Measured Sleep Characteristics Research Articles

Sleep measures as a predictor of suicidal ideation among high-risk adolescents.

Suicide is the second leading cause of death among youth aged 15-24years. Identifying modifiable risk factors relevant to adolescents is crucial for suicide prevention. Sleep patterns have been linked to suicidality in adults, but lack sufficient study in youth. This ecological momentary assessment (EMA) study aimed to explore the relationship between objectively and subjectively measured sleep characteristics and next-day suicidal ideation in high-risk youth. We included 29 adolescents (12-18 years old) admitted to the inpatient psychiatric ward post-suicide attempt or due to suicidal intent within the previous month. We conducted objective (actigraphy) and subjective (sleep diary) sleep pattern assessments over ten consecutive days. Daily suicidal ideation was evaluated using a questionnaire based on the validated C-SSRS interview. A significant positive association was observed between sleep onset latency (SOL) and expressing a "death wish" the following day (OR = 1.06, 95% CI [1-1.11], p = .04), with each minute of longer SOL increased the risk for a death wish the following day by 6%. In addition, a marginally significant negative association was observed between total sleep time (TST) and expressing a "death wish" the following day (OR = 0.57, 95% CI [0.3-1.11], p = 0.1), with each one-hour decrease in objectively measured TST increasing the odds of a death wish by 43%. Our study highlights the interplay between sleep patterns and suicidal ideation, with SOL and TST playing a significant role that may function as proximal risk factors for suicidality and as a target for intervention while treating suicidal youth.

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

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

0158 Preliminary Study of the Links Between Adverse Childhood Experiences and Actigraphy-Measured Sleep Characteristics in Young Adults

Abstract Introduction Adverse Childhood Experiences (ACEs) are highly stressful events during the first 18 years of life that have been linked with adverse adult health outcomes. Sleep is an important behavioral risk factor for a myriad of health outcomes that have been linked to ACE exposure. A growing body of evidence indicates that ACEs are associated with low self-reported sleep durations, but these findings should be verified using objectively measured sleep characteristics. The purpose of this study was to examine associations of ACE exposure with actigraphy-measured sleep duration, timing, and variability. Methods Methods: In twenty-four young adults (20F/4M; mean±SD, age=24±5 y), we assessed ACE exposure using the 10-item ACE scale and measured sleep characteristics over a ≥6 day period using a wrist-worn actigraphy device. Participants with 0–1 ACEs were characterized as low-ACE (ACE-low, n=10) and participants with 2+ ACEs were characterized as moderate-high-ACE exposure (ACE-mh, n=14). Independent samples t-tests and Hedges’ g effect sizes were used to compare total sleep duration, bed-time, get-up time, time-in-bed, sleep onset latency and the standard deviation of bed time and total sleep duration between groups. Results Time-in-bed was greater in ACE-mh than in ACE-low (mean±SE difference=-60±25 min; p=0.027; g=-0.95), yet there was no difference in total sleep duration (-9±10 min; p=0.46; g=-0.37). This discrepancy was accompanied by a non-significant, but large-effect size difference between ACE-mh and ACE-low (-15±7 min; p=0.051; g=-0.83) in sleep onset latency. There were no differences between groups in either bed-time (p=0.34; g=0.39) or get-up time (p=0.35; g=-1.2), nor in either bed-time (p=0.84; g=-0.08) or total sleep duration (p=0.36; g=-0.37) variability. Conclusion In contrast to prior evidence based on self-report, our initial evidence indicates that ACE exposure is not linked with shorter sleep durations or higher sleep variability when measured using actigraphy. Instead, ACE exposure is linked to greater time in bed and greater sleep onset latencies, suggesting that individuals exposed to ACEs may have less efficient sleep. Support (if any) Support: Research reported in this publication was supported in part by the NCATS of the NIH (UL1TR002537) and by the Injury Prevention Research Center through the CDC (R49 CE003095).

