bluuebunny/crossref_metadata_2025_split huggingface dataset:
138 Short Sleep and Insomnia as Independent Predictors of Obesity, Hypertension, and Diabetes
Authors: Knowlden Adam , Grandner Michael 
Published: May 2021

Abstract

Introduction
Epidemiological evidence of short sleep’s (&lt;6 hours) association with negative cardiometabolic health outcomes continues to mount; yet, the complex relationship between sleep and health is still not well-understood. Sleep problems, such as short sleep and insomnia, are often analyzed as a singular construct at the population level; however, it has been proposed that, although these two sleep problems likely overlap, they are separate phenomena. The purpose of this study was to: (1) determine if short sleep and insomnia were independent constructs; and to (2) evaluate whether short sleep and insomnia predicted obesity, hypertension, and diabetes.

Methods
Analyses were based on the 2015-2016 National Health and Nutrition Examination Survey (NHANES). NHANES employs a complex, multistage, probability sampling design to survey a representative sample of non-institutionalized U.S. adults (≥18 years). Data related to short (&lt;6), normal (7-8), and long (9+) sleep duration, insomnia (present: mild, moderate, severe), hypertension (present: previous hypertension/hypertension medications/blood pressure in the hypertensive range), and diabetes (present: history of diabetes/fasting blood sugar of 130+) were extracted for analysis. Age, sex, and obesity (body mass index, 30.0+) were entered as covariates into the models.

Results
Among the subjects, 0.08% were normal sleepers with insomnia; 0.21% were short sleep with insomnia; and, 0.59% had insomnia with short sleep. Short sleep without insomnia (OR=1.35; p&lt;.001), normal sleep with insomnia (OR=1.56; p&lt;.001), and short sleep with insomnia (OR=1.64; p&lt;.001) uniquely predicted obesity. As well, short sleep without insomnia (OR=1.23; p=0.004) as well as short sleep with insomnia (OR=1.21; p&lt;0.001) independently predicted hypertension. Furthermore, short sleep with (2.01; p&lt;0.001) and without (OR=1.48; p&lt;0.001) insomnia as well as normal sleep with insomnia (p=0.007) uniquely predicted diabetes.

Conclusion
Findings from this study suggested short sleep and insomnia are independent constructs, uniquely predicting obesity, hypertension, and diabetes. Short sleep and insomnia neither mediated nor moderated one another, implying these two sleep outcomes are not additive in nature, but are instead separate health problems. The distinction between short sleep and insomnia may have important epidemiological and clinical implications.

Support (if any)
N/A
141 Screen-based activities predict delayed sleep timing within and between adolescents
Authors: Reichenberger David , Master Lindsay , Buxton Orfeu , Hale Lauren , Chang Anne-Marie 
Published: May 2021

Abstract

Introduction
Daytime and evening screen use have been associated with poor sleep health among adolescents, especially delayed sleep timing. However, most studies only investigate associations between adolescents rather than within the same person across multiple nights. Our multilevel modeling approach allows for assessment of connection between screen use and subsequent sleep timing.

Methods
We analyzed approximately five days of data from the Fragile Families and Child Wellbeing Study, a longitudinal birth cohort (n=475 adolescents, 15.4±0.5 years old). Adolescents wore wrist actigraphy devices and completed daily surveys reporting how many hours across the day they engaged in screen-based activities (e.g., communicating with friends, playing video games) and whether they engaged in screen-based activities in the hour before bed. Screen use was separated into within- and between-person variables predicting sleep onset and midpoint that night. Multilevel models with random intercepts for each sleep outcome adjusted for school days, bedtime routines, adolescent demographics, and family socioeconomic status.

