Nocturnal Sleep Research Articles

Longitudinal study of childhood sleep trajectories and adolescent mental health problems.

To investigate whether childhood sleep trajectories are associated with mental health symptoms such as social phobia, generalized anxiety, depression, attention deficit hyperactivity disorder (ADHD), conduct problems, and opposition at age 15. A total of 2120 children took part in the Quebec Longitudinal Study of Child Development. Childhood sleep trajectories were computed from maternal reports at 2.5, 3.5, 4, 6, 8, 10, and/or 12 years. At age 15, 1446 adolescents filled out mental health and sleep questions. A path analysis model was assessed in the full sample. Four childhood nocturnal sleep duration trajectories were identified: (1) a short pattern (7.5%), (2) a short-increasing pattern (5.8%), (3) a 10 hours pattern (50.7%), and (4) an 11 hours pattern (36.0%). Three childhood sleep latency trajectories were found: (1) a short pattern (31.7%), (2) an intermediate pattern (59.9%), and (3) a long pattern (8.4%). Finally, two childhood wakefulness after sleep-onset trajectories were found: (1) a normative pattern (73.0%) and (2) a long pattern (27.0%). The path analysis model indicated that children following a long childhood sleep latency trajectory were more likely to experience symptoms of depression (β = 0.06, 95% CI: 0.01 to 0.12), ADHD (β = 0.07, 95% CI: 0.02 to 0.13), conduct problems (β = 0.05, 95% CI: 0.00 to 0.10) and opposition (β = 0.08, 95% CI: 0.02 to 0.13) at age 15. This longitudinal study revealed that children presenting a long sleep latency throughout childhood are at greater risk of symptoms of depression, ADHD, conduct problems, and opposition in adolescence.

Dynamic Sleep Architecture Revealed: Sleep Auditory Evoked Potentials from N100 to P900

Background: The research landscape in sleep is currently shifting toward minute changes in brain functioning during different stages. This fine approach necessitates a dynamic assessment as in the case of electrophysiology. The present study aimed to investigate brain responsiveness during different stages and times of nocturnal sleep using auditory evoked potentials (AEPs). Materials and Methods: Sleep recordings of 18 volunteer subjects were analyzed. During sleep recordings, auditory stimuli were presented in the ear channels. Sleep stages were scored according to the American Academy of Sleep Medicine system. AEPs were analyzed in nonrapid eye movement sleep stages. Alterations of N100, P200, N300, P450, N550, and P900 waveforms were investigated in the first and second halves of sleep duration. Results: N100 amplitude was higher in light sleep, both in the first and the second halves of the night (sleep duration). The amplitude of P900 was higher in the deep sleep stage in both halves. Significant amplitude reductions were found in N100, P200, P450, and P900 in the second half of the sleep. Conclusions: The changes found suggest that they are related to the dynamics of sensory processing to maintain functional sleep. The findings of the present study emphasize that in the course of sleep, both the proportions of sleep stages and the microarchitecture within the stages alter between the first and second halves of sleep.

Population trajectories and age-dependent associations of obesity risk factors with body mass index from childhood to adolescence across European regions: A two-cohort study.

To investigate population trajectories of behavioural risk factors of obesity from childhood to adolescence and their associations with body mass index (BMI) in children across European regions. Data were harmonised between the European multi-centre IDEFICS/I.Family and the Amsterdam Born Children and their Development Cohort. Participants were aged 2.0-9.9 and 5.0-7.5 years at baseline, respectively, and were followed until age 18 years. Behavioural risk factors of interest included diet, physical activity, media use and sleep. Mixed effects models were used for statistical analyses to account for repeated measurements taken from the same child. The study included a total of 14 328 individuals: 4114, 4582, 3220 and 2412 participants from Northern, Southern, Eastern Europe and Amsterdam, respectively. Risk factor means and prevalences changed with age, but the trajectories were mostly similar across regions. Almost no associations between behavioural factors and BMI were found at the age of 6 years. At 11 years, daily sugar-sweetened foods consumption, use of active transport, sports club membership and longer nocturnal sleep duration were negatively associated with BMI in most regions; positive associations were found with media use. Most associations at 11 years of age persisted to 15 years. Whilst population trajectories of media use and nocturnal sleep duration are similar across European regions, those of other behavioural risk factors like active transport and daily vegetable consumption differ. Also, associations between behavioural risk factors and BMI become stronger with age and show similar patterns across regions.

