bluuebunny/crossref_metadata_2025_split huggingface dataset:
0239 Perceptions of Sleep Health among Black Americans: Recommendations for Improving Sleep
Authors: Johnson Dayna , Smith-Ireland Daekiara , Enun Bassey , Barber Lauren 
Published: May 2023

Abstract

Introduction
Despite African Americans having a high prevalence of poor sleep health, the determinants remain understudied. Sleep disparities research mainly examines quantitative data, with little attention to qualitative data, which can inform targeted interventions. We aimed to qualitatively identify 1) perceptions of sleep; 2) facilitators/barriers to healthy sleep; and 3) preferences for receiving sleep recommendations in a socioeconomically diverse sample of African Americans.

Methods
Participants (N=36 individuals divided into 11 groups) attended online focus groups and discussed the following topics: attitudes and beliefs about sleep, facilitators and barriers to sleep, and knowledge and attitudes about sleep recommendations. Self-reported sleep was measured via the Pittsburgh Sleep Quality Index. The focus group data were analyzed using a rapid analytic approach.

Results
The sample had a mean age of 34 (13.1), and 64% identified as female. The overall prevalence of poor sleep quality, short sleep duration, and long sleep duration was 39%, 24%, and 15%, respectively. Participants defined healthy sleep as a matter of quality over quantity and waking up feeling well-rested. Women, men, and gender non-conforming individuals reported average sleep durations of 6.3 hours, 5.9 hours, and 8 hours, respectively. Women, but not men or gender non-confirming individuals reported disturbed mood because of poor sleep. Regardless of gender, participants reported anxiety, stress, and daily responsibilities such as work, taking care of family, and sudden changes in plans as barriers to healthy sleep. A subset of respondents (25.5%) reported screen time and feeling unsafe as barriers. Men and women reported listening to music, aromatherapy, relaxing, and limiting phone use before bedtime as facilitators to healthy sleep. Men preferred information on how to achieve and maintain deep/quality sleep, whereas women preferred more personalized information on sleep and the sleep-mental/physical health relation. Social media was generally the preferred avenue for receiving sleep recommendations.

Conclusion
Mood, stress, screen time and lack of safety were identified barriers to healthy sleep patterns. Participants were interested in strategies for improving sleep health. Future studies should consider targeting relaxing bedtime routines and enhanced safety as sleep interventions.

Support (if any)
National Institutes of Health, National Institute for Heart Lung and Blood 1R01HL157954 and K01HL138211.
0240 Greenspace in Relation to Sleep Health among a Racially and Ethnically Diverse Cohort of US Women
Authors: Gaston Symielle , Sweeney Marina , Martinez-Miller Erline , Jones Rena , James Peter , Jackson W Braxton , Sandler Dale , Jackson Chandra 
Published: May 2023

Abstract

Introduction
Exposure to greenspace has been associated with better sleep health by potentially supporting salubrious activities (e.g., physical activity), buffering noise, improving air quality, and promoting mental health. However, most prior studies have included few sleep dimensions or lacked racial/ethnic diversity. Further, access to greenspace is not equitably distributed across racial/ethnic groups due to structural racism, including environmental justice issues.

Methods
To investigate cross-sectional associations between greenspace with sleep health, overall and by race/ethnicity, we used data collected at enrollment (2003-2009) from women in the Sister Study (n=1,575 Hispanic/Latina, n=4,421 non-Hispanic (NH)-Black, and n=41,628 NH-White). Participants’ home addresses (X-Y coordinates) were linked to NASA’s Moderate Resolution Imaging Spectroradiometer Normalized Difference Vegetation Index data (250m resolution) during July of the year of enrollment to capture tertiles of proximity to greenspace. Participants reported multiple sleep dimensions including short sleep duration (&lt; 7 hours), insomnia symptoms, frequent napping, and sleep debt (≥2-hour difference between average longest and shortest sleep duration during a week). Adjusting for both individual- and neighborhood-level sociodemographic characteristics, log Poisson regression with robust variance estimated prevalence ratios (PRs) for low/moderate vs. high greenspace associated with poor sleep, overall and by race/ethnicity.

