bluuebunny/crossref_metadata_2025_split huggingface dataset:
309 Food consumption and meal timing in hospital nurses with shift work: A preliminary study
Authors: Kim Jee Hyun 
Published: May 2021

Abstract

Introduction
One of the important nonphotic zeitgebers is food consumption. The timing of food consumption in relation to melatonin onset has been reported to be associated with fat proportion and BMI. Irregular meal timing along with irregular sleep schedules due to shift work would increase the metabolism problem as well as influencing sleep problems. The aim of the study is to evaluate the meal timing and food consumption in shift workers.

Methods
The nurses with 3-rapid rotating shifts were enrolled to keep food diaries for two weeks including all three shift schedules. They filled out a morningness-eveningness questionnaire. They wore actigraphy to monitor sleep-wake patterns with a daily sleep diary. The timing and the frequencies of meal/snack and caffeine consumption during each shift and day-off were reviewed. The calorie from each food was calculated depending on the nutritional information on the internet.

Results
13 female nurses were screened and 6 finished the study. The mean age is 29.4±7.69 years and the mean body mass index was 20.2±1.1kg/m2. Average frequencies of meals are 2.59±0.49, 1.66±0.75, 1.93±0.41, 2.09±0.96 times per day, and average frequencies of snack consumption are 1.37±0.9, 1.07±0.74, 0.75±0.82, 0.96±0.79 times per day for the morning, evening, night, and the day off, respectively. Total calorie consumed are 1662.5±564.8, 1380.8 ± 940.3, 1596.8±838.1, 1505.8±706.9 kcals in the same order. Caffeine consumption was 0.29±0.46, 0.4±0.48, 0.72±0.65, 0.46±0.54 cups per day in the same order. One subject with morning type showed a relatively regular meal schedule throughout the shifts. The timing for main calorie consumption seemed to show delayed on evening and night shifts than morning shift although total calorie consumption was similar between each shift.

Conclusion
Although this is a preliminary study with a small number of subjects, it showed shift worker nurses have an inconsistent number of meals and calorie intake depending on their shifts. Caffeine consumption is very lower than expected. The subject with morning chronotype seemed to keep relatively regular meal timing throughout the shifts, suggesting chronotype influences meal timing in shift workers.

Support (if any)
This study was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (No.2019R1A2C1090643).
310 Outcomes of a Sleep and Stress-Focused Employee Wellness Program
Authors: Carter Patricia , Eyer Josh , Horton Abby , MacVicar Carolyn 
Published: May 2021

Abstract

Introduction
The Sleep More, Stress Less Program (SMSL) is a University of Alabama (UA) employee wellness program designed to help participants implement health behavior changes to improve sleep quality and stress management. Workplace wellness programs offer a win-win for the employee and employer through improved health and reduced absenteeism. However, many programs fail to show effectiveness on health and workplace metrics, even with an increase in targeted health behaviors. This may be due—at least in part—to employee self-selection and data collection limitations. The SMSL program addresses these challenges by recruiting employees experiencing sleep and stress issues and using a rigorous assessment approach that records data on behavior changes, process goals, intermediate mechanisms, and health outcomes. We present findings from the SMSL program evaluation conducted Fall 2020.

Methods
The SMSL program is delivered online with both synchronous and asynchronous content (videos and exercises). The content combines evidence-based interventions for sleep and stress with the science of behavioral motivation. All adult (19–99 years) UA employees were eligible and recruitment occurred through the WellBama website and employee emails. Employees are encouraged to select programs that match their health issues. Participants complete an online pre-program assessment and track their sleep and stress for one week. Next, participants complete the SMSL educational program over the next three weeks. In the fifth week, participants track their sleep and stress and complete the online post-program assessment.

Results
60 of the initial 85 participants completed all assessments (70.5%). Participants were primarily Female (79%) and Caucasian (77%) or Black (15%), and aged 24–68 (m=44) years. Moderate improvements were reported in total sleep time, sleep maintenance, and time to return to sleep after awakening. Similar improvements were observed in stress scores. Qualitative evaluation of participant behavior goals revealed a focus on sleep scheduling, stimulus reduction, and relaxation.

