Bedtime Use Research Articles

Childhood sleep is prospectively associated with adolescent alcohol and marijuana use

IntroductionPrior studies have examined the cross-sectional relationship between adolescent sleep and substance use; however, fewer have explored the long-term connections between childhood sleep and adolescent substance use. MethodsThis study investigated both cross-sectional associations during adolescence and prospective associations between childhood weeknight sleep and later alcohol and marijuana use in the Future of Families and Child Wellbeing Study, a diverse national birth cohort of urban children from 20 cities with populations greater than 200,000. Parents reported their child’s bedtime at ages 3, 5, and 9 and their child’s sleep duration at ages 5 and 9. ResultsAt age 15, adolescents self-reported their bedtime, sleep duration, and alcohol and marijuana use (n = 1514). Logistic regression analyses for each substance use outcome at age 15 were adjusted for sex, age at time of assessment, race/ethnicity, income-relative-to-poverty threshold, family structure, and caregiver education level. At age 15, later bedtime (AOR=1.39; 95 % CI=1.22, 1.57) and shorter sleep duration (AOR=1.28; 95 % CI=1.14, 1.43) were associated with greater odds of consuming a full drink of alcohol more than once, and later bedtime was associated with greater odds of trying marijuana (AOR=1.35; 95 % CI=1.20, 1.51). Unexpectedly, later bedtimes at age 3 were associated with lower odds of drinking alcohol by age 15 (AOR=0.74; 95 % CI=0.59, 0.92). In contrast, later bedtimes at age 9 were associated with greater odds of drinking alcohol (AOR=1.45; 95 % CI=1.11, 1.90). Additionally, later bedtime at age 5 (AOR=1.26; 95 % CI=1.01, 1.58) and shorter sleep duration at age 9 (AOR=1.19; 95 % CI=1.04, 1.36) were associated with greater odds of trying marijuana. Conclusion: Taken together, these associations support the importance of protecting childhood sleep habits to reduce the likelihood of substance use starting as early as mid-adolescence. Implications and contributionIn this longitudinal cohort study, adolescents were more likely to have consumed alcohol or tried marijuana by age 15 if they had later bedtimes and shorter sleep duration during childhood and adolescence. Protecting sleep health throughout childhood may reduce the likelihood of substance use during early adolescence.

Associations between Shokuiku during School Years, Well-Balanced Diets, and Eating and Lifestyle Behaviours in Japanese Females Enrolled in a University Registered Dietitian Course.

This study comprehensively examined the associations between shokuiku (food and nutrition education) during school years, current well-balanced diets, and current eating and lifestyle behaviours of Japanese female university students. A hypothetical model was developed using factors potentially associated with well-balanced diets. A simultaneous multipopulational analysis was performed according to the living arrangements of 148 female Japanese students (48.6% living alone) from a registered dietitian course. The analysis showed acceptable goodness of fit and a significant positive path from shokuiku during school years (living alone: standardised estimate 0.29, p = 0.004; with family: 0.32, p = 0.006) and a negative path from eating out frequency (-0.19, p = 0.039; -0.24, p = 0.017) towards a well-balanced diet. A significant negative path was identified from late bedtimes (-0.45, p < 0.001) and home meal replacement use frequency (-0.24, p = 0.010) in those living alone and from late-night snacking frequency (-0.27, p = 0.007) in those living with family. Well-balanced diets in female university students may be positively associated with shokuiku during school years and limited by a late bedtime, eating out, and home meal replacement use in those living alone, and by late-night snacking and eating out in those living with family.