An acute bout of high-intensity exercise affects nocturnal sleep and sleep-dependent memory consolidation.

Acute exercise has been shown to affect long-term memory and sleep. However, it is unclear whether exercise-induced changes in sleep architecture are associated with enhanced memory. Recently, it has been shown that exercise followed by a nap improved declarative memory. Whether these effects transfer to night sleep and other memory domains has not yet been studied. Here, we investigate the influence of exercise on nocturnal sleep architecture and associations with sleep-dependent procedural and declarative memory consolidation. Nineteen subjects (23.68 ± 3.97 years) were tested in a balanced cross-over design. In two evening sessions, participants either exercised (high-intensity interval training) or rested immediately after encoding two memory tasks: (1) a finger tapping task and (2) a paired-associate learning task. Subsequent nocturnal sleep was recorded by polysomnography. Retrieval was conducted the following morning. High-intensity interval training lead to an increased declarative memory retention (p = 0.047, d = 0.40) along with a decrease in REM sleep (p = 0.012, d = 0.75). Neither procedural memory nor NREM sleep were significantly affected. Exercise-induced changes in N2 showed a positive correlation with procedural memory retention which did not withstand multiple comparison correction. Exploratory analyses on sleep spindles and slow wave activity did not reveal significant effects. The present findings suggest an exercise-induced enhancement of declarative memory which aligns with changes in nocturnal sleep architecture. This gives additional support for the idea of a potential link between exercise-induced sleep modifications and memory formation which requires further investigation in larger scaled studies.

Accelerometry reveals nocturnal biphasic sleep behavior in wild giraffe

Most research on mammalian resting and sleep behavior is conducted under controlled laboratory or zoo settings, with limited studies taking place in their natural habitats. To analyze these behaviors within a natural setting, actigraphy has been identified as a valuable method. This study sought to, firstly, measure inactivity and sleep in free-roaming Angolan giraffe (Giraffa giraffa angolensis) and, secondly, present their nocturnal behavioral rhythmicity. Three giraffe were fitted with an accelerometer-GPS device attached to an ossicone in November 2018 and behavioral data were collected daily between December 2018 and April 2019 to record their cranial movement. As giraffe show behavior specific head movements, sleep events could be detected as well as active and inactive behavior patterns. In this study, we analyzed how long giraffe were inactive during the night, how many sleep events they showed and for how long they were in the sleep position during the night. Giraffe were inactive for 490.8 ± 43.7 minutes during the night (from 19:00 to 7:00 local time), and a total of 857 sleep events were recorded with an average of 2.0 ± 1.0 events per night and total length of sleep per night averaged 8.6 ± 7.9 minutes. Further, results show a clear biphasic sleep profile during the night with peaks of inactivity and sleep events during the hours after sunset (21:00–23:00) and during the early morning hours before sunrise (3:00–5:00). We found individual differences for the number or sleep events, the total time sleeping as well as for inactivity. Interestingly, differences between months only were detected for inactivity. No differences were found for the number of sleep events nor for the total sleep time per night between months. For the first time, this study sheds light on the nocturnal sleep behavior and biphasic inactivity rhythm of giraffe in their natural habitat, providing additional support for previous findings indicating brief sleep episodes in giraffe.

Role of sleep in neurodegeneration: the consensus report of the 5th Think Tank World Sleep Forum.

