Poor Sleep Efficiency Research Articles

Does sleep moderate the effects of exercise training or complex mental and social activities on cognitive function in adults with chronic stroke? Secondary analysis of a randomized trial.

Exercise (EX) or cognitive and social enrichment (ENRICH) are two strategies for promoting cognition post-stroke. Whether sleep moderates the effects of EX or ENRICH on cognition in adults with chronic stroke is unknown. A three-arm parallel randomized clinical trial among community-dwelling adults aged 55+ years with chronic stroke (i.e., ≥12 months since stroke). Participants were randomized to 2x/week EX, ENRICH, or balance and tone control (BAT). At baseline, device-measured sleep duration and efficiency were measured using wrist-worn actigraphy; self-reported quality was measured by Pittsburgh Sleep Quality Index (PSQI). Participants were categorized at baseline as having good or poor device-measured duration, device-measured efficiency, or self-reported quality based on PSQI. The primary cognitive outcome was Alzheimer's Disease Assessment Scale Plus (ADAS-Cog-Plus) measured at baseline, 6 months (end of intervention), and 12 months (6-month follow-up). We examined if baseline sleep categorizations (i.e., good/poor) moderated effects of EX or ENRICH on ADAS-Cog-Plus. We enrolled 120 participants in the trial (EX=34; ENRICH=34; BAT=52). Sleep quality (i.e., device-measured sleep efficiency or self-reported sleep quality) categorization moderated effects of EX (but not ENRICH) on ADAS-Cog-Plus. Compared with BAT participants with poor sleep quality, EX participants with poor sleep quality had better ADAS-Cog-Plus performance at 6 months (estimated mean difference for those with poor device-measured sleep efficiency: -0.48; 95% CI:[-0.85, -0.10]; p=0.010); estimated mean difference for those with poor self-reported sleep quality: -0.38; 95% CI:[-0.70, -0.07]; p=0.014). There was no effect of EX on ADAS-Cog-Plus for participants with good sleep quality. Device-measured sleep duration did not moderate intervention effects. Exercise is particularly beneficial in improving cognitive function in adults with chronic stroke and poor sleep quality.

Sleep characteristics and recurrence in platinum-sensitive ovarian cancer survivors: A prospective cohort study

ObjectiveTo describe characteristics of sleep (quality, duration, efficiency, and insomnia) in a cohort of high-grade epithelial ovarian cancer (EOC) survivors who have completed and responded to first-line chemotherapy, and to explore their relationships with disease recurrence. MethodsIn this cohort of 97 women, sleep and other factors were assessed at baseline and 4 months later. The distribution of participants by categories of sleep characteristics were calculated. Hazard ratios (HRs) and 95 % confidence intervals (95 % CI) for the association between each sleep characteristic and recurrence were estimated using the Cox proportional hazards model, and adjusted for confounding using propensity scores. Associations were estimated for all women and among those defined as fully platinum-sensitive. ResultsAt baseline, just over half of participants (52.6 % to 56.7 %) had poor sleep quality, efficiency and duration, while most (62.9 %) did not experience insomnia. Distributions remained similar 4 months later. During follow-up, 47 recurrences occurred. Among all participants, HRs (95 % CIs) of recurrence were close to the value of 1, indicating no association, for sleep quality and efficiency, 1.22 (0.66–2.23) for not meeting vs. meeting sleep duration guidelines and 0.68 (0.34–1.39) for the presence vs. absence of insomnia. In fully platinum-sensitive women, the HRs (95 % CIs) were 1.50 (0.64–3.53) for not meeting duration guidelines, 1.25 (0.56–2.79) for poor sleep efficiency, 1.44 (0.55–3.72) for the presence of insomnia, and remained null for sleep quality. ConclusionMost EOC survivors have poor sleep quality, duration, and efficiency. Research with larger sample sizes is required to better understand the relationship between these sleep characteristics and the risk of recurrence.

