Objective Sleep Measures Research Articles

Abstract P231: Are Resiliency and Religiosity/Spirituality Associated With Better Sleep Outcomes in Midlife Latinas?

Background: The disproportionate cardiovascular disease (CVD) burden among Latinas is not completely explained. An important health behavior in CVD prevention is sleep. In the United States (U.S.), Latinas experience unique sociocultural stressors that may impact sleep, particularly in midlife. Yet, little is known about protective factors such as resiliency and religiosity/spirituality among midlife Latinas. Aims: To assess the relation of resiliency and religiosity/spirituality with sleep disturbances in midlife Latinas. Methods: We conducted a cross-sectional analysis using baseline data from 49 participants in a pilot study to reduce CVD risk in midlife Latinas. Participants were Latinas aged 40-60 years who were perimenopausal or early postmenopausal, free of CVD, with no menopause hormone therapy use in the prior three months. Women were recruited from community settings. The frequency of sleep disturbances (trouble falling asleep, waking early, or nocturnal awakenings) over the past two weeks was assessed, and a sum score was created (0-16). The 6-item Brief Resilience Scale was used to assess the perceived ability to “bounce back” or recover from hardship. Religiosity/spirituality was determined by self-report (how important is religion/spirituality to you). Multivariable linear regression models were performed at p<0.15, adjusting for sociodemographic. Results: Participants were on average aged 47.1±4.5 years, 47% had less than a high school education, and 98% were born outside of the continental U.S. Sixty-nine percent of women experienced trouble falling asleep. The mean sleep score was 6.9±4.6. In adjusted models, we found an inverse relationship between resiliency and sleep (ß[SE]= -0.33[0.13],p=0.01). Religiosity/spirituality was not related to sleep disturbances (ß[SE]= 1.15[1.60],p=0.48). Conclusions: In this analysis of midlife Latinas, higher resiliency was associated with poorer sleep. Findings suggest that the ability to “bounce back” after hardship and religiosity/spirituality may not buffer the negative impact of stress on sleep. Further research is necessary with objective sleep measures to identify protective factors for sleep disturbances that may subsequently improve CVD risk in midlife Latinas.

Night-to-night variability of objective sleep outcomes in youth Middle Eastern football players

ObjectiveTo describe components of night-to-night variation in objective measures of sleep. MethodsWe conducted a secondary data analysis of consecutive and chronologically ordered actigraphy-based measurements for time in bed (min), time asleep (min), and wake-after-sleep onset (min). This investigation examined 575 individual night-based measures available for a sub-sample of fifty-two, male youth Middle Eastern football players tracked over a 14-day surveillance period (chronological age range: 12.1 to 16 years). Distinct multivariable-adjusted generalized additive models included each objective sleep outcome measure as dependent variable and disaggregated components of variation for night measurement-by-sleep period interaction, week part (weekday or weekend), and study participant random effects from within-subject night-to-night sleep variation. ResultsThe within-subject standard deviation (SD) of ±98 min (95% confidence interval [CI], 92 to 104 min) for time in bed, ±87 min (95%CI, 82 to 93 min) for time asleep, and ±23 min (95%CI, 22 to 25 min) for wake-after-sleep-onset overwhelmed other sources of variability and accounted for ∼44% to 53% of the overall night-to-night variation. The night measurement-by-fragmented sleep period interaction SD was ±83 min (95%CI, 44 to 156 min) for time in bed, ±67 min (95%CI, 34 to 131 min) for time asleep, and ±15 min (95%CI, 7 to 32 min) for wake-after-sleep-onset that accounted for ∼22% to 32% of each sleep outcome measure overall variability. ConclusionsSubstantial random night-to-night within-subject variability poses additional challenges for strategies aiming to mitigate problems of insufficient and inconsistent sleep that are detrimental to school learning and youth athlete development processes.

Actigraphic sleep dimensions and associations with academic functioning among adolescents.