Sleep abnormalities may represent an independent risk factor for neurodegeneration. An international expert group convened in 2021 to discuss the state-of-the-science in this domain. The present article summarizes the presentations and discussions concerning the importance of a strategy for studying sleep- and circadian-related interventions for early detection and prevention of neurodegenerative diseases. An international expert group considered the current state of knowledge based on the most relevant publications in the previous 5years; discussed the current challenges in the field of relationships among sleep, sleep disorders, and neurodegeneration; and identified future priorities. Sleep efficiency and slow wave activity during non-rapid eye movement (NREM) sleep are decreased in cognitively normal middle-aged and older adults with Alzheimer's disease (AD) pathology. Sleep deprivation increases amyloid-β (Aβ) concentrations in the interstitial fluid of experimental animal models and in cerebrospinal fluid in humans, while increased sleep decreases Aβ. Obstructive sleep apnea (OSA) is a risk factor for dementia. Studies indicate that positive airway pressure (PAP) treatment should be started in patients with mild cognitive impairment or AD and comorbid OSA. Identification of other measures of nocturnal hypoxia and sleep fragmentation could better clarify the role of OSA as a risk factor for neurodegeneration. Concerning REM sleep behavior disorder (RBD), it will be crucial to identify the subset of RBD patients who will convert to a specific neurodegenerative disorder. Circadian sleep-wake rhythm disorders (CSWRD) are strong predictors of caregiver stress and institutionalization, but the absence of recommendations or consensus statements must be considered. Future priorities include to develop and validate existing and novel comprehensive assessments of CSWRD in patients with/at risk for dementia. Strategies for studying sleep-circadian-related interventions for early detection/prevention of neurodegenerative diseases are required. CSWRD evaluation may help to identify additional biomarkers for phenotyping and personalizing treatment of neurodegeneration.

SEX EFFECTS ON THE QUALITY OF SLEEP IN DOWN SYNDROME

AbstractBackgroundSex differences in biological factors, such as sleep, might contribute to sex differences in dementia risk. Down’s syndrome (DS) is a genetically determined form of Alzheimer’s disease (AD), with disrupted sleep and a high prevalence of obstructive sleep apnea (OSA). However, sex differences in nocturnal sleep in adults with DS have not been yet investigated. Thus, we aimed to evaluate the sex effect on polysomnographic sleep measures in adults with DS.MethodCross‐sectional study of 187 adults with DS from the Down‐Alzheimer Barcelona Neuroimaging Initiative (DABNI) that underwent a nocturnal polysomnography study. Sleep macrostructure parameters of i)sleep continuity [Total sleep time(TST), Sleep efficiency(SE), Wake after sleep onset(WASO), Sleep latency and latency to REM sleep], ii) NREM (phase N1, N2, N3) and REM stages, in minutes and percentages, and iii) respiratory parameters to determine the presence of OSA were evaluated. Chi‐squared and Mann‐Whitney tests were used to test differences between categorical data, and continuous variables, respectively. To evaluate the sex effects on sleep parameters, we performed ANCOVAs using sleep measurements as dependent variables, the sex, presence of dementia, and OSA as fixed effects, and age as a covariate. Interactions between subjects effects were aso calculatedResultOur cohort includes 187 adults with DS (57,2% females and 42.8% males). OSA was present in 76,2% of the subjects, and 22% of the subjects had symptomatic AD (prodomal/demented) without significant differences in both prevalences between sexes(p = 0.23, p = 0.08 respectively) (table 1). Females presented significant longer TST, WASO, NREM (m), N2(m), N3(m), with higher SE and N3(%), and decreased N1(%) compare to males. These sex differences were maintained after age correction. Results remain essentially similar when including dementia and OSA in the statistical models. No significant interactions between sex and OSA and sex and dementia were observed(Table2).ConclusionAs in general euploid population, females with DS presented a better objective sleep quality with more deep sleep than men. Further work is needed to investigate how sex differences in sleep parameters can influence clinical and biomarker profiles of AD in adults with Down syndrome.

The role of immunological signaling in disrupted proteostasis in the gut‐brain axis

