Earlier Bedtimes Research Articles

An Examination of Adult Women’s Sleep Quality and Sleep Routines in Relation to Pet Ownership and Bedsharing

ABSTRACTPeople in many parts of the world commonly share their beds not only with human partners but also with dogs and cats. Self-report and actigraphy data have shown that sleeping with an adult human partner has both positive and negative impacts on human sleep, but there has been little exploration of the impacts that pets have on human sleep quality. We collected survey data online from 962 adult women living in the United States to investigate relationships between pet ownership and human sleep. Fifty-five percent of participants shared their bed with at least one dog and 31% with at least one cat. In addition, 57% of participants shared their bed with a human partner. Our findings did not show a strong relationship between pet ownership status or bedsharing conditions and sleep quality as assessed by the Pittsburgh Sleep Quality Index (PSQI), although according to this measure, a high percentage of study participants did experience sleep quality deficits. It is possible that pet ownership contributed to the high global PSQI scores we observed, especially since all but 7% of participants resided with dogs and/or cats. Other measures included in this study indicate that dogs and cats, and where they sleep, may indeed affect sleep habits and perceptions of sleep quality. Dog owners had earlier bedtimes and wake times than individuals who had cats but no dogs. Compared with human bed partners, dogs who slept in the owner’s bed were perceived to disturb sleep less and were associated with stronger feelings of comfort and security. Conversely, cats who slept in their owner’s bed were reported to be equally as disruptive as human partners, and were associated with weaker feelings of comfort and security than both human and dog bed partners. Follow-up research is necessary to determine if pet owners’ perceptions of pets’ impacts on their sleep align with objective measures of sleep quality.

Caregiver-perceived sleep outcomes in toddlers sleeping in cribs versus beds

ObjectiveLittle is known about whether sleep space impacts toddler sleep outcomes. We examined the prevalence of crib-sleeping and its association with caregiver-reported sleep patterns and problems in a large sample of toddlers from Western countries. MethodsParticipants were caregivers of 1983 toddlers ages 18.0–35.9 months (51.7% male; mean age 25.3 months) from Australia, Canada, New Zealand, the United Kingdom, and the United States sleeping in a crib or bed in a separate room from caregivers. Caregiver-reported sleep patterns and problems were collected via a free, publicly available child sleep smartphone application. ResultsAcross countries/regions, rates of crib-sleeping decreased linearly with age, with 63.4% of toddlers ages 18.0–23.9 months, 34.3% of toddlers ages 24.0–29.9 months, and 12.6% of toddlers ages 30.0–35.9 months sleeping in a crib. Across age groups and countries, crib sleeping was significantly associated with an earlier bedtime, shorter sleep onset latency, fewer night awakenings, longer stretches of time asleep, increased nighttime sleep duration, and decreased bedtime resistance and sleep problems. The duration of night awakenings did not significantly differ by sleep space. ConclusionSleeping in a crib instead of a bed is associated with enhanced caregiver-reported sleep quantity and quality for toddlers in Western countries. Consistent with practice recommendations, deferring the crib-to-bed transition until age 3 years may benefit toddlers’ sleep in Western contexts. Additional research is needed to identify the impact of sleep space on child sleep in other countries/regions.

Sleep duration, timing, variability and measures of adiposity among 8- to 12-year-old children with obesity.

