionally revealed significant methodological issues that hamper understanding of the role of parental control (versus autonomy-granting) as separate from parental affiliation (versus hostility). This topic points the way to a crucial next step in developing an empirically grounded and comprehensive interpersonal model of sleep.

Support (if any)
0120 Interactions between Temperament and Parent-Child Relationship Quality in Early Childhood and Sleep in Middle Childhood
Authors: Hincapie Maria Valencia , Rojo-Wissar Darlynn , Coe Jesse , Seifer Ronald , Tyrka Audrey , Parade Stephanie
Published: May 2023

Introduction

Effects of child temperament on biopsychosocial outcomes, including sleep, are known to differ based on parent-child relationship quality (PCRQ). However, previous studies have primarily focused solely on early childhood, relied on subjective reports of PCRQ and sleep, and have neglected to examine variability in sleep, which is an important dimension of sleep health. We examined whether there were interactions between temperament and objectively measured PCRQ during early childhood in association with actigraphy measured sleep (average and variability) in middle childhood.

Methods

Participants included 90 preschoolers (mean age=4.24 years, SD=0.81) who were 47% female; 37% White, 17% Black, 47% other racial groups; and 46% Hispanic. Thirty-four percent experienced moderate to severe maltreatment. PCRQ was coded from a video-recorded free-play task between each child and their primary caregiver. Child temperament dimensions including Activity Level, Anger, Social Fear, Inhibitory Control, and Appropriate Attentional Allocation were measured with the parent-report Toddler Behavior Assessment Questionnaire. Child Mean and SDs of total sleep time (TST) and sleep efficiency (SE) were generated from actigraphy data collected for two weeks during a follow-up study when participants were ages 8-11.

Results

There were no direct effects of any of the temperament variables or PCRQ on sleep. In models adjusted for demographic characteristics and number of adversities experienced, greater attentional allocation was associated with greater average TST only among those children high in PCRQ (estimate = 20.59, 95% CI = 5.19, 35.99). For every one unit increase in attentional allocation score (possible range 1:7), there is a more than 20 min increase in mean TST. In contrast, greater activity levels were associated with better average sleep efficiency, only among those low in PCRQ (estimate = 2.35, 95% CI = 0.46, 4.24). For each unit increase in activity level score, there was a 2% increase in sleep efficiency.

Conclusion

Findings extend cross-sectional research in early childhood and provide support for models showing that children have differing susceptibility to the effects of temperament on sleep, depending on PCRQ.

Support (if any)

NIMH R01 MH083704, NICHD R01 HD086487, NICHD, R01 HD095837, SRCD Small Grant for Early Career Scholars, T32HD101392, NIGMS P20 GM139767.
0123 Sleep Problems and Externalizing Behaviors for Youth in Juvenile Justice Facilities
Authors: McGee Ryann , Bistline Lily , Adornetti Julianna , Busby Ryan , Spargo Sammie , Bayley Shania , Carlucci Marianna , Crowley Stephanie , Wolfson Amy
Published: May 2023

Introduction

Adolescents who experience insufficient, poor quality sleep, and sleep problems might experience difficulties with externalizing behaviors including aggression and impulse control (Bauducco et al., 2019; Brown et al., 2022). Surprisingly, sleep and behavior for youth residing in long and short-term juvenile justice facilities is understudied. The present preliminary analysis explores self-reported sleep problems and aggressive and impulse control symptoms for youth under the care of the Department of Juvenile Services (DJS).

Methods

Participants (N=62, 86% male, mean age = 16.8, SD=1.2) were recruited from 11 DJS detention and treatment facilities in Maryland. Racial Backgrounds: 55% Black, 18% White, 14% Multiracial, and 12% Other. They completed an online questionnaire focused on sleep behaviors (daytime sleepiness, sleep-wake behavior problems) and daytime functioning including aggressive and impulse control behaviors (e.g., modified Aggression Questionnaire, Buss & Perry, 1992; Weinberger Adjustment Inventory, WAI, 1990). Using Pearson correlations, associations between sleep problems, daytime sleepiness and externalizing behaviors were examined.

