bluuebunny/crossref_metadata_2025_split huggingface dataset:
0103 Greater actigraphic sleep variability and later timing are associated with more school-related problems in adolescents
Authors: Mathew Gina , Reichenberger David , Master Lindsay , Buxton Orfeu , Chang Anne-Marie , Hale Lauren 
Published: May 2023

Abstract

Introduction
Adolescents often obtain short sleep duration, which has been linked to poor grades and greater behavioral issues at school. There is limited research on the association between other dimensions of sleep and school-related outcomes, and few studies use objective measures of sleep. The current study examined associations of multiple actigraphic sleep dimensions with school-related outcomes among adolescents.

Methods
Data were collected from a sub-study of the age 15 wave of the Fragile Families and Child Wellbeing Study (N=774-782 depending on the outcome), a national sample of diverse teens. Adolescents wore a wrist-actigraphy device for approximately one week (mean=6.6 nights) and completed a survey reporting current grades and current or past problems at school. Separate linear and logistic regression models assessed whether actigraphic sleep duration, timing, maintenance efficiency, variability (SD) in duration and timing, and sleep regularity index (SRI) were associated with grades and behavioral issues at school. Analyses adjusted for demographic and household characteristics, depressive symptoms, and anxious symptoms.

Results
Greater variability in sleep onset was associated with higher odds of receiving a D or F in any course (OR=1.29, p=.040) and of ever failing a course (OR=1.26, p=.038). Later sleep onset (β=−.07, p=.029) and offset (β=−.08, p=.014) and greater variability in sleep duration (β=−.07, p=.035) were associated with fewer A grades. Later sleep offset was also associated with lower average GPA (β=−.07, p=.033). Later sleep onset (OR=.91, p=.049) and offset (OR=.91, p=.035) and greater variability in sleep offset (OR=.83, p=.029) were associated with lower odds of ever taking an honors course. Later sleep offset (OR=1.11, p=.034) and greater variability in sleep duration (OR=1.31, p=.012) and onset (OR=1.42, p=.004) were associated with higher odds of ever being suspended or expelled in the past two years. Greater variability in sleep duration was associated with greater behavioral problems in school (β=.13, p&lt;.001). Sleep duration, maintenance efficiency, and SRI were not associated with school-related outcomes (p≥.05).

Conclusion
Later sleep timing and greater sleep variability are risk factors for school-related problems among adolescents. Promoting earlier sleep timing and reducing sleep variability across the week may improve academic and behavioral outcomes among adolescents in school.

Support (if any)
R01HD073352
0104 Greater sleep regularity among adolescents predicts less daytime video game playing
Authors: Reichenberger David , Master Lindsay , Mathew Gina , Russell Michael , Buxton Orfeu , Hale Lauren , Chang Anne-Marie 
Published: May 2023

Abstract

Introduction
Daytime video game playing is a sedentary behavior that has been associated with worse adolescent health outcomes, including obesity, mood disorders, and poor sleep. However, few studies have explored the influence of sleep on time spent engaged in screen-based activities. This is the first study to examine whether sleep regularity, a measure that encapsulates within-person sleep timing, duration, and disruption across successive days of actigraphy, is associated with daytime video gaming among adolescents.

Methods
We analyzed sleep sub-study data from the age 15 wave of the Fragile Families and Child Wellbeing Study (n=314 adolescents, 15.4±0.5 years old). Adolescents wore wrist actigraphy devices and concurrently completed daily surveys reporting how many hours they played video games. The sleep regularity index (SRI) was calculated as the percentage probability of an individual being in the same sleep/wake state at any two times 24 hours apart across seven consecutive days of valid actigraphy (range 0-100). Multilevel Poisson models with random intercepts for daily video gaming adjusted for school days, sex, ethnoracial group, bedtime routines, parent education, family poverty, and family structure. The stability of the association between SRI and video gaming was additionally tested using the first two to six consecutive days of actigraphy.