Results
Within-person results showed that on days when adolescents played video games more than their daily average±SE (79±3 min) sleep onset was delayed (5±2 min, p&lt;0.01) and midpoint was delayed (4±2 min, p&lt;0.03) for each additional hour. Between-person results showed that adolescents who played video games had delayed sleep onset (9±4 min, p&lt;0.02) and midpoint (7±3 min, p&lt;0.04) for each hour spent playing across the day. Adolescents who spent time using screens to communicate with friends had delayed sleep onset (11±3 min, p&lt;0.01) and midpoint (9±3 min, p&lt;0.01) for each hour across the day. Adolescents who were more likely to use screens to communicate with friends or play video games before bed had delayed sleep onset (29±13 min, p&lt;0.03) and midpoint (24±12 min, p&lt;0.05). Other screen-based activities such as watching videos were not associated with sleep timing.

Conclusion
Daytime and evening screen-based activities may not uniformly delay sleep. Adolescents who engage in social or interactive screen-based activities may delay sleep timing more than day-to-day variation alone. Future research should evaluate how attributes of screen-based socializing and interactivity affect sleep health.

Support (if any)
R01HD073352 (to LH), R01HD36916, R01HD39135, R01HD40421
152 Prospective associations between pre-sleep electronics use and same-night sleep in healthy school-aged children
Authors: So Christine , Gallagher Matthew , Palmer Cara , Alfano Candice 
Published: May 2021

Abstract

Introduction
Electronic media devices are ubiquitous in modern society and believed to adversely affect nighttime sleep. Cross-sectional research provides evidence of robust associations but prospective findings are limited and mixed. In this study, we examined the impact of specific types of electronics devices and overall use on objective and subjective sleep parameters the same night across one week.

Methods
The sample consisted of school-aged children (N=55) between the ages of 7 to 11 years. Hierarchical linear modeling was used to assess the impact of pre-bedtime electronics use on sleep the same night across 5 weekday nights. A sleep diary was used to record pre-bed electronic devices used and subjective sleep parameters. Objective sleep variables were assessed concurrently via actigraphy.

Results
The usage of different types of electronic media varied significantly between and within children across the five days. However, neither total electronics usage nor any individual type of device was found to significantly predict self-reported or objective sleep parameters the same night.

Conclusion
The extent to which the use of electronic media specifically within an hour of bedtime impacts sleep in school-aged children remains unclear. Future research should investigate these relationships using more robust methodology, including prospective designs and examination of relevant contextual and environmental factors.

Support (if any)
This study was funded by the National Institute of Mental Health [grant number #R21 MH099351] awarded to the last author.
160 Underlying Factors Contributing to Sleep Health Among Middle-aged and Older Adults
Authors: Lorenz Rebecca , Chandola Varun , Auerbach Samantha , Orom Heather , Li Chin-Shang , Chang Yu-Ping 
Published: May 2021

Abstract

Introduction
Although poor sleep is not inherent with aging, an estimated 50-70 million adults in the US have insufficient sleep. Sleep duration is increasingly recognized as incomplete and insufficient. Instead, sleep health (SH), a multidimensional concept describing sleep/wake patterns that promote well-being has been shown to better reflect how sleep impacts the individual. Therefore, focusing on the underlying factors contributing to sleep health may provide the opportunity to develop interventions to improve sleep health in middle-age and older adults.

Methods
Data from the 2014 wave of the Health and Retirement Study (HRS) were used. Sample size was restricted to those who completed an additional questionnaire containing sleep variables. A derivation of the SH composite was constructed using eight selected sleep variables from the HRS data based on the five dimensions of sleep: Satisfaction, Alertness, Timing, Efficiency, and Duration. Total score ranged from 0-100, with higher scores indicating better SH. Weighting variables were based on complex sampling procedures and provided by HRS. Machine learning-based framework was used to identify determinants for predicting SH using twenty-six variables representing individual health and socio-demographics. Penalized linear regression with elastic net penalty was used to study the impact of individual predictors on SH.

