bluuebunny/crossref_metadata_2025_split huggingface dataset:
202 COVID-19 Pandemic Sleep Disturbances Related To Dietary Behavior at the US-Mexico Border
Authors: 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 disrupted life at the US-Mexico border in many ways, including sleep and dietary behavior. Given the potential long-term impact of worsening sleep and metabolic health due to the pandemic, the present study examines whether changes to dietary behavior were associated with changes to sleep.

Methods
Participants were 155 individuals who completed the Nogales Cardiometabolic Health and Sleep (NOCHES) Study and were contacted about completing a COVID-19 sub-study (95% Hispanic/Latino). Participants reported the degree to which they experienced pandemic-related changes to sleep, including a more regular schedule, overall improvement, overall worsening, more initial insomnia, more middle-of-the-night insomnia, more daytime sleepiness, and more napping. They were also asked whether as a result of the pandemic they consumed an overall healthier diet, more homecooked meals, more processed meals, more regular meals, whether they enjoyed food more, and degree of overeating. Ordinal regressions with diet change as outcome and sleep change as predictor were adjusted for age, sex, education, and socioeconomics.

Results
Those who reported more regular sleep were more likely to report a healthier overall diet (oOR=3.12,p&lt;0.0005), more homecooked meals (oOR=2.18,p=0.001), more enjoyment of food (oOR=1.71,p=0.028), and less likelihood of overeating (oOR=0.59,p=0.033). Similarly, those who reported more “improved” sleep reported healthier overall diet (oOR=7.42,p&lt;0.0005), more homecooked meals (oOR=2.59,p=0.001), more regular diet (oOR=2.15,p=0.006), more enjoyment of food (oOR=2.92,p&lt;0.0005), less consumption of processed foods (oOR=0.54,p=0.039), and less overeating (0.33,p&lt;0.0005). Those whose sleep worsened reported eating more processed foods (oOR=1.78,p=0.030) and overeating (oOR=3.90,p&lt;0.0005). Those who reported more initial insomnia reported eating more processed foods (oOR=1.93,p=0.016), more regular diet (oOR=1.65,p=0.042), and overeating more often (oOR=4.11,p&lt;0.0005). More middle-of-the-night insomnia was associated with eating more processed foods (oOR=2.45,p=0.001), more regular diet (oOR=1.66,p=0.031), and overeating more often (oOR=3.68, &lt;0.0005). Those with more daytime sleepiness also reported eating more processed foods (oOR=2.36,p=0.003), more regular diet (oOR=1.79, =0.019), and overeating more often (oOR=3.28,p&lt;0.0005). More napping was associated with a more regular diet (oOR=1.90,p=0.011) and more overeating (oOR=3.53,p&lt;0.0005).

Conclusion
Overall, worse sleep led to worse dietary behavior, especially eating more processed food and overeating.

Support (if any)
Supported by T32HL007249, R01MD011600, R01DA051321
207 Sociodemographic, Behavioral, and Health-Related Factors Associated with Sleep Among Native Hawaiians and Other Pacific Islanders
Authors: Barker Madison , Gilles Allyson , Ghani Sadia , Killgore William , Knowlden Adam , Wills Chloe , Grandner Michael 
Published: May 2021

Abstract

Introduction
Previous studies have suggested that Native Hawaiians/Pacific Islanders show different associations between sleep and health risks, compared to other groups. The present study evaluated sleep and health risk factors in a nationally-representative sample.

Methods
Data from the Native Hawaiian and Pacific Islander National Health Interview Survey (NHPI-NHIS), collected by the CDC in 2013, was used for analysis. A total of N=2,124 individuals provided complete data on all variables. Sleep outcomes included hours of sleep (3-12h), days/week difficulty falling asleep, difficulty maintaining sleep, and nonrestorative sleep (ordinal). Weighted regression analyses (linear or ordinal logistic) evaluated whether sleep outcomes were associated with cancer, diabetes, hypertension, stroke, obesity, poor health, depression, anxiety, smoking, alcohol, activity, functional limitations, foregoing medical care due to cost, frequent healthcare utilization, health insurance, and difficulty paying medical bills, in models that also included age, sex, immigrant status, multiracial status, education, employment, income, and relationship status.

