Changes In Sleep Time Research Articles

Construct validity of the General Health Questionnaire (GHQ-12) in patients with COVID-19 and its demographic and medical correlates.

The present cross sectional study aimed to evaluate the construct and criterion validity, reliability, and gender and age differences of the 12-item General Health Questionnaire (GHQ-12) among hospitalized patients with COVID-19 in 2020. The criterion validity was assessed via its link with perceived stress, sleep quality, daily life activities, and demographic and medical characteristics. A total of 328 COVID-19 patients (55.8% men; Mage = 50.49, SD = 14.96) completed the GHQ-12, the Perceived Stress Scale (PSS), the Pittsburgh Sleep Quality Index (PSQI), the Activities of Daily Life (ADL)-Katz Scale, and the Lawton Instrumental Activities of Daily Living Scale (IADL). Among 13 factorial models, the three-factor model (successful coping, self-esteem, and stress) was shown to have the best fit. GHQ-12 was positively associated with PSQI, PSS, Hyperlipidemia, psychiatry disorders, hospitalization duration, the change in sleep time, and use of sleeping pills, and negatively correlated with educational level, and the number of family members. The GHQ-12 also had a negative correlation with ADL and IADL in over 60 years of age group. Females scored higher on total GHQ-12 scores, compared to males. Finally, the hospitalization duration was longer for patients over 60 (mean = 8.8 days, SD = 5.9) than patients under 60 (mean = 6.35 days, SD = 5.87). Overall, the findings provided evidence that mental distress in patients with COVID-19 is correlated with high perceived stress, low sleep quality, low ADL and IADL, and a range of demographic features and medical conditions. Designing psychological interventions for these patients that target the aforementioned correlates of mental distress is warranted.

Impact of School Start Time Delays and Learning Modality on Sleep Timing and Duration During COVID-19

ABSTRACT Objectives To assess the impact of a school start time (SST) delay on adolescent sleep health during the COVID-19 pandemic, and whether there were differences by learning modality. Methods Data were collected from a longitudinal study evaluating sleep, education, and health among high school students in Georgia in 2020. Paired t-tests and multivariable linear regression analyses were conducted to examine changes in sleep duration and timing among 9th grade students (n = 134) and their association with the learning modality (remote vs. in-person learner). Results Students’ school day wake times were 1.5 hours later, school night sleep duration was 1.2 hours longer, and social jetlag was 0.9 hours shorter after the school start time delay (all P < .05). The learning modality was a significant predictor of changes in sleep timing but was not associated with changes in sleep duration. Conclusions Delayed school start time was associated with positive changes in adolescent sleep health during the COVID-19 pandemic. Sleep timing was affected by the learning modality, however in-person and virtual students had similar gains in sleep duration. Learning modality may be more beneficial for adolescents with early school start times to promote healthier sleep habits.

0012 Night Owls and Morning Birds Fly Over the Gym: Circadian Misalignment Does Not Predict Physical Activity in Adolescents

Abstract Introduction Given that obesity rates have reached epidemic-level proportions in the U.S., it is more important than ever to identify preventative interventions to reduce obesity risk. Many aspects of sleep have been associated with obesity through their relationship to physical activity. Circadian misalignment is an area of sleep that is yet understudied but that may be especially relevant given the rapid biological and social changes in sleep timing seen in adolescence. This study examined the relationship between circadian misalignment and physical activity among adolescents. Methods Fifty adolescents completed an 11-day protocol that began with a baseline appointment where study staff measured participants’ height and weight. Over the next 10 days, participants wore waist accelerometers that measured physical activity and completed manual sleep diaries. After 10 days, participants completed a six-hour appointment in a dimly lit room (lux level &amp;lt; 5) where study staff collected saliva samples every 30 minutes to measure the onset of participants’ melatonin levels. In this preliminary analysis, circadian misalignment was calculated by subtracting the timing of melatonin onset from the average bedtime noted in participants’ sleep diaries; lower scores are reflective of greater circadian misalignment. Results Adolescents engaged in 12,038.77 minutes (SD=1737.62) of sedentary activity, 767.29 minutes (SD=260.93) of light physical activity, and 1,263 (SD= 411.89) of moderate-to-vigorous physical activity across this ten-day monitoring period. We conducted multiple regression analyses with circadian misalignment as a predictor of sedentary, light, and moderate-to-vigorous physical activity levels. Circadian misalignment was not a statistically significant predictor of sedentary physical activity (p=.85), light physical activity (p=.70), or moderate-to-vigorous physical activity (p=.30). Conclusion In our study, circadian misalignment did not predict sedentary, light, or moderate-to-vigorous physical activity levels. Current literature on other facets of sleep suggests that sleep duration and quality is related to physical activity. However, our results suggest that improving circadian alignment may not be a viable intervention to increase physical activity. Further studies are needed to validate these results as well as to explore the effects of circadian alignment on other aspects of obesity risk. Support (if any)