The relationship between chronotype video game addiction and sleep quality in school-age children: A structural equation modeling approach

ABSTRACT This study aimed to investigate the relationship between chronotype, video game addiction, and sleep quality in school-age children using structural equation modeling. It was performed using structural equation modeling, with 545 secondary school students in northern Turkey meeting the inclusion criteria. Data were collected through face-to-face interviews utilizing the Personal Information Form, the Morningness Eveningness Scale for Children (MESC), the Video Game Addiction Scale for Children (VASC), and the Sleep Quality Scale. The findings revealed that the average video game addiction score of children was 55.22, which was associated with poor sleep quality and efficiency. Additionally, chronotype was found to mediate the relationship between video game addiction and both sleep quality (β = 0.024; p < 0.001) and sleep efficiency (β = −0.068; p < 0.001). The model was found to be close to acceptable levels for the variables according to the fit indices.

THE ROLE OF PHYSICAL ACTIVITY IN IMPROVING THE QUALITY OF SLEEP OF PATIENTS WITH VARIOUS SLEEP DISORDERS

Sleep is an important human behavior and difficulties with sleep are closely related to health, potentially leading to the development of diseases and a reduced quality of life. Sleep disorders cover a wide range of problems associated with mental health disorders, such as anxiety and depression, and contribute to an increased tendency to become overweight or obese. In addition, sleep difficulties can lead to more serious sleep disorders, such as problems with sleep maintenance, poor sleep efficiency, and reduced daytime attention. The purpose of the study is to highlight the role of physical activity in improving the quality of sleep in patients with various sleep disorders. Materials and methods. To better understand the impact of physical activity on sleep quality and its positive effect on sleep onset and duration, a search of scientific literature was conducted between 2019 and 2024 in the PubMed, Scopus, Web of Science, and Google Scholar databases using the terms “exercise,” “sleep,” “quality of life,” “insomnia,” and “activity.” The search resulted in the selection of publications that examined the relationship between daily sleep and physical activity and will be discussed in this review. Results. The study identified potential biological pathways that explain the possible interactions between sleep and physical activity in the short and long term. Acute or repetitive physical activity increases total sleep time by reducing insulin resistance and the concentration of inflammatory markers, better regulation of circadian rhythm, and the release of brain-derived neurotrophic factor. In turn, sleep deprivation can alter physical performance or contribute to fatigue during physical activity by increasing cortisol concentrations, decreasing growth hormone and prolactin concentrations, and stimulating inflammatory markers. Scientific studies have established the beneficial effects of physical activity in alleviating sleep problems. Numerous studies show that moderate to vigorous physical activity has a positive effect on sleep quality. Physical activity has pluripotential beneficial effects on bodily functions. These benefits include a reduction in the incidence of cardiovascular disease, coronary heart disease, hypertension, type 2 diabetes, and death. In addition to these effects, physical activity has a significant beneficial effect on the onset, duration, and quality of sleep, which complements its beneficial effects. In contrast, lack of sleep is associated with an increased incidence of cardiovascular complications and death. In this regard, physical activity serves as a non-pharmacological means of improving sleep, especially in older people who often have difficulty falling asleep. Regarding the time of exercise and its effect on sleep, there was no difference between morning and evening exercise in terms of sleep onset and quality. In addition, the multifaceted benefits of physical activity go beyond improving sleep to contribute to overall well-being and longevity, offering a comprehensive health solution that is comparatively better than alternative treatments. Conclusions. Based on the research presented here, it can be concluded that the scientific literature has identified an improvement in sleep quality after physical activity, and empirical evidence confirms its positive impact, regardless of type or intensity. Increased physical activity was found to be associated with improved total sleep duration, reduced sleep latency, and improved sleep efficiency. Exercise can improve sleep by reducing sleep latency and increasing slow wave sleep.

