Night Owls Research Articles

0192 Sleep Hygiene and Self-Efficacy for Sleep Hygiene among Good and Poor Sleepers: A Secondary Analysis

Abstract Introduction College students are at risk for sleep disturbances that may influence academic performance and cognitive function. Poor sleep hygiene and sleep quality over time results in inadequate sleep and daytime sleepiness, which, if not addressed, eventually leads to sleep deprivation and adverse health effects. The current study aims to identify if sleep hygiene practices and self-efficacy relate to poor and good sleepers categorized according to the Pittsburg Sleep Quality Index (PSQI) Score > or < 5) among a sample of college students. Methods Secondary analysis of baseline data from college student participants aged 18-26 from an intervention study was used. All participants completed demographic, sleep hygiene, and sleep quality assessments. (e.g., Sleep hygiene index [SHI], Self-efficacy for sleep hygiene inventory [SHESHI], and PSQI). Descriptive statistics were calculated for demographic, sleep quality, and sleep hygiene variables. Results The sample (n=119) included 15 Freshmen, 30 Sophomores, 52 Juniors, and 21 Seniors, of which 26 were male and 93 female college students. The total sample mean age=20.6 y +2.0, range: 18-26; 82.4% were White, 55% worked part-time, and 69.8% considered themselves night owls. Data were examined to determine if poor and good sleepers differed across key demographic variables. There were no statistically significant differences between the groups. The sample comprised 47.0 % (n=56) poor sleepers and 52.9% (n=63) good sleepers. A Mann-Whitney U test was run to determine if there were differences in self-efficacy scores and sleep hygiene practices between poor and good sleepers. Mean rank self-efficacy scores for poor sleepers (44.15) were significantly lower than for good sleepers (74.09), U=876, z = -4.725, p <.001. Mean rank sleep hygiene index scores for poor sleepers (76.05) were significantly higher than good sleepers (45.73) U=865, z = -4.793, p <.001. Conclusion Preliminary descriptive findings highlight significant characteristics of sleep hygiene efficacy in college students with good and poor sleep. All surveys were subjective measures. Future use of an objective measure of actual sleep time and sleep health index would add to an understanding of sleep issues in college students. Support (if any) N/A

0256 Modeling Individual Sleep Needs from Wearable-Device Data

Abstract Introduction There are currently thought to be two processes that interact to regulate one’s sleep/wake cycle: a sleep homeostat, which depends on the amount of time you have been awake; and the circadian rhythm, an internal 24-hour molecular clock present in nearly every cell of the body. Both processes differ between individuals, whether that’s from a decision to pull an all-nighter or from a genetic inclination towards being an “early bird” or a “night owl”. This project focuses on building a model that can predict how sleep disruptions impact an individual’s sleep cycle, and the ability to recover from these disruptions. Methods A “two-process” model with the capability to simulate a theoretical sleep-wake cycle with disruptions was implemented in Python, and is being tuned using machine learning (ML) on actigraphy data. Actigraphy measures motion using a noninvasive accelerometer embedded into a wearable-device (e.g. FitBit), allowing for the study of sleep activity patterns in a real-world setting. Data was collected from approximately 20,000 individuals, who reside in 121 different countries. ML algorithm was trained and tested on synthetic data generated from the “two-process” model, and then applied to the actigraphy dataset to evaluate prediction accuracy. Results Our model has shown that recovery from sleep disruptions can be modeled mathematically, and can be individualized using actigraphy data. The mathematical model was able to successfully simulate the “two-process” interaction, and, by sweeping parameter values, those that yielded a single sleep bout of 8-9 hours/night were identified. ML algorithm tuning with actigraphy data is ongoing. Conclusion Our results suggest that it is possible to predict the sleep patterns of individuals despite disruptions in their schedules from sleep disorders, travel, work, or social and family commitments. Future research should focus on optimization of sleep in individuals using the informational output of our model, and extending it to incorporate the behavioral and/or clinical changes that have proven to improve an individual’s sleep. By incorporating this additional set of data, the resulting model can not only predict the impact of disruptions, but also provide recommendations for prevention and recovery based on an individual’s input about their lifestyle and their sleep. Support (if any)

From early birds to night owls: a longitudinal study of actigraphy-assessed sleep trajectories during the transition from pre- to early adolescence.