Effects of emerging alcohol use on developmental trajectories of functional sleep measures in adolescents.

Adolescence is characterized by significant brain development, accompanied by changes in sleep timing and architecture. It also is a period of profound psychosocial changes, including the initiation of alcohol use; however, it is unknown how alcohol use affects sleep architecture in the context of adolescent development. We tracked developmental changes in polysomnographic (PSG) and electroencephalographic (EEG) sleep measures and their relationship with emergent alcohol use in adolescents considering confounding effects (e.g. cannabis use). Adolescents (n = 94, 43% female, age: 12-21 years) in the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study had annual laboratory PSG recordings across 4-years. Participants were no/low drinkers at baseline. Linear mixed effect models showed developmental changes in sleep macrostructure and EEG, including a decrease in slow wave sleep and slow wave (delta) EEG activity with advancing age. Emergent moderate/heavy alcohol use across three follow-up years was associated with a decline in percentage rapid eye movement (REM) sleep over time, a longer sleep onset latency (SOL) and shorter total sleep time (TST) in older adolescents, and lower non-REM delta and theta power in males. These longitudinal data show substantial developmental changes in sleep architecture. Emergent alcohol use during this period was associated with altered sleep continuity, architecture, and EEG measures, with some effects dependent on age and sex. These effects, in part, could be attributed to the effects of alcohol on underlying brain maturation processes involved in sleep-wake regulation.

Impact of reduced night work on shift workers' sleep using difference-in-difference estimation.

We used a quasi-experimental design to investigate the impact of a change in the shift work system by reducing overnight work on the sleep health of workers. A difference-in-difference (DID) analysis was used to investigate changes in sleep time and sleep quality between the experimental group (shift workers, N = 116 in 2007 and N = 118 in 2013) and the control group (regular day workers, N = 256 in 2007 and N = 185 in 2013) before and after a change in the shift system that eliminated overnight work. The sleep outcomes were measured using a questionnaire that inquired about sleep duration, mid-sleep awakenings, and subjective sleep quality. We used a generalized estimating equation model to investigate differences in the prevalence of sleep-related outcomes between baseline and post-intervention. In the DID models, the sleep time per day (+0.5 h), the prevalence of awakening during sleep (-13.9%), and self-reported poor sleep quality (-34.9%) were improved with statistical significance during evening shifts in the experimental group, but there was no significant change during day shifts in the experimental group compared to the control group after the implementation of the new shift system without overnight shift. Quitting overnight work improved sleep health of shift workers.

Longitudinal Trends in Sleep and Related Factors Among South Korean Adults From 2009 to 2018.

