Improve Sleep Health Research Articles

The impact of fear of hypoglycaemia on sleep in adolescents with type 1 diabetes.

Fear of hypoglycaemia (FOH) can contribute to impaired sleep for adults with type 1 diabetes (T1D) and parents of children with T1D, although it is unknown how FOH may affect sleep for adolescents with T1D. This study examines the relationship between adolescent FOH and sleep and assessed the influences of continuous glucose monitor (CGM) and insulin pump use. Adolescents ages 14-18 years with T1D completed questionnaires evaluating FOH (Child Hypoglycemia Fear Survey) and sleep (Pittsburgh Sleep Quality Index, PSQI). Analyses included linear and logistic regression, t-tests and Fisher's exact tests. Participants included 95 adolescents (52 female) with a median (IQR) age of 16.5 (15.3-17.7) years and a T1D duration of 5.7 (2.5-9.6) years. Analyses showed increased FOH-Worry subscale scores were associated with reduced sleep duration (β= -0.03, p= 0.042, adjusting for BMI z-score, race and ethnicity) and increased sleep disturbances (OR=1.1, p= 0.038, adjusting for race and ethnicity). Frequent CGM users had longer sleep duration (average 7.5h) compared with infrequent or non-CGM users (average=6.8h; p= 0.029), and pump users had overall improved sleep health as determined by PSQI score (p= 0.019). Technology use did not have significant interactions in the relationships between FOH and sleep duration or sleep disturbances. Worrying about hypoglycaemia was associated with impaired sleep for adolescents with T1D. Diabetes technology users have some sleep improvements, but CGM and pump use do little to alter the relationship between FOH and sleep outcomes.

Racial and ethnic disparities in insufficient sleep among US in infants and preschoolers

ObjectiveTo examine racial and ethnic disparities and associated factors of insufficient sleep among children from infancy to preschool-aged. MethodsWe analyzed parent-reported data on US children ages 4 months-5 years (n = 13,975) from the 2018 and 2019 National Survey of Children's Health. Children who slept less than the age-specific minimum hours recommended by the American Academy of Sleep Medicine were classified as having insufficient sleep. Logistic regression was used to estimate unadjusted and adjusted odds ratios (AOR). ResultsAn estimated 34.3% of children from infancy to preschool-aged experienced insufficient sleep. Socioeconomic factors (poverty [AOR] = 1.5, parents’ education level [AORs] from 1.3 to 1.5); parent-child interaction variables (AORs from 1.4 to 1.6); breast feeding status (AOR = 1.5); family structure (AORs from 1.5 to 4.4); and weeknight bedtime regularity (AORs from 1.3 to 3.0) were significantly associated with having insufficient sleep. Non-Hispanic Black (OR = 3.2) and Hispanic children (OR = 1.6) had significantly higher odds of insufficient sleep compared to non-Hispanic White children. Racial and ethnic disparities in insufficient sleep between non-Hispanic White children and Hispanic children were largely attenuated by adjusting for social economic factors. However, the difference in insufficient sleep between non-Hispanic Black and non-Hispanic White children remains (AOR = 1.6) after adjusting socioeconomic and other factors. ConclusionsMore than one-third of the sample reported insufficient sleep. After adjusting for socio-demographic variables, racial disparities in insufficient sleep decreased but persistent disparities existed. Further research is warranted to examine other factors and develop interventions to address multilevel factors and improve sleep health among racial and ethnic minority group children.

Improving sleep health management in primary care: A potential role for community nurses?

To explore community nurses sleep health practices and their perspectives on improving sleep health care provision. An exploratory study utilizing the qualitative description methodology. Semi-structured interviews were conducted with community nurses from May 2019 - October 2021. Interviews were audio-recorded, transcribed, and subjected to an inductive thematic analysis using a constructivist-interpretive paradigm. Twenty-three Australian community nurses were interviewed. Participants frequently encountered sleep disturbances/disorders in their patients. Data analysis yielded three main themes: (1) Sleep health in the community serviced, (2) sleep health awareness and management, and (3) community nurses' A to Z of improving sleep health. The most common sleep disorder presentations were insomnia and sleep apnea. Although most community sleep apnea cases were appropriately managed, insomnia was often mismanaged. Participants described their sleep health knowledge as deficient, with the majority advocating for increased sleep-related education tailored to their profession. Other important factors needed for improving sleep health provision were standardized patient treatment/referral pathways, increased interprofessional collaboration, and sufficient time for patient consults. Community nurses service a patient population that requires increased sleep health care. However, they are currently underequipped to do so, leading to suboptimal treatment provision. Providing community nurses with the appropriate resources, such as increased sleep-related education and standardized treatment frameworks, could enable them to better manage sleep disturbance/disorder presentations, such as insomnia. Little is known about how community nurses care for patients with sleep disturbance/sleep disorders. This study found that contemporary sleep health care was lacking due to knowledge deficits, competing challenges, and a need for standardized care pathways. These findings can inform the development of targeted education/training and standardized guidelines for community nurses providing sleep health care to patients as well as the design of future practice models of care provision. Previous research by authors has involved extensive engagement with patients and health professionals, such as community pharmacists, general practitioners, and naturopaths who play a role in sleep health in the primary health care sector. These previous research projects built a significant understanding of the patient and health practitioner experience and have provided the background to the concept and design of this study.