Conclusion
Employee wellness program evaluation is often affected by selection and measurement bias. The SMSL program targeted individuals experiencing stress and/or sleep problems and measured multiple outcomes to identify benefits over the 5-week program. Other wellness programs would benefit from this approach in order to capture true program outcomes.

Support (if any)
N/A
311 Can a Brief Sleep Education Training Improve Sleep Quality Among Shipboard Sailors?
Authors: Harrison Elizabeth , Schmied Emily , Perez Vanessa , Hurtado Suzanne , Glickman Gena 
Published: May 2021

Abstract

Introduction
Sleep disturbance is pervasive among active duty military service members (ADSM) and has serious adverse effects on performance and health. Interventions designed to improve sleep in operational settings are critical to maintain the health and readiness of this at-risk population. The objective of this study is to evaluate a novel sleep education program developed for ADSM.

Methods
Participants were U.S. Sailors (N=150; 82.7% male, 35.3% &lt;25 years old) assigned to either an intervention (44.7%) or control (55.3%) condition. Intervention participants attended the Circadian, Light, and Sleep Skills program for military personnel (“CLASS-M”). The 30-minute education program was designed to teach ADSM how to maximize sleep quality in operational environments. All participants completed a questionnaire at both baseline and 2 months post-intervention assessing demographics, sleep quality (Pittsburgh Sleep Quality Index; PSQI), sleep-related behaviors, knowledge and motivation. During the follow-up period, participants went underway for 2–8 weeks.

Results
At baseline, scores were comparable for the PSQI (Control: 8.58±0.35 vs. Intervention: 8.58±0.38), sleep behaviors (12.26±0.35 vs. 11.32±0.38; Range: 0–17), sleep-related knowledge (0.48±0.21 vs. 0.50±0.24; Range: 0–1), and sleep motivation (4.12±0.35 vs. 4.07±0.34; Range: 0–5). A significant group x time interaction indicating benefits for the intervention group were observed on PSQI (F (1,139) = 7.99, p=0.005), knowledge (F (1,139) = 36.54, p&lt;0.001), and behaviors (F (1,139) = 4.75, p=0.03), but not motivation (p&gt;.05). Main effects of group were observed (p&lt;0.05) on PSQI and sleep knowledge only.

Conclusion
Study results indicate that participation in a brief, educational program prior to deploying may improve ADSM’s sleep quality. Future research is needed to explore mechanisms of intervention effect, and to determine best practices for disseminating such programs force-wide.

Support (if any)
This work was supported by Defense Health Program 6.7 under work unit no. N1634. The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, nor the U.S. Government.
317 Sleep-wake survival dynamics in people with insomnia
Authors: Hermans Lieke , Regis Marta , Fonseca Pedro , Hoondert Bertram , Leufkens Tim , Overeem Sebastiaan , van Gilst Merel 
Published: May 2021

Abstract

Introduction
Assessing objective measures of sleep fragmentation could yield important features reflecting impaired sleep quality in people with insomnia. Survival analysis allows the specific examination of the stability of NREM sleep, REM sleep and wake. The objective of this study was to assess the differences between survival dynamics of NREM sleep, REM sleep and wake between people with insomnia and healthy controls.

Methods
We analyzed polysomnography recordings from 88 people with insomnia and 92 healthy controls. For each participant, survival dynamics of REM sleep, NREM sleep and wake were represented using Weibull distributions. We used lasso penalized linear regression to analyze the difference between participant groups with respect to the Weibull scale and shape parameters, while correcting for age, sex, total sleep time and relevant interaction effects. Because comparisons were done for scale and shape parameters of REM sleep, NREM sleep and wake, a Bonferroni correction was applied, resulting in an alpha value of 0.05/6 = 0.0083.

Results
Significant effects of group were found for the NREM scale parameter (unstandardized model coefficient B=-0.79, t=-3.0, p=0.0035), and for the scale and shape parameters of wake (scale parameter B=7.6, t=2.8, p=0.0065; shape parameter B=0.20, t=2.9, p=0.0048). Results indicated that people with insomnia had less stable NREM sleep and more stable wake after sleep onset compared to healthy controls. Additionally, the altered distribution of wake segment lengths indicated an increased difficulty to fall asleep after longer awakenings in the insomnia group. However, these differences were mainly observed in younger participants. Significant effects of group for the survival parameters of REM sleep were not found.