Results
Every 10 units increase in SRI was associated with 9% fewer daily hours of video gaming on average (OR=0.91, CI=0.84, 0.998, p=0.046). Findings were consistent when SRI was calculated using the first four or more consecutive days of actigraphy (8-10%, p≤0.043), and the association was nonsignificant when using the first two or three days.

Conclusion
Adolescents who had greater sleep regularity tended to spend less time playing video games. Future research should consider interventions that target the consistency of sleep patterns across the week. Improving the regularity of sleep timing and duration may reduce video game playing and confer positive downstream effects on adolescent health.

Support (if any)
R01HD073352, R01HD36916, R01HD39135, R01HD40421, T32DA017629
0105 INSIGHT Study associations between sleep health and child behavior at age 6 years
Authors: Dadzie Adwoa , Master Lindsay , Hohman Emily , Hernandez Erika , Tauriello Sara , Paul Ian , Savage Jennifer , Anzman-Frasca Stephanie , Buxton Orfeu 
Published: May 2023

Abstract

Introduction
Sub-optimal sleep duration, quality and timing are associated with the presence of disruptive behaviors in childhood. Previous studies have largely utilized parent-/teacher-report of children’s behaviors and focused on mean sleep duration and quality measures, ignoring sleep variability. This analysis uses actigraphy and standardized laboratory behavioral tasks to examine the associations of average levels and variability (SD) of sleep duration, timing, and quality with child behavior.

Methods
The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) Study randomized families with firstborn newborns to a responsive parenting intervention or a safety control shortly after delivery. At age 6 years, children wore a wrist actigraphy device (Spectrum Plus) for 7 days to measure sleep and completed frustration (Transparent Box) and parent-child interaction (Picture Frame) tasks. Tasks were recorded and coded using global behavioral coding schemes; inter-rater reliability was sufficient (Transparent Box ICCs=.83-.97; Picture Frame=.83-1). Children with data on sleep (≥3 valid days) and both behavioral tasks were included in this secondary data analysis (n=143). Separate linear regression models examined associations between 10 sleep variables (M/SD of onset, offset, and midpoint of sleep timing, sleep maintenance efficiency, and total sleep time) and 4 behavioral variables (Transparent Box: emotion regulation, impulsivity; Picture Frame: prosocial and antisocial behavior). Models controlled for child sex and age, household income, and study group.

Results
Children were aged 6.7 ± 0.3 years and predominantly White, non-Hispanic (95%). Sleep onset (timing) variability was positively associated with impulsivity (B=.85, p=.004) and negatively associated with emotion regulation (B=-.65, p=.01). Sleep midpoint (timing) variability was positively associated with impulsivity (B=.80, p=.03). Mean sleep timing, sleep duration, and sleep maintenance efficiency were not associated with any of the behavioral variables.

Conclusion
The regularity of sleep timing (onset and midpoint) at age 6 had a greater role in behavioral and emotional regulation than duration and quality of sleep. These findings support existing literature that highlight the importance of parents implementing consistent routines (e.g., consistent bedtime) and how such routines play a key role in socioemotional outcomes among children.

Support (if any)
R01DK088244
0111 Wearable-based Measures of Sleep Across the Menstrual Cycle in Healthy Women in the Reproductive Stage and Early Menopause
Authors: Alzueta Elisabet , Gombert Marie , Camacho Leticia , Perez-Amparan Evelyn , Yuksel Dilara , de Zambotti Massimiliano , Simon Katharine , Sattari Negin , Zhang Jing , Shuster Alessandra , Pena Andres , Mednick Sara , Baker Fiona C 
Published: May 2023

Abstract

Introduction
Sleep is an essential part of women’s health and well-being. Hormonal fluctuations that occur across the menstrual cycle or when approaching menopause might affect sleep quality. Most studies rely on self-reported data, or laboratory measures in small samples, to examine changes in sleep across the menstrual cycle. Here, we investigated sleep quality, as measured continuously with a wearable device, across the menstrual cycle in different reproductive stages (reproductive, menopausal transition).

