Differences In Sleep Characteristics Research Articles

Sleep characteristics during the first year postpartum in a cohort of Black and White women

Study objectivesThe postpartum period is a unique time when sleep deficiency often occurs. Black and White adults are reported to have differences in sleep characteristics, but little is known if these differences exist in the postpartum period. Therefore, the purpose of this study was to examine sleep characteristics in a cohort of Black and White women from 6-8 weeks to 12 months postpartum. MethodsParticipants were 49 Black and 85 White women who gave birth to an infant at ≥37 weeks gestation. Participants were instructed to wear an Actiwatch for 7 days at 6-8 weeks, 4, 6, 9, and 12 months postpartum. Mixed-effects linear models with a race by time interaction were used to examine if characteristics differed between races over time. ResultsOnly bedtime varied by race. White women had a later bedtime at 6-8 weeks compared to 6 months, but no significant change occurred for Black women. For the entire sample, average nighttime sleep duration increased from 385 min at 6-8 weeks to 404 min at 4 months postpartum. Percent sleep during the sleep interval and wake after sleep onset (WASO) improved by 6 and 9 months, respectively. However, average WASO remained >45 min and sleep efficiency <85 % at all timepoints for both Black and White women. Compared to White women, Black women had significantly shorter sleep duration (range: 40.6-59.9 min shorter across all timepoints, p < 0.0001) and time in bed (range: 17.5-67.6 minutes shorter, p = 0.0046), and lower percent sleep (range: 0.7-1.2 % lower, p = 0.0407) and sleep efficiency (range: 2.6-5.7 % lower, p = 0.0005). Sociodemographic factors were associated with sleep outcomes in Black and White women while behavioral factors were associated with sleep outcomes in White women only. ConclusionWhile there were improvements in nighttime sleep duration and quality, sleep duration remained suboptimal, and quality remained poor throughout the first year postpartum. In this sample, differences existed in factors associated with sleep outcomes between Black and White women.

Racial differences in treatment adherence and response to acupuncture and cognitive behavioral therapy for insomnia among Black and White cancer survivors.

Racial disparities in sleep are well-documented. However, evidence-based options for addressing these disparities are lacking in cancer populations. To inform future research on sleep interventions, this study aims to understand racial differences in treatment responses to acupuncture and cognitive behavioral therapy for insomnia (CBT-I) among Black and White cancer survivors. We conducted a secondary analysis of a comparative effectiveness trial evaluating acupuncture versus CBT-I for insomnia in cancer survivors. We compared insomnia severity, sleep characteristics, and co-morbid symptoms, as well as treatment attitudes, adherence, and responses among Black and White participants. Among 156 cancer survivors (28% Black), Black survivors reported poorer sleep quality, longer sleep onset latency, and higher pain at baseline, compared to White survivors (all p < 0.05). Black survivors demonstrated lower adherence to CBT-I than White survivors (61.5% vs. 88.5%, p = 0.006), but their treatment response to CBT-I was similar to white survivors. Black survivors had similar adherence to acupuncture as white survivors (82.3% vs. 93.4%, p = 0.16), but they had greater reduction in insomnia severity with acupuncture (-3.0 points, 95% CI -5.4 to 0.4, p = 0.02). This study identified racial differences in sleep characteristics, as well as treatment adherence and responses to CBT-I and acupuncture. To address racial disparities in sleep health, future research should focus on improving CBT-I adherence and confirming the effectiveness of acupuncture in Black cancer survivors.

Relationship Between Amyloid Positivity and Sleep Characteristics in the Elderly With Subjective Cognitive Decline.

