Low Sleep Quantity Research Articles

The Role of Emotion Dysregulation in the Relationship Between Sleep Disturbances and PTSD Symptom Severity.

Emotion dysregulation is implicated in the development, maintenance, and treatment of sleep disturbances and posttraumatic stress disorder (PTSD) separately. However, few studies have assessed interactions among these variables. To address this gap, this study examined whether the associations of sleep quality and sleep quantity with PTSD severity were stronger at higher levels of negative and positive emotion dysregulation in a community sample of 199 trauma-exposed individuals. This study found that both poorer sleep quality and lower sleep quantity were associated with greater PTSD severity at low to average (but not high) levels of negative emotion dysregulation. Positive emotion dysregulation did not moderate the relationships between sleep quality or quantity and PTSD severity. Exploratory additive multiple moderation analyses showed significant associations between poorer sleep quality and lower sleep quantity with greater PTSD severity at low to average levels of negative emotion dysregulation, coupled with any level of positive emotion dysregulation. Findings inform theoretical perspectives on the sleep-PTSD relationship and clinical applications of targeting emotion dysregulation in the treatment of sleep disturbances and PTSD symptoms for trauma-exposed individuals.

The Relationship Between Mental Workload and Sleep Quantity with Work Fatigue among Haul Dump Truck Operators in Coal Mining

Introduction: In mining production activities, haul dump trucks are utilized for transportation purposes and are driven by an operator. The haul dump truck operator works in a shift work system consisting of 12 working hours. The workers are required to always control the steering speed, causing potential work fatigue. This study aimed to analyze the relationship between mental workload and sleep quantity with work fatigue among haul dump truck operators. Method: This study was a quantitative research study using a cross-sectional design. The population was 179 haul dump trucks operators, while the sample was 123 respondents determined through simple random sampling. The variables of this study were age, years of service, education level, mental workload, sleep quantity, and work fatigue complaints. The data was tested using the Chi-Square test. The instruments used to obtain the data were the National Aeronautics and Space Administration Task Load Index and the Work Fatigue Measurement Tool Questionnaire. Result: The haul dump truck operators (54.5%) had a high mental workload, low sleep quantity (61.8%) with less than 7 hours of sleep, and moderate fatigue complaints (44.7%). There was a significant relationship found between age (P-value = 0.018), years of service (P-value = 0.039), and sleep quantity (P-value = 0.001) with work fatigue complaints. The level of education and mental workload had a significance value above 0.05. Conclusion: Sleep quantity has a significant relationship with work fatigue complaints. This can be responded to by intensifying the information on the socialization of fatigue and the importance of maintaining the quality of sleep.

P042 Actigraphy-derived sleep characteristics of healthy children who benefit the most from a sleep extension protocol

Abstract Introduction Although experimental manipulation of sleep can extend children’s sleep via earlier bedtimes, this is not always possible. We aimed to determine true sleep gains made with a one hour earlier bedtime, and which actigraphy variables at baseline predicted the best gains. Methods Secondary analysis within a randomised crossover trial (99 children; 49.5% female; mean age=10.3 years, range 8-12 years). Each child underwent one week of sleep restriction and extension in a random order (1h later or earlier bedtime respectively) separated by a one-week washout. Sleep data comparing baseline and extension weeks were analysed using linear or logistic regression, controlling for randomised order. Results The mean (SD) difference in total sleep time (TST) with sleep extension was 14.3 (44.1) min/night. Thirty-three percent extended their sleep by at least 30 min/night. At baseline, having lower sleep quantity (TST) and quality (efficiency, WASO, waking frequency) significantly predicted more sleep gain. For each 1 h lower TST at baseline, 29.7 min (95% CI 19.4, 40.1) more sleep was gained. At baseline, a TST below 8 h 49 min was the optimal cut-point to predict whether children could extend their sleep by at least 30 min/night (found in 40% of children). Adjusting for relevant demographics and sleep hygiene made little difference. Conclusion Children who slept less than 8 h 49 min/night obtained the most sleep gain from a 1 hour earlier bedtime maintained over a week. Maintenance over the longer term is unknown. Findings have implications for understanding the sleep requirements of children.

