bluuebunny/crossref_metadata_2025_split huggingface dataset:
0262 Awakening to Inequality: Exploring the Social Determinants of Sleep Health in Low-Income, Black Americans
Authors: Troxel Wendy , Haas Ann , Ghosh-Dastidar Bonnie , Rosso Andrea , Hale Lauren , Buysse Daniel , Dubowitz Tamara 
Published: April 2024

Abstract

Introduction
Sleep health is defined as a multidimensional pattern of sleep and wakefulness that is adapted to individual, societal, and environmental demands, and that fosters mental and physical well-being. Prior research demonstrates that social determinants, operating at the household, interpersonal, and community levels, associate with individual dimensions of sleep health (e.g., sleep duration), and may underlie racial disparities in such dimensions. However, scant research has investigated social determinants of multidimensional sleep health. The current study investigates cross-sectional associations between multi-level social determinants, including household food insecurity, interpersonal discrimination, and neighborhood social cohesion, safety and satisfaction, and multidimensional sleep health among a low-income, Black American community-based sample.

Methods
Participants included 530 Black American participants (82% female; mean age= 60.3) from two urban neighborhoods. Based on the Ru SATED construct, we constructed a composite Sleep Health (SH) score from the sum of scores representing “healthy” and “unhealthy” ranges of 6 sleep dimensions [i.e., regularity, satisfaction, alertness/ sleepiness, timing, efficiency and duration (Range = 0-6)]. Sleep dimensions were derived from actigraphy or self-reports. Food insecurity (range=0-3), interpersonal discrimination (range=0-21), and neighborhood cohesion, safety, and satisfaction (each with range=1-5) were measured via validated self-report surveys. Linear regression analyses examined the association between each social determinant and sleep health, after adjustment for age, sex, neighborhood, education, and body mass index.

Results
Greater food insecurity and greater interpersonal discrimination were associated with poorer sleep health scores (B=-.15; SE=.05 and B=-.03; SE=.01, respectively). In contrast, greater neighborhood safety and satisfaction were associated with better sleep health scores (B= .22; SE=.06 and B=.11; SE=.05, respectively). There was not a significant association between social cohesion and sleep health.

Conclusion
These findings demonstrate that determinants of sleep health go beyond the individual level, encompassing socio-environmental influences that may act as risk or protective factors. Our results suggest that both individual and policy-level interventions may be needed to mitigate pervasive and enduring sleep health disparities.

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AG R01AG072652
0264 Sleep Duration Among Samoan Children: A Descriptive Study of Behavioral and Sociodemographic Correlates
Authors: von Ash Tayla , Choy Courtney , Dunsiger Shira , Soti-Ulberg Christina , Wang Dongging , Reupena Muagututia , Duckham Rachel , Naseri Take , Hawley Nicola 
Published: April 2024

Abstract

Introduction
Sleep is important for child health and development and has been associated with obesity risk. Pacific Island nations have amongst the highest obesity prevalence globally, but little is known about child sleep in these settings. The study aimed to: 1) describe nighttime sleep duration and the proportion of children who met sleep recommendations between 2 and 9 years old, and 2) identify behavioral and sociodemographic correlates of sleep duration in Samoa.

Methods
This secondary analysis used three waves of data collected from the Ola Tuputupua’e (‘Growing Up’) cohort in Samoa between 2015 and 2020. Primary caregivers reported how many hours their child slept at night. Means and standard deviations were calculated for child sleep duration, while frequencies and proportions were calculated for meeting the World Health Organization age-based sleep recommendation (&gt;11 hours for toddlers, &gt;10 hours for preschool-age children, and &gt;9 hours for school-age children. We ran multivariable regression models, stratified by age group to assess associations between child characteristics, sociodemographic characteristics, and zBMI, diet-, and activity-related factors with sleep duration across the waves. Mixed effects models were used to account for the fact that data was repeated within participants and allow for both time varying and time-invariant factors.

Results
Average nighttime sleep duration was 9.7 (1.1) for toddlers, 9.5 (1.0) for preschoolers, and 9.4 (1.3) for school-age children. Based on nighttime sleep duration, approximately 86% of toddlers did not meet their age-specific sleep recommendation, compared to 51% of preschoolers and 23% of school-age children. Living in a lower income household was associated with more sleep (β: 0.57 [95% CI: 0.29, 0.86]) compared to living in a higher income household, while having a primary caregiver who did not complete high school (β: -0.62 [95% CI: -0.88, -0.36]) was associated with less sleep. Increased total carbohydrate intake (β: -0.19 [95% CI: -0.33, 0.00]) and greater adherence to a neotraditional dietary pattern (β: -0.14 [95% CI: -0.24, -0.05]) were associated with shorter sleep.

