Irregular Schedules Research Articles

US research needs related to fatigue, sleep, and working hours among oil and gas extraction workers.

During 2003-2013, 1189 US oil and gas extraction (OGE) workers died while working, resulting in an average annual workplace fatality rate seven times that for all US workers. OGE work commonly involves long hours, shiftwork, irregular schedules, and long commutes, but effects of these factors on fatigue, occupational injury, and illness in OGE are largely unknown. A scoping review of relevant OGE research during 2000-2019 was completed and supplemented by input from a NIOSH-sponsored Forum. Seventy-eight papers were identified; 76% reported only offshore research. Five themes for research needs emerged: build knowledge about the impacts of fatigue; explore interactions between on- and off-the-job risk factors; identify and evaluate interventions; assess effectiveness of technology; and increase the diffusion of fatigue risk management information. Further collaboration between researchers and OGE operators and contractors can lead to action-oriented recommendations to mitigate the effects of fatigue, inadequate sleep, and shiftwork.

Abusive leadership, psychological well-being, and intention to quit during the COVID-19 pandemic: a moderated mediation analysis among Quebec's healthcare system workers.

PurposeTo examine the effects from work-organization conditions, abusive leadership, and their interaction on Quebec healthcare system workers’ psychological well-being and intention to quit during the COVID-19 pandemic.MethodsMediation and moderated mediation analyses were performed using MPlus software on a sample of 921 Quebec healthcare system workers.ResultsSkill utilization, decision authority, social support from co-workers and supervisors, and recognition were associated directly and positively with psychological well-being, while psychological and physical demands were associated directly and negatively with psychological well-being. Skill utilization, irregular work schedule, and recognition were associated directly and negatively with intention to quit, while psychological demands were associated directly and positively with intention to quit. Moreover, the results demonstrated that abusive leadership attenuated the effects from recognition and decision authority on psychological well-being (moderation effects), contributing to greater intention to quit among workers (moderated mediation effects).ConclusionsThe obtained results underline the importance of work-organization conditions and leadership style on healthcare system workers’ psychological health and their intention to quit their jobs during a pandemic. In particular, and given their key role, leaders/managers must be sensitized concerning leadership style and its possible effects on their employees’ psychological well-being and intention to quit. Therefore, training programs should be offered to leaders/managers to prevent adoption of abusive leadership styles.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00420-021-01790-z.

Working Conditions Influencing Drivers' Safety and Well-Being in the Transportation Industry: "On Board" Program.

The conditions of work for professional drivers can contribute to adverse health and well-being outcomes. Fatigue can result from irregular shift scheduling, stress may arise due to the intense job demands, back pain may be due to prolonged sitting and exposure to vibration, and a poor diet can be attributed to limited time for breaks and rest. This study aimed to identify working conditions and health outcomes in a bussing company by conducting focus groups and key informant interviews to inform a Total Worker Health® organizational intervention. Our thematic analysis identified three primary themes: lack of trust between drivers and supervisors, the scheduling of shifts and routes, and difficulty performing positive health behaviors. These findings demonstrate the value of using participatory methods with key stakeholders to determine the unique working conditions and pathways that may be most critical to impacting safety, health, and well-being in an organization.

Barriers to seeking timely treatment for severe childhood pneumonia in rural Bangladesh

ObjectiveDelays in seeking medical attention for childhood pneumonia may lead to increased morbidity and mortality. This study aimed at identifying the drivers of delayed seeking of treatment for severe childhood...

Shift work and health outcomes: an umbrella review of systematic reviews and meta-analyses of epidemiological studies.

Shift work is commonly increasing, and some physiological changes occur as workers sleep less and their circadian rhythms are disrupted. This umbrella review not only summarizes the evidence but also evaluates the validity of the associations of shift work with different health outcomes. We searched the MEDLINE, Web of Science, and Embase databases from their inception to April 25, 2020. For each systematic review and/or meta-analysis, we estimated the summary effect size, the 95% confidence interval, the 95% prediction interval, the between-study heterogeneity, evidence of small-study effects, and evidence of excess-significance bias. Eight eligible systematic reviews and meta-analyses were identified, providing data on 16 associations. We observed highly suggestive evidence for associations between shift work and myocardial infarction (having ever vs having never done shift work) and diabetes mellitus incidence (per 5-year increment in shift work). Furthermore, we observed suggestive evidence for an association between shift work and diabetes mellitus incidence (having ever vs having never done shift work). Two health outcomes, including prostate cancer incidence (having ever vs having never done shift work and rotating night shift work vs daytime work) and colorectal cancer incidence (longest vs shortest shift work time), were only supported by weak evidence. This umbrella review found that shift work was associated with several health outcomes with different levels of evidence. Associations for myocardial infarction and diabetes mellitus incidence were supported by highly suggestive evidence. Registry: PROSPERO; Identifier: CRD42020188537. Wu Q-J, Sun H, Wen Z-Y, etal. Shift work and health outcomes: an umbrella review of systematic reviews and meta-analyses of epidemiological studies. J Clin Sleep Med. 2022;18(2):653-662.