Sleep patterns in adolescents and associations with substance use

ObjectivesGood sleep during adolescence is crucial for maintaining physical and psychological health; however, sleep disturbance during this period may contribute to health risks, such as substance use. This study aimed to identify the latent sleep patterns across male and female adolescents, and their association with drug use. MethodA cross-sectional study was conducted involving 1391 high school students (aged 15-17; 56.4% female). Participants completed the brief Pittsburgh Sleep Quality Index alongside other sleep measures, and the Timeline Follow-Back and Drug Use History Questionnaire to measure substance use. A multiple-group latent class analysis was used to identify sleep patterns across sexes, and pairwise Logistic Regression models to compare their association with substance use. ResultsFour sleep patterns were identified with varying degrees of sleep difficulties: "Good Sleep" (43.3%), "Night Awakenings" (31.8%), "Poor Efficiency and Sleep Onset" (9.4%), and "Poor Sleep" (15.5%). Female adolescents were more likely to belong to Poor Sleep and Poor Efficiency and Sleep Onset patterns, and male adolescents to Good Sleep. Likewise, binge drinking and using alcohol for a longer period were associated with experiencing Poor Efficiency and Sleep Onset (OR=1.03 and 2.3, respectively); smoking tobacco within the past month was linked to Night Awakenings (OR=2.2); and using cannabis or illegal drugs to the Poor Sleep pattern (OR=2.4 and 2.6, respectively). ConclusionsVaried sleep difficulties exist among adolescents that significantly correlate with different aspects of drug use. Targeted interventions that address both sleep and drug prevention are recommended.

Objective and self-reported assessment of sleep quality during each trimester of pregnancy: A prospective observational study

ObjectivesStudies on actual circumstances of sleep in pregnant women are limited to surveys of self-reported symptoms, and objective assessments are missing. Sleep disturbances due to hormonal imbalances are common during pregnancy. This study aimed to assess sleep quality by objective assessment using an actigraph and by self-reported assessment using a questionnaire for sleep during each trimester of pregnancy and to elucidate how sleep quality changed from the first to the third trimester of pregnancy. Study designA longitudinal questionnaire survey was administered and sleep measurements using an actigraph were recorded at three time points during the first, second, and third trimesters in primiparous women who had conceived naturally. ResultsDuring the first trimester, “feeling of being refreshed when waking up in the morning” was not noted, and a decline was observed in mental function. During the second trimester, a positive correlation was observed between morning sickness and sleep quality. ConclusionsSleep quality was the worst during the third trimester, with the shortest total sleep time and poor sleep efficiency, along with poor physical function scores. Back pain and leg cramps significantly correlated with sleep efficiency in the third trimester. Poor sleep during pregnancy begins in the first trimester. If minor problems, such as morning sickness, continue in the second trimester, sleep quality is greatly affected. Furthermore, during the third trimester of pregnancy, low back pain and leg cramps are more likely to occur due to an increase in the abdominal area and may interfere with sleep.

Evaluation of sleep quality in stage II and stage III colorectal cancer patients–secondary analysis of a randomized controlled trial

Abstract Background: Sleep quality in cancer patients often does not receive sufficient attention from their treating physicians and nurses. This report aims to highlight this under-researched issue among colorectal cancer patients scheduled to receive adjuvant chemotherapy. Materials and Methods: This is a secondary analysis of data from 129 participants from a randomized controlled trial conducted to determine the nurse-led intervention’s effect on cognitive and non-cognitive functions and serum TNF-alpha levels in patients receiving chemotherapy for colorectal cancer at Tata Memorial Hospital. The Pittsburgh Sleep Quality Index was used to collect data on sleep quality. The study also explored potential reasons for the reported poor sleep quality in the selected cohort. Results: The prevalence of poor sleep quality was approximately 60%. Sleep was primarily affected due to poor sleep latency and sleep efficiency. Also, women were more likely to experience issues related to sleep. Patients did not consider it a significant issue to report to their treating physicians and nurses. Factors contributing to poor sleep quality included financial concerns, child-rearing responsibilities, and anxiety about disease outcomes. Conclusion: Cancer patients do experience poor sleep quality, and it is crucial to assess and address this issue promptly to prevent adverse responses to cancer therapy, which can lead to increased morbidity and mortality.