SummaryObjectivesSleep disruption in laboratory studies increases adiposity and decreases glucose tolerance. However, few epidemiological studies have used objective measures of sleep. This study aims to assess associations between sleep duration, timing and regularity with measures of adiposity.MethodsThis is a cross‐sectional study of 188 children with obesity (age: 10.50 ± 1.39 years; body mass index: 29.24 ± 5.04 kg m−2). Nightly sleep duration, bedtime and wake time were measured by multiple‐day actigraphy and parent reports. Per cent overweight (per cent over median body mass index for age and sex) was chosen as the primary measure of obesity status. Objective measures of height, weight, waist circumference, blood pressure, fasting blood lipids, glucose, insulin, glycated haemoglobin and C‐reactive protein were obtained. Television screen time and total caloric intake were assessed via parent questionnaire.ResultsEach hour later in weekday bedtime was associated with an additional 6.17 per cent overweight (95% confidence interval [CI]: 1.42–10.92). Each hour greater in day‐to‐day variability in weekday bedtime and weekday wake time was associated with an additional 10.20 (95% CI: 0.50–19.91) and 10.02 (95% CI: 1.55–18.50) per cent overweight, respectively. Associations were similar after controlling for other obesity‐related behaviours (television screen time, total caloric intake and physical activity.)ConclusionsAmong children with obesity, later bedtime and greater variability in bedtime and wake time are associated with greater adiposity, independent of other obesity‐related behaviours. Early bedtime and wake time and consistent day‐to‐day sleep timing may be strategies to reduce adiposity in high‐risk children.

Association between bedtime and the prevalence of newly diagnosed non‐alcoholic fatty liver disease in adults

Emerging evidence supported that circadian clocks played an important role in the development and progression of non-alcoholic fatty liver disease (NAFLD). Bedtime is a strong regulator of circadian rhythms, implying that it may contribute to the onset of NAFLD. However, few studies have examined the association between bedtime and NAFLD. The purpose of the study was to determine whether late bedtime is associated with newly diagnosed NAFLD in an adult population. This population-based study was performed in 22807 participants in Tianjin, China. Bedtime was obtained from a self-administered questionnaire, and NAFLD was diagnosed by abdominal ultrasonography. Odds ratios of NAFLD for bedtime categories were estimated with multiple logistic regression models. The prevalence of newly diagnosed NAFLD was 18.8% in the present study. After adjustment for the potential confounders, compared with the reference group (bedtime ≤22:00), the odds ratios (95% confidence intervals) of NAFLD were 1.18 (1.05-1.32) and 1.42 (1.21-1.68) for bedtime from 22:00 to 24:00 and ≥24:00, respectively. Late bedtime was slightly but significantly associated with an increased prevalence of newly diagnosed NAFLD, independently of confounding factors. It is suggested that early bedtime may be beneficial in preventing NAFLD.

The influence of sleep hygiene education on sleep in professional rugby league athletes

ObjectiveTo examine the usefulness of sleep hygiene education on the sleep of professional rugby league athletes during a 10-week period of the competitive season. DesignCase study. ParticipantsTwenty-four professional rugby league athletes. MeasurementsInitially, participants were monitored for a 2-week period using wrist activity monitors allowing baseline estimation of sleep. Following this, 12 athletes attended two 30-minute sleep hygiene education seminars delivered over successive weeks, whereas the remaining 12 athletes received no education. Sleep was monitored in all athletes across the 2-week education period and for a 2-week period 1 month following the end of education. Split-plot analysis of variance and paired t tests were used to examine differences in sleep across the duration of the investigation. ResultsAn initial sleep hygiene education seminar resulted in an earlier bedtime (effect size [ES] = 0.53 ± 0.48), more time in bed (ES = 0.53 ± 0.49), and increased sleep duration (ES = 0.47 ± 0.44). A second sleep hygiene education seminar resulted in more time in bed (ES = 0.84 ± 0.50) but a reduction in sleep efficiency (ES = 1.15 ± 0.48). One month following sleep hygiene education, sleep behavior was comparable to that observed at baseline. ConclusionThis study shows that sleep hygiene education can lead to positive changes in sleep behavior. However, changes in sleep from education may not be sustained following the initial intervention.

Can you snooze your way to an 'A'? Exploring the complex relationship between sleep, autonomic activity, wellbeing and performance in medical students.

