Nocturnal Sleep Duration Research Articles

Adiposity-related risks among the middle-aged and elderly Chinese: the role of siesta and nocturnal sleep duration.

Background: increasingly, research suggests that lack of sleep is linked to adiposity worldwide, but few studies have been conducted in middle-aged and elderly Chinese subjects. The purpose of the present study was to analyze the association of siesta and nocturnal sleep duration with the prevalence of adiposity in middle-aged and elderly Chinese individuals. Methods: a total of 7,891 community dwelling Chinese subjects who had participated in the 2015 China Health and Retirement Longitudinal Study were included. A four-stage random sampling method was used to select participants. Siesta and nocturnal sleep duration was self-reported. Adiposity, including general obesity and abdominal obesity, was assessed. Multiple logistic analyses were conducted to explore the association between siesta, nocturnal sleep duration, and adiposity. Results: people with long siesta durations (≥ 1 hour/day) were significantly associated with an increased risk for abdominal obesity, independently and in all subgroup analyses, when compared to those without regular siesta. ORs after adjustment of confounding factors included: all subjects, OR = 1.45, 95 % CI, 1.23 to 1.70; middle-aged subjects, OR = 1.46, 95 % CI, 1.15 to 1.86; elderly, OR = 1.43, 95 % CI, 1.14 to 1.78. Conclusions: our data show that siesta duration plays a role in the prevalence of age-specific abdominal obesity. Individuals with long siesta durations are more likely to have abdominal obesity among the middle-aged and elderly population when compared to those without regular siesta. The results of this study need to be confirmed by further studies.

Prospective Associations of Sleep Duration with Cognitive Impairment: Findings from the China Health and Retirement Longitudinal Study (CHARLS)

Background: The association between sleep duration and cognition are inconclusive. Our study aimed to comprehensively investigate the effects of sleep duration on the risk of cognitive impairment in the middle-aged and older Chinese population. Methods: We used the data from four waves of the China Health and Retirement Longitudinal Study (CHARLS) cohort. Exposures included total sleep duration, nocturnal sleep duration, post-lunch napping, and changes in sleep duration over time. Cognitive function was assessed by a Chinese version of the Modified Mini-Mental State Examination (MMSE). Findings: We identified a U-shaped association of total sleep duration as well as nocturnal sleep duration with the risk of cognitive impairment among the included 7497 participants. 7-8 hours of total sleep duration and 6-7 hours of nocturnal sleep had the lowest risk of cognitive impairment. Further results showed that post-lunch napping within two hours was beneficial to cognition and 60 minutes was optimal. Moreover, analyses of changes in sleep duration further supported that sleeping less or more was a risk factor of cognitive impairment. Remarkably, those “excessive-change” sleepers (from ≤ 6 to ≥ 9 hours, or from ≥ 9 to ≤ 6 hours) had more risks. Interpretation: Keeping 7-8 hours per day in midlife and late life was related to the lowest risk of cognitive impairment, and an optimal post-lunch napping was 60 minutes for these stable sleepers. Excessive changes in sleep duration over time led to poorer cognition. These findings highlight the importance of optimal sleep habits to cognitive function. Funding Information: None. Declaration of Interests: We declare no competing interests Ethics Approval Statement: Ethical approval for the data collection of the CHARLS was obtained from the institutional review board of Peking University (IR1052-11015). All participants provided written informed consents during the investigation. We confirmed that all methods were conducted according to the relevant guidelines and regulations.

Mothers' and fathers' sleep: Is there a difference between first-time and experienced parents of 6-month-olds?

Sleep disruption and deprivation are highly prevalent among parents of an infant. However, most postpartum sleep studies focus solely on mothers, and few studies have investigated whether sleep differs between first-time and experienced parents. The present study aimed to determine whether self-reported sleep duration and quality differ between first-time and experienced mothers and fathers during the postpartum period. A total of 111 parents (54 couples and three single mothers) of 6-month-old infants completed a 2-week sleep diary to evaluate measures of sleep duration, sleep continuity, and sleep quality. An analysis of covariance model was used to compare the sleep variables of first-time to experienced parents. Breastfeeding frequency, infant sleep location, depression, education, and work status were used as co-variables. First-time mothers reported a longer consecutive nocturnal sleep duration (mean [SEM] 297.34[17.15] versus 246.01[14.79]min, p<.05), fewer nocturnal awakenings (mean [SEM] 1.57[0.20] versus 2.12[0.17], p<.05), and rated their sleep quality higher (mean [SEM] score 7.07[0.36] versus 5.97[0.30], p<.05) than experienced mothers, while total nocturnal sleep duration did not differ. There were no differences in subjective sleep measures between first-time and experienced fathers. The present study indicates that experienced mothers reported more fragmented sleep and perceived having worse sleep quality than first-time mothers, but that paternal sleep did not differ as a function of parental experience. These findings have clinical implications for healthcare professionals working with families of various configurations and sizes.

Self‐reported sleep duration is not associated with pet amyloid deposition in the oldest‐old: The 90+ Study

AbstractBackgroundSome, but not all cross‐sectional studies have suggested a relationship between sleep and PET‐measured amyloid burden in older adults without cognitive impairment. It is hypothesized that amyloid clearance from the brain is related to sleep duration. Our aim is to examine the cross‐sectional association between self‐reported sleep duration and amyloid accumulation in the oldest‐old (90+ years), a group with high prevalence of amyloid burden and sleep changes.MethodWe analyzed data on 115 participants of The 90+ Study, a longitudinal study of aging and dementia, who reported their monthly average nocturnal sleep duration using the Medical Outcomes Study Sleep Scale (MOS) and had 18F‐florbetapir (amyloid) PET. Sleep duration was categorized as &lt;8, 8 (reference, mean sleep duration) and &gt;8 hours. Standardized uptake value ratio (SUVr) was computedfor the posterior cingulate/precuneus (region affected early by Alzheimer’s neuropathological changes) and analyzed both as continuous and binary (SUVr &lt;0.8 vs. ≥0.8) variables. Cognitive diagnosis from the clinical evaluation closest to PET was used to categorize participants as normal vs. cognitively impaired (dementia or cognitive impairment without dementia). We analyzed sleep duration in relation to SUVr using multiple linear regression and logistic regression, controlling for age, Geriatric Depression Scale score, sleep medications, and cognitive diagnosis at the time of MOS; and additionally sex, education, APOEe4 status, and time between MOS and PET.ResultAt the time of MOS, average age was 95 years, 60% were women, 65% had normal cognition. The average sleep duration was 8 hours. Average PET SUVr was 0.77 and 33% of participants were amyloid positive. Amyloid burden was higher (0.80 vs. 0.75) and sleep was longer (8.14 vs. 7.51 hours) in cognitively impaired compared to cognitively normal participants (Table 1). Sleep duration was not associated with amyloid accumulation in the entire group analysis or when stratified by cognitive diagnosis (Tables 2 and 3, Figure 1).ConclusionIn this group of oldest‐old individuals, self‐reported sleep duration was not associated with amyloid accumulation in the posterior cingulate/precuneus. It is possible that amyloid accumulation is not associated with sleep in this age group or it is associated with other sleep‐related measures.

Cross-sectional and longitudinal associations between sleep duration, sleep quality, and bone stiffness in European children and adolescents

SummaryIn this large perspective cohort among European children and adolescents, we observed that daytime napping was positively associated with bone stiffness, while short or long sleep duration combined with poor sleep quality was associated with less bone stiffness. Our findings are important for obtaining optimal bone stiffness in childhood.IntroductionTo examine the cross-sectional and longitudinal associations between sleep duration, sleep quality, and bone stiffness index (SI) in European children and adolescents.MethodsFour thousand eight hundred seventy-one children aged 2–11 years from the IDEFICS study and 861 children aged 6–15 years from the subsequent I.Family study were included. Sleep duration (i.e., nocturnal sleep and daytime napping) and sleep quality (i.e., irregularly bedtime routine, have difficulty falling asleep and trouble getting up in the morning) were reported by self-administrated questionnaires. Nocturnal sleep duration was converted into age-specific z-scores, and total sleep duration was classified into short, adequate, and long based on the National Sleep Recommendation. Calcaneal SI of both feet were measured using quantitative ultrasound. Linear mixed-effects models with country as a random effect were used, with adjustments for sex, age, pubertal status, family socioeconomic status, physical activity, screen time, body mass index, and daylight duration.ResultsNocturnal sleep duration z-scores were positively associated with SI percentiles among participants with adequate sleep duration at baseline. Moreover, the positive association between daytime napping and SI percentiles was more pronounced in participants with adequate sleep duration at baseline, while at 4-year follow-up was more pronounced in participants with short sleep duration. In addition, extreme sleep duration at baseline predicted lower SI percentiles after 4 years in participants with poor sleep quality.ConclusionThe positive associations between nocturnal sleep, daytime napping and SI depended on total sleep duration. Long-term detrimental effect of extreme sleep duration on SI only existed in individuals with poor sleep quality.

Improvement in sleep duration was associated with higher cognitive function: a new association.

