Rest-activity Rhythm Research Articles

Sex and the Clock: Exploring Sex Differences in Chronotype and Circadian Preferences Among Cognitively Healthy Older Adults.

This study aimed to compare objective circadian rest-activity-rhythm (RAR) measures with self-reported circadian behavior and morning-evening preference in cognitively healthy older men and women. A total of 129 participants (ages 65-90) completed the Horne & Ostberg Morning-Eveningness Questionnaire (MEQ) and the Circadian Type Inventory (CTI) to assess their morning-evening preference and circadian traits, including rigidity, vigor, languidness, and flexibility. These subjective measures were compared to objective actigraphy data from a sub-cohort of 70 individuals who wore actigraphy watches for 24 hours a day over a 7-day period. Rest-activity rhythm variables were derived from the actigraphy data and analyzed. The results revealed sex differences in circadian behavior. Languid and flexible men (higher CTI scores) had significantly higher depression scores (GDS, p = 0.045) and showed more evening preference (MEQ, p = 0.007) compared to their vigorous and rigid counterparts, while no significant differences were found in women. Actigraphy data showed that men had less stable (interdaily stability, IS, p = 0.030) and more fragmented (interdaily variability, IV, p = 0.001) circadian rhythms than women. A significant association was found between acrophase time and CTI-FR scores (β = -0.406, p < 0.001), with earlier acrophase times linked to more rigid circadian rhythms. Additionally, earlier acrophase times and morningness preference were associated with faster information processing speeds (IPS, p = 0.018). These findings suggest that circadian behaviors and their impact on mood and cognition are more pronounced in older men than women, highlighting the value of actigraphy in assessing circadian profiles and sex differences in aging.

The association of 24-hour behavior rhythms with stroke among American adults with prediabetes/diabetes: evidence from NHANES 2011–2014

BackgroundEmerging evidence suggests that circadian rhythms play a role in the regulation of cardiovascular diseases (CVDs). We aim to examine the relationship between the 24-hour behavior rhythms (activity-rest and feeding-fasting rhythms) and stroke.MethodsThe study included 3201 adult participants with prediabetes/diabetes from the National Health and Nutrition Examination Survey (NHANES) 2011–2014. The 24-hour behavior rhythm indices were calculated using data from accelerometer wearable device and dietary recall for two nonconsecutive days. Six indices were calculated including interdaily stability (IS), intradaily variability (IV), relative amplitude (RA), average activity during the least active continuous 5-hour period (L5), Average activity during the most active continuous 10-hour period (M10) which reflects the activity-rest rhythm, and feeding rhythm score which reflects the feeding-fasting rhythm. These continuous variables were divided into quintiles for logistic regression models.ResultsComparing participants in quintile 1, those in quintile 5 of IS and RA exhibited a lower odds of stroke. Conversely, participants in quintile 5 of IV, L5, and L5 start time demonstrated a higher odds of stroke. Furthermore, participants in quintile 5 of feeding rhythm score had a significantly lower odds of stroke. The associations of IV and feeding rhythm score with stroke were more pronounced in participants with diabetes compared to those with prediabetes/diabetes. No significant associations were observed between other 24-hour behavior rhythms and stroke.ConclusionsOverall, this study highlights a significant association between 24-hour behavior rhythm and stroke in American adults with prediabetes/diabetes.

The effects of COVID-19 lockdown and reopening on rest-activity rhythms in Singaporean working adults: A longitudinal age group comparison study

Study objectivesCOVID-19 mobility restrictions disrupted daily rhythms worldwide, but how this rhythm disruption differs across age groups is unclear. We examined the course of age-related differences in trajectories of rest-activity rhythm during the COVID-19 pandemic lockdown and reopening in Singapore. We also evaluated the association of these patterns with mental well-being. Methods24-hour step count data (Fitbit) were obtained from 617 younger (age range: 21-40) and 602 older adults (age range: 55-70) from January 2020 (baseline) through lockdown (April 2020) and reopening periods until August 2021. Nonparametric rest-activity rhythm metrics: interdaily stability, intradaily variability and most active 10-hour period (M10) were computed. Longitudinal changes in rest-activity rhythm, age-related differences in changes, and the associations between mental well-being and these changes were assessed using nonlinear latent-growth models. ResultsIn younger adults, mobility restrictions during lockdown caused significant decline in interdaily stability and M10, alongside significant increase in intradaily variability. However, in older adults, changes were confined to increased intradaily variability and decreased M10. Older adults also showed less change in intradaily variability and M10 compared to younger adults. Gradual recovery of rest-activity rhythm metrics during reopening was observed, with interdaily stability and M10 remaining lower after 15months post-lockdown. In younger but not older adults, a larger decline in interdaily stability was associated with poorer mental well-being 15months post-lockdown. ConclusionYounger adults appear more vulnerable than older adults to mobility restrictions as reflected in their rest-activity rhythm metrics. A significant disruption of daily routine may have long-lasting effects on younger adults’ mental well-being. Statement of significanceAlthough stringent mobility restrictions imposed to curb the spread of COVID-19 were imposed primarily to protect older adults, we found that younger adults were more vulnerable to rhythm disruption arising from mobility restrictions. Disrupted rhythm stability was associated with poorer mental well-being 15months after the lockdown ended in younger but not older adults. These asymmetric long-term effects on mental health on younger relative to older adults should be kept in mind when planning for large-scale catastrophes linked to mobility restrictions.