Pre- and early adolescence are believed to constitute periods of important age-related changes in sleep. However, much of the research on these presumed developmental changes has used cross-sectional data or subjective measures of sleep, limiting the quality of the evidence. In addition, little is known about the development of certain features of the sleep-wake cycle pertaining to regularity (e.g. weekend-weekday differences and intra-individual variability) or circadian rhythms (e.g. sleep midpoint). This study examined the sleep trajectories of 128 typically developing youth (69 girls) from ages 8 to 12 years on four sleep characteristics: sleep onset, sleep offset, total sleep time (TST), and sleep midpoint. For each of these characteristics, actigraphy-derived estimates of typical (i.e. mean) sleep and sleep regularity were obtained at each time point. Multilevel growth curves were modeled. Overall, the sleep-wake cycle significantly changed between 8 and 12 years. Mean sleep onset, offset and midpoint exhibited an ascending curvilinear growth pattern that shifted later with age, while mean TST decreased linearly. Weekend-weekday differences (social jetlag) for sleep offset and midpoint became more pronounced each year. Weekday TST was longer than weekend TST, though this difference became smaller over time. Finally, intra-individual variability increased over time for all sleep characteristics, with variability in TST ascending curvilinearly. Important between-person and sex differences were also observed. This study reveals the marked changes that occur in the sleep of typically developing pre- and early adolescents. We discuss the potential implications of these trajectories.

Mind the Gap

My wife, Michelle, came downstairs with weary eyes. She had every right to be miffed. I’m a morning person and she’s a night owl, so every day I wake up before she does. As I go through my morning routine in the kitchen, grabbing pans, bowls, and spoons, I tend to loudly slam the cabinet doors.

Chronotype in college science students is associated with behavioral choices and can fluctuate across a semester

ABSTRACT Many students self-report that they are “night owls,” which can result from neurodevelopmental delays in the circadian timing system. However, whether an individual considers themselves to be an evening-type versus a morning-type (self-reported chronotype) may also be influenced by academic demands (e.g. class start times, course load) and behavioral habits (e.g. bedtime social media use, late caffeine consumption, daytime napping). If so, then chronotype should be malleable. We surveyed 858 undergraduate students enrolled in demanding science courses at up to three time points. The survey assessed morning/evening chronotype, global sleep quality, academics, and behavioral habits. Evening and morning-type students showed similar demographics, stress levels, and academic demands. At baseline measurements, relative to morning-types, evening-types showed significantly worse sleep quality and duration as well as 22% greater bedtime social media usage, 27% greater daytime napping duration, and 46% greater likelihood of consuming caffeine after 5pm. These behavioral habits partially mediated the effects of self-reported chronotype on sleep quality/duration, even after controlling for demographic factors. Interestingly, 54 students reported switching from being at least moderate evening-types at baseline to being at least moderate morning-types later in the semester and 56 students showed the reverse pattern (6.3% of students switched from “definitely” one chronotype to the other chronotype). Evening-to-morning “chrono-switchers” consumed less caffeine after 5pm and showed significantly better sleep quantity/quality at the later timepoint. Thus, some students may consider themselves to be night owls in part because they consume caffeine later, take more daytime naps, or use more social media at bedtime. Experimental work is needed to determine whether nudging night owls to behave like morning larks results in better sleep health or academic achievement.