AbstractBackgroundThe pathophysiological mechanism underlying the progressive neurodegenerative process in Alzheimer’s disease (AD) is not well understood. Hence, there is no disease‐modifying treatment. It is then imperative to identify the triggering molecular factors of the disease and the mechanisms supporting molecular spreading of toxic assemblies. Our search for these key clues in the periphery is founded on the fact that peripheral dysfunction, particularly in the gastrointestinal (GI) system, can arise decades before the onset of the classic symptoms in neurodegenerative disorders. In fact, the risk of AD increases significantly in patients with inflammatory bowel disease (IBD) when compared with the non‐IBD population. Furthermore, Tau accumulates in Crohn’s Disease guts and in sigmoid colon of AD and FTD patients. Thus, we are investigating the physiological and molecular mechanisms that support Tau spreading in the prodromal stages, particularly, along the gut‐brain axis.MethodTo test whether corrupted proteins expressed in the gut will spread their pathology to the brain, we employed the Gal4/UAS system and expressed wild‐type or mutant human Tau in selected populations of gut epithelium cells. We then monitor behavior on aging flies expressing Tau in the gut epithelium using Drosophila activity monitors and analyzed their circadian patterns of activity along with several sleep parameters.ResultWe observed that flies selectively expressing full‐length‐2N4R human Tau in enteroendocrine cells of the gut exhibited a significant impairment in their daily activity pattern that specifically affected their behavior during the light phase (day) but not during the dark period (night). Interestingly, these flies also showed an increased sleepiness during the day without affecting their nocturnal sleep pattern.ConclusionOur results support the presence of spreading mechanisms for Tau from gut epithelial cells to the brain; hence, affecting the neuronal physiology that sustain daily activity patterns. We are now investigating the pathways and mechanisms that pathological Tau in the gut employs to target these brain regions responsible for the behavioral phenotypes: transsynaptic spreading or humoral signaling via the innate immune system. We are dissecting the 3 major pathways of innate immunity in Drosophila (Imd‐Toll‐TNF) for their role in disease progression and the involvement of their target antimicrobial peptides.

POINTER‐zzz: Study Design and Baseline Characteristics from the U.S. Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk (U.S. POINTER) Sleep Ancillary

AbstractBackgroundSleep disordered breathing (SDB) leads to nocturnal hypoxemia and sleep disruption, which are linked to adverse health conditions, particularly in older adults at risk for dementia. Few prospective studies of SDB examine cognitive decline among those at increased risk for cognitive impairment and dementia. POINTER‐zzz, a sleep ancillary study of U.S. study to PrOtect brain health through lifestyle INTErvention to Reduce risk (U.S. POINTER), allows us to examine the role of lifestyle intervention on sleep quality, and potential moderating effects of sleep on cognition to the intervention in medically and cognitively vulnerable older adults.MethodU.S. POINTER was designed to investigate the effects of two 2‐year lifestyle interventions on cognitive trajectories in 2,000 older, cognitively normal adults (aged 60‐79 yrs) at increased risk for cognitive decline and dementia due to physical inactivity, poor diet and cardiovascular disease. POINTER‐zzz enrolled a subset of parent trial participants and administered in‐home sleep assessments using WatchPAT (1 night) and ActiGraph (6 nights) devices. We summarize participants’ baseline characteristics including apnea hypopnea index (AHI), sleep duration and sleep efficiency.ResultTo date, 688 POINTER‐zzz participants enrolled and completed baseline WatchPAT and/or Actigraph assessments. Participant ages averaged 68.6 years old (standard deviation, 5.13); 21% of participants self‐identified as Black/African American, 4% Hispanic/Latino, and 66% White. More than half (68%) were female, and 69% had a Bachelor’s degree or higher. Overall, 87% of participants had at least mild sleep apnea (AHI>5). Severe sleep apnea (AHI≥30) was observed in 14% of participants overall, and 21% of those aged ≥75 yrs. Severe sleep apnea was more prevalent among males (19%) than females (11%). Overall, nightly sleep duration for the cohort averaged 6.6 hours, with 83% sleep efficiency, and an average of 79.3 minutes awake after sleep onset.ConclusionPOINTER‐zzz participants have sleep characteristics that align with expectations for a cohort that is broadly representative of a diverse older adult population in the US. POINTER‐zzz provides an unparalleled opportunity to test the effects of a multi‐domain lifestyle intervention on sleep disturbances that are linked to cognitive decline and AD in a well‐characterized, diverse cohort of at‐risk older adults.

Sleep and Its Disturbance in Parents of Children and Adolescents with Epilepsy: A Systematic Review and Meta-Analysis.