Sex Differences in the Association Between 24-hour Rest-Activity Rhythms and Frailty Among U.S. Older Adults: Findings from NHANES 2011-2014.

Little is known as to how rest-activity rhythms (RAR) are associated with frailty and how this relationship differs by sex. This study examined the relationship between RAR and frailty in a nationally representative sample of US older adults, focusing on the moderating role of sex. 2,531 participants aged ≥60yrs [Females:55.2%; Frail:5.15% (4.02-6.29); Pre-frail:33.49% (31.29-35.68)] were included using the 2011-2014 National Health and Nutrition Examination Survey. Non-parametric RAR parameters, including inter-daily stability (IS), intra-daily variability (IV), relative amplitude (RA), most active 10-h, and least active 5-h, were estimated from wrist-worn actigraphy data. Frailty status was assessed using a modified version of frailty phenotype (range:0-5): frail (≥3), pre-frail (1-2), and non-frail (0). Multinomial logistic regression models were used to examine the interest of associations, adjusting for potential confounders. Frail and pre-frail older adults exhibited significantly lower RA, IS, higher IV, and phase delay when compared to non-frail older adults (p's<.05). Particularly, older adults with low RA had significantly greater odds of being frail and pre-frail [aOR(95%CIs); Frailty:5.60(2.61-12.04); Pre-frailty:1.58(1.13-2.20)]. Significant sex-interaction was observed (p<.01), with this association being greater in females than in males [aOR(95%CIs); Females:7.78(2.98-20.30) for frailty, 2.31(1.60-3.32) for pre-frailty; Males:4.48(1.38-14.54) for frailty, 1.12(0.61-2.07) for pre-frailty]. Weakened RAR strength is unfavorably associated with frailty, particularly in females. RAR may be a useful indicator associated with frailty in older adults, but sex-specific differences should be considered. Further longitudinal research is necessary to investigate the bidirectionality of their association.

Abstract 4136762: Association Between Circadian Rest/Activity Rhythms and Incident Dementia in Older Adults: The Atherosclerosis Risk in Communities (ARIC) Study

Introduction: Alterations in circadian rest/activity rhythms (RARs) are common among older adults. RARs can be derived from accelerometry data and are routinely used as proxy measures. Evidence suggests that altered (e.g., fragmented, delayed) RARs may be risk factors for dementia. However, results have been mixed. Using data from the ARIC Study, a community-based cohort, we assessed the association between RARs and incident dementia. Methods: ARIC participants without dementia who wore the Zio XT ECG Patch in 2016-17 for &gt; 3 days were included. RARs were obtained from an accelerometer within the Zio XT ECG Patch and measures of interdaily stability (IS; consistency), intradaily variability (IV; fragmentation), and relative amplitude (RA; strength) were derived. Dementia cases were identified through 2020 using in-person and phone-based cognitive assessments, hospitalization discharge codes, or death certificates. Cox proportional hazards models were used. Results: Of the 2,183 participants (mean [SD] age 79 [4.5] years, 58% female, 24% identified as Black), 176 (8%) developed dementia. Median follow-up time was 3 years and mean Zio XT ECG Patch wear time was 12 days. After multivariable adjustment, lower RA and higher IV were associated with incident dementia (HRs [95% CIs] per 1-SD increment: 0.65 [0.56-0.76], 1.19 [1.02-1.38]). No significant association between IS and dementia was noted; however, there was an interaction by race (p=0.03). Stratified results were not significant, but effect estimates were in opposite directions: (HRs [95% CIs] per 1-SD increment in IS: 0.78 [0.59-1.02] in Black participants and 1.17 [0.96-1.41] in white participants, respectively). No interactions by sex or APOEε4 were noted (p&gt;0.10). Conclusion: In this community-based cohort of older adults, weaker circadian rhythm strength and fragmentation were associated with dementia risk. The association between IS and dementia may differ by race; however, this needs to be further examined in future research. Overall, measures of circadian RARs may be risk factors for dementia. Additional research is warranted to determine whether they can be novel targets for dementia prevention.