Results

Self-reported daytime sleepiness and sleep-wake behavior problems were associated with increased aggressive and impulse control difficulties. Youth with more sleep-wake behavior problems reported higher levels of aggressive behaviors (r = .39, p < .01) and impulse control behaviors as measured by the WAI (r = .33, p < .05). Similarly, youth with high levels of daytime sleepiness also reported more impulse control behaviors (r = .40, p < .01).

Conclusion

Preliminary findings suggest that youth residing in juvenile justice facilities with sleep difficulties are more likely to report aggressive and impulse control challenges. Further analyses will provide a greater understanding of the modifying factors to better understand the youth’s sleep-living environment.

Support (if any)

This research is made possible by the American Academy of Sleep Medicine (AASM) Foundation Award #22-CS-19 and Maryland Department of Juvenile Services’ supportive collaboration.
0126 CVD biomarker profiling reveals distinct responses to acute exercise under conditions of recurrent sleep loss in healthy humans
Authors: Hong Mun-Gwan , Brandão Luiz Eduardo Mateus , Benfeitas Rui , Emami Payam , Cedernaes Jonathan
Published: May 2023

Introduction

Physical exercise impacts a plethora of signaling pathways, which mediate the acute and long-term benefits of exercise. Whereas the acute effects of exercise on overall metabolism and cardiovascular disease (CVD) risk factors have been extensively studied in humans, little is known about how a wider range of CVD biomarkers change in response to acute exercise under conditions of sleep loss. Thus, here we examined whether a few nights of short sleep alter the diurnal and exercise-induced levels of a range of CVD biomarkers.

Methods

In a randomized two-condition crossover study, 16 men partook in two sessions, comprising three consecutive nights of full-night sleep (NS, 8.5 hours sleep/night) and three nights of partial sleep restriction (SR, 4.25 hours/night). In both conditions, blood was repeatedly sampled in the evening and about 12 hours later (for evening-to-morning analysis) as well as repeatedly before and after a 30-min bout of high-intensity exercise (at 75% VO2maxReserve). Olink's CVD II panel and ELISAs were used to measure 92 CVD protein biomarkers.

Results

Under pre-exercise sedentary conditions, the diurnal changes of several CVD biomarkers differed in response to SR compared with NS. However, several proteins exhibited diurnal changes regardless of sleep condition (as also confirmed in a separate a cohort with overnight wakefulness). In response to exercise, we observed that most proteins increased vs. decreased in their relative levels, including inflammatory markers. Furthermore, some proteins exhibited an early vs. more delayed increase. However, following SR, the exercise-induced induction of CVD biomarkers was markedly dampened, compared with the NS condition, and SR resulted in an altered exercise-induced response for several inflammatory-related CVD biomarkers.

Conclusion

Recurrent sleep restriction impacts the evening-to-morning dynamics of several CVD biomarkers, and the extent to which blood-based CVD biomarkers are induced by acute, high-intensity exercise. This may indicate that some of the cardiometabolic responses to vigorous exercise differ under conditions of sleep loss. Whether such changes alter the long-term benefits of aerobic exercise under conditions of chronic sleep loss, and whether these changes differ in e.g. older subjects or CVD, remains to be investigated.

Support (if any)

Swedish Society for Medical Research, Swedish Cancer Foundation, Diabetesfonden, Göran Gustafsson, Hjärnfonden
0134 Associations between psychological resilience and slow wave sleep in healthy adults
Authors: Chen Chris Xie , Wang Ran , Cheung Forrest Tin Wai , Chan Ngan Yin , Chan Joey , Li Cheng , Hou Wai Kai , Yau Sonata Suk-Yu , Liu Fiona Yan , Lee Tatia Mei-Chun , Li Shirley Xin , Wing Yun Kwok
Published: May 2023

Introduction

Psychological resilience can be viewed as a personality trait, an ability to bounce back, or a positive outcome after life adversities. Although there have been increasing reports of the importance of sleep and circadian factors in contributing to an individual’s resilience, current studies were devoid of objective measurements and in-depth analysis. Whether psychological resilience is related to the slow wave sleep that facilitates recovery processes is of particular interest.