Results
Among participants (mean±SD age=55.7±9.0 years), Hispanic/Latina and NH-Black participants comprised 8% of the population with high greenspace, 15% with low/moderate greenspace, and reported shorter sleep duration and poorer sleep quality compared to NH-White participants. After adjustment for sociodemographic characteristics, neighborhood disadvantage, and population density, low/moderate vs. high greenspace was associated with an 8% higher prevalence of frequent napping (PR=1.08 [95% CI:1.02-1.15]). Low/moderate greenspace was also marginally associated with a higher prevalence of short sleep duration (PR=1.01 [0.98-1.05]), insomnia symptoms (PR=1.03 [0.99-1.07]), and comorbid short sleep with insomnia symptoms (PR=1.04 [0.99-1.10]) but was not associated with sleep debt. Associations did not vary by race/ethnicity.

Conclusion
Low or moderate greenspace was marginally associated with poorer sleep across racial/ethnic groups, supporting greenspace as beneficial for all. Although replication with longitudinal data and objective sleep measures is warranted, greenspace interventions may improve population sleep health; equitable access may help address racial/ethnic sleep disparities.

Support (if any)
NIEHS (Z1AES103325[CLJ] and Z01ES044005[DPS]):
0242 Sleep Duration Associated with Sexual and Gender Minority Status in the US: Influence of Sexual Orientation and Gender Identity
Authors: Marquez-Velarde Guadalupe , Grandner Michael , Miller Gabe H , Carreon Samantha , Hernandez Stephanie 
Published: May 2023

Abstract

Introduction
The inclusion of sexual orientation and gender identity measurements in national epidemiological surveys allows for the assessment of sleep disparities among sexual and gender minorities. Our objective is to establish the association of sexual orientation and gender identity with sleep duration.

Methods
We used 2020 Behavioral Risk Factor Surveillance System data from 33 states who included the sexual orientation and gender identity (SOGI) optional module in their questionnaires. The outcome variable is sleep duration (≤4 hours, 5, 6, 7, 8, 9, and ≥10 hours). Main predictors are sexual orientation (heterosexual, gay/lesbian, bisexual, and other) and gender identity (cisgender, trans woman, trans man, and trans gender non-conforming). We estimated multinomial logistic regression models due to the categorical nature of our outcome variable using Stata 17. We estimated models using sexual orientation alone as main predictor, gender identity alone, and then a combined model with both SOGI measures, and adjusted for sociodemographic characteristics and physical and mental health.

Results
Of the complete sample, 92% reported being heterosexual, 2% gay/lesbian, 3% bisexual, and 3% other sexual orientations. In addition, 99% reported being cisgender, and 0.2% reported being trans woman, trans man, and trans gender non-conforming, respectively. In the fully adjusted sexual orientation models, identifying as gay/lesbian was associated with a 27% increased likelihood of sleeping 8 hours and 71% increased likelihood of sleeping 10+ hours compared to heterosexuals. Self-identifying as bisexual and other orientations is associated with an 86% and 52% increased likelihood of sleeping 10+ hours, respectively. In the fully adjusted gender identity models, trans women were 115% more likely to report 8 hours of sleep, 122% more likely to report 9 hours of sleep, and 223% more likely to report 10+ hours of sleep. In the combined fully adjusted model, self-identifying as gay/lesbian, bisexual, or other orientations is associated with a 68%, 84%, and 63% increased likelihood of sleeping 10+ hours. Trans women are 149% more likely to report 10+ hours of sleep.

Conclusion
Based on our empirical analyses, being a sexual and/or gender minority is associated with a greater likelihood of reporting 10+ hours of sleep.

Support (if any)
0244 The Relationship between Sleep and Metabolic Syndrome in Late Adolescents: Racial Differences
Authors: Ji Xiaopeng , Covington Lauren , Brownlow Janeese , Patterson Freda 
Published: May 2023

Abstract

Introduction
Disparities in sleep health and metabolic syndrome (MetS) components co-exist in ethnic/racial minorities. Late adolescents (18-21 y.o.) are a high-risk, yet overlooked population to study sleep disparities and the associated metabolic health. This study aimed to examine the interaction between race and sleep health metrics on MetS components in late adolescents.