Changes in Rest-Activity Rhythms in Adolescents as They Age: Associations With Brain and Behavioral Changes in the ABCD Study.

Adolescents with disrupted rest-activity rhythms (RAR) including shorter sleep duration, later sleep timing and low physical activity levels are at a greater risk for mental and behavioral problems. However, it remains unclear whether the same associations can be observed for within-subject changes in RAR. Our longitudinal investigation on RAR used Fitbit data from the Adolescent Brain Cognitive Development (ABCD) Study at the 2-year (FL2: aged 10-13 years) and 4-year follow-up (FL4: aged 13-16 years). 963 youths had good-quality Fitbit data at both time points. In this study we examined changes in RAR from FL2 to FL4, their environmental and demographic contributors as well as brain and behavioral correlates. From FL2 to FL4, adolescents showed decreases in sleep duration and physical activity as well as delayed sleep timing (Cohen's d .44-.75). The contributions of environmental and demographic factors to RAR changes were greatest for sleep timing (explained 10% variance) and least for sleep duration (explained 1% variance). Delays in sleep timing had stronger correlations with behavioral problems including impulsivity and poor academic performance than reductions in sleep duration or physical activity. Additionally, the various brain measures differed in their sensitivity to RAR changes. Reductions in sleep duration were associated with decreased functional connectivity between subcortical regions and sensorimotor and cingulo-opercular networks and with enhanced functional connectivity between sensorimotor, visual and auditory networks. Delays in sleep timing were mainly associated with grey matter changes in subcortical regions. The current findings corroborate the importance of sleep and physical activity in adolescents' brain neurodevelopment and behavioral problems. RAR might serve as biomarkers for monitoring behavioral problems and be potential therapeutic targets for mental disorders in adolescents.

Phenotypes of sleep health among adults with chronic heart failure in a randomized controlled trial of cognitive behavioral therapy for insomnia

BackgroundPoor sleep contributes to adverse health in heart failure. However, studies are limited to isolated sleep characteristics. PurposesTo evaluate changes in sleep health phenotypes after cognitive behavioral therapy for insomnia or attention control and associations between sleep health phenotypes, symptoms, stress, functional performance, and emergency department visits and hospitalizations. MethodsSecondary analysis of a randomized controlled trial of cognitive behavioral therapy for insomnia among adults with heart failure. We measured sleep (rest-activity rhythms, sleep duration, quality, and efficiency, insomnia severity, daytime sleepiness), symptoms, cognitive ability, vigilance, and 6-minute walk distance at baseline and 3-, 6-, and 12-month postintervention and collected hospitalizations and emergency department visits. We used K-means cluster analysis and generalized linear mixed models, generalized estimating equations, and Cox proportional hazard models. ResultsAmong 166 participants (M age=63.2 (SD=12.6) years; 57% male; 23% New York Heart Association Class III/IV), there were four sleep health phenotypes (“Unstable Sleep” (15%); “Short Sleep” (39%); “Low Sleep Efficiency” (25%); and “Good Sleep” (21%)) at baseline. The healthiest phenotype was associated with the lowest fatigue. The proportions of participants in the healthiest sleep group increased from pre- to post-treatment. Low sleepiness (p = .0188) and a robust circadian quotient (p = .007) predicted transition to the healthiest phenotype. The poorest sleep phenotype at baseline predicted time to hospitalizations and emergency department visits (hazard ratios 0.35-0.60) after adjusting for covariates. ConclusionSleep phenotypes predict heart failure outcomes. Tailored interventions targeting phenotypes may be more effective than approaches that focus on single sleep characteristics.

