bluuebunny/crossref_metadata_2025_split huggingface dataset:
175 Household and Transnational Caregiving and Sleep in Latinx Adults: The modifying effects of employment status
Authors: Giorgio Luciana , Alcantara Carmela 
Published: May 2021

Abstract

Introduction
Although caregiving is associated with shorter sleep durations and worse sleep quality, particularly among employed individuals, these studies have mostly examined household (i.e., child, adult) and domestic caregiving among majority non-Latinx White samples. Sending remittances, a form of transnational caregiving whereby financial support is provided to relatives in one’s country of origin, is associated with positive mental health among Latinxs, yet its association with sleep remains unexamined. We examined the association of household and transnational caregiving with sleep duration and quality, and explored the moderating effects of employment status on these relationships.

Methods
Using cross-sectional data of healthy Latinx adults in New York City (N=188), we conducted separate age and gender-adjusted linear regressions or logistic regressions to examine the association of caregiving and sleep duration, and poor sleep quality, respectively. Sleep duration (continuous) and sleep quality (fairly/very poor) were measured using two items from the PSQI. Household caregiving was defined as caregiving for children or adults in the household. Transnational caregiving was operationalized as sending remittances. Moderation was tested using employment status*caregiving cross-products in adjusted models.

Results
Participants were Mage=37.61(SD=14.07), 71.3% employed, 66.5% female, and 59.6% immigrants. Overall, 14.9% were household caregivers and 28.72% sent remittances. Household caregiving was not significantly associated with sleep duration or quality. Those who sent remittances reported on average sleeping 27.63 minutes less than non-remitters (b=-27.63,SE=13.93,p&lt;0.05). Sending remittances was associated with 2.30 increased odds of reporting poor sleep quality (OR:2.30; 95%CI:1.03-5.14.) Employment status was a significant moderator (p&lt;0.05). Among those who were employed, sending remittances was associated with 3 times higher odds of poor sleep quality (OR:3.00;95%CI:1.46-10.59) and 48.94 fewer minutes of sleep duration than non-remitters (b=-48.94,SE=15.72,p&lt;0.05). These relationships were not observed among unemployed Latinxs.

Conclusion
Transnational caregivers were more likely to report shorter sleep duration and poorer sleep quality than their counterparts, and this was only observed among employed vs. unemployed Latinxs. Household caregiving was not significantly associated with sleep. Employed transnational caregivers may have multiple jobs that further constrain opportunities for longer and high-quality sleep. Future studies should examine potential upstream factors (e.g., working conditions) that may limit employed, transnational caregivers’ ability to obtain adequate sleep.
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179 Insomnia Symptoms in Latinx emerging adults: The role of perceived discrimination
Authors: Soto Pablo , Dzierzewski Joseph , Ramos Mayra , Dautovich Natalie , Corona Rosalie 
Published: May 2021

Abstract

Introduction
An individual’s culture presents unique risk and protective factors related to sleep outcomes. Similarly, emerging adulthood also represents a unique developmental period as it relates to sleep. The study of cultural factors during emerging adulthood is critical for better understanding the development of sleep dysfunction in vulnerable segments of the population. The present study investigated the association between perceived discrimination and insomnia symptoms in Latinx emerging adults. We hypothesized that perceived discrimination would result in higher insomnia symptom presentation above and beyond anxiety and depressive symptoms.

Methods
Participants included 198 (73.7% female; mean age=18.96) college-aged individuals self-identifying as Hispanic/Latinx who completed an online survey that assessed perceived racial/ethnic discrimination (Everyday Discrimination Scale; EDS), anxiety symptoms (General Anxiety Disorder Scale; GAD-7), depression symptoms (Patient Health Questionnaire; PHQ-9), and insomnia symptoms (Insomnia Severity Index; ISI). A three-block hierarchical regression was used to assess the impact of perceived discrimination on the presentation of insomnia symptomology above and beyond demographic characteristics and anxiety and depressive symptoms.

Results
The final model significantly predicted insomnia symptom presentation, F(5, 191)=26.379, p&lt;.001, R2=.408. When age and gender identity were entered into the model they did not significantly predict insomnia symptoms F(2, 194)=.199, p=.82, R2=.002. Blocks 2, anxiety and depression symptoms (∆R2=.388), and 3, perceived discrimination (∆R2=.018), accounted for significant change in variance. In the final model, perceived discrimination significantly predicted insomnia symptoms (β=.151) above and beyond age (β=.016), gender identity (β= -.085), anxiety (β= -.075), and depression (β=.621).