Quasi-causal associations between chronotype and post-traumatic stress disorder symptoms: A twin study

ObjectiveThe evening (“night owl”) chronotype is associated with greater severity and lifetime prevalence of post-traumatic stress disorder (PTSD) symptoms compared to morning or intermediate chronotypes. This twin study investigated the gene-environment relationships between chronotype, recent PTSD symptoms, and lifetime intrusive symptoms. MethodsWe used the reduced Horne-Östberg Morningness-Eveningness Questionnaire (rMEQ) to assess chronotype in a sample of 3777 same-sex adult twin pairs raised together (70.4% monozygotic, 29.6% dizygotic) in the community-based Washington State Twin Registry. PTSD symptoms were reported on the Impact of Events Scale (IES) and a single item for lifetime experience of intrusive symptoms after a stressful or traumatic event. ResultsGenetic influences accounted for 50% of chronotype variance, 30% of IES score variance, and 14% of lifetime intrusive symptom variance. Bivariate twin models showed a phenotypic association (bp) between evening chronotype and more severe PTSD symptoms (bp = −0.16, SE = 0.02, p < .001) that remained significant even after adjusting for shared genetic and environmental influences (bp = −0.10, SE = 0.04, p = .009), as well as age, sex, and self-reported sleep duration (bp = −0.11, SE = 0.04, p = .004). An association was found between evening chronotype and lifetime intrusive symptoms (bp = −0.11, SE = 0.03, p < .001) that was no longer significant after adjusting for shared genetic and environmental influences (bp = 0.04, SE = 0.06, p = .558). ConclusionsOur results suggest a “quasi-causal” relationship between evening chronotype and PTSD symptoms that is not purely attributable to genetic or shared environmental factors. Evening chronotype may increase vulnerability to pathologic stress responses in the setting of circadian misalignment, providing potential avenues of prevention and treatment using chronobiological strategies.

Early Birds and Night Owls: Distinguishing Profiles of Cannabis Use Habits by Use Times with Latent Class Analysis.

Understanding, predicting, and reducing the harms associated with cannabis use is an important field of study. Timing (i.e., hour of day and day of week) of substance use is an established risk factor of severity of dependence. However, there has been little attention paid to morning use of cannabis and its associations with negative consequences. The goal of the present study was to examine whether distinct classifications of cannabis use habits exist based on timing, and whether these classifications differ on cannabis use indicators, motives for using cannabis, use of protective behavioral strategies, and cannabis-related negative outcomes. Latent class analyses were conducted on four independent samples of college student cannabis users (Project MOST 1, N=2,056; Project MOST 2, N=1846; Project PSST, N=1,971; Project CABS, N=1,122). Results determined that a 5-class solution best fit the data within each independent sample consisting of the classes: (1) "Daily-morning use",(2) "Daily-non-morning use", (3) "Weekend-morning use", (4) "Weekend-night use", and (5) "Weekend-evening use." Classes endorsing daily and/or morning use reported greater use, negative consequences and motives, while those endorsing weekend and/or non-morning use reported the most adaptive outcomes (i.e., reduced frequency/quantity of use, fewer consequences experienced, and fewer cannabis use disorder symptoms endorsed). Recreational daily use as well as morning use may be associated with greater negative consequences, and there is evidence that most college students who use cannabis do avoid these types of use. The results of the present study offer evidence that timing of cannabis use may be a pertinent factor in determining harms associated with use.