Around the clock: unveiling giraffe rest-activity rhythms and social dynamics

Understanding the daily activity patterns and social dynamics of giraffes (Giraffa camelopardalis) is crucial for their management and conservation. In this study, a comprehensive 24-hour observational analysis of three female reticulated giraffes kept for three weeks at the Opel-Zoo in Kronberg, Germany, was conducted. Using infrared-sensitive cameras, the study captured behavioral data across baseline and two intervention phases involving changes in group composition. Social network analysis was performed using the Mantel test to assess changes in social interactions between day and night and across different study periods, while the MRQAP was applied to evaluate the influence of individual subtypes on the social structure. During the day, the giraffes exhibited a high level of activity, primarily engaging in walking, standing, and feeding behaviors. Diurnal resting was minimal, with sporadic lying phases. Night-time behavior was markedly different, with the giraffes spending most of the night lying down, interspersed with periods of feeding. The presence of a male giraffe during one intervention phase significantly altered diurnal activity patterns, increasing standing behaviors and decreasing feeding time. Social interactions, including nearest neighbor preferences, varied across day and night periods and changed with alterations in group composition. The study highlights the complexity of giraffe social dynamics and their adaptation to different social contexts. These findings provide valuable insights into the natural behavioral rhythms and social behaviors of giraffes, which are essential for effective zoo management and conservation strategies.

Disrupted rest-activity circadian rhythms are associated with all-cause mortality in patients with chronic kidney diseases

ABSTRACT Circadian rhythms are important biological contributors to health. Rest activity rhythms (RAR) are emerging as biomarkers of circadian behavior that are associated with chronic disease when abnormal. RAR have not yet been characterized in chronic kidney diseases (CKD). Leveraging the National Health and Nutrition Examination Survey (2011–2014), patients with CKD (n = 1114; Mean [95% CI]: Age, 50 [58–61] y; 52% female) were compared with non-CKD individuals (n = 5885; Age, 47 [46–48] y; 52% female). Actigraphy data were processed for RAR parameters including rhythmic strength (amplitude), the rhythm adjusted mean (mesor), the timing of peak activity (acrophase), activity regularity (inter-daily stability), and activity fragmentation (intra-daily variability). Cox regression was performed to assess RAR parameters for the prediction of all-cause mortality. Compared to non-CKD adults, patients with CKD had a lower rhythmic amplitude and mesor, and exhibited greater fragmentation and less day-to-day stability in RAR (ps < 0.001). Among CKD patients, a lower rhythmic amplitude (HR [95% CI]: 0.88 [0.82–0.96]; p < 0.001), a lower rhythm adjusted mean (0.87 [0.81–0.95]; p = 0.002), and a higher daily activity fragmentation (1.87 [1.10–3.18]; p = 0.023) were associated with an increased risk of all-cause mortality. Patients with CKD showed dampened rhythmic amplitudes and greater fragmentation of activity that were associated with a higher risk of all-cause mortality. These findings demonstrate a relationship between circadian disruption and prognosis in patients with CKD.

Associations between rest–activity/light-exposure rhythm characteristics and depression in United States adults: A population-based study

This cross-sectional study investigated the association between 24-hour rest-activity rhythm (RAR), light exposure rhythm (LER), and depression symptoms in American adults, using data from the National Health and Nutrition Examination Survey (2011–2014, N = 6852). RAR and LER characteristics were derived from a 24-hour activity recorder and analyzed using the extended cosine model, focusing on intradaily variability (IV), interdaily stability (IS), and relative amplitude (RA). Depression was assessed via the Patient Health Questionnaire-9 (PHQ-9).Multiple logistic and linear regression models showed that higher IV in RAR and LER were associated with increased depression risk (RAR-IV OR = 1.92 [95 % CI: 0.89–4.13]; LER-IV OR = 2.5 [1.45–4.30]), while higher IS and RA in both rhythms were linked to lower depression risk (RAR-IS OR = 0.22 [0.10–0.48], RAR-RA OR = 0.20 [0.11–0.37], LER-IS OR = 0.22 [0.10–0.49], LER-RA OR = 0.29 [0.15–0.56]). Participants in the highest tertile for IS and RA had a significantly lower depression risk compared to the lowest tertile. Subgroup analyses indicated interactions between age and RAR-IV, gender and LER-IV, and BMI and LER-RA (p-interaction < 0.05). Disruptions in RAR and LER are positively associated with depression, emphasizing the need for rhythm regulation interventions considering age, gender, and BMI factors.

Reliable measures of rest-activity rhythm fragmentation: how many days are needed?