Factors associated with perceived performance drops and musculoskeletal injuries in Brazilian recreational triathletes.

The aim of the study was to investigate sleep characteristics, use of supplements, and training volume of recreational triathletes, and to verify possible associations with perceived performance drops and occurrence of injuries. Recreational triathletes (n=942) answered a questionnaire inquiring about their demographic characteristics, performance, injuries and training volume. When comparing athletes who slept more (9-10 hours) with those who slept less, less sleep was associated with a higher prevalence of perceived performance drops. Regarding difficulties in initiating sleep, the absence of initiating difficulties (p<0.001) was a protective factor against perceived performance drops. Regarding weekly training volume, compared to those who trained more than 20 hours, training less than 3 hours (p<0.001), 3-5 hours (p<0.001), or 12-14 hours (p<0.001) were protective factors against perceived performance drops. Concerning training volume and injuries, we found that compared to those who trained more than 20 hours, training 18-20 hours (p<0.001), 15-17 hours (p<0.001), 12-14 hours (p<0.001), 6-8 hours (p<0.001), or 3-5 hours (p<0.001) were protective factors against injuries. Triathletes with a lower sleep quantity and those who have difficulties initiating sleep frequently experience drops in performance. Training volumes can influence both performance and the likelihood of injuries.

Vaping and Sleep as Predictors of Adolescent Suicidality.

To investigate sleep quantity as a moderator of vaping and self-reported suicidality among adolescents. Cross-sectional. Setting: United States high schools. 10,520 high-school students with complete data on the primary outcome of suicide attempt in the past year (76.9% response rate). 2019 Youth Risk Behaviors Survey. Logistic regression to examine main effects and potential moderation. Students with under seven sleep hours on school nights (OR = 2.6; 95% CI = 2.1-3.3) and who vaped in the past month (OR = 3.0; 95% CI = 2.1-3.9) had higher odds of attempting suicide in the last year. Sleep quantity moderated the relationship between vaping and suicidal thoughts in the past year (P = .01) but did not moderate the relationship between vaping and a suicide plan (P = .15) or suicide attempts (P = .06). Specifically, vaping had a smaller effect on suicidal thoughts among students who slept under seven hours on school nights (OR = 1.8) compared to the descriptively larger effect among participants with more sleep (OR = 2.5). Students who vape or report low sleep quantity would be ideal participants in suicide prevention interventions as they may be at higher risk for suicidality. Organizations implementing sleep or vaping interventions should incorporate information regarding the higher odds of suicide among students with low sleep quantity or vaping habits.

0230 Vaping and Sleep as Predictors of Adolescent Suicidality

Abstract Introduction Suicide is a leading cause of death for adolescents aged 14-18. Because of the challenges of suicide prevention interventions (e.g., cost or effectiveness), it is critical to examine potential, modifiable risk factors related to adolescent suicide. This study examined self-reported suicidality, vaping, and sleep quantity among high school students in the U.S. We investigated sleep quantity as a moderator of vaping and multiple aspects of suicidality (thoughts, plans, and attempts). This study is, to our knowledge, the first to examine the effects of both vaping and sleep on suicide outcomes. Methods Authors utilized responses from adolescents with complete data on the primary outcome of a suicide attempt in the past year in the 2019 Youth Risk Behaviors Survey (n=10,520). Logistic regression was utilized to estimate the main effects of vaping in the past 30 days, sleep hours on school nights, and the interaction of vaping and sleep on suicide attempts (primary outcome), suicidal thoughts (secondary outcome), and suicide plans (secondary outcome). Results Students who vaped in the past month had 2.78 (95% CI = [2.171-3.549]) times the odds of a suicide attempt in the last year compared to students who did not vape. Students who slept less than seven hours had 1.93 (95% CI = [1.583-2.352]) times the odds of a suicide attempt in the last year compared to students who slept seven or more hours. Sleep quantity moderated the relationship between vaping and suicidal thoughts in the past year but did not moderate the relationship between vaping and a suicide plan or suicide attempts. Specifically, vaping had a reduced effect on suicidal thoughts among students who slept under seven hours. Conclusion Adolescents who vaped in the past month or who reported less than 7 hours of sleep on school nights had significantly higher odds of reporting a suicide attempt in the past year. Students who vape or report low sleep quantity would be ideal participants in suicide prevention interventions as they may be at higher risk for suicidality. Organizations implementing sleep or vaping interventions should incorporate information regarding the higher odds of suicide among students with low sleep quantity or vaping habits. Support (If Any)

The impact of COVID-19 lockdown on gambling habit: A cross-sectional study from Italy.