Excess or insufficient sleep, irregular sleep-wake patterns, and an extreme early or late chronotypes adversely impact physical and mental health. Changes in sleep characteristics should therefore be tracked, and factors that contribute to poor sleep should be identified. We investigated the changes in sleep patterns among South Korean adults during 2009-2018. Using data of a representative sample of South Korean adults from the 2009 (n=2,658, 48.5% males; age=44.5±15.0 years old [mean±standard deviation], age range=19-86 years) and 2018 (n=2,389, 49.1% males; age=47.9±16.3 years, age range=19-92 years) Korean Headache-Sleep Study, we explored changes in sleep timing, sleep duration, chronotype, and social jetlag (SJL). Logistic regression analysis was used to examine the association between average sleep duration and depression. From 2009 to 2018, bedtimes were advanced by 10 and 25 min on workdays and free days, respectively. Meanwhile, wake-up times were advanced by 13 min and delayed by 12 min on workdays and free days, respectively. The average sleep duration significantly decreased from 7.45 h to 7.13 h. The prevalence of short sleep duration (<7 h) increased, whereas that of long sleep duration (≥8 h) decreased. A circadian preference toward eveningness and SJL increased. The prevalence of depression increased from 4.6% to 8.4%, and there were significant reverse J-shaped and U-shaped associations between average sleep duration and depression in 2009 and 2018, respectively. Changes in sleep patterns and the association between sleep duration and depressive mood were determined from a representative sample of the South Korean adult population. Interventions to modify sleep behaviors might improve public health.

코로나19 격리경험자의 스트레스가 우울에 미치는 영향 : 신체활동 및 수면시간 변화의 조절효과를 중심으로

This study aimed to investigate the relationship between depression and stress in people who experienced COVID-19 quarantine, focusing on moderating effect of changes in physical activity and sleep time. Data were collected through the 2020 Community Health Survey (CHS), and 523 people with COVID-19 quarantine experience were used in the analysis. This study conducted descriptive analysis, one-way ANOVA, and moderated regression analysis using SPSS Win 18.0. The results are as follows. First, in descriptive analysis, depression and stress in those who experienced COVID-19 quarantine were low, and compared to before COVID-19, physical activity mostly decreased, but sleep time did not change much. Second, there was a significant difference in depression due to both changes in physical activity and sleep time, and stress showed a significant difference only due to changes in physical activity, not sleep time. Finally, stress and changes in sleep time were significantly associated with depression of those who experienced COVID-19 quarantine, and the relationship between depression and stress was moderated by changes in physical activity and sleep time. This study discussed implications and limitations based on the results.

Increased sleep duration and delayed sleep timing during the COVID-19 pandemic

Many studies have examined how the 2019 Coronavirus Disease (COVID-19) has impacted sleep health. Early evidence suggests that lockdown policies worldwide have led to changes in sleep timing, duration, and quality; however, few studies have attempted to look at the longer-term effects across multiple countries in a large data set. This study uses self-reported data from 64,858 users of the Sleep As Android smartphone application from around the world over a 24-month period in 2019 to 2020. We found a significant but modest increase in time in bed (TIB), as well as a significant delay in sleep timing that was especially prominent on weekdays. While this effect persisted throughout the year, differences in sleep timing were more widespread and pronounced in the earlier months of the pandemic. We observed a small overall increase in TIB when comparing 2020 to 2019, but these changes depended on location and time of year, suggesting that sleep duration may have more closely tracked the progression of the pandemic in each country. Our findings suggest that pandemic-induced changes in lifestyle, such as remote work and lockdown policies, may have facilitated later sleep timing but that these changes may diminish as restrictions are lifted.

0049 Screen time and sleep in young adolescents before and across the first year of the COVID-19 pandemic

Abstract Introduction The COVID-19 pandemic has been associated with profound biopsychosocial changes for children, potentially affecting their health and wellbeing. Among these changes are altered sleep patterns and screen time use, however, no work has examined interactions between these two behaviors in the context of the pandemic. Here, we used longitudinal data from the Adolescent Brain Cognitive Development (ABCD) Study® to investigate changes in both sleep and screen time, and their relationship, from before and across the first year of the COVID-19 pandemic in young adolescents. Methods More than 5000 adolescents (11-14 years; 48% girls) completed digital surveys about their sleep and daily screen time use before the pandemic and across six timepoints during 2020-2021, as part of the ongoing ABCD Study®. Random intercept linear mixed effect models (LMMs) were used to examine longitudinal associations between bedtime, wake-up time, and daily screen time use (social media, gaming), considering age, sex, and school effects. Results Adolescents’ wake up time was delayed (R2 = 0.51; ~1.5 hour) during May-August 2020 relative to the pre-pandemic assessment (p&amp;lt;0.01), which was partially related to the summer break (p&amp;lt;0.01), before advancing to earlier times in October 2020. Bedtimes also delayed at all pandemic assessments (R2=0.62; ~1 hour), even after starting the new school year (p&amp;lt;0.01), particularly in older adolescents (p&amp;lt;0.01) and girls (p&amp;lt;0.01). Recreational screen time was dramatically higher across the first year of the pandemic, relative to pre-pandemic (p&amp;lt;0.01; ~45min social media, ~20min video gaming). More time spent with screen related activities was associated with later bedtimes and wake up times (p&amp;lt;0.01), across the pandemic, with effects being evident in male and female adolescents. Conclusion Our findings show profound changes in sleep timing and screen time use across the pandemic in young adolescents, and critically, that excessive screen time negatively impacts sleep. As adolescents increasingly turn to more screen usage, these data highlight the need to promote their balanced and informed use of social media platforms, video games, and other digital technology to ensure adequate opportunity to sleep and maintain other healthy behaviors during this critical period of developmental change. Support (If Any) NIH U01DA041022

