Risk Of Sleep Disturbances Research Articles

Association between Sleep Quality and Personality Based on the Big Five Factor Model in a Non-clinical Sample

Introduction. Sleep is essential for maintaining health, well-being, and functionality. The personality traits of the Five Factor Model (FFM) have proven promising as determinants of sleep quality. Objective. To explore the relationship between personality traits and sleep quality in a Brazilian sample by testing a predictive model based on multiple linear regression. Method. The study involved 447 adult participants (with an average age of 37.7 years), who completed an online survey including the following instruments: a sociodemographic questionnaire, the Pittsburgh Sleep Quality Index (PSQI-BR), the Patient Health Questionnaire (PHQ-4), and the Big Five Inventory (BFI). Participants were selected through social media advertisements calling for volunteers for a study on sleep quality. Results. The regression model revealed that age, educational attainment, family income, BMI, neuroticism, and psychopathological symptoms were predictors of sleep quality. The gender, conscientiousness, extraversion, and agreeableness variables were not predictors of sleep quality in the multivariate analysis. Discussion and conclusion. The study emphasizes the role of neuroticism in predicting sleep quality over other personality traits. Additionally, the results suggest that the risk of or protection against the development of anxiety and depressive symptoms is a key mechanism linking personality traits to sleep. These findings can therefore contribute to identifying individuals at risk for sleep disturbances and developing health intervention strategies.

The mediating role of sleep disturbance in the relationship between depression and cardiovascular disease.

Studies suggest that both depression and disrupted sleep disturbance are linked to cardiovascular disease (CVD). However, the precise role of sleep disturbance in the connection between depression and CVD is poorly understood. Therefore, we sought to examine the associations among these factors and further explore the mediating role of sleep disturbance in the association between depression and CVD. This study included data from 29,831 adults (≥20 years old). Multifactorial logistic regression analyses were conducted to examine the relationships among depression, sleep disturbance, and CVD. Additionally, bootstrap tests were used to investigate whether the association between depression and CVD was mediated by sleep disturbance. Our research showed that individuals who experienced depression or sleep disturbance had a notably greater likelihood of developing CVD than those who did not have these issues (depression: OR: 2.21, 95% CI=1.96-2.49; sleep disturbance: OR: 1.74, 95% CI=1.6-1.9). Even after adjusting for potential confounders, depression was still positively associated with the risk of sleep disturbance (OR: 4.07, 95% CI=3.73-4.44). Furthermore, sleep disturbance significantly mediated the association between depression and CVD, with a mediating effect of 18.1%. Our study demonstrated that depression, sleep disturbance, and CVD are interrelated. The increased risk of CVD among patients with depression may be attributed to the mediating role of sleep disturbance. This finding underscores the importance of interventions focused on sleep disturbances as a means to address the connection between depression and CVD.