There is mixed evidence regarding associations of sleep duration with academic functioning in adolescents and a lack of research on other sleep dimensions, particularly using objective sleep measures. We examined associations of multiple actigraphic sleep dimensions with academic functioning among adolescents. Data were from the sleep sub-study of the age 15 wave of the Future of Families and Child Wellbeing Study (n = 774-782; 52% female), a national, diverse sample of teens. Adolescents wore wrist-actigraphs for ~1 week and completed a survey reporting academic performance and school-related behavioral problems. Regression models assessed whether average sleep duration, timing, maintenance efficiency, and SD-variability were associated with self-reported academic functioning in cross-sectional analyses adjusted for demographic characteristics, depressive symptoms, and anxious symptoms. Later sleep timing (hours) and greater sleep variability (SD-hours) were associated with poorer academic outcomes, including sleep onset variability with higher odds of receiving a D or lower (OR = 1.29), sleep onset (β = -.07), sleep offset (β = -.08), and sleep duration variability (β = -.08) with fewer A grades, sleep offset with lower GPA (β = -.07), sleep offset (OR = 1.11), sleep duration variability (OR = 1.31), and sleep onset variability (OR = 1.42) with higher odds of being suspended or expelled in the past 2 years, and sleep duration variability with greater trouble at school (β = .13). Sleep duration, sleep maintenance efficiency, and sleep regularity index were not associated with academic functioning. Later sleep timing and greater sleep variability are risk factors for certain academic problems among adolescents. Promoting sufficient, regular sleep timing across the week may improve adolescent academic functioning.

Abstract A032: Preliminary evaluation of sleep-related patient-reported outcomes (pros), morningness-eveningness chronotype, & objective sleep measures using smart wearables in a primary brain tumor patient population

Abstract Introduction: Sleep is vitally important for the improvement of cancer outcomes, but evaluation of sleep in the primary brain tumor (PBT) population is limited. This analysis aims to provide preliminary data on the consistency/reliability of sleep-related patient-reported outcomes (PROs) and to assess sleep symptom severity with both PROs and objective sleep measurements. Methods: PBT patients ³ 18 years wore a Fitbit smart-wearable device for 4 weeks, which captured objective sleep measures (total sleep time, sleep latency, nap odds/number/duration, and wake after sleep onset (WASO)). The Morningness-Eveningness Questionnaire (MEQ) was completed at baseline, PROMIS Sleep-Related Impairment (SRI) and Sleep Disturbance (SD) Short-Forms were completed at baseline and at the end of the study, and daily sleep diaries were done during the final week. Descriptive statistics were used to describe patient demographics/clinical characteristics, Cronbach’s alpha to test consistency, McNemar’s tests for change in PRO severity, and Pearson’s correlations for relationships between PROs and objective sleep measures at week 1 and week 4. Results: 54 patients (median 46 years (24-71), 56% male, 85% white non-Hispanic, 81% KPS ≥ 90) completed the study. Most had anaplastic astrocytoma (20%) or glioblastoma (17%), had received radiation therapy (83%), had prior tumor recurrence (32%), and were not on active treatment (80%) during the study. PROMIS SRI/SD and MEQ were all consistent and reliable (Cronbach’s alpha 0.74-0.92). Fifty-six percent of patients had an intermediate sleep chronotype, 35% moderate-morning, 4% definite-morning, and only 6% moderate-evening (0% definite-evening). Moderate-severe SD and SRI were reported in 13% and 17% at baseline, and 4% (p=0.06) and 13% (p=0.69) at study exit. Co-occurrence of SD and SRI decreased from 11% to 2% (p=0.06). Fitbit-recorded measures showed a correlation at week 4 between WASO and SD (r=0.35, p=0.009), and a trend with SRI (r=0.24, p=0.08). Conclusions: This investigation shows initial evidence that sleep-related PROs are consistent and reliable in PBT patients, >10% of participants had significant SD and SRI, and the majority had intermediate and morningness chronotypes. Surprisingly, significant improvement in SD was reported during the study, which may be related to increased awareness of sleep patterns by the participants. Lack of sleep improvement (high SD/SRI) was associated with increased WASO, suggesting greater sleep fragmentation and potentially greater circadian vs. homeostatic sleep drive dysregulation in this population, warranting further investigation. Citation Format: Maeve M. Pascoe, Elizabeth Vera, Hope Miller, Alex Wollet, Dorela Shuboni-Mulligan, Amanda L. King, Terri S. Armstrong. Preliminary evaluation of sleep-related patient-reported outcomes (pros), morningness-eveningness chronotype, & objective sleep measures using smart wearables in a primary brain tumor patient population [abstract]. In: Proceedings of the AACR Special Conference on Brain Cancer; 2023 Oct 19-22; Minneapolis, Minnesota. Philadelphia (PA): AACR; Cancer Res 2024;84(5 Suppl_1):Abstract nr A032.