Conclusion
As illustrated by our results, survival analysis can be very useful for disentangling different types of sleep fragmentation in people with insomnia. For instance, the current findings suggest that people with insomnia have an increased fragmentation of NREM sleep, but not necessarily of REM sleep. Additional research into the underlying mechanisms of NREM sleep fragmentation could possibly lead to a better understanding of impaired sleep quality in people with insomnia, and consequently to improved treatment.
Support (if any):
320 Effect of accumulated unhealthy behaviors on insomniaâ€•lifestyle-related disease differences in a Japanese community population
Authors: Kato Suzuka , Harada Sei , Iida Miho , Kuwabara Kazuyo , Sugiyama Daisuke , Takeuchi Ayano , Hirata Aya , Sata Mizuki , Matsumoto Minako , Kurihara Ayako , Okamura Tomonori , Takebayashi Toru 
Published: May 2021

Abstract

Introduction
Some studies reported that health behaviors and lifestyles are related to sleep disorder; obesity, drinking, smoking and lack of physical exercise are risk factors for insomnia. However, it’s unclear the association between accumulated unhealthy behaviors and insomnia in consideration of lifestyle-related diseases. Therefore, this study was to examine the effect of accumulated unhealthy behaviors on insomnia in a Japanese community population.

Methods
The subjects included 1,1002 participants aged 35–74 years. Sleep quality was assessed by the Athens Insomnia Scale. Unhealthy behaviors were classified into smoking, drinking, no habit of exercising, obesity, and skipping breakfast. We examined the impact of unhealthy behaviors accumulation, which was stratified into three categories, i.e., 0-1,2-3,4 or more, on insomnia. The association between accumulated unhealthy behaviors and insomnia was estimated by logistic regression analysis. Further analysis after stratification by lifestyle-related diseases was also performed.

Results
The overall prevalence of insomnia was 14.6% for men and19.3% for women. Men with unhealthy behaviors were more likely to have insomnia after adjusting for potential confounders, compared with the least unhealthy groups (trend p=0.017). Women with 4 or more unhealthy behavior factors were more likely to have the suspected insomnia, compared with the lowest groups (ORs 1.176 95% CI 1.079–1.282). Then, we analyzed to stratify by lifestyle-related disease. Insomnia has an association with unhealthy behaviors among men with the absence of diabetes (trend p=0.015) and dyslipidemia (trend p=0.032). Women without hypertension were more likely to have the suspected insomnia, compared with the lowest groups (ORs 1.215 95% CI 1.102–1.340), but the odd for those with the hypertension was 1.031(95%CI 0.855–1.243).

Conclusion
Accumulated unhealthy behaviors were associated with increased rates of insomnia in the Japanese community population. According to stratification by lifestyle-related disease, men showed the associations by the presence or absence of diabetes. Women showed the associations by the absence of hypertension. These associations were nearly similar regardless of the presence or absence of lifestyle-related disease.

Support (if any)
This research was supported by research funds from the Yamagata Prefectural Government and the city of Tsuruoka and the Grant-in-Aid for Scientific Research (JP24390168, JP15H04778 and JP19K19441) from the Japan Society for the Promotion of Science.
321 Subjective Sleep and NEO Five Factor Personality Domains in Individuals with Primary Insomnia Compared to Good Sleeper Controls
Authors: Orff Henry , Rivera Guadalupe , Almklov Erin 
Published: May 2021

Abstract

Introduction
Insomnia is a common sleep disorder in adults. Primary Insomnia (PI) can be specified in cases where the insomnia symptoms cannot be overtly attributed to medical, psychiatric, or environmental reasons. Although the underlying predisposing causes of insomnia are unclear, one possible contributing factor may be personality traits. To date no consensus on the relationship between insomnia and personality has been determined, although many studies have found a general association with neuroticism. To better explore these associations, this study compared NEO Five Factor Model (FFM) personality traits with measures of subjective sleep in PIs and Good Sleeper (GS) controls.