Conclusion
Results suggest that discrimination among Hispanic/Latinx emerging adults is a unique contributor that may explain some of the higher prevalence rates of insomnia symptomology in this segment of the population. As such, it would be beneficial to tailor existing approaches aimed at improving sleep outcomes by accounting for stressors that could result from or influence discrimination against the individual and incorporate other cultural factors into treatment protocols.

Support (if any)
National Institute on Aging (K23AG049955, PI: Dzierzewski).
192 Self-reported sleep features in the Italian population across the first and second wave of the COVID-19 pandemic
Authors: De Rosa Oreste , Cellini Nicola , Conte Francesca , Malloggi Serena , Giganti Fiorenza , Ficca Gianluca 
Published: May 2021

Abstract

Introduction
Several studies have shown the negative impact of COVID-19-related confinement measures (spring 2020) on sleep features and quality. Here we aim to follow-up on these data by assessing self-reported sleep characteristics during the second wave of the pandemic (autumn 2020) in Italy, where the government responded with a second, partial, lockdown.

Methods
Using a longitudinal approach, 214 participants (Mage=36.78±14.2y; 159F) who had participated in a previous survey (April 2020 – Total Lockdown, TL) completed the same online survey from November 10th to December 1st (Partial Lockdown, PL). In each survey, participants had to respond to a set of questionnaires, including the Pittsburgh Sleep Quality Index (PSQI), referring to their current situation and, retrospectively, to their situation before the lockdown, resulting in four time-points (pre-TL, TL, pre-PL, PL).

Results
Linear mixed-model analysis showed that bedtime was delayed from pre-TL (23:46) to TL (24:42) and then linearly advanced in pre-PL (24:02) and PL (23:56). The same pattern emerged for rise time (pre-TL: 07:48, TL: 9:05, pre-PL: 8:28, PL: 7:58) and time in bed, which increased from pre-TL (8h4min) to TL (8h24min) and then linearly decreased (pre-PL: 8h15m, PL: 8h2m). Subjective sleep quality decreased in the two lockdowns compared to the period with no restrictions. The proportion of poor sleepers (PSQI&gt;5) increased from 39.7% (pre-TL) to 48.6% in TL and again from 36.9% (pre-PL) to 47.7% in PL.

Conclusion
Sleep habits and quality showed different profiles across four time-points of the COVID-19 pandemic and related restrictive measures. Sleep timing alterations appeared during the first lockdown, recovered after the confinement period, and almost returned to baseline during the second lockdown (likely due to a normalization of working schedules). Instead, subjective sleep quality markedly worsened during both lockdowns relative to the preceding respective months. These data suggest that subjective sleep quality is particularly sensitive to changes in life habits and psychological factors, independently of sleep habits. Considering that the pandemic situation may continue for several months, there is a need for interventions targeting sleep quality.

Support (if any)
N/A
203 Changing Sleep During the COVID Pandemic Associated with Daytime Cognitive Function
Authors: Jajoo Anjalee , Kennedy Kathryn , Lujan Matthew , Killgore William , Wills Chloe , Grandner Michael 
Published: May 2021

Abstract

Introduction
The novel Coronavirus has caused major disruptions to sleep and cognitive function of many individuals. The present study evaluated the degree to which daytime cognitive dysfunction may be related to worsening sleep.

Methods
Data from adults aged 18 and older in the 2020 Coronavirus and Impact on Dreams (CovID) study were used. Individuals were asked “how would you rate your sleep quality overall” and answered with “very good, fairly good, fairly bad, or very bad.” Subjects were asked if it takes “30 minutes or more to fall asleep” and answered with how frequently that happened. In addition, participants were asked how often they wake up during the night. Participants were then asked how much they think their sleep problems have contributed to daytime functioning and answered on a scale of 0 to 5, from “not at all” to “very much,” respectively.