Results
Shorter sleep was associated with older age, earning &lt;$20,000, and being divorced/widowed/separated, and longer sleep was associated with being female and less than high school education. Shorter sleep was also associated with fair health and current drinking. Difficulty falling asleep was positively associated with older age, earning &lt;=$44,999, being divorced/widowed/separated, obesity, worse health, depressed mood, anxiety, daily smoking, former and current drinking, functional limitations, foregoing care, frequent care, and difficulty with bills. Difficulty falling asleep was negatively associated with immigrant status and being retired. Difficulty maintaining sleep was associated with older age, being unmarried but partnered, obesity, worse health, depression, anxiety, daily smoking, current or heavy drinking, being inactive, functional limitations, foregoing care, frequent care, and difficulty with medical bills. Nonrestorative sleep was associated with non-immigrant status, employment, being a homemaker, disability, being unmarried, obesity, worse health, depression, anxiety, daily smoking, former, current, or heavy drinking, inactivity, functional limitations, foregoing care, frequent care, and difficulty with medical bills.

Conclusion
Short sleep was not significantly associated with common health risk factors seen in other groups. Sleep difficulties, though, were related to a constellation of sociodemographic, socioeconomic, behavioral, and cardiometabolic risks. Further research regarding insomnia as a health risk factor in this population is warranted.

Support (if any)
R01MD011600, R01DA051321
217 Sleep in heavy marijuana users after smoking differing THC doses compared to controls
Authors: Sibai Mohammad , Roehrs Timothy , Koshor Gail , Verkler Jelena , Lundahl Leslie 
Published: May 2021

Abstract

Introduction
Sleep disturbances are commonly reported by chronic marijuana (MJ) users and often identified as reasons for MJ relapse and/or other drug use. In the current study we compared the sleep architecture of 12 heavy MJ users to 11 normal controls.

Methods
Participants in the marijuana group met DSM-V criteria for cannabis use disorder but were otherwise healthy individuals. On the first study day, individuals smoked (1330-1400 hr) 11 puffs from a cannabis cigarette (7% THC). During the next four days, under varying experimental contingencies participants smoked an average of 4.58 (±3.48) day 1, 4.92 (±3.62) day 2, 4.75 (±3.52) day 3, and 4.17 (±3.56) day 4 puffs from cannabis cigarettes (7% THC). Their sleep was recorded the first four study nights using standard polysomnography procedures at Henry Ford Sleep and Research Center Hospital, under an 8-hr fixed time in bed (2300-0700 hr). Controls (n=11) had no history of illicit drug use or medical illness and were not shift workers. Neither group reported a history of sleep-related disorders. PSG recordings were scored using Rechtschaffen and Kales standard criteria. Sleep measures included sleep efficiency (total sleep time/time in bed * 100), latency to persistent sleep, and percent of time spent in Stage 1, 2, 3/4, and rapid eye movement (REM).

Results
PSGs taken across all four nights of inpatient stay showed that MJ users spent significantly more time in REM sleep compared to controls (means 24.91, 24.64, 24.42, 24.13 vs 18.81, p&lt;.001) and less time in stage 3/4 sleep (means 4.33, 4.79, 4.53, 6.91 vs 15.68, p&lt;.001). MJ users showed reduced sleep efficiency compared to controls on night 4 (means 82.03 vs 90.32, p=0.039), and increased latency to persistent sleep on night 1 (means 6.04 vs 17.77, p=0.026).

Conclusion
These data show reduced sleep efficiency, lightened sleep (reduced stage 3/4), as well as an increased duration during REM sleep in heavy MJ users during decreased use, findings that are predictive of relapse in other drug abuse populations.

Support (if any)
NIH/NIDA R21 DA040770 (LHL)
221 Social Integration and Sleep Quality during the COVID-19 Pandemic: Prospective Evidence from a Study of Retired Older Adults
Authors: Chin Brian , Tracy Eunjin , Lehrer H Matthew , Carroll Lucas , Lacey Precious , Kimutis Sarah , Buysse Daniel , Hall Martica 
Published: May 2021

Abstract

Introduction
Growing evidence has documented the adverse impact of the global coronavirus pandemic on sleep quality. Older adults may be especially susceptible to declines in sleep quality for multiple reasons, including their elevated risk of social isolation and loneliness during the pandemic. Given the adverse health consequences of poor sleep, there is a need to identify resilience factors that help protect older adults against decreased sleep quality. Social integration is a plausible resilience factor because involvement in a broad range of social relationships is thought to promote psychological well-being (e.g., meaning, purpose in life), as well as reduce the intensity and duration of negative psychological states. Social integration may also assume increased importance during the coronavirus pandemic because of normative declines in overall social contact. This prospective study assessed the impact of the coronavirus pandemic on older adults’ sleep quality and tested whether social integration moderated the impact of the pandemic on sleep quality.