Assessment of sleep parameters in adults with persistent post-concussive symptoms

ObjectivesThe primary aim of this study was to characterize sleep in adults with persistent post-concussive symptoms (PPCS). Secondary aims explored relationships between sleep parameters, injury characteristics, and symptom questionnaires. MethodsThis case-controlled, cross-sectional study recruited adults (18–65yrs) diagnosed with PPCS and age and sex-matched controls. Participants wore a wrist-worn actigraph for 3–7 nights and completed daily sleep diaries. Participants completed questionnaires examining daytime sleepiness, fatigue, anxiety/depressive symptoms, and sedentariness. Sleep parameters were compared between groups using Mann-Whitney U tests. Secondary analyses used two-way ANOVA and Spearman's rank correlations. ResultsFifty adults with PPCS (43.7 ± 10.6yrs, 78 % female) and 50 controls (43.6 ± 11.0yrs) were included in this study. Adults with PPCS had significantly longer sleep onset latency (PPCS 16.99 ± 14.51min, Controls 8.87 ± 6.44min, p < 0.001) and total sleep time (PPCS 8.3 ± 1.0hrs, Control 7.6 ± 0.9hrs, p = 0.030) compared to controls, but woke up later (PPCS 7:57:27 ± 1:36:40, Control 7:17:16 ± 0:50:08, p = 0.026) and had poorer sleep efficiency (PPCS 77.9 ± 7.5 %, Control 80.8 ± 6.0 %, p = 0.019) than controls. Adults with PPCS reported more daytime sleepiness (Epworth Sleepiness Scale: PPCS 8.70 ± 4.61, Control 4.28 ± 2.79, p < 0.001) and fatigue (Fatigue Severity Scale: PPCS 56.54 ± 12.92, Control 21.90 ± 10.38, p < 0.001). Injury characteristics did not significantly affect sleep parameters in adults with PPCS. Actigraphy parameters were not significantly correlated to questionnaire measures. ConclusionSeveral actigraphy sleep parameters were significantly altered in adults with PPCS compared to controls, but did not correlate with sleep questionnaires, suggesting both are useful tools in characterizing sleep in PPCS. Further, this study provides potential treatment targets to improve sleep difficulties in adults with PPCS.

Sleep deficiency and symptoms of pain, fatigue, and depressed mood in youth with and without childhood systemic lupus erythematosus.

We undertook a study to describe and compare sleep deficiency and symptoms of pain, fatigue, and depressed mood in youth with childhood systemic lupus erythematosus (cSLE) to a healthy comparison group of youth and test the associations between sleep and symptoms of pain, fatigue, and depressed mood in youth with cSLE. Forty-three youth (23 youth with cSLE; 20 age- and sex-matched healthy youth) wore actigraphs and completed sleep diaries for 10 days and completed self-report questionnaires on sleep quality, pain, fatigue, and depressed mood. On average, both groups had a total sleep time of less than 7 hours. Youth with cSLE had worse sleep efficiency (73.3%) and sleep regularity index scores (55.4) compared to the healthy comparison group of youth (79.2% and 60.1, respectively). Youth with cSLE had worse pain (P = .03) and fatigue (P = .004) compared to the healthy comparison group. Negative associations were found among self-reported sleep quality, sleep satisfaction, and symptoms of pain, fatigue, and depressed mood in youth with cSLE and wake after sleep onset was positively associated with fatigue. Poor sleep efficiency and sleep irregularity accompanied by symptoms of pain, fatigue, and depressed mood was prevalent in youth with cSLE. Youth with lupus should be encouraged to maintain a regular sleep schedule. Because this is the first study to incorporate objective sleep and sleep regularity measures in youth with cSLE, additional studies with objective and self-reported sleep measures are needed to replicate our findings. Wi D, Palermo TM, Stevens A, Ward TM. Sleep deficiency and symptoms of pain, fatigue, and depressed mood in youth with and without childhood systemic lupus erythematosus. J Clin Sleep Med. 2024;20(10):1607-1614.

Association between the Dietary Inflammatory Index and Sleep Quality among Lebanese University Students.