Racial and Ethnic Trajectories of Sleep Disturbances: Variations by Age andCohort.

The racial and ethnic differences in trajectories of sleep disturbances in later life are crucial for addressing health disparities, but are not well understood. This study examines (a) how trajectories of sleep disturbances vary by race and ethnicity and birth cohort and (b) whether social and health risk factors explain such variations. The study uses longitudinal data from the 2002-2018 Health and Retirement Study (N=21963) and the multilevel growth curve model to assess trajectories of sleep disturbances and their variations across 6 cohorts of White, Black, and Hispanic older adults. Sleep disturbances are measured using a modified Jenkins Sleep Scale. Without controls, sleep disturbances increased with aging for all racial and ethnic groups, but more rapidly among minorities, particularly younger cohorts of Hispanic older adults. When controlling for social and health risks, sleep disturbances did not change with aging for Whites and Blacks and increased for younger cohorts of Hispanics. Cohort effects were observed among White older adults, with higher sleep disturbances in younger cohorts. Importantly, the racial and ethnic disparities in age and cohort effects were not fully explained by social and health risks. Of the symptoms, the most salient racial and ethnic disparities were found in "waking up at night" and "not feeling rested." Findings reveal several differences by race and ethnicity and birth cohort in trajectories of sleep disturbances. Efforts should be made to improve sleep health for older adults as they age, especially for younger cohorts of Blacks and Hispanics.

A qualitative study of sleep in young breast cancer survivors: "No longer able to sleep through the night".

Sleep disturbance is common among women with breast cancer and is associated with greater symptom distress and poorer outcomes. Yet, for the unique subgroup of young women with breast cancer (YWBC), there is limited information on sleep. To address the gap in our understanding of sleep health in YWBC, we explored their perspective on sleep quality, sleep changes over time, contributing factors, and any strategies used to promote sleep. As part of an explanatory sequential mixed method study, we recruited a sub-sample of 35 YWBC (≤ 50years of age at the time of diagnosis) from the larger quantitative study phase. These participants were within the first 5years since diagnosis and completed primary and systemic adjuvant therapy. We conducted virtual semi-structured interviews, transcribed them verbatim, and analyzed data with an interpretive description approach. YWBC experience difficulty falling asleep, waking up at night, and not feeling refreshed in the morning. They attributed interrupted sleep to vasomotor symptoms, anxiety/worry, ruminating thoughts, everyday life stressors, and discomfort. The sleep disturbance was most severe during and immediately after treatment but persisted across the 5years of survivorship. The participants reported trying pharmacologic and non-pharmacologic strategies to improve the quantity and quality of their sleep. Future research would benefit from longitudinal designs to capture temporal changes in sleep and develop interventions to improve sleep health. Clinically, assessment of sleep health is indicated for YWBC related to the prevalence of disturbed sleep. IMPLICATIONS FOR CANCER SURVIVORS: Early access to sleep assessment and management, ideally before cancer treatment, would be beneficial for youngbreast cancer survivors. In addition, cancer treatment plans should include physical and psychological symptoms,especially those reported by women in this study: vasomotor symptoms, anxiety and worry, discomfort, and pain.

Sleep and Performance in Professional Athletes.