Association Between Objectively Measured Sleep Characteristics and Cardiovascular Disease Risk in Females Aged 50+

Association Between Objectively Measured Sleep Characteristics and Cardiovascular Disease Risk in Females Aged 50+

Sleep Disturbances in Adolescents with Attention-Deficit/Hyperactivity Disorder.

Delayed sleep phase syndrome (DSPS) and insomnia disorders are prevalent in adolescents and are comorbid with attention-deficit/hyperactivity disorder (ADHD), but only limited information is available regarding the prevalence of DSPS and insomnia in adolescents with ADHD. Moreover, previous studies comparing objective sleep parameters averaged the findings across all participants of each group (ADHD, control) regardless of each individual's level of reported sleep disturbance. This might have resulted in inconsistency between information obtained by objective and subjective sleep measures in adolescents with ADHD. The objectives of the present study were 1) to compare the prevalence of risk for DSPS and insomnia in adolescents with ADHD and control adolescents in our samples; 2) to compare objectively measured sleep characteristics of adolescents with ADHD and controls while taking into consideration their levels of risk for DSPS or their level of insomnia; and 3) to compare the ADHD symptom levels of adolescents with moderate/high and low risk for DSPS or insomnia. Seventy-three adolescents (37 ADHD, 36 controls) aged 12-15years participated in a cross-sectional study. Actigraphy was used to characterize objective sleep parameters and parents' or adolescents' reports were used to characterize subjective sleep parameters. Of the participants in the ADHD and control groups, 33.33% and 27%, respectively, had moderate/high levels of risk for DSPS. Adolescents in the high-risk group for DSPS had an objectively measured delayed sleep schedule and more variable sleep duration, time in bed, and sleep efficiency compared to adolescents in the low-risk group for DSPS, regardless of their ADHD diagnosis. Adolescents with higher levels of insomnia spent more time in bed and had more variable sleep efficiency compared to adolescents with no insomnia, regardless of their diagnosis. The prevalence of moderate/high risk for DSPS was similarly high in adolescents with ADHD and controls. Participants' subjective reports of sleep disturbances were consistent with their objective sleep parameters when the type and level of subjectively defined sleep disturbance were considered. ADHD symptom levels were not different in adolescents with moderate/high or low risk for DSPS or insomnia.

INTERACTIONS BETWEEN SLEEP AND BIOLOGICAL MARKERS OF AGING

Abstract There is well documented evidence that sleep architecture and circadian patterns change as people age in part due to accumulation of comorbidities, polypharmacy, and other factors inherent to the aging process. While a number of studies have examined sleep in the context of these factors, recent advances in the assessment of biological aging (including epigenetic age, metabolomics, and measurement of inflammatory biomarkers) have made it possible to identify potential mechanisms by which sleep impacts the aging course. In this symposium, we will highlight research that investigates the link between sleep disturbances and biological factors in order to identify whether sleep could be a modifiable risk factor for accelerated aging. Our first presentation will examine the association between insomnia symptoms and short sleep duration with epigenetic age acceleration using data from the Health and Retirement Study. Second, we will describe whether objectively measured sleep characteristics are associated with a number of metabolomic markers of aging. The third presentation will center around the extent to which social disparities in presence of inflammatory biomarkers may be mediated by sleep quality. Finally, we will examine how daytime sleepiness may be associated with longitudinal BMI trajectories. These presentations will, as a whole, highlight the importance of sleep as a contributor to healthy aging and longevity, and inform the development of interventional approaches targeting biological mechanisms to promote successful aging more broadly.

Sleep Characteristics in Older Adults with Different Levels of Risk for Dementia: A Cross-sectional Study.