Methods
Nine PI and nine GS matched for age, sex, and education were studied. Each participant was administered the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and NEO FFM. Participants also completed a sleep diary for 1-week. ANOVAs compared PI vs GS on ISI, PSQI, NEO FFM, and 7-day averaged data from the sleep diary. Lastly, sleep variables were collapsed across groups and Pearson correlations were run to explore the relationship between sleep and personality.

Results
PIs (4M/5F, age=39.6+/-10.1, education=16.0+/-1.7) and GSs (4M/5F, age=38.6+/-7, education=15.1+/-1.5) showed significant differences in ISI (p&lt;.001) and PSQI (p&lt;.001) total scores. Additionally, the groups differed on diary measures of total sleep (p=.001), sleep efficiency (SE: p&lt;.001), sleep latency (p=.005), and wake after sleep onset (p&lt;.001). On the NEO FFM only the Agreeableness domain was found to differentiate the two groups (p=.004). Pearson correlations found significant negative relationships for Agreeableness with ISI (r= -.625/p=.006), PSQI (r= -.611/p=.007), and a significant positive relationship with SE from the sleep diary (r=.602/p=.008).

Conclusion
In a small but well-matched study of PI and GS, significant differences in Agreeableness on the NEO FFM were observed. Lower levels of agreeableness were associated with poorer sleep on the ISI and PSQI, and lower SE on the sleep diaries. Unlike other published reports this study did not find a relationship between insomnia and neuroticism, which may reflect the use of a well-screened Primary Insomnia sample with limited comorbidities. Future research should determine if other insomnia subtypes (e.g., psychophysiological, paradoxical insomnia) are associated with different personality profiles.
Support (if any):
327 Developmental Trajectories of Insomnia and Risk of Internalizing Disorders in Young Adulthood
Authors: Fernandez-Mendoza Julio , Puzino Kristina , Qureshi Myra , Calhoun Susan , Toth Savannah , Liao Jiangang , He Fan , Vgontzas Alexandros , Liao Duanping , Bixler Edward 
Published: May 2021

Abstract

Introduction
Internalizing disorders (ID) are the most common form of psychopathology and a large proportion of individuals experience their first onset after the age of 18. Childhood insomnia symptoms, i.e., difficulties initiating or maintaining sleep (DIMS), have been shown to be associated with ID. However, little is known about the developmental trajectories of insomnia symptoms and their associated risk of ID as the child transitions into adulthood. The present study examined the risk of ID in young adulthood associated with the longitudinal trajectories of insomnia symptoms across three developmental stages.

Methods
The Penn State Child Cohort is a population-based sample of 700 children (Mdn=9y), who were followed-up 8 years later as adolescents (N=421, Mdn=16y) and 15 years later as young adults (N=492, Mdn=24y). Insomnia symptoms were defined as parent-reported (childhood) or self-reported (adolescence and young adulthood) moderate-to-severe DIMS. The developmental trajectories of insomnia symptoms across the three time-points were identified as never, remitted, waxing-and-waning, persistent and incident. The presence of ID was defined as a self-report of a diagnosis or treatment for mood and/or anxiety disorders. Cox regression models were adjusted for sex, race/ethnicity, age and childhood/adolescent history of ID or psychoactive medication use.

Results
A persistent developmental trajectory was associated with a 2.8-fold increased risk of adult ID (HR=2.83, 95%CI=1.79–4.49) and an incident trajectory with a 1.9-fold risk (HR=1.88, 95%CI=1.10–3.20), while a waxing-and-waning trajectory was marginally associated with adult ID (HR=1.70, 95%CI=0.99–2.91). A remitting trajectory was not associated with an increased risk of adult ID (HR=0.92, 95%CI=0.38–2.24).

Conclusion
This 15-year longitudinal study with three developmental stages shows that childhood-onset insomnia symptoms that persist across the life-course are strong determinants of ID in young adulthood, independent of past diagnosis or medication use. In contrast, childhood insomnia symptoms that remit in the transition to adolescence do not confer increased risk of ID in young adulthood. Given that insomnia symptoms may precipitate and/or maintain ID, these data further reinforce the need for early sleep interventions to prevent mental health disorders.

Support (if any)
NIH Awards Number R01HL136587, R01MH118308, R01HL97165, R01HL63772, UL1TR000127
328 Insomnia in older HIV patients: a systematic review
Authors: Freire Igor , Meira e Cruz Miguel , Salles Cristina 
Published: May 2021

Abstract

Introduction
Insomnia is a common sleep disorder in elderly. Although the HIV-positive population have a similar life expectancy when compared to the general population, some factors may interact with immunity conditions and therefore contribute to a worse prognosis. Little is known however, about the frequency of insomnia in older HIV-positive patients. OBJECTIVE: To systematic review the prevalence of insomnia in older HIV-positive patients.

Methods
Systematic Review. Several databases were consulted (MEDLINE-PubMed, Embase, Cochrane Library, CINAHL, Web of Science, Scopus, SciELO, LILACS, and VHL) and manual searches were performed. The terms used for the search were related to prevalence, HIV, insomnia, and advanced age. The inclusion criteria were: cross-sectional, cohort, and longitudinal studies. The accepted data were in patients with the previous diagnosis of HIV in advanced age, those over 50 years; studies that report the frequency of insomnia or insomnia symptoms (accepted symptoms: difficulty in starting sleep, difficulty in maintaining sleep, multiple awakenings during sleep and early awakening). The criteria for exclusion were: clinical trials, animal studies, letters, abstracts, conference proceedings, studies with other sleep scales that did not include insomnia.

Results
There were 2805 publications found in the database and a further 10 articles were included manually. Of this total, four were included in this review, resulting in a total of 2,227 participants. The prevalence of insomnia in HIV-positive patients over 50 years varied from 12.5% to 76.5%.

Conclusion
The frequency of insomnia was higher in the profile of the population studied than in the general population. This should be clinically relevant in order to adequately treat and impact on the prognosis of those patient.
Support (if any):
330 Characteristics Associated with Napping Among Pregnant Women with Insomnia
Authors: Badon Sylvia , Dietch Jessica , Tutek Joshua , Solomon Natalie , Simpson Norah , Manber Rachel 
Published: May 2021

Abstract

Introduction
Napping is common in pregnant women; however, characteristics associated with napping in pregnant women with insomnia have not been studied.

Methods
We used baseline data from a randomized controlled trial of insomnia treatment during pregnancy for this cross-sectional analysis (n=159). Women self-reported sociodemographic characteristics (age, race/ethnicity, education, income, employment), pregnancy-related characteristics (parity, trimester), sleep-related characteristics (7-day sleep diary including total napping time per day, Insomnia Severity Index), and depression symptoms (Edinburgh Postnatal Depression Scale). Women were categorized as non-nappers (0 days with napping), infrequent nappers (1–3 days with napping), and frequent nappers (≥4 days with napping). Characteristics were compared across napping categories using descriptive statistics and multinomial logistic regression.

Results
Eighteen percent of women were frequent nappers, 53% were infrequent nappers, and 30% were non-nappers. Average time spent napping on days with naps was 67 minutes (SD=35). In unadjusted analyses, frequent nappers were more likely to have a high school diploma or less (36% vs 19%), be unemployed (57% vs 41%), and be nulliparous (21% vs 13%) than non-nappers. Infrequent nappers were more likely to have a 4-year college degree (32% vs 11%), have a household income $100k or more (58% vs 45%), be working full time (51% vs 39%), and be nulliparous (26% vs 13%) than non-nappers. Age, race/ethnicity, trimester, sleep-related characteristics, and depression symptoms were similar across napping categories. In analyses adjusted for education and trimester, being unemployed (OR=3.6; 95% CI: 0.8, 15.4), working part time (OR=2.3; 95% CI: 0.5, 11.2), and nulliparity (OR=2.4; 95% CI: 0.4, 14.6) were most strongly associated with frequent napping (though confidence intervals were wide) but were not associated with infrequent napping. Sleep-related characteristics were not associated with frequent or infrequent napping in adjusted analyses.

Conclusion
Among pregnant women with insomnia, frequent napping was associated with characteristics that suggest greater feasibility of napping (not working, working part time, pregnant with first child), but was not associated with nocturnal sleep parameters or insomnia severity. Given napping can reduce homeostatic sleep drive at bedtime, it should be addressed during insomnia treatment in pregnant women, particularly among women with greater opportunity to nap.

Support (if any)
National Institutes of Health (K99HD100585, R01NR013662)