bluuebunny/crossref_metadata_2025_split huggingface dataset:
172 Sleep Disparities in Preschool-Aged Children
Authors: Holmes Jennifer , Hanron Olivia , Spencer Rebecca 
Published: May 2021

Abstract

Introduction
Sleep is known to be associated with socioeconomic status (SES) in older children and adults with those from lower SES households often experiencing poorer sleep quality. Whether this disparity exists in early childhood is relatively unknown, despite being an important age marked by sleep transitions and the establishment of lifelong sleep habits. Furthermore, it is a critical period for cognitive development and learning, which are supported by sleep. Here, we explore associations between sleep and SES in a preschool population. We hypothesized that children from lower SES households would exhibit shorter overnight sleep, longer and more frequent naps, and shorter 24-hr sleep. Additionally, we considered racial and ethnic disparities in sleep which can be confounded with SES in some samples.

Methods
Child (n=441; M age=51.9mo; 45.4% female) sleep was measured objectively using actigraph watches, worn for 3-16 days (M=9.5 days). Caregivers reported child demographics and household data. Race/ethnicity of our sample was 72% White, 10.2% Black, 17.8% other or more than one race, and 28.4% identified as Hispanic. 20.1% of our sample was categorized as low SES. Effects of SES and race/ethnicity on continuous sleep measures were assessed using multiple regression models, with age and gender as covariates. Nap habituality was assessed using chi-square tests.

Results
Lower SES was associated with shorter nighttime sleep duration, longer nap duration, and shorter 24-hr sleep duration (p’s&lt;.001). Children from lower SES households were also more likely to nap habitually (p=.04) as were Hispanic children (p&lt;.001). Hispanic children also tended to have longer nap bouts (p=.002). Hispanic and Black children on average had shorter overnight sleep durations than White children (p’s&lt;.04), but their 24-hr sleep did not differ.

Conclusion
SES-related sleep disparities were present in this preschool population, with lower SES children exhibiting poorer sleep. When controlling for SES, Hispanic children tended to sleep less overnight which was compensated for by longer, more frequent naps. This underscores the necessity of naps for some children to achieve adequate sleep. Future directions will explore the relationship between parenting factors and sleep, such as bedtime routines and parent knowledge surrounding child sleep needs.

Support (if any)
NIH R01 HL111695
181 Sleep health concordance among socioeconomically disadvantaged caregiver-child dyads
Authors: Covington Lauren , Brewer Benjamin , Blair Rachel , Hoopes Elissa , Laurenceau Jean-Philippe , Patterson Freda 
Published: May 2021

Abstract

Introduction
Child and caregiver sleep typically occurs within a family system. Disadvantaged families experience disproportionately poorer sleep health than more advantaged families. The extent to which objectively measured sleep health metrics (e.g. duration, timing, regularity, efficiency) are concordant within disadvantaged family systems, such as caregiver-child dyads, is not clear. To address this gap, this study aimed to: (1) characterize sleep health metrics, and (2) identify levels of sleep health concordance among disadvantaged caregiver-child dyads.

Methods
23 disadvantaged dyads were recruited from Philadelphia and Delaware communities. Dyads were eligible if the child was between 6-14 years, slept in the same house as the caregiver at least four nights/week, had no diagnosis of a sleep disorder or use of sleep medication, and qualified for federally funded food assistance programs (e.g., food stamps, WIC or SNAP benefits). Sleep health of the dyads was objectively measured for 7-14 days. Sleep metrics used to characterize the sample were: nighttime sleep duration (hours), time-to-bed, sleep regularity (standard deviation of sleep duration), sleep midpoint (halfway point between sleep onset and wake time) and efficiency (percentage of time spent asleep versus awake). Concordance in sleep health metrics within dyads was calculated using Pearson’s correlation coefficients of the average sleep metrics over the monitoring period.

Results
Children (46.2% female) slept, on average, 7.96 hours per night, with 1.25 hours of nightly sleep variability, bedtime of 10:47 PM, sleep midpoint of 2:56 AM, and sleep efficiency of 83.55%. Caregivers (mean age = 40.5 years, 85.0% female) slept, on average, 6.92 hours per night, with 1.22 hours of nightly sleep variability, bedtime of 11:24 PM, sleep midpoint of 3:04 AM, and sleep efficiency of 76.29%. Bedtime (r = 0.19, p &lt; 0.001), sleep midpoint (r = 0.39, p &lt; 0.001), and sleep efficiency (r = 0.24, p &lt; 0.001) were significantly concordant among caregiver-child dyads.