Personality Traits and Insomnia Symptoms in Shift Workers.

The discrepancy between natural sleep-wake rhythm and actual sleep times in shift workers can cause sleep loss and negative daytime consequences. Irregular shift schedules do not follow a fixed structure and change frequently, which makes them particularly harmful and makes affected individuals more susceptible to insomnia. The present study compares insomnia symptoms of non-shift workers, regular shift workers, and irregular shift workers and takes into account the moderating role of the Big Five personality traits and levels of perfectionism. Employees of an Austrian railway company completed an online survey assessing shift schedules, sleep quality and duration, daytime sleepiness, and personality traits. A total of 305 participants, of whom 111 were non-shift workers, 60 regular shift workers, and 134 irregular shift workers, made up the final sample. Irregular shift workers achieved significantly worse scores than one or both of the other groups in time in bed, total sleep time, sleep efficiency, sleep duration, sleep quality, sleep latency, and the number of awakenings. However, the values of the irregular shifts workers are still in the average range and do not indicate clinical insomnia. Participants working regular shifts reported the best sleep quality and longest sleep duration and showed the least nocturnal awakenings, possibly due to higher conscientiousness- and lower neuroticism scores in this group. Agreeableness increased the effect of work schedule on total sleep time while decreasing its effect on the amount of sleep medication taken. Perfectionism increased the effect of work schedule on time in bed and total sleep time. Generalization of results is limited due to the high percentage of males in the sample and using self-report measures only.

Human circadian variations.

Circadian rhythms, present in most phyla across life, are biological oscillations occurring on a daily cycle. Since the discovery of their molecular foundations in model organisms, many inputs that modify this tightly controlled system in humans have been identified. Polygenic variations and environmental factors influence each person's circadian rhythm, contributing to the trait known as chronotype, which manifests as the degree of morning or evening preference in an individual. Despite normal variation in chronotype, much of society operates on a "one size fits all" schedule that can be difficult to adjust to, especially for certain individuals whose endogenous circadian phase is extremely advanced or delayed. This is a public health concern, as phase misalignment in humans is associated with a number of adverse health outcomes. Additionally, modern technology (such as electric lights and computer, tablet, and phone screens that emit blue light) and lifestyles (such as shift or irregular work schedules) are disrupting circadian consistency in an increasing number of people. Though medical and lifestyle interventions can alleviate some of these issues, growing research on endogenous circadian variability and sensitivity suggests that broader social changes may be necessary to minimize the impact of circadian misalignment on health.

Mothers’ nonstandard work schedules and the use of multiple and center-based childcare

Mothers with a nonstandard work schedule may be more likely to use multiple childcare arrangements to accommodate their childcare needs and find it difficult to use center-based care that typically operates during daytime hours. Using the framework that working mothers’ workplace demands influence their childcare needs, while families’ relational and financial resources enable them to satisfy the needs, this study examined the association between mothers’ nonstandard work schedules and their use of multiple and center-based childcare. Using a sample of 2566 young children of working mothers from the Survey of Income and Program Participation of 2008, we found that the odds of multiple childcare arrangements were 36% higher when mothers worked an irregular schedule. The odds that one of the arrangements was a childcare center were 54% and 30% lower when mothers had a shift schedule and an irregular schedule. Families’ relational resource, the presence of non-mother adults in the family, was associated with the use of both multiple and center-based care arrangements, but financial resources were related only to the use of center-based care. Potential policy efforts are discussed to help low-wage working mothers better achieve a work-family balance.

Sleep disruption considerations for Paralympic athletes competing at Tokyo 2020.