Methods
In this cross-sectional study, we enrolled a convenience sample of 60 college students (19.22±1.06 y.o.). Actigraph accelerometers assessed total sleep time (TST), sleep efficiency (SE), and wake after sleep onset (WASO) over one week. Participants completed the Pittsburgh Sleep Quality Index (PSQI) and questions about demographic/socioeconomic information and risk behaviors. A point-of-care test provided the fasting glucose and cholesterol panel. The number (0 vs. &gt;1) of MetS components, including high waist circumference, blood pressure, fasting triglycerides and glucose, and low High-Density Lipoprotein, indicated metabolic health. Logistic regression tested interaction terms controlling for adolescents’ age, sex, alcohol consumption, and parents’ education, marital status, and family income.

Results
Most participants (n=55; 92%) slept &lt; 7 hours and 43% reported poor sleep (PSQI&gt;5). More than half (n=33; 55%) had at least one MetS component. On average, White (non-Hispanic) participants had higher TST (6.07 vs. 5.63, t=1.93, p=0.06) and SE (84.89% vs. 81.07%, t=2.31, p=0.02) than their racial/ethnic minority (Black/Hispanic/Asian American/other) peers. Race significantly interacted with TST (OR=0.24, p=0.04), SE (OR=0.69, OR=0.10), and WASO (OR=1.08, p=0.02), such that associations of decreasing odds of MetS with increasing TST and SE and decreasing WASO were significant only in the racial/ethnic minority group. Furthermore, racial/ethnic minority adolescents (vs. White) had a greater MetS risk, when TST hours were at low levels (i.e., &lt; 6 hours). Similarly, low SE (&lt; 85%) and high WASO (&gt;60 min) were associated with greater odds of MetS in racial/ethnic minority (vs. White) adolescents. PSQI scores were not independently associated with MetS or interacted with race in the association with MetS.

Conclusion
Unhealthy sleep is associated with increased MetS risk, particularly for racial/ethnic minority adolescents. Given the greater sensitivity to sleep health, improving sleep quantity and quality may be candidate targets for MetS interventions in at-risk populations who experience health disparities.

Support (if any)
American Nurses Foundation (18A01422). Center of Biomedical Research Excellence (COBRE) in cardiovascular health (P20GM113125)
0245 Association Between Neighborhood Conditions and Sleep Quality in The Offspring Study
Authors: Hokett Emily , Lao Patrick , Turney Indira , Seblova Dominika , Osorio Ricardo , Brickman Adam , Palta Priya , Manly Jennifer 
Published: May 2023

Abstract

Introduction
On average, minoritized racial and ethnic groups, including non-Hispanic Black and Hispanic adults, sleep more poorly than non-Hispanic White adults (hereafter, Black and White). Although racial and ethnic sleep disparities have been well-documented, few studies have investigated factors that may contribute to sleep disparities, such as the neighborhood environment. We hypothesized that Black and Hispanic adults demonstrate associations between more positive neighborhood conditions and higher sleep quality.

Methods
In the community-based Offspring Study, we assessed cross-sectional associations between the neighborhood environment and self-reported sleep quality in Black, Hispanic, and White adults (n=993; 27-91 years; M=56 , SD=11). Participants self-reported positive (cohesion, safety) and negative (problems, disorder) aspects of their neighborhood experiences on 29 questionnaire items, which were summed on subscales for each aspect of the neighborhood. We assessed sleep quality with the Pittsburgh Sleep Quality Index. Both sleep quality and neighborhood experiences were treated as continuous variables. We performed multivariable regression analyses stratified by racial and ethnic group and adjusted for age, education, and gender identity.