Methods

This study focused on the association between resilience and sleep in healthy young individuals free of physical and mental disorders. 160 young adults (61.7% female, mean age: 29.55±4.94) were included. Psychological resilience was defined as both a trait and a positive health outcome despite adversities. The trait resilience was measured by the Connor-Davidson Resilience Scale (CDRS-10), at which scores exceeding the 50th percentile of CDRS-10 were categorized as a “High resilient trait”. The outcome resilience was measured by the residual score of the linear regression model with psychological health level as the dependent variable and accumulative adversities as the independent variable. Those with a positive residual value were categorized as “Resilient outcome”. The accumulative adversities included childhood adversities (e.g., emotional and physical neglect, sexual abuse) and lifetime stressors (e.g., accident, death of families or close friends). Sleep architecture was assessed by polysomnography, and sleep microstructure was computed by spectrum power analysis and slow wave sleep autodetection.

Results

Resilient participants had more slow wave sleep (SWS; N3%: 15.69% vs 12.89%, p = 0.021) and higher delta power in N3 (Absolute: 750.36 uV2 vs 617.55 uV2, p = 0.059) than those non-resilient participants. Linear regression models showed that increased SWS was associated with higher resilient trait (SWS density: B=0.25, p=0.006; Absolute power of N3 delta: B=0.003, p=0.004) and resilient outcome (N3%: B=0.02, p=0.058; SWS density: B: 0.03, p=0.073; Delta power in N3: B=0.0004, p=0.020).

Conclusion

Psychological resilience was related to greater slow wave sleep. The findings suggested a critical role of sleep quality in maintaining psychological resilience. Longitudinal studies are need to examine the underlying mechanism of the link between resilience and slow wave sleep.

Support (if any)

The Collaborative Research Fund of Hong Kong, China (C7069-19GF).
0136 Decreased Sleep Efficiency May Link Adverse Childhood Experiences with Increased Visceral Adiposity
Authors: Schwager Laura , Hart Thomas , Zucker Anna , Flores Mark , Diesel Sara , Moon Chooza , Thomas Emily , Jenkins Nathaniel
Published: May 2023

Introduction

Poor sleep has been shown to negatively impact cardiometabolic health. Adverse Childhood Experiences (ACEs), potentially traumatic events occurring within the first 18 years of life, have been linked to both poor sleep and cardiometabolic disease in adulthood. Evidence is needed to understand whether poor sleep plays a mechanistic role in the link between ACE exposure and cardiometabolic risk. The purpose of this study was to examine associations of ACE exposure with self-reported sleep efficiency (SE%) and waist circumference (WC).

Methods

In 25 young adults (21F/4M; mean±SD, age=25±5 y), we assessed ACE exposure using the 10-item ACE Questionnaire and SE% as the reported average sleep duration relative to time-in-bed from the Pittsburgh Sleep Quality Index. We measured WC, a known cardiometabolic risk factor, as a surrogate of visceral adiposity. We used multiple linear regression analyses to examine associations between ACE exposure, SE%, and WC adjusted for sex. We then utilized ANCOVA analyses to examine the possible mechanistic effect of SE% on the relationship between ACE exposure and WC. For these analyses, participants with 0-1 ACEs were categorized as low-ACE exposure (ACE-low) and participants with 2+ ACEs were categorized as moderate-to-high ACE exposure (ACE-mh).

Results

Following adjustment for sex, ACE score predicted SE% (β=-0.53, p=0.009) and WC (β=0.52, p=0.01), and SE% predicted WC (β=-0.44, p=0.03). Similarly, ANCOVA analyses indicated that ACE-mh was associated with greater WC than ACE-low, adjusted for sex (adjusted means ± 95% CI, 0.86 ± 0.07 m vs. 0.78±0.06 m; p=0.049). However, the effect of ACE group on WC was no longer significant following inclusion of SE% as a covariate (0.84 ± 0.07 m vs. 0.80 ± 0.07 m; p=0.29).