Alzheimer's disease (AD) is a neurodegenerative disease characterized by a progressive decline in cognition and performance of daily activities. Recent studies have attempted to establish the relationship between AD and sleep. It is believed that patients with AD pathology show altered sleep characteristics years before clinical symptoms appear. This study evaluated the differences in sleep characteristics between cognitively asymptomatic patients with and without some amyloid burden. Sleep characteristics of 76 subjects aged 60 years or older who were diagnosed with subjective cognitive decline (SCD) but not mild cognitive impairment (MCI) or AD were measured using Fitbit® Alta HR, a wristwatch-shaped wearable device. Amyloid deposition was evaluated using brain amyloid plaque load (BAPL) and global standardized uptake value ratio (SUVR) from fluorine-18 florbetaben positron emission tomography. Each component of measured sleep characteristics was analyzed for statistically significant differences between the amyloid-positive group and the amyloid-negative group. Of the 76 subjects included in this study, 49 (64.5%) were female. The average age of the subjects was 70.72±6.09 years when the study started. 15 subjects were classified as amyloid-positive based on BAPL. The average global SUVR was 1.598±0.263 in the amyloid-positive group and 1.187±0.100 in the amyloid-negative group. Time spent in slow-wave sleep (SWS) was significantly lower in the amyloid-positive group (39.4±13.1 minutes) than in the amyloid-negative group (49.5±13.1 minutes) (p=0.009). This study showed that SWS is different between the elderly SCD population with and without amyloid positivity. How SWS affects AD pathology requires further research.

In vivo marker of brainstem myelin is associated to quantitative sleep parameters in healthy young men

The regional integrity of brain subcortical structures has been implicated in sleep–wake regulation, however, their associations with sleep parameters remain largely unexplored. Here, we assessed association between quantitative Magnetic Resonance Imaging (qMRI)-derived marker of the myelin content of the brainstem and the variability in the sleep electrophysiology in a large sample of 18-to-31 years healthy young men (N = 321; ~ 22 years). Separate Generalized Additive Model for Location, Scale and Shape (GAMLSS) revealed that sleep onset latency and slow wave energy were significantly associated with MTsat estimates in the brainstem (pcorrected ≤ 0.03), with overall higher MTsat value associated with values reflecting better sleep quality. The association changed with age, however (MTsat-by-age interaction—pcorrected ≤ 0.03), with higher MTsat value linked to better values in the two sleep metrics in the younger individuals of our sample aged ~ 18 to 20 years. Similar associations were detected across different parts of the brainstem (pcorrected ≤ 0.03), suggesting that the overall maturation and integrity of the brainstem was associated with both sleep metrics. Our results suggest that myelination of the brainstem nuclei essential to regulation of sleep is associated with inter-individual differences in sleep characteristics during early adulthood. They may have implications for sleep disorders or neurological diseases related to myelin.

How do psychosocial and cultural factors influence sleep and circadian health disparities?

Sleep and circadian health disparities are persistent differences in sleep characteristics and circadian rhythms that have adverse outcomes and disproportionately affect vulnerable, marginalized, disadvantaged, minority, and minoritized populations. Inequalities in sleep duration, efficiency, timing, regularity, alertness, and quality are manifestations of and contributors to social injustice. Populations known to experience sleep and circadian health disparities include adolescents, indigenous people, refugees, asylum seekers, migrants, immigrants, racial and ethnic minorities, sexual and gender minorities, women, pregnant people, older adults, individuals with mental and physical illness or disabilities, some religious groups, the socioeconomically disadvantaged, the homeless, and those living in underserved rural areas (Billings et al 2021; Garbers et al 2023 Huber et al 2022; Moore et al 2023; Nandagiri et al 2023; Richter et al 2020; Roncoroni et al 2022; Schneeberger et al 2019; Yang et al 2023; Zarhin 2023). A nascent literature has begun to identify potential psycho-social-cultural determinants of sleep and circadian health disparities including social categorization, social identity, intersectionality, social power structures, socio-structural constraints, social, political, and economic context, discrimination, prejudice, and cultural sleep values (Billings et al 2021; Grandner et al 2016; Majeno et al 2023; Zarhin 2023). Many other factors are yet to be discovered. Research that informs our understanding of the factors that contribute to sleep and circadian health disparities can lead to tailored approaches for specific populations that are sensitive to sociocultural contexts, thereby improving health throughout the world (Etindele Sosso et al 2021).