Background and aimsFew preliminary studies have shown an impact of COVID-19 confinement on gambling habits. We aim to evaluate short-term effects of lockdown restrictions on gambling behaviors in Italy.MethodsWithin the project Lost in Italy, a web-based cross-sectional study was conducted on a representative sample of 6,003 Italians aged 18–74 years, enrolled during April 27–May 3 2020, and were asked to report gambling activity before the lockdown and at the time of interview.ResultsThe prevalence of participants reporting any gambling decreased from 16.3% before lockdown to 9.7% during lockdown. Traditional gambling decreased from 9.9 to 2.4% and online gambling from 9.9 to 8.0%. Among gamblers, median time of gambling grew from 4.5 to 5.1 h/month. Among non-players before lockdown, 1.1% started playing. Among players before lockdown, 19.7% increased gambling activity. Multivariate analysis showed an increase in gambling activity in younger generations (p for trend = 0.001), current smokers (odds ratio, OR 1.48), users of electronic cigarettes (OR 1.63), heated tobacco products (OR 1.82), cannabis (OR 5.16), psychotropic drugs (OR 3.93), and subjects having hazardous alcohol drinking (OR 1.93). Self-reported low quality of life (OR 1.97), low sleep quantity (OR 2.00), depressive symptoms (OR 3.06) and anxiety symptoms (OR 2.93) were significantly related to an increase in total gambling activity during lockdown.Discussion and conclusionsAlthough gambling substantially decreased during lockdown, time spent in gambling slightly increased. The strong relationship found between compromised mental health and addictive behaviors calls for urgent policies to prevent vulnerable populations from increasing and developing severe gambling addiction.

Self-control during daily work activities and work-to-nonwork conflict

Drawing on theories of self-regulation we propose that the nature of the activities performed at work, particularly those requiring self-control, can play an important role in the work-to-nonwork conflict process. We argue that because functional nonwork behavior requires continued self-control after work, occurrences of work-to-nonwork conflict will be more likely when one's limited self-control resources are expended during the day, and incidents of subsequent self-control failure in relation to the nonwork domain become more likely. We test hypotheses via a daily diary study, capturing the timing of different activities across a workday, along with independent ratings of how much self-control the activities require. We find, at the within-person level, that the extent that work activities performed that day require selfcontrol explains variance in work-to-nonwork conflict, beyond the effects of work hours and mediated by depleted state self-control capacity after work. Furthermore, afternoon self-controlled work activities, compared to morning, are more strongly associated with work-to-nonwork conflict. Against our hypothesis, low sleep quantity weakened the association between self-controlled work activities and self-control capacity. We discuss our findings in relation to the utility of self-regulation approaches to work-to-nonwork conflict based on the self-control strength model.

Community Violence Exposure and Academic Performance: Examining the Roles of Posttraumatic Stress Symptoms and Sleep Quantity and Quality among College Students

ABSTRACT The current study sought to address the roles of PTSD symptoms, low sleep quantity, and poor sleep quality in the association between community violence exposure and college academic performance. College students (N = 267) from an urban commuter college were surveyed between Fall 2012 to Spring 2016. The age range of the sample was 17 to 29 (M = 20.26, SD = 2.19) and 75.7% were females. Findings indicate that students were exposed to multiple types of community violence and other potentially traumatic events. There was a significant association between community violence exposure and lower GPA, but this association was not directly mediated by accounting for sleep difficulties. Findings may be influenced by sex and race differences. Our findings suggest that screening for community violence exposure among college students might identify students who may benefit from greater academic support as well as greater psychological support.