0192 Sleep Hygiene and Self-Efficacy for Sleep Hygiene among Good and Poor Sleepers: A Secondary Analysis

Abstract Introduction College students are at risk for sleep disturbances that may influence academic performance and cognitive function. Poor sleep hygiene and sleep quality over time results in inadequate sleep and daytime sleepiness, which, if not addressed, eventually leads to sleep deprivation and adverse health effects. The current study aims to identify if sleep hygiene practices and self-efficacy relate to poor and good sleepers categorized according to the Pittsburg Sleep Quality Index (PSQI) Score > or < 5) among a sample of college students. Methods Secondary analysis of baseline data from college student participants aged 18-26 from an intervention study was used. All participants completed demographic, sleep hygiene, and sleep quality assessments. (e.g., Sleep hygiene index [SHI], Self-efficacy for sleep hygiene inventory [SHESHI], and PSQI). Descriptive statistics were calculated for demographic, sleep quality, and sleep hygiene variables. Results The sample (n=119) included 15 Freshmen, 30 Sophomores, 52 Juniors, and 21 Seniors, of which 26 were male and 93 female college students. The total sample mean age=20.6 y +2.0, range: 18-26; 82.4% were White, 55% worked part-time, and 69.8% considered themselves night owls. Data were examined to determine if poor and good sleepers differed across key demographic variables. There were no statistically significant differences between the groups. The sample comprised 47.0 % (n=56) poor sleepers and 52.9% (n=63) good sleepers. A Mann-Whitney U test was run to determine if there were differences in self-efficacy scores and sleep hygiene practices between poor and good sleepers. Mean rank self-efficacy scores for poor sleepers (44.15) were significantly lower than for good sleepers (74.09), U=876, z = -4.725, p <.001. Mean rank sleep hygiene index scores for poor sleepers (76.05) were significantly higher than good sleepers (45.73) U=865, z = -4.793, p <.001. Conclusion Preliminary descriptive findings highlight significant characteristics of sleep hygiene efficacy in college students with good and poor sleep. All surveys were subjective measures. Future use of an objective measure of actual sleep time and sleep health index would add to an understanding of sleep issues in college students. Support (if any) N/A

What is the Role of Computer Game Addiction in the Sleep Disturbance Risk Among Children of COVID Lock Down? A Cross-sectional Study

What is the Role of Computer Game Addiction in the Sleep Disturbance Risk Among Children of COVID Lock Down? A Cross-sectional Study

A daily-level, within-person examination of emotion regulation as a mediator of the relationship between sleep and behavior in youth

ObjectiveYouth who experience behavioral and emotional problems are at risk for sleep disturbance, while sleep disturbance also perpetuates behavioral and emotional problems. While the relationship between sleep and psychopathology in clinical mental health samples is well-established, exploration of the underlying mechanisms maintaining this relationship is limited. The purpose of this study is to explore within-person variability in emotion regulation as a mechanism of the relationship between sleep and psychopathology in a clinical youth sample.MethodsUsing a within-person design, 25 children (ages 6–11; 64% male; 44% non-Hispanic White) presenting to outpatient behavioral health treatment with mental health concerns were recruited to participate in a 14-day study. Daily reports of objective sleep duration via actigraphy, self-reported subjective sleepiness, and parent-reported internalizing and externalizing problems and emotion regulation were collected. Multilevel mediation analyses were used to examine the mediating effect of emotion regulation on the daily-level relationship between sleep and behavior problems.ResultsAt the within-person level, emotion dysregulation was a significant mediator of the relationships between objective sleep duration and both externalizing [MCCI (0.0005–0.0063)] and internalizing problems [MCCI (0.0001–0.0025)]. Contrary to hypotheses, when youth slept more than usual, internalizing and externalizing problems were worse through the indirect effect of increased emotion dysregulation.ConclusionsInconsistencies in schedules and routines, even if in a positive direction, may have short-term negative consequences for youth with emotional and behavioral concerns. Future research should look to address sleep variability and how deviations in routine may impact behavior more broadly, through the indirect effects of emotion regulation.

Sleep disturbances in parental caregivers and patients with congenital central hypoventilation syndrome.