The role of sleep is now recognized as an important component for success in athletic performance, and sleep is proposed to be one of the most effective recovery strategies available. Insufficient sleep is commonly reported among athletes while several factors have been put forward to explain why elite athletes might experience poor sleep. However, Paralympic athletes may be predisposed to a greater risk of poor sleep due to the associated complexities of some impairment types. In fact, clinical research has previously shown that individuals with disabilities have a higher prevalence of sleep disturbances when compared to their able-bodied counterparts. However, research and evidence-based practices regarding the sleep of elite Paralympic athletes are limited. Firstly, this narrative review aims to identify challenges associated with the Paralympic games to obtain optimal sleep. Secondly, identify the specific risk factors to sleep associated with particular impairment groups within the Paralympic population, and lastly to propose potential sleep-enhancing strategies that might be of relevance for Paralympic athletes. From this review, initial observations have identified that Paralympic athletes may have a heightened risk of sleep-related problems, and importantly highlighted the current lack of understanding within this population group. Furthermore, this review identified where further research is warranted to better understand how specific impairments impact sleep and, consequently, athletic performance. Additionally, this review highlighted that the forthcoming Tokyo games may offer a unique challenge for athletes trying to obtain optimal sleep, due to the anticipated thermal demands and the consequent irregular scheduling of events.

A classification approach to estimating human circadian phase under circadian alignment from actigraphy and photometry data.

The time of dim light melatonin onset (DLMO) is the gold standard for circadian phase assessment in humans, but collection of samples for DLMO is time and resource-intensive. Numerous studies have attempted to estimate circadian phase from actigraphy data, but most of these studies have involved individuals on controlled and stable sleep-wake schedules, with mean errors reported between 0.5 and 1hour. We found that such algorithms are less successful in estimating DLMO in a population of college students with more irregular schedules: Mean errors in estimating the time of DLMO are approximately 1.5-1.6hours. We reframed the problem as a classification problem and estimated whether an individual's current phase was before or after DLMO. Using a neural network, we found high classification accuracy of about 90%, which decreased the mean error in DLMO estimation-identifying the time at which the switch in classification occurs-to approximately 1.3hours. To test whether this classification approach was valid when activity and circadian rhythms are decoupled, we applied the same neural network to data from inpatient forced desynchrony studies in which participants are scheduled to sleep and wake at all circadian phases (rather than their habitual schedules). In participants on forced desynchrony protocols, overall classification accuracy dropped to 55%-65% with a range of 20%-80% for a given day; this accuracy was highly dependent upon the phase angle (ie, time) between DLMO and sleep onset, with the highest accuracy at phase angles associated with nighttime sleep. Circadian patterns in activity, therefore, should be included when developing and testing actigraphy-based approaches to circadian phase estimation. Our novel algorithm may be a promising approach for estimating the onset of melatonin in some conditions and could be generalized to other hormones.

Sample size determination for stepped wedge cluster randomized trials in pragmatic settings.

The stepped-wedge cluster randomized design has been increasingly employed by pragmatic trials in health services research. In this study, based on the GEE approach, we present closed-form sample size calculation that is applicable to both closed-cohort and cross-sectional stepped wedge trials. Importantly, the proposed method is flexible to accommodate design issues routinely encountered in pragmatic trials, such as different within- and between-subject correlation structures, irregular crossover schedules for the switch to intervention, and missing data due to repeated measurements over prolonged follow-up. The closed-form formulas allow researchers to analytically assess the impact of different design factors on sample size requirement. We also recognize the potential issue of limited numbers of clusters in pragmatic stepped wedge trials and present an adjustment approach for underestimated variance of the treatment effect. We conduct extensive simulation to assess the performance of the proposed sample size method. An application example to a real clinical trial is presented.

Article Desktop Based National Police Commission Activities Information System

In the implementation of the activities of the National Police Commission (Kompolnas) every month it is necessary to prepare a monthly report by the Secretariat of the National Police Commission to be reported to the Chair of the National Police, so that it can be used as a benchmark for the implementation of Kompolnas performance. However, making monthly reports is often late and mistaken because there are factors that influence, including: data storage such as official travel administration and irregular activity schedules making it difficult to find data, difficult to monitor ongoing activities, many activities implemented and others. In this regard, a desktop-based information system for the implementation of Kompolnas is required. The research method uses Research and Development to create a desktop-based Kompolnas activity information system. Meanwhile, the data teaching technique used literature study and field study (interview and document examination). Then the system development method used is the waterfall method which has several stages, namely: needs analysis, system design, coding & testing, program implementation, and maintenance. The research resulted in a supporting information system for compiling a monthly report on Kompolnas activities because data on Kompolnas activities such as reference documents, orders, materials, photos / videos, are easy to input and can be viewed, downloaded and printed. In doing so, it can realize a paperless office, thus giving the printer paper, ink and time.