General health complaints and sleep associated with new injury within an endurance sporting population: A prospective study

ObjectivesTo examine the association between subjective health complaints, sleep quantity and new injury within an endurance sport population. DesignProspective cohort study. MethodsNinety-five endurance sporting participants were recruited from running, triathlon, swimming, cycling and rowing disciplines. Over 52-week period participants submitted weekly data regarding subjective health complaints (SHCs) (cardiorespiratory, gastrointestinal and psychological/lifestyle), sleep quantity, training load and new injury episodes. Applying a 7- and 14-day lag period, a shared frailty model was used to explore new injury risk associations with total SHCs and sleep quantity. Results92.6% of 95 participants completed all 52 weeks of data submission and the remainder of the participants completed ≥30 weeks. Seven-day lag psychological/lifestyle SHCs were significantly associated with new injury risk (Hazard ratio (HR)=1.32; CI 95%=1.01–1.72, p<0.04). In contrast, cardiorespiratory (HR=1.15; CI 95%=0.99–1.36, p=0.07) and gastrointestinal (HR=0.77; CI 95%=0.56–1.05, p=0.09) SHCs were not significantly associated with new injury risk. New injury risk had a significant increased association with 14-day lag <7h/day sleep quantity (HR=1.51; CI 95%=2.02–1.13, p<0.01) and a significant decreased association with >7h/day sleep quantity (HR=0.63, CI 95%=0.45–0.87, p<0.01. A secondary regression analysis demonstrated no significant association with total SHCs and training load factors (Relative Risk (RR)=0.08, CI 95%=0.04–0.21, p=0.20). ConclusionsTo minimise an increased risk of new injuries within an endurance sporting population, this study demonstrates that psychological/lifestyle subjective health complaints and sleep quantity should be considered. The study also highlights a lag period between low sleep quantity and its subsequent impact on new injury risk. No association was demonstrated between subjective health complaints, sleep quantity and training load factors.

Adolescent Health Lifestyles and Educational Risk: Findings From the Monitoring the Future Study, 2010–2016

Research has linked educational risk to various risky health behaviors (e.g., drug use, violence, risky sexual behaviors). This study builds upon this research by examining the link between additional health lifestyle indicators-nutritional risk factors, low sleep quantity, and low exercise frequency-and academic risk factors among a recent, nationally representative sample of adolescents. Data from the 7 most recent cohorts (2010-2016) of the Monitoring the Future survey were analyzed in 2018 (n=45,757-46,206). A multistage random sampling technique was used to acquire the sample. All examined risky health lifestyle indicators were associated with significantly greater odds of school disengagement and lower academic expectations. Youth were especially likely to exhibit educational risks when they engaged in multiple risky health behaviors. Each additional risky health lifestyle indicator conferred significant increases in the odds of every examined educational risk factor, with the odds of school disengagement increasing by a factor of 7.48 when youth engaged in 4 or more risky health behaviors (relative to none). Findings suggest that activities that promote adolescent health across multiple dimensions (i.e., nutrition, physical exercise, and sleep) may also promote academic engagement and expectations for future academic achievements.

Factors Influencing Sleep Difficulty and Sleep Quantity in the Citizen Pscientist Psoriatic Cohort.