Sleep problems are very prevalent in older adults, especially in those at risk for dementia. But the relationships between sleep parameters and subjective or objective cognitive decline are still inconclusive. The study aimed to investigate the self-reported and objectively measured sleep characteristics in older adults with mild cognitive impairment (MCI) and subjective cognitive decline (SCD). This study adopted a cross-sectional design. We included older adults with SCD or MCI. Sleep quality was measured separately by the Pittsburgh sleep quality index (PSQI) and ActiGraph. Participants with SCD were divided into low, moderate, and high levels of SCD groups. Independent samples T-tests, one-way ANOVA, or nonparametric tests were used to compare the sleep parameters across groups. Covariance analyses were also performed to control the covariates. Around half of the participants (45.9%) reported poor sleep quality (PSQI＜7), and 71.3% of participants slept less than 7 hours per night, as measured by ActiGraph. Participants with MCI showed shorter time in bed (TIB) (p＜0.05), a tendency of shorter total sleep time (TST) at night (p = 0.074) and for each 24-hour cycle (p = 0.069), compared to those with SCD. The high SCD group reported the highest PSQI total score and longest sleep latency than all the other three groups (p＜0.05). Both the MCI and high SCD groups had shorter TIB and TST for each 24-hour cycle than the low or moderate SCD groups. Besides, participants with multiple-domain SCD reported poorer sleep quality than those with single-domain SCD (p＜0.05). Sleep dysregulation is prevalent in older adults with a risk for dementia. Our findings revealed that objectively measured sleep duration might be an early sign of MCI. Individuals with high levels of SCD demonstrated poorerself-perceived sleep quality and deserved more attention. Improving sleep quality might be a potential target to prevent cognitive decline for people with a risk for dementia.

Associations between Sleep and Body Composition in Older Women and the Potential Role of Physical Function.

The relationship between sleep and adiposity in older women remains unclear partly due to the reliance of body mass index as a measure of adiposity. The purpose of this study was to investigate associations between objectively measured sleep characteristics and body composition measured by dual energy x-ray absorptiometry (DXA) in older women. A secondary purpose was to examine if physical function mediates this relationship. Non-obese older women (ages 60-75 years, n=102) were included in the study. Total sleep time (TST), time in bed (TIB), sleep efficiency (SE), and wake after sleep onset (WASO) were determined by actigraphy. A battery of tests was used to assess physical function. With adjustment for age, there was a negative association between TST and TIB with lean mass. Both grip strength and dominant leg extension were associated with TST, TIB, and lean mass; the associations between TST and TIB with lean mass were lost after adjusting for grip strength or leg extension strength. Additionally, SE was negatively associated with total, gynoid, and trunk lean mass, and there was a positive association between TST and percent trunk fat, and WASO and gynoid lean mass, with age adjusted. Sleep characteristics, TST, TIB, SE, and WASO, were associated body composition measures in this sample of older women. The relationship between TST and TIB with body composition was mediated, in part, by grip strength and leg extension strength.

Sleep influences daily suicidal ideation through affective reactivity to interpersonal events among high-risk adolescents and young adults.

Identifying proximal risk factors for suicidal ideation that are modifiable and relevant for adolescents and young adults is critical for suicide prevention. This study used an intensive monitoring approach to examine whether objectively- and subjectively- measured sleep characteristics predict next-day suicidal ideation occurrence and intensity through affective reactivity to interpersonal events in young people at high risk for suicide. Participants included 59 (13-23 years; 76% White; 75% female) adolescents and young adults undergoing intensive outpatient program treatment for depression and suicidality. Participants completed daily ratings of suicidal ideation, sleep quality, and affective reactivity to positive and negative interpersonal events for up to 3 months (M = 56 days, SD = 24.13). Actigraphy captured behavioral sleep duration and timing. Multilevel modeling was used to evaluate within-person fluctuations in sleep and affective reactivity as predictors of suicidal ideation, and multilevel mediation tested the indirect effects of sleep on suicidal ideation via affective reactivity to interpersonal events. Results indicate significant indirect effects of objectively measured sleep duration and subjective sleep quality on next-day suicidal ideation via affective reactivity to negative and positive interpersonal events, respectively. Shorter-than-usual sleep predicted the presence and intensity of next-day suicidal ideation via heightened affective reactivity to negative interpersonal events. Worse sleep quality than usual predicted next-day suicidal ideation via reduced affective reactivity to positive interpersonal events. Affectivity reactivity is a proximal mechanism through which sleep indices may influence risk for suicidal thinking on a daily basis. Findings highlight the utility of targeting sleep and emotion regulation in suicide prevention among adolescents and young adults at high-risk for suicide.