BackgroundA more fragmented, less stable rest-activity rhythm (RAR) is emerging as a risk factor for health. Accelerometer devices are increasingly used to measure RAR fragmentation using metrics such as inter-daily stability (IS), intradaily variability (IV), transition probabilities (TP), self-similarity parameter (α), and activity balance index (ABI). These metrics were proposed in the context of long period of wear but, in real life, non-wear might introduce measurement bias. This study aims to determine the minimum number of valid days to obtain reliable fragmentation metrics.MethodsWrist-worn accelerometer data were drawn from the Whitehall accelerometer sub-study (age: 60 to 83 years) to simulate different non-wear patterns. Pseudo-simulated data with different numbers of valid days (one to seven), defined as < 1/3 of non-wear during both day and night periods, and with omission or imputation of non-wear periods were compared against complete data using intraclass correlation coefficient (ICC) and mean absolute percent error (MAPE).ResultsFive days with valid data (97.8% of participants) and omission of non-wear periods allowed an ICC ≥ 0.75 and MAPE ≤ 15%, acceptable cut points for reliability, for IS and ABI; this number was lower for TPs (two-three days), α and IV (four days). Overall, imputation of data did not provide better estimates. Findings were consistent across age and sex groups.ConclusionsThe number of days of wrist accelerometer data with at least 2/3 of wear time for both day and night periods varies from two (TPs) to five (IS, ABI) days for reliable RAR measures among older adults.

Attenuated melanopsin-mediated post-illumination pupillary response (PIPR) is associated with reduced actigraphic amplitude and mesor in older adults.

This study aimed to explore the relationship between post-illumination pupillary response (PIPR) with sleep and circadian measures in a community sample of healthy older adults. Eligible participants were invited to complete a one-week sleep diary, actigraphy and provide an overnight urine sample to measure urinary 6-sulfatoxymelatonin (aMT6s). PIPR was defined as the as the pupil constriction at 6s post-stimulus (PIPR-6s), and ii) for 30s beginning 10s after stimulus (PIPR-30s) normalized as a percentage to the baseline pupil diameter, after 1s of blue and 1s of red-light stimulus, respectively. The Net-PIPRs were reported by subtracting the PIPR to red stimulus from the PIPR to blue stimulus. The relationship between PIPR metrics to aMT6s and actigraphic rest-activity rhythm parameters was examined by generalized linear models. A total of 48 participants were recruited (Mean age: 62.6 ± 7.1 years, Male: 44%). Both Net PIPR-6s and Net PIPR-30s were significantly associated with actigraphic rest-activity amplitude (B=0.03, p=0.001 and B=0.03, p=0.01, respectively), and actigraphic rest-activity mesor (B=0.02, p=0.001 and B=0.03, p=0.004, respectively). Additionally, the Net PIPR-30s were positively associated with overnight aMT6s level (B=0.04, p=0.03), and negatively associated with actigraphic rest-activity acrophase (B=-0.01, p=0.004) in the fully adjusted models. Attenuated PIPR is associated with a reduced actigraphic amplitude and mesor. The reduced retinal light responsivity may be a potential pathway contributing to impaired photic input to the circadian clock and resulted in the age-related circadian changes in older adults.

Cognitive correlates of circadian rhythm and sleep-wake behaviour in chronic obstructive pulmonary disease patients

ABSTRACT Chronic obstructive pulmonary disease (COPD) patients often experience reduced physical activity, sleep disturbances, and cognitive impairment. However, reports on measurement of rest-activity rhythm and sleep-wake behavior and their impact on cognitive functions in COPD patients are limited. This study aimed to objectively measure circadian rhythms (rest-activity and ambient illuminance) and sleep behaviors in clinically stable COPD patients and their relationship with cognitive functions. The study involved 65 male COPD patients and 50 age-matched controls, monitored over 3–7 days using actigraphy. Cognitive status was assessed using the Montreal Cognitive Assessment (MoCA) followed by short interbal time estimation via time production and reproduction with reaction time measurement using TimeProd software. Findings indicated significant disruptions in circadian rhythms in COPD patients, characterized by lower mesor, amplitude, and autocorrelation coefficients compared to controls. Patients also reported poorer sleep quality and higher sleep fragmentation, with 85.7% displaying cognitive impairment. Notably, longer time estimations, increased variability in task performance, and slower reaction times suggested cognitive deterioration. Positive correlations emerged between rhythm parameters (amplitude and circadian quotient) and cognitive performance metrics. This highlights the relevance of circadian and sleep disturbances in COPD, suggesting that addressing these rhythms could help mitigate cognitive decline, potentially through chronotherapeutic strategies.

Association between rest-activity rhythm and diabetic retinopathy among US middle-age and older diabetic adults.