IntroductionSleep is essential for overall health and well-being, yet more than one-third of adults report inadequate sleep. The prevalence is higher among people with psoriasis, with up to 85.4% of the psoriatic population reporting sleep disruption. Poor sleep among psoriasis patients is particularly concerning because psoriasis is independently associated with many of the same comorbidities as sleep dysfunction, including cardiovascular disease, obesity, and depression. Given the high prevalence and serious consequences of disordered sleep in psoriasis, it is vital to understand the nature of sleep disturbance in this population. This study was designed to help meet this need by using survey data from Citizen Pscientist, an online patient portal developed by the National Psoriasis Foundation.MethodsOur analysis included 3118 participants who identified as having a diagnosis by a physician of psoriasis alone or psoriasis with psoriatic arthritis. Demographic information, psoriasis severity and duration, sleep apnea status, smoking and alcohol consumption, itch timing, and sleep characteristics were included. Two separate multivariate logistic regression models in STATA were used to determine whether the presence of psoriatic arthritis, age, gender, body mass index, comorbid sleep apnea, psoriasis severity, timing of worst itch, smoking status, or high-risk alcohol consumption were associated with sleep difficulty or low sleep quantity, defined by the American Academy of Sleep Medicine as less than 7 h of sleep per night on average.ResultsResults from the multivariate logistic regressions found that sleep difficulty was associated with psoriatic arthritis (OR 2.15, 95% CI [1.79–2.58]), female gender (2.03 [1.67–2.46]), obese body mass index (BMI ≥ 30) (1.25 [1.00–1.56]), sleep apnea (1.41 [1.07–1.86]), psoriasis severity of moderate (1.59 [1.30–1.94]) or severe (2.40 [1.87–3.08]), and smoking (1.60 [1.26–2.02]). Low sleep quantity was associated with obese BMI (1.62 [1.29–2.03]), sleep apnea (1.30 [1.01–1.68]), psoriasis severity of moderate (1.41 [1.16–1.72]) or severe (1.40 [1.11–1.76]), and smoking (1.62 [1.31–2.00]). Sleep difficulty and low sleep quantity were not associated with age, alcohol consumption, or timing of worst itch.ConclusionThese results are potentially meaningful in several aspects. We identify an important distinction between sleep difficulty and sleep quantity in psoriatic disease, whereby having psoriatic arthritis and being female are each associated with sleep difficulty despite no association with low sleep quantity. Furthermore, there is conflicting evidence from prior studies as to whether psoriasis severity is associated with sleep difficulty, but this well-powered, large study revealed a strong, graded relationship between psoriasis severity and both sleep difficulty and low sleep quantity. Overall, our results show that both sleep difficulty and low sleep quantity were associated with multiple factors in this analysis of a large psoriatic cohort. These findings suggest that dermatologists may gather clinically useful information by screening psoriatic patients for trouble sleeping and low sleep quantity to identify potential comorbidities and to more effectively guide disease management.

Sleep Quantity and Problems as Mediators of the Eveningness-Adjustment Link during Childhood and Adolescence.

Chronotype, or morningness/eveningness, has been associated with adjustment in both children and adolescents. Specifically, eveningness has been linked to adjustment difficulties; however, the mechanism underlying this association is poorly understood. The purpose of this study was to test whether the associations between eveningness and adjustment difficulties could be explained by an unfavorable impact of eveningness on sleep. Links from chronotype to internalizing problems and problem behaviors via sleep quantity and sleep problems were tested in a sample from the European Longitudinal Study of Pregnancy and Childhood (N = 3485; 48.8% female), both when the participants were children (7 years at T1, 11 at T2) and when they were adolescents (15 years at T1, 18 at T2). The findings provided evidence that eveningness predicted greater sleep problems and lower sleep quantity; however, only sleep problems predicted internalizing problems and problem behaviors. Sleep quantity did not mediate the eveningness-adjustment link, and sleep problems did so only in children. The findings show that sleep problems appear to be more important in explaining the eveningness-adjustment link rather than altered sleep quantity, commonly associated with eveningness.

Assessment of Sleep Quantity and Sleep Disturbances During Recovery From Sports-Related Concussion in Youth Athletes

ObjectiveTo determine the relation between sleep quantity and sleep disturbances on symptoms and neurocognitive ability during the acute phase (<7d) and after sports-related concussion (SRC; >21d). DesignProspective inception cohort study. SettingGeneral community setting of regional middle and high schools. ParticipantsA sample (N=971) including youth athletes with SRC (n=528) and controls (n=443) (age, 10–18y). InterventionsNot applicable. Main Outcome MeasuresAthletes completed the Immediate Post-Concussion Assessment and Cognitive Testing battery. Partial correlation analyses and independent t tests were conducted to assess sleep quantity the night before testing. Multivariate analysis of covariance was used to assess sleep disturbances and their interaction with age. ResultsLess sleep quantity was correlated with greater report of cognitive (P=.001) and neuropsychological (P=.024) symptoms specific to prolonged recovery from SRC. Sleep disturbances significantly affect each migraine, cognitive, and neuropsychological symptoms (P<.001). A significant interaction was found between sleep disturbances and age (P=.04) at >21 days post-SRC. ConclusionsFindings emphasize that the continued presence of low sleep quantity and sleep disturbances in youth athletes with SRC should be a specific indicator to health professionals that these athletes are at an increased risk of protracted recovery. Further research should identify additional factors that may interact with sleep to increase the risk of protracted recovery.