Methods
56 women participated, with 31 in the reproductive stage (age: 24.65 +/- 6.09 years) and 25 in the early menopausal transition (47.36 +/- 2.78 years). Participants were healthy, without sleep disorders, and free of premenstrual and mood complaints, as well as not using hormonal contraceptives. Sleep was tracked with the Oura ring across an entire menstrual cycle – confirmed as ovulatory using ovulation tests. Participants also completed a sleep diary each morning, rating sleep quality and how refreshed they felt. Measures were averaged for four phases: menses, ovulation, mid-luteal, late-luteal. Participants were assessed for mood symptoms (DASS-21) once during each of these phases.

Results
Objective measures of sleep quality (Total Sleep Time, Efficiency, and Wake After Sleep Onset) did not change across the menstrual cycle in either group or differ between groups. Similarly, self-reported sleep and mood symptoms remained stable across the menstrual cycle, although women in the menopausal transition reported poorer sleep quality and felt less refreshed than reproductive stage women, overall. Physiological measures (Temperature, Heart Rate, and Heart Rate Variability) during sleep reflected the well-known fluctuations across the menstrual cycle (e.g., increased temperature in the luteal phase vs. menses) in both groups of women.

Conclusion
Objective, wearable-derived measures indicate sleep quality remains stable across the menstrual cycle during reproductive and early-menopausal transition stages, at least in healthy women without mood or premenstrual complaints. While women in the menopausal transition reported a poorer sleep quality, there was no difference in objective sleep continuity measures between groups. Future studies are needed to better understand sleep across the reproductive lifespan, considering cycle-related (e.g., premenstrual syndrome) and other factors that could make some women sensitive to menstrual cycle effects on sleep.

Support (if any)
NIH, RF1AG061355 (BAKER/MEDNICK)
0113 Data-Driven Mathematical Modeling of Sleep Consolidation in Early Childhood
Authors: Stowe Shelby , Athanasouli Christina , LeBourgeois Monique , Booth Victoria , Behn Cecilia Diniz 
Published: May 2023

Abstract

Introduction
During early childhood, sleep behavior transitions from a biphasic pattern (daytime nap and nighttime sleep) to a monophasic pattern (nighttime sleep only). The transition to consolidated sleep, occurring in most children between 2- and 5-years old, is a major developmental milestone and reflects interactions between the homeostatic sleep drive and the circadian drive. This study aimed to utilize experimental data and mathematical modeling to determine the contributions of developmentally-mediated changes in the homeostatic sleep drive to the consolidation of sleep observed in early childhood.

Methods
Using extant, de-identified longitudinal data from 2.5 – 5.9 year-old children (n=36) and a physiologically-based mathematical model of sleep-wake regulation, we simulate sleep-wake behavior consistent with average 2-year-old napping and 5-year-old non-napping sleep patterns. We vary four homeostatic dynamic parameters between experimentally estimated 2- and 5-year-old values, constraining their variation to follow the trends of the 2-, 3-, and 5-year-old data estimates. We quantify the progression to consolidated sleep including how and at what ages the sleep pattern changes (i.e., bifurcation analysis). Using the range of experimental estimates of the dynamic parameters and varying sensitivity to homeostatic pressure, we investigate interindividual variability in the transition from habitually napping to non-napping. Finally, we analyze how light exposure patterns may impact a child’s transition from habitually napping to non-napping.

Results
We find that the data-driven variation of homeostatic parameters results in a transition from biphasic to monophasic sleep. Through variation of the homeostatic parameters’ developmental trajectories, we establish that the developmental trajectories influence the timing and duration of the transition from biphasic to monophasic sleep, as well as the predicted sleep patterns occurring during the transition.