Objectives: Previous studies have indicated that improvement in sleep duration might correlate with better cognition. We aimed to examine the associations between changes in sleep duration and cognitive function.Results: A change from short sleep duration (SSD) to moderate sleep duration (MSD) was associated with better global cognition scores (β=0.54, P <0.01). A change from SSD to long sleep duration (LSD) (β=-0.94, P <0.001) or a change from LSD to SSD (β=-1.38, P <0.01) was associated with lower global cognition. For individuals with MSD, a≥2 h increase (β=-0.89, P <0.001) or decrease (β=-0.70, P <0.001) in sleep duration was associated with lower global cognition.Conclusions: For short sleepers, improvement in sleep duration correlated with better cognition. For long sleepers, there was no need to reduce sleep duration. Excessive changes or deviation from the moderate duration was associated with lower cognition.Methods: A total of 10325 individuals aged 45 and older from the China Health and Retirement Longitudinal Study (CHARLS) were included. Self-reported nocturnal sleep duration and cognitive function were assessed in the three waves of CHARLS from 2011 to 2015. Cognitive function was assessed by a global cognition score, which included episodic memory, visuospatial abilities, calculation, orientation and attention.

The associations between different sleep patterns and osteoporosis based on the Osteoporosis Self-Assessment Tool for Asians

SummaryBased on the use of Osteoporosis Self-Assessment Tool for Asians (OSTA) to assess osteoporosis risk, we found that short sleep duration and taking a daytime nap had an increased risk of osteoporosis.PurposeTo explore the associations between different sleep patterns with osteoporosis.Methods3659 postmenopausal women (average age of 60 years) were divided into low, middle, and high osteoporosis risk categories based on the Osteoporosis Self-Assessment Tool for Asians (OSTA). After having collected by a standard questionnaire, total and nocturnal sleep duration was collapsed to form categories of ≤ 6 h, > 6 h and ≤ 7 h, > 7 h and ≤ 8 h, > 8 h and ≤ 9 h, > 9 h, and daytime nap duration of 0 h and > 0 h.ResultsAs a categorical variable, the total sleep duration of ≤ 6 h per day (OR = 1.34, 95% CI 1.04–1.72), nocturnal sleep duration of ≤ 6 h per night (OR = 1.65, 95% CI 1.24–2.18), and taking a daytime nap (OR = 1.33, 95% CI 1.09–1.64) had higher osteoporosis risk after adjustment for covariates. As a continuous variable, after the adjustment for covariates, both longer total (OR = 0.86, 95% CI 0.78–0.94) and nocturnal sleep duration (OR = 0.83, 95% CI 0.76–0.91) had lower risk of osteoporosis risk while taking longer daytime nap (OR = 1.10, 95% CI 1.02–1.19) had higher osteoporosis risk.ConclusionsPostmenopausal women with both short total and nocturnal sleep duration (6 h or less) and taking a daytime nap had increased osteoporosis risk as assessed by OSTA.

Poor sleep efficiency and daytime napping are risk factors of depersonalization disorder in female university students

ObjectivesDepersonalization is characterized by feelings of detachment from reality and has been associated with anxiety and depression, both of which have a bi-directional relationship with sleep. To date, few studies have directly examined the potential relationship between sleep and depersonalization, which was the primary objective of our study. Design/methodsA cross-sectional study of female, Emirati, university students (n = 100) was conducted. Participants completed the Pittsburgh Sleep Quality Index (PSQI), the Cambridge Depersonalization Scale (CDS) and the Hospital Anxiety and Depression Scale (HADS). Additionally, 36 of the 100 participants wore wrist actigraphy for two consecutive weekdays. Average sleep duration, and average sleep efficiency (SE; %) across the two nocturnal sleep episodes were calculated. Total number of sleep episodes were obtained from wrist actigraphy and sleep logs. ResultsA significant, positive relationship was observed between PSQI global score and CDS total score (r = 0.21, p = 0.04). Actigraphy-estimated average nocturnal sleep duration was not significantly associated with the CDS. Compared to nocturnal sleepers only, those who undertook daytime naps had almost three times the risk of meeting the criteria for depersonalization disorder (OR = 2.95, 95% CI: 1.04–8.41), after adjustment. For each 1% increase in SE a 23% decreased risk of depersonalization was observed (OR = 0.77, 95% CI: 0.61–0.96), after adjustment. ConclusionsSleep screening in young adults may help to ensure better detection and management of psychological health outcomes. Our findings need to be confirmed prospectively in larger samples and amongst different populations but reiterate the importance of sleep habits pertaining to mental health.

Sleep of preschoolers during the coronavirus disease 2019 (COVID-19) outbreak.