Conclusion
Interventions focusing on early childhood sleep may be needed in Samoa. However, further investigations accounting for daytime sleep are needed and research to inform intervention components.

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0265 Disparities in Bed and Wake Times in the US Population Associated with Typical Work Hours
Authors: Garber Sofia , Kennedy Kathryn E R , Hartstein Lauren , Valencia Dora Y , Killgore William , Grandner Michael A 
Published: April 2024

Abstract

Introduction
Racial and ethnic minority populations are at an increased risk of having shorter sleep duration and poorer sleep quality. This nationally-representative study examines whether groups differ on their typical sleep opportunity window, and whether this depends on typical work hours.

Methods
Data were obtained from adults who participated in the National Health And Nutrition Examination Survey (NHANES), overseen by the CDC, for the 2017-2018 and 2019-2020 (March, pre-pandemic) waves. These data were combined and weighted using NHANES sample weights. Habitual sleep timing was assessed as self-reported typical bedtime and wake time, which was converted to minutes from midnight. Race/ethnicity was self-reported as non-Hispanic White, Black/African-American, Mexican-American, Other Latinx, Asian, or Multiracial/Other. Work time was categorized as None, 20 or fewer hours, 21-39 hours, 40 hours (reference), 41-59 hours, or 60 or more hours. Covariates included demographics (age, sex) and socioeconomics (education, income-poverty ratio).

Results
Overall, compared to Non-Hispanic Whites, Blacks/African-Americans went to bed 14 minutes later, Mexican Americans went to bed 18 minutes earlier and got out of bed 33 minutes earlier, and Asians went to bed 13 minutes later and woke up 16 minutes later. And compared to those who worked 40 hours, those who worked less than 40 hours went to bed later and woke up later, and those who worked 60+ hours went to bed later. There was a significant race/ethnicity by work hours interaction. The relationship between race/ethnicity and sleep timing differed depending on which work hours category respondents were in. Overall, Black-White differences in bedtime were seen in those who worked 41-59 hours. Mexican-White differences in bedtime were seen for non-working and 40 hours and for waketime were seen for all &lt;=40 hours groups. Asian-White differences were seen for bedtime for 41-59 hours and for waketime in non-working, 40 hours, and 60+ hours. Multiracial-White differences were seen for bedtime in non-working 21-39 hours, and for waketime in 21-39 hours.

Conclusion
Even after accounting for other elements of sleep, Blacks/African-Americans, and Asians still exhibit delayed sleep. Future research is required to further explore disparities in circadian rhythm and culturally targeted interventions for sleep health.

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0268 Sleep Duration Associated with Cognitive Decline: Influence of Age and Race/Ethnicity
Authors: Ghani Sadia , Tubbs Andrew , Seixas Azizi , Killgore William , Grandner Michael 
Published: April 2024

Abstract

Introduction
Insufficient and excessive sleep are associated with cognitive dysfunction in older adults. Limited studies are available for adults &lt; 50 years of age and the influence of race/ethnicity in a nationally representative population. We investigated the association between sleep duration and cognitive decline and the influence of age and race/ethnicity, in U.S adults &gt;40 years of age.

Methods
Data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS) was used. Twelve states collected data on cognitive decline, assessed with: “During the past 12 months, have you experienced confusion or memory loss that is happening more often or is getting worse?” among individuals aged 40 or older (N=63,948). Population-weighted logistic regression analyses examined this in relation to self-reported habitual sleep duration in models that also included age (by decade), sex, race/ethnicity, education, and depression history.