Sleep is an essential human behavior that plays a key role in proper biopsychosocial development as well as short- and long-term biological, physical, psychological, and cognitive health. Sleep plays a key role in athletic performance, influencing an athlete's ability to train, recover, and perform, as well as their overall wellness. Over the recent decade, the awareness of sleep's import has penetrated just about every professional sport domain. The purpose of the review was to identify and synthesize the literature published within the past 5years (2018-2022) that relates to sleep and performance in professional athletes. Literature related to nonprofessional, high-level athletes (e.g., collegiate; Olympic) was omitted as well as those associated with non-traditional professional sports (e.g., eSports). Results from 38 articles were incorporated into this review, which covered (1) the sleep's role in the training, physical injury prevention and recovery, competitive performance, and mental health of professional athletes, (2) common sleep problems and disorders in professional athletes, and (3) the impact of unique challenges from training, travel, competition, and other factors on sleep health. Additionally, we provide an orientation to utilized strategies and interventions to assist with sleep health in professional athletes, as well as conclude with a commentary on critical steps forward. Sleep plays a critically important role in the training, recovery, performance, and overall wellness of professional athletes. Professional athletes are vulnerable to a variety of sleep-related problems and disorders, due to unique factors related to training, travel, and competition, among other factors. Improved, standardized research methodology and partnerships between professional athletes, coaches, teams, and organizations and researchers are necessary to advance the knowledge of sleep and performance in professional athletes, including identifying sport-specific differences and variation across individual characteristics, as well as developing individualizable, dynamic, and appropriate interventions for improving sleep health among professional athletes.

Eliminating Sleep Health Disparities and Achieving Health Equity: Seven Areas for Action in the Behavioral Sleep Medicine Community

ABSTRACT Racial and ethnically minoritized and under-resourced populations do not reap the same benefits of sufficient sleep as their white counterparts resulting in insufficient sleep and sleep health disparities. Research exploring these disparities have documented a plethora of factors including social determinants of health, community violence, and structural issues – all of which are associated with adverse sleep. There are robust evidence base behavioral intervention that can be leveraged to improve sleep health among racial and ethnic groups. However, EBIs are not well leveraged. In 2021, with participation from members of the society of behavioral sleep medicine, we conducted this report to bring together the field of behavioral sleep medicine including researchers, clinicians and trainees to discuss gaps and opportunities at the intersection of the COVID-19 pandemic, systemic racism, and sleep health. The goals were anchored around seven recommendations toward reducing disparities in the near-term and longer-term approaches to eliminating disparities. Furthermore, we acknowledge that reducing and eliminating disparities in sleep health requires a multifaceted approach that includes a focus on individual, community, health care and societal levels of influence with participation from diverse partners including federal, state and local.

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.

FRAILTY AND DEPRESSIVE SYMPTOMS MEDIATE THE IMPACTS OF FOOD INSECURITY ON SLEEP DEFICIENCY AMONG OLDER FILIPINOS

Abstract Although research has shown that food insecurity may lead to sleep problems due to mental illness, it remains unclear whether physical health also mediates this relationship in addition to poor mental health. We investigated whether frailty and depressive symptoms mediated the association of food insecurity with sleep deficiency (i.e., inadequate and poor sleep) among community-dwelling older adults. We analyzed the baseline data of the Longitudinal Study of Ageing and Health in the Philippines, a study with national representative sample of adults aged 60 years or older (Nf5,187). Sleep deficiency was conceptualized as self-reported sleeping less than 6 hours, complaining about trouble with falling asleep and staying asleep, and/or having non-restorative sleep. Food insecurity was defined as being hungry and not having enough food in the past three months in the household. Frailty was operationalized using modified definitions under Fried’s criteria. Depressive symptoms were assessed using the Center for Epidemiological Studies-Depression Scale. Covariates included socio-demographics (age,sex,education,wealth,insurance,living arrangement,urbanity), health (pain,chronic diseases), and lifestyles (smoking,drinking). Mediation analysis was performed using PROCESS macro. The results from bootstrapping showed that the indirect effects from food insecurity through frailty (b=.024,SE=.009,95%CI=.009-.043) and depressive symptoms (b =.118,SE=.022,95% CI=.078-.166) onto sleep deficiency were significant, but the direct effect from food insecurity to sleep deficiency was not (b=.243,SE=.134,95% CI=-.018-.505). The results suggested that the effects of food insecurity on sleep deficiency were fully mediated through frailty and depressive symptoms among community-dwelling older Filipinos. Preventing frailty and depression may help improve sleep health among individuals being food insecure.