0192 Effects of emerging alcohol use on developmental trajectories of functional sleep measures in adolescents

Abstract Introduction Adolescence is characterized by developmental changes in sleep timing and architecture as well as alcohol use initiation. While the effects of acute and chronic alcohol use on sleep in adults are well-documented, much less is known in adolescents. We used longitudinal data from the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) to examine how emerging alcohol use affected sleep architecture in adolescents. Methods Overnight polysomnographic recordings were made each year, for 4 years, in 94 adolescents (12–21 years at baseline, 43% female) from the NCANDA cohort. All participants were no or low (youth adjusted Cahalan score of zero) alcohol users at baseline. These data were used to examine developmental trajectories of sleep macro-architecture and sleep electroencephalographic (EEG) measures using linear mixed effect models (LMMs), considering age, sex, family history of alcohol use, body mass index, ethnicity, and alcohol use class (i.e., no-to-low, moderate or heavy) at each annual assessment. Results There were strong developmental changes in sleep macro-structure and EEG, most notably, a decrease in slow wave sleep percentage and slow wave (delta) EEG activity with advancing age (p=0.02)​. Compared to those who remained no-to-low drinkers, participants who became moderate/heavy drinkers during the follow-up period, had different sleep trajectories, especially those older at baseline at baseline, including higher slow wave activity (p = 0.04), higher REM sleep percentage (p = 0.03), poorer sleep efficiency​ (p=0.003), and longer latency to sustained sleep (p = 0.03). The effects of alcohol use depended on sex, with male heavy drinkers having more REM sleep than female heavy drinkers (p = 0.04). Overall, a positive family history of alcohol use was associated with less NREM sleep and shorter sleep duration. Conclusion Our results present novel findings showing that emerging alcohol use during adolescence exerts complex effects on sleep macro- and micro-structure, over and above normal developmental changes in sleep. These effects could, in part, be alcohol effects on brain maturation processes underlying sleep regulation. Support (If Any) AA021696, AA021690

Family-based treatment of children with severe obesity in a public healthcare setting: Results from a randomized controlled trial.

SummaryTo compare the effectiveness of family‐based behavioural social facilitation treatment (FBSFT) versus treatment as usual (TAU) in children with severe obesity. Parallel‐design, nonblinded, randomized controlled trial conducted at a Norwegian obesity outpatient clinic. Children aged 6–18 years referred to the clinic between 2014 and 2018 were invited to participate. Participants were randomly allocated using sequentially numbered, opaqued, sealed envelopes. FBSFT (n = 59) entailed 17 sessions of structured cognitive behavioural treatment, TAU (n = 55) entailed standard lifestyle counselling sessions every third month for 1 year. Primary outcomes included changes in body mass index standard deviation score (BMI SDS) and percentage above the International Obesity Task Force cut‐off for overweight (%IOTF‐25). Secondary outcomes included changes in sleep, physical activity, and eating behaviour. From pre‐ to posttreatment there was a statistically significant difference in change in both BMI SDS (0.19 units, 95% confidence interval [CI]: 0.10–0.28, p < .001) and %IOTF‐25 (5.48%, 95%CI: 2.74–8.22, p < .001) between FBSFT and TAU groups. FBSFT participants achieved significant reductions in mean BMI SDS (0.16 units, (95%CI: −0.22 to −0.10, p < .001) and %IOTF‐25 (6.53%, 95% CI: −8.45 to −4.60, p < .001), whereas in TAU nonsignificant changes were observed in BMI SDS (0.03 units, 95% CI: −0.03 to 0.09, p = .30) and %IOTF‐25 (−1.04%, 95% CI: −2.99 to −0.90, p = .29). More FBSFT participants (31.5%) had clinically meaningful BMI SDS reductions of ≥0.25 from pre‐ to posttreatment than in TAU (13.0%, p = .021). Regarding secondary outcomes, only changes in sleep timing differed significantly between groups. FBSFT improved weight‐related outcomes compared to TAU.