Objective The association between sleep quality and overall health has been extensively examined. However, few studies have investigated the relationship between sleep and the inflammatory potential of the diet. Thus, the purpose of the present study was to explore the association between the scores on the Energy-Adjusted Dietary Inflammatory Index (E-DII) and sleep quality in Lebanese university students. Materials and Methods We conducted a cross-sectional study with students attending the Tripoli campus of Beirut Arab University. A total of 270 students aged between 17 and 25 years were randomly selected. All students filled out a multicomponent questionnaire that included an assessment of their sleep quality using the Pittsburg Sleep Quality Index, and of their physical activity level using the short version of the International Physical Activity Questionnaire. The scores on the E-DII were calculated based on a validated food frequency questionnaire. Results Individuals in the highest (most proinflammatory) quartile of the E-DII were at an increased risk of having poor overall sleep quality compared with the lowest quartile (odds ratio [OR] = 2.86; 95% confidence interval [95%CI]: 1.27-6.44). Regarding the individual domains of sleep quality, subjects in quartiles 3 and 4 of the E-DII were at an increased risk of having poor sleep efficiency compared with those in quartile 1 (OR = 2.49; 95%CI: 1.12-5.54; and OR = 2.52, 95%CI: 1.13-5.62 respectively). However, individuals in quartile 3 were at a reduced risk of having daytime dysfunction compared with those in the lowest quartile (OR = 0.44; 95%CI: 0.23-0.83). Conclusion The inflammatory potential of the diet seems to be related to sleep quality in our sample of Lebanese university students. Future prospective studies are required to further explore this association.

Delivering a sleep intervention across a youth mental health service using non-expert practitioners: A service evaluation.

Poor sleep is highly prevalent in young people and increases risk of mental health difficulties, yet access to sleep interventions remains limited. This paper evaluates the use of a sleep intervention delivered by non-expert practitioners in a secondary care youth mental health service. Assistant psychologists were trained to deliver a six-session 1:1 cognitive-behavioural sleep intervention adapted for use with young people with mental health difficulties. A within-subject design assessed clinical outcomes relating to sleep (Insomnia Severity Index), psychological distress and personal goals (Goal Based Outcome Measures) at four time points. High referral, intervention take-up (82.82%) and completion (70%) rates were reported, together with high baseline levels of insomnia (Insomnia Severity Index mean 20.47, SD 3.68) and poor sleep efficiency (56.36%, SD 17.23). Fifty-six young people (average age 19.2 years, SD 3.25) were included in the outcome analysis. Statistically and clinically significant improvements were seen across all outcome measures, with 68% no longer meeting clinical threshold (ISI ≥15) for insomnia at endpoint. This study demonstrates exceptionally high levels of clinical need and engagement with a sleep intervention adapted specifically for young people with mental health difficulties. Whilst limited by the uncontrolled design, large improvements in insomnia and psychological distress support its effectiveness and utility in clinical settings. More robust implementation and evaluation is warranted in broader youth mental health services to promote earlier access.

0895 Greater Sleep Reactivity and Poorer Sleep Efficiency Are Associated with Increased Medical Expenditures

0895 Greater Sleep Reactivity and Poorer Sleep Efficiency Are Associated with Increased Medical Expenditures

Suboptimal self-reported sleep efficiency and duration are associated with faster accumulation of brain amyloid beta in cognitively unimpaired older adults.

This study investigated whether self-reported sleep quality is associated with brain amyloid beta (Aβ) accumulation. Linear mixed effect model analyses were conducted for 189 cognitively unimpaired (CU) older adults (mean±standard deviation 74.0±6.2; 53.2% female), with baseline self-reported sleep data, and positron emission tomography-determined brain Aβ measured over a minimum of three time points (range 33.3-72.7 months). Analyses included random slopes and intercepts, interaction for apolipoprotein E (APOE) ε4 allele status, and time, adjusting for sex and baseline age. Sleep duration<6hours, in APOE ε4 carriers, and sleep efficiency<65%, in the whole sample and APOE ε4 non-carriers, is associated with faster accumulation of brain Aβ. These findings suggest a role for self-reported suboptimal sleep efficiency and duration in the accumulation of Alzheimer's disease (AD) neuropathology in CU individuals. Additionally, poor sleep efficiency represents a potential route via which individuals at lower genetic risk may progress to preclinical AD. In cognitively unimpaired older adults self-report sleep is associated with brain amyloid beta (Aβ) accumulation.Across sleep characteristics, this relationship differs by apolipoprotein E (APOE) genotype.Sleep duration<6hours is associated with faster brain Aβ accumulation in APOE ε4 carriers.Sleep efficiency< 65% is associated with faster brain Aβ accumulation in APOE ε4 non-carriers.Personalized sleep interventions should be studied for potential to slow Aβ accumulation.