Conclusion

Both ACEs and sleep efficiency are associated with visceral adiposity. Further, SE% may serve as a mechanistic biobehavioral link between ACE exposure and increased visceral adiposity in young adults. These preliminary findings warrant further investigation with implications for sleep interventions as a possible preventative approach to reduce cardiometabolic risk in individuals exposed to ACEs.

Support (if any)

Research reported in this publication was partly supported by the NCATS of the NIH (UL1TR002537) and by the Injury Prevention Research Center through the CDC (R49 CE003095).
0137 The effect of the 2020 US Presidential election on sleep and its relationship to public mood and alcohol consumption
Authors: Cunningham Tony , Fields Eric , Denis Dan , Bottary Ryan , Stickgold Robert , Kensinger Elizabeth
Published: May 2023

Introduction

Major events, such as the Super Bowl, World Cup, elections, and disasters can influence the general public's affective state in both positive and negative directions. More recently, evidence has indicated that other affect-related processes, such as sleep, may be similarly influenced, but the relationship between changes in sleep and emotion metrics in the wake of these significant events remains unknown. Here, we investigated the extent that a major sociopolitical event – the 2020 US presidential election – impacted sleep, measures of public mood and emotional well-being, and alcohol consumption. We also explored the relationship between changes in sleep, affect, and alcohol consumption during the peak period of election stress.

Methods

A non-representative, convenience sample of US-residing (n = 437) and non-US-residing (n = 106) participants were recruited online for participation as part of the Boston College COVID-19 Sleep and Well-Being Study (https://osf.io/gpxwa/). For the present analysis, participants were responded to daily surveys via email assessing their affect, sleep, and alcohol consumption during a baseline period (October 1-13, 2020) and in the days surrounding the 2020 US Election (October 30-November 12, 2020).

Results

Changes following the election were investigated separately for US and non-US participants. Election Day evoked a significant reduction in sleep duration and efficiency, coupled with heightened stress, negative affect, and increased alcohol use. While the impact was greater for US participants in a number of domains, non-US residents also reported sleep loss and increased stress on Election night compared to baseline. Across participants, changes in emotional well-being and alcohol consumption on Election Day correlated with changes in sleep metrics on Election Night.

Conclusion

These results suggest that major sociopolitical events can have global impacts on sleep that interact with significant fluctuations in public mood and well-being. Further, while the largest impact is on the local population, these results suggest that globalization may extend the effects beyond borders. These findings provide an ecologically-relevant example of the relationship between daytime mood and subsequent sleep and highlight the potential impact of future sociopolitical events on public well-being.

Support (if any)

Project was supported by Boston College and a Small Research Grant from the Sleep Research Society Foundation
0140 Nightmares are Associated with Increased Suicidality in Young Adulthood: A Population-based Cohort Study
Authors: Atha Raegan , Paquet Caitlin , Calhoun Susan , He Fan , Vgontzas Alexandros , Liao Jason , Bixler Edward , Liao Duanping , Fernandez-Mendoza Julio
Published: May 2023

Introduction

Childhood nightmares have a second increase in incidence in young adulthood, which has been attributed to trauma and psychopathology. As suicide rates are high in young adults and have been associated with nightmares, more research is needed regarding this relationship in this age range. This study aimed to examine the association of nightmares, independent of sleep disturbances, insufficient sleep or trauma-history, with suicidality in young adulthood.