Results
Our sample included 5,163 adults with a mean age of 67.8 years (SD=9.9; range 50-98 years). The majority were female (59%), white (78%), and married (61%). SH score ranged from 27-61 (mean=50; SD=6.7). Loneliness (coefficient=-1.92), depressive symptoms (coefficient=-1.28), and physical activity (coefficient=1.31) were identified as the strongest predictors of SH. Self-reported health status (coefficient=-1.11), daily pain (coefficient=-0.65), being middle-aged (coefficient=-0.26), and discrimination (coefficient=-0.23) were also significant predictors in this model.

Conclusion
Our study identified key predictors of SH among middle-aged and older adults using a novel approach of Machine Learning. Improving SH is a concrete target for health promotion through clinical interventions tailored towards increasing physical activity and reducing loneliness and depressive symptoms among middle-aged adults.

Support (if any)
This study was supported by National Heart, Lung, and Blood Institute (NHLBI) UB Clinical Scholar Program in Implementation Science to Achieve Triple Aims-NIH K12 Faculty Scholar Program in Implementation Science
169 Qualitative Identification of Multilevel Influences on Sleep in Latinx Pre-Adolescents
Authors: Nguyen-Rodriguez Selena , Buxton Orfeu 
Published: May 2021

Abstract

Introduction
The prevalence of obesity among U.S. Latinx children is nearly 10% higher than in their white counterparts. Long-term success of diet and activity level-focused interventions has been limited. Poor sleep is associated with increased obesity risk in youth. Application of social ecological models of behavior change to identify influences of sleep in Latinx youth may reveal unique intervention targets to improve their sleep, which may reduce obesity risk. This qualitative study aimed to identify the multilevel factors that Latinx pre-adolescents believe affect their sleep duration, quality and timing.

Methods
Eleven focus groups were conducted with forty-six 10-to-12-year-old Latinx pre-adolescents (50% female). Focus groups continued until saturation was reached, and no new information was emerging. Iterative deductive thematic content analysis was conducted by two independent coders (IRR=.815).

Results
Three themes affecting children’s sleep resulted: 1) Individual-level (emotional/ physical feelings or behaviors); 2) Social (direct interactions with others); and 3) Environmental (characteristics, objects or perceptions of physical environment) influences. Individual-level influences were primarily psychological (e.g., stress, “Whenever I have a test the next day, I am stressed and I wake up I’m like so tired”) and behavioral (e.g., activity levels, “just sitting just the whole day… when it comes to nighttime, you’re not even tired”), and affected sleep quality and timing. Interactions with siblings (e.g., “She [sister] always gets mad at me and like in the night she like wakes me up” and friends (e.g., “arguments like with a really good friend… the whole night I think about it”) were social factors affecting sleep quality. Environmental influences came from within the sleep area and neighborhood, including temperature (e.g., “I like my pillows cold”) and noise (e.g., “My neighbor’s dog… they always take them out at night time to like play with them and then I could hear the dog barking and them screaming”).

Conclusion
While social influences exist, individual feelings and sleep environment seem to be more prevalent impacts on sleep of Latinx children. Findings support the notion that developing multi-level strategies may be effective in enhancing sleep duration, quality and timing for Latinx pre-adolescents.

Support (if any)
NIH-NHLBI 5K01HL140283
174 Discrimination moderates the association of sleep and cognitive function in older Black adults: The Einstein Aging Study
Authors: Ji Linying , Jiao June , Zhaoyang Ruixue , Derby Carol , Buxton Orfeu , Gamaldo Alyssa 
Published: May 2021

Abstract

Introduction
Experiences of discrimination attributed to a range of individual characteristics (race, skin color, age, sex, etc.) may influence the extent to which sleep impacts cognitive functioning in order adults, particularly within older minorities. Thus, we investigated the effect of discrimination on the relationship between actigraphic sleep quality and cognitive function in analyses stratified by race.