Sleeping through a Lockdown: How Adolescents and Young Adults Struggle with Lifestyle and Sleep Habits Upheaval during a Pandemic

ABSTRACT Objectives The objective of the present study was to investigate the relationship between chronotype, lifestyle habits during the pandemic, and changes in sleep timing during the first wave of the COVID-19 pandemic in youth. Method An online survey of adolescents and young adults (N = 449) was conducted in June 2020. Multivariate hierarchical regressions assessed the contribution of chronotype and changes in lifestyle habits to sleep timing during the COVID-19 pandemic in two age groups (12 to 17 years old and 18 to 25 years old). Results Chronotype was a significant predictor of changes in sleep habits during the pandemic in both age groups. In adolescents, electronic device usage during the pandemic was a significant predictor of bedtimes and wake times on weekdays, and caffeine during the pandemic was a predictor of weekday wake times. The number of hours worked during the pandemic was a significant predictor of weekday wake times in both age groups. In young adults, cannabis consumption during the pandemic was a predictor of weekend bedtimes. A later chronotype, along with higher usage of electronic devices, fewer hours worked, as well as higher caffeine and cannabis consumption during the pandemic were associated with delayed sleep timing during the pandemic in youth. Conclusion These results highlight the importance of assessing lifestyle habits when exploring changes in sleep habits in youth.

O030 Changes in sleep-wake patterns, circadian timing, and mood in Australian teens during the COVID-19 pandemic

Abstract During the COVID-19 pandemic, schools rapidly transitioned from in-person to remote learning. We examined sleep- and mood-related changes in early adolescents, before and after this transition to assess the impact of in-person vs. remote learning. Sleep-wake timing was measured using wrist-actigraphy and sleep diaries over 1–2 weeks in Year 7 students (age M±SD =12.79±0.42 years) during in-person learning (n=28) and remote learning (n=58; n=27 were studied in both conditions). Circadian timing was measured under a single condition in each individual using salivary melatonin (Dim Light Melatonin Onset; DLMO). Online surveys assessed mood (PROMIS Pediatric Anxiety and Depressive Symptoms) and sleepiness (Epworth Sleepiness Scale – Child and Adolescent) in each condition. During remote vs. in-person learning: (i) on school days, students went to sleep 26 min later and woke 49 min later, resulting in 22 min longer sleep duration (all p&amp;lt;0.0001); (ii) DLMO time did not differ significantly between conditions, although participants woke at a later relative circadian phase (43 minutes, p=0.03) during remote learning; (iii) participants reported significantly lower sleepiness (p=0.048) and lower anxiety symptoms (p=0.006). Depressive symptoms did not differ between conditions. Changes in mood symptoms were not mediated by changes in sleep timing. Although remote learning had the same school start times as in-person learning, removing morning commutes likely enabled adolescents to sleep longer, wake later, and to wake at a later circadian phase. These results indicate that remote learning, or later school start times, may extend sleep duration and improve some subjective symptoms in adolescents.

Social Jetlag Changes During the COVID-19 Pandemic as a Predictor of Insomnia - A Multi-National Survey Study.