Objectively Measured Sleep Characteristics and Incidence of Ischemic Stroke: The Sleep Heart Health Study.

ObjectiveSleep disorders are associated with the prevalence of stroke. However, there is limited evidence regarding the association between objectively measured sleep characteristics and ischemic stroke.MethodsIschemic stroke was assessed during the mean follow-up period of 11 years in the Sleep Heart Health Study. Sleep parameters such as wake after sleep onset (WASO) and sleep efficiency (SE) were objectively measured based on in-home polysomnography records. Multivariable Cox regression analysis was utilized to examine the relationship between objective sleep characteristics and ischemic stroke incidence.ResultsThis study involved 4204 participants (1978 males and 2226 females, 63.8±11.1 years). The incidence of ischemic stroke increased in individuals with long WASO, poor SE, and short sleep duration. Multivariable Cox regression analysis showed that WASO within the fourth quartile (hazard ratio [HR] 3.771, 95% confidence interval [CI] 1.805–7.877, P<0.001), third quartile (HR 3.009, 95% CI 1.433–6.317, P=0.004), and second quartile (HR 3.108, 95% CI 1.470–6.568, P=0.003) had a higher incidence of ischemic stroke than WASO within the first quartile. Poor SE (<80.0%) was also found to be a predictor for ischemic stroke (HR 2.220, 95% CI 1.244–3.960, P=0.007). Additionally, a short sleep duration (<6 h) was associated with an increased risk of ischemic stroke (HR 1.725, 95% CI 1.026–2.899, P=0.040).ConclusionOur results revealed a relationship between WASO, SE, and sleep duration and ischemic stroke. Therefore, these sleep characteristics may be adequate predictors for the incidence of ischemic stroke.

Cross-sectional associations between objectively measured sleep characteristics and body mass index in European children and adolescents

BackgroundShort sleep duration has been found to be associated with a higher risk for overweight and obesity. However, previous studies have mainly relied on subjective measures of sleep duration and other sleep characteristics (eg quality, timing) have often been neglected. Therefore, we aimed to investigate associations between several, mainly objectively measured sleep characteristics and body mass index (BMI). Further, we aimed to identify distinct sleep subtypes based on these sleep characteristics and to study their association with BMI. MethodsChildren aged 9–16 years participating in the European I.Family study (N = 559, 51.2% girls, 32.9% overweight/obese) wore an accelerometer for one week on their wrist and recorded their daily wake-up and lights-off times in a sleep diary. Information on sleep duration, sleep efficiency and sleep latency was derived. To identify sleep subtypes, we conducted a latent class analysis using all five sleep variables. Associations between single sleep variables, sleep subtype and age- and sex-specific BMI z-score were investigated using linear mixed-effects regression models to accommodate clustering among siblings. ResultsNo statistically significant associations were observed between the single sleep variables (sleep duration, sleep efficiency, sleep latency, wake-up and lights-off times) and BMI z-score. Four sleep subtypes were identified and children were assigned to one of the groups based on their highest probability for latent group membership: “early birds” (17.5% of the sample), “short sleep duration” (14.7%), “optimal sleep” (47.6%) and “poor sleep quality” (20.2%). Sleep subtype was not associated with BMI z-score. ConclusionsUsing objective sleep data, we did not find convincing evidence for associations between the sleep variables under investigation and BMI.

Association of Sleep Quality With Greater Left Ventricular Mass in Children Aged 9 to 11 Years.