Conclusion
Given their level of concordance, bedtime, sleep midpoint and efficiency are modifiable factors of sleep health in disadvantaged dyads that could be targeted using family versus individual level interventions.

Support (if any)
University of Delaware General University Research Grant and School of Nursing SEED funding.
188 Racial Disparities in Sleep During the COVID-19 Pandemic
Authors: Harra Ryan , Snyder Hope , Thurmon Casey , Hire Veronica , Walker Jamie , Vargas Ivan 
Published: May 2021

Abstract

Introduction
The purpose of the present study was to estimate average sleep duration and sleep disturbance in the United States during the COVID-19 pandemic. In addition, we investigated whether sleep varied as a function of sociodemographic variables, in particular race. Long standing disparities in condition and available resources between racial demographics often lead to disparities in health. At the advent of a pandemic, which strains these systems further, it is important to assess whether or not racial disparities persist. This is important given that racial groups are likely affected by the pandemic, both directly and indirectly, in various ways. Here, we plan to at least assess whether there are any disparities with regard to sleep.

Methods
4,048 adults (Mage = 45.8 years; 79% women) completed an online survey during April – June 2020. The final sample’s self-reported race/ethnicity consisted of 84% White, 5.1% Black, 3.4% LatinX, 4.2% Asian or Asian American, and 2.9% Multi-racial. Sleep disturbance was assessed using a retrospective sleep diary and the Insomnia Severity Index (ISI).

Results
Average sleep duration in the sample was 7.1 hours. Participants reported taking on average 32 minutes (SD = 38 mins) to fall asleep and reported waking up for 32 minutes (SD = 53 mins) during the night. Approximately 17% of the sample endorsed clinically elevated insomnia symptoms (based on the ISI ≥ 15 cut-off). With regard to racial differences, shorter total sleep time (TST), longer sleep latencies (SL), and greater total ISI scores were observed in Black (mean TST = 6.4 hours; SL = 37.7 minutes; ISI Total = 9.8) and LatinX (mean TST = 6.9 hours; SL = 37.1 minutes; ISI Total = 9.6) participants relative to White participants (Mean TST = 7.1 hours; SL = 30.9 minutes; ISI Total = 8.4). All p’s &lt; 0.05.

Conclusion
Sociodemographic variables, particularly race, should be considered when estimating the relative impact of sleep on overall health. These findings are significant as they may have implications for a number of health disparities observed in the United States, especially during the COVID-19 pandemic.

Support (if any)
Vargas: K23HL141581
200 COVID-19 Pandemic Sleep Changes Related to Social and Financial Impacts at the US-Mexico Border
Authors: Arce Ruya , Valencia Dora , Ghani Sadia , Delgadillo Marcos , Madhivanan Purnima , Krupp Karl , Ruiz John , Seixas Azizi , Jean-Louis Giardin , Killgore William , Wills Chloe , Grandner Michael 
Published: May 2021

Abstract

Introduction
The COVID-19 pandemic has caused major impacts to social and financial status for many people, including those living in the vulnerable US-Mexico border region. This study examined relationships between changes in sleep and perceived impacts to social and financial stability due to the pandemic.

Methods
Participants were 155 individuals who completed the Nogales Cardiometabolic Health and Sleep (NOCHES) and were contacted about completing a COVID sub-study (95% Hispanic/Latino). Participants were asked if the COVID-19 pandemic was causing them to feel more socially isolated, negatively impacting their finances, causing increased worry about finances, affecting their primary job, causing a job loss, and impacting their belief life will one day return to normal. In addition, they were asked to report the degree to which they experienced pandemic-related changes to sleep, including a regularity, overall improvement/worsening, initial and middle-of-the-night insomnia, daytime sleepiness, and napping. Logistic regression analyses were adjusted for age, sex, socioeconomics, and mental health (PHQ4).