An assessment of prevalence of poor sleep quality among construction workers in Southern India

PurposeSleep quality has been associated with health and safety issues influencing construction labour productivity in developing countries. Despite its significantly adverse contribution to these facets if left unattended to, limited studies have sought to establish its prevalence and causal factors in labour-intensive contexts. This study aims to bridge the gap between the prevalence and casual factors of poor sleep quality among construction workers.Design/methodology/approachAdopting a case study research design, data were collected from a randomly selected sample of construction workers (n = 475) recruited from four construction-based corporations in Southern India. Self-administered questionnaires comprising a Pittsburgh Sleep Quality Index (PSQI) scale was used to measure sleep quality among respondents alongside demographic characteristics, lifestyle preferences and work-habits data. Data were analysed using multivariate logistic regression analysis and descriptive statistical techniques.FindingsSlightly more than a third of the construction workers (n = 33.9%) surveyed experienced poor sleep quality based on a PSQI method score of = 5. Also, the nexus between demographic characteristics, lifestyle preferences and work habits on the incidence of poor sleep quality among construction workers was confirmed.Practical implicationsThe study contributes to the contemporary discourse on improving sleep health of construction workers to enhance their well-being thereby enabling their contribution towards achieving improved construction labour productivity.Originality/valueThis study makes an original contribution to the extent that it seeks to not only determine the prevalence of sleep quality within the construction industry and associated causal factors but to explore its implications on construction labour productivity.

Racial Differences in Positive Airway Pressure Adherence in the Treatment of Sleep Apnea.

Although data are limited, studies suggest on average lower positive airway pressure use in Black, indigenous, and people of color (BIPOC) compared with Whites in most but not all studies. Most of these observational studies are certainly limited by confounding by socioeconomic status and other unmeasured factors that likely contribute to differences. The etiology of these observed disparities is likely multifactorial, due in part to financial limitations, differences in sleep opportunity, poor sleep quality due to environmental disruptions, and so forth. These disparities in sleep health are likely related to chronic inequities, including experiences of racism, neighborhood features, structural, and contextual factors. Dedicated studies focusing on understanding adherence in BIPOC are lacking. Further research is needed to understand determinants of PAP use in BIPOC subjects and identify feasible interventions to improve sleep health and reduce sleep apnea treatment disparities.

P015 Improving sleep health management in primary care: A potential role for community nurses?

Abstract Background Community nurses commonly care for a diverse patient population, often with complex chronic diseases. Sleep health is a key contributor to overall wellbeing and sleep disturbances/disorders frequently co-exist with comorbidities and can hasten disease progression. Community nurses are therefore ideally situated to care for sleep disturbed patients, but to what degree this is currently being undertaken is not known. Objectives To explore community nurses’ current sleep health practices and to look into their perspectives around potential change that can improve sleep health care provision. Methods Qualitative semi-structured interviews were conducted with nurses working in community settings. Interviews were audio recorded, transcribed and thematically analysed. Results Twenty-three Australian community nurses were interviewed. Participants frequently encountered patients with sleep disturbances/disorders with insomnia and sleep apnea being the most common presentations. Data analysis yielded three themes: 1) Sleep health in the community serviced, 2) Sleep health awareness and management, 3) Community nurses A to ZZZ of improving sleep health. Whilst sleep apnea appeared to be managed appropriately, insomnia was often mismanaged. Participants described their sleep health knowledge as deficient with the majority advocating for increased sleep-related education. Other important factors for improved sleep health care were standardised treatment/referral pathways, increased health professional collaboration and sufficient patient consult time. Conclusion Community nurses commonly care for patients requiring increased sleep health care. However, they are currently underequipped to do so. Providing community nurses with appropriate resources, such as sleep-related education and standardised treatment frameworks could enable them to better manage sleep disturbance/disorder presentations.

P016 Evaluating the effectiveness of an interactive educational intervention on sleep health for second-year pharmacy students