PS-C12-10: “CHRONOBIOLOGY” THE NEW PARADIGM OF CLINICAL APPROACH

1) Definition: Chronobiology is the study of biological rhythms. Over the past few decades, chronobiology has developed into a multidisciplinary field. 2) The suprachiasmatic nucleus (SCN) is a bilateral structure located in the anterior part of the hypothalamus. It is the central pacemaker of the circadian timing system and regulates most circadian rhythms in the body. 3) Why your circadian rhythm matters? Our circadian rhythm matters in all parts of our life. For eg: if your sleep times are off, your hunger could be off or your eating times. We often see people who are sleep deprived either their hunger goes up or down. And the time when they get hungry changes. 4) How to tell it is time to reset our circadian rhtym ? You might need to reset your circadian rhythm:: if you have trouble falling asleep, staying awake in the evening, waking in the morning, focusing on daily tasks and responsibilities. 5) Our circadian rhythms evolve over time. As we age, our circadian timing gets earlier. People in their 50 s, 60 s and 70 s may start to want go to bed earlier and wake up earlier. If you were a night owl as a teenager, you could be a morning person when you are an older adult. 6) Small Study at LMR Hospital: TARGET PEOPLE 1) ELDERLY PEOPLE WITH HYPERTENSION 2) MID AGED PEOPLE BOTH MALE AND FEMALE 25-40 YEARS WITH BORDERLINE HYPERTENSION Observations: 1) In a group of 1000 elderly people with HTN correction in 1 hour of sleep cycle has improved their quality of life by 60 to 70 percent and thereby reducing the dose of antihypertensives. 2) In middle aged females and males of 1000 people (age 30–40) with prehypertension timely sleeping, avoiding nighttime electronic gadgets tv, increased physical activity almost avoided the need for the antihypertensives. Conclusions: A very small variation in the circadian rhythm will have great impact on our health. For eg:: 1 hour deprivation of sleep may increase the stroke risk from 40 % to 80 % and thereby increasing mortality rate. It is very important to note that even in clinical trials of many drugs, circadian rhythm should also be taken in to consideration. for eg:: dippers and non dippers in population. 9) Goal of this Entire Study: Doctor treating the patients accordingly to the biological clock will give the chance for getting excellent results without increasing the dose of medication.

The Witch in Flight

The Witch in Flight

Circadian rhythm shifts and alcohol access in adolescence synergistically increase alcohol preference and intake in adulthood in male C57BL/6 mice

BackgroundAdolescents have a natural tendency to be night owls, maintaining delayed circadian rhythms, and this rhythm is in direct conflict with the early wake times required during the school year. This leads to ‘social jetlag’, chronic circadian stress or desynchrony (CD) in which the rhythm of the intrinsic body clock is out of sync with behavior. CD increases alcohol intake in adolescents and adults, yet it is unknown whether adolescent CD also increases long-term addiction risk. The goal of this study was to determine whether adolescent alcohol intake in CD would increase adult alcohol preference and intake in male C57BL/6 J mice. Methods: We measured free access alcohol intake, water intake, and wheel-running activity during a normal 12 h (h) baseline photoperiod and then during shifting lighting schedules (Experiment 1) or a shortened circadian day (Experiment 2). Results: In Experiment 1, altered lighting produced a persistent increase in adolescent alcohol intake and in binge-like drinking (drinking at least 5 licks per minute, with no more than a 1 min break in drinking) in adulthood, but only a transient increase in total alcohol intake for the first week after alcohol was reintroduced in adulthood. In Experiment 2, the circadian shift produced a significant increase in alcohol intake in both adolescence and adulthood. Molecular analysis demonstrated changes in plasma corticosterone and neuronal markers of stress and addiction at the conclusion of these experiments in the CD and alcohol-exposed groups. Conclusions: Thus, we conclude that circadian stress during adolescence is sufficient to produce a long-lasting susceptibility to alcohol use.

고려시기 개경 일대 야생동물의 출몰과 그 의미

It is highly important to figure out the ecological environments of Gaegyeong to understand the lives of Gaegyeong residents during Goryeo. The ecological environment around Gaegyeong was comprised of diverse elements, and this study focused on the investigation of wild animals based on Ohaengji of Goryeosa. Of wild animals that appeared around Gaegyeong, representative examples of mammals include the tiger, roe deer, fox, and deer. There were also savage beasts including the leopard, bear, boar, wolf, and wildcat and herbivores including the antelope, goat, and hare. In the birds family, the owl, night owl, pheasant, and crow appeared most frequently. In addition, there were the magpie, sparrow, meadow bunting, crane, stork, red-crowned crane, and quail. The eight species of wild animals including the tiger, roe deer, fox, deer, owl, night owl, pheasant, and crow made the most contacts with the people of Gaegyeong those days, thus having the biggest influences on them. The mammals appeared a lot in spring and summer, and the birds appeared frequently in autumn and winter. The combined number of mammals and birds was the biggest during the reign of Kings Chungryeol, Gongmin, and Woo. There were many different factors behind the appearance of wild animals in Gaegyeong, and the deterioration of the ecological environment around the capital city must have been a very important one. When it became difficult to get preys in the wild, wild animals would take a risk and enter into a capital where the human population was dense. It must have been especially true with mammals. Having a high mobility level, birds must have received relatively less impact by the ecological environment around the city, but it was not true that they had nothing to do with changes to the ecological environment. When wild animals appeared in Gaegyeong, they afflicted direct harm on people, who rather accepted their appearance seriously as they were ill omens. In the case of wild animals appearing in the city, they would hold events to prevent future ill fortunes. They would hold Beopseok and Doryang in the Buddhist style, and even government officials themselves supervised events to prevent misfortune. There were, however, no efforts to find the causes of wild animals appearing in the capital city. It was difficult to find the awareness of protecting and preserving wild animals like the modern society in the people of Gaegyeong those days. Based on these findings, the study proposes future research tasks including the reality of the entire ecological environment not limited to wild animals, its impacts on people, the impacts of people on it, and human cognition, ideas, and attitude toward it.