Results
Those who kept a more regular schedule had lower odds of endorsing isolation (OR=0.32,p&lt;0.0005) and higher odds of believing things will return to normal (OR=1.67,p=0.041). Those whose sleep improved also had lower odds of feeling isolated (OR=0.40,p=0.005). Those with worsened sleep had increased odds of feeling isolated (OR=2.14,p=0.023), experiencing a financial impact (OR=1.85,p=0.016) and increased financial worry (OR=1.71,p=0.033), and lower odds of believing things will return to normal (OR=0.53,p=0.012). More initial insomnia was associated with isolation (OR=3.62,p=0.001), financial impact, (OR=1.89,p=0.015), financial worry (OR=1.87,p=0.016) and job impact (OR=1.95,p=0.010). More middle-of-the-night insomnia was associated with financial worry (OR=1.82,p=0.016) and job impact (OR=1.93,p=0.009). More sleepiness was associated with job loss (OR=1.84,p=0.043). More napping was associated with financial impact (OR=1.89,p=0.017) and worry (OR=1.88,p=0.017), impact to job (OR=1.89,p=0.016) or lost job (OR=1.81,p=0.041), and decreased likelihood of believing things will return to normal (OR=0.45,p=0.003).

Conclusion
Pandemic-related stress was linked with sleep disturbances. Worse sleep was indicative of increased social isolation, greater financial fears, more job-related impacts and less of a general sense that things would return to normal.

Support (if any)
Supported by T32HL007249, R01MD011600, R01DA051321
205 Changes in Sleep Due to COVID Pandemic Associated with Changes to Dietary Patterns
Authors: Ghani Sadia , Kennedy Kathryn , Seixas Azizi , Jean-Louis Giardin , Killgore William , Knowlden Adam , Wills Chloe , Grandner Michael 
Published: May 2021

Abstract

Introduction
The COVID-19 pandemic has affected sleep and diet for many people. The present study sought to examine potential associations between changes to sleep and eating habits during the COVID-19 pandemic.

Methods
A sample of N=419 US adults completed online surveys about sleep and COVID-19 experiences. Questions for diet asked, “since quarantine: I’m eating healthier, eating more processed foods, home-cooked meals and more regularly,” “I’m enjoying food in quarantine and I’m struggling with overeating in quarantine.” Sleep questions asked “since quarantine: I have managed to keep a regular sleep-wake schedule, my sleep has improved, I’m struggling to fall asleep, I’m waking up more during the night, I’m more sleepy during the day and I’m taking more naps during the day.” Answers were reported on a 4-point scale ranging from “strongly disagree to strongly agree.” Ordinal logistic regressions were used, adjusted for age and sex and examined each dietary variable as ordinal outcome and each sleep variable as predictor.

Results
Those who report that they kept a more regular schedule were more likely to report eating healthier (oOR=3.13, p=0.007), eating more home-cooked meals (oOR=3.19, p=0.005), and less likely to be eating more processed foods (oOR=0.39, p=0.02), struggle with overeating (oOR=0.39, p=0.02) or undereating (oOR=0.30, p=0.004) or snacking (oOR=0.25, p=0.001). Those reporting more difficulty falling asleep were less likely to be eating healthier (oOR=0.25, p=0.002) and more likely to be eating more processed foods (oOR=3.07, p=0.009) and snacking (oOr=2.36, P=0.04). Those reporting more difficulty with awakenings were less likely to report eating healthier (oOR=0.34, p=0.03) and more likely to report eating more processed foods (oOR=4.52, p=0.001). Those with more sleepiness were less likely to report eating healthier (oOR=0.29, p=0.01) and more homecooked meals (oOR=0.40, p=0.046) and more likely to report eating more processed foods (oOR=6.42, p&lt;0.0005), overeating (oOR=3.63, p=0.01) and snacking (oOR=5.81, p=0.001).

Conclusion
Research studying psychological, behavioral and environmental factors that are contributing to changes in sleep and dietary patterns is especially important during a pandemic that has forced people into changes that they may not have been prepared for and which may result in long-term health outcomes.

Support (if any)
T32HL007249, R01MD011600, R01DA051321
212 An Election During a Pandemic: Relationship Between Political Affiliation and Pandemic-Related Sleep and Dreams
Authors: Grandner Michael , Ruby Perrine , Killgore William , Kennedy Kathryn , Wills Chloe 
Published: May 2021

Abstract

Introduction
In 2020, a global pandemic impacted sleep for many people in the US, which was also experiencing an extremely contentious election season. These overlapped somewhat, as the liberal/left side of the political spectrum was more vocal about the dangers of COVID-19 and the pandemic, while the conservative/right frequently expressed less concern about COVID-related risks. Perhaps this confluence was borne out in sleep quality and dreams.