Research has consistently found associations between sleep characteristics and cardiovascular disease risk in children, adolescents, and adults. Although primarily investigated in clinical samples (e.g., in those with sleep disorders), greater left ventricular mass is associated with poor sleep quality in nonclinical adult populations as well; however, this has not been evaluated in children or adolescents. Our study aim was to consider the relationship between objectively measured sleep characteristics and left ventricular mass in children. We assessed sleep and cardiac structure in a biracial sample of 9- to 11-year-old children (n = 176; 41% White, 59% Black; 50% female). Sleep was assessed with actigraphy for five nights. Cardiac dimensions were assessed using echocardiography. After adjusting for covariates, we found that poor sleep quality was associated with significantly greater left ventricular mass (β = 0.13, t(167) = 2.14, p = .034, Cohen d = 0.16, for activity during sleep; β = 0.15, t(167) = 2.43, p = .016, Cohen d = 0.18, for sleep fragmentation). Other cardiac dimensions (namely, relative wall thickness and right ventricular dimension) were also significantly associated with sleep characteristics. Notably, associations did not differ as a function of sex or race. The present findings are novel and unique because no prior reports have systematically documented the association between poor sleep quality with potentially detrimental cardiac remodeling in a nonclinical sample of children. However, the novelty and importance of these findings require additional research for confirmation.

Abstract 17318: Cardioprotective Microbes and Restorative Sleep Are Reduced and Blood Pressure During Sleep is Increased When Rats Have Fragmented Sleep

Introduction: Sleep that is restless and fragmented impairs cardiovascular (CV) health. Using a rat model, we measured sleep characteristics and assessed bacterial communities in the gut microbiome. We hypothesized poor quality sleep to be associated with a reduction in cardioprotective microbiomes and adverse CV outcomes. Methods: Wistar Kyoto rats had normal sleep (n= 7, controls) or 8-hrs of fragmented sleep (n = 8) for 28 days. Implanted telemetry transmitters recorded blood pressure (BP), heart rate (HR), and cortical electroencephalogram (EEG) signals continuously. Fecal samples were collected daily; microbial composition was determined by 16S rRNA amplicon sequencing. Results: The sleep fragmented (SF) rats could not achieve deep slow-wave sleep (SWS) for 8-hrs each day—compared with controls, relative EEG delta power (a marker of the depth of sleep) was significantly lower (29±3% versus 39±3%, P = 0.04). In addition, SF was associated with a rise in BP and HR. The relative abundance of Parabacteroides (classified to genus level) and Tannerellaceae (classified to family level), both gram-negative anaerobic bacteria from the phylum Bacteroidetes, were decreased in SF rats during late-SF (intervention days 20 &amp; 27), relative to controls. Elevated Parabacteroides levels (%) were significantly and inversely correlated with systolic (R= -0.002, P &lt;0.001) and diastolic (R= -0.003, P &lt;0.001) BP levels recorded during sleep in both groups of rats. Conclusions: Parabacteroides levels in the gut microbiome may contribute to changes in BP. Undesirable changes in sleep from SF are associated with reduced levels of Parabacteroides during the late-SF period in the gut microbiome, compared with controls. The Parabacteroides -BP associations and reactivity of this bacterium to disrupted sleep support Parabacteroides as an exciting cardioprotective biomarker to stratify and prevent negative CV outcomes provoked by SF.

Sleep Characteristics and Rest-Activity Rhythms Are Associated with Gastrointestinal Symptoms Among Adults with Inflammatory Bowel Disease.