Medical training brings with it multiple stressors, including demanding workloads in highly competitive environments, with well-documented impact on psychiatric morbidity. This study evaluated the impact of sleep-related factors on psychological wellbeing, cognitive task performance and academic standing in medical students. A total of 59 undergraduate medical students took part in this cross-sectional study over two consecutive days. Participants responded to questionnaires about their physical and psychological health, sleep, functioning and academic performance at the initial visit. Participants then wore an ambulatory bioharness overnight (to derive heart rate variability measures), before returning to complete a computerised battery of cognitive tasks. A sleep diary was completed for the next 7 days. Poor sleep quality in the month preceding assessment correlated with psychological distress ( p < 0.001) and reduced nocturnal heart rate variability ( p = 0.007). Psychological distress also correlated with reduced nocturnal heart rate variability ( p = 0.031) and less refreshing sleep during the monitoring week ( p < 0.001), but not with sleep timing parameters. A greater increase in heart rate variability during the transition from awake to sleep significantly predicted better spontaneous cognitive performance ( p = 0.021). Better academic standing was predicted by consistently short, less refreshing sleep (all p < 0.001), along with earlier bedtimes ( p = 0.004) and greater psychological wellbeing ( p = 0.009). Unrefreshing, short-duration sleep and psychological distress are prevalent in medical students during university training and were associated with reduced nocturnal parasympathetic autonomic activity. Achieving higher academic grades was associated with high psychological wellbeing despite consistently short, unrefreshing sleep. The long-term repercussions of such sleep behaviours on later professional functioning remain unclear, warranting further research.

Do players and staff sleep more during the pre- or competitive season of elite rugby league?

This study establishes the sleep behaviour of players and staff during the pre- and competitive seasons of elite rugby league. For seven days during both the pre- and competitive seasons, seven rugby league players and nine full-time staff from one professional Australian rugby league club had their sleep monitored via wrist actigraphy and self-report sleep diaries. Two-way repeated measures analysis of variance determined differences between the pre- and competitive season in players and staff, with effect sizes (ES) used to interpret the practical magnitude of differences. Findings show an earlier bed time and wake time for players (−34 min, ES = 1.5; ±0.5 and −39 min, 2.1; ±0.5 respectively) and staff (−29 min, ES = 0.8; ±0.3 and −35 min, ES = 1.7; ±0.4 respectively) during pre-season when compared to the competitive season. Despite this, no differences were seen when considering the amount of time in bed, sleep duration or sleep efficiency obtained between the pre- and competitive seasons. Our results suggest that early morning training sessions scheduled during pre-season advances wake time in elite rugby league. However, both players and staff can aim to avoid reductions in sleep duration and sleep efficiency with subsequent adjustment of night time sleep patterns. This may be particularly pertinent for staff, who wake earlier than players during both the pre- and competitive seasons.

Effects of Preseason Training on the Sleep Characteristics of Professional Rugby League Players.

To investigate the influence of daily and exponentially weighted moving training loads on subsequent nighttime sleep. Sleep of 14 professional rugby league athletes competing in the National Rugby League was recorded using wristwatch actigraphy. Physical demands were quantified using GPS technology, including total distance, high-speed distance, acceleration/deceleration load (SumAccDec; AU), and session rating of perceived exertion (AU). Linear mixed models determined effects of acute (daily) and subacute (3- and 7-d) exponentially weighted moving averages (EWMA) on sleep. Higher daily SumAccDec was associated with increased sleep efficiency (effect-size correlation; ES = 0.15; ±0.09) and sleep duration (ES = 0.12; ±0.09). Greater 3-d EWMA SumAccDec was associated with increased sleep efficiency (ES = 0.14; ±0.09) and an earlier bedtime (ES = 0.14; ±0.09). An increase in 7-d EWMA SumAccDec was associated with heightened sleep efficiency (ES = 0.15; ±0.09) and earlier bedtimes (ES = 0.15; ±0.09). The direction of the associations between training loads and sleep varied, but the strongest relationships showed that higher training loads increased various measures of sleep. Practitioners should be aware of the increased requirement for sleep during intensified training periods, using this information in the planning and implementation of training and individualized recovery modalities.