P422 Prevalence of poor sleep quality assessed by wrist actigraphy and sleep questionnaire in Inflammatory Bowel Disease patients and its association with disease activity and quality of life

Abstract Background An association between active inflammatory bowel disease (IBD) and poor sleep quality has been proposed, however studies evaluating both subjective and objective assessment of disease activity and sleep quality are limited. Our study aimed to investigate the prevalence of poor sleep quality assessed by wrist actigraphy and sleep questionnaires in IBD patients and its association with disease activity and quality of life. Methods A prospective observational study was conducted in Siriraj Hospital, Mahidol University, Bangkok, Thailand from March 2021 to December 2022. Eligible IBD patients were categorized into remission, mild, and moderate-to-severe groups, based on standard clinical disease activity scores. Demographic data, inflammatory markers, inflammatory bowel disease questionnaire (IBDQ), sleep questionnaire (Pittsburgh Sleep Quality Index, PSQI), and seven-day sleep data from wrist actigraphy (Actiwatch®, CamNtech, Cambridge, United Kingdom) were obtained. The prevalence of sleep disorder and group comparison were analyzed. Results Eighty-four participants (40 Crohn’s disease, 44 UC), consisting of 60 remission, 16 mild, and 8 moderate-to-severe disease activity, were enrolled. Baseline demographic data were comparable between each group. Lower hemoglobin and albumin levels, and higher serum C-reactive protein, and fecal calprotectin levels were found in the more clinically active groups (table1). Fifty patients (60%) had poor sleep defined by PSQI &amp;gt; 5 with a trend to be higher in the group with active symptoms (57% in remission, 63% in mild, and 75% in moderate-to-severe group, p=0.31). Using actigraphy, the group with moderate-to-severe symptoms tended to have longer sleep latency, more frequently awake after sleep, and poorer sleep efficiency than the other groups (Figure 1). Patients with more severe disease activity had poorer quality of life with a mean IBDQ of 190 in remission, 159 in mild, and 134 in moderate-to-severe group (p&amp;lt;0.001). Conclusion Poor sleep quality is common among IBD patients, even those with clinical remission. Those with more severe symptoms had poorer sleep quality and worse quality of life. Sleep assessment and treatment should be integrated into IBD standard clinical care.

Sleep Efficiency and Sleep Onset Latency in One Saskatchewan First Nation.

Sleep efficiency and sleep onset latency are two measures that can be used to assess sleep quality. Factors that are related to sleep quality include age, sex, sociodemographic factors, and physical and mental health status. This study examines factors related to sleep efficiency and sleep onset latency in one First Nation in Saskatchewan, Canada. A baseline survey of the First Nations Sleep Health project was completed between 2018 and 2019 in collaboration with two Cree First Nations. One-night actigraphy evaluations were completed within one of the two First Nations. Objective actigraphy evaluations included sleep efficiency and sleep onset latency. A total of 167 individuals participated, and of these, 156 observations were available for analysis. Statistical analysis was conducted using logistic and linear regression models. More females (61%) than males participated in the actigraphy study, with the mean age being higher for females (39.6 years) than males (35.0 years). The mean sleep efficiency was 83.38%, and the mean sleep onset latency was 20.74 (SD = 27.25) minutes. Age, chronic pain, ever having high blood pressure, and smoking inside the house were associated with an increased risk of poor sleep efficiency in the multiple logistic regression model. Age, chronic pain, ever having anxiety, heart-related illness, and smoking inside the house were associated with longer sleep onset latency in the multiple linear regression model. Sleep efficiency and sleep onset latency were associated with physical and environmental factors in this First Nation.

