Prevalence and Correlates of Self-Reported Sleep Difficulty Among Older Persons in the Slums of Kampala, Uganda

Objective/Background Self-reported sleep difficulties, such as insomnia symptoms, have been reported among adolescents. Yet, studies of their prevalence and correlates are scarce among Latin Americans. This study sought (1) to describe associations between sociodemographic and lifestyle factors with self-reported sleep difficulties and (2) to examine associations between self-reported sleep difficulties and actigraphy-based sleep. Participants Participants included 477 Mexican adolescents from the ELEMENT cohort. Methods Over 7 days, self-reported sleep measures (hard time falling asleep, overall sleep difficulties, and specific types of sleep difficulties) were obtained from daily sleep diaries. Actigraphy-based sleep measures (duration, i.e. sleep onset to morning wake, midpoint, and fragmentation) were concurrently assessed using a wrist actigraph. Results Mean (SD) age was 15.9 (2.2) years, and 53.5% were females. Mean (SD) sleep duration was 8.5 (1.2) h/night. Half reported a hard time falling asleep at least 3 days, and 25% had sleep difficulties at least 3 days over 7 days. The 3 types of sleep difficulties commonly reported among the entire cohort were insomnia/restlessness (29%), environmental (27%), and mental/emotional difficulties (19%). Female sex, smoking behavior, and socioeconomic indicators were among the most consistent factors associated with sleep difficulties. Subjective sleep difficulties were associated with shorter sleep duration (β = −20.8 [−35.3, −6.2] min), while subjective hard time falling asleep was associated with longer sleep duration (β = 11.3 [4.6, 27.2] min). Conclusion A high proportion of Mexican adolescents in the sample reported sleep difficulties. Findings demonstrate the importance of obtaining subjective and objective sleep measures for a more comprehensive assessment of adolescent sleep.

To evaluate the impact of contextual stressors on postpartum sleep among Black mothers. This prospective observational study examined associations of racial discrimination and financial strain (measured at 1 week postpartum) with self-reported maternal sleep difficulties at 1, 8, and 16 weeks postpartum and actigraph-estimated maternal sleep at 8 weeks postpartum. Mothers (N = 212) were Black/African American (100%) and non-Hispanic (98.6%) and averaged 22.7 (SD = 4.5) years of age. Multivariate regression models found unique associations between racial discrimination and financial strain and mothers' postpartum sleep, even after controlling for covariates expected to predict mothers' sleep (including infant sleep). Specifically, past-year racial discrimination measured at 1 week postpartum was associated with poorer concurrent self-reported sleep (b = 1.24, p < .001) as well as greater actigraph-estimated night-to-night variability in total sleep time at 8 weeks postpartum (b = 12.89, p = .005). Financial strain reported at 1 week postpartum was prospectively associated with more self-reported sleep difficulties at 16 weeks postpartum (b = 0.52, p = .007) and with more actigraph-estimated sleep timing variability at 8 weeks postpartum (b = 9.77, p = .02). Experiences of racial discrimination and financial strain may negatively impact Black mothers' sleep in the postpartum period, beyond the effects of their infant's sleep. Sleep-Safe: A Strong African American Families Study (https://clinicaltrials.gov/study/NCT03505203, ClinicalTrials.gov ID: NCT03505203).

Research in the general population indicates that sleep fragmentation is detrimental for cognitive function, but little attention has been given to this issue in dialysis patients. We hypothesized that patients with self-reported persistent sleep difficulty would have an increased risk of scoring lower on a cognitive function measure at follow-up compared to their score at baseline. Sleep difficulty and cognitive function were reported by a large national patient cohort near the start of dialysis and at a 9- to 12-month follow-up. Logistic regression was used to investigate the risk of scoring lower on a cognitive function measure at follow-up as a function of self-reported sleep difficulty, controlling for patients' sociodemographic, clinical and treatment characteristics, including depressed mood. At follow-up, cognitive function scores were lower among 35.8% of the cohort. Patients with self-reported persistent sleep difficulty had the lowest average cognitive function score. Men with reported persistent sleep difficulty, regardless of presence of depressed mood, had a significantly increased risk of a lower cognitive function score at follow-up. Women with reported persistent sleep difficulty as well as depressed mood had significantly increased risk of a lower cognitive function score. The potential impact of sleep difficulty and depressed mood on the cognitive function of dialysis patients emphasizes the importance of evaluating and treating these risks and highlights the value of continued research to improve our understanding and management of these issues.