The disruption of circadian rhythm has been reported to aggravate the progression of diabetic retinopathy (DR). Rest-activity rhythm (RAR) is a widely used method for measuring individual circadian time influencing behavior. In this study, we sought to explore the potential association between RAR and the risk of DR. Diabetic participants aged over 40 from 2011-2014 National Health and Nutrition Examination Survey (NHANES) were enrolled. Data from the wearable device ActiGraph GT3X was used to generate RAR metrics, including interdaily stability (IS), intradaily variability (IV), most active 10-hour period (M10), least active 5-hour period (L5), and Relative amplitude (RA). Weighted multivariable logistic regression analysis and restricted cubic spline analysis were conducted to examine the association between RAR metrics and DR risk. Sensitivity analysis was also conducted to examine the robustness of the findings. An unsupervised K-means clustering analysis was conducted to identify patterns in IV and M10. A total of 1,096 diabetic participants were enrolled, with a DR prevalence of 20.53%. The mean age of participants was 62.3 years, with 49.57% being male. After adjusting covariates, IV was positively associated with DR (β: 3.527, 95%CI: 1.371-9.073). Compared with the lowest quintile of IV, the highest quintile of IV had 136% higher odds of DR. In contrast, M10 was negatively associated with DR (β: 0.902, 95%CI: 0.828-0.982), with participants in the highest M10 quintile showing 48.8% lower odds of DR. Restricted cubic spline analysis confirmed that these associations were linear. Meanwhile, sensitivity analysis confirmed the robustness. K-means clustering identified three distinct clusters, with participants in Cluster C (high-IV, low-M10) had a significantly higher risk of DR comparing with Cluster A (low-IV, high-M10). A more fragmented rhythm and lower peak activity level might be associated with an increased risk of DR. These findings indicate that maintaining a more rhythmic sleep-activity behavior might mitigate the development of DR. Further research is necessary to establish causality and understand the underlying mechanisms, and focus on whether interventions designed to enhance daily rhythm stability and increase diurnal activity level can effectively mitigate the risk of progression of DR.

Biobehavioral mechanisms underlying symptoms in cancer patients with chronic graft-versus-host disease

Chronic graft-versus-host disease (cGVHD) is a complication of allogeneic hematopoietic cell transplant (HCT) and is associated with morbidity and high symptom burden. This study evaluated two biobehavioral mechanisms, inflammation and circadian rest-activity rhythms, that may underly commonly reported psychological and physical symptoms in cGVHD patients. Adults with cGVHD (N=57) wore a wrist actigraph for 7 days, provided a blood sample, and completed patient-reported outcome (PRO) measures. 24-hour rest-activity indices were derived from actigraphy. Cytokines and chemokines relevant to cGVHD were measured in peripheral blood plasma using multi-analyte immunoassays. Multiple regression evaluated the extent to which rest-activity indices and inflammatory biomarkers predicted PROs. Higher levels of circulating IL-8 and MIP-1α were associated with worse depression (β = 0.35, p = 0.01; β = 0.33, p = 0.02) and sexual function (β = -0.41, p = 0.01; β = -0.32, p = 0.03). MIP-1α was associated with more severe insomnia (β = 0.36, p = 0.01). Higher circulating MIF was associated with more severe anxiety (β = 0.28, p = 0.048) and fatigue (β = 0.35, p = 0.02). Il-6, TNFα, and MCP-1 showed few associations with PROs. There were few associations between actigraphy indices and PROs; however, participants with a later daily activity peak (acrophase) reported poorer sexual function (β = -0.31, p = 0.04). Models covarying for age, cGVHD severity, and time since HCT yielded a similar pattern of results. Results suggest that pro-inflammatory cytokines and chemokines associated with cGVHD may contribute to PROs, identifying a biobehavioral mechanism that may be a useful target for future interventions.

Rest-Activity Rhythm Phenotypes in Adults with Epilepsy and Intellectual Disability.