Innovative promotional strategies and diversification of flavoured mass merchandise cigar products: a case study of Swedish match

In 2009, the Family Smoking Prevention and Tobacco Control Act (TCA) granted the U.S. Food and Drug Administration (FDA) regulatory authority over tobacco products, although initially this only included cigarettes,...

Diurnal Variation in Motivation, Cocaine Value, and In Vivo Dopamine Release

Circadian rhythms have been shown to influence a number of psychiatric disorders, like substance use disorder (SUD). For example, individuals with evening chronotypes (i.e. night owls) express higher vulnerability to drug‐craving and drug‐taking behaviors.Similarly, the mesolimbic dopamine (DA) system, which is an essential circuit in these behaviors, exhibits diurnal rhythms in activity and function. Although diurnal rhythms have been documented in both drug‐taking and DA dynamics, it remains unclear whether these variations in DA confer with variations in‐drug taking. Here, we utilized in vivo fast scan cyclic voltammetry and a behavioral economic analysis of cocaine self‐administration to examine time‐of‐day variations in in vivo DA release, motivation, and cocaine value. We hypothesize that the degree to which the magnitude of mesolimbic DA release in the nucleus accumbens (NAc) varies across time will correspond diurnal variations found in motivation to take cocaine. We found that in vivo DA release was increased across the dark cycle in comparison to time‐points in the light cycle. We found no difference in cocaine intake in rats across time‐of‐day when cocaine “cost” was low and easy to obtain (Q0). However, we found that rats in the mid‐point of their dark cycles were more persistent in maintaining high cocaine intake as the “cost” or effort to maintain blood‐levels increased within their session in comparison to rats midway through their light cycle. These novel data suggest that specific time‐points across the dark cycle are associated with corresponding increases in DA and motivation to self‐administer cocaine under high, but no low, cost conditions. Understanding this dynamic modulation of diurnal variations may provide another therapeutic avenue for the circadian intervention of SUDs as well as target time‐points at which current pharmacotherapies might be most effective.

Implicit and Explicit Stigma of Chronotype in Emerging Adults

ABSTRACT Background Individuals with poor sleep (e.g., insomnia) and mental health (e.g., depression) experience negative stigma but no studies have examined the relationship between stigma and evening chronotype. The present mixed methods study aimed to assess and describe explicit and implicit attitudes about evening and morning chronotypes in a sample of emerging adults. Participants 49 undergraduates (M age = 19.9 [SD = 1.5], 83.7% female). Methods Participants completed self-reports of demographics and chronotype. Attitudes about “night owls” and “early birds” were measured with self-report questionnaires (explicit attitudes) and an Implicit Association Task (implicit attitudes). Participants described associations with evening and morning chronotypes in free-text responses, which were qualitatively coded. Results We found evidence of implicit bias against night owls and for early birds. The positive mean implicit d score was 0.57 (SD = 0.47), indicating a moderate implicit bias for pairing “bad” with “night owl” and “good” with “early bird.” No baseline characteristics, including chronotype, were significantly associated with implicit bias. Analyses of explicit bias revealed participants perceived night owls as significantly more lazy, unhealthy, undisciplined, immature, creative, and young. Analysis of free-text responses provided further evidence of these associations. Conclusions Consistent with hypothesis, undergraduates demonstrated predominantly negative implicit and explicit stigma toward evening chronotypes compared to morning types. As stigma can lead to adverse consequences, future studies should assess the impact of negative societal and self-stigma on evening types. Consideration of societal stigma within clinical intervention contexts could have the potential to reduce shame or other emotions that interfere with sleep.