Abstract Background Pharmacists are usually the most frequently consulted professionals in primary care for health concerns, such as sleep disturbances. However, conventionally, curricular space devoted to sleep health has been insufficient and this eventuates in suboptimal care provision. For example, pharmacists often provide over the counter/complementary medicines rather than the recommended behavioural counselling for insomnia management. Clearly, pedagogically informed learning experiences about sleep health/insomnia management are important to improve practice. Objectives To develop, implement and evaluate an interactive sleep health educational intervention for 2nd year pharmacy students. Methods An educational intervention utilising a flipped classroom approach, with interactive lectures, self-reflection around personal sleep habits, and role-playing behavioural treatment provision was designed and implemented. A questionnaire assessing pre- and post-intervention changes in knowledge about and attitudes towards sleep as well as post-intervention learning satisfaction, was administered to students. Results Mean total knowledge scores for participating students (n=125, 70.4% females) improved significantly post-intervention from a baseline of 11.1 ± 3.8 to 17.1 ± 3.5 post-intervention, p <0.05 (Score range= 0-25). The mean total attitudes scores also improved from 28.8 ± 3.2 at baseline to 29.4 ± 3.8 (Score range= 10-50), p=0.07; however, this change was insignificant. Conclusion Carefully crafted educational interventions for pharmacy students can help improve sleep health knowledge. Whilst a trend to improved sleep health attitudes was evident, it was not significant, possibly because of positive sleep health attitudes even at baseline. Such programs should be incorporated into pharmacy pre-registration curricula to potentially enhance future pharmacists’ skills in sleep health provision.

O062 Sleep behaviour modification in shift workers: Applying models of arousal dynamics tailored to individual shift schedules and personal commitments

Abstract Introduction Circadian-based biomathematical models of sleep-wake and alertness regulation can improve sleep health in shift workers by providing physiologically optimal times for sleep. It is unclear whether they can be successfully implemented in real-world contexts. This study, for the first time examined associations between model-based sleep-wake recommendations and modification of sleep behaviours in shift workers. Methods Nurses (n=28; 37.2±9.6yrs) with matching-rotating shift schedules received personalised sleep recommendations from either the Phillips-Robinson Model or Model of Arousal Dynamics. Nurses used sleep diaries to record sleep-wake behaviours: (i) pre-exposure to recommendations (baseline, 1-week), (ii) upon exposure (1-week) and completed PROMIS-sleep disturbance, sleep-related impairments pre and post. Results During baseline, participants usual bedtimes and waketimes were at least 180mins away from recommended times from both models. Upon exposure to recommendations, sleep behaviours were aligned within: (i) 62±11mins for bedtime, 71±9mins for waketime (Model of Arousal Dynamics), (ii) 104±16mins for bedtime, 89±12mins for waketime (Phillips-Robinson model) with large effect sizes (p<.00001 for both models). Participants sleep windows had better compliance with recommended sleep windows for the CRC Alertness model (79% overlap) compared to the Phillips-Robinson model (69% overlap). Sleep disturbance and sleep-related impairments improved significantly upon study conclusion (small-effect sizes both groups). Participants reported that automated recommendation delivery, and use of diurnal preference and real-time sleep behaviours to further personalise recommendations will facilitate greater uptake. Conclusion The study provides positive proof-of-concept for the implementation of biomathematical models of sleep-wake dynamics in shift work contexts. Accounting for individual differences may improve applicability of recommendations.

Sleep and self-efficacy: The role of domain specificity in predicting sleep health

ObjectivesAlthough a number of empirically supported sleep interventions exist, sleep-related beliefs remain largely unexplored as clinical tools for enhancing existing interventions. The present study aimed to determine the differential associations between general and sleep self-efficacy with sleep health among a sample of adults ParticipantsParticipants were 3284 adults (Mean Age = 43 years, 48.5% female, 6.4% other-identifying, 80.8% white). MeasurementsParticipants completed measures of self-efficacy (general and sleep self-efficacy) and sleep health as part of their involvement in a larger online study. General self-efficacy and sleep self-efficacy were measured with the General Self-Efficacy and Sleep Self-Efficacy scales respectively. Sleep was assessed with the RegUlarity, Satisfaction, Alertness, Timing, Efficiency, Duration scale. A structural equation model was conducted to determine the associations between measures of general and sleep self-efficacy and sleep health, represented by 2-factors derived from the RegUlarity, Satisfaction, Alertness, Timing, Efficiency, Duration measure. ResultsThe structural model evidenced adequate to good fit to the data and indicated that both general and sleep self-efficacies were directly associated with the latent sleep quality/quantity and circadian rhythm outcomes. Higher general and sleep self-efficacies were positively associated with sleep regularity, timing, and alertness. Higher sleep self-efficacy and lower general self-efficacy were associated with higher sleep satisfaction, duration, and efficiency. ConclusionsFindings highlight the importance of domain specificity in the association between self-efficacy and sleep health outcomes. There is a need for more research into and application of interventions targeted toward increasing sleep self-efficacy as a potential avenue to improve sleep health.