Daily light exposure profiles and the association with objective sleep quality in patients with Parkinson's disease: The PHASE study.

Light information crucially influences sleep initiation and continuity. The purpose of this study was to compare daily light exposure between patients with Parkinson's disease (PD) and non-PD older adults and evaluate the association of daily light exposure with objective sleep measures in patients with PD. In this cross-sectional study of 189 outpatients with PD and 1101 community-dwelling older adults (controls), daily light exposure was measured using wrist light meters during the daytime and light meters set in the bedrooms during the nighttime, and objective sleep quality was measured by wrist actigraphy. The median duration of exposure to ≥ 1000 lux light was significantly shorter in patients with PD than in controls. The median nighttime light intensity was higher in patients with PD than in controls. Among patients with PD, multivariable analysis suggested that the highest quartile of exposure to ≥ 1000 lux light during the daytime was linked to significantly higher sleep efficiency (SE) by 8.0% and shorter wake after sleep onset (WASO) by 36.9 minutes than the lowest quartile. During the nighttime, the highest quartile of mean light intensity had significantly lower SE by 6.8%, longer WASO by 24.1 minutes, longer sleep onset latency, and higher fragmentation index, than the lowest quartile. Importantly, daytime and nighttime light levels were independently associated with objective sleep measures. The present study illustrated that greater daytime light exposure and lower nighttime light exposure are significantly associated with better objective sleep measures in patients with PD.

Insomnia with objective but not subjective short sleep duration is associated with incident cardiovascular and/or cerebrovascular disease.

Insomnia with objective short sleep duration (ISSD) has been associated with cardiometabolic outcomes (ie, hypertension or diabetes). We examined whether ISSD, based on objective or subjective sleep measures, is associated with more serious health problems, such as incident cardiovascular and/or cerebrovascular disease (CBVD). 1,258 men and women from the Penn State Adult Cohort (56.9% women, aged 48.3 ± 12.95 years) without CBVD at baseline were followed up for 9.21 ± 4.08 years. The presence of CBVD was defined as a history of diagnosis or treatment of heart disease and/or stroke. Insomnia was defined as a complaint of insomnia with a duration ≥ 1 year. Poor sleep was defined as a complaint of difficulty falling asleep, staying asleep, nonrestorative sleep, or early morning awakening. Objective short sleep duration was defined as < 6 hours' sleep based on polysomnography. Subjective short sleep duration was based on the median self-reported percentage of sleep time (ie, < 7 hours). Compared with normal sleepers with normal sleep duration, the highest risk of incident CBVD was in the ISSD group (odds ratio = 2.46, 95% confidence interval = 1.04-5.79), and the second highest was in normal sleepers with short sleep duration (odds ratio = 1.68, 95% confidence interval = 1.11-2.54). The risk of incident CBVD was not significantly increased in poor sleepers or those with insomnia with normal sleep duration. Finally, insomnia with subjective short sleep duration was not associated with increased incident CBVD. These data add to the cumulative evidence that ISSD, based on objective but not subjective measures, is the more severe biological phenotype of the disorder associated with incident CBVD. Pejovic S, Vgontzas AN, Fernandez-Mendoza J, etal. Insomnia with objective but not subjective short sleep duration is associated with incident cardiovascular and/or cerebrovascular disease. J Clin Sleep Med. 2024;20(7):1049-1057.

Racial/ethnic disparities in objective sleep measures from polysomnographic studies in the U.S.

Racial/ethnic disparities in objective sleep measures from polysomnographic studies in the U.S.

Sleep and allergic diseases among young Chinese adults from the Singapore/Malaysia Cross-Sectional Genetic Epidemiology Study (SMCGES) cohort