Sleep and rest-activity rhythms (RARs) are perturbed in many forms of neuropsychiatric illness. In this study, we applied wrist actigraphy to describe the extent of RAR perturbations in adults with epilepsy and intellectual disability ("E+ID"), using a cross-sectional case-control design. We examined whether RAR phenotypes correlated with epilepsy severity, deficits in adaptive function and/or comorbid psychopathology. Primary caregivers of E+ID adults provided informed consent during routine ambulatory clinic visits and were asked to complete standardized surveys of overall epilepsy severity (GASE, Global Assessment of Severity of Epilepsy), adaptive function (ABAS-3, Adaptive Behavior Assessment System-3) and psychopathology (ABCL, Adult Behavior Checklist). Caregivers were also asked to ensure that subjects wore an Actiwatch-2 device continuously on their nondominant wrist for at least ten days. From recorded actograms, we calculated RAR amplitude, acrophase, robustness, intradaily variability (IV), interdaily stability (IS) and estimates of sleep quantity and timing. We compared these RAR metrics against those from (i) a previously published cohort of adults with epilepsy without ID (E-ID), and (ii) a cohort of age- and sex-matched intellectually able subjects measured within the Study of Latinos (SOL) Ancillary actigraphy study (SOL). Within E+ID subjects, we applied k-means analysis to divide subjects into three actigraphically distinct clusters. 46 E+ID subjects (median age 26 [20-68], 47% female) provided a median recording duration of 11 days [range 6-27]. Surveys reflected low to extremely low levels of adaptive function (ABAS3 General Adaptive Composite score: median 50 [49-75]), and low/subclinical levels of psychopathology (ABCL total score: median 54.5 [25-67]). Compared with E-ID (n=57) and SOL (n=156) cohorts, E+ID subjects displayed significantly lower RAR amplitude, robustness and IS, with significantly higher IV and total daily sleep. K-means clustering of E+ID subjects recognized an intermediate cluster "B", with RAR values indistinguishable to E-ID. Cluster "A" subjects displayed pronounced hypoactivity and hypersomnia with high rates of rhythm fragmentation, while cluster "C" subjects featured hyper-robust and high amplitude RARs. All three clusters were similar in age, body mass index, antiseizure medication (ASM) polytherapy, ABAS3 and ABCL scores. We qualitatively describe RAR examples from all three clusters. We show that adults with epilepsy and intellectual disability display a wide spectrum of RAR phenotypes that do not neatly correlate with measures of adaptive function or epilepsy severity. Prospective studies are necessary to determine whether continuous actigraphic monitoring can sensitively capture changes in chronobiological health that may arise with disease progression, iatrogenesis (e.g., ASM toxicity) or acute health deteriorations (e.g., seizure exacerbation, pneumonia). Similar long-term data is necessary to recognize whether behavioral interventions targeted to 'normalize' RARs may promote improvements in adaptive function and therapy engagement.

Sleep During the COVID-19 Pandemic: Longitudinal Observational Study Combining Multisensor Data With Questionnaires.

The COVID-19 pandemic prompted various containment strategies, such as work-from-home policies and reduced social contact, which significantly altered people's sleep routines. While previous studies have highlighted the negative impacts of these restrictions on sleep, they often lack a comprehensive perspective that considers other factors, such as seasonal variations and physical activity (PA), which can also influence sleep. This study aims to longitudinally examine the detailed changes in sleep patterns among working adults during the COVID-19 pandemic using a combination of repeated questionnaires and high-resolution passive measurements from wearable sensors. We investigate the association between sleep and 5 sets of variables: (1) demographics; (2) sleep-related habits; (3) PA behaviors; and external factors, including (4) pandemic-specific constraints and (5) seasonal variations during the study period. We recruited working adults in Finland for a 1-year study (June 2021-June 2022) conducted during the late stage of the COVID-19 pandemic. We collected multisensor data from fitness trackers worn by participants, as well as work and sleep-related measures through monthly questionnaires. Additionally, we used the Stringency Index for Finland at various points in time to estimate the degree of pandemic-related lockdown restrictions during the study period. We applied linear mixed models to examine changes in sleep patterns during this late stage of the pandemic and their association with the 5 sets of variables. The sleep patterns of 27,350 nights from 112 working adults were analyzed. Stricter pandemic measures were associated with an increase in total sleep time (TST) (β=.003, 95% CI 0.001-0.005; P<.001) and a delay in midsleep (MS) (β=.02, 95% CI 0.02-0.03; P<.001). Individuals who tend to snooze exhibited greater variability in both TST (β=.15, 95% CI 0.05-0.27; P=.006) and MS (β=.17, 95% CI 0.03-0.31; P=.01). Occupational differences in sleep pattern were observed, with service staff experiencing longer TST (β=.37, 95% CI 0.14-0.61; P=.004) and lower variability in TST (β=-.15, 95% CI -0.27 to -0.05; P<.001). Engaging in PA later in the day was associated with longer TST (β=.03, 95% CI 0.02-0.04; P<.001) and less variability in TST (β=-.01, 95% CI -0.02 to 0.00; P=.02). Higher intradaily variability in rest activity rhythm was associated with shorter TST (β=-.26, 95% CI -0.29 to -0.23; P<.001), earlier MS (β=-.29, 95% CI -0.33 to -0.26; P<.001), and reduced variability in TST (β=-.16, 95% CI -0.23 to -0.09; P<.001). Our study provided a comprehensive view of the factors affecting sleep patterns during the late stage of the pandemic. As we navigate the future of work after the pandemic, understanding how work arrangements, lifestyle choices, and sleep quality interact will be crucial for optimizing well-being and performance in the workforce.