0957 SLEEP PATTERNS OF STUDENTS IN A SPORT STUDIES PROGRAM

Teenagers go through modifications characterized by a delay in sleep-wake pattern. This contrasts with fixed schedules imposed by school demands and therefore may influence daytime functioning. However, specialized school programs, such as Sport Studies, may be more demanding because of additional training hours. The purpose of this study was to investigate sleep patterns of high school Sport Studies students and to verify its association with daytime sleepiness. Forty-eight Sport Studies students (15–17 years old) and 411 standard High School students (15–17 years old) completed questionnaires on sleep habits, sleep disorders and daytime functioning at the start of the school year (October). T-tests comparing both groups during school nights (SN) and weekend nights (WN) were performed on total sleep time (TST), bedtime and wake-up time. Then, t-tests were performed to compare both groups for the differences in sleep midpoint with SN and WN (∆sleep midpoint), sleep disorders (SD) and daytime sleepiness (DS). During SN, Sport Studies students have earlier bedtimes [Sport Studies=10:07PM±45min; High School=10:23PM±53min; t(457)=3.9, p<0.01] and wake-up times [Sport Studies=6:26AM±28min; High School=6:49AM±40min; t(457)=2.0, p<0.05], but no difference in TST [Sport Studies=7:52 ± 62min; High School=7:59 ± 58min; t(448)=0.7, p=0.47]. During WN, similar results were obtained with Sport Studies students having earlier bedtimes [Sport Studies =11:29PM±65min; High School=00:18AM±86min; t(440)=3.8, p<0.01] and wake-up times [Sport Studies=8:56AM±91min; High School=9:54AM±103min; t(455)=3.7, p<0.01] and no differences in TST [Sport Studies=9:03 ± 77min; High School=9:16 ± 91min; t(432)=0.9, p=0.36]. Finally, results showed a significant difference in ∆sleep midpoint [t(438)=3.2, p=0.001), less SD (t(377)=2.6, p=0.01] for the Sport Studies students, but no difference between groups in DS [t(444)=1.8, p=0.069]. This study suggests that Sport Studies programs are associated with different sleep habits in teenagers who seem to be shifting their sleep-wake patterns towards an earlier time compared to “regular” students. This earlier shifting is not associated with DS. However, this study did not investigate these sleep patterns and their impact over the course of an entire school year. Moreover, further studies should look more closely at different Sport Studies programs, since great variability exists among them, with programs like swimming having training sessions as early as 5:00AM. N/A

Circadian phase, dynamics of subjective sleepiness and sensitivity to blue light in young adults complaining of a delayed sleep schedule

ObjectiveTo assess factors that might contribute to a delayed sleep schedule in young adults with sub-clinical features of delayed sleep phase disorder. MethodsTwo groups of 14 young adults (eight women) were compared: one group complaining of a delayed sleep schedule and a control group with an earlier bedtime and no complaint. For one week, each subject maintained a target bedtime reflecting their habitual sleep schedule. Subjects were then admitted to the laboratory for the assessment of circadian phase (dim light melatonin onset), subjective sleepiness, and non-visual light sensitivity. All measures were timed relative to each participant's target bedtime. Non-visual light sensitivity was evaluated using subjective sleepiness and salivary melatonin during 1.5-h exposure to blue light, starting one hour after target bedtime. ResultsCompared to control subjects, delayed subjects had a later circadian phase and a slower increase of subjective sleepiness in the late evening. There was no group difference in non-visual sensitivity to blue light, but we found a positive correlation between melatonin suppression and circadian phase within the delayed group. ConclusionsOur results suggest that a late circadian phase, a slow build-up of sleep need, and an increased circadian sensitivity to blue light contribute to the complaint of a delayed sleep schedule. These findings provide targets for strategies aiming to decreasing the severity of a sleep delay and the negative consequences on daytime functioning and health.