Background and objectiveSleep disruption has been shown to affect immune function and thus influence allergic disease manifestation. The specific effects of sleep on allergic diseases, however, are less well-established; hence, in a unique population of young Chinese adults, we investigated the association between sleep and allergic disease.MethodsYoung Chinese adults recruited from Singapore in the Singapore/Malaysia Cross-Sectional Genetic Epidemiology Study (SMCGES) were analyzed. We used the International Study of Asthma and Allergies in Childhood (ISAAC) protocol and a skin prick test to determine atopic dermatitis (AD), allergic rhinitis (AR), and asthma status. Information regarding total sleep time (TST) and sleep quality (SQ) was also obtained.ResultsOf 1558 participants with a mean age of 25.0 years (SD = 7.6), 61.4% were female, and the mean total sleep time (TST) was 6.8 h (SD = 1.1). The proportions of AD, AR, and asthma were 24.5% (393/1542), 36.4% (987/1551), and 14.7% (227/1547), respectively. 59.8% (235/393) of AD cases suffered from AD-related sleep disturbances, 37.1% (209/564) of AR cases suffered from AR-related sleep disturbances, and 25.1% (57/227) of asthma cases suffered from asthma-related sleep disturbances. Only asthma cases showed a significantly lower mean TST than those without asthma (p = 0.015). Longer TST was significantly associated with lower odds of AR (OR = 0.905, 95% CI = 0.820–0.999) and asthma (OR = 0.852, 95% CI = 0.746–0.972). Linear regression analyses showed that lower TST was significantly associated with asthma (β = − 0.18, SE = 0.076, p-value = 0.017), and AR when adjusted for AR-related sleep disturbances (β = − 0.157, SE = 0.065, p-value = 0.016). Only sleep disturbances due to AR were significantly associated with a poorer SQ (OR = 1.962, 95% CI = 1.245–3.089).ConclusionsWe found that sleep quality, but not sleep duration was significantly poorer among AD cases, although the exact direction of influence could not be determined. In consideration of the literature coupled with our findings, we posit that TST influences allergic rhinitis rather than vice versa. Finally, the association between TST and asthma is likely mediated by asthma-related sleep disturbances, since mean TST was significantly lower among those with nighttime asthma symptoms. Future studies could consider using objective sleep measurements coupled with differential expression analysis to investigate the pathophysiology of sleep and allergic diseases.

Enhanced external counterpulsation improves sleep quality in chronic insomnia: A pilot randomized controlled study

PurposeTo investigate the short-term efficacy of enhanced external counterpulsation (EECP) on chronic insomnia. MethodsThis is a pilot randomized, participant-blind, and sham-controlled study. Forty-six participants with chronic insomnia were randomly assigned in a 1:1 ratio to receive EECP or sham EECP intervention (total of 35 sessions with 45 min each). The primary outcome was Pittsburgh Sleep Quality Index (PSQI). The secondary outcomes included sleep diary, Hospital Anxiety and Depression Scale (HADS), Short-Form Health Survey (SF12), flow mediated dilation (FMD), serum biomarkers of melatonin, cortisol, interleukin-6, and high sensitivity C-reactive protein. Outcomes were assessed after treatment and at 3-month follow-up. ResultsThe PSQI was significantly decreased in both EECP and sham groups after 35-session intervention (13.74 to 6.96 in EECP and 13.04 to 9.48 in sham), and EECP decreased PSQI more than sham EECP (p = 0.009). PSQI in two groups kept improved at 3-month follow-up. After treatment, the total sleep time, sleep efficiency, FMD value and SF12 mental component of EECP group were significantly improved, and group differences were found for these outcomes. At follow-up, total sleep time, sleep efficiency and SF12 mental component of EECP group remained improved, and group difference for SF12 mental component was found. Post-treatment and follow-up HADS-A significantly decreased in both groups, with no differences between groups. Post-treatment serum biomarkers showed no differences within and between groups. LimitationLack of objective sleep measurement. ConclusionEECP could improve sleep quality and mental quality of life in chronic insomnia and the therapeutic effect maintained for 3 months.

O02 Assessing SleeP in INfants with moderate-severe atopic Dermatitis by Longitudinal Evaluation (The SPINDLE study)