Conclusion
We found that the slower homeostatic dynamics estimated in older children contributed to decreased sleep need, lower napping propensity, and shorter sleep durations. We also found that the lower sensitivity to the homeostatic drive was associated with decreased sleep need, shorter sleep durations, and transitions to consolidated sleep at earlier ages. In certain cases, a nap opportunity with dim light exposure promoted an earlier transition to monophasic sleep.

Support (if any)
NIHM R01-MH086566, NSF DMS 1853506 and DMS 1853511
0115 Psychometric evaluation of the Chinese version of Sleep Health Index in pregnant women
Authors: Wang Yueying , Yuan Jinjin , Lin Qin , Wang Jinle , Li Hong , Zhu Bingqian 
Published: May 2023

Abstract

Introduction
The aim of this study was to investigate the psychometric properties of the Chinese version of the Sleep Health Index (SHI-C) among pregnant women.

Methods
This study used a cross-sectional design. Pregnant women (N=264) from three public hospitals in China were recruited through a convenience sampling method. The Sleep Health Index (SHI-C) was used to measure sleep health. The Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) were used to measure sleep quality and insomnia, respectively. Epworth Sleepiness Scale (ESS), Fatigue Assessment Scale (FAS), and Edinburgh Postnatal Depression Scale (EPDS) were used to measure daytime sleepiness, fatigue, and depression, respectively. Structural validity was assessed via confirmatory factor analysis (CFA). Concurrent and convergent validity were assessed using bivariate correlation analyses. Known-group validity was assessed by comparing the SHI-C score between different groups. Cronbach’s α was calculated for reliability.

Results
The sample was 30.6 years on average. CFA confirmed the three-factor structure of SHI-C. The SHI-C total and sleep quality sub-index scores had moderate to strong correlations with both PSQI (r=-0.542, p&lt; 0.01; r=-0.648, p&lt; 0.01) and ISI (r=-0.692, p&lt; 0.01; r=-0.752, p&lt; 0.01). The SHI-C total and sleep quality sub-index scores were significantly associated with ESS, FAS, and EPDS (r=-0.171 to -0.276; p&lt; 0.01). The SHI-C total score also differed based on work status (p&lt; 0.01), trimester (p&lt; 0.01), coffee intake (p&lt; 0.05), taking a nap (p&lt; 0.05), subclinical insomnia (p&lt; 0.01), and poor sleep quality (p&lt; 0.01). The Cronbach’s α of the SHI-C total and the sleep quality sub-index were 0.723 and 0.806, respectively. The Cronbach's α of sleep duration and disordered sleep sub-indices were 0.594 and 0.545, respectively.

Conclusion
Overall, the SHI-C has good validity and acceptable reliability among the pregnant population in China. It can be a useful tool for the assessment of sleep health. More research is warranted to refine the sleep duration and disordered sleep sub-indices.

Support (if any)
This work was supported in part by the National Natural Science Foundation of China [71904119], and Innovation Research Team of High-Level Local Universities in Shanghai [SHSMU-ZDCX20212800]. Bingqian Zhu was supported by Shanghai Municipal Education Commission “Young Eastern Scholar” (China).
0117 Association between Mother-Child Sleep-Wake Rhythm Synchrony and Maternal Emotional Health
Authors: Rodheim Katrina , St. Laurent Christine , Holmes Jennifer , Hoyniak Caroline , Spencer Rebecca 
Published: May 2023

Abstract

Introduction
Synchrony between mother and infant sleep-wake rhythms is positively associated with attachment and maternal mental health. Chronotype is a measure of one’s circadian rhythm which influences sleep timing and other physiological processes. Whether synchrony of mother-child chronotype is similarly associated with maternal mental health into early childhood, when children’s behavior is less dependent on the mother, is unknown. Thus, we examined the relation between mother-child chronotype synchrony and mother’s emotional health.

Methods
106 healthy preschool-aged children (50.78±9.54 months) and mothers (34±8.7 years) were included in this secondary analysis. Wrist-worn actigraphy (range 3-16 days) was used to assess sleep duration and sleep midpoint. The Munich Chronotype Questionnaire was used to calculate midpoint of overnight sleep on free days (MSFsc) which was corrected for sleep debt on workdays. Dyad synchrony was calculated as a phase angle (phase difference) between mothers’ MSFsc and children’s MSFsc. Maternal emotional health was measured with the Center for Epidemiologic Studies Depression Scale (CESD).

Results
Linear regression (adjusted for the child’s age, sex, Peabody Picture Vocabulary Test score, and maternal socioeconomic status, employment status, and shiftwork) indicated no significant association between dyad synchrony and mothers’ emotional health (p=0.33). However, a median split on mothers’ emotional health scores (CESD) supports that children’s MSFsc is later (i.e. later chronotype) in mothers with more depression symptoms (p&lt;.01).

Conclusion
The present results provide tentative support for the hypothesis that earlier child chronotype is associated with better maternal mental health even into early childhood. Future research needs to be done to elucidate whether mothers whose sleep is not aligned with their child’s primary sleep bout may experience less attachment and more negative interactions with their child leading to worse mental health. Further analyses will consider additional measures of synchrony that incorporate more than just the alignment of sleep midpoint. These findings may point to a possible source of poor maternal mental health which can be targeted in future research.

Support (if any)
NIH R01 HL111695
0119 Characterizing Sleep Patterns Among School-Age Children in Accra, Ghana
Authors: Holmes Jennifer , Kyeremateng Kate , Nimo James , Hughes Allison , Spencer Rebecca , Arku Raphael 
Published: May 2023

Abstract

Introduction
Sleep habits among school-age children in North American and European countries is well-documented and most health recommendations are based on those data. What is woefully lacking in the literature is objective sleep data from the Global South, particularly from sub-Saharan African countries. Lack of data in this population represents a major gap in our knowledge and a barrier to the establishment of guidelines for healthy sleep for all children. Here, we begin to broaden the view of child sleep by characterizing sleep and chronotypes of school-age children in Accra, Ghana.

Methods
Children (N=34; Mage=10.03, range:9-13 years; 51.5% female) wore actigraph watches for two weeks (M=11 nights). Additionally, children and their caregivers completed surveys pertaining to demographics, sleep habits, and household environment. Chronotype was assessed using the Children’s Chronotype Questionnaire. Daytime drowsiness was assessed using the Sleep Behavior Questionnaire.

Results
Children’s average sleep duration was 519.5±66.9mins. Average sleep onset was 21:02(± 49.7mins) and average wake onset was 5:46(± 47.5mins). Sleep duration was longer on weekends (M=536.9mins) vs. weekdays (M=506.8mins; p=.001). Sleep onset was similar across all days, while wake onset was significantly later on weekends (6:07) vs. weekdays (5:29; p&lt;.001). Only 21.6% of children obtained adequate sleep for their age (9-11hrs) according to WHO recommendations, yet none reported high levels of daytime drowsiness (M score=9.93, range: 5-16; possible range: 5-25). Sleep/wake onset were both earlier than averages found in prior research with similar-aged children, with only 8.8% falling asleep later than 22:00. Variability in sleep midpoint (SD) was low (M=34mins), with 11.7% of children experiencing sleep timing that varied &gt;60 mins on average. For chronotype, children were primarily morning types (n=24, 70.6%).

Conclusion
While many children in this sample did not meet WHO recommendations for sleep duration, their sleep timing was earlier than other reports and with low night-to-night variability. This may be related to the consistency in day length in Ghana which may support their overall sleep quality. Future directions will explore impact of daylight exposure and other environmental factors (air/noise pollution) on children’s sleep, along with continued data collection from more diverse SES neighborhoods in Accra.

Support (if any)
National Geographic Society Exploratory Grant [NGS-64242R-19]