PurposeLifestyle and work habits have been drastically altered by restrictions due to the COVID-19 pandemic. Whether the associated changes in sleep timing modulate the risk of suffering from symptoms of insomnia, the most prevalent sleep disorder, is however incompletely understood. Here, we evaluate the association between the early pandemic-associated change in 1) the magnitude of social jetlag (SJL) – ie, the difference between sleep timing on working vs free days – and 2) symptoms of insomnia.Patients and MethodsA total of 14,968 anonymous participants (mean age: 40 years; 64% females) responded to a standardized internet-based survey distributed across 14 countries. Using logistic multivariate regression, we examined the association between the degree of social jetlag and symptoms of insomnia, controlling for important confounders like social restriction extension, country specific COVID-19 severity and psychological distress, for example.ResultsIn response to the pandemic, participants reported later sleep timing, especially during workdays. Most participants (46%) exhibited a reduction in their SJL, whereas 20% increased it; and 34% reported no change in SJL. Notably, we found that both increased and decreased SJL, as a result of the COVID-19 pandemic, were associated with later sleep midpoint (indicating a later chronotype) as well as more recurrent and moderate-to-severe symptoms of insomnia (about 23–54% higher odds ratio than subjects with unchanged SJL). Primarily those with reduced SJL shifted their bedtimes to a later timepoint, compared with those without changes in SJL.ConclusionOur findings offer important insights into how self-reported changes to the stability of sleep/wake timing, as reflected by changes in SJL, can be a critical marker of the risk of experiencing insomnia-related symptoms – even when individuals manage to reduce their social jetlag. These findings emphasize the clinical importance of analyzing sleep-wake regularity.

Sleeping through a pandemic: impact of COVID-19-related restrictions on narcolepsy and idiopathic hypersomnia.

To assess the impact of coronavirus disease 2019 (COVID-19)-related restrictions on narcolepsy type 1 (NT2), narcolepsy type 2 (NT2), and idiopathic hypersomnia (IH). Participants with NT1, NT2, and IH followed in a university hospital completed an online 78-question survey assessing demographic, clinical, and occupational features of the population during the first COVID-19-related lockdown. A total of 219 of 851 (25.7%) respondents of the survey reported a mean increase of 1.2 ± 1.9 hours (P < .001) in night sleep time and a mean decrease of 1.0 ± 3.4 points (P < .001) on the Epworth Sleepiness Scale during lockdown. Bedtime was delayed by 46.1% of participants and wakeup time was delayed by 59.6%, driven primarily by participants with IH. Teleworkers (but not in-person workers) reported a mean increase of 0.9 ± 1.2 hours in night sleep (P < .001) and a mean decrease in sleepiness score of 1.6 ± 3.1 (P < .001). Cataplexy improved in 54.1% of participants with NT1. Sleepiness correlated with psychological wellness (r = .3, P < .001). As many as 42.5% enjoyed the lockdown, thanks to reallocation of time usually spent commuting toward longer sleep time, hobbies, and family time, and appreciated a freer napping schedule. Conversely, 13.2% disliked the lockdown, feeling isolation and psychological distress. Extended sleep time, circadian delay (in patients with IH), and teleworking resulted in decreased symptoms of central hypersomnias. These findings suggest that people with IH, NT1, and NT2 may benefit from a decrease in social and professional constraints on sleep-wake habits, and support advocacy efforts aimed at facilitating workplace and schedule accommodations for this population. Nigam M, Hippolyte A, Dodet P, etal. Sleeping through a pandemic: impact of COVID-19-related restrictions on narcolepsy and idiopathic hypersomnia. J Clin Sleep Med. 2022;18(1):255-263.

Covid-19 related School Closure Impact on School going Children and Adolescents of Raipur, Chhattisgarh

The Covid-19 induced strict measures like strict lockdown caused schools to be shut down. The classes turned into non-contact and online. This caused children and adolescents to stay at home and take classes from the comfort of their rooms. The lockdown had a positive impact on sleep pattern of children and adolescents as they are not under pressure to wake up early nor they have serious deadlines to submit homework. The data of children and adolescents were collected by the means of questionnaire which was distributed to them. The questionnaire was taken back and analysed. The lack of pressure on students has helped them get positive sleep patterns. Of 44 respondents who took part in the study 68% reported change in sleep time. Out of these 88% were from urban area. Similarly, 57% respondents reported sleeping better during the lockdown and subsequent unlock periods. 68% students experienced that they do not require help in waking up which was around 41% before Covid-19 induced lockdown. This happened because students wake up late as there was no pressure to wake up early. This study again provided evidence in support of late start of school. The policy makers and school administrators should consider the increasing amount of evidence and change the school timings in such a way that student is not forced to wake up too early.