Coronavirus disease 2019 (COVID-19) has resulted in a significantly large number of psychological consequences, including sleep health. The present study evaluated sleep patterns, sleep disturbances, and associated factors in Chinese preschoolers confined at home during the COVID-19 outbreak. Caregivers of 1619 preschoolers (aged 4-6years) recruited from 11 preschools in Zunyi, Guizhou province completed the Children's Sleep Habit Questionnaire (CSHQ) between 17th and 19th February 2020. Data were compared to a sociodemographically similar sample of preschoolers (included in the 11 preschools) in 2018. Compared to the 2018 sample, the confined preschoolers demonstrated changes in sleep patterns characterized by later bedtimes and wake times, longer nocturnal and shorter nap sleep durations, comparable 24-hr sleep duration, and fewer caregiver-reported sleep disturbances. Moreover, behavioural practices (sleeping arrangement, reduced electronic device use, regular diet) and parenting practices (harmonious family atmosphere and increased parent-child communication) were associated with less sleep disturbances in the confined sample. The present study provides the first description of the impact of prolonged home confinement during the COVID-19 outbreak on sleep patterns and sleep disturbances in preschoolers, as well as highlighting the importance of the link between sleep health and family factors. Given that disrupted and insufficient sleep has been linked to immune system dysfunction, our findings also have potential implications for resilience to infection in young children during the COVID-19 pandemic. Future studies should further explore deficient sleep as a risk factor for coronavirus infection.

Sleep ecology and sleep patterns among infants and toddlers: a cross-cultural comparison between the Arab and Jewish societies in Israel

ObjectiveThe purpose of this study was to examine differences in reported sleep patterns (eg, sleep onset, nocturnal sleep duration, nocturnal wakefulness) and aspects of sleep ecology (eg, sleeping arrangements), in a sample of young children, between two cultural groups in Israel: Arab and Jewish. MethodMothers of 497 healthy, typically developing infants and toddlers, ranging in age from 3 to 36 months, participated in the study: 253 of the mothers were Arab and 244 were Jewish. The mothers were asked to complete the Brief Infant Sleep Questionnaire – a well-validated questionnaire of early childhood sleep patterns. Mothers also completed a demographic questionnaire. ResultsSubstantial cross-cultural differences in reported sleep patterns were found between Arab and Jewish children. Arab children, compared to Jewish children, had later bedtimes, shorter overall night duration, and longer periods of nocturnal wakefulness. Furthermore, Arab mothers perceived their children's sleep as more problematic than did Jewish mothers. Arab families were more likely to room-share, with higher rates of maternal involvement at bedtime. Sleep onset played an important role in predicting nighttime sleep in Arab children; in the Jewish group, nighttime sleep was linked to parental proximity and assistance at bedtime. ConclusionThe findings emphasize the importance of deepening the understanding regarding the role of culture in infants sleep patterns. This will enable health care professionals to attune their interventions to the specific cultural context. Further studies are needed to understand the basis and impacts of these cultural differences.

Sleep characteristics and cerebrospinal fluid biomarkers of Alzheimer's disease pathology in cognitively intact older adults: The CABLE study.

This study tested the self-reported sleep characteristics associated with cerebrospinal fluid (CSF) Alzheimer's disease (AD) biomarkers in cognitively intact older adults. The linear and non-linear regression analyses were conducted in 736 cognitively normal participants (mean [standard deviation; SD] age, 62.3 [10.5] years, range 40 to 88 years, 59% female) who had measurements of cerebrospinal fluid (CSF) amyloid beta (Aβ) and tTau proteins and sleep characteristics, after adjusting for age, gender, education, apolipoprotein E gene (APOE) ε4 status, and general cognition. Greater daytime sleepiness was associated with higher CSF indicators of amyloid deposition in female patients. No significant associations were revealed for CSF tTau proteins after Bonferroni correction. A U-shaped relationship was revealed for nocturnal sleep habits, such that those with insufficient or excessive nocturnal sleep duration had greater CSF biomarkers of amyloid deposition (the reflection range: bedtime: around 10:00 p.m. and sleep duration: 6.0 to 6.5 hours). These findings consolidated the close relationship between sleep and AD.

Associations between sleep duration and insulin resistance in European children and adolescents considering the mediating role of abdominal obesity.