외부요인으로 인한 업무 공백이 조종사의 스트레스 수준에 미치는 영향

Recently, the issue of maintaining pilot competency has emerged as one of the major challenges in the aviation industry due to irregular schedules and flight intervals caused by the global COVID-19. Therefore, a survey was conducted on airline pilots to determine how stressed they would be when returning to their flights after experiencing irregular schedules or long-term furloughs. The level of stress that pilots receive due to flight intervals was divided into periods, and correlation with general characteristics was identified to see what emotional burdens exist as the lengths of flight interval increased. As a result, burdened flight intervals and the Pilot Flying(PF) intervals were identified as a statistically significant variables. In the case of the Pilot Flying interval, the level of stress was confirmed to be worse as the flying interval was elongated, and in the case of the burdened flying interval, the tendency of the stress index were lower as the period increased. Through this study, pilots who experienced reduced flight times were found to be accompanied by considerable amount of emotional burden proportionate to the length of the interval period.

Study Risk Minimization of The Use Bottled Drinking Water (BDW) By Consumers Using Hazard Analysis Critical Control Point (HACCP) Method

Bottled drinking water (BDW) is an effort to meet the demand for drinking water needs of the community which continues to increase every year. BDW is the community’s main choice because it can be consumed directly without the need to cook it first. The high demand for drinking water produced by bottled water requires a comprehensive, easy to apply, and standardized quality control method to maintain and improve the quality of the products produced so that they are safe for consumption by bottled drinking water customers. The suitable method for quality control is the method Hazard Analysis Critical Control Point (HACCP). This method is a risk analysis system by establishing an appropriate control and supervision system to avoid irregularities that can lead to poor quality of drinking water products produced, as well as producing quality bottled water products. The HACCP method can be applied to all aspects of production and aspects of human resources (HR) in bottled water starting from raw water management until the product is produced. In this method, there are 5 important principles used, such as analyzing the risk of hazards that can occur during the production process, determining the critical point of hazard risk analysis, determining critical limits, preparing monitoring system monitoring procedures, and finally preparing corrective actions to avoid deviations from critical limits. Based on the analysis of existing conditions at the BDW in Cirebon City, there are advantages and disadvantages on its own in the production process. For example, the poor performance of some treatment units and the need for control can be caused by replacing treatment units that exceed usage limits and irregular replacement schedules that can affect the water quality of these products. The HACCP method is needed in planning quality control to evaluate the performance of the BDW production processing unit, and determine the quality control of bottled drinking water products to minimize negative impacts for customers who consume them.

Challenges facing community health workers in promoting maternal and neonatal health in Bagamoyo and Mkuranga districts, Tanzania

Objectives: Community health workers (CHWs) play significant roles in areas where professional health workforce succumb to serious human resource deficiencies. This study explored challenges the CHWs face in promoting maternal and neonatal health in two districts of Tanzania.Design: A cross-sectional study design was conducted in Bagamoyo and Mkuranga districts from March to May 2019.Methods: Qualitative data were collected using in-depth interviews from 30 CHWs, thematic analysis was carried out by identifying major key themes emerging from the data.Results: The study found little community support resulted from jealousy of male household heads, mistrust, socialcultural believes and lack of community appreciation on the role of CHWs. Little support from local government resulted by political grievances among local leaders due to change in political administration. Other challenges were lack of basic knowledge in maternal and neonatal health, including breastfeeding. Irregular working schedules dueto poor supervision, huge workload, old age and tirednessConclusion: CHWs programs in Bagamoyo and Mkuranga districts were inactive and required innovative strategies to raise community and local government cooperation. Jealousy among male household’s heads and CHWs need community members to participate in establishment of selection criteria. Socio-cultural beliefs call for community sensitization on how they affect maternal and neonatal health. Lack of community appreciation on the role of CHWs, irregular working schedule implied poor supervision and defined age limit would overcome challenges related to old age.

The Chronic Health Effects of Work-Related Stressors Experienced by Police Communications Workers.

BackgroundLaw enforcement communications (i.e., 911 dispatch and call takers) is a challenging and stressful occupation. The purpose of this study is to identify the main stressors associated with employment in law enforcement communications, and to identify and provide context to how these stressors affect workers' health and wellbeing.MethodsThis research study included focus groups with 23 call takers and 911 dispatchers employed by a large, urban law enforcement agency in 2018. Thematic analyses were conducted to identify trends.ResultsFour themes of stressors emerged (i.e., the high stakes nature of some 911 calls for service, understaffing, supervisor-related stress, and recruiting practice). Two health-related themes emerged as being occupation-related: weight gain and poor sleep patterns/insufficient sleep). Specifically, participants reported negative eating habits resulting in weight gain and obesity, lack of sleep and irregular sleep schedules, and development of hypertension and/or diabetes since beginning their jobs.ConclusionLaw enforcement communications professionals experience a number of the same stressors facing law enforcement officers in patrol. These stressors, combined with the sedentary nature of the job, could result in long-term, chronic health problems.