To advance understanding of the relationship between discrimination and sleep duration and difficulties, with consideration of multiple dimensions of discrimination, and attention to concurrent stressors; and to examine the contribution of discrimination and other stressors to racial/ ethnic differences in these outcomes. Cross-sectional probability sample. Chicago, IL. There were 2,983 black, Hispanic, and white adults. Outcomes included self-reported sleep duration and difficulties. Discrimination, including racial and nonracial everyday and major experiences of discrimination, workplace harassment and incivilities, and other stressors were assessed via questionnaire. In models adjusted for sociodemographic characteristics, greater exposure to racial (β = -0.14)) and nonracial (β = -0.08) everyday discrimination, major experiences of discrimination attributed to race/ethnicity (β = -0.17), and workplace harassment and incivilities (β = -0.14) were associated with shorter sleep (P < 0.05). The association between major experiences of discrimination attributed to race/ethnicity and sleep duration (β = -0.09, P < 0.05) was independent of concurrent stressors (i.e., acute events, childhood adversity, and financial, community, employment, and relationship stressors). Racial (β = 0.04) and non-racial (β = 0.05) everyday discrimination and racial (β = 0.04) and nonracial (β = 0.04) major experiences of discrimination, and workplace harassment and incivilities (β = 0.04) were also associated with more (log) sleep difficulties, and associations between racial and nonracial everyday discrimination and sleep difficulties remained after adjustment for other stressors (P < 0.05). Racial/ethnic differences in sleep duration and difficulties were not significant after adjustment for discrimination (P > 0.05). Discrimination was associated with shorter sleep and more sleep difficulties, independent of socioeconomic status and other stressors, and may account for some of the racial/ethnic differences in sleep.

The strong association between self-reported sleep difficulties and depressive symptoms is well documented. However, individuals who suffer from depressive symptoms could potentially interpret the values attached to a subjective scale differently from others, making comparisons of sleep difficulties across individuals with different depressive symptoms problematic. The objective of this study is to determine the existence and magnitude of reporting heterogeneity in subjective assessment of sleep difficulties by those who have depressive symptoms. We implement an online survey using Visual Analogue Scales and anchoring vignettes to study the comparability of subjective assessments of sleep difficulties among college students in Switzerland (N = 1, 813). Using multivariate linear regressions and double-index models, our analysis shows that reporting heterogeneity plays only a marginal role in moderating the association between sleep difficulties and depression, irrespective of the severity of the depressive symptoms of the individuals. This suggests that unadjusted comparisons of self-reported sleep difficulties between college students are meaningful, even among individuals with depressive symptoms.

The strong association between self-reported sleep difficulties and depressive symptoms is well documented. However, individuals who suffer from depressive symptoms could potentially interpret the values attached to a subjective scale differently from others, making comparisons of sleep difficulties across individuals with different depressive symptoms problematic. The objective of this study is to determine the existence and magnitude of reporting heterogeneity in subjective assessment of sleep difficulties by those who have depressive symptoms. We implement an online survey using Visual Analogue Scales and anchoring vignettes to study the comparability of subjective assessments of sleep difficulties among college students in Switzerland (N = 1, 813). Using multivariate linear regressions and double-index models, our analysis shows that reporting heterogeneity plays only a marginal role in moderating the association between sleep difficulties and depression, irrespective of the severity of the depressive symptoms of the individuals. This suggests that unadjusted comparisons of self-reported sleep difficulties between college students are meaningful, even among individuals with depressive symptoms.

Sugar-sweetened beverages and poor sleep quality in adults from resource-limited settings in Peru

Objective: While agreement between clients and their clinicians on therapy goals has frequently been investigated as a process-level variable (i.e., working alliance), dyadic convergence on presenting concerns is also important for initial case formulation. Transdiagnostic presenting problems, like sleep difficulty, pose a particular challenge for client-therapist convergence. The current study describes sleep difficulty in a treatment-seeking college population and investigates the impact of client and therapist baseline sleep problem reports on therapy outcomes. Method: Data were collected through a large practice research network, with the sample comprising 47,023 clients from 99 university counseling centers across the United States. Results: A larger proportion of clients (49.3%) had self-reported high baseline sleep difficulty than those with a clinician-identified sleep concern (16.0%). Clients with baseline sleep difficulty were more likely to end treatment with greater self-reported sleep difficulty and psychological symptom distress, although they may experience larger gross symptom change than clients without baseline sleep difficulty. Clinician-identified sleep concerns were significantly associated with client outcomes, particularly when clients did not report baseline sleep difficulty themselves. Conclusion: Findings from this study suggest that it may be efficacious and efficient with limited time for treatment to address sleep concerns in a college setting. Clinical or methodological significance of this article: Clinicians’ attendance to their clients’ transdiagnostic presenting concerns, like sleep difficulty, may increase clients’ own awareness of problematic patterns of behavior. When time for therapy is short, as is often the case in college counseling, it may be efficient to prioritize these concerns with the potential to impact a broad range of symptoms.

2211 – Are Lifetime Self-reported Health (srh), Sleep Difficulties, And Negative Affect Correlates Of Suicidal Ideation In Pregnancy And Postpartum?