Results
46% of the sample did not report problems with daytime cognitive function, while 33%, 12%, and 9% reported mild, moderate, and severe problems, respectively. Those who reported that they have kept a regular schedule during the pandemic were 83% less likely to report greater daytime cognitive dysfunction (95%CI:0.08,0.37, p&lt;0.0005). Those who indicated that overall their sleep worsened or improved did not demonstrate a difference in likelihood of daytime cognitive problems. Regarding specific sleep experiences, those who reported more problems falling asleep due to the pandemic were 8.2 times more likely to report daytime cognitive dysfunction (95%CI:3.53,19.07, p&lt;0.0005) and those who reported more problems with morning awakenings were 5.7 times more likely (95%CI:2.10,15.56, p&lt;0.001). Those who reported that they were sleepier as a result of the pandemic were 9.3 times as likely to report daytime cognitive dysfunction (95%CI:3.53,24.46, p&lt;0.0005) and those who reported taking more naps were 4.4 times more likely (95%CI:1.90,10.40, p&lt;0.001).

Conclusion
In general, people who reported increased sleepiness, a less regular schedule, more insomnia, and more napping were more likely to experience daytime cognitive dysfunction during the COVID-19 pandemic.

Support (if any)
R01MD011600, R01DA051321
211 Pandemic-Related Sleep Changes Associated with COVID-Related General, Financial, Food, Housing, Family and Relationship Stress
Authors: Kennedy Kathryn , Seixas Azizi , Jean-Louis Giardin , Killgore William , Wills Chloe , Grandner Michael 
Published: May 2021

Abstract

Introduction
The COVID-19 pandemic has caused widespread disruption and stress for people of all ages and circumstances around the world. This study investigates the relationship between general and specific stressors and various dimensions of sleep health.

Methods
A sample of N=419 US adults completed online surveys about sleep and COVID-19 experiences. Participants were asked whether they experienced increased general, financial, food, housing, family and relationship stress due to the COVID-19 pandemic. They were also asked whether they experienced a more regular schedule, improved sleep, worsened sleep, more early insomnia, more middle-of-the-night insomnia, more daytime sleepiness, and more naps due to the COVID-19 pandemic. Ordinal logistic regressions with sleep change as outcome and stress variable as predictor were adjusted for age, sex, and race/ethnicity.

Results
COVID-19-related general, financial, food, housing, family, and relationship stress were all associated with a decreased likelihood of maintaining a more regular schedule (oOR=0.52-0.67, all p&lt;0.001) and improved sleep (oOR=0.56-0.67, all p&lt;0.001). They were also all associated with a greater likelihood of worsened sleep (oOR=1.48-2.41, all p&lt;0.001), early insomnia (oOR=1.63-1.85, all p&lt;0.001), middle-of-the-night insomnia (oOR=1.40-2.00, all p&lt;0.001), and daytime sleepiness (oOR=1.58-2.07, all p&lt;0.001). Increased napping was also associated with more COVID-related financial, food, and housing stress (oOR=1.33-1.55, all p&lt;0.005).

Conclusion
Regular sleep schedules can be disrupted by stressors directly, or by the anxiety that so often accompanies stress. Stressed individuals may experience increased difficulty falling asleep, or more nighttime arousals, or find themselves waking up earlier than usual, all as a result of ruminating thoughts, stress-induced nightmares, or outside disturbances. Disruption to sleep at night often results in increased daytime sleepiness and fatigue, with a higher chance of napping. This study reports the significant association of some of these with COVID-19 pandemic-related stress. More individuals now find themselves working from home with greater flexibility in their schedules, but this has not necessarily led to better sleep. The impact of the pandemic on various health outcomes as a result of stress is still to be revealed.
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218 BIDEN WON, BUT SLEEP LOST IN THE 2020 US ELECTION
Authors: Gahan Luke , Ruder Michael , O’Mullane Brian , Watson Nathaniel , Raymann Roy 
Published: May 2021

Abstract

Introduction
The 2020 US Presidential Election captivated the US public resulting in record turnout. In the months preceding the elections COVID-19, racial injustice and the economic downturn had a daily impact on the lives of voters. In this research, we analyze the sleep behavior of Americans in the lead up to the Presidential Elections. We examine specifically the nights of the Presidential and Vice-Presidential Debates and Election Night.