Abstract 16765: Association of Evening or Bedtime Dosing of Antihypertensive Medications With Nighttime Blood Pressure and Cardiovascular Prognoses

Introduction: Previous studies suggested that bedtime use of antihypertensive medications does not improve cardiovascular outcomes. However, there is a few studies reporting the association of bedtime dosing of antihypertensives with nighttime blood pressure (BP) and cardiovascular prognoses. Hypothesis: Evening/bedtime dosing of antihypertensives may improve cardiovascular outcomes through reductions in nocturnal BP. Methods: We used the dataset of nationwide prospective, the Japan Ambulatory Blood Pressure Monitoring Prospective (JAMP) study to assess the association of evening/bedtime dosing with nighttime BP and cardiovascular prognoses. Among whole 6,359 participants underwent 24h ambulatory BP monitoring, participants with pre-history of cardiovascular disease and not use antihypertensives were excluded in this analysis. Evening or bedtime and two occasions (morning and evening/bedtime) use of antihypertensives were defined as the group of evening/bedtime dosing. Results: Among 4,085 participants (69.1 years and 45% of male), there was no difference between the group of evening/bedtime and morning/others dosing in 24h systolic BP (SBP) (132.9±14.2 vs. 132.0±14.0, p=0.086). Nighttime SBP was higher in evening/bedtime dosing (123.1±17.5 vs. 121.4±16.8, p=0.004). During the median 4.9-years followed-up, 150 cardiovascular events (coronary artery disease, stroke, heart failure) occurred. The evening/bedtime dosing was not associated with cardiovascular events risk adjusted by 24h ambulatory BP (adjusted HR [95%CI], 1.11 [0.78-1.57]) or nighttime BP (Figure). In stratified analysis of participants with or without nocturnal hypertension (nighttime SBP≥120 mmHg or diastolic BP≥70 mmHg), evening/bedtime dosing was also not associated with cardiovascular outcomes. Conclusions: Our study suggested that evening/bedtime dosing of antihypertensives did not give benefit for nighttime BP control and cardiovascular prognoses.

Bedtime versus morning use of antihypertensives in frail continuing care residents (BedMed-Frail): protocol for a prospective, randomised, open-label, blinded end-point pragmatic trial

IntroductionBedMed-Frail explores risks and benefits of switching antihypertensives from morning to bedtime in a frail population at greater risk of hypotensive adverse effects.Methods and analysisDesign: Prospective parallel randomised, open-label, blinded...

Tolerability of bedtime diuretics: a prospective cohort analysis

ObjectivesWe sought to validate, or refute, the common belief that bedtime diuretics are poorly tolerated due to nocturia.DesignPrespecified prospective cohort analysis embedded within the randomised BedMed trial, in which hypertensive...

Assessment of Oxidative Stress Markers in Hypertensive Patients under the Use of Renin-Angiotensin-Aldosterone Blockers.

As in other fields, chronotherapy applied to arterial hypertension (AHT) may have implications on oxidative stress. We compared the levels of some redox markers between hypertensive patients with morning and bedtime use of renin-angiotensin-aldosterone system (RAAS) blockers. This was an observational study that included patients older than 18 years with a diagnosis of essential AHT. Blood pressure (BP) figures were measured using twenty-four-hour ambulatory BP monitoring (24-h ABPM). Lipid peroxidation and protein oxidation were assessed using the thiobarbituric acid reactive substances (TBARS) and reduced thiols assays. We recruited 70 patients with a median age of 54 years, of whom 38 (54%) were women. In hypertensive patients with bedtime use of RAAS blockers, reduced thiol levels showed a positive correlation with nocturnal diastolic BP decrease. TBARS levels were associated with bedtime use of RAAS blockers in dipper and non-dipper hypertensive patients. In non-dipper patients, bedtime use of RAAS blockers was also associated with a decrease in nocturnal diastolic BP. Chronotherapy applied to bedtime use of some BP-lowering drugs in hypertensive patients may be linked to a better redox profile.