Methods
A sample of 115 retired older adults (mean age = 68.6, 58% female, 89% white) completed self-report assessments of their social integration (number of roles on Cohen’s Social Network Index) and sleep quality (global score on Pittsburgh Sleep Quality Index) before and after the onset of the coronavirus pandemic (mean duration of follow-up = 2.3 years).

Results
Multilevel analyses indicated that social integration moderated the impact of the coronavirus pandemic on sleep quality; there was no main effect of time. Older adults with low social integration had reduced sleep quality from Time 1 to Time 2 (b=.94, p=.02), whereas older adults with high social integration showed no changes in sleep quality over time (b=-.38, p=.37).

Conclusion
Broader social networks confer resilience against pandemic-related declines in sleep quality among older adults. The level of social integration should be addressed when studying or treating sleep complaints during the coronavirus pandemic. Additional research is warranted to determine whether psychosocial interventions targeted towards older adults with low social integration can reduce observed differences in sleep quality.

Support (if any)
This research was supported by R01AG047139, T32HL007560, T32HL082610, T32MH019986.
222 COVID-19 Related Stress Intensify the Impact of Child Maltreatment on Sleep Quality
Authors: Zhang Linhao , Cui Zehua , Sasser Jeri , Oshri Assaf 
Published: May 2021

Abstract

Introduction
Child maltreatment (CM) is a significant stressor that is associated with sleep problems in children and adolescents. The COVID-19 pandemic introduces new psychosocial stressors, which may be particularly harmful to youth already experiencing stress in the home environment. Using multi-dimensional (threat vs deprivation) assessments of CM, the present study aimed to test whether COVID-19 related stress intensified the association between maltreatment (abuse vs neglect) and sleep problems among youth.

Methods
This study utilized data from a longitudinal sample of youth (N=126; Mage at T1=12.9) assessed between January 2019 and March 2020 (T1) and after the beginning of the COVID-19 pandemic (May 2020; T2). Latent factors for COVID-19 related stress included three questions asking about negative changes, uncertainty about the future, and stress-induced by disruptions. CM at T1 was measured with the Childhood Trauma Questionnaire (CTQ). Multidimensional aspects of CM included a threat factor (sum of Emotional, Physical, and Sexual Abuse) and a deprivation factor (sum of Emotional and Physical Neglect). Sleep-related problems at both T1 and T2 were assessed using the Pittsburgh Sleep Quality Index (PSQI) global score. Structural equation modeling was conducted in Mplus 8.1 to test direct and interaction effects of CM and COVID-19 related stress on sleep problems at T2 while controlling for sleep problems at T1 and demographic covariates.

Results
Threat-related abuse was significantly associated with increased sleep problems at T2 (β =.43, p &lt; .01) but neglect was not (β =.03, p = .85). Additionally, COVID-19 related stress significantly intensified the link between abuse and sleep problems (β =.14, p &lt; .05) as well as between neglect and sleep problems (β =.43, p &lt; .01) at T2. Among youth who experienced higher levels of CM, increased COVID-19 related stress exacerbated sleep problems.

Conclusion
These results bolster extant research on the negative impact CM bears on youth sleep health and indicates that COVID-19 stress may exacerbate sleep problems. Our findings inform future prevention and intervention efforts that aim to reduce sleep problems among youth who experience CM during the COVID-19 pandemic.

Support (if any)
NIH/NIDA K Grant 1K01DA045219-01
226 Changes in sleep amount and sleep quality due to the COVID-19 pandemic confinement associate with ratings of health and stress
Authors: Jones Christopher , Kaizi-Lutu Marc , Cordoza Makayla , Mange Ami , Dinges David 
Published: May 2021

Abstract

Introduction
In March 2020, an unprecedented number of individuals were confined to their homes in an effort to stem the spread of the novel Coronavirus (Covid-19), however the impact of this confinement on health and behavior is unknown. Long-duration confinement studies have found effects on homeostatic biology and neurobehavioral functions, including reduced sleep durations. This study evaluated how confinement due to Covid-19 has impacted health and stress through changes in sleep.

Methods
The Anonymous Survey on Confinement during the COVID-19 Pandemic was available online to any individual ≥18 years of age through the Penn Medicine Clinical Research webpage on May 14, 2020 and the data presented are through October 24, 2020. The survey collected self-reported information on demographics, the amount and quality of sleep, as well as ratings of health and stress. To determine the impact of confinement on these domains, participants were asked to answer questions relative to pre-confinement levels. To test associations between sleep amounts and sleep quality on health and stress, generalized linear models were used and adjusted for age, sex, and race.