Methods
We examined sleep data from the PSG-validated SleepScore Mobile Application, which uses a non-contact sonar-based method to objectively capture sleep-related metrics and self-reported lifestyle data. The data set included 123,723 nights (5,967 users residing in the US, aged 18-85, mean age: 46.6 +/- 16.7 years, 52.3% female). Data from September 1st until November 3rd were included. This covered the nights of the Presidential Debates (Tuesday 09/29/2020 and Thursday 10/22/2020) and the Vice-Presidential Debate (Wednesday 10/07/2020). Election night was Tuesday, November 3, 2020. Self-reported stress level (0-24 scale) and alcohol consumption (0-9 drinks) were measured using digital slider scales. Mixed Effect Modelling was used for analysis.

Results
The night of the 1st Presidential debate saw a change in sleep-related behavior with users going to bed 9.5 minutes later, as compared to a regular Tuesday Night. This resulted in a decrease in both TST (11.5 mins, p&lt;0.001) and TIB (11.8 mins, p&lt;0.001). Interestingly, neither the the 2nd Presidential Debate, nor the Vice Presidential Debate resulted in significant differences in sleep behavior. On election night users went to bed 14.5 (p&lt;0.001) min later on average, as compared to a normal Tuesday Night. This resulted in a decrease in both TIB (24.3 mins, p&lt;0.001) and TST (19.2 mins, p&lt;0.001). Self-report data showed a 13.3% (p&lt;0.001) increase in stress level on election night and 34.4% (p&lt;0.001) increase alcohol consumption Importantly, election night was two nights after the end of Daylight Savings Time (DST), Sunday, November 1st.

Conclusion
This analysis shows the 2020 US Presidential election negatively impacted US population sleep. The impact was most pronounced on election night, but also observed following the first Presidential debate. The effect of DST on these findings is unknown but surmised to be meaningful.
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219 Comparing Sleep Amount and Quality for People Working from Home with and Without Minor Dependents during the COVID-19 Pandemic
Authors: Cordoza Makayla , Kaizi-Lutu Marc , Jones Christopher , Mange Ami , Dinges David 
Published: May 2021

Abstract

Introduction
The global pandemic due to the novel coronavirus (COVID-19) has had unprecedented effects on society, in particular for those who are also working with children in the household. The aim of this analysis was to evaluate sleep amount and sleep quality during the COVID-19 pandemic compared to before COVID-19 for those working from home with minor household dependents.

Methods
We developed the “Anonymous Survey on Confinement during the COVID-19 Pandemic”, a national survey for individuals ≥18 years of age hosted on the Penn Medicine Clinical Research website from May 16th to November 11th, 2020. This 200 question survey captured demographics and multiple dimensions of health and well-being, including stress, sleep, eating behaviors, and coping activities. Respondents who indicated they were working from home were stratified by whether they were living with ≥1 minor dependent vs no dependents. Separate ordinal logistic regression models were used to evaluate associations between living with a minor dependent and sleep amount (less, same, more) and disturbed quality (none, less, same, more) during, compared to before, COVID-19 controlled for age, sex, ethnicity, and annual income.

Results
A total of 232 respondents (n=182 no dependents, n=50 dependents, 84.9% Caucasian) reported working from home, the majority of which had been in confinement (95.7%). Respondents with dependents were younger (mean age 38.9±13.5 vs 47.4±18.0, p=0.002) and mostly female (86% vs 76.9%, p=0.03). On average, reported days worked/week (3.5±2.4 days) and hours worked/day (5.5±4.17 hours) were similar regardless of dependents. Comparing those without to those with minor dependents, there were no significant differences in log odds of getting enough sleep (β=-0.38, p=0.25) or worse sleep quality (β=0.41, p=0.22) during the COVID-19 pandemic compared to before COVID-19. Respondents with dependents reported a higher log odds of taking longer to fall asleep during COVID-19 (β=0.71, p=0.045), and higher stress (β=-0.65, p=0.04).

Conclusion
In this mostly Caucasian female sample of people working from home, having minor dependents in the household did not significantly impact sleep amount or quality compared to no minor household dependents. However, respondents with dependents reported longer time to fall asleep and were more stressed.

Support (if any)
MC/CJ are supported by NHLBI (T32 HL007713).
220 Sleep schedule changes during the COVID-19 pandemic: Relations to circadian preferences
Authors: Ruder Michael , Gahan Luke , O’Mullane Brian , Watson Nathaniel , Raymann Roy 
Published: May 2021

Abstract

Introduction
The COVID-19 pandemic profoundly altered individual lifestyles, reducing commutes and restricting nocturnal in-person socialization. We examine whether the stay-at-home orders and the attendant increase in sleep scheduling autonomy, impact bedtimes and waketimes and influence circadian preference alignment.