The association between multidimensional sleep health and migraine burden among patients with episodic migraine.

Using the Sleep Regularity, Satisfaction, Alertness, Timing, Satisfaction, and Duration (Ru-SATED) sleep health framework, we examined the association between multidimensional sleep health and headache burden in a cohort of 98 adults with episodic migraine. Participants wore wrist actigraphs and completed twice-daily electronic diaries regarding sleep, headaches, and other health habits for 6 weeks. We calculated separate composite sleep health scores from diary and actigraphy assessed measures using the Ru-SATED framework. We used adjusted multivariable linear regression models to examine the association between composite sleep health scores and headache frequency, duration, and pain intensity. Among 98 participants (mean age: 35 ± 12 years; 87.8% female), 83 had healthy ranges in ≥ 3 sleep dimensions. In models adjusted for age, sex, menopausal status, physical activity and alcohol intake, good sleep health was associated with fewer headache days/month (actigraphy: 3.1 fewer days; 95% confidence interval: 0.9, 5.7; diary: 4.0 fewer days; 95% confidence interval: 1.1, 6.9). Results did not change substantively with further adjustment for stress and depressive symptoms. We did not observe an association between sleep health and headache duration or intensity, respectively. Among patients with episodic migraine, good multidimensional sleep health, but not the majority of singular dimensions of sleep, is associated with approximately 3-4 fewer headache days/month. In addition, there was no association with headache duration or intensity. These findings highlight the importance of assessing multiple dimensions of sleep and suggest that improving sleep health may be a potential clinical strategy to reduce headache frequency. Yoo A, Vgontzas A, Chung J, etal. The association between multidimensional sleep health and migraine burden among patients with episodic migraine. J Clin Sleep Med. 2023;19(2):309-317.

Adolescent sleep myths: Identifying false beliefs that impact adolescent sleep and well-being

ObjectiveCommonly held beliefs about sleep unsupported by scientific evidence (ie, myths) among adolescents and their parents/caregivers may adversely influence sleep-related attitudes and behaviors among adolescents. Thus, identifying such myths with the goal of developing effective evidence-based counter-messages has the potential to improve sleep health in adolescents. MethodWe identified myths with a panel of adolescent sleep health experts (n = 12) using the Delphi method in three sequential steps: (1) focus groups; (2) online discussion; and (3) closed-ended questionnaires with which the experts rated myths on: (1) falseness and (2) public health significance using 5-point Likert scales ranging from 1 (not at all false/important for public health) to 5 (extremely false/important for public health). Next, we explored the prevalence of the myths among a demographically diverse sample of parents/caregivers of adolescents in the United States. Finally, we report the counterevidence to refute each myth. ResultsTen myths about adolescent sleep were identified by the experts using the Delphi method. The most prevalent myths were the beliefs that (1) “Going to bed and waking up late on the weekends is no big deal for adolescents, as long as they get enough sleep during that time,” reported by 74% of parents/caregivers; (2) “If school starts later, adolescents will stay up that much later,” reported by 69% of parents/caregivers; and (3) “Melatonin supplements are safe for adolescents because they are natural,” reported by 66% of parents/caregivers. ConclusionParents/caregivers have the potential to serve as sleep health advocates for their adolescent and support their adolescent's sleep health behaviors. Our study found that many parents/caregivers endorse myths about adolescent sleep that may hinder their ability to support their adolescent's sleep health. Future research may explore methods for promoting evidence-based beliefs about adolescent sleep among parents/caregivers.

Characteristics and Predictors of Sleep Among Spousal Care Dyads Living With Chronic Conditions.

Poor sleep is common among older adults with chronic health conditions and their spousal caregivers. However, dyadic sleep patterns among spouses are underexplored within the literature. This study examines dyadic sleep characteristics and associated contextual factors among spousal care dyads. Participants included 462 older adult spousal care dyads from the 2015 National Health and Aging Trends Study and National Study of Caregiving (mean ages of care recipients/caregivers = 79 and 76 years, respectively; 22% of dyads were living with dementia). Self-reported sleep included frequency of (a) trouble falling back asleep among dyads, (b) care-related sleep disturbances among caregivers, and (c) trouble initiating sleep among care recipients. Predictors included between-dyad characteristics such as whether respondents had dementia, care burden and support, relationship quality, neighborhood cohesion, and within-dyad characteristics such as demographics, depression, and positive affect. We conducted multilevel dyadic analysis and actor-partner interdependence modeling. Sleep was correlated more among dyads living with dementia than those with other chronic conditions. Care dyads had poorer sleep if caregivers reported higher care burden; however, better relationship quality marginally ameliorated the association. Depressive symptoms had a partner effect on poorer sleep among care dyads, whereas positive emotions and older age only had an actor effect on better sleep for care recipients and spousal caregivers. Neighborhood cohesion, care support, and other demographic characteristics were not associated with dyadic sleep outcomes. Addressing both care recipient- and caregiver-related factors may improve sleep health for both members of the care dyad living with chronic conditions.