Results
N=228 participants (n=180 female [79.0%]) were on average 45.0±17.1 years of age. During confinement relative to pre-confinement, 41.7% of participants reported sleeping more, 37.3% reported sleeping the same amount, and 21.0% reported less sleep, while 14.0% reported better sleep quality, 47.4% the same, and 38.6% worse quality of sleep relative to pre-confinement. Ratings of worse health during confinement were associated with both reduced sleep amount (β=0.695; P&lt;0.0001) and worse sleep quality (β=0.532; P=0.0002). Lower stress ratings were associated with increased sleep amount (β=0.734; P=0.034), better sleep quality (β=1.396; P=0.0002), better health ratings (β=-0.079; P=0.0045). Conversely, worse sleep quality was associated with higher stress ratings (β=-1.086; P=0.0007).

Conclusion
The confinement resulting from the COVID-19 pandemic has impacted the amount and quality of sleep and good sleep may help to reduce stress and maintain health. These findings highlight the need to further examine how long-term confinement influences human health and behavior and warrant examining what factors or life-style behaviors promote resilience to the negative effects of confinement.

Support (if any)
CWJ supported by NHLBI NRSA (T32 HL007713).
230 Association Between Chronotype and Subjective Cognitive Functioning: Population-Based Study
Authors: Hwang Inha , Oh Dana , Yoon Jee-Eun , Kim Daeyoung , Yang Kwang Ik , Chu Min Kyung , Park Seong-Ho , Yun Chang-Ho 
Published: May 2021

Abstract

Introduction
Increasing research suggests that subjective cognitive decline (SCD) in the absence of objective cognitive dysfunction may be a forerunner of non-normative cognitive decline and eventual progression to dementia. We investigated the association between chronotype and subjective cognitive functioning in the representative sample of the adult population.

Methods
We included subjects who participated in a nationwide cross-sectional survey of sleep and headache in 2018 in the Republic of Korea. A total of 2136 subjects (age 19-92, mean 48.3 ± 16.5 years old, 1062 male) was included in the analysis. To assess subjective cognitive functioning, we adopted the Mail-In Cognitive Function Screening Instrument (MCFSI). The MCSFSI is a brief, self-administered potential outcome measure developed by the Alzheimer’s Disease Cooperative Study (ADCS) to detect early changes in cognitive and functional abilities in individuals without clinical impairment. MCFSI scores ≥5 were considered abnormal for this study. As an indicator of chronotype, we adopted the “midpoint of sleep on free days corrected for sleep extension on free days (MSFsc).” MSFsc was calculated as follows: MSFsc = midpoint of sleep on free days − 0.5 × (sleep duration on free days − [5 × sleep duration on workdays + 2 × sleep duration on free days]/7). Participants whose MSFsc occurred before 04:00 AM, between 04:00 and 04:59 AM, and after 05:00 AM were classified as early, intermediate, and late chronotype, respectively. The associations between chronotype and subjective cognitive functioning were analyzed with logistic regression models adjusted for potential confounders.

Results
Subjective cognitive functioning was abnormal in 381 subjects (17.8%). A late chronotype was significantly associated with abnormal subjective cognitive functioning compared with an early chronotype independent of age, sex, average sleep duration, alcohol, smoking, regular exercise, anxiety, depression, body mass index (BMI), education years, and income status (OR 1.619, 95% CI 1.03 - 2.55, p=0.038). Abnormal subjective cognitive functioning was significantly associated with older age, female sex, lower education, higher BMI, anxiety, and depression.

Conclusion
This survey cohort results provide evidence at the population level that late chronotype is associated with abnormal subjective cognitive functioning.
Support (if any):
233 COVID-19 Related Worries and Sleep Disturbances in Patients Previously Hospitalized with COVID-19 Illness
Authors: Shechter Ari , Abdalla Marwah , Raju Datla , Kronish Ian , Liyanage-Don Nadia 
Published: May 2021

Abstract

Introduction
In patients hospitalized for COVID-19 illness, sleep disturbances after discharge may impact quality of life and prognosis. We examined the relationship of COVID-19-related worries with sleep disturbances in patients three months after COVID-19 hospitalization.