Methods

The Penn State Child Cohort is a random, population-based sample of 700 children (5-12 years at baseline) studied in the sleep laboratory who returned for follow-up visits during adolescence and young adulthood. For the current study, 258 young adults (25.1±2.7 years old, 53.9% female, 24.8% racial/ethnic minority) completed their follow-up visit 15.9±2.0 years later. Nightmares were ascertained by self-report. The presence of suicidality was ascertained from responses on items querying suicidal ideation and/or attempts via clinically-relevant sources (i.e., MINI structured interview, Child Behavior Checklist Adult Self-Report, and Depression Anxiety and Stress Scale). General linear and logistic regression models adjusted for important covariates.

Results

Subjects reporting nightmares (n=109) had a significantly higher rate of suicidality (29%) than those absent of nightmares (14%; p=0.002), after adjusting for sex, age, sleep disturbances, sleep duration and trauma history. This rate was even higher (46%) in those reporting moderate-to-severe nightmares (n=24; p< 0.01). The odds of suicidality associated with nightmares were 2.3-fold (95%CI=1.1-4.7), after adjusting for sex, age, sleep disturbances, sleep duration and trauma history (p=0.023); a risk that increased to 6.1-fold (95%CI=2.0-18.6) in those reporting moderate-to-severe nightmares (p=0.001).

Conclusion

These findings further strengthen previous research that has established nightmares’ significant relationship to increased suicidality, even when controlling for other important risk factors such as sleep disturbances and trauma history. Furthermore, as these results come from a random, population-based sample, it also demonstrates the generalizability of the association between nightmares and suicide. As the search for effective prevention strategies for suicide continues, it will be important to assess for the presence and severity of nightmares in those who express suicidal ideation, especially given the treatable nature of nightmares.

Support (if any)

National Institutes of Health (R01HL136587, R01MH118308, UL1TR000127)
0141 Short-Term Stability of Sleep Parameters in Comorbid Nightmares and Chronic Insomnia Disorder
Authors: Paquet Caitlin , Lenker Kristina , Calhoun Susan , Vgontzas Alexandros , Bixler Edward , Fernandez-Mendoza Julio
Published: May 2023

Introduction

Nightmares are highly comorbid with insomnia and have been associated, yet not consistently, with distinct polysomnographic (PSG) disturbances, such as reduced total sleep time (TST), sleep efficiency and slow wave sleep as well as increased nocturnal awakenings and wake after sleep onset (WASO) or abnormal REM sleep. However, most prior studies have relied on a single night of PSG and the degree of stability of sleep parameters or overall differences between individuals with nightmares comorbid with insomnia disorder (NCI), individuals with chronic insomnia disorder (CID) and otherwise good sleeping controls (GSC), remain unknown. Therefore, the aim of this study was to determine if there were significant differences amongst these aforementioned groups in the way their sleep changes across time while being studied in the lab.

Methods

A total of 142 GSC, 126 CID and 24 NCI participants underwent 8-hour PSG recordings for 4 consecutive nights. Outcomes included sleep continuity, architecture, and REM-related parameters across nights 1 through 4. Intraclass correlation coefficients (ICC) with mixed-effect variances and repeated-measure analysis of variance (ANOVA) were used to determine short-term stability as well as between-subjects and time-by-group interaction effects, respectively.

Results

ICC were similar across groups on all outcomes (ICCs>0.6) except that the NCI group did not display stability for WASO, stage 1 sleep, REM latency or REM interval. There were no significant time-by-group interaction effects on PSG parameters (ps>0.05). There were significant between-group effects for SOL, number of awakenings, WASO, TST, REM latency, and number of REM episodes (all ps< 0.05), where the NCI group showed significantly longer SOL (58.10±11.08), shorter TST (6.64 hours±1.02), and less REM episodes (3.81±0.76).

Conclusion

This study suggests greater night-to-night variability and overall disturbance in nighttime sleep continuity and REM sleep in individuals with NCI. These disturbances may be attributed to the occurrence of nightmares, causing wakefulness out of REM sleep, as well as a greater level of hyperarousal as evidenced by the greater SOL and reduced TST, relative to the other groups. These data also suggest the utility of objective sleep measures in nightmare research and clinical practice alike.

Support (if any)

National Institutes of Health (UL1TR000127)