Results
In adjusted analyses, increased likelihood of perceived cognitive decline was seen for ≤4h (OR=2.50), 5h (OR=2.06), 6h (OR=1.51), 9h (OR=1.34), and 10+hr (OR=2.15), compared to 7h. A 3-way interaction was found (p=0.0001), as well as a 2-way interaction for sleep-by-age (p&lt; 0.0001) but not sleep-by-race (p=0.16). There was an age gradient, such that for participants in their 40s, short sleep duration was more strongly associated with cognitive decline, and as age increased, these relationships generally weakened. However, a sleep-by-race interaction was seen for older adults only, where the relationship between cognitive decline and both short and long sleep duration was stronger among Blacks/African-Americans compared to Non-Hispanic Whites. Further, secondary analyses among those who reported cognitive decline showed that those with ≤4h sleep duration were more likely to talk about it with a doctor (OR=1.67), and greater ordinal likelihood of cognitive decline interfering with social functioning was associated with both short and long sleep duration.

Conclusion
Sleep duration is related to cognitive decline and its social effects, though this depends on age and race/ethnicity, especially among older adults. Interventions should focus on effects of insufficient sleep in younger populations in general, and older Black/African-American groups.

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0271 Heterogeneities in Sleep Outcomes Among U.S. Immigrants from Different Racial and Ethnic Backgrounds
Authors: Liu Xiaoyue , Li Junxin , Cho Yeilim , Wu Bei 
Published: April 2024

Abstract

Introduction
Sleep plays an essential role in overall health and well-being. Although U.S. immigrants are considerably growing, few studies have examined sleep in this diverse population, particularly those from Asian backgrounds. It is also unclear how sleep differs by the length of residence (LOR) across immigrant groups. Using a nationally representative sample of U.S. immigrants, this study sought to address three questions: 1) Do sleep outcomes differ across racial/ethnic groups? 2) Is there an association between LOR and sleep outcomes? and 3) Does LOR moderate the association between race/ethnicity and sleep outcomes?

Methods
Data were pooled from the 2013-2018 National Health Interview Survey. The sample (N = 27,761; 14% ≥ 65 years old) included foreign-born adults from six racial/ethnic groups: non-Hispanic (NH) White, NH Black, NH Asian (Chinese, Filipino, Asian Indian), and Hispanic/Latino. LOR was categorized as &lt; 5, 5-9, 10-14, and ≥15 years. Sleep outcomes included self-reported sleep duration (short &lt; 7, normal 7-8, and long ≥ 9 hours) and sleep quality (trouble falling asleep, trouble staying asleep, and waking up feeling unrested).

Results
Over one-third of the sample reported either short or long sleep duration. The prevalence of poor sleep quality ranged from 15.6 to 40.2% among racial/ethnic groups. Compared to NH Whites, Filipinos (odds ratio [OR]=1.91, 95% confidence interval [CI]: 1.60-2.28), NH Blacks (OR=1.84, 95%CI: 1.58-2.15), and Hispanics/Latinos (OR=1.15, 95%CI: 1.03-1.29) were more likely to report short sleep, while Asian Indians were less likely to experience poor sleep quality (p &lt; 0.05). Immigrants with LOR ≥ 15 years exhibited significantly worse sleep outcomes in comparison to those with LOR &lt; 5 years, and LOR ≥ 15 years moderated White-Asian differences in sleep quality. Additionally, different immigrant groups showed variations in sleep patterns as they resided longer in the U.S.

Conclusion
Immigrants from different racial/ethnic backgrounds exhibited substantial heterogeneities in sleep outcomes. Future research should investigate the factors contributing to the variations in sleep patterns, both between racial/ethnic groups and within the same group of immigrants. More importantly, routine sleep assessments should be conducted for this population to promptly identify sleep problems and initiate tailored interventions.

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0272 Associations Between Sleep Architecture, Appetite and Food Reward over 6 Months in Black Emerging Adults
Authors: McNeil Jessica , Koch Hannah , Sims Jesse , Finlayson Graham , Pickett Stephanie , Wideman Laurie 
Published: April 2024

Abstract

Introduction
Short sleep duration is associated with increased feelings of appetite and food reward, though few studies have assessed associations between sleep architecture with appetite and food reward measures. Additionally, no data exists on these measures in Black emerging adults (ages 18-28 years old), despite higher risks of poor sleep and obesity in this population. This analysis aims to examine relationships between sleep architecture with appetite and food reward over 6 months in Black emerging adults.