Sleep disturbance is common in inflammatory bowel disease (IBD) and is associated with poorer quality of life and increased disease activity; however, sleep is a multidimensional process, and little is known about specific sleep characteristics and rest-activity rhythms (RARs) in this population. The purposes were to (1) describe sleep characteristics and RARs; (2) compare sleep characteristics and RARs and GI symptoms by disease activity; and (3) describe associations between sleep characteristics, RARs, and GI symptoms among adults with IBD. We conducted a cross-sectional study of adults with IBD. We measured sleep characteristics and RARs (continuous wrist actigraphy); GI symptoms (PROMIS-GI); and disease activity (physicians' global assessment). We conducted cosinor and nonparametric analyses to compute RAR variables and bivariate analyses to address the aims. The sample included 37 participants [age M = 38years (SD = 13.8) and 21 (56.8%) female], of whom 23 (60.6%) were in remission. Sleep efficiency [M = 82.91% (SD 5.35)] and wake after sleep onset (WASO) [M = 42.26min (SD 18.57)] were not associated with disease activity. Inter-daily stability of the RAR was associated with heartburn/reflux (r = - .491, p = .005) and gas/bloating (r = - .469, p = .008). Intra-daily variability of the RAR was associated with heartburn/reflux (r = .421, p = .018). People with IBD may have disrupted RARs, which are associated with GI symptoms. Research is needed to improve understanding of these associations and to develop interventions to improve these characteristics in adults with IBD.

Associations of objectively measured sleep characteristics and incident hypertension among police officers: The role of obesity.

This study investigated the associations of baseline sleep onset latency, wake after sleep onset, longest wake episode, number of awakenings, sleep efficiency and sleep duration with incident hypertension during a 7-year follow-up (n=161, 68% men) and the joint effect of insufficient sleep and obesity on incident hypertension. Sleep parameters were derived from 15-day actigraphy data. Relative risks and 95% confidence intervals were estimated using a robust Poisson regression model. Each 10-min increase in sleep onset latency was associated with an 89% higher risk of hypertension (95% confidence interval [CI]=1.12-3.20). Each 10-min increase in longest wake episode was associated with a 23% higher risk of hypertension (95% CI=1.01-1.50) and each 10% decrease in sleep efficiency was associated with a 50% higher risk of hypertension (95% CI=1.02-2.22). These associations were independent of demographic and lifestyle characteristics, depressive symptoms, shift work, sleep duration and body mass index. Having <6hr of sleep and a body mass index ≥30kg/m2 increased the risk of hypertension (relative risk=2.81; 95% CI=1.26-6.25) compared with having ≥6hr of sleep and a body mass index <30 after controlling for confounders. Relative excess risk due to interaction was 3.49 (95% CI=-1.69-8.68) and ratio of relative risk was 3.21 (95% CI=0.72-14.26). These results suggest that poor sleep quality is a risk factor for hypertension. Longitudinal studies with larger sample sizes are warranted to examine the joint effect of insufficient sleep and obesity on development of hypertension.

Maternal Bonding Predicts Actigraphy-Measured Sleep Parameters in Depressed and Nondepressed Adults.

Associations between subjective maternal bonding recalled from the first 16 years of life and current sleep indices were investigated in a clinical sample of 34 adults with major depressive disorder and 36 normal controls (n = 70) using the self-report parental bonding instrument and wrist actigraphy. Results of multiple linear regression analyses indicated that reports of maternal bonding indices were associated with several sleep indices in adulthood independent of depression status. Higher levels of maternal care were associated with greater time in bed and total sleep time. Higher levels of maternal overprotection were associated with fewer awakenings. Findings indicate that reported maternal bonding characteristics in childhood are related to objectively measured sleep characteristics in adulthood, independent of mood state.

Sleep: population epidemiology and concordance in Australian children aged 11-12 years and their parents.