204 Changes in Physical Activity During the COVID-19 Pandemic Associated with Changes in Sleep

IntroductionThe COVID-19 global pandemic has likely led to changes in physical activity as behavioral patterns were disrupted. This is important because sleep and physical activity are interrelated and promote health, and well-being. This study examined whether changes to physical activity were related to changes to sleep health as a result of the COVID-19 pandemic.MethodsA sample of N=419 US adults completed online surveys about sleep and COVID-19 experiences. Participants were asked to estimate the number of minutes per day they engaged in physical activity during the pandemic, as well as before. These were subtracted from each other, and a difference score was computed. Then, responses were categorized as no change (<=15 mins difference), 16-45 minutes more or less activity, or 46+ minutes more or less activity (5 categories total). Outcome variables included the degree to which participants believed that due to the pandemic, they experienced (1) more schedule regularity, (2) better sleep, (3) worse sleep, (4) more difficulty falling asleep, (5) more difficulty maintaining sleep, (6) more sleepiness, and (7) more napping. Ordinal regressions were adjusted for age, and sex.ResultsThose who increased their activity by over 45 minutes per day reported that they were less likely to experience more daytime sleepiness (oOR=0.28, p<0.02). Those who decreased their activity by over 45 minutes per day reported that they were more likely to experience worse sleep (oOR=2.38, p<0.01) and less likely to experience a more regular schedule (oOR=0.37, p<0.003) than prior to the pandemic.ConclusionOverall, those who increased their physical activity since the beginning of the pandemic reported less daytime sleepiness; and those who decreased their physical activity reported worse sleep experiences and a more irregular schedule. The relationship between physical activity and sleep during the pandemic may be bidirectional.Support (if any)R01MD011600, R01DA051321

309 Food consumption and meal timing in hospital nurses with shift work: A preliminary study

Abstract Introduction One of the important nonphotic zeitgebers is food consumption. The timing of food consumption in relation to melatonin onset has been reported to be associated with fat proportion and BMI. Irregular meal timing along with irregular sleep schedules due to shift work would increase the metabolism problem as well as influencing sleep problems. The aim of the study is to evaluate the meal timing and food consumption in shift workers. Methods The nurses with 3-rapid rotating shifts were enrolled to keep food diaries for two weeks including all three shift schedules. They filled out a morningness-eveningness questionnaire. They wore actigraphy to monitor sleep-wake patterns with a daily sleep diary. The timing and the frequencies of meal/snack and caffeine consumption during each shift and day-off were reviewed. The calorie from each food was calculated depending on the nutritional information on the internet. Results 13 female nurses were screened and 6 finished the study. The mean age is 29.4±7.69 years and the mean body mass index was 20.2±1.1kg/m2. Average frequencies of meals are 2.59±0.49, 1.66±0.75, 1.93±0.41, 2.09±0.96 times per day, and average frequencies of snack consumption are 1.37±0.9, 1.07±0.74, 0.75±0.82, 0.96±0.79 times per day for the morning, evening, night, and the day off, respectively. Total calorie consumed are 1662.5±564.8, 1380.8 ± 940.3, 1596.8±838.1, 1505.8±706.9 kcals in the same order. Caffeine consumption was 0.29±0.46, 0.4±0.48, 0.72±0.65, 0.46±0.54 cups per day in the same order. One subject with morning type showed a relatively regular meal schedule throughout the shifts. The timing for main calorie consumption seemed to show delayed on evening and night shifts than morning shift although total calorie consumption was similar between each shift. Conclusion Although this is a preliminary study with a small number of subjects, it showed shift worker nurses have an inconsistent number of meals and calorie intake depending on their shifts. Caffeine consumption is very lower than expected. The subject with morning chronotype seemed to keep relatively regular meal timing throughout the shifts, suggesting chronotype influences meal timing in shift workers. Support (if any) This study was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (No.2019R1A2C1090643).

359 Tailoring of Cognitive Behavior Therapy for Insomnia for Patients with Kidney Failure Undergoing Hemodialysis: The SLEEP-HD Study

Abstract Introduction Patients with kidney failure treated with hemodialysis (HD) frequently report insomnia symptoms. Cognitive-behavior therapy for insomnia (CBT-I) is a first line treatment for insomnia but there are unique issues surrounding kidney failure and HD that impact patients’ ability to access CBT-I and follow standard treatment recommendations. This presentation describes CBT-I protocol modifications made to address these issues as part of an ongoing multi-center clinical trial testing the efficacy of telehealth CBT-I compared to trazodone or medication placebo control. Methods CBT-I protocol modifications were made prior to starting the SLEEP-HD randomized trial based upon unique clinical considerations for HD patients, e.g., irregular sleep-wake scheduling that HD treatment demands, and napping during HD sessions or afterwards due to post-HD treatment fatigue. Participants in the SLEEP-HD study are undergoing thrice-weekly maintenance hemodialysis for &amp;gt;3 months and have baseline Insomnia Severity Index scores &amp;gt;10 with sleep disturbances &amp;gt;3 nights/week for &amp;gt;3 months. Participants randomized into the modified CBT-I protocol receive six weekly sessions, delivered by trained CBT-I therapists (1 MSW, 1 PhD) face-to-face via a HIPPA-compliant video telehealth platform. Participants keep a daily sleep diary throughout the CBT-I treatment period. Results To date, 91 patients (mean age=56.5 years [SD=14.7], 48.4% female) recruited from community-based dialysis facilities in Seattle and Albuquerque have been randomized into the SLEEP-HD study (n=31 CBT-I). Forty-eight percent of CBT-I clients have chosen to conduct their telehealth sessions during dialysis with the remainder choosing a different location. CBT-I adaptations include therapists developing weekly bed restriction recommendations based on non-dialysis treatment days; allowing shifts in dialysis day “bed window” scheduling for patients with very early or very late dialysis schedules so long as a consistent total time in bed in maintained; and including napping during early/late dialysis sessions as part of the allowable bed window duration. Treatment modifications were also designed to accommodate the diverse socioeconomic circumstances of dialysis patients, including housing instability, which can impact adherence to some standard stimulus control and bed restriction CBT-I recommendations. Conclusion It is feasible to deliver CBT-I via telehealth to HD patients but modifications to standard protocols are required. Support (if any) This work was supported by PHS grant 5R01AG053221.

771 Sleep Health Knowledge, Attitudes, Beliefs, and Practices among Mothers with a History of Perinatal Depression or Anxiety

Abstract Introduction Tailored interventions could optimize sleep health for mothers with a history of perinatal depression or anxiety. The purpose of this study was to describe sleep health knowledge, attitudes, beliefs, and practices among mothers who were previously treated for perinatal depression or anxiety, to inform future tailored sleep health interventions. Methods Mothers (N = 16) who had previously received treatment for perinatal depression or anxiety from a clinic serving low-resourced communities completed a single-occasion research home visit that included a demographics questionnaire and semi-structured interview. Interview data were analyzed using inductive content analysis, adapted from grounded theory. Results Mothers were, on average, 28.19 (SD = 7.71) years and had a child who was between 12 and 36 months. Of the mothers, 43.8% were White, 18.8% Black, 23.5% multiracial, 25.0% other race, 37.5% Hispanic, and 75.0% reported an annual household income of &amp;lt; $40,000. “Needing to focus on sleep” was the core construct that emerged from the interview data, which was comprised of three domains. The first domain, “Having pretty good sleep,” described mothers’ experiences of good sleep health including easily falling and staying asleep, feeling satisfied with their sleep, and feeling well-rested. The second domain, “Trying to get normal healthy sleep,” described mothers’ experiences of poor sleep health and its consequences for physical and mental health. The third domain, “Wondering how to get better sleep with everything going on,” described everyday realities that got in the way of good sleep health including child sleep problems, competing demands on time, irregular work schedules, symptoms of depression or anxiety, and significant life transitions around school/work and pregnancy/postpartum. Conclusion Findings showed a range of maternal sleep health experiences. Mothers’ sleep health overlapped with mental health and wellbeing, children’s sleep health, and social determinants of health. Future sleep health interventions for mothers with a history of perinatal depression or anxiety could include tailored approaches that build on existing maternal strengths, integrate with existing mental health care services and child sleep health interventions, address social determinants, and attend to significant life transitions. Support (if any) 2018 Sigma/Rosemary Berkel Crisp Award; NINR (T32NR016913); NICHD (R01HD080851, U54HD083091).