Methods
In a repeated measures design, 15 Black emerging adults (12 females; age, 21±2.4 years; height, 168±11.1 cm; weight, 72.4±12.6 kg; body fat, 25.8±11.9%) completed a baseline (BLN) and 6-month follow-up (6MO) visit. In-home sleep over 2 nights was measured with polysomnography. Outcome measures included fasting and post-standard breakfast appetite sensations over 180 minutes (desire to eat, hunger, fullness, and prospective food consumption; visual analogue scales) and food reward (implicit wanting, explicit liking and explicit wanting; Leeds Food Preference Questionnaire). Linear mixed models using a restricted maximum likelihood estimation with a Kenward-Roger correction for small samples were used to assess associations between sleep stage duration (minutes of stage 2, slow-wave sleep (SWS) and rapid eye movement (REM) sleep) with fasting appetite sensations, post-meal appetite area under the curve (AUC) and food reward measures. Covariates included time (BLN vs. 6MO) and body weight. Participant ID was used as a grouping variable.

Results
No significant associations were noted between sleep stage duration with fasting appetite sensations and post-breakfast appetite AUC. Lower stage 2 sleep duration was associated with greater explicit wanting (β= -0.13, 95%CI [-0.23, -0.04], p=0.01) and explicit liking (β= -0.19, 95%CI [-0.28, -0.11], p&lt; 0.0001) for sweet relative to savory foods.

Conclusion
These findings suggest that habitual, in-home measures of sleep stage duration are not associated with appetite sensations in Black emerging adults. However, greater explicit wanting and liking for sweet relative to savory foods in response to lower stage 2 sleep duration may be a mechanism by which short sleep duration leads to an increased risk of positive energy balance and obesity over time.

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0274 Associations Between Sleep Architecture and Energy Balance in Black Emerging Adults
Authors: Koch Hannah , Sims Jesse , Pickett Stephanie , Wideman Laurie , McNeil Jessica 
Published: April 2024

Abstract

Introduction
Body weight is determined by sustained changes in energy balance (EB), reflecting the difference between energy intake (EI) and energy expenditure (EE). Insufficient sleep negatively impacts EB to favor weight gain. Black emerging adults have a higher risk for insufficient sleep and obesity, but little data exists on these measures in this population. This analysis aims to examine relationships between sleep architecture with parameters of energy balance (EI and EE) in Black emerging adults.

Methods
In a repeated measures design, 15 Black emerging adults (12 females; age, 21±2.5 years; height, 168±11.1 cm; body mass, 72.4±12.6 kg; body fat, 25.8±11.9%) completed an initial (BLN) and 6-month follow-up (6MO) visit. In-home sleep over 2 nights was captured with polysomnography. Physical activity EE (PAEE) and moderate-to-vigorous physical activity (MVPA) were measured over seven days via actigraphy and calculated using the Freedson VM3 Combination and Freedson (1998) algorithms, respectively. Resting metabolic rate (RMR) and thermic effect of food were measured via indirect calorimetry. Ad libitum EI was measured using 3 days of provided meals. Spearman’s Rank correlations assessed relationships between changes in sleep measures (minutes and percentage of stage 2, slow wave sleep (SWS), and REM) with changes in parameters of EB. Linear mixed models assessed relationships between sleep variables and EB variables, with participant ID as a grouping variable and body weight as a covariate.

Results
There were no significant associations between changes in sleep architecture with changes in EB variables. SWS duration was positively related to EI (Beta = 9.11, 95%CI [0.486, 17.734], p = 0.049). RMR was inversely related to stage 2 percentage (Beta = -63.3, 95%CI [-101.48, -25.12], p &lt; 0.01), SWS percentage (Beta = -52.63, SE: 18.85, p = 0.01), and REM percentage (Beta = -55.36, 95%CI [-92.84, -17.88], p = 0.01).

Conclusion
These results suggest that greater SWS duration was related to higher EI, and that relative time spent in stage 2 sleep, SWS, and REM sleep were inversely related to RMR. Therefore, habitual measures of sleep architecture may impact obesity risk via modifications in EB parameters in Black emerging adults.

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0275 Associations Between Sleep Architecture, Cortisol, and Body Composition over 6 Months in Black Emerging Adults
Authors: Koch Hannah , Sims Jesse , Pickett Stephanie , Wideman Laurie , McNeil Jessica 
Published: April 2024

Abstract

Introduction
Cortisol awakening response (CAR), diurnal slope (DS), and total daily output (TDO) are metrics of the hormone, cortisol. Emerging adults (ages 18-28 years old) experience poor sleep, which is linked to a blunted CAR, flatter DS, and obesity risk. Little data exists on these measures in Black emerging adults, despite higher risks of poor sleep and obesity. This analysis aims to examine relationships between sleep architecture, cortisol metrics, and body mass and composition changes over 6 months in Black emerging adults.