Short sleep duration has been suggested to lead to insulin resistance both directly by altering glucose metabolism and indirectly through obesity. This study aims to investigate associations between nocturnal sleep duration and insulin resistance considering abdominal obesity as a mediator. We analysed data of 3 900 children aged 2-15 years participating in the second (2009/10) and third (2013/14) examination wave of the European IDEFICS/I.Family study (hereafter referred to as baseline and follow-up). Information on nocturnal sleep duration was collected by questionnaires and age-standardised (SLEEP z-score). The homeostasis model assessment (HOMA) was calculated from fasting insulin and fasting glucose obtained from blood samples; waist circumference (WAIST) was measured with an inelastic tape. HOMA and WAIST were used as indicators for insulin resistance and abdominal obesity, respectively, and transformed to age- and sex-specific z-scores. Cross-sectional and longitudinal associations between SLEEP z-score and HOMA z-score were investigated based on a path model considering WAIST z-score as a mediator adjusting for relevant confounders. Cross-sectionally, baseline SLEEP z-score was negatively associated with baseline WAIST z-score (unstandardised effect estimate -0.120, 95% confidence interval [-0.167; -0.073]). We observed no direct effect of baseline SLEEP z-score on baseline HOMA z-score but a negative indirect effect through baseline WAIST z-score (-0.042 [-0.058; -0.025]). Longitudinally, there was no direct effect of baseline SLEEP z-score on HOMA z-score at follow-up but a negative indirect effect through both baseline WAIST z-score and WAIST z-score at follow-up (-0.028 [-0.040; -0.016]). Our results do not support the hypothesis of an association between short sleep duration and insulin resistance independent of abdominal obesity. However, longer sleep duration may exert short and long term beneficial effects on insulin resistance through its beneficial effects on abdominal obesity.

Assessment of Insomnia and Sleep Quality among Medical Students-Benghazi University: A Cross-Sectional Study

Background: Academic pressure and its associated stress are responsible for disturbances in the circadian cycle of the students, Medical students have a stressful academic career, so it is important to identify those students with sleep issues, extent of issues and factors contributing to it. The aim of the current study is to determine the frequency of poor sleep quality among fourth and fifth year medical students at Faculty of Medicine, Benghazi university; using the PSQI. Materials and Methods: An observational, cross-sectional study conducted anonymously and voluntarily with undergraduate fourth and fifth year medical students at faculty of medicine, Benghazi university.150 students were assessed using the Pittsburgh Sleep Quality Index (PSQI). Results: 150 medical students were participated in the study, 95(63.3%) were females and 55 (36.7%) were males. The sample's mean age was 26.1 ± 1.1 years (range = 23–30 years). More than half the sample (52.7%) were sleeping alone, 44.7% were sharing a room with a roommate, and 2.7% were married . The calculated means of total PSQI, nocturnal sleep duration, and sleep latency were 7.04 ± 3.47 hours, 6.23 ± 1.51 hours, 38.7 ± 39.1 minutes, respectively. The average wake-up time and The average bedtime were 7.45 ± 1.5, and 4.49 ± 7.06respectively. 115 (76.67%) students were poor sleeper and the prevalence of poor sleep quality was slightly higher among females than males (76.8%) and (74.4%) respectively with P = 0.004. Younger students were about two and half times more prone to have poor sleep quality compared to older participants (OR=2.4; 95% CI: 1.62-3.55). Conclusion: Poor sleep quality is common among our medical students. It established that most medical students have a poor sleep quality, which could be related to their sleep habits. This study highlights a strong need for integrating sleep hygiene education for young students, to improve their sleeping practices and consequent physical and mental health.

0161 Greater Negative Affectivity Predicts Shorter Infant Sleep Duration

Abstract Introduction Certain temperament characteristics in infants have been shown to be associated with infant sleep patterns. However, other sleep-related practices, such as co-sleeping and breastfeeding, are also known to be associated with sleep in infancy and are not always taken into account in studies assessing the association between temperament and sleep. Thus, this study aims to examine the associations between infant temperament and sleep parameters at six months of age, while controlling for co-sleeping and breastfeeding practices. Methods Mother-infant dyads (n=60) were recruited in the metropolitan Montreal area and consented to participate in the study. Infant sleep was reported by mothers at six months of age (±1 month) using sleep diaries (two-week period). Total nocturnal and longest consecutive sleep duration were retrieved from the diaries and averaged through the two-week period. Temperament was measured with the Infant Behaviour Questionnaire-Revised (IBQ-R). Sleep-related parental practices (co-sleeping and breastfeeding) were measured using the Sleep Practices Questionnaire (SPQ). Multiple regression analyses were conducted to determine the degree to which the temperament composite negative affectivity predicted total nocturnal and longest consecutive sleep duration while controlling for breastfeeding and co-sleeping practices. Results Regression analyses revealed significant regression models for total nocturnal (F(3,44)=6.25, p=.001, R2=.30), and longest consecutive sleep duration (F(3,44)=6.26, p=.001, R2=.30). Greater infant negative affectivity predicted shorter nocturnal sleep duration (β;;=-0.28, p=.034) and shorter longest consecutive sleep duration (β;;=-0.34, p=.010) after adjusting for breastfeeding and co-sleeping practices. Conclusion Findings suggest infants with greater negative affectivity sleep for fewer hours during the night and have shorter periods of consecutive sleep, even when sleep-related parental practices are considered. These results provide further support for the relationship between infant temperament and sleep at six months of age. Future research should investigate the relationship between infant temperament and sleep using paternal report in addition to maternal report. Support SSHRC