The relationship of sleep complaints risk factors with sleep phase, quality, and quantity in Japanese workers

Numerous studies have determined that lifestyle factors (smoking, drinking, snacking, etc.) and the bedroom environment can influence sleep. We developed a new sleep scale—the 3-Dimensional Sleep Scale (3DSS)—which measures three elements of sleep: phase, quality, and quantity. The purpose of this study is to determine which risk factors of sleep complaints are associated with these sleep elements. Data were obtained from 366 Japanese day workers (302 men and 64 women). Sleep condition was assessed with the 3DSS, and we also assessed various habits within 2 h of going to bed, including smoking, drinking, snacking, caffeine intake, mobile phone use, and working. We also asked about bedroom environmental conditions (noise, lighting, and temperature and humidity). Multivariate logistic regression analysis using the backward selection method (likelihood ratio) was used, with 3DSS scores as the outcome (i.e., over or under the cutoff). The results showed that smoking was associated with significantly greater odds ratio [2.71 (1.65–4.44)] of disordered sleep phase, while lighting as well as temperature and humidity led to greater odds [3.67 (1.55–8.68), 1.93 (1.20–3.11)] of poor sleep quality. Finally, only noise was significantly related to greater odds [1.98 (1.13–3.46)] of low sleep quantity. These findings indicated the various risk factors of sleep complaints could be associated with different sleep elements. This might help in the effective treatment of sleep complaints.

What keeps children with cystic fibrosis awake at night?

BackgroundSleep disturbance is common in children with cystic fibrosis (CF) however there are limited studies investigating the causes for poor sleep quality. In a cross sectional observational study we aimed to evaluate the clinical correlates of sleep disturbance in this population. MethodsChildren with CF (7–18years) free from pulmonary exacerbation completed medical review, overnight oximetry, the OSA-18 and 14days of actigraphy recordings with a sleep diary. ResultsIn addition to FEV1 <80% and low baseline SpO2, CF-related diabetes, PEG feeding and co-morbid behaviour disorder were associated with lower objective sleep quantity. Paternal smoking and a family member with a mood disorder were also associated with sleep disturbance. The use of electronic devices before bedtime was associated with lower sleep quantity and quality. FEV1, nocturnal cough, age and a behaviour disorder predicted sleep duration. FEV1, nocturnal cough, SpO2 nadir and asthma predicted sleep efficiency. Conversely, sleep efficiency independently predicted FEV1. ConclusionsReduced sleep quality in children with CF is related to lung health and co-morbidities. However, family characteristics and poor sleep hygiene in the child were also associated with sleep disturbance. Optimal management of CF would seem to be the primary intervention to alleviate children's sleep disturbance, however our data raises additional targets for attempts to improve sleep.

Optimizing sleep to maximize performance: implications and recommendations for elite athletes.

Despite a growing body of literature demonstrating a positive relationship between sleep and optimal performance, athletes often have low sleep quality and quantity. Insufficient sleep among athletes may be due to scheduling constraints and the low priority of sleep relative to other training demands, as well as a lack of awareness of the role of sleep in optimizing athletic performance. Domains of athletic performance (e.g., speed and endurance), neurocognitive function (e.g., attention and memory), and physical health (e.g., illness and injury risk, and weight maintenance) have all been shown to be negatively affected by insufficient sleep or experimentally modeled sleep restriction. However, healthy adults are notoriously poor at self-assessing the magnitude of the impact of sleep loss, underscoring the need for increased awareness of the importance of sleep among both elite athletes and practitioners managing their care. Strategies to optimize sleep quality and quantity in athletes include approaches for expanding total sleep duration, improving sleep environment, and identifying potential sleep disorders.