Sensory processing and sleep characteristics in preterm infants in the early period of life

ObjectiveThe present study aimed to investigate the following: (i) differences in sensory processing and sleep characteristics between preterm infants born at < 32 weeks', vs. those born at ≥ 32 weeks’ gestation; (ii) differences in sleep characteristics between preterm infants with typical vs. atypical sensory processing; and (iii) relationship between sensory processing and sleep characteristics in preterm infants at 3 months of age. MethodsA total of 189 preterm infants, 54 born at < 32 weeks' gestation (26 females; mean gestational age [standard deviation (SD)], 30.1 [1.7] weeks), and 135 born at ≥ 32 weeks’ gestation (78 females; mean gestational age [SD], 34.9 [0.9] weeks) were included in the present study. Sleep characteristics were evaluated using the Brief Infant Sleep Questionnaire, and sensory processing was assessed using the Infant Sensory Profile-2. ResultsThere were no significant differences in sensory processing (P > 0.05) or sleep characteristics (P > 0.05) between the preterm groups; however, more infants snored in the <32 weeks’ gestation group (P = 0.035). Preterm infants with atypical sensory processing showed lower nighttime (P = 0.027) and total sleep durations (P = 0.032), and higher rates of nocturnal wakefulness (P = 0.038) and snoring (P = 0.001) than preterm infants with typical sensory processing. A significant relationship, therefore, was observed between sensory processing and sleep characteristics (P < 0.05). ConclusionsSensory processing patterns may play an important role in understanding sleep problems in preterm infants. The early detection of sleep problems and sensory processing difficulties are necessary for early intervention.

The 24-hour rhythm in alcohol craving and individual differences in sleep characteristics and alcohol use frequency.

Evidence implicates sleep/circadian factors in alcohol use, suggesting the existence of a 24-h rhythm in alcohol craving, which may vary by individual differences in sleep factors and alcohol use frequency. This study sought to (1) replicate prior findings of a 24-h rhythm in alcohol craving, and (2) examine whether individual differences in sleep timing, sleep duration, or alcohol use frequency are related to differences in the timing of the peak of the craving rhythm (i.e., the acrophase) or magnitude of fluctuation of the rhythm (i.e., amplitude). Finally, whether such associations varied by sex or racial identity was explored. Two-hundred fifteen adult drinkers (21 to 35years of age, 72% male, 66% self-identified as White) completed a baseline assessment of alcohol use frequency and then smartphone reports of alcohol craving intensity six times a day across 10days. Sleep timing was also recorded each morning of the 10-day period. Multilevel cosinor analysis was used to test the presence of a 24-h rhythm and to estimate acrophase and amplitude. Multilevel cosinor analysis revealed a 24-h rhythm in alcohol craving. Individual differences in sleep timing or sleep duration did not predict rhythm acrophase or amplitude. However, alcohol use frequency moderated this rhythm wherein individuals who used alcohol more frequently in the 30days prior to beginning the study had higher mean levels of craving and greater rhythm amplitudes (i.e., greater rhythmic fluctuations). Associations did not vary by sex or racial identity. Results show that alcohol craving exhibits a systematic rhythm over the course of the 24h and that the frequency of alcohol use may be relevant to the shape of this rhythm. Consideration of daily rhythms in alcohol craving may further our understanding of the mechanisms that drive alcohol use.

Geographical Distribution of Insomniac Patients in Western Iran

Background: Sleep disorders are among important challenges for health policymakers due to its high prevalence and very high economic burden. Effect of air and noise pollutions on sleep quality and disorders has been proposed. Objectives: In the present study, the geographical distribution of people diagnosed as insomnia in Sleep Disorders Research Centers (SDRC) in the western Iran was investigated. Methods: All patients with primary insomnia who diagnosed by polysomnography (PSG) in SDRC between 2011 to 2019 were recruited. The postal addresses of participants specified by a geographical coordinate represented longitude, latitude, and vertical position. These geographical coordinates converted to Geographic Information System (GIS) and addresses were located on the map. Then participants were divided into noisy and quiet environment groups based on their distance from highways, boulevards, and streets. Subjective and objective sleep characteristics were compared between these two groups by independent sample t-test or U Mann Whitney test using the Statistical Package for the Social Sciences (SPSS) version.22. Results: Of 78 participants, 47 were from Kermanshah city, 19 were from counties of Kermanshah province, and 14 participants were from Kurdistan, Ilam, Hamedan, Lorestan, Khuzestan and Tehran provinces. The location of all participants was presented on GIS maps. Result didn’t indicate any significant differences in sleep characteristics between the two noisy and quiet environment groups. Conclusions: Most insomniac patients investigated in the SDRC come from Kermanshah city. Patient with insomnia may reach a level of the pathophysiological condition in sleep-wake regulation systems that lead to problematic sleep characteristics independently from environmental noise.