Abstract Introduction Atopic dermatitis (AD) is associated with sleep disruption due to pruritus, inflammation, increased transepidermal water loss (TEWL) and circadian alterations. Little is known about the impact of AD on sleep in early infancy, a critical time for neurodevelopment. The aim of this study was to deeply characterise the sleep architecture of 6-month-old infants with moderate-severe AD, compared to controls. Methods Overnight movements (defined as 10-15 seconds of movement) were measured for five consecutive nights using a novel wearable movement sensor. Infantile and parental sleep measures were reported by parents. Daytime sleep quality and quantity was measured by electroencephalogram (EEG) polysomnography. AD was assessed using clinical severity scoring, skin barrier assessment (TEWL, natural moisturising factor levels, and filaggrin mutational analysis) and inflammatory cytokine analysis by tape stripping. Results 57 controls and 33 cases were recruited. Average EASI at time of 6-month assessment was 7.2 (range 0.8-34.8). Infants with AD recorded almost twice as many overnight movements as controls (19.2 versus 11.2, p&amp;lt;0.05). Infants with AD slept for 13.1 hours versus 13.8 (p&amp;lt;0.05), and woke 3.5 times versus 1.9 (p&amp;lt;0.05). Infants with AD had differences in EEG sleep measures, including sleep spindle power and frequency. Mothers of cases had worse total sleep time (6.3 versus 7.1 hours, p&amp;lt;0.05), sleep-­onset latency (27.1 versus 12.8 minutes, p&amp;lt;0.05), and sleep ­efficiency. Conclusion This is the most detailed study ever performed on sleep in infants with AD using objective sleep measures, and has revealed significant effects on sleep architecture, sleep duration, and overnight movement.

A pilot time-in-bed restriction intervention behaviorally enhances slow-wave activity in older adults

IntroductionIdentifying intervention methods that target sleep characteristics involved in memory processing is a priority for the field of cognitive aging. Older adults with greater sleep efficiency and non-rapid eye movement slow-wave activity (SWA) (0.5–4 Hz electroencephalographic activity) tend to exhibit better memory and cognitive abilities. Paradoxically, long total sleep times are consistently associated with poorer cognition in older adults. Thus, maximizing sleep efficiency and SWA may be a priority relative to increasing mere total sleep time. As clinical behavioral sleep treatments do not consistently enhance SWA, and propensity for SWA increases with time spent awake, we examined with a proof-of concept pilot intervention whether a greater dose of time-in-bed (TiB) restriction (75% of habitual TiB) would increase both sleep efficiency and SWA in older adults with difficulties staying asleep without impairing memory performance.MethodsParticipants were adults ages 55–80 with diary-reported sleep efficiency &amp;lt; 90% and wake after sleep onset (WASO) &amp;gt;20 min. Sleep diary, actigraphy, polysomnography (PSG), and paired associate memory acquisition and retention were assessed before and after a week-long TiB restriction intervention (n = 30). TiB was restricted to 75% of diary-reported habitual TiB. A comparison group of n = 5 participants repeated assessments while following their usual sleep schedule to obtain preliminary estimates of effect sizes associated with repeated testing.ResultsSubjective and objective sleep measures robustly improved in the TiB restriction group for sleep quality, sleep depth, sleep efficiency and WASO, at the expense of TiB and time spent in N1 and N2 sleep. As hypothesized, SWA increased robustly with TiB restriction across the 0.5–4 Hz range, as well as subjective sleep depth, subjective and objective WASO. Despite increases in sleepiness ratings, no impairments were found in memory acquisition or retention.ConclusionA TiB restriction dose equivalent to 75% of habitual TiB robustly increased sleep continuity and SWA in older adults with sleep maintenance difficulties, without impairing memory performance. These findings may inform long-term behavioral SWA enhancement interventions aimed at improving memory performance and risk for cognitive impairments.

Effectiveness of a proprietary Dichrostachys glomerata extract (DYG-400®) on Adult's Sleep Quality and Activity: A Pilot Trial

Objectives: The purpose of this study was to examine the effectiveness of Dichrostachys glomerata (Dyglomera®) supplementation on adults’ sleep quality and daytime activity. Methods: Using a double-blind placebo-controlled pilot trial, 56 adults with nonclinical poor sleep (M age = 44.50) were randomized to either the Dichrostachys glomerata Group (300 mg/d) or Placebo Group for 60 days. Outcomes were the self-reported Insomnia Severity Index and objective sleep and daytime activity via the Oura Ring. Analysis was undertaken at Day 0 (Baseline), Day 30, and Day 60. Results: The Dichrostachys glomerata Group had improved Insomnia Severity Index symptoms, with significant improvements from Day 0 to Day 60. Objective sleep measures indicated that the Dichrostachys glomerata Group had significantly improved sleep score and deep sleep duration, while the Placebo Group declined in these parameters. The Dichrostachys glomerata Group also improved on sleep latency and time awake, contrasting with worsened of these sleep metrics in the Placebo Group, p’s &lt; .05. No group differences were found for REM. The Dichrostachys glomerata Group improved significantly on the activity outcomes. Conclusion: These results provide preliminary support for the potential of Dichrostachys glomerata supplementation to enhance both sleep and daytime activity. Further research is warranted to validate these findings in diverse populations. Clinical trial registry = ISRCTN10099861.