Sleep disturbances are commonly reported by parents of children and adolescents with epilepsy. However, evidence synthesis including quality and quantity of sleep in parents of children and adolescents with epilepsy is lacking. This systematic review and meta-analysis was conducted to quantify pooled mean estimates of parental sleep variables and to determine the prevalence of sleep disturbances in parents of children and adolescents with epilepsy. Five electronic databases, PubMed, Medline, Embase, PsychINFO, and CINAHL, were systematically searched from inception to September 2021. Eleven observational studies examining parents of pediatric patients aged <18 years with epilepsy using a quantitative measure of sleep duration, sleep quality, or sleep disturbance were reviewed. Our results showed that the pooled nocturnal sleep duration was 5.93 hours (95% CI: 4.64 to 7.21 hours). Overall sleep quality as estimated by the bias-adjusted pooled Pittsburgh Sleep Quality Index total score was 6.65 (95% CI: 5.98 to 7.33). Parents of children with epilepsy had significantly higher Pittsburgh Sleep Quality Index total scores compared to parents of healthy children (differences in means 1.84, 95% CI: 1.29 to 2.39). The pooled estimated prevalence of parental sleep disturbances was 58.1% (95% CI: 45.7% to 69.6%). Our findings demonstrate a high prevalence of sleep disturbances with poor sleep quality and substantial reductions in sleep time in parents of children and adolescents with epilepsy. Healthcare professionals in pediatric neurology clinics should proactively initiate screening for sleep disturbances in parents of children and adolescents with epilepsy and refer parents to a sleep specialist when necessary.

Sleep at high altitude: A bibliometric study and visualization analysis from 1992 to 2022

BackgroundAs an important monitoring index for adaptation to hypoxia, sleep may reflect the adaptive state of the body at high altitudes. The literature has shown a link between altitude and sleep problems, and sleep changes have become a common problem for individuals at high altitudes, negatively impacting their physical and mental health. As research on high-altitude sleep has gained attention in recent years, the publishing volume has increased worldwide, necessitating a more comprehensive understanding of this field. This manuscript evaluates the key themes and emerging trends in high-altitude sleep over the past few decades and predicts future research directions. MethodsArticles related to high-altitude sleep published from 1992 to 2022 were retrieved from the Web of Science Core Collection, and the relevant literature characteristics were extracted after the screening. Then, bibliometric analyses and visualizations were performed using Microsoft Excel, CiteSpace, VOSviewer, and an online analysis platform (http://bibliometric.com). ResultsA total of 1151 articles were retrieved, of which 368 were included in the analysis, indicating a gradually increasing trend. The United States, Switzerland, and China have made significant contributions in this field. Bloch KE from the University of Zurich was determined to be the most productive and academically influential author in this field. The highest-yielding journal was High Altitude Medicine & Biology. Initially, altitude training was the primary research topic. Currently, research focuses on sleep disorders and sleep apnea. In the coming years, keywords such as “sleep quality,” “prevalence,” and “obstructive sleep apnea” will attract more attention. ConclusionOur findings will assist scholars to better understand the intellectual structure and emerging trends in this field. Future developments in high-altitude sleep research are highly anticipated, particularly in terms of sleep quality at high altitudes and its associated prevalence. This research is also crucial for the improvement and treatment of symptoms during nocturnal sleep in patients with chronic hypoxia due to cardiopulmonary diseases at high altitudes.

Are parent-reported sleep logs essential? A comparison of three approaches to guide open source accelerometry-based nocturnal sleep processing in children.

We examined the comparability of children's nocturnal sleep estimates using accelerometry data, processed with and without a sleep log. In a secondary analysis, we evaluated factors associated with disagreement between processing approaches. Children (n = 722, age 5-12 years) wore a wrist-based accelerometer for 14 days during Autumn 2020, Spring 2021, and/or Summer 2021. Outcomes included sleep period, duration, wake after sleep onset (WASO), and timing (onset, midpoint, waketime). Parents completed surveys including children's nightly bed/wake time. Data were processed with parent-reported bed/wake time (sleep log), the Heuristic algorithm looking at Distribution of Change in Z-Angle (HDCZA) algorithm (no log), and an 8 p.m.-8 a.m. window (generic log) using the R-package 'GGIR' (version 2.6-4). Mean/absolute bias and limits of agreement were calculated and visualised with Bland-Altman plots. Associations between child, home, and survey characteristics and disagreement were examined with tobit regression. Just over half of nights demonstrated no difference in sleep period between sleep log and no log approaches. Among all nights, the sleep log approach produced longer sleep periods (9.3 min; absolute mean bias [AMB] = 28.0 min), shorter duration (1.4 min; AMB = 14.0 min), greater WASO (11.0 min; AMB = 15.4 min), and earlier onset (13.4 min; AMB = 17.4 min), midpoint (8.8 min; AMB = 15.3 min), and waketime (3.9 min; AMB = 14.8 min) than no log. Factors associated with discrepancies included smartphone ownership, bedroom screens, nontraditional parent work schedule, and completion on weekend/summer nights (range = 0.4-10.2 min). The generic log resulted in greater AMB among sleep outcomes. Small mean differences were observed between nights with and without a sleep log. Discrepancies existed on weekends, in summer, and for children with smartphones and screens in the bedroom.