Early childhood caries- Etiology, prevention and management: A Review

Early Childhood Caries (ECC) is a severe debilitating disease affecting the primary dentition of young children in both developing and industrialized countries. Historically, the management of ECC has a global scenario showing operative management of the disease. The contemporary method of preventing the carious process mainly focuses on dietary factors, host factors and removal of plaque biofilm. Enamel demineralization is caused by acidogenic and aciduric bacteria. Colonization of microorganisms in the mouth of children can occur via horizontal or vertical transmission or both. The bacteria present in dental plaque metabolize sugars and starches to produce acids, which lowers the pH in the mouth and promotes loss of minerals from the tooth surface. Sucrose is the most common sugar and when metabolized, produces dextrans which promote superior bacterial adhesion to teeth. Visible plaque on the labial surfaces of the maxillary incisors were strongly associated with the caries development. Saliva buffers plaque acids, aids in oral clearance and acts as a reservoir for minerals to assist in the mineralization of enamel. Most studies have put forward a correlation between bed time use of bottles with sweetened contents especially lactose. One of the factors included by Newbrun in factors causing dental caries is time. The CPP-ACP complex, an effective remineralizing complex preventing the acidic environment reduce incidence of caries. Conventional probiotics comprised of lactobacilli and bifidobacterium which were mainly of intestinal origin; the contemporary probiotic research has brought forward that oral diseases like dental caries, periodontal problems and candida infections have direct link with oral microbial disequilibria. A promising new approach towards primary prevention of the disease is to target the infectious component of Early Childhood Caries by preventing or delaying acquisition of Streptococcus mutans at an early age.

P078 Effects of Shokuiku and Current Eating and Lifestyle Behaviors on Well-Balanced Dietary Habits in Japanese University Students

<h3>Background</h3> School-aged Japanese children receive shokuiku (food and nutrition education) to encourage them to eat well-balanced diets [cereal grains (shushoku), proteins (shusai), vegetables (fukusai)]. However, few young adults regularly eat well-balanced diets. <h3>Objective</h3> To examine the causal structure of the effects of school shokuiku on young adults' dietary habits and the association of current eating and lifestyle behaviors. <h3>Study Design, Setting, and Participants</h3> The subjects were 148 female university students (48.6% living alone) among 161 who completed a 2020 self-administered questionnaire (99.4% response rate) in a cross-sectional study of first- to fourth-year nutrition course students in Hyogo Prefecture. <h3>Outcome Measures and Analysis</h3> A hypothetical model was developed using factors potentially associated with well-balanced dietary habits (twice daily or more), including school shokuiku (three variables: past conversation about dietary balance consisting of the "three food groups"; major nutrients; and importance of breakfast) and current eating and lifestyle behaviors as limiting factors. A covariance structure analysis was performed by living arrangement (living alone or with family). <h3>Results</h3> Simultaneous multi-population analysis by living arrangement showed acceptable goodness of fit (GFI = 0.918, AGFI = 0.852, CFI = 0.966, RMSEA = 0.040, AIC = 113.168) and a significant positive path from school shokuiku (living alone: standardized estimate 0.29, <i>P</i> = 0.004; with family: 0.32, <i>P</i> = 0.006) and a negative path from eating-out frequency (–0.19, <i>P</i> = 0.039; –0.24, <i>P</i> = 0.017) toward well-balanced dietary habits. A significant negative path was identified from bedtime (–0.45, <i>P</i> < 0.001) and home-meal replacement (ready-to-eat foods) frequency (–0.24, <i>P</i> = 0.010) in those living alone, and from late-night snacking frequency (–0.27, <i>P</i> = 0.007) if living with family. <h3>Conclusions</h3> Well-balanced dietary habits in female university students may be positively affected by school shokuiku and limited by late bedtime and home-meal replacement use if living alone and late-night snacking if living with family, plus by eating out. <h3>Funding</h3> None

Meeting families where they sleep: a collaborative approach to improving sleep health for urban children.

Meeting families where they sleep: a collaborative approach to improving sleep health for urban children.

Bedtime versus morning use of antihypertensives for cardiovascular risk reduction (BedMed): protocol for a prospective, randomised, open-label, blinded end-point pragmatic trial

IntroductionSleep-time blood pressure correlates more strongly with adverse cardiovascular events than does daytime blood pressure. The BedMed trial evaluates whether bedtime antihypertensive administration, as compared with conventional morning use, reduces...