Methods
We compared bedtimes and wake times during the 4 weeks before and after a March 19th, 2020 stay-at-home order announcement. Data from the PSG-validated SleepScore Mobile Application were analyzed. Users answering a circadian preference question (a five-point Likert scale ranging from “definitely a morning person” to “definitely an evening person”) who also recorded 10 or more nights of sleep both before and after the March 19th announcement were included in the analysis. The data set included 69,656 total nights of sleep from 1,487 users: 51.0% female, age range 18 to 91 years (mean = 50.3 +/- 30.3). Differences in average bedtime and wake time before and after March 19th were compared using paired sample t-tests. Associations between circadian preference and changes in bedtime and wake time were examined using Spearman’s correlation coefficient.

Results
All five circadian preference groups showed a significant delay in both bedtime and wake time (p &lt; .01) after the March 19th announcement. Greatest delays were observed in those reporting the strongest eveningness preference, with median bedtimes being 17 minutes later and wake times 33 minutes later. Delays were smallest in users with the strongest morningness preference, with bedtimes being 7 minutes later and wake times 12 minutes later. Wake time delay was significantly greater than bedtime delay for evening types (p &lt; 0.001) but not morning types. Eveningness preference was associated with greater bedtime delay (Spearman correlation = 0.098, p &lt;0.001) and wake time delay (Spearman correlation= 0.178, p &lt; 0.000001).

Conclusion
The stay-at-home order provided many individuals more freedom to choose their sleep schedule. This increased sleep scheduling autonomy was associated with delayed bedtimes and wake times for each circadian preference group, with the evening-types exhibiting the greatest shift towards a later sleep schedule. We conclude that stay-at-home orders allowed evening types to choose sleep schedules more aligned with their natural tendencies.
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223 Sleep Duration and Sleep Quality in Chronic Cannabis Users and Non-Users
Authors: Tse Caroline , Stewart Alicia , Ordaz-Johnson Omar , Herzig Maya , Gagnon Jacqueline , Emens Jonathan , Shea Steven , Bowles Nicole 
Published: May 2021

Abstract

Introduction
Cannabis use is on the rise in the United States, with 10% of adults reporting cannabis use in the past 30 days. Users commonly report consuming cannabis to improve sleep despite the lack of research that supports an association between cannabis use and sleep. In this pilot study we sought to examine objective measures of sleep duration and sleep quality among non- and chronic-cannabis users, and any patterns in relation to the time since consumption of cannabis.

Methods
Chronic cannabis users (cannabis used 2 or more times/week) and non-users provided up to 2-weeks of actigraphy (ActiGraph wGT3X-BT), worn on the wrist and verified by sleep diary. Chronic cannabis users also reported the date, time, amount, and route of their cannabis use. Mixed-effects models with participant as a random factor were used to examine: 1) the relationship between daily sleep parameters in cannabis non-users vs. users; and 2) the elapsed time between cannabis use and time in bed in chronic cannabis users.

Results
Chronic cannabis users (n=6) and non-users (n=7) collectively provided 151 nights of sleep. Participant characteristics (38.5% female; age, 25.8 years ± 4 years; BMI, 23.4 kg/m2 ± 3.4 kg/m2) did not significantly differ between groups. Cannabis use was associated with decreased total sleep time (measured in hours, ß=-0.58, p&lt;0.001) and increased wake after sleep onset (WASO, ß=32.79, p=0.005), but not with the number of awakenings (ß=6.02, p=0.068). Among chronic cannabis users, cannabis use within two hours of bed was associated with increased sleep latency compared to use greater than two hours (ß=6.66, p=0.026). There was no association between time of cannabis use and WASO (p=0.621) or the number of awakenings (p=0.617).

Conclusion
In this pilot study of objectively measured sleep, we found that chronic cannabis use compared to non-use is associated with decreased sleep duration of otherwise healthy adults. Cannabis used closer to bedtime is associated with increased sleep latency. Additional studies that are able to assess the mode and dosage of use are needed to further understand the effects of cannabis and its components on sleep.

Support (if any)
KL2TR002370, AASM, Oregon Institute of Occupational Health Sciences