The Impact of Sleep Improvement on Food Choices in Adolescents With Late Bedtimes

PurposeThe aim was to investigate the effect of sleep improvement on desire for and intake of weight gain–promoting foods in adolescents with late bedtimes. MethodsA sample of 42 adolescents with late bedtimes was enrolled in an intervention designed to improve sleep. Their desire for and intake of food in the morning was assessed at before and after treatment. ResultsAdolescents with earlier bedtimes at post-treatment relative to pretreatment increased their caloric intake of low glycemic index, fruit, and dairy foods at post-treatment. This effect was not observed in adolescents who did not improve their bedtime at post-treatment. ConclusionsThese findings suggest that advancing bedtimes earlier can improve breakfast choices, an important meal for obesity prevention during adolescence.

Bedtime in Preschool-Aged Children and Risk for Adolescent Obesity

To determine whether preschool-aged children with earlier bedtimes have a lower risk for adolescent obesity and whether this risk reduction is modified by maternal sensitivity. Data from 977 of 1364 participants in the Study of Early Child Care and Youth Development were analyzed. Healthy singleton-births at 10 US sites in 1991 were eligible for enrollment. In 1995-1996, mothers reported their preschool-aged (mean=4.7years) child's typical weekday bedtime, and mother-child interaction was observed to assess maternal sensitivity. At a mean age of 15years, height and weight were measured and adolescent obesity defined as a sex-specific body-mass-index-for-age ≥95th percentile of the US reference. One-quarter of preschool-aged children had early bedtimes (8:00 p.m. or earlier), one-half had bedtimes after 8:00 p.m. but by 9:00 p.m., and one-quarter had late bedtimes (after 9:00 p.m.). Children's bedtimes were similar regardless of maternal sensitivity (P=.2). The prevalence of adolescent obesity was 10%, 16%, and 23%, respectively, across early to late bedtime groups. The multivariable-adjusted relative risk (95% CI) for adolescent obesity was 0.48 (0.29, 0.82) for preschoolers with early bedtimes compared with preschoolers with late bedtimes. This risk was not modified by maternal sensitivity (P=.99). Preschool-aged children with early weekday bedtimes were one-half as likely as children with late bedtimes to be obese as adolescents. Bedtimes are a modifiable routine that may help to prevent obesity.

Objective assessment of sleep status and its correlates in hospitalized children with cancer: Exploratory study.

Children with cancer are known to have sleep problems. Although hospitalization and psychosocial factors are considered to be the factors affecting children's sleep, few studies have confirmed these effects. The aims of this study were to describe the sleep status of hospitalized children with cancer and to explore the correlates. The sleep status of 11 hospitalized children (aged 2-12 years) with cancer was measured using actigraph and sleep diary during hospitalization and a short home stay. Possible correlates were assessed using a questionnaire. The participants had significantly longer sleep onset latency, earlier bedtime, and poorer self-evaluated sleep quality during hospitalization than the short home stay. They had shorter total sleep time, longer wake time after sleep onset, and less sleep efficiency at home, compared with healthy historical controls. Children's age, symptoms, hospitalization period, Cognitive Fatigue, Procedural Anxiety, Treatment Anxiety, Social Anxiety, and Separation Anxiety, as well as caregiver anxiety, Receptive and Focused Attitude, and Regimented Attitude were significantly correlated with sleep variables. Hospitalization decreased self-evaluated sleep quality, and difficulty falling asleep. The sleep of the participants at home was disturbed compared with that of healthy children. Hospitalization, patient characteristics, disease-related, and some psychosocial factors were associated with sleep variables. Medical professionals should develop a favorable environment for falling asleep in hospital for individual children. Children with cancer in the early period of hospitalization need increased care to facilitate good sleep.