ObjectivesTo describe objectively measured sleep characteristics in children aged 11–12 years and in parents and to examine intergenerational concordance of sleep characteristics.DesignPopulation-based cross-sectional study (the Child Health CheckPoint), nested within the Longitudinal Study of Australian Children.SettingData were collected between February 2015 and March 2016 across assessment centres in Australian major cities and selected regional towns.ParticipantsOf the participating CheckPoint families (n=1874), sleep data were available for 1261 children (mean age 12 years, 50% girls), 1358 parents (mean age 43.8 years; 88% mothers) and 1077 biological parent–child pairs. Survey weights were applied and statistical methods accounted for the complex sample design, stratification and clustering within postcodes.Outcome measuresParents and children were asked to wear a GENEActive wrist-worn accelerometer for 8 days to collect objective sleep data. Primary outcomes were average sleep duration, onset, offset, day-to-day variability and efficiency. All sleep characteristics were weighted 5:2 to account for weekdays versus weekends. Biological parent–child concordance was quantified using Pearson’s correlation coefficients in unadjusted models and regression coefficients in adjusted models.ResultsThe mean sleep duration of parents and children was 501 min (SD 56) and 565 min (SD 44), respectively; the mean sleep onset was 22:42 and 22:02, the mean sleep offset was 07:07 and 07:27, efficiency was 85.4% and 84.1%, and day-to-day variability was 9.9% and 7.4%, respectively. Parent–child correlation for sleep duration was 0.22 (95% CI 0.10 to 0.28), sleep onset was 0.42 (0.19 to 0.46), sleep offset was 0.58 (0.49 to 0.64), day-to-day variability was 0.25 (0.09 to 0.34) and sleep efficiency was 0.23 (0.10 to 0.27).ConclusionsThese normative values for objective sleep characteristics suggest that, while most parents and children show adequate sleep duration, poor-quality (low efficiency) sleep is common. Parent–child concordance was strongest for sleep onset/offset, most likely reflecting shared environments, and modest for duration, variability and efficiency.

Does sleep affect weight gain? Assessing subjective sleep and polysomnography measures in a population-based cohort study (CoLaus/HypnoLaus).

Although several studies have linked short and long sleep duration to weight gain, mixed results exist. Contrarily, few studies associated objectively measured sleep characteristics with weight gain. We investigated the association between several sleep characteristics measured by questionnaire and polysomnography with prospective weight gain in a population-based, middle-aged cohort. Three samples were analyzed: sample 1 (n = 2551, 47.3% men, 56.9 ± 10.3 years) had data for subjective sleep characteristics, sample 2 (n = 1422, 49.4% men, 57.6 ± 10.4 years) had objective sleep assessment (polysomnography), and sample 3 consisting of 1259 subjects included in both samples. Multivariable logistic regressions were performed to assess the relationship between sleep characteristics and ≥5 kg weight gain during a median follow-up of 5.3 years. In both study samples, 12% of the subjects gained ≥5 kg during follow-up. Multivariable analyses showed poor subjective sleep quality (as assessed by Pittsburgh Sleep Quality Index: odds ratio [95% confidence interval] = 1.54 [1.19 to 1.99]), percentage of sleep spent in stage 2 (1.32 [1.10 to 1.58]), and less than 90% oxygen saturation (SpO2 < 90) (1.23 [1.07 to 1.41]); moderate/severe Oxygen Desaturation Index (1.70 [1.01 to 2.85]) and autonomic arousal duration (1.22 [1.02 to 1.45]) were related to ≥5 kg weight gain. Only poor subjective sleep quality was robustly associated with weight gain in all sensitivity analyses, except in female subsamples. Poor subjective sleep quality, and to some extent moderate to severe oxygen desaturation, but no other sleep characteristics, were robustly associated with weight gain. Future studies should confirm the relationship between sleep quality and weight gain, assess sex differences, and investigate underlying mechanisms.

Sleep characteristics and inflammatory biomarkers among midlife women.