190 Changing national trends in sleep and related features among Korean adults between 2009 and 2018

Abstract Introduction Sleep patterns have been linked to various heath disease. Evaluating population-level trend of sleep could provide a comprehensive population health-forecasting model that has the potential to inform targeted interventions. Therefore, we aimed to examine the cross-sectional differences in sleep characteristics among Korean adults during a 9-year period of 2009-2018. Methods The data in this study were derived from two nationwide survey regarding sleep and headache in the representative sample of Korean adult population, namely the Korean Sleep Headache Study phase I (2009) and II (2018). The survey was conducted through door-to-door visit and face-to-face interview by using structured questionnaires. Total of 2,836 participants from Phase I (47.9±16.4 years old; female, 50.2%) and 2,501 participants (47.9±16.4 years old; female, 50.3%) from Phase II gave informed consents and completed the survey. For this study, we excluded those who worked as shift workers and missing data. From the MCTQ, we collected participants’ sleep schedule during workdays and free days over the past four weeks. Average sleep duration was a weighted mean of sleep duration on workdays and free days. Poor sleep quality was defined as PSQI &amp;gt;5. Excessive daytime sleepiness and Depression are performed with ESS and PHQ-9, respectively. Results During the 9 years, average sleep duration decreased by 21 minutes, especially more reduction on free days (workday: 7:17±1:58 vs. 7:06±1:06, p &amp;lt;0.001; free days 8:04±2:32 vs. 7:49±1:23, p &amp;lt;0.001). People go to sleep and wake up earlier on workday (workday 23:39±1:50 vs. 23:25±1:30, p &amp;lt;0.001; free days 23:51±2:11 vs. 23:25±2:11, p &amp;lt;0.001), whereas they go to bed earlier and wake up later on free days compared to past (workday 6:52±1:36 vs. 6:37±1:11, p &amp;lt;0.001; 7:42±2:04 vs. 7:49±1:42 p =0.023). Social jetlag was increased by 5 minutes (0:46±1:35 vs. 0:51±0:52, p =0.028). There was the difference of age on the habitual sleep-wake rhythm and sleep related symptoms. Also, short or long sleep duration was associated with a significant increase in each health outcomes. Conclusion Decreased sleep duration seems to be on the rise in the general adult population, which lead to a poor health status. Interventions to promote adequate sleep is urgently needed. Support (if any):

Sleep Characteristics of Elite Youth Athletes: A Clustering Approach to Optimize Sleep Support Strategies.

Elite athletes experience chronic sleep insufficiency due to training and competition schedules. However, there is little research on sleep and caffeine use of elite youth athletes and a need for a more nuanced understanding of their sleep difficulties. This study aimed to (1) examine the differences in sleep characteristics of elite youth athletes by individual and team sports, (2) study the associations between behavioral risk factors associated with obstructive sleep apnea and caffeine use with sleep quality, and (3) characterize the latent sleep profiles of elite youth athletes to optimize the sleep support strategy. A group (N = 135) of elite national youth athletes completed a self-administered questionnaire consisting of the Pittsburgh Sleep Quality Index (PSQI)and questions pertaining to obstructive sleep apnea, napping behavior, and caffeine use. K-means clustering was used to characterize unique sleep characteristic subgroups based on PSQI components. Athletes reported 7.0 (SD = 1.2) hours of sleep. Out of the total group,45.2% of the athletes had poor quality sleep (PSQI global >5), with team-sport athletes reporting significantly poorer sleep quality than individual-sport athletes. Multiple logistic regression analysis indicated that sport type significantly correlated with poor sleep quality. The K-means clustering algorithm classified athletes' underlying sleep characteristics into 4 clusters to efficiently identify athletes with similar underlying sleep issues to enhance interventional strategies. These findings suggest that elite youth team-sport athletes are more susceptible to poorer sleep quality than individual-sport athletes. Clustering methods can help practitioners characterize sleep-related problems and develop efficient athlete support strategies.