Results
More positive neighborhood experiences (higher neighborhood cohesion and safety; lower disorder and problems) were associated with higher sleep quality in Black, Hispanic, and White adults in unadjusted models. In adjusted models, only neighborhood cohesion was associated higher sleep quality in each racial and ethnic group (Black: 0.17, [0.03, 0.31]; Hispanic: 0.09, [0.03, 0.16]; White: B=0.129, [0.004, 0.25]). In White adults, higher neighborhood problems were associated with poorer sleep quality (B=-0.17, [-0.26, -0.07]). In Black and Hispanic adults, safer neighborhoods (Black: B=0.82, [0.24, 1.41]; Hispanic: B=0.65, [0.37, 0.93]) and lower neighborhood disorder (Black: B=0.14, 0.01, 0.27]; Hispanic: B=0.09, [0.02, 0.15]) were associated with higher sleep quality.

Conclusion
Neighborhood environment may be a driver of individual differences in sleep quality across the adult lifespan. Improving neighborhood conditions may be one method to improve sleep quality and reduce racial and ethnic sleep disparities.

Support (if any)
This research is supported by the Columbia Center for Interdisciplinary Research on Alzheimer's Disease Disparities (P30AG059303-01), NIH (R01AG054070), and the American Academy of Sleep Medicine Sleep Research Program for Advancing Careers travel scholarship.
0249 Individual differences of sleep pattern and duration between two consecutive night shifts among night workers
Authors: Zhang Yuan , Holst Heidi Lammers-van der , Barger Laura , Murphy Audra , Qadri Salim , Ronda Joseph , Desnoyers Brian , Duffy Jeanne 
Published: May 2023

Abstract

Introduction
Working at night leads to shortened and disturbed daytime sleep. Night workers usually adopt one of several sleep patterns between consecutive nights: sleeping right after night work (morning sleep), delaying sleep to the afternoon (afternoon sleep), or dividing sleep into two or more episodes (split sleep). However, few studies have examined sleep pattern and duration between consecutive nights in real-world workers. The objective of this study was to examine individual differences in sleep pattern and duration when working consecutive night shifts.

Methods
Night workers (n=241, 43.0±16.5y, 67.2% female) from various occupations who reported working consecutive nights completed an online survey. The survey included questions on socio-demographics and daytime sleep and nap schedules. Sleep pattern (morning vs. afternoon vs. split) and total sleep time (sleep+naps) were derived from survey responses. Cross-tabulations and ANOVA were conducted.

Results
On average, night workers reported a total daytime sleep of 5.37±2.69 hours (range 0-14.25 hours). 65.1% reported morning sleep, 10% afternoon sleep, and 24.9% split sleep. Split sleepers (6.78±2.13 hours) reported longer total sleep than morning (4.86±2.75 hours) or afternoon (5.11±2.37 hours) sleepers. Younger age (&lt; 50y), single marital status, shorter night shift tenure (≤10 years), working ≤3 consecutive shifts, and having ill or disabled dependents were associated with greater prevalence of morning sleep; older age (≥50y), married or separated/widowed, &gt;10 years night shift tenure, working ≥4 consecutive shifts, and having no dependents were associated with greater prevalence of afternoon or split sleep. Having childcare responsibility was associated with more split sleep than no children. Similarly, younger age (&lt; 50y), singles, shorter night shift tenure, working three or fewer consecutive shifts, having ill or disabled dependents, and having a second job were associated with shorter total sleep. However, having childcare responsibility was associated with greater total sleep.

Conclusion
Sleep timing and duration between consecutive nights were influenced by age, marital status, dependents, night work tenure, and number of consecutive night shifts. Future studies are needed to explore what sleep pattern is most beneficial for sleep, performance, safety, and health outcomes of these workers.

Support (if any)
The study was supported by grant R01 AG044416 from the US National Institutes of Health.
0251 Sex differences in the associations of childhood obesity with sleep characteristics, access to screens, and nocturnal melatonin
Authors: Gombert Marie , Carbonell Vanessa Martin , Garcia Alvaro Carrasco , Arboledas Gonzalo Pin , Luna Joaquin Carrasco , Codoner-Franch Pilar 
Published: May 2023

Abstract

Introduction
Insufficient sleep and circadian rhythm alterations are associated with metabolic disorders including obesity, with increasing evidence that these associations can emerge in childhood. In parallel, screen media access in the bedroom at night has negative effects on circadian rhythms, sleep, and other behaviors, which can contribute to obesity development. In the current work, we analyzed the associations of childhood obesity with self-reported sleep characteristics, access to screens in the bedroom, and nocturnal melatonin, considering potential sex differences.