Age and objectively measured sleep: investigating associations and interactions by sex and race in middle-aged and older adults

Abstract Study Objectives Few studies of middle-aged and older adults have examined the association between age and sleep using objective sleep measures. We examined these associations in adults aged ≥40 years using wrist actigraphy, and investigated whether these associations differed by sex and race. Methods Participants were 468 cognitively normal adults aged ≥40 years enrolled in the Baltimore Longitudinal Study of Aging who completed wrist actigraphy. We used Generalized Least Squares Models to examine the associations of age with actigraphic sleep parameters, including total sleep time (TST), sleep efficiency, sleep onset latency, and wake after sleep onset (WASO). We conducted interaction and stratification analyses to test whether cross-sectional age-sleep associations were modified by sex and race. Results In analyses adjusting for sex, body mass index, and individual medical conditions, older age was associated with longer TST from ages 40–70 that plateaued after age 70. Older age also was associated with lower sleep efficiency, longer sleep onset latency, and greater WASO. In men only, after age 70, older age was associated with shorter TST, lower sleep efficiency, longer onset latency, and greater WASO. However, we did not observe any significant interactions of race with age. Conclusions Older age was associated with longer TST from ages 40 to 70 and with poorer sleep quality after age 40, and these relationships might vary by sex. Future studies with larger sample sizes are needed to investigate mechanisms that may account for sex differences in the observed age-sleep associations.

Measuring Sleep Among Cancer Survivors: Accelerometer Measures Across Days and Agreement Between Accelerometer and Self-Reported Measures

Background: The associations between subjective (self-reported) and objective (actigraphy) sleep measurements are not well documented among survivors of cancer. The purpose of this study was to examine actigraphy measurements across days and the associations of two self-reported sleep measures with actigraphy-measured sleep measures. Methods: Sleep data were collected using self-reported sleep diary, the Pittsburgh Sleep Quality Index, and hip-worn actigraphy at baseline for a subsample participating in the Lifestyle Intervention for oVarian cancer Enhanced Survival (N = 516) randomized controlled trial. Intraclass correlation coefficients were used to evaluate consistency of actigraphy sleep measures across days of wear and associations of sleep diary with actigraphy for total sleep time (TST), time asleep, and time awake. Bland–Altman plots were used to assess the associations of sleep duration and sleep efficiency derived from Pittsburgh Sleep Quality Index and actigraphy. Results: Participants were aged 60.3 years (SD 9.3 years). For TST, the associations were strongest after 3 weekdays of consecutive actigraphy wear (ICC = .43 95% CI [.35, .51]), and actigraphy-measured daily TST was longest (617, SD 135 min) compared with self-reported measures. Sleep diary versus actigraphy associations for TST, time asleep, and time awake were weak to moderate. Pittsburgh Sleep Quality Index versus actigraphy association was weak for all sleep constructs. Conclusion: The strength of association between self-reported and actigraphy measures of sleep ranged from weak to very strong, depending on the sleep construct. Impact: Results highlight the importance of selecting an appropriate measurement tool for estimating individual sleep constructs among survivors of cancer.

A pilot randomised controlled trial exploring the feasibility and efficacy of a human-AI sleep coaching model for improving sleep among university students.