Exploration of sleep quality and rest-activity rhythms characteristics in Bilateral Vestibulopathy patients

Sleep and circadian timing systems are constantly regulated by both photic and non-photic signals. Connections between the vestibular nuclei and the biological clock raise the question of the effect of peripheral vestibular loss on daily rhythms, such as the sleep-wake cycle and circadian rhythm. To answer this question, we compared the sleep and rest-activity rhythm parameters of 15 patients with bilateral vestibulopathy (BVP) to those of 15 healthy controls. Sleep and rest-activity cycle were recorded by a device coupling actimetry with the heart rate and actigraphy at home over 7 days. Subjective sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). Sleep efficiency and subjective sleep quality were significantly reduced, and sleep fragmentation was increased in BVP patients compared to controls. BVP patients displayed a damped amplitude of the rest-activity rhythm and higher sleep fragmentation, reflected by a higher nocturnal activity compared to controls. These results suggest that both rest-activity and sleep cycles are impaired in BVP patients compared to healthy controls. BVP patients seem to have greater difficulty maintaining good sleep at night compared to controls. BVP pathology appears to affect the sleep-wake cycle and disturb the circadian rhythm synchronization. Nevertheless, these results need further investigation to be confirmed, particularly with larger sample sizes.

The association between maternal sleep and circadian rhythms during pregnancy and infant sleep and socioemotional outcomes.

Studies have established that maternal sleep and circadian rhythm disturbances during pregnancy are associated with poor prenatal and perinatal outcomes for mothers and offspring. However, little work has explored its effects on infant sleep or socioemotional outcomes. The current study examined the relationship between maternal sleep and circadian rhythm disturbances during pregnancy and infant sleep and socioemotional outcomes in a diverse sample of N = 193 mothers and their infants (51% White; 52% Female; Mage = 11.95months). Maternal sleep and circadian rhythms during pregnancy were assessed using self-reports and actigraphy. Mothers reported on infants' sleep and socioemotional outcomes when infants were one year old. When controlling for infant sex, age, gestational age at birth, family income-to-needs ratios, and maternal depression, mothers who reported more sleep problems during pregnancy had infants with more sleep disturbances when they were one year old. Moreover, mothers who had later sleep timing (i.e., went to bed and woke up later, measured via actigraphy) during pregnancy had infants with more dysregulation (e.g., increased feeding difficulties, sensory sensitivities) and externalizing problems, and mothers with increased intra-daily variability in rest-activity rhythms (as measured via actigraphy) had infants with more externalizing problems. Findings suggest that maternal sleep and circadian rhythm disturbances during pregnancy may be a risk factor for infant sleep problems and socioemotional difficulties.

Improvement of social frailty is associated with stability of nonparametric characteristics of the rest-activity rhythm and improvement of the usual walking ability in the elderly

ABSTRACT Our study, conducted between April 2022 and January 2024, was aimed at clarifying components of the rest-activity rhythm (RAR) involved in improvement of social frailty state before or after a 3-month multi-component exercise intervention in the elderly. Participants were recruited from the general population in Akita prefecture, Japan. We administered a four-item social frailty screening questionnaire to classify the severity of social frailty in each participant before and after the 3-month intervention. The RAR parameters were measured on an Actiwatch Spectrum Plus device worn by the subjects for 7 continuous days. As the final sample, 65 participants classified into the improved/maintained group (n = 36) or the deteriorated group (n = 29) according to the change in the social frailty classification after the intervention were included in the analysis. The results of a binomial logistic regression analysis showed significantly higher values of interdaily stability (IS) and usual walking speed at the post-test after the intervention. Based on our findings, we propose that stability of the rest-activity rhythm related to synchronization with external stimuli (such as social effect and physical activity) might have clinical impact on improvement of social frailty state in elderly community-dwellers.