0955 Does Primary Caregiver Influence Sleep in Preschoolers? Evidence from a Large-Scale Longitudinal Study in China

Abstract Introduction The aim of the study is to characterize sleep disturbances and sleep patterns in preschoolers, and to examine the potential role of primary caregivers and particularly its transition on children’s sleep in a large-scale cohort study in China. Methods A representative sample of 20324 newly enrolled preschoolers(age 3-4 years) were recruited in Shanghai,China at 2016.11. Sleep disturbances were examined at 3 timepoints from age 3-4 years to 5-6 years by the Children’s Sleep Habits Questionnaire(CSHQ). Data on bedtime, onset time and offset time were included, along with primary caregivers derived from each follow-up. Prevalence and trend estimates of sleep disturbances and sleep patterns were presented. Multivariable logistic regression and propensity score-adjusted models for sleep disturbances at wave3 on different caregiving models were analysed adjusting for demographics, socioeconomic status, family characteristics, maternal mental health and CSHQ total score at baseline. Results Prevalence of global sleep disturbances (CSHQ total score&amp;gt;41) steadily fell from 84.2% to 73.8%. Specifically, behavioral sleep problem domains of “Bedtime besistance”and “Sleep anxiety” decreased from 66.4% to 47.3% and 53.4% to 37.8%, respectively. Meanwhile, Bedtime gradually delayed from 21:04(SD=0:37) to 21:20(SD=0:33) while offset time changed slightly from 7:13(SD=0:29) to 7:17(SD=0:27). Compared with counterparts in western countries, children slept for a shorter nocturnal sleep duration (NSD) with 9.51(SD=0.57) hours at wave1, 9.42(SD=0.57) hours at wave2 and 9.42(SD=0.52) hours at wave3. Different caregiving models were independently associated with sleep disturbances at wave3. Taking “Predominant parental care” as reference, “Predominant grandparental care” and “Transition from parental to grandparental care” were associated with higher odds of sleep disturbances (OR=1.32, 95% CI [1.17, 1.48], p&amp;lt;0.001 and OR=1.25, 95% CI [1.03, 1.52], p=0.020, respectively). While “Transition from grandparental to parental care” has no significant effect(OR=1.04, 95%CI [0.94, 1.15], p=0.436). Conclusion Grandparental care is associated with increased risk of sleep disturbances among preschoolers in China. Parenting and Grandparenting factors should be considered when assessing and treating sleep disturbances and optimizeing sleep health in preschoolers. Support Supported by the Chinese National Natural Science Foundation of China (81773443, 81728017, 81728017); Ministry of Science and Technology (2016YFC1305203); Shanghai Science and Technology Commission (17XD1402800, 18695840200, 2018SHZDZX05, 18JC1420305);

0177 Measuring Sleep Health Across Survey, Actigraphy, and Diary Methods in Young Adults

Abstract Introduction Sleep health is a relatively new construct including multiple dimensions of nighttime and daytime sleep across the 24-hour day. To date, few studies have investigated sleep health across various types of sleep measures. We collected sleep health data using survey, actigraphy, and daily diary, affording the unique ability to compare the latent factor structure of the sleep health construct across methods in a single sample of healthy young adults. Methods Undergraduates (N=540; 50% female; 71% white; mean age=18) self-reported sleep health via the 6-item RUSATED survey (Buysse, 2014), which queries “typical” sleep patterns including: daytime alertness and nocturnal sleep regularity, satisfaction, timing, efficiency, and duration (0=rarely/never to 2=usually/always); total score=0–12 (higher=better sleep health). A subsample (N=114) provided 7-day actigraphy and daily diaries, which were used to derive weeklong averages of the aforementioned sleep dimensions. Confirmatory factor analysis was conducted to assess model fit of three factors (survey, actigraphy, diary), each including within-method indicators of the six sleep dimensions; note the actigraphy model included diary satisfaction. Acceptable model fit was assessed using established criteria (e.g., Bentler, 1990): RMSEA &amp;lt; .08, CFI &amp;gt; .90, and TLI &amp;gt; .90. Maximum likelihood estimation was used. Results Average RUSATED total score was 7.1 (SD=2.5). Average actigraphy [diary] sleep dimensions were: Alertness (i.e., proportion of days napped)=21% [25%]; Duration=6.2hr [7.1hr]; Timing (i.e., midpoint)=5:00am [3:30am]; Regularity (i.e., SD of midpoint)=56 min [40 min]; Efficiency= 82% [95%]; Satisfaction=“average” to “good”. The survey model demonstrated acceptable fit (RMSEA [90%CI] = .06 [.03, .09], CFI=.96, TLI=.92) after correlating regularity and timing, as suggested by modification indices; factor loadings [λ(SE)] ranged from .27(.05) for efficiency to .71(.04) for satisfaction. Fit was poor for the diary model, whereas the actigraphy model failed to converge. Conclusion Sleep health models demonstrated adequate fit using survey but not actigraphy or diary data. The lack of acceptable fit for the latter may reflect differences in the measurement timeframe (e.g., “typical” sleep vs. 7-day averages) or the smaller sample size for the actigraphy/diary measures. Determining how to best measure sleep health and ultimately apply it to health-relevant outcomes is a valuable research agenda. Support T32HL07560; T32MH018269