Sleep quality is a crucial concern, particularly among youth. The integration of health coaching with question-answering (QA) systems presents the potential to foster behavioural changes and enhance health outcomes. This study proposes a novel human-AI sleep coaching model, combining health coaching by peers and a QA system, and assesses its feasibility and efficacy in improving university students' sleep quality. In a four-week unblinded pilot randomised controlled trial, 59 university students (mean age: 21.9; 64% males) were randomly assigned to the intervention (health coaching and QA system; n = 30) or the control conditions (QA system; n = 29). Outcomes included efficacy of the intervention on sleep quality (Pittsburgh Sleep Quality Index; PSQI), objective and self-reported sleep measures (obtained from Fitbit and sleep diaries) and feasibility of the study procedures and the intervention. Analysis revealed no significant differences in sleep quality (PSQI) between intervention and control groups (adjusted mean difference = -0.51, 95% CI: [-1.55-0.77], p = 0.40). The intervention group demonstrated significant improvements in Fitbit measures of total sleep time (adjusted mean difference = 32.5, 95% CI: [5.9-59.1], p = 0.02) and time in bed (adjusted mean difference = 32.3, 95% CI: [2.7-61.9], p = 0.03) compared to the control group, although other sleep measures were insignificant. Adherence was high, with the majority of the intervention group attending all health coaching sessions. Most participants completed baseline and post-intervention self-report measures, all diary entries, and consistently wore Fitbits during sleep. The proposed model showed improvements in specific sleep measures for university students and the feasibility of the study procedures and intervention. Future research may extend the intervention period to see substantive sleep quality improvements.

The association between timing of dietary macronutrient and sodium consumption and sleep duration and quality.

The objective of this study was to examine the association between the timing of dietary macronutrients and sodium intake and sleep quantity and quality. This was a cross-sectional study that included 34 adults between 21 and 50 years of age. The main outcome measures were objective sleep measures assessed from three nights of wrist actigraphy including sleep duration, fragmentation, and wake after sleep onset (WASO), and one night of polysomnography (PSG), including rapid eye movement (REM) sleep, non-REM stage 2 (N2), stage 3 (N3), and WASO. Multiple linear regression models and linear mixed models were used to estimate the associations between sleep measures and dietary measures (carbohydrates, fats, saturated fats, proteins, and sodium). Dietary timing was examined in two ways: (1) the average amount of each nutrient consumed within 3 hours of sleep start, and (2) the interval between the final intake of each nutrient and sleep. Average fat intake within 3 hours of sleep was associated with greater WASO from PSG (β = 4.48, p = 0.01). No other associations were found between the macronutrients or sodium intake (p > 0.05) within 3 hours of sleep and the sleep parameters from PSG or actigraphy. Similarly, no associations were found between any of the PSG or actigraphy sleep measures and the interval between final nutrient intakes and sleep with sleep duration. The study suggests that greater fat but not carbohydrate, protein, saturated fat, or sodium intake close to sleep may be associated with greater sleep disruption; however, no other associations were observed.

The role of the tongue in post-stroke dysphagia and obstructive sleep apnea: Correlation with sonography measurement

ObjectiveObstructive sleep apnea (OSA) is a common risk factor for stroke, and dysphagia and pneumonia are both well-known complications of stroke. The development of these conditions is related to the oropharyngeal structures. We investigated whether specific structural features of the tongue may lead to the development of these complications. MethodsPatients with ischemic stroke who required admission and community-dwelling elderly controls were enrolled. The participants underwent tongue measurements by received hand-held ultrasound, and received questionnaires to evaluate sleep quality and daytime sleepiness. The patient group also underwent objective sleep measurement by actigraphy and the 3-Step Swallowing Test (3-SSS). Sleep parameters and outcomes were analyzed. ResultsPatient with ischemic stroke had significantly thicker tongue than controls (6.53 cm v. 6.05 cm, p = 0.002). Multiple logistic regression analysis revealed that the anatomical parameters of the tongue in patients with stroke were significantly correlated with parameters of OSA, and the thickness of the tongue was positively correlated with the development of OSA (p = 0.024) and pneumonia (p = 0.048). ConclusionsA thicker-than average tongue may be a risk factor for OSA and pneumonia in patient with stroke. Hand-held ultrasound can be used to identify these anatomical features. Further studies are warranted to clarify the role of the tongue in these post-stroke complications.

Evaluating the impact of adjunct bright light therapy on subjective sleep quality in major depressive disorder