Associations of self-reported sleep duration and sleep difficulties with cardiometabolic risk factors among U.S.-born and foreign-born black adults in the United States: NHANES 2005-2016

Chronic sleep difficulties in non-depressed young women: a longitudinal population-based investigation

Introduction Decreased energy and activity may be a mechanism linking poor sleep health and cardiometabolic risk. This study aimed to examine, at the national level, whether poor sleep quality was associated with more sedentary time (as opposed to less exercise, which has been difficult to establish). Methods Data from the 2017 - March 2020 National Health and Nutrition Examination Survey was used. A linear regression analysis was completed to assess the relationship between sedentary minutes and self-reported sleep difficulties. These were assessed by self-report of difficulty “falling asleep, staying asleep, or sleeping too much” over the past 2 weeks, with options for “never,” “less than half the days,” “more than half the days” and “almost always.” Covariates included sex, age, race/ethnicity, education level, and relationship status. Results are unweighted; weighted results are forthcoming. Results All groups experiencing self-reported sleep difficulties demonstrated increased sedentary minutes when compared to those that do not experience sleep difficulties. More specifically, unadjusted results show 21.5 more sedentary minutes (B: 21.5, [95%CI:10.8,32.2], p&amp;lt;0.001) for those that have sleep problems several days a week, 21.8 more sedentary minutes (B:21.8, [95%CI:4.90,38.7], p&amp;lt;0.001) for those that have sleep difficulties more than half the days in a week, and 42.3 minutes (B: 42.3, [95%CI:26.8,57.8], p&amp;lt;0.001) for those that have sleep difficulties nearly every day during the week. Once adjusted for covariates, results showed 17.6 more sedentary minutes (B:17.6, [95%CI:6.76,28.3], p&amp;lt;0.001) for those that have sleep difficulties several days a week, 18.3 more minutes (B:18.3, [95%CI:1.45,35.1], p&amp;lt;0.001) for those that have sleep difficulties more than half the days in a week, and 48.4 more sedentary minutes (B:48.4, [95%CI:32.8,63.9], p&amp;lt;0.001) for those that have sleep difficulties nearly every day during the week. Conclusion Those with general sleep difficulties were more likely to report more sedentary minutes per day. Although previous efforts have focused on improving physical activity directly, perhaps future efforts could target sleep health as a way to reduce sedentary behavior. Support (If Any)

Sleep deprivation is a common phenomenon among older population and is commonly linked to behavioral, physiological, and psychosocial factors. Not much is known about sleep deprivation among older population in Africa. Therefore, in this study we aimed to investigate the basic sociodemographic and psychosocial predictors of self-reported sleep deprivation among older population.In this study we analyzed cross-sectional data on 1495 community dwelling men and women aged 50 years and above. Data were collected from the SAGE Well-Being of Older People Study conducted in South Africa and Uganda. Outcome variable was self-reported sleep difficulty last 30 days. Multivariable logistic regression models were used to identify the variables significantly associated with sleep difficulty.The prevalence of mild-moderate sleep difficulty was 32.6% (27.9, 37.6) and severe/extreme 23.0% (20.3, 26.0) respectively. Multivariable analysis revealed that sleep difficulty was associated with several behavioral, environment, and illness conditions. In South Africa, those who reported dissatisfaction with living condition had 1.592 [1.087, 2.787] times higher odds of reporting mild/moderate sleep difficulty. Poor subjective quality of life (QoL) was associated with higher odds of severe/extreme sleep difficulties (odds ratios [OR] = 4.590, 95% confidence interval [CI] = 2.641, 7.977 for South Africa, and OR = 4.461, 95% CI = 2.048 and 9.716 for Uganda). In Uganda, perceived depression was associated with higher odds of severe/extreme (OR = 2.452, 95% CI = 1.073, 5.602) sleep difficulties among men, and both mild/moderate (OR = 1.717; 95% CI = 1.011, 2.914) and severe/extreme sleep difficulties among women (OR = 2.504, 95% CI = 1.408, 4.453).More than half of the participants had sleep difficulty of certain degrees, emphasising an urgent need for intervention for sleep deprivation in the population. Interventions targeting to promote subjective health, quality of life, and living environment may prove beneficial for improving sleep health in this regard.

Do individual differences in state and trait anxiety predict sleep difficulties in healthy older adults?

To examine the association between discrimination and sleep duration and difficulty among Asians and Pacific Islanders (APIs) in the United States, and to test nativity and ethnic identity (EI) as effect modifiers. This cross-sectional study of 1,765 adults from the National Epidemiology Study of Alcohol and Related Conditions III, assessed discrimination using the Experiences of Discrimination scale. Discrimimation was classified as low, moderate, and high. Regression models were used to examine self-reported sleep duration and difficulty. In bivariate analyses, individuals with high discrimination had the shortest sleep and reported sleep difficulty most often. Using linear models adjusted for sociodemographic and health characteristics, moderate and high discrimination were associated with 9 min (standard error [SE]: 4.8, p < .10) and 14.4 min (SE: 6.0, p < .05) less sleep, respectively, relative to low discrimination. Individuals with moderate and high discrimination had higher prevalence of sleep difficulty compared to those with low discrimination (prevalence ratio [PR]: 1.51, 95% confidence interval [CI]: 1.14-1.99 and PR: 1.73, 95% CI: 1.33-2.24, respectively). Interaction effect was observed in sleep difficulty by nativity and EI, but not duration. The association between discrimination and sleep difficulty was stronger among U.S.-born relative to foreign-born participants. Among participants with low EI, moderate and high discrimination were associated with sleep difficulty, whereas among those with high EI, only high discrimination displayed this association. Discrimination is associated with sleep duration and difficulty, and varies by nativity and EI. Research is needed to improve sleep among APIs that experience discrimination.