0376 Demographic and Socioeconomic Implications of Excessive Daytime Sleepiness in the Community

Abstract Introduction Daytime sleepiness impairs daily functioning and may be directly related to insufficient nighttime sleep. Previous studies have assessed disparities in sleep duration and quality, but community-level disparities in daytime sleepiness using validated measures are lacking. Methods Data were from the Sleep and Healthy Activity, Diet, Environment, and Socialization (SHADES) study of N=1007 adults age 22-60. Daytime sleepiness was assessed with the Epworth Sleepiness Scale (ESS). Predictors included age, sex, race/ethnicity, education, and social class (“Upper middle class or above,” “Middle class,” “Lower middle class,” “Poor,” or “Very Poor”). One-way ANOVAs evaluated group differences. Stepwise linear modeling evaluated ESS score relative to sociodemographic predictors. Final models included all variables entered together to evaluate independent effects. Finally, habitual sleep duration was entered as an additional covariate. Results ESS score was higher among racial/ethnic minorities (p=0.0006), men (p&amp;lt;0.0001), those with less education (p=0.008) and lower social class (p=0.0007), and those who are retired or unable to work (p=0.03); marginal differences were seen according to age (p=0.06). Using a model-building approach, age, sex, race/ethnicity, education, social class, and employment were evaluated. Only race/ethnicity (F=5.1, p=0.0004), education (F=4.8, p=0.003), and social class (F=2.14, p=0.046) incrementally added variance to model R2. No 2-way interactions were found. In the final model, significant predictors included Black/African-American race/ethnicity (B=0.94, p=0.01), some college (B=0.99, p=0.005), and being very poor (B=2.16, p=0.005). When controlling for nocturnal sleep duration, the increased sleepiness associated with being Black/African was attenuated (p=0.06), but the other relationships were still significant. Conclusion There is a “sleepiness disparity” in the population associated with race/ethnicity and socioeconomics. Daytime sleepiness in the community is associated with being Black/African-American, having some college, and being “very poor.” The race/ethnicity difference in daytime sleepiness may be partially explained by differences in total sleep time. Support This work was supported by a grant from Jazz Pharmaceuticals. The SHADES study was funded by R21ES022931. Dr. Grandner is supported by R01MD011600.

Association of Longitudinal Patterns of Habitual Sleep Duration With Risk of Cardiovascular Events and All-Cause Mortality