Association between Sleep Duration, Use of Electronic Devices and Obesity in Medical Students

Background: With the advancement in technology and use of multiple electronic devices and decreasing duration of sleep, adolescents are more prone to obesity, i.e., increased BMI (body mass index). Objectives: The objectives of the study were to determine the association between sleep duration, use of electronic devices, and obesity in medical students. Methods: Medical students between the age groups 17-22 years were recruited. The study design was cross-sectional. The main study variables were the type and duration of use of various electronic devices during daytime and bedtime. The independent variable used in the study was the subjects' self-reported average number of hours of sleep obtained per night based on the questionnaire. To calculate the BMI, height and weight were obtained. Results: There is a significant association between short sleep duration and prolonged use of electronic devices. (p<0.01) Those who engaged in electronic devices for a longer period had significantly higher BMI (obesity) p < 0.001. Maximum use of mobile phones was found during bedtime. The males were using more mobile phones for video gaming than female medical students. Conclusions: Reducing bedtime use of electronic devices and improving sleep hygiene in adolescents could decrease the prevalence of obesity in adolescents.

Change of Internet Use and Bedtime among Junior High School Students after Long-Term School Closure Due to the Coronavirus Disease 2019 Pandemic.

Most schools in Japan were closed in spring 2020 due to the novel coronavirus disease 2019 (COVID-19) pandemic. We investigated lifestyle and internet use among junior high school students across eight schools after long-term school closure and compared the data with those we obtained from previous surveys. In the summers of 2018, 2019, and 2020, we conducted questionnaire surveys on seventh-grade students from the same schools. In total, 2270 participants were analyzed. All questionnaires included items regarding background, bedtime, and internet use. The participants of the 2020 survey had significantly less sleepiness during classes and longer internet use times compared with those of the previous surveys. In the 2020 survey, the rate of problematic internet use (Young’s Diagnostic Questionnaire score, ≥5) was not significantly different from the results of previous surveys. The COVID-19 pandemic might have strongly influenced the sleepiness experienced by students in classes and increased the time spent using the internet since the summer of 2020. Our results indicate the need for attempts to encourage students to improve their sleep habits and moderate their media use.

Use of the Consumer-Based Meditation App Calm for Sleep Disturbances: Cross-Sectional Survey Study.

BackgroundOver 30% of Americans report regular sleep disturbance, and consumers are increasingly seeking strategies to improve sleep. Self-guided mindfulness mobile apps may help individuals improve their sleep. Despite the recent proliferation of sleep content within commercially available mindfulness apps, there is little research on how consumers are using these apps for sleep.ObjectiveWe conducted a cross-sectional survey among subscribers to Calm, a popular, consumer-based, mindfulness-based meditation app, and described and compared how good sleepers, poor sleepers, and those with self-reported insomnia use the app for sleep.MethodsParticipants who were paying subscribers of Calm and had used a sleep component of Calm in the last 90 days were invited to complete an investigator-developed survey that included questions about sleep disturbance and the use of Calm for sleep. Based on self-reports of sleep disturbances and of insomnia diagnosis, participants were categorized as “good sleepers,” “poor sleepers,” or “those with insomnia diagnosis.” Chi-square tests compared reasons for downloading the app and usage patterns across participants with and without sleep disturbance.ResultsThere was a total of 9868 survey respondents. Approximately 10% of participants (1008/9868, 10.21%) were good sleepers, 78% were poor sleepers (7565/9868, 77.66%), and 11% reported a diagnosis of insomnia (1039/9868, 10.53%). The sample was mostly White (8185/9797, 83.55%), non-Hispanic (8929/9423, 94.76%), and female (8166/9578, 85.26%). The most common reasons for sleep disturbances were racing thoughts (7084/8604, 82.33%), followed by stress or anxiety (6307/8604, 73.30%). Poor sleepers and those with insomnia were more likely than good sleepers to have downloaded Calm to improve sleep (χ22=1548.8, P<.001), reduce depression or anxiety (χ22=15.5, P<.001), or improve overall health (χ22=57.6, P<.001). Respondents with insomnia used Calm most often (mean 5.417 days/week, SD 1.936), followed by poor sleepers (mean 5.043 days/week, SD 2.027; F2=21.544, P<.001). The most common time to use Calm was while lying down to sleep (7607/9686, 78.54%), and bedtime use was more common among poor sleepers and those with insomnia (χ22=382.7, P<.001). Compared to good and poor sleepers, those with insomnia were more likely to use Calm after waking up at night (χ22=410.3, P<.001). Most participants tried to use Calm on a regular basis (5031/8597, 58.52%), but regular nighttime use was most common among those with insomnia (646/977, 66.1%), followed by poor sleepers (4040/6930, 58.30%; χ22=109.3, P<.001).ConclusionsOf the paying subscribers to Calm who have used one of the sleep components, approximately 90% have sleep difficulties, and 77% started using Calm primarily for sleep. These descriptive data point to areas of focus for continued refinement of app features and content, followed by prospective trials testing efficacy of consumer-based meditation mobile apps for improving sleep.