Post-training sleep modulates motor adaptation and task-related beta oscillations.

Motor adaptation reflects the ability of the brain's sensorimotor system to flexibly deal with environmental changes to generate effective motor behaviour. Whether sleep contributes to the consolidation of motor adaptation remains controversial. In this study, we investigated the impact of sleep on motor adaptation and its neurophysiological correlates in a novel motor adaptation task that leverages a highly automatised motor skill, that is, typing. We hypothesised that sleep-associated memory consolidation would benefit motor adaptation and induce modulations in task-related beta band (13-30 Hz) activity during adaptation. Healthy young male experts in typing on the regular computer keyboard were trained to type on a vertically mirrored keyboard while brain activity was recorded using electroencephalography. Typing performance was assessed either after a full night of sleep with polysomnography or a similar period of daytime wakefulness. Results showed improved motor adaptation performance after nocturnal sleep but not after daytime wakefulness, and decreased beta power: (a) during mirrored typing as compared with regular typing; and (b) in the post-sleep versus the pre-sleep mirrored typing sessions. Furthermore, the slope of the electroencephalography signal, a measure of aperiodic brain activity, decreased during mirrored as compared with regular typing. Changes in the electroencephalography spectral slope from pre- to post-sleep mirrored typing sessions were correlated with changes in task performance. Finally, increased fast sleep spindle density (13-15 Hz) during the night following motor adaptation training was predictive of successful motor adaptation. These findings suggest that post-training sleep modulates neural activity supporting adaptive motor functions.

Comparison of the clinical and electrophysiological characteristics between type 1 and type 2 narcolepsy: a cross-sectional study

IntroductionNarcolepsy is a chronic brain disease characterized by excessive sleepiness and classified into two types based on the presence of cataplexy or reduced level of cerebrospinal fluid orexin-A (hypocretine-1): narcolepsy type 1 (NT1) and narcolepsy type 2 (NT2). These two types differ in symptoms other than cataplexy, as well as in certain examination findings. The present study aimed to investigate the clinical and electrophysiological characteristics of NT1 by comparing its features with those of NT2.MethodsSubjects were 118 first diagnosed and untreated patients with narcolepsy. They underwent both polysomnography (PSG) and multiple sleep latency test (MSLT) as a sleep test. Diagnosis was established in accordance with International Classification of Sleep Disorders, Third Edition, and the type of narcolepsy was determined by the presence or absence of cataplexy, patients with cataplexy were diagnosed with NT1, and without cataplexy were diagnosed with NT2. We investigated characteristics of the patients, PSG and MSLT outcomes, and applied a suite of duly statistical analysis to account for each parameter.ResultsAmong the 118 subjects, 35 patients (29.7%) were NT1, and 83 patients (70.3%) were NT2. Excessive daytime sleepiness which was measured by Japanese version of Epworth sleepiness scale (JESS) was significantly higher in NT1 than NT2. Furthermore, the presence of sleep hallucination (n = 29, 82.9%), sleep paralysis (n = 18, 51.4%), difficult maintaining sleep (n = 22, 62.9%), and sleep related movement and behavior disorders (n = 7, 20.0%) were significantly higher in NT1 than those in NT2. Additionally, parameters indicative of sleep fragmentation, such as the arousal index and wake time after sleep onset measured in PSG, exhibited a statistically significant increase in NT1 when contrasted with NT2.ConclusionsFragmentation of nocturnal sleep which is explained by the high arousal index and the long wake time after sleep onset on PSG was considered a characteristic finding of NT1 compared with NT2, and the patients with NT1 experienced greater difficulty of maintaining sleep. Concomitantly, the prevalence of NT1 in this study may be a representative value of the prevalence of NT1 among the patients with narcolepsy in Japan.