Methods
Patients hospitalized for COVID-19 illness completed a survey three months post-discharge (n=153). We measured COVID-19-related worry along two domains: worry directly related to the disease (COVID-illness worry) and worry related to the socioeconomic impact of the pandemic (COVID-impact worry). COVID-illness worry included worry regarding: 1) getting COVID again, 2) dying from COVID, 3) family members getting COVID, 4) losing a loved one to COVID, 5) unknowingly infecting others with COVID, 6) having significant financial burdens because of COVID. COVID-impact included worry regarding: 1) employment loss, 2) not having enough food, 3) not having access to medical care/medications, 4) not having access to mental health care/medications, 5) reduction in interactions with other people, 6) separation from family members, 7) being lonely. Patients rated how much they worried about each item on a 4-point scale (not at all, a little, moderately, extremely). Scores on each domain were summed to reflect overall severity. Past month sleep was assessed for insomnia symptoms (none, mild, moderate, severe, very severe) and self-reported sleep duration. Binary logistic regression was used to evaluate the association of COVID-illness worry and COVID-impact worry, separately, with sleep measures, adjusting for age, sex, race/ethnicity, and presence of persistent COVID-related symptoms.

Results
The prevalence of insomnia (moderate, severe, or very severe symptoms) and short sleep duration (&lt;6 h/day) was 47.0% and 39.2%, respectively. COVID-illness worry severity was significantly associated with presence of insomnia (OR: 1.91, 95% CI: 1.13-3.23, p=0.016) and short sleep (OR: 2.20, 95% CI: 1.25-3.86, p=0.006). In a separate model, COVID-impact worry severity was significantly associated with presence of insomnia (OR: 1.98, 95% CI: 1.23-3.19, p=0.005) and short sleep (OR: 2.11, 95% CI: 1.26-3.55, p=0.005).

Conclusion
Sleep disturbances are common among patients previously hospitalized with COVID-19 illness, and COVID-19 related worries are associated with insomnia and short sleep. Additional research is needed to determine whether addressing COVID-19 related worries reduces sleep disturbance, which in turn may promote post-COVID recovery.
Support (if any):
234 Sleep quality during the coronavirus pandemic in a Brazilian family-based cohort
Authors: Taporoski Tamara , Beijamini Felipe , Ruiz Francieli , Ahmed Sabrina , von Schantz Malcolm , Pereira Alexandre , Knutson Kristen 
Published: May 2021

Abstract

Introduction
Early in the COVID-19 pandemic, Brazil adopted measures to minimize the spread of the virus, including quarantine orders where people only left home for essential business. This practice could negatively impact sleep by reducing exposure to daylight and physical activity. We examined subjective sleep quality in Baependi, a small rural town in Brazil during the COVID-19 quarantine order.

Methods
This sample is from the Baependi Heart Study, a family-based cohort of adults. Participants (n=800, 71% women, mean age 51.6±15.6 years) completed the Pittsburgh Sleep Quality Index (PSQI) early in the COVID pandemic (April-May, 2020). They were also asked about their compliance to the quarantine order (yes/no). We compared sleep between quarantined (QT) and not-quarantined individuals (NQT). Longitudinal data was obtained from a subsample of 417 individuals who also completed a pre-COVID PSQI between January, 2010 and September, 2014.

Results
Individuals compliant with the quarantine had worse sleep quality than non-quarantined individuals [QT PSQI= 6.1 (±3.9), NQT PSQI= 5.0 (±3.5), p&lt;0.01]. Stratified analysis showed that differences in PSQI scores between QT and NQT was greater for women [QT = 6.4 (±4), NQT = 5.2 (±3.7), p&lt;0.01] and older people [QT = 6.6 (±0.1), NQT = 5.5 (±3.3), p=0.02]. Associations were attenuated after adjusting for age and gender. PSQI components demonstrated a higher sleep latency for the QT group in the full sample (p=0.02), women (p&lt;0.01) and young (&lt;50 years, p=0.03). Sleep duration was shorter in the QT young subsample (p=0.03). QT women also reported lower sleep efficiency (p=0.01) and greater use of sleep medication than NQT women (p&lt;0.01). In the longitudinal subsample, PSQI scores were significantly higher during COVID than pre-pandemic [COVID= 5.7 (±3.8), pre-COVID= 5 (±3.3), p&lt;0.01]. The significant change in PSQI was only observed in the QT participants [COVID= 5.9 (±3.7), pre-COVID= 5.2 (±3.4), p&lt;0.01] and not NQT [COVID= 5 (±3.7), pre-COVID= 4.5 (±3), p=0.12.

Conclusion
Individuals who quarantined during COVID-19 had worse sleep quality than individuals who did not quarantine. Longitudinal comparison demonstrated that participants who quarantined had worse sleep quality during COVID compared to before to the pandemic.

Support (if any)
NIH 1R01HL141881