Abstract P3-08-04: Improving sleep to reduce breast cancer risk in shift workers

Abstract BACKGROUND: Shiftwork that involves circadian disruption has been designated as a 2A (probable) breast cancer carcinogen by the International Agency for Research on Cancer. Night shift workers experience many lifestyle disturbances including disrupted sleep. While the specific biological mechanisms that confer increased breast cancer risk are not yet clear, sleep disruption is hypothesized to have both direct (lowering melatonin levels) and indirect (obesity status) impacts on risk status. However, few interventions of any type have been reported for shift workers to potentially reduce their risk for breast cancer. An effective intervention to improve sleep quality would be one way to potentially reduce breast cancer risks in these women. METHODS: 47 female shift workers aged 40-65 who had experienced high circadian disruption (rotating or permanent night shifts) at least 3 times per month for at least 2 years participated in a single arm study examining the impact of a sleep intervention on health behaviours and breast cancer risk. Over the course of 10 months, women received with a 10-session (plus 2 booster sessions), telephone-delivered sleep hygiene intervention. The program was adapted from a hospital-based sleep clinic protocol based on cognitive behaviour therapy (CBT) principles and aimed to improve sleep quality and quantity. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). Data were assessed at baseline and 6 and 12 months. RESULTS: Mean age was 47 years, 68% were partnered, and 78% had diploma level education or higher. Participants were nurses (49%), emergency communications personnel (17%) and paramedics (13%), and others. At baseline, 79% had "poor" sleep quality (score above 5 on the PSQI), decreasing to 54% at 6 months and 49% at 12 months (p&amp;lt;0.001 for both changes between baseline and 6 months, and between baseline and 12 months, based on McNemar's test). Significant correlates of better sleep included younger age, being married, and having more education, but not obesity (measured by body mass index). We also investigated chronotype, which characterizes sleep time preferences that reflect underlying circadian rhythms; individuals may be "morning types" or larks (preferring early awakenings and bedtimes), "evening types" or owls (preferring late nights and mornings), or intermediate. We found that our intervention was more significantly effective for larks (where 11% reported good sleep at baseline and 67% at 12 months) and intermediates (where 28% reported good sleep at baseline and 62% at 12 months) than for owls (where 15% reported good sleep at baseline and 18% at 12 months). DISCUSSION: Most female shift workers in this study report impaired sleep quality. Our CBT-based sleep intervention led to significant improvements in sleep quality in 6 months, and these improvements were maintained at one year. This approach was more effective for some chronotypes than others, and "night owls" may require a different intervention. Sleep is a modifiable risk factor that is increasingly linked with cancer-related outcomes, including cancer incidence. Interventions to improve sleep quality such as the program used here offer a novel approach with the potential to reduce breast cancer risk. Citation Format: Gotay C, Aronson K, Campbell K, Demers P, Fleming J, Gelmon K, Goodfellow E, Munoz C, Neil-Sztramko S, Pollak M, Shen H, Spinelli J. Improving sleep to reduce breast cancer risk in shift workers. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P3-08-04.

Sleep health literacy in head start families and staff: exploratory study of knowledge, motivation, and competencies to promote healthy sleep

ContextHealthy child development requires sufficient, quality sleep. Sleep problems in early childhood impair social-emotional and cognitive function and increase obesity risk. From a health literacy framework, “sleep health literacy” denotes the knowledge, motivation, and competencies to promote healthy sleep and to recognize a sleep problem. DesignTo explore the untapped potential of early childhood education (ECE) programs to promote sleep health literacy, we surveyed staff (n = 63) and parents (n = 196) in Head Start about sleep-related knowledge, attitudes/beliefs, sleep hygiene, and sleep problems. Head Start is the largest ECE program in the United States. ResultsMost parents believed that their child had healthy sleep habits (81%); few believed that he or she had a sleep problem (10%). Yet, unhealthy bedtime practices and insufficient sleep for age were reported in 50% and 33% of children, respectively. Between 10% and 12% of children had 1 or more sleep onset or awakening problems. Every unhealthy bedtime practice but one was associated with a sleep problem; parental presence at bedtime was associated with the most problems. Insufficient sleep was significantly associated with unhealthy sleep practices. More children with late vs early bedtimes (48% vs14%, P < .01) and frequent vs less frequent parental presence at bedtime (50% vs 26%-30%, P < .02) failed to obtain sufficient sleep. Staff members are more comfortable discussing healthy sleep with parents (87%) than counseling them (45%). ConclusionAmong parents, there is a “disconnect” between actual and perceived sleep hygiene. Similarly, staff perceived a gap between their competencies to promote healthy sleep in families and their capacity to address sleep problems. US health literacy goals include the need to embed accurate, accessible, and actionable health information in ECE programs. Study findings strongly support the need to work toward sleep health literacy in ECE programs.