Sleep Disturbance Is Associated With the Presence of Portosystemic Collaterals in Patients With Compensated Cirrhosis.

Disturbed sleep is common among patients with cirrhosis. The extent to which this is associated with the different stages of compensated cirrhosis is unknown. This study examines whether the presence of portosystemic collaterals, an indicator of clinically significant portal hypertension, is associated with sleep disturbance in compensated cirrhosis. We conducted a cross‐sectional study among patients with compensated cirrhosis, comparing sleep characteristics, sleep quality, and excessive daytime sleepiness between 21 patients without and 21 patients with portosystemic collaterals. Patients were assessed with wrist actigraphy, Pittsburgh Sleep Quality Index, and the Epworth Sleepiness Scale. Collateral presence was determined by imaging and esophagogastroduodenoscopy. Differences in sleep characteristics were analyzed using t tests and computed effect sizes. Multivariable linear regression analysis was used to evaluate the association between collaterals and sleep disturbance while controlling for possible confounders. The group of patients with collaterals had greater beta‐blocker and tobacco use, lower albumin, and higher international normalized ratio compared to the group without collaterals. Patients with collaterals had more sleep fragmentation (Cohen’s d = −0.86), lower sleep efficiency (Cohen’s d = 0.59), and lower total sleep time (Cohen’s d = 0.75) than patients without collaterals. The presence of collaterals was independently associated with greater sleep fragmentation (P = 0.046) and greater daytime sleepiness (P = 0.030). Conclusion: Patients with compensated cirrhosis complicated by portosystemic collaterals experienced more sleep disturbance than those without collaterals.

Adolescent sleep characteristics and body-mass index in the Family Life, Activity, Sun, Health, and Eating (FLASHE) Study

Sleep may play a role in overweight and obesity in adolescents. The objective of this study is to investigate the relationships between sleep duration and timing and overweight and obesity status in adolescents, with a special emphasis on weekday–weekend difference in sleep characteristics as well as sex-specific relationships. We examined 1,254 U.S. adolescents (12–17 years) self-reported sleep duration, timing, weekday–weekend differences in duration and timing in relation to overweight and obesity. We found an inverse association between sleep duration and overweight and obesity. Compared to 8–9 h of sleep, short sleep (< 7 h) on weekdays was associated with higher odds of overweight and obesity [Odds ratio (95% confidence interval), 1.73 (1.00, 2.97)] in the overall population, while long sleep (10+ h) on weekends was associated with lower odds, but only in males [0.56 (0.34, 0.92)]. We also found that a larger weekday–weekend difference in sleep duration was associated with overweight and obesity in females, but not in males. Specifically, the odds of overweight and obesity were significantly higher among females reporting longer sleep on weekends than weekdays by ≥ 2 h [2.31 (1.15, 4.63)] when compared to those reporting little weekday–weekend differences. Sleep timing, or weekday–weekend differences in sleep timing, were not associated with overweight and obesity in the overall population, although we found suggestive evidence linking later weekend sleep with overweight and obesity in females. Our findings support a role of sleep in adolescent obesity and suggest sex-differences in this relationship that warrant future studies.