Examining the role of psychological need satisfaction in sleep: A Self-Determination Theory perspective

Although ample research has shown the satisfaction of the basic psychological needs for autonomy, competence, and relatedness, as defined within Self-Determination Theory, to be related to well-being, the relation with sleep-related functioning has not yet been examined. Hence, the present study explored the association between basic psychological need satisfaction and subjective measures of sleep and daytime dysfunction, as well as the explanatory role of need satisfaction in the relation between mindfulness and financial strain and these outcomes, in an adult sample (N=215, 61% female; Mean age=31). The results indicated that low psychological need satisfaction related to poor sleep quality, lower sleep quantity, and more daytime dysfunction. Finally, mindfulness and financial strain related, respectively, negatively and positively to poor sleep quality and daytime dysfunction through need satisfaction, suggesting that need satisfaction represents a critical explanatory mechanism. The role of psychological need satisfaction in the adequate regulation and satisfaction of the physiological need for sleep is discussed.

The Effects of Sleep Quality and Sleep Quantity on Concussion Baseline Assessment

Proper concussion assessment is imperative for properly caring for athletes who sustain traumatic brain injuries. Decreased sleep quality and sleep quantity affect cognition and may threaten the validity of clinical measures often used as a part of the concussion assessment. The purpose of this study was to determine if sleep quality or sleep quantity affects performance on clinical measures of concussion. Prospective cohort design. Clinical research center. One hundred fifty-five college student-athletes (57 females, 98 males; age = 18.8 ± 0.8 years; mass = 78.4 ± 19.6 kg; height = 177.4 ± 12.3 cm). We performed preseason baseline testing by using a well-accepted and multifaceted protocol inclusive of neurocognition, balance performance, and symptom reporting. Information related to sleep quality and sleep quantity was also collected during preseason baseline testing. The CNS Vital Signs battery (computerized neurocognitive test), Sensory Organization Test (computerized dynamic posturography), and a Graded Symptom Checklist (symptom evaluation) were used. Subjects with a low sleep quantity the night before baseline reported both a greater number of symptoms and higher total symptom severity score. No clinically significant effects for sleep quality were observed. Sleep-deprived athletes reporting for baseline testing should be rescheduled for testing after a normal night's sleep.

Increasing sleep duration to lower beat‐to‐beat blood pressure: a pilot study

Strong evidence has accumulated over the last several years, showing that low sleep quantity and/or quality plays an important role in the elevation of blood pressure. We hypothesized that increasing sleep duration serves as an effective behavioral strategy to reduce blood pressure in prehypertension or type 1 hypertension. Twenty-two participants with prehypertension or stage 1 hypertension, and habitual sleep durations of 7h or less, participated in a 6-week intervention study. Subjects were randomized to a sleep extension group (48±12years, N=13) aiming to increase bedtime by 1h daily over a 6-week intervention period, or to a sleep maintenance group (47±12years, N=9) aiming to maintain habitual bedtimes. Both groups received sleep hygiene instructions. Beat-to-beat blood pressure was monitored over 24h, and 24-h urine and a fasting blood sample were collected pre- and post-intervention. Subjects in the sleep extension group increased their actigraphy-assessed daily sleep duration by 35±9min, while subjects in the sleep maintenance condition increased slightly by 4±9min (P=0.03 for group effect). Systolic and diastolic beat-to-beat blood pressure averaged across the 24-h recording period significantly decreased from pre- to post-intervention visit in the sleep extension group by 14±3 and 8±3mmHg, respectively (P<0.05). Though the reduction of 7±5 and 3±4mmHg in the sleep maintenance group was not significant, it did not differ from the blood pressure reduction in the sleep extension group (P=0.15 for interaction effect). These changes were not paralleled by pre- to post-intervention changes in inflammatory or sympatho-adrenal markers, nor by changes in caloric intake. While these preliminary findings have to be interpreted with caution due to the small sample size, they encourage future investigations to test whether behavioral interventions designed to increase sleep duration serve as an effective strategy in the treatment of hypertension.