Salivary Cortisol and Melatonin, Sleep, and Behavioral Patterns in Older Adults Living With Dementia.

Over half of the older adults living with dementia have behavioral and psychological symptoms of dementia (BPSD), including sleep disturbance; however, little is known about physiological markers. Salivary cortisol and melatonin have been identified as potential biomarkers of BPSD, with evidence suggesting a relationship between these biomarkers and various behavioral factors, as well as sleep and activity patterns. The aim of this study was to investigate the time-dependent changes in salivary cortisol and melatonin levels in older adults with dementia, their relationship with the sleep-wake cycle, and their correlation with BPSD symptoms and behavioral factors. This observational study conducted in Seoul and Gyeonggi-do, South Korea, used data from 172 older adults with dementia, measuring sleep and activity patterns for 2 weeks using a wearable device, in addition to administering questionnaires for neuropsychiatric and psychological symptoms-the Neuropsychiatric Inventory, Cohen-Mansfield Agitation Inventory, and Cornell Scale for Depression in Dementia. Salivary cortisol and melatonin levels were measured at four time points and divided into four groups based on a dual-trajectory model. Differences among the groups were analyzed using one-way analysis of variance. The participants showed normal but heterogeneous patterns of salivary cortisol and melatonin levels. Dual-trajectory pattern analysis showed that higher levels of melatonin during the daytime were correlated with poor nighttime sleep efficiency and decreased disinhibited behaviors, and higher levels of cortisol at all four time points were associated with decreased physical activity. Measuring and analyzing periodic changes in cortisol and melatonin levels can predict various behavioral symptoms (e.g., sleep disturbances, activity counts, and disinhibition) in older adults with dementia. A study with an experimental design is needed to discover the direct physiological interactions between cortisol, melatonin, and these symptoms.

Attentional Control Accounts for the Association Between Anxiety Sensitivity and Sleep Efficiency in Clinic-Referred Youth.

Youth with anxiety disorders report difficulty falling asleep and returning to sleep after sleep onset (i.e., poor sleep efficiency). Anxiety sensitivity, the excessive attention to physical symptoms of anxiety and their threatening interpretations, has been linked to poor sleep efficiency. We tested a conceptual model wherein attentional control, attentional focusing and attentional shifting would account for the relationship between anxiety sensitivity and poor sleep efficiency. 255 youths (6-17years old, 78% Hispanic/Latino) who presented to a university-based research clinic completed measures on anxiety sensitivity, sleep, and attentional control. Poorer sleep efficiency was significantly correlated with higher anxiety sensitivity and lower attentional control, attentional focusing, and attentional shifting. Higher anxiety sensitivity was significantly correlated with lower attentional control and attentional focusing. Attentional control and attentional focusing, not attentional shifting, accounted for the relationship between anxiety sensitivity and poor sleep efficiency. These findings identify attentional control and attentional focusing as variables that may explain the association between anxiety sensitivity and sleep efficiency in youth.

Field Survey Analysis of CO2 Concentration and Its Impact on Sleep Efficiency in University Dormitory

This study aims to investigate the impact of carbon dioxide (CO2) levels on sleep efficiency in university dormitories. The quality of the indoor environment, including CO2 concentrations, can significantly influence the health and comfort of dormitory occupants. Poor sleep efficiency can lead to long-term cognitive disturbances and health problems. Therefore, understanding the relationship between CO2 levels and sleep efficiency in the university dormitory environment is crucial to improving the living conditions of students. The study was carried out through field surveys at Diponegoro University Dormitory. The real-time CO2 data in the rooms was measured using a logger monitoring device. In addition, the sleep efficiency of the students was evaluated using sleep tracking devices and sleep journals filled out by the participants. Other data, such as ventilation rates and room temperature, were also collected as determinants of environmental quality. The results of the analysis revealed a significant association between CO2 levels (665.33 ± 207,20 ppm) and sleep efficiency (86,71 ± 3,11 %). High levels of CO2 were found to be associated with lower sleep efficiency, leading to sleep disturbances and irregular sleep patterns. Other environmental factors, such as ventilation rates, were also relevant to sleep efficiency.