192 Assessing treatment effect of baricitinib in atopic dermatitis using digital endpoints derived from actigraphy data: nocturnal scratch and sleep disturbance

192 Assessing treatment effect of baricitinib in atopic dermatitis using digital endpoints derived from actigraphy data: nocturnal scratch and sleep disturbance

P005 Decolonizing measures of sleep and wellbeing to assess the outcomes of a MĀORI-led sleep intervention in Aotearoa whānau (New Zealand families).

Abstract Introduction The creation of culturally relevant questionnaires is an important step towards decolonizing research methodologies to ensure that they are appropriate for use in diverse populations. Our team aimed to develop and test a new questionnaire about sleep, wellbeing and whānau connection for use in Aotearoa whānau with 0-2 year old infants. Methods Our ethnically diverse research team co-designed with relevant communities a new 56-item questionnaire. Some items were adapted from existing questionnaires, with others newly developed through a Māori worldview. The new questionnaire was disseminated online for testing by caregivers of 0-2 year old children. Quantitative and qualitative findings about, and associations between three dimensions of children’s sleep health and caregiver and whānau wellbeing and connection, were examined to determine their acceptability as key outcome measurements for an upcoming trial. Results 957 caregivers completed the new questionnaire. Small, yet consistent positive associations were observed between children’s sleep quality, and caregivers’ perceptions of children’s sleep, and caregiver wellbeing, whānau wellbeing, and connection. Conversely, children’s nocturnal sleep duration was not related to caregiver or whānau wellbeing or connection. Only 14% of caregivers found questions about their perception of their children’s sleep difficult to answer. Qualitative feedback indicated that questions about wellbeing and connection were culturally relevant and acceptable to diverse whānau. Discussion Caregiver perception of children’s sleep, children’s sleep quality, caregiver wellbeing, whānau wellbeing and connection can be measured in a culturally relevant manner when a collaborative team work together to create, and consciously decolonize, new and existing questionnaire items.

Monitoring Sleep and Scratch Improves Quality of Life in Patients with Atopic Dermatitis.

Atopic dermatitis itch may cause sleep disturbance and impair quality of life. For patients finding topical therapy difficult to continue, it is important to control itch and reduce scratching. This study developed algorithms to measure nocturnal sleep and scratch, using an actigraph device worn on the back of the hand, and assessed smartphone application feedback to improve adherence with therapy. In the first trial, actigraph measurements in 5 participants who wore the device were highly correlated with measurements by a sleep-monitoring device beneath the mattress. Total actigraph-measured scratching duration for each hour of sleep was highly correlated with measurements by a person rating infrared video-recording of the sleepers. In the second trial, 40 patients with atopic dermatitis were randomly allocated into an intervention group that used the actigraph and smartphone application, and a control group that did not. Both groups were instructed to use the same moisturizer. Dermatology Life Quality Index scores decreased significantly from baseline and were lower than those in the control group at week 8. It is suggested that the device and associated smartphone application reinforced therapy adherence, moisturizer use, and contributed to improved quality of life in patients with atopic dermatitis.

Assessing ‘readiness’ by tracking fluctuations in daily sleep duration and their effects on daily mood, motivation, and sleepiness

Study objectivesConsumer sleep trackers issue daily guidance on ‘readiness’ without clear empirical basis. We investigated how self-rated mood, motivation, and sleepiness (MMS) levels are affected by daily fluctuations in sleep duration, timing, and efficiency and overall sleep regularity. We also determined how temporally specific these associations are. Methods119 healthy university students (64 female, mean age = 22.54 ± 1.74 years) wore a wearable sleep tracker and undertook twice-daily smartphone-delivered ecological momentary assessment of mood, motivation, and sleepiness at post-wake and pre-bedtime timings for 2–6 weeks. Naps and their duration were reported daily. Nocturnal sleep on 2471 nights were examined using multilevel models to uncover within-subject and between-subject associations between sleep duration, timing, efficiency, and nap duration on following day MMS ratings. Time-lagged analyses examined the temporal specificity of these associations. Linear regression models investigated associations between MMS ratings and sleep variability, controlling for sleep duration. ResultsNocturnal sleep durations were short (6.03 ± 0.71 h), and bedtimes were late (1:42AM ± 1:05). Within-subjects, nocturnal sleep longer than a person's average was associated with better mood, higher motivation, and lower sleepiness after waking. Effects of such longer sleep duration lingered for mood and sleepiness till the pre-bedtime window (all Ps < .005) but did not extend to the next day. Between-subjects, higher intraindividual sleep variability, but not sleep duration, was associated with poorer mood and lower motivation after waking. Longer average sleep duration was associated with less sleepiness after waking and lower motivation pre-bedtime (all Ps < .05). Longer naps reduced post-nap sleepiness and improved mood. Controlling for nocturnal sleep duration, longer naps also associated with lower post-waking sleepiness on the following day. ConclusionsPositive connections between nocturnal sleep and nap duration with MMS are temporally circumscribed, lending credence to the construction of sleep-based, daily ‘readiness’ scores. Higher sleep duration variability lowers an individual's post waking mood and motivation. Clinical trial idClinicalTrials.gov NCT04880629.