Association of bedtime usage of social media and sleep quality among governmental elementary school teachers in Jeddah city, Saudi Arabia

Objectives: This study aimed to determine the independent association of bed time use of social media among elementary school teachers and disturbed sleep while controlling for potential covariates. Materials and Methods: Hundred eighty-three male and 223 female teachers from Jeddah governmental schools participated in the present cross-sectional study. Pittsburgh Sleep Quality Index (PSQI) was used to assess teachers’ quality of sleep. The independent t- test and one-way ANOVA were used to examine the linkage between sleep quality and participants characteristics, including demographics, health related behavioral characteristics, teaching related activities, associated health problems, as well as bed time use of social media. Multiple Enter linear regression analysis was performed to identify variables with higher predictive power of sleep quality. Results: Mean ± SD age of the sampled teachers was 39.87 ± 6.08. The PSQI indicated poor sleep quality (global score, mean ± SD was 8.0±3.91). Positive association was found between poor sleep and both frequency and volume of near bed time usage of social media. Regression model showed that in addition to social media use, having comorbid condition or consumption of caffeine containing drinks strongly predicted bad sleep (p

Perception of Sleep Disturbances due to Bedtime Use of Blue Light-Emitting Devices and Its Impact on Habits and Sleep Quality among Young Medical Students.

Introduction The use of blue light-emitting devices (smartphones, tablets, and laptops) at bedtime has negative effects on sleep due to light stimulation and/or problematic excessive use. We aimed to evaluate, among young medical students, if the perception of sleep disturbances due to bedtime use of these devices is consistent with healthier habits and a better sleep quality. Materials and methods 294 medical students in medicine and pharmacy from the Faculty of Medicine and Pharmacy of Rabat, Morocco, took part in this anonymous and voluntary cross-sectional study and answered an electronic questionnaire. Student and Mann–Whitney U tests were used to compare variables between 2 groups based on their perception of sleep disturbances. The level of significance was p ≤ 0.05. Results 286 students (97.3%) used a blue light-emitting smart device at bedtime before sleep, and sleep quality was poor (Pittsburgh Sleep Quality Index, PSQI > 5) in 101 students (35.3%). The perception of sleep disturbances due to this night usage was reported by 188 of them (65.7%). In this group, 154 (81.9%) used their device with all the lights turned off in the room (p=0.02), 34 (18.1%) put devices under pillows (p=0.04), 114 (60.6%) interrupted sleep to check messages (p < 0.001), and the mean duration use of these technologies at bedtime was 2 h ± 23 min per night (p=0.02). Also, the mean sleep duration was 6.3 hours ± 1.25 (p=0.04), 119 (63.3%) presented fatigue on waking more than one time per week (p=0.04), and 76 (40.4%) presented poor sleep quality (75.2% of the students with PSQI > 5) (p=0.005). Conclusions Despite the perception of sleep disturbances due to bedtime use of blue light-emitting devices, unhealthy sleep habits tend to be frequent in young medical students and worrying because it is associated to significant poor sleep quality.