Suboptimal sleep efficiency and duration predict faster cognitive decline in cognitively unimpaired older adults

AbstractBackgroundResearch indicates a role for suboptimal sleep, in cognitive ageing. An increasing, though inconsistent body of evidence has associated aspects of suboptimal self‐reported sleep quality with poorer cognitive performance. The current study investigated whether self‐reported sleep quality parameters predict the slope of domain specific cognitive performance.MethodParticipants were drawn from the Australian Imaging, Biomarkers and Lifestyle study of ageing. Linear mixed effect model (LMM) analyses were conducted on 525 cognitively unimpaired, older adults (M = 74.1, SD = 5.5, 56.4% female), characterised by apolipoprotein E (APOE) ε4 status, with baseline self‐reported sleep characteristics. Comprehensive cognitive assessments were conducted over a minimum 3 timepoints (range 29.64 ‐ 98.16 months). All models included random slopes, random intercepts, interaction effects for time, and APOE ε4 carriage, with each model adjusted based on the model of best fit for each cognitive outcome variable of interest.ResultFollowing Bonferroni correction, sleep duration &lt;6 hours and sleep efficiency &lt;65% in the whole cohort, and in APOE ε4 non‐carriers, forecasted accelerated decline in attention and speed of processing. In the same groups, greater sleep efficiency (%) forecasted greater preservation within the attention and speed of processing domain. No associations were observed for other sleep variables or cognitive domains of interest.ConclusionThese findings suggest a role for self‐reported suboptimal sleep efficiency and duration in the early stages of cognitive decline, represented by declining attention and speed of processing performance, in cognitively unimpaired individuals. Additionally, short sleep duration and poor sleep efficiency may increase future risk of cognitive decline independent of APOE ε4 carriage. Our findings also suggest the potential utility of self‐report screening for sleep efficiency and duration as a marker for increased risk of declining attention and speed of processing performance. Individuals with suboptimal sleep may benefit from an intervention to improve sleep efficiency and duration to lessen future risk of cognitive decline.

The influence of baseline sleep on exercise‐induced cognitive change in older adults: A randomised clinical trial

AbstractBackgroundObservational studies consistently demonstrate that physical activity is associated with enhanced cognitive function and reduced risk for dementia. However, there remains significant heterogeneity in study findings regarding the effect of exercise interventions on cognitive function. Individual variation in sleep behaviours are hypothesized to be a source of this variability in the effectiveness of exercise to influence cognition, however this has not yet been investigated. Thus, the current study aimed to 1) investigate the influence of a 6‐month exercise intervention on sleep pre‐ and post‐intervention and 2) investigate whether baseline sleep measures moderate exercise‐induced cognitive changes.MethodWe utilised data from the Intense Physical Activity and Cognition (IPAC) study (n = 89), a 6‐month moderate intensity and high intensity exercise intervention, in cognitively normal community‐dwelling older adults aged 60‐80 years (68.76 ± 5.32). Exercise was supervised and completed on a stationary exercise bicycle, and cognitive function was measured using a comprehensive neuropsychological battery administered pre‐ and post‐intervention. Sleep was measured using the Pittsburgh sleep quality index (PSQI) to yield measures of sleep duration, efficiency, and sleep latency.ResultThere was no effect of the exercise intervention on any sleep outcomes from pre‐ to post‐intervention. There was a significant moderating effect of baseline sleep efficiency on both episodic memory and global cognition within the moderate intensity exercise group (β = ‐0.024, SE = 0.008, p = .004; β = ‐0.011, SE = 0.005, p = .036), such that those with poorer sleep efficiency at baseline showed greater exercise‐induced cognitive improvements.ConclusionThese results indicate that those with poorer sleep may have the greatest exercise‐induced cognitive benefits and that baseline sleep behaviours may be an important source of heterogeneity in previous exercise interventions targeting cognitive outcomes.