Sleep characteristics among black cisgender sexual minority men and black transgender women during the COVID-19 pandemic: The role of multi-level COVID-19-related stressors

ObjectivesTo determine the association between individual, network, and structural COVID-19-related stressors and changes in sleep duration and quality among Black cisgender sexual minority men (SMM) and Black transgender women during the COVID-19 peak infectivity rate in Chicago. MethodsFrom April 20, 2020 to July 31, 2020, we conducted the N2 COVID Study in Chicago (n = 226). The survey included questions regarding multi-level COVID-19-related stressors (eg, food unavailability, partner violence, housing instability, concern about neighborhood COVID-19), sleep duration, and sleep quality. ResultsAbout 19.5% of our sample reported a shorter duration of sleep during the initial peak COVID-19 infectivity, while 41.2% reported more sleep and 38.9% reported about the same. Compared to the prepandemic period, 16.8% reported that their sleep quality worsened in the COVID-19 pandemic, while 27.9% reported their sleep quality had improved and 55.3% reported it was about the same. In multivariable models, we found that ≥1 day of physical stress reaction, worrying about being infected with COVID-19, traveling during COVID-19 being a financial burden, not having enough medication, knowing someone who was diagnosed with COVID-19, partner violence and housing instability were associated with poor sleep health in the COVID-19 pandemic (adjusted risk ratio: 1.82-3.90, p < .05). ConclusionsThese data suggest that COVID-19-related stressors impacted poor sleep duration and quality during the pandemic among this cohort. Multi-level interventions to reduce COVID-19-related stressors (eg, meditation, intimate partner violence prevention and housing programs) may be useful for improving sleep health among Black cisgender sexual minority men and Black transgender women.

Assessment Of Sleep Quality By The Athlete Sleep Screening Questionnaire In Chinese Collegiate Athletes

Purpose: This study aimed to characterize sleep quality and to explore the factors that are associated with the severity of sleep difficulty among Chinese collegiate athletes. Methods: Sleep quality and associated factors were assessed by the Athlete Sleep Screening Questionnaire (ASSQ) in college athletes (n = 395, 73.6% response rate, aged 18 to 32 years, 47.6% female, 22.5% were master level, 47.6% national level and 29.9% second level in 15 different sports events). A sleep difficulty score (SDS) and level of sleep problem (0-4, none; 5-7, mild; 8-10, moderate; 11-17, severe) were used to classify participants. In addition, sports-related information such as sports events and training years were collected. Categorical variables were analyzed by Chi-squared (ꭓ2) or fisher’s exact test. An ordinal logistic regression analysis was used to explore factors with poor sleep (SDS > 8). Results: Approximately 14.2% of participants were found to have moderate to severe sleep problem (SDS > 8). When athletes travelled to participate in sports competitions, those who have experienced sleep disturbance were more diagnosed in the moderate-to-severe problem category than those without sleep disturbance (11.4% Vs. 2.8%, ꭓ2, 27.5; P < 0.001). While athletes who experienced daytime dysfunction when traveling fell more into the moderate-to-severe sleep problem category than athletes without daytime dysfunction (7.6% Vs. 6.6%, ꭓ2, 20.7; P < 0.001). No significant difference was found in SDS category between gender, sports level and sports events (All P > 0.05). Athletes with evening chronotype were more likely to report worse sleep compared to athletes with morning chronotype (OR, 2.25; 95%CI, 1.44 - 3.52; P < 0.001). For each additional year of age, there was an increase in odds ratio for poor sleep quality (OR1.15; 95% CI, 1.04 - 1.26; P = 0.004). However, increasing each additional year of training reduced the odds ratio for poor sleep quality (OR,0.95; 95% CI, 0.91 - 0.99; P = 0.044). Conclusion: To improve sleep health in collegiate athletes, chronotype, travel-related issues, age and training years should be taken into consideration in sleep counseling.