Methods
Participants (N=286, mean age=77.4 years, 32% males; 45% white, 41% Black, 14% Hispanic/others) enrolled in The Einstein Aging Study were included. Sleep disturbance, as measured by wake after sleep onset (WASO) (mean=63 min, sd=27 min), was calculated from wrist actigraphy over 15.4±1.4 days. Participants’ mean ambulatory cognitive function was assessed with a validated, memory binding, smartphone-based EMA task (Color Shapes) repeated 4 times daily. A modified version of the Williams’ Everyday Discrimination questionnaire, optimized for older adults, measured participants’ endorsement of discriminated characteristics. Linear regressions, stratified by race (white, Black separately), were conducted with interaction terms to investigate whether discrimination moderated associations between WASO and ambulatory cognitive function. Models controlled for age, education, income, and gender. Regions of significance were also evaluated.

Results
Race-stratified analysis indicated that the association between mean WASO and cognitive function was significantly moderated by the number of discriminated characteristics among Black adults (n=117), not whites (n=128). Specifically, among Black adults who identified few discriminated characteristics, WASO was not significantly associated with memory binding. However, Black adults who identified discriminated characteristics at +1 SD above the mean (5.5 traits) exhibited a 12% lower average memory binding test score (percent responses correct) with each half-hour greater mean WASO (p=.01). Analysis of the region of significance showed the association is significant when participants endorsed more than three discriminated characteristics.

Conclusion
These findings emphasize the importance of considering sociocultural factors, such as discrimination, to understand the association between sleep quality and cognitive functioning, particularly for older Blacks.

Support (if any)
R01AG062622
176 Linear and Nonlinear Associations Between Sleep and Academic Achievement in Middle Childhood: The Role of Early Life SES
Authors: Rea-Sandin Gianna , Breitenstein Reagan , Doane Leah , Vakulskas Emily , Valiente Carlos , Lemery-Chalfant Kathryn 
Published: May 2021

Abstract

Introduction
Elementary-aged children in low socioeconomic environments are more likely to experience poor sleep, which can negatively impact academic performance. However, it is unknown whether early-life socioeconomic status (SES) influences associations between sleep and academic achievement later in childhood. Using a demographically diverse sample of children followed longitudinally from 1 to 8 years, we tested linear and nonlinear associations between actigraphy-based sleep duration, midpoint time, sleep duration variability, and parent-reported sleep problems with academic achievement. In addition, we examined whether these associations varied by early SES.

Methods
The sample comprised 707 twins (52% female; Mage=8.44 years; 28.7% Hispanic/Latinx; 29.7% at or below the poverty line). SES was ascertained at 1 and 8 years, and children wore actigraph watches to assess sleep for 7 nights (Mnights=6.79) and completed the Applied Math, Picture Vocabulary, and Passage Comprehension subtests of the Woodcock-Johnson IV Tests of Achievement. Primary caregivers also reported on their children’s sleep and academic performance (Children’s Sleep Habits Questionnaire and Health and Behavior Questionnaire, respectively).

Results
Sleep was not linearly related to academic achievement, but there was a significant quadratic association between sleep midpoint with Picture Vocabulary (b=0.28, p&lt;.01) and Passage Comprehension (b=0.17, p&lt;.05). More parent-reported sleep problems were negatively related to Applied Problems performance for lower (b=-1.16, p&lt;.001) and positively associated for higher early SES (b = 1.00, p &lt; .01). More parent-reported sleep problems predicted lower Passage Comprehension for lower (b = -0.59, p &lt; .05), but not higher early SES. Longer sleep duration predicted higher parent-reported academic achievement for lower early SES (b=0.14, p&lt;.01) and lower achievement for higher early SES (b=-0.23, p&lt;.001).

Conclusion
Our findings illustrate the complex, sometimes nonlinear associations between children’s sleep and academic performance. Many associations varied by early-life SES, suggesting that early childhood environments have long-lasting implications for child functioning, over and above the effect of concurrent SES. Increasing the quantity and quality of children’s sleep could improve academic outcomes, particularly for children who have experienced socioeconomic disadvantage.