Methods
A sample of N=419 US adults completed online surveys about sleep and COVID-19 experiences. Participants rated their political affiliation on a scale of 0 (Very Conservative/Right) to 6 (Very Liberal/Left). Participants were also asked whether, since the pandemic, their sleep improved or worsened, whether their dream content has become more positive (more or less positive content, versus same) or negative (more or less negative content, versus same), the number of nightmares they recall, and whether their dreams included themes of politics and/or COVID. Regression analyses examined political affiliation as independent variable with ordinal logistic analyses for sleep improvement/worsening, multinomial logistic analyses for positive/negative content, linear regression analyses for nightmare frequency, and binary logistic analyses for presence of political/COVID themes in dreams. All analyses were adjusted for age, sex, and race/ethnicity.

Results
Greater liberal/left affiliation was associated with a greater likelihood of worsened sleep (oOR=1.20, p=0.002), but no difference in likelihood of sleep improvement. Greater liberal/left affiliation was associated with a greater likelihood of decreased positive dream content (RRR=1.29, p=0.001) but no different in likelihood of increased positive content. In addition, greater liberal/left affiliation was associated with an increased likelihood of more negative dream content (RRR=1.33, p&lt;0.0005) but no difference in the experience of less negative content. Liberal/left affiliation was also associated with more frequent nightmares during the pandemic (B=1.55, p=0.019), and more political dreams (OR=1.29, p=0.010) but no difference in COVID-related dreams.

Conclusion
During the COVID-19 pandemic, more liberal/left individuals reported a greater degree of worsening sleep and dream content that was less positive and more negative in nature. Though there was no difference in COVID-related dream content, there was a difference in political content in dreams.

Support (if any)
None
227 Poor sleep as a predictor of COVID-19 related stress, fear and sadness in young adolescents: a longitudinal study
Authors: Kiss Orsolya , Alzueta Elisabet , Yuksel Dilara , Durley Ingrid , Volpe Laila , Dulai Teji , Arra Nicole , Obilor Todd , Pohl Kilian , de Zambotti Massimiliano , Baker Fiona 
Published: May 2021

Abstract

Introduction
Adolescence is a transitional life-stage accompanied by large biopsychosocial changes and greater psychophysiological vulnerability. Global events like the COVID-19 pandemic may increase vulnerability to depression and anxiety in this population. Poor sleep is often associated with depression, and both sleep and mood have been shown to be strongly impacted by the COVID-19 pandemic, with most studies focusing on adults. The current study investigates psychological distress in young adolescents during the pandemic, and specifically, whether poor sleep before the pandemic predicts psychological distress.

Methods
Self-report data were analyzed from 3099 adolescents (9-10 years at baseline) in the population-based, demographically diverse, Adolescent Brain Cognitive Development (ABCD) study across three pre-pandemic annual visits and 3 monthly time points during the COVID-19 pandemic (ages 11-13 years). At each assessment, children and their guardians completed questionnaires including those about sleep, environment, and psychological wellbeing. Gradient Boosted Tree machine learning algorithms were used to identify the strongest predictors of pandemic-related psychological distress in individuals. We trained models using pre-pandemic sleep measures along with demographics, economic, and social measures during the pandemic. We evaluated the performance of the models using area under curve (AUC) metrics and interpreted the models by using the recently proposed SHapley Additive exPlanations methodology.

Results
Pandemic-related perceived stress, fear and sadness were accurately detected with our classifiers (AUC = 0.83 for perceived stress, AUC = 0.73 for fear, AUC = 0.79 for sadness). Across all models, shorter sleep duration, prolonged sleep onset latency, and longer time between waking and getting out of bed predicted greater distress. Moreover, female sex, and pandemic-related factors, including greater family conflict, fewer economic resources, and more screen time contributed to prediction performance in all three models.

Conclusion
Findings highlight the importance of addressing sleep problems and ensuring sufficient sleep duration in children to protect against the psychological impact of major life events, including the COVID-19 pandemic. Considering the long-lasting effects of sleep, it would be crucial to improve sleep health by targeted prevention, intervention and increased awareness among adolescents.

Support (if any)
NIH U01DA041022
241 Remotely Delivered Yoga Nidra for Insomnia and Anxiety during COVID-19
Authors: Sharpe Erica , Butler Matthew , Hanes Doug , Bradley Ryan 
Published: May 2021

Abstract

Introduction
Insomnia and related anxiety affect 30 - 50% of the US adult population. These conditions often coexist, and contribute to increased mortality from depression, heart disease, and stroke. The current COVID-19 pandemic has heightened anxiety and sleeplessness, and 53% of US adults report the pandemic has affected their mental health. There is a need for research into therapies for anxiety and insomnia that can be delivered remotely for increased accessibility to reach more individuals in need.