Associations of outdoor play and screen time with nocturnal sleep duration and pattern among young children.

Sleep duration and pattern have important implications for children's health. This study aims to investigate nocturnal sleep duration, sleep pattern and their relationships with outdoor play and screen time among children aged 2 to five years. The study used data from the Healthy Beginnings Trial undertaken in Sydney, Australia. Data on children's sleep, outdoor playtime and screen time were reported by mothers via face-to-face interviews when children were 2, 3.5 and five years old. Both cross-sectional and longitudinal analyses were conducted. At age 2, 3.5 and five years, 497, 415 and 369 mother-child dyads participated. Significantly, there was an overall increase in children's nocturnal sleep duration, sleep latency and an earlier bedtime, and there was a decrease in the proportion of children who woke at night over time. Each additional hour of screen time was associated with three-minute (95% CI 0.6-5) shorter sleep, 1.6-minute (95% CI 0.59-2.63) longer sleep latency, four-minute (95% CI 1.8-6.0) later bedtime and less likely sleeping ≥10 hours per night with adjusted odds ratio 0.88 (95% CI 0.77-1.00), after controlling for mothers' demographics. Among young children, screen time and outdoor playtime were associated with sleep duration and pattern. Reducing screen time and increasing outdoor playtime might help improving children's sleep.

‘Byron and the Mediterranean’ 10th International Student Byron Conference Messolonghi, 22–27 May 2015

The Tenth International Student Byron Conference, held from 22-27 May 2015 in Messolonghi, Greece, appropriately acknowledged tenth anniversary of such an ambitious and successful conference by choosing broad theme 'Byron and Mediterranean'. As in past, conference-which as always was flawlessly organised and managed by President of Messolonghi Byron Society. Mrs. Rosa Florou- drew participants from around world for nearly a week of insightful scholarship regarding Byron's life and works, travel spanning region, and intellectual companionship. This year's participants were undergraduate and graduate students, professors and local enthusiasts. They traveled from such places as United States, Canada, United Kingdom, Taiwan, Lebanon, and Greece.Because conference officially began with registration at four o'clock on 22 May, that first Friday was an opportunity for many participants to explore parts of Athens (where most travellers first arrived from their home countries), beautiful coastline and mountains that separate Athens and Messolonghi and that include such famous sites as Corinth Canal, or charming town of Messolonghi itself. Once everyone arrived and checked in at Theoxenia Hotel, participants boarded a coach for Byron House containing administrative office of Messolonghi Byron Society and library of Byron Research Center. There they were greeted by delicious homemade desserts and coffee and had an opportunity to mingle before being welcomed by conference directors Mrs. Rosa Florou, Professor Peter Graham, Director of International Relations for Messolonghi Byron center, and Joint President of International Association of Byron Societies, Professor Naji Oueijan. After refreshments, group was treated to a tour of a variety of significant sites in Messolonghi, including Cathedral of Agios Spyridon, which Byron visited during his time living in 'sacred city', and Gallery of Christos and Sophia Moschandreou to see an exhibition of modern paintings relating to Byron and to local area. Both were beautiful experiences that built nicely towards final sightseeing opportunity at Municipal Museum of History and Art Municipal Gallery, which provided useful historical background information of area. After perusing art in Municipal Gallery, participants were welcomed by Mayor of Messolonghi, Mr. Nikos Karapanos, who gave a warm and passionate speech in Greek, translated into English by several lively impromptu translators. The evening concluded with a welcoming dinner at nearby Archontiko restaurant, followed by (for many of those jet lagged) an early bedtime or else (for those more rested) a night of dancing and socialising in heart of Messolonghi.The academic portion of conference began on Saturday 23 May, at Regional building. There, Rosa Florou, Peter Graham, Jonathan Gross, Naji Oueijan, and Peter Myrian greeted participants but also, more significantly, reflected on life and scholarship of recently deceased English Byron scholar Peter Cochran. Following a moment of silence, first session, chaired by Peter Myrian, began. The first paper, given by Stephen Minta (York), revisited Stephen Cheeke's Byron and Place: History, Translation, and Nostalgia and paid particular attention to Byron's complicated relationship with Greece of past and of his present day using Childe Harold's Pilgrimage as a foundation for his argument. Perhaps even more interestingly, Minta addressed questions regarding 'authenticity of traveller's engagement with what Byron calls the truth of history [...] and of place.' Elli Karampela (Aristotle University of Thessaloniki) gave next paper, which made use of Benedict Anderson's theoretical framework 'imagined communities' to examine Byron's own complex relationship with place of England versus place of Greece. …