Support (if any)
This research was supported by grants from NICHD (R01HD079520 and R01HD086085) and ASU T. Denny Sanford School of Social and Family Dynamics.
178 Sleep Disparities in Adolescent Women: Role of Pubertal Development, Menstrual Cycle and Premenstrual Symptoms
Authors: Kaur Harsimar , Hasoglu Tuna , Gomaa Hassaan , Ricci Anna , Criley Carrie , Calhoun Susan , Vgontzas Alexandros , Liao Duanping , Bixler Edward , Fernandez-Mendoza Julio 
Published: May 2021

Abstract

Introduction
About 20-30% of children experience sleep difficulties and about 50-60% of those persist into adolescence. Sex differences in sleep become more apparent after the onset of puberty, suggesting a role for maturational changes in the sleep of males and females. In addition, adolescent females experience greater sleep difficulties with the advancement of pubertal stages and around the time of menstruation. Although adult studies have shown sex differences in sleep continuity and architecture, there is a large gap of knowledge in adolescents.

Methods
We analyzed data from the Penn State Child Cohort, a random, population-based sample of 421 adolescents (16.5±2.3y, 53.9% male) who underwent one-night in-lab polysomnography (PSG) and seven-night at-home actigraphy (ACT) as well as a thorough physical exam and clinical history, including self-reports of Tanner staging, menstrual cycle and use of oral contraceptives (OC).

Results
Upon PSG, females had a longer sleep latency (p&lt;0.05), while males a greater number of awakenings (p&lt;0.05), longer wake after sleep onset (p&lt;0.01) and greater stage N1 (p&lt;0.05). Per ACT, females had longer total sleep time and greater sleep efficiency (p&lt;0.01). Sex differences in PSG and ACT parameters were more prominent among adolescents reporting Tanner stages 4-5, including females having greater stage N3 than males (p&lt;0.01) and females reporting premenstrual symptoms (PMS) having a longer sleep latency than males or than those not reporting PMS (P&lt;0.05). Among females, those who had their last period 8-14 days prior to the PSG had a shorter sleep latency than those who had their period within the previous 7 days (p&lt;0.01) or 15-25 days before (p&lt;0.05). Females using OC (n=38) did not show significantly different PSG or ACT parameters than those not using OC (n=156).

Conclusion
Our study provides evidence for sex-related health disparities in objective sleep arising in adolescence. Females sleep objectively better than males from a sleep continuity and sleep architecture perspective, particularly when examined at the same pubertal stage. Additionally, sleep onset is significantly impacted by the menstrual cycle and associated symptoms but females preserve greater levels of deep sleep, a sign of sleep resilience.

Support (if any)
NIH Awards Number R01MH118308, R01HL136587, R01HL97165, R01HL63772, UL1TR000127
183 Influence of Feelings of Neighborhood Safety on Anxiety and Sleep
Authors: Vane Ryan , Habhab Zouhour , Corona Frida , Mednick Sara 
Published: May 2021

Abstract

Introduction
Sleep is a significant factor in the regulation of mood and behavior in individuals, with loss of sleep potentially leading to negative effects such as behavioral or emotional difficulties (Dahl 1999; Baum, Desai, Field, Miller, Rausch, & Beebe, 2014). Neighborhood safety plays a critical role in the perception of stress, with the negative perception of safety predicting higher mental distress, thus leading to rumination and increasing the difficulty for the individual to fall asleep (Henderson, Child, Moore, Moore, & Kaczynski, 2016; Dahl 1996). The goal of this study is to analyze how feelings of neighborhood safety and neighborhood demographics influence anxiety and sleep.

Methods
A subset of 200 participants from a larger data collection were recruited to participate in a questionnaire administered through Amazon Mechanical Turk, university SONA credit system, and social media. Measures include the Pittsburgh Sleep Quality Index, Neighborhood Questionnaire Safety Subscale, and the Spielberger State-Trait Anxiety Inventory.

Results
Poorer sleep quality is predicted by higher feelings of anxiety and lower feelings of safety in ones neighborhood.

Conclusion
The specific factors contributing to the anxiety resulting from feelings of lower neighborhood safety are an area that require further investigation with a broader sample.
Support (if any):