Single self-reported measures of sleep duration are associated with adverse health outcomes; however, long-term patterns of self-reported sleep duration and their association with cardiovascular events (CVEs) and all-cause mortality remain unknown. To determine whether trajectories of long-term vs single-measure sleep duration are associated with subsequent risk of CVEs and all-cause mortality. The Kailuan study is a prospective, population-based cohort study that began in 2006. The present cohort included 52 599 Chinese adults without atrial fibrillation, myocardial infarction, stroke, or cancer to 2010. Trajectories in sleep duration from January 1, 2006, to December 31, 2010, were identified to investigate the association with risk of CVEs and all-cause mortality from January 1, 2010, to December 31, 2017. Data analysis was conducted from July 1 to October 31, 2019. Habitual self-reported nocturnal sleep durations were collected in 2006, 2008, and 2010. Trajectories in sleep duration for 4 years were identified by latent mixture modeling. All-cause mortality and first incident CVEs (atrial fibrillation, myocardial infarction, and stroke) from 2010 to 2017 were confirmed by medical records. Based on the baseline sleep duration and patterns over time, 4 trajectories were categorized (normal stable, normal decreasing, low increasing, and low stable). Of the 52 599 adults included in the study (mean [SD] age at baseline, 52.5 [11.8] years), 40 087 (76.2%) were male and 12 512 (23.8%) were female. Four distinct 4-year sleep duration trajectory patterns were identified: normal stable (range, 7.4 to 7.5 hours [n = 40 262]), normal decreasing (mean decrease from 7.0 to 5.5 hours [n = 8074]), low increasing (mean increase from 4.9 to 6.9 hours [n = 3384]), and low stable (range, 4.2 to 4.9 hours [n = 879]). During a mean (SD) follow-up of 6.7 (1.1) years, 2361 individuals died and 2406 had a CVE. Compared with the normal-stable pattern and adjusting for potential confounders, a low-increasing pattern was associated with increased risk of first CVEs (hazard ratio [HR], 1.22; 95% CI, 1.04-1.43), a normal-decreasing pattern was associated with increased risk of all-cause mortality (HR, 1.34; 95% CI, 1.15-1.57), and the low-stable pattern was associated with the highest risk of CVEs (HR, 1.47; 95% CI, 1.05-2.05) and death (HR, 1.50; 95% CI, 1.07-2.10). In this study, sleep duration trajectories with lower or unstable patterns were significantly associated with increased risk of subsequent first CVEs and all-cause mortality. Longitudinal sleep duration patterns may assist in more precise identification of different at-risk groups for possible intervention. People reporting consistently sleeping less than 5 hours per night should be regarded as a population at higher risk for CVE and mortality.

Bedtime, body mass index and obesity risk in preschool-aged children.

Although sleep duration is a risk factor for obesity in young children, less is known about other aspects of sleep health, including bedtime, on obesity risk. To determine whether bedtime is associated with body mass index (BMI) z-score or obesity risk in children ages 2 to 5 years, and to determine if associations are independent of sleep duration. Cohort analyses were undertaken using three early life obesity prevention trials (POI, INSIGHT, Healthy Beginnings) and a longitudinal cohort study (HOME). Bedtime was assessed by questionnaire and BMI through clinical measurement between 2 and 5 years in 1642 children. Adjusted regression models examined whether BMI z-score and obesity (BMI z-score ≥ 2) were associated with bedtime, nocturnal sleep time and 24-hour sleep time. A discrete mixture model categorized children into bedtime trajectory groups across time points. Bedtime was inconsistently associated with BMI z-score. Although each hour later of bedtime was associated with greater odds of obesity at ages 3 (OR; 95% CI: 1.05; 1.003, 1.10) and 5 (1.35; 1.08, 1.69) years, odds were attenuated after adjustment for nocturnal or 24-hour sleep time. Longer nocturnal sleep duration at 2 years was associated with lower odds of obesity (OR 0.90; 0.86, 0.94), as was longer 24-hour sleep duration at 3 years in girls (0.70; 0.62, 0.78). BMI z-score and odds of obesity were not significantly different between 'early to bed' and 'late to bed' trajectory groups. Timing of bedtime appears inconsistently related to obesity in young children, possibly via influencing overall sleep duration.

Predictors of Sleep Duration and Sleep Disturbance in Children of a Culturally Diverse Region in North-Eastern Greece.

Background Aim: The aim of this study was to examine the sleep characteristics of children and explore associations with various socio-demographic factors in an area of Greece characterized by cultural diversity.Methods: A questionnaire about children's sleep habits had been distributed to parents of children who visited the pediatric outpatient clinic of University General Hospital of Alexandroupolis for a medical examination and to get a health certificate for participation in sports activities. Children with chronic health conditions were excluded.Results: In the study, 449 children (27.1% belonging to minorities) were included, aged 7.6 ± 2.9 years. Most of them (81.7%) slept after 10 p.m., with a mean nocturnal sleep duration of 9.4 ± 1.2 h. The most commonly reported disturbance was snoring (26.2%). Age and high educational level of the mother were both important determinants for sleeping late [OR 1.139 (1.033–1.255); p = 0.009 and OR 1.086 (1.004–1.175); p = 0.040, respectively]. The latter was also associated with an absence of any reported sleep disorder in children [OR 0.934 (0.877–0.994); p = 0.031]. A longer sleep duration was reported among Roma children (p = 0.022), which was more overt in girls (mean sleep duration 10.4 ± 1.6 h). In the Roma group also, the prevalence of sleep disorders was higher.Conclusion: Age progression and maternal educational level, along with cultural background, seem to be correlated with variations in the sleep characteristics of children in a culturally diverse population in Greece.