Comparative characteristics of patients with arterial hypertension with positive and negative reactions to salt load at night time

Objective: comparison of peripheral and central blood pressure, vascular wall stiffness and glomerular filtration rate in patients divided into salt-sensitive and salt-resistant based on the dynamics of blood pressure during night time after salt loading.Materials and methods: the study included 180 patients with arterial hypertension: 96 men (53%) and 84 (47%) women, median age 59 (56-64) years. Salt sensitivity was assessed according to the method of V.I. Kharchenko with distribution into groups according to the results of blood pressure dynamics at night. Peripheral and central blood pressure, vascular stiffness, and glomerular filtration rate were compared.Results: in 61% of salt resistant patients, there was a sufficient decrease in blood pressure during nocturnal sleep — the “dipper” profile, while in the group of salt sensitive patients, the decrease in blood pressure was sufficient only in 48%. Glomerular filtration rate was also higher in salt resistant patients compared to salt sensitive: 76,5 ml/min./1.73m2 versus 68 ml/min./1,73m2.Conclusion: arterial hypertension is more severe in salt sensitive patients, which was reflected in the intergroup comparison of peripheral and central blood pressure, vascular stiffness, and excretory function of the kidneys. Assessment of salt sensitivity at night may be useful in identifying high-risk groups of patients requiring the most careful monitoring and “aggressive” antihypertensive therapy.

Midday Napping, Nighttime Sleep, and Mortality: Prospective Cohort Evidence in China

ObjectiveIn developed countries, midday napping and nighttime sleep duration have been linked to long-term survival; however, little is known about such effects in less developed regions. Therefore, this study aimed to assess the associations of midday napping and nocturnal sleep with mortality in middle-aged and older Chinese adults. MethodsA nationwide cohort of 15,524 adults aged ≥ 45 years was enrolled from 28 provincial regions across mainland China and followed up from 2011 to 2018, using data from the Chinese Health and Retirement Longitudinal Study. Midday napping and nighttime sleep duration were assessed using standardized questionnaires. Cox proportional hazards models with random intercepts for the surveyed provinces were used to estimate hazard ratios (HRs) of all-cause mortality, adjusting for sociodemographic characteristics, behavioral factors, and health status. ResultsA total of 1,745 deaths occurred during a median follow-up of 7.1 years, and the mean (standard deviation) age was 59 (10.1) years at baseline. Compared with non-nappers, over 60 min nappers had a higher risk of all-cause mortality [HR: 1.35, 95% confidence interval (CI): 1.17–1.56], while no significant associations were observed among < 30 min nappers. Compared with sleep duration of 6–8 h/night, both short (< 6 h) and long (≥ 8 h) sleep duration were significantly associated with increased mortality, with corresponding HR (95% CI) estimates of 1.21 (1.05–1.38) and 1.26 (1.10–1.44), respectively. We observed significant patterns for greater risks associated with longer nap duration, with a Ptrend value < 0.001 for all-cause mortality. No significant evidence of an additive interaction was identified between midday napping and nighttime sleep. ConclusionLong midday napping and inappropriate nighttime sleep were independently associated with an increased risk of all-cause mortality in middle-aged and older Chinese populations. Biological studies are needed to validate our findings and clarify the mechanisms underlying this association.