Diurnal Preference Contributes to Maximal UVB Sensitivity by the Hour of the Day in Human Skin In Vivo

Diurnal Preference Contributes to Maximal UVB Sensitivity by the Hour of the Day in Human Skin In Vivo

Drug Use in Night Owls May Increase the Risk for Mental Health Problems.

Drugs of abuse are widely known to worsen mental health problems, but this relationship may not be a simple causational one. Whether or not a person is susceptible to the negative effects of drugs of abuse may not only be determined by their addictive properties, but also the users’ chronotype, which determines their daily activity patterns. The present study investigates the relationship between chronotype, drug use and mental health problems in a cross-sectional community sample. Participants (n = 209) completed a selection of questionnaires online, including the Munich Chronotype Questionnaire, the Depression Anxiety Stress Scale, the Alcohol Use Disorder Identification Test, the Cannabis Use Disorder Identification Test and the Fagerström Test for Nicotine Dependence. We conducted multiple regression models to determine relationships between participants’ chronotype and their reported mental health symptoms and then estimated mediation models to investigate the extent to which their drug consumption accounted for the identified associations. Chronotype was significantly associated with participants’ overall mental health (β = 0.16, p = 0.022) and their anxiety levels (β = 0.18, p = 0.009) but not with levels of depression or stress. However, both relationships were fully mediated by participants’ overall drug consumption. Thus, late chronotypes, so-called “night owls”, not only use more drugs but consequently have an increased risk for developing anxiety and deteriorating mental health status. This group may be particularly vulnerable to the negative psychological effects of drugs. Our results point toward the importance of considering chronotype in designing preventative and therapeutic innovations, specifically for anxiety, which at present has been largely neglected.

Night Owls and Lone Wolves

ABSTRACT Diurnal preference for evening time has been associated with poorer physical and mental health outcomes. In the current report, perceived loneliness and brain structure (hippocampal and amygdala volumes) were compared in a large (N = 4684) sample of morning- and evening-type individuals. Definite eveningness was associated with increased odds for reporting self-perceived loneliness and lonely evening-types had significantly smaller right hippocampal volume as compared to morning and more socially connected evening types. These data add to the mounting body of evidence linking an evening profile with increased risk for psychiatric disorder.

Effects of plan specificity and eveningness–morningness orientation on health goal pursuit

AbstractExtant research has identified several boundary conditions for the beneficial effects of planning in goal pursuit. The present research examines how consumers with morningness‐ (early birds) or eveningness‐orientation (night owls) benefit differentially from health goal planning. Specifically, three studies in an eating context show that early birds respond better to specific diet plans, while night owls respond better to general diet plans. Therefore, a match between plan specificity and one's eveningness–morningness orientation promotes self‐efficacy in carrying out the plans and the consequent health goal‐directed motivation and behaviors. The fourth study in an exercise context further reveals that individual differences in body mass index moderate the combined effect of plan specificity and eveningness–morningness orientation on health goal pursuit. Together, our findings provide practical implications by demonstrating how planning‐based interventions can motivate different consumer segments in health goal pursuit.