Methods
To contribute to this need, we examined the effects of remotely delivered Yoga Nidra (translated to mean “yogic sleep”), a guided meditation practice, on anxiety and sleep. The practice was delivered in real-time before bed, or asynchronously via an online REDCap-based platform, once per week for 16-weeks from April to July (during the early months of the COVID-19 pandemic).

Results
Seventy-four individuals joined the study, of whom 71% reported subthreshold insomnia (Insomnia Severity Index score of 14 ± 4), and 74% reported anxiety (Generalized Anxiety Disorder Index score of 10 ± 5). Seventy-one (96%) participants accessed the asynchronous recordings. Remote delivery of this practice proved very feasible, with no adverse events reported, and although we provided no monetary compensation, 50% of our sample still completed a post-intervention survey. Further, 52% of n=25 respondents who completed both pre- and post-intervention sleep surveys reported decreased sleep onset latency (SOL) the following day, with a mean decrease of 10 minutes (95% CI = −19.0, −0.5) for all respondents, and strongest change (−34 min; p=.017) measured for those who reported SOL between 30-120 min at baseline. Overall state anxiety was decreased by 41% for n=32 respondents who completed pre-post State Trait Anxiety Index (STAI) surveys surrounding a single practice (average score of 47 ± 11 before practice vs. 27 ± 8 after practice, p&lt;.0001).

Conclusion
Remotely delivered Yoga Nidra is feasible to deliver, and demonstrates potential benefits for anxiety and insomnia, warranting additional research.

Support (if any)
This work was supported by the R90 BRIDG grant at the Helfgott Research Institute at the National University of Natural Medicine.
243 Adverse relationships between sleep apnea, white matter integrity and perfusion is attenuated in more physically fit older adults
Authors: Driscoll Ira , Hagen Erika , Barnet Jodi , Lose Sarah , Edmunds Kyle , Gaitán Julian , Motovylyak Alice , Okonkwo Ozioma , Peppard Paul 
Published: May 2021

Abstract

Introduction
White matter (WM) integrity declines with age and is sensitive to vascular risk modifiers, such as exercise. Sleep apnea is believed to contribute to cerebral white matter change via intermittent hypoxia-induced alterations to cerebral blood flow resulting in cerebrovascular shearing. Existing literature highlights the relationships between poor sleep and numerous adverse health outcomes, including risk for cardiovascular disease and dementia. Conversely, exercise seems to have a positive effect on both brain structure and function. Here we examine a potential interaction between sleep apnea severity and cardiorespiratory fitness (characterized by a gender-specific Non-Exercise CardioRespiratory Fitness Measure, NECRFM) as predictors of MRI measures of brain WM integrity and cerebral blood flow (CBF) in a sample of non-demented older adult participants of the Wisconsin Sleep Cohort (WSC).

Methods
Cross-sectional linear models using data from a subset of 124 WSC participants (50% female; mean age[range]=67.6 [49.6, 85.3]) examined the relationship between sleep apnea severity (apnea-hypopnea index, AHI) and cardiorespiratory fitness in predicting MRI-assessed total WM and lesion volumes, WM hyperintensities (WMHs; a marker of small vessel disease in the brain) and Arterial Spin Labeling (ASL) CBF, controlling for age, sex, BMI, education, and hypertension.

Results
Greater sleep apnea severity was associated more strongly with both total lesion and WMH loads in less fit compared to more fit persons (p’s&lt;0.05) in the absence of significant differences in total WM volume. Regional perfusion revealed higher CBF in the angular gyrus, middle frontal cortex, and superior frontal gyrus and lower CBF in the anterior cingulate gyrus and the hippocampus of more fit compared to less fit persons (p’s&lt; 0.05), in the absence of differences in mean global perfusion.

Conclusion
Overall, our results suggest that better general fitness may attenuate negative brain health outcomes related to poor sleep. We highlight an important relationship between brain health and modifiable behavioral factors, namely sleep and fitness, that have the potential to help maintain or improve brain integrity with age.

Support (if any)
This work was supported by United States National Institutes of Health grants R01AG062167, R01AG058680, R01HL62252, 1R01AG036838 and 1UL1RR025011.