Digital media use in the 2 h before bedtime is associated with sleep variables in university students

Digital media use is widespread in University students, and use of digital media near bedtime has a broadly negative effect on sleep outcomes. Adequate and good quality sleep is important for physical and mental health, but few studies have rigorously measured both sleep and digital media use. In this study, we investigated whether self-reported sleep patterns were associated with digital media use in a first-year University student (N = 254, 48% male) population. Students tracked their sleep through daily online diaries and provided digital media use data in 15-min blocks for 2 h prior to bedtime on nine occasions. A longer duration of digital media use was associated with reduced total sleep time and later bedtime, while greater diversity of digital media use was associated with increased total sleep time and earlier bedtime. Analysis of activities in the last hour before bedtime indicated that activity type plays a role in digital media's effect on sleep, with computer work, surfing the Internet, and listening to music showing the strongest relationship to multiple sleep variables. These findings have implications for physical and mental health of University students and can inform design of devices to minimize negative effects of digital media on sleep.

Associations between time in bed and suicidal thoughts, plans and attempts in Korean adolescents

ObjectivesTo examine the hypothesis that respondents with any of three specific sleep patterns would have a higher likelihood of suicidality than those without reports of these patterns in Korean adolescents.SettingData...

Effects of the Young Adolescent Sleep Smart Program on sleep hygiene practices, sleep health efficacy, and behavioral well-being

ObjectivesUsing a social learning model, the aim of the Sleep Smart Program was to primarily improve sleep health behaviors and secondarily improve academic performance and behavioral well-being. DesignRandomized control trial for a social learning-based preventive intervention program. ParticipantsA diverse group of seventh graders from 2 urban, middle schools were randomly assigned, according to school, to an 8-session Sleep Smart Program (SS = 70) or a comparison group (comparison = 73). MeasurementsSleep patterns, sleep hygiene, and sleep health efficacy; academic performance; and behavioral well-being were assessed at 4 times of measure (baseline, postintervention, 2 follow-up times in eighth grade). ResultsSS seventh graders experienced significantly greater sleep health efficacy, improved physiological and emotional sleep hygiene, more time in bed, and earlier bedtimes vs comparison group. SS (vs comparison) participants also reported a significant decrease in internalizing behavior problems and sustained academic performance. Finally, although not maintained at time 4, SS participants continued to report improved sleep health efficacy at time 3, whereas the comparison group participants' sleep health efficacy declined. ConclusionThe Sleep Smart preventive intervention was effective in improving sleep health efficacy, sleep hygiene, time in bed, and bedtimes; in maintaining grades; and in reducing internalizing behavior problems, yet these changes were not sustained at follow-up.