0845 The Difference in Sleep Characteristics of Chronic Insomnia Disorder According to Gender and Age

Abstract Introduction Impacts of age and gender on sleep have been reported in normal population, but rarely in chronic insomnia disorder (CID). This study aimed to investigate difference in sleep characteristics of CID according to gender and age. Methods The participants with drug-naïve CID and aged between 40 and 79 years were recruited. We compared subjective and objective sleep parameters between the middle-aged (40-64 years, N=86) and the elderly (65-79 years, N=50), and between men (N=45) and women (N=91). The subjective sleep quality and habitual sleep time were measured by Pittsburgh Sleep Quality Index (PSQI). The participants were asked to wear an actigraph for 4 days to obtain objective sleep parameters. Results In the PSQI, the elderly reported earlier bedtime and wake-up time (p=0.018; p=0.026), reduced total sleep time (TST) and sleep efficiency (p=0.003; p=0.011), and low sleep quality (p=0.034) compared to the middle-aged. However, according to the actigraphy, differences were observed only in the bedtime (p=0.016) and the wake-up time (p=0.002) between the two age groups. Between genders, the actigraphy showed that the male patients woke up earlier than the female group (p=0.015); except for this finding, there was no significant gender effect. Meanwhile, regarding gender and age interactions, the elderly women with CID showed longer time in bed (TIB) with increase in both TST and wake after sleep onset (WASO) compared to the middle-aged women. The elderly men showed decreased TIB and TST, and slightly decreased WASO than the middle-aged men. Conclusion The elderly with CID show more subjective sleep complaints than the middle-aged CID despite little difference in objective sleep characteristics, which suggests that the elderly CID may seek medical help more than the middle aged. As women with CID get older, they increase time spent in bed to maintain sleep time, but with resultant increase in wake. Support None

Effects of sleep apnea and kidney dysfunction on objective sleep quality in nondialyzed patients with chronic kidney disease: an ESADA study.

Patients with chronic kidney disease (CKD) often report poor sleep quality, but they commonly exhibit OSA. The aim of this study was to evaluate the influence of OSA severity and of estimated glomerular filtration rate impairment on objective sleep quality in nondialyzed patients with CKD, defined as an estimated glomerular filtration rate <60 mL/min/1.73m². Polysomnographic sleep characteristics were compared between patients with (n = 430) and without CKD (n = 6,639) in the European Sleep Apnea Database cohort. Comparisons were repeated in 375 patients with CKD and 375 control patients without CKD matched for sleep center, age, sex, and AHI, and in 310 matched CKD and non-CKD patients without psychiatric disturbances. Among all patients with and without CKD, total sleep time was similar but sleep stage N1 (median 8.7% [IQR 4.8-18.0] vs 6.7% [3.6-12.7], respectively) and sleep stage R (12.6% [6.8-17.7] vs 14.2% [8.8-19.8], respectively) significantly differed (P < .0001). No difference in sleep characteristics was observed between matched patients either with or without psychiatric disturbances. After subdividing the matched patients according to AHI tertile (<25, ≥25 to <49, and ≥49 events/h) and estimated glomerular filtration rate (≥60, 45 to <60, <45 mL/min/1.73m²), we found a significant effect of AHI on sleep stages N2, N3, and R (P < .001), but there was no effect of CKD. In nondialyzed patients with CKD, objective sleep quality is influenced similarly by AHI as in patients without CKD but is not affected by CKD severity. Previously reported poor sleep quality in CKD may partly result from the high prevalence of OSA in CKD.

Racial/ethnic disparities in women's sleep duration, continuity, and quality, and their statistical mediators: Study of Women's Health Across the Nation.