A qualitative exploration of potential determinants of accelerated summer weight gain among school-age children: perspectives from parents

BackgroundThere is growing evidence that school children in the United States gain weight more rapidly during the summer than the school year, but few studies have explored the causes of this phenomenon. The goal of this study was to qualitatively explore potential determinants of accelerated summer weight gain by interviewing parents of school-age children.MethodsKey informant interviews were conducted with parents of third and fourth grade students enrolled in a school-based physical activity intervention in three peri-urban communities in Eastern Massachusetts. A structured interview guide was developed to assess school year and summertime differences in child diet, physical activity, daily routine, and family rules. Interviews were recorded and transcribed verbatim. Transcripts were coded and major themes were identified using thematic analysis.ResultsSummer activities varied substantially by family. Many parents characterized summer as a time with less structure and more relaxed rules, particularly around bedtime and screen use. Parents perceived their child to be more physically active in the summer and reported few barriers to summertime physical activity. Parents reported increases in both positive (increased consumption of fruits and vegetables) and negative (increased consumption of “sweets” and “junk foods”) dietary behaviors. They highlighted several stressors unique to summer, such as the high cost of camps and the need to coordinate childcare and manage children’s time.ConclusionsParents perceived their children to be more physically active in the summer and consume more fruits and vegetables than during the school year. However, they also perceived children to consume more energy-dense, nutrient poor foods, engage in more screen time, and have later bedtimes during the summer. These behaviors are important targets for summertime obesity prevention interventions. Large-scale quantitative studies are needed to determine whether these parent perceptions reflect meaningful risk factors for accelerated summer weight gain.

Reducing late evening bedtime electronic device intentions and use among young adults

ObjectivesWe examined (Study #1) the association of attitudes, subjective norms (SN), and perceived behavioral control (PBC) with intentions to reduce late evening electronic device (e-device) use and (Study #2) the impact of a brief theory-driven message on reducing the use. MethodsYoung adults aged 18-30 years participated in Internet surveys to assess sleep quality, attitudes, SN, PBC, and intentions to reduce and patterns of late evening e-device use. In Study #1, participants (n = 160) were randomized to receive a Theory of Planned Behavior (TPB)–driven message based on information from the National Sleep Foundation and were assessed for intentions to decrease late evening e-device use immediately afterward. In Study #2, participants (n = 148) were given the same message but were assessed for behaviors 24 hours–1 week afterward. ResultsIn Study #1, regressions indicated that less supportive attitudes and higher PBC were associated with higher intention to reduce e-device use at baseline (P < .01); intentions and PBC were associated with current use (P < .01). Participants receiving the message were more likely to reduce late evening e-device use intentions (adjusted odds ratio: 2.30, 95% confidence interval: 1.06-4.99). In Study #2, those receiving the intervention with attitudes consistent with limiting use were more likely to reduce use 24 hours–1 week after the intervention (adjusted odds ratio: 3.13, 95% confidence interval: 1.10-8.91). ConclusionAttitudes and PBC were associated with intention to reduce late evening e-device use, and our brief TPB-driven message benefited young adults with attitudes inconsistent with use. TPB-based interventions can decrease late evening e-device use and promote better quantity and quality of sleep.

Screens in bed: visual art, sleep and handheld screen devices

This article seeks an understanding of sleeping and waking life in bed in relation to the use of handheld screen devices. The bedtime use of these devices has come to public attention through the involvement of this practice in the construction of two contemporary crises of sleep: Sleep science’s crisis of chronic sleep deprivation and the wider cultural crisis of the invasion of sleep by fast capitalism, as proposed by Jonathan Crary. Visual art is employed to gain insights into the two related understandings of sleep: one concerned with individual sleep self-regulation and the other with the corporeal commonality of sleep. The sociology of sleep, based on Michele Foucault’s concept of ‘biopower’, is augmented by philosophical insights from Jean-Luc Nancy and Gilles Deleuze to reconfigure the sleeping body beyond the bounds of disciplinary regimes and permit a reassessment of the affective potential of sleep. Works of digital media art, together with ethnographic and cultural studies on the use of mobile devices, are employed to tease out the entanglement of these screen devices with waking and sleeping bedroom life. An ontology of sleep as a pre-individual affective state is proposed as an alternative basis for resisting the appropriation of sleep by the always-waking world accessed through the use of smartphones and tablets.