Methods
The study cohort is composed of 244 children 7-16 years old, among which 140 have a body mass index z-scores &gt;2, characterized as obesity according to world health organization criteria. There are 124 girls (11.21 ± 2.42 years) and 120 boys (11.19 ± 2.22 years). Melatonin was measured through immunoassay in saliva samples, which were collected at three time points of the evening of a school day: 4h before sleep, 2h before sleep, and 1h after sleep start. The chronotype score was obtained using the Horne and Ostberg questionnaire. Participants reported the number of screens present in the bedroom at night, and their bedtimes and wakeup times during both weekdays and weekend. The sleep disturbance scale for children and an abbreviated pediatric sleep questionnaire about sleep apnea symptoms were completed by a parent.

Results
BMI z-scores were significantly correlated with more parent-reported sleep disturbances (p&lt; 0.01), higher sleep apnea scores (p&lt; 0.01), shorter sleep duration during weekdays (p&lt; 0.01), and the number of screens in the bedroom (p=0.05) in boys but not in girls (p=0.52, p=0.15, p=0.83, and p=0.37). On the other hand, BMI z-scores were significantly correlated with melatonin level at +1h after sleep onset (p=0.05) in girls but not in boys (p=0.96). No significant correlations were observed between the BMI z-score and the pre-sleep melatonin measures.

Conclusion
According to our findings, there is some differentiation by sex in relationships between body weight and various sleep and circadian measures. Specifically, in boys, obesity was associated with shorter and disturbed sleep with more sleep apnea, whereas in girls, obesity was linked with lowered nocturnal melatonin expression.

Support (if any)
0253 Consumption of a Western diet impacts sleep microstructure during normal sleep and recovery sleep – a randomized crossover trial
Authors: Brandão Luiz Eduardo Mateus , Popa Alexandru , Cedernaes Erasmus , Cedernaes Christopher , Lampola Lauri , Cedernaes Jonathan 
Published: May 2023

Abstract

Introduction
While intake of specific macronutrients has been associated with changes in sleep parameters in humans – such as sleep macrostructure – direct interventional evidence is lacking. Thus, we conducted a randomized trial to examine how consumption of an unhealthy, Western diet impacts sleep at the macrostructure to microstructure level in humans.

Methods
In a crossover study, 15 healthy normal-weight men consumed two isocaloric diets in random order: an unhealthy high-fat, high-sugar diet, and a healthy, low-fat, low-sugar diet. Following each week-long diet, in-lab sleep was recorded using polysomnography (PSG), during a full night of sleep, and after recovery sleep occurring after extended wakefulness. Sleep duration, macrostructure and microstructure (sleep oscillatory pattern and slow waves) were investigated using machine learning-based algorithms.

Results
Sleep duration did not differ across the diets, based on actigraphy and the in-lab PSG. Sleep macrostructure was similar after one week on each diet. Compared with the healthy diet, the Western diet resulted in reduced delta power and slow-wave amplitude, but increased alpha and theta power, during NREM sleep. Furthermore, the Western diet also impacted the sleep oscillatory pattern in a similar direction during the recovery sleep.

Conclusion
Short-term consumption of an unhealthy, Western diet modulates restorative properties of sleep, and these changes persisted even into recovery sleep. Whether such changes can mediate adverse health outcomes of an unhealthy diet warrants further investigation.

Support (if any)
This work was supported by the Swedish Society for Medical Research (SSMF), the Swedish Research Council, and the following foundations: Diabetesfonden (2019-489), Diabetes Wellness Sverige (25-2231), Familjen Ernfors, Göran Gustafsson (2019-1941), Selander, the Swedish Cancer Foundation (19 0269 Pj); the Swedish Brain Foundation (FO2022-0704). The study sponsor/funding agencies were not involved in the design of the study; the collection, analysis, and interpretation of data; writing the report; and did not impose any restrictions regarding the publication of the report.