Methods
In a repeated measures design, 14 Black emerging adults (12 females; age, 21±2.5 years; height, 166±9.3 cm; body mass, 73.0±12.9 kg; body fat, 27.4±10.8%) completed an initial (BLN) and 6-month follow-up (6MO) visit. In-home sleep over 2 nights was captured with polysomnography. Salivary cortisol was collected at wake, 30-, 45-min post-wake, 12pm, and 7pm on 2 days. CAR area under the curve (AUC) was calculated with the wake, 30-, and 45-min post-wake samples with respect to wake (AUCi) and to ground (AUCg). DS was calculated as the slope using wake, 12pm, and 7pm samples. TDO AUC was calculated using all samples with respect to ground. Body mass and composition were assessed with BodPod. Paired t-tests evaluated differences in all variables between BLN and 6MO. Pearson correlations assessed relationships between sleep stage duration, cortisol metrics, and body mass and composition at each timepoint, and 6-month changes in these variables.

Results
There was an increase in body mass (MD: 2.7 kg, 95%CI [1.0, 4.4], p&lt; 0.01), but not fat mass (p&gt;0.05). REM sleep duration was positively associated with TDO at BLN (r = 0.57, p=0.03) but not at 6MO. REM sleep duration at BLN was also positively associated with 6-month changes in body mass (r=0.55; p=0.03). Greater increases in slow-wave sleep (SWS) duration were associated with a more positive DS (r = 0.73; p&lt; 0.01).

Conclusion
These results suggest that greater amounts of REM sleep are associated with greater cortisol output and body weight changes, whereas greater amounts of SWS are associated with better DS profiles.

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0276 Sex Influences the Relationship Between Sleep-Related Impairment Score and Blood Chloride Among Blacks
Authors: Scott Sadeaqua , Blanc Judite , Gallop Erin-Leigh , Oliveira Bruno , Thompson Michelle , Locklear Clarence , Moise Rhoda , Nicholson Nadine , Seixas Azizi , Jean-Louis Girardin 
Published: April 2024

Abstract

Introduction
Sleep inefficiency is associated with increased risk of cardiovascular disease (CVD) and kidney disease. CVD and kidney disease have a bidirectional relationship, with one enhancing the disease progression of the other, and sharing biomarkers of inflammation and infection such as blood urea nitrogen (BUN) and chloride, respectively. Although Blacks have disproportionately higher rates of sleep inefficiency associated with cardiovascular, kidney, and inflammatory disease, data is limited concerning whether sleep-related impairment (SRI) is associated with these disease biomarkers, and sex in Blacks. This study investigated the association between SRI, sex and biomarkers of cardiometabolic, kidney and inflammatory disease including chloride and BUN within Blacks.

Methods
Data were extracted from 104 Blacks, aged 36 to 73 years, who were enrolled in two NIH-funded community-based sleep studies, ESSENTIAL and MOSAIC, from January 2020 until October 2023. Of the participants, 34.6% (n=36) were male and 65.4% (n=68) were female. The PROMIS Sleep-Related Impairment (SRI) 8a short form questionnaire was completed by all participants to determine subjective sleep efficiency. An independent t-test and multilinear regression analysis were conducted to explore associations between sleep-related impairment scores, chloride, BUN, and sex. Interaction effects between SRI score and potential moderators (sex, chloride and BUN) were conducted to examine which variables displayed a significant effect on SRI score.

Results
Black women reported higher sleep inefficiency compared to men (t(77.67) =-2.3, p ≤ 0.023). Controlling for age and sex, linear regression analysis showed that significant variables associated with (SRI) among participants were blood chloride (p ≤ 0.016) and sex (p ≤ 0.012). A moderation analysis showed a significant relationship between blood urea nitrogen, blood chloride and sex (p = 0.003), and that sex influences the relationship between SRI score and blood chloride. Regression analysis showed that all variables are significant predictors of SRI score.

Conclusion
The association of SRI to chloride, and its moderation by sex, with women scoring higher than males, suggests further investigations should be performed to analyze how these associations play a role in accounting for greater sleep inefficiency and CVD in Black women as compared to Black men.

Support (if any)
NIH (R01AG067523, R01HL142066, T32HL166609)