670 Changes in Childhood Sleep Patterns in an Intervention Study Prior to and During COVID19 Restrictions

IntroductionWe conducted a childhood sleep promotion study between March 2019 and December 2020 in Philadelphia. COVID19 was first detected in Pennsylvania in March 2020 and non-essential services were strictly curtailed (including school closures), with easing of curtailments by the fall 2020 (including hybrid schooling in some districts). We determined if changes in sleep duration were consistent during pre-, earlier, and later COVID19 periods.MethodsTypically developing children (9-12y) with sleep duration <8.5 hours per weeknight were enrolled. Sleep was measured using Fitbit devices during a baseline week and a 7-week intervention period. A factorial design was used to test five candidate intervention components: 1) sleep goal; 2) electronic device reduction messaging; 3) daily routine messaging; 4) child-directed financial incentive; and 5) parent-directed financial incentive. Sleep data were transmitted to a mobile health platform that automated delivery of the intervention components. We categorized participants when they completed the study: 1) Spring-Fall 2019 semesters (pre-COVID19); 2) Spring 2020 semester (started pre-COVID19, with strict restrictions impacting intervention periods); or 3) Fall 2020 semester (easing of COVID19 restrictions). Mixed effect modelling determined sleep changes.ResultsMean age of participants was 11.6y (51% female and 29% Black participants). Pre-COVID19 (N=59), average sleep duration increased from baseline by 21 (95% CI: 10, 30) minutes per weeknight during the intervention. In spring 2020 (N=18), the average sleep duration increase was two times larger in magnitude at 41 (95% CI: 25, 59) minutes per weeknight. For fall 2020 (N=20), the average sleep duration increase was 24 (95% CI: 7, 40) minutes per weeknight. Changes in sleep timing from baseline during the intervention were consistent pre-COVID19 and in the fall 2020 (e.g., ≈15 minutes earlier sleep onset throughout the intervention period), whereas sleep timing changes were dynamic in the spring 2020 (e.g., 41 minutes earlier for week 1, and 44 minutes later for week 7).ConclusionThis sleep intervention demonstrated increases in sleep duration pre-COVID19, with marked duration increases and dynamic timing changes coinciding with COVID19 restrictions during earlier (Spring 2020), but not later (Fall 2020), weeks of the COVID19 pandemic in Pennsylvania.Support (if any)K0 1 HL1 2 3 6 1 2 and CHOP

225 Sleep Timing and Chronotype in Mothers: Longitudinal Changes and Associations with Wellbeing from Pregnancy to 2 Years Postpartum

Abstract Introduction Women experience significant changes to sleep during perinatal periods. Existing research focuses on sleep duration and quality, but not sleep timing or chronotype (i.e., preferred timing for activity and sleep). This study investigated change trajectories of sleep timing and chronotype from late pregnancy to two years postpartum, and examined longitudinal associations between chronotype and insomnia, sleep-related daytime impairment, and mood. Methods Data were from a 2-arm randomized controlled trial testing behavioral sleep and diet interventions. A community sample of nulliparous women without severe sleep/mental health conditions participated. Women self-reported bedtime, risetime, chronotype (reduced Morningness-Eveningness Questionnaire), Insomnia Severity Index, and PROMIS Depression, Anxiety, and Sleep-Related Impairment over 7 time points: 30 and 35 weeks’ gestation, and postpartum months 1.5, 3, 6, 12 and 24. Results 163 women (mean age 33.35 ± 3.42 years) took part. Mixed effects models controlling for age and group allocation showed that both bed- and risetimes became progressively earlier over time by approximately 20-30 minutes on average (p &amp;lt; .001); chronotype also shifted progressively towards morningness (p &amp;lt; .01). After controlling for covariates (sleep duration and efficiency, mental health history, social support, age, group allocation), greater morningness was significantly associated with lower symptoms of insomnia and sleep-related impairment over time (p-values &amp;lt; .001); longitudinal associations between chronotype and symptoms of depression and anxiety were non-significant (p-values &amp;gt; .65). Conclusion This is one of the first studies to examine longitudinal changes in sleep timing and chronotype from pregnancy to two years postpartum. Sleep timing and chronotype became progressively earlier over the first two postpartum years. The magnitude of changes is beyond what is expected with increasing age. Greater morningness was associated with lower sleep complaints and sleep-related daytime impairment during the postpartum period. The mechanisms underlying these associations require further research. Support (if any) Australasian Sleep Association, Monash University, Australian Government RTP Scholarship and National Health and Medical Research Council.