Research suggests that sleep disturbances are associated with elevated levels of inflammation. Some evidence indicates that women may be particularly vulnerable; increased levels of inflammatory biomarkers with sleep disturbances are primarily observed among women. Midlife, which encompasses the menopause transition, is typically reported as a time of poor sleep. We tested whether poorer objectively measured sleep characteristics were related to a poorer inflammatory profile in midlife women. Two hundred ninety-five peri- and postmenopausal women aged 40-60 completed 3 days of wrist actigraphy, physiologic hot flash monitoring, questionnaires (e.g. Berlin sleep apnea risk questionnaire], and a blood draw for the assessment of inflammatory markers, including C-reactive protein (CRP), interleukin-6 (IL-6), and von Willebrand factor (VWF) antigen. Associations of objective (actigraphy) sleep with inflammatory markers were tested in regression models. Sleep efficiency was inverse log transformed. Covariates included age, race/ethnicity, education, body mass index, sleep apnea risk, homeostatic model assessment (a measure of insulin resistance), systolic blood pressure, low-density lipoprotein cholesterol, and physical activity. In separate models controlling for age, race/ethnicity, and education, lower sleep efficiency was associated with higher IL-6 [b(SE) = .02 (.10), p = .003] and VWF [b(SE) = .02 (.08), p = .002]. More minutes awake after sleep onset was associated with higher VWF [b(SE) = .12 (.06), p = .01]. Findings persisted in multivariable models. Lower sleep efficiency and more minutes awake after sleep onset were independently associated with higher circulating levels of VWF. Lower sleep efficiency was associated with higher circulating levels of IL-6. These findings suggest that sleep disturbances are associated with greater circulating inflammation in midlife women.

Abstract P278: Impaired Nighttime Sleep Negatively Effects Next-Day Physical Activity: Results From an Ecological Momentary Assessment Study

Introduction: Intention to engage in physical activity (PA) is an important concept in behavior change theories. However, age, body mass index (BMI), and sleep may influence one’s intention to engage in PA and intention might not predict actual activity. Purpose: This secondary analysis examined predictors of intention to engage in PA and if the factors associated with intention predicted objectively measured moderate-to-vigorous physical activity (MVPA) in adults who were overweight or obese and enrolled in a weight loss study. Methods: We used 6- and 12-mo data from the EMPOWER Study, an observational study examining triggers of lapse following intentional weight loss. Objective measures included up to 7 days of overlapping accelerometer and actigraphy data to assess daily MVPA and sleep. Self-report data included responses to the question “Do you intend to be physically active today?” hereafter called intention, collected at the beginning of each day via ecological momentary assessment. Analyses were performed examining: 1) the effects of subject-level covariates (e.g., age, sex, race, BMI) on intention, 2) the effects of objectively measured sleep characteristics (e.g., total sleep time [TST], number of awakenings, sleep fragmentation) on intention, and 3) the relationships between sleep, intention, and MVPA. Logistic regression using generalized estimating equations and linear mixed-effect models were used. Results: The analyses included 680 person-days at 6 mo and 678 person-days at 12 mo. Participants (N=136) were mostly female (89.8%) and white (81.8%) with a mean (± SD) age of 51.5 ± 9.9 years and BMI of 33.5 ± 4.6. At 6 mo, participants intended to engage in PA on 81.2% of days, had a mean TST of 408.9 ± 81.8 min/night, and a mean of 32.4 ± 14.7 awakenings/night. At 12 mo, PA intention decreased to 80.6% of days, TST increased to 416.5 ± 82.5 min/night, and awakenings increased to 34.0 ± 14.4 per night (p = .089 for TST; p = .043 for awakenings). Mean daily MVPA decreased from 19.0 ± 23.9 min at 6 mo to 17.3 ± 23.4 min at 12 mo (p = .185). Intention increased with increasing age (odds ratio [OR] = 1.04; 95% confidence interval [95% CI] = 1.02 -1.07). At 6 mo, sleep fragmentation, after adjusting for age, negatively affected intention (OR = 0.96; 95% CI = 0.94 - 0.98); however, it did not significantly affect intention at 12 mo. When comparing days with no PA intention to days in which participants intended to engage in PA, mean MVPA nearly tripled from 7.4 min (95% CI = 3.6 - 11.2) to 21.2 min (95% CI = 18.4 - 24.0). Furthermore, when controlling for age, time of assessment, and intention, participants engaged in an estimated 0.135 (95% CI = 0.241 - 0.029) fewer min of MVPA for each awakening. Conclusions: Based on these findings, future weight loss programs should include interventions that improve sleep quality by reducing fragmentation and strengthen the link between intention and engagement in PA.