Prevalence and Correlates of Hypersomnolence Symptoms in US Teens.

Recent attention to pervasive sleep deficits in US adolescents has focused on sleep patterns and insomnia, but there are limited data on the prevalence and correlates of hypersomnolence symptoms. The sample included 6,483 adolescents 13 to 18 years of age who were interviewed directly and had parent reports in the National Comorbidity Survey Replication Adolescent Supplement (NCS-A), a nationally representative sample of US youth. Information on sleep patterns/symptoms that were collected in the interview was used to determine the population prevalence of DSM-5 criterion A-defined hypersomnolence and component symptoms. Logistic regression analyses were used to examine associations between sleepiness and sub-symptoms of hypersomnolence with weekday/weekend bedtime, sleep duration, mental disorders, and psychotropic medication use. Of the sample, 41.5% reported feeling sleepy during the daytime and 11.7% met criteria for hypersomnolence. The prevalence of hypersomnolence varied depending on age (p< .001) and was more common in adolescent girls (odds ratio [OR] 1.40, 95% CI 1.09-1.78). Excessive sleepiness and hypersomnolence symptoms were associated with shorter sleep duration and delayed bedtimes on weekdays and weekends Hypersomnolence was significantly associated with insomnia (OR 2.45, 95% CI 1.87-3.21) and mental disorders (OR 1.99, 95% CI 1.42-2.77). After accounting for insomnia, hypersomnolence was no longer associated with use of psychotropic medication (OR 1.61, 95% CI 0.97-2.66). Of adolescents with adequate sleep duration, 11.7% still reported symptoms of hypersomnolence. The strong association between hypersomnolence and insomnia suggests that sleep disorders in adolescents can fluctuate between over- and under-sleeping. Potential mechanisms underpinning the strong associations between sleep disturbances and mental disorders should be further pursued and could provide insight into prevention efforts.

Household chaos and screen media use among preschool-aged children: a cross-sectional study

BackgroundExcess screen media use is a robust predictor of childhood obesity. Understanding how household factors may affect children’s screen use is needed to tailor effective intervention efforts. The preschool years are a critical time for obesity prevention, and while it is likely that greater household disorder influences preschool-aged children’s screen use, data on that relationship are absent. In this study, our goal was to quantify the relationships between household chaos and screen use in preschool-aged children.MethodsA cross-sectional, online survey was administered to 385 parents of 2–5 year-olds recruited in 2017. Household chaos was measured with the Confusion, Hubbub and Order Scale (i.e., the chaos scale), a validated, parent-reported scale. The scale consists of 15 items, each scored on a 4-point Likert scale. Final scores were the sum across the 15 items and modeled as quartiles for analyses. Parents reported their children’s screen use for nine electronic media activities. Adjusted linear and Poisson regression were used to model associations between household chaos and children’s total weekly screen use, screen use within one hour of bedtime and screen use in the bedroom.ResultsChildren averaged 31.0 (SD = 23.8) hours per week with screens, 49.6% used screens within one hour of bedtime and 41.0% used screens in their bedrooms. In adjusted regression models, greater household chaos was positively associated with weekly screen use (P = 0.03) and use of screens within one hour of bedtime (P < 0.01) in a dose-dependent manner. Children in the fourth versus the first quartile of household chaos were more likely to use screens in their bedroom (P = 0.03).ConclusionsGreater household chaos was associated with increased total screen use as well as screen use behaviors that are related to disrupted nighttime sleep. Findings suggest that household chaos may be an obesity risk factor during the preschool years because of such effects on screen use, and highlight the need to consider household chaos when implementing home-based obesity prevention programs for young children.