Meta-analysis of age and actigraphy-assessed sleep characteristics across the lifespan.

Sleep quantity and continuity vary across the lifespan. Actigraphy is a reliable and widely used behavioral measure of sleep in research and personal health monitoring. This meta-analysis provides a novel examination of whether age (in years) is associated with actigraphy-assessed sleep across the lifespan. A systematic search of PubMed, Embase.com, Cochrane CENTRAL, and PsycINFO using "actigraphy" and "sleep" terms provided 7079 titles/abstracts; studies of individuals with known psychiatric or medical comorbidities were excluded. Ninety-one articles (N = 23 365) provided data for six meta-analyses examining sleep duration (k = 89), sleep efficiency (k = 58), bedtime (k = 19) and waketime (k = 9) for individuals ages 6-21, and bedtime (k = 7) and waketime (k = 7) for individuals ages 22 and older. At older ages, sleep duration was shorter (r = -0.12) and sleep efficiency was lower (r = -0.05). Older age was associated with later bedtime (r = 0.37) and wake-up time (r = 0.24) from ages 6-21, whereas older age was associated with earlier bedtime (r = -0.66) and wake-up time (r = -0.59) for ages 22 and above. The strength of these associations was modified by study continent, but not by any other moderator. Age was negatively associated with actigraphy-assessed sleep duration and efficiency, but the effects were small in magnitude. On the other hand, large associations were observed between age and sleep timing, despite a smaller literature and the absence of analyzable data for ages 30-60. Changes in sleep timing, rather than changes in sleep duration or continuity, may better characterize the effects of age on human sleep.

Changes in sleep timing and subjective sleep quality during the COVID-19 lockdown in Italy and Belgium: age, gender and working status as modulating factors

Italy and Belgium have been among the first western countries to face the Coronavirus disease 2019 (COVID-19) emergency, imposing a total lockdown over the entire national territories. These limitations have proven effective in slowing down the spread of the infection. However, the benefits obtained in public health have come with huge costs in terms of social, economic, and psychological well-being. In the current study, we aimed to investigate how the period of home confinement affected self-reported sleep characteristics in Italians and Belgians, with special regard to sleep timing and subjective quality. Using an online survey we collected data from 2272 participants, 1622 Italians (Mage = 34.1 ± 13.6 years, 1171 F), and 650 Belgian (Mage = 43.0 ± 16.8 years, 509 F). Participants reported their sleep pattern (eg, bedtime, risetime) and perceived sleep quality during and, retrospectively, before the lockdown. During the lockdown, sleep timing was significantly delayed, time spent in bed increased, and sleep quality was markedly impaired in both Italians and Belgians. The most vulnerable individuals appeared to be women, subjects experiencing a more negative mood, and those perceiving the pandemic situation as highly stressful. However, the two samples differed in the subgroups most affected by the changes, possibly because of the different welfare systems of the two countries. In fact, in the Italian sample sleep quality and timing underwent significant modifications especially in unemployed participants, whereas in the Belgian sample this category was the one who suffered less from the restrictions. Considering that the novel coronavirus has spread across the whole globe, involving countries with different types of health and welfare systems, understanding which policy measures have the most effective protective role on physical and mental health is of primary importance.