To describe racial/ethnic differences in sleep duration, continuity, and perceived sleep quality in postmenopausal women and to identify statistical mediators of differences in sleep characteristics. Recruited from the observational Study of Women's Health Across the Nation (SWAN), 1,203 (548 white, 303 black, 147 Chinese, 132 Japanese, and 73 Hispanic; mean age 65 years, 97% postmenopausal) women participated in a week-long actigraphy and daily diary study in 2013-2015. Actigraphic measures of sleep duration and wake after sleep onset (WASO), and diary-rated sleep quality were averaged across the week. Candidate mediators included health-related variables; stress; and emotional well-being assessed up to 13 times across 18 years from baseline to sleep study. Whites slept longer than other groups; the significant mediators were concurrent financial hardship and increasing number of stressors for Hispanics or Japanese versus whites. Whites had less WASO than blacks and Hispanics; significant mediators were concurrent number of health problems, physical inactivity, waist circumference, vasomotor symptoms, number of life stressors, and financial hardship, and increasing number of health problems from baseline to sleep study. Whites reported better sleep quality than blacks, Chinese, and Japanese; significant mediators were concurrent physical inactivity, vasomotor symptoms, positive affect, and depressive symptoms. Sleep differences between blacks or Hispanics versus whites were mediated by health problems, number of stressors, and financial hardship, whereas sleep differences between Chinese or Japanese versus whites were mediated by emotional well-being. This is the first study using formal mediational approaches.

Difference in Sleep Characteristics between Restless Leg Syndrome With and Without Periodic Limb Movement during Wakefulness

Objectives Restless leg syndrome (RLS) is a common sensorimotor disorder and is frequently associated with periodic limb movement in sleep (PLMS). Also about one third of patient with RLS have periodic limb movement during wakefulness (PLMW). However there is little research on the correlation between PLMW and RLS. We aimed to evaluate difference in sleep characteristics between patients with RLS with PLMW and those without PLMW. Methods Our study included twenty eight RLS patients. Subjects underwent suggested immobilization test (SIT) prior to one full-night polysomnography study. Patients were classified into two groups according to the presence of PLMW based on SIT-PLMW index. Polysomnographic findings, subjective sleep quality, and hematologic results were analyzed and compared between the two groups. Results Mean age of patient with frequent PLMW (SIT-PLMW ≥40/hr) was significantly higher. RLS patients with frequent PLMW were also significantly related to insomnia severity. The PLMS index was higher in patients with PLMW and showed a significant correlation with the PLMW index. Conclusions PLMW influence sleep quality such as insomnia and is correlated with movement during sleep. Keywords: Restless legs syndrome, Periodic leg movement during sleep, Periodic leg movement during wakefulness, Polysomnography, Suggested immobilization test.

Comparing the acute presentation of sport-related concussion in the adult and pediatric populations

Introduction Despite growing research on concussion, there is currently minimal evidence comparing the acute presentation of sport-related concussion between adult and pediatric patients. Objective To assess and compare the injury characteristics, symptoms and neurologic exam findings in acute sport-related concussion between adult and pediatric patients. Methods Retrospective cohort study of all patients presenting to an outpatient sports neurology clinic for initial assessment of an acute concussion within 7 days of injury between January 2016 and August 2017. Patients were divided into 2 groups, 18 and older (n = 28) and 17 and younger (n = 107). Data assessed included age, sex, injury date, date of visit, injury characteristics, Sport Concussion Assessment Tool (SCAT3) symptom scale, sleep characteristics, comorbid medical diagnoses, and neurologic exam findings. Results There were no significant differences between the adult and pediatric patients in any SCAT3 symptom score, neurologic exam category, pertinent elements of past medical history, or characteristics of the acute concussion, including number of head impacts, presence of helmet, loss of consciousness, amnesia, or continuation of play. The pediatric group had significantly higher average hours of sleep ( p = 0.034) and were less likely to wake up refreshed ( p = 0.024). There were no other significant differences in sleep characteristics between the groups. Conclusions The initial presentation of acute concussion within 7 days of injury will likely not differ by age, specifically 18 and older vs 17 and younger. These data suggest no indication for focusing on specific portions of the history or neurologic examination based on these age groups.