Skin-inspired wearable self-powered electronic skin with tunable sensitivity for real-time monitoring of sleep quality

In modern times, it is essential to ensure excellent sleep quality and comfort, and a way to scientifically assess these conditions is urgently needed. However, most existing sleep monitoring devices are complicated and uncomfortable to wear. Here, a dermal papillae-bioinspired self-powered multifunctional electronic skin (e-skin) with an all-fibrous multilayer nanostructure based on a triboelectric nanogenerator is proposed, which is sensitive, lightweight, ultrathin, breathable, biocompatible, and low-cost. Owing to the bead polyvinylidene fluoride nanofibers of the e-skin simulating the dermal papillae of natural skin and the N-(2-aminoethyl)-3-aminopropyl trimethoxy silane-modified nature of the collagen aggregate nanofibers, the e-skin exhibits the highest sensitivity (0.32 V kPa−1) in the range of 0–135 kPa. Additionally, it has short response and recovery times (20 and 33 s, respectively) in the humidity range of 25–85% RH. More importantly, the e-skin converts mechanical energy into electrical energy for humidity detection via an energy circulation system. The e-skin can collect the heartbeat and respiration signals and perform an analysis on their frequency and stability, which can be used to accurately measure the different sleep phases. By analyzing the proportion of each phase and environmental humidity, the e-skin can be employed to scientifically assess the sleep quality and comfort of insomnia patients and night owls through real-time monitoring.

A Transdiagnostic Self-management Web-Based App for Sleep Disturbance in Adolescents and Young Adults: Feasibility and Acceptability Study.

BackgroundSleep disturbance and its daytime sequelae, which comprise complex, transdiagnostic sleep problems, are pervasive problems in adolescents and young adults (AYAs) and are associated with negative outcomes. Effective interventions must be both evidence based and individually tailored. Some AYAs prefer self-management and digital approaches. Leveraging these preferences is helpful, given the dearth of AYA treatment providers trained in behavioral sleep medicine. We involved AYAs in the co-design of a behavioral, self-management, transdiagnostic sleep app called DOZE (Delivering Online Zzz’s with Empirical Support).ObjectiveThis study tests the feasibility and acceptability of DOZE in a community AYA sample aged 15-24 years. The secondary objective is to evaluate sleep and related outcomes in this nonclinical sample.MethodsParticipants used DOZE for 4 weeks (2 periods of 2 weeks). They completed sleep diaries, received feedback on their sleep, set goals in identified target areas, and accessed tips to help them achieve their goals. Measures of acceptability and credibility were completed at baseline and end point. Google Analytics was used to understand the patterns of app use to assess feasibility. Participants completed questionnaires assessing fatigue, sleepiness, chronotype, depression, anxiety, and quality of life at baseline and end point.ResultsIn total, 83 participants created a DOZE account, and 51 completed the study. During the study, 2659 app sessions took place with an average duration of 3:02 minutes. AYAs tracked most days in period 1 (mean 10.52, SD 4.87) and period 2 (mean 9.81, SD 6.65), with a modal time of 9 AM (within 2 hours of waking). DOZE was appraised as highly acceptable (mode≥4) on the items “easy to use,” “easy to understand,” “time commitment,” and “overall satisfaction” and was rated as credible (mode≥4) at baseline and end point across all items (logic, confident it would work, confident recommending it to a friend, willingness to undergo, and perceived success in treating others). The most common goals set were decreasing schedule variability (34/83, 41% of participants), naps (17/83, 20%), and morning lingering in bed (16/83, 19%). AYAs accessed tips on difficulty winding down (24/83, 29% of participants), being a night owl (17/83, 20%), difficulty getting up (13/83, 16%), and fatigue (13/83, 16%). There were significant improvements in morning lingering in bed (P=.03); total wake time (P=.02); sleep efficiency (P=.002); total sleep time (P=.03); and self-reported insomnia severity (P=.001), anxiety (P=.002), depression (P=.004), and energy (P=.01).ConclusionsOur results support the feasibility, acceptability, credibility, and preliminary efficacy of DOZE. AYAs are able to set and achieve goals based on tailored feedback on their sleep habits, which is consistent with research suggesting that AYAs prefer autonomy in their health care choices and produce good results when given tools that support their autonomy.Trial RegistrationClinicalTrials.gov NCT03960294; https://clinicaltrials.gov/ct2/show/NCT03960294