BackgroundSleep disturbances are a fundamental feature of depression, with their persistence after remission serving as a key risk factor for recurrence of depressive episodes, suicide, and hypnotics abuse. Though Adjunct Bright Light Therapy (BLT) has shown efficacy in treating depression by improving sleep duration and timing, its impact on subjective sleep quality remains underexplored. ObjectiveThis study investigates the effect of adjunct BLT on the subjective experience of sleep quality of Major Depressive Disorder (MDD) inpatients. MethodsA randomized controlled trial was undertaken with 100 MDD consecutively admitted inpatients on consistent antidepressant regimens. Participants were divided into two groups; Group A, received pharmacotherapy augmented with BLT, Group B, received pharmacotherapy alone. The Hamilton Depression Rating Scale assessed depressive symptoms, while the Pittsburgh Sleep Quality Index (PSQI) evaluated subjective sleep quality. ResultsWhile both groups displayed enhanced depressive symptomatology, only Group A manifested significant improvement in perceived sleep quality (PSQI scores: A T0 8.05 ± 5.07 vs. T1 5.64 ± 3.64, p < 0.001; B T0 7.11 ± 3.17 vs. T1 6.50 ± 3.04, p = 0.072). LimitationsStudy limitations include its single-site design, lack of objective sleep measurement, and exclusive SSRI use, suggesting caution in generalizing findings. Further, the absence of placebo control and unmeasured expectancy effects may influence treatment outcomes. ConclusionsThese findings underscore the criticality of subjective sleep quality in clinical evaluations and highlight the potential of adjunct BLT as an augmentation therapeutic strategy to ameliorate sleep perception in MDD patients, emphasizing its potential role in enhancing therapeutic outcomes.

DAILY ASSOCIATIONS OF SOCIAL INTERACTIONS WITH OBJECTIVE SLEEP MEASURES AMONG OLDER ADULTS

Abstract Disturbed sleep is a common problem and can have profound effects on older adults. Social relationships are known to be associated with quantity and quality of sleep. To extend prior research, we examined the associations of daily social interactions and sleep, using objective sleep measures and an ecological momentary assessments (EMA) approach. Participants in the Einstein Aging Study (n=285, Mage=77, range=70-90, 68% women, 46% White, 40% Black) reported their recent social interactions and physical contact four times a day for 16 days via EMA on mobile phones. Objective sleep measures (sleep timing, night sleep time, wake after sleep onset (WASO), sleep maintenance efficiency) were calculated from concurrent wrist actigraphy. Multilevel models controlled for demographics, living arrangement, Instrumental Activities of Daily Living, sleep-disordered breathing, and hypoxemia. Results showed that, on days when older adults had more day-time social interactions than their average, they had earlier sleep timing, shorter night sleep time, and less WASO, but no differences in sleep efficiency. On days when older adults had more physical contact than their average, they had earlier sleep timing and shorter night sleep time but no differences in WASO or sleep efficiency. These micro-longitudinal analyses among older adults suggest that daily social interactions are related to subsequent earlier sleep timing and shorter sleep at night, and can be beneficial for sleep quality. Physical contact seemed to be only associated with the timing and quantity of sleep but not sleep quality. Potential benefits of using an EMA approach in sleep research will be discussed.

OBJECTIVE SLEEP AND CIRCADIAN REST–ACTIVITY RHYTHMS AND MULTIPLE DOMAINS OF COGNITIVE FUNCTION IN OLDER ADULTS

Abstract Evidence suggests that sleep and circadian rest-activity rhythms (RAR) play a key role in dementia and Alzheimer Disease (AD) pathology. Studies with objective measures of sleep and RAR and multiple domains of cognition remain limited. We studied 820 older adults enrolled in the Study of Muscle, Mobility and Aging (SOMMA). Actigraphs were worn for one week, and processed for sleep-wake measures including total sleep time (TST) and sleep efficiency (SE); and parametric (acrophase, pseudo-F) and non-parametric (interdaily stability [IS], intradaily variability [IV], and relative amplitude [RA]) 24-hour RAR variables. Cognitive assessments included global cognition (the Montreal Cognitive Assessment), executive function (Trails B test), memory (California Verbal Learning Test-short form; and psychomotor performance (Digit-Symbol Coding Test). Adjusting for age, sex, clinic site and education, we examined adjusted mean cognitive test scores by categories of sleep and RAR exposures. Mean age was 76 years, 58% were female, and 15% were non-white. Higher RA, reflecting a more robust 24-hour RAR, was associated with better cognition on all tests (p for trend &amp;lt;0.05). Reduced SE was related to lower cognitive function (psychomotor performance, global cognition, memory; p&amp;lt;.05). There were no associations with TST and any cognitive measures examined. SE and RAR were variably associated with both global and specific domains of cognition in older men and women. The RA in particular was strongly related to multiple domains of cognition related to AD, and may be useful in identifying individuals at risk. Additional analyses will explore sex differences and longitudinal associations.