Cardiovascular Autonomic Control Is Altered in Children Born Preterm with Sleep Disordered Breathing

To assess if the effects of sleep disordered breathing (SDB) on heart rate (HR) and HR variability, as a measure of autonomic control, were more severe in a group of children born preterm compared with a group of children born at term referred to our sleep laboratory for assessment of SDB. Children (3-12 years of age) referred for polysomnographic assessment of SDB were recruited; 50 born preterm (<37 weeks of gestation) and 50 at term, matched for age and SDB severity. The mean HR and HR variability using power spectral analysis were calculated for each child for wake and sleep, and stages N1, N2, N3, and rapid eye movement sleep. Ex-preterm children were born between 23 and 35 weeks of gestational age (29.3 ± 3.6; mean ± SEM). There were no differences in the demographic, sleep, or respiratory characteristics between the groups. High-frequency power (reflecting parasympathetic activity) was greater in the ex-preterm children in both N2 and N3 (P < .05 for both) and total power was greater in N3 (P < .05). When the children were divided by SDB severity, these effects were most marked in those preterm born children with moderate to severe disease. Preterm born children matched for age and SDB severity with children born at term showed no differences in sleep characteristics; however, they did exhibit increased parasympathetic tone during non-rapid eye movement sleep.

Black-White Differences in Housing Type and Sleep Duration as Well as Sleep Difficulties in the United States.

Housing environments can directly and indirectly affect sleep, and blacks are more likely than whites to live in suboptimal housing conditions, which may independently contribute to sleep disparities. However, few large-scale epidemiological studies consider the potential influence of housing type on sleep health. Using data from the 2004–2015 National Health Interview Survey, we investigated overall and Black-White differences in the association between housing type (house/apartment versus mobile home/trailer) and sleep duration as well as sleep difficulties among 226,208 adults in the U.S. Poisson regression with robust variance was used to estimate sex-specific prevalence ratios (PR) for sleep categories, first comparing houses/apartments to mobile homes/trailers and then blacks to whites within housing types. All models were adjusted for age, educational attainment, income, occupational class, self-reported general health status, and region of residence. Compared to participants living in houses/apartments, the prevalence of short sleep was higher for men (PR = 1.05 (95% confidence interval (CI): 1.02–1.08)) and women (PR = 1.07 (95% CI: 1.04–1.09)) in mobile homes/trailers. Black men (PR = 1.26 (95% CI: 1.21–1.30)) and women (PR = 1.24 (95% CI: 1.20–1.27)) in a house/apartment were more likely to be short sleepers than their white counterparts. There was generally no significant difference in sleep characteristics (except long sleep) between black and white men in mobile homes/trailers after adjustments, and black men in houses/apartments as well as black women in both housing types were less likely to report sleep difficulties although being more likely to report short sleep. Overall, individuals in mobile homes/trailers, which may represent suboptimal housing, had worse sleep than those in houses/apartments; and racial differences in the quality of houses and apartments are likely to greatly vary in ways that still contribute to sleep disparities. Race–sex group differences in sleep duration among residents in a house/apartment and even a lack of racial difference among individuals living in mobile homes/trailers support the need for more research on residential environments and eventually multi-level interventions designed to reduce sleep disparities.

No Compromise of Competition Sleep Compared With Habitual Sleep in Elite Australian Footballers.

To assess the impact of match-start time and days relative to match compared with the habitual sleep characteristics of elite Australian Football (AF) players. 45 elite male AF players were assessed during the preseason (habitual) and across 4 home matches during the season. Players wore an activity monitor the night before (-1), night of (0), 1 night after (+1), and 2 nights (+2) after each match and completed a self-reported rating of sleep quality. A 2-way ANOVA with Tukey post hoc was used to determine differences in sleep characteristics between match-start times and days relative to the match. Two-way nested ANOVA was conducted to examine differences between competition and habitual phases. Effect size ± 90% confidence interval (ES ± 90% CI) was calculated to quantify the magnitude of pairwise differences. Differences observed in sleep-onset latency (ES = 0.11 ± 0.16), sleep rating (ES = 0.08 ± 0.14), and sleep duration (ES = 0.08 ± 0.01) between competition and habitual periods were trivial. Sleep efficiency was almost certainly higher during competition than habitual, but this was not reflected in the subjective rating of sleep quality. Elite AF competition does not cause substantial disruption to sleep characteristics compared with habitual sleep. While match-start time has some impact on sleep variables, it appears that the match itself is more of a disruption than the start time. Subjective ratings of sleep from well-being questionnaires appear limited in their ability to accurately provide an indication of sleep quality.