Congenital central hypoventilation syndrome (CCHS) is a rare disease characterized by impaired control of breathing caused by paired-like homeobox 2B (PHOX2B) gene variants, necessitating lifelong assisted ventilation (AV). This study aimed to assess sleep quality in patients with CCHS and their parents using sleep questionnaires. Parents of patients with CCHS completed the Pittsburgh Sleep Quality Index (PSQI) regarding their sleep and the Sleep Disturbance Scale for Children (SDSC) regarding their child's sleep. Twenty participants completed the questionnaires. The median (interquartile range) ages of the parents and patients were 41.5 (38.5-51.5) and 11.5 (7.4-16.7) years, respectively. The median (interquartile range) PSQI and SDSC scores were elevated at 6.5 (4-10) and 41.5 (34-51.5), respectively, suggesting that parents and patients with CCHS can experience sleep disturbances and poor sleep quality. There were no significant differences in SDSC (P = 1.0) and PSQI (P = .76) scores for AV with or without tracheostomy. Similarly, there were no significant differences in SDSC (P = .22) and PSQI (P = .34) scores based on PHOX2B genotypes. There was a moderately strong, significant, and positive correlation between the CCHS SDSC scores and parental PSQI scores (r = .48, P = .03), suggesting that sleep disturbances in patients with CCHS were associated with poor parental sleep quality. There was no difference in the median parental sleep duration between those with and without nighttime home nursing (P = .09). Patients with CCHS and their parents are at risk for sleep disturbances regardless of their AV modality and PHOX2B genotype. In addition to AV management, patients with CCHS and their parents should be assessed for sleep disturbances. Finch CE, Leu RM, Harford K-L, Westbrook AL, Kasi AS. Sleep disturbances in parental caregivers and patients with congenital central hypoventilation syndrome. J Clin Sleep Med. 2023;19(3):549-554.

Factors related to the mental health of nursing students during the fourth wave of COVID-19 in Vietnam

Background: During the COVID-19 pandemic, all health workforces, including nursing students, were mobilized to prevent the spread of the disease. The physical and mental health of frontline healthcare workers has been shown to have several adverse effects during the COVID-19 outbreak. However, few studies analyzed the mental health of nursing students participating in COVID-19 prevention, especially in Vietnam. Objective: The study was to identify and analyze the mental health of students and its related factors during the fourth wave of COVID-19 in Vietnam. Methods: A cross-sectional survey was conducted among 672 nursing students participating in COVID-19 in Ho Chi Minh City, Vietnam, from September to October 2021. Self-administered and online-based surveys were used to collect data using Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9),and the Insomnia Severity Index. Descriptive statistics and logistic regression were done for data analysis using R 3.6.0 software. Results: Among our participants, the proportion of depression symptoms, anxiety symptoms, and insomnia were 2.88%, 5.1%, and 4.33%, respectively. Students who had physical activity habits before involvement in COVID-19 and maintained physical activity while participating in the epidemic had lower symptoms of anxiety, depression, and the risk of sleep disturbances. Furthermore, students with healthy diet status had fewer negative consequences on their mental health. Conclusions: Our findings provided evidence for organizations strategizing to preserve the emotional health of nursing students while engaging in the COVID-19 campaign.

Gene–environment interaction between circadian clock gene polymorphisms and job stress on the risk of sleep disturbances

Sleep disturbances was associated with numerous adverse health outcomes. Many studies have reported that long-term exposure to job stress can lead to sleep disturbances, which may be influenced by genetic and environmental factors. This cross-sectional study investigated whether circadian clock gene polymorphisms modulated the influence of job stress on sleep disturbances in a Chinese Han population, which to our best knowledge has not been explored. The Effort-Reward Imbalance (ERI) scale and the Pittsburgh Sleep Quality Index (PSQI) were both used to access job stress and sleep disturbances. The SNaPshot SNP assay was carried out by screening for circadian clock gene polymorphisms in every participant. Interactions associated with sleep disturbances were assessed by linear hierarchical regression analysis and SPSS macros (PROCESS). Linear hierarchical regression analysis showed that job stress was significantly related to sleep disturbances. Likewise, our study found a significant effect of PER2 rs2304672 polymorphisms on sleep disturbances (p < 0.01), after controlling for confounding factors. In addition, the PER2 rs2304672 genotype modulated the relationship between job stress and sleep disturbances (β = 0.414, p = 0.007). Interestingly, further analysis of the results of the PER2 gene rs2304672 × job stress interaction showed that rs2304672 G-allele carriers had a high-risk effect on sleep disturbances under high job stress. Our results suggest that the PER2 rs2304672 polymorphism may modulate the influence of job stress on sleep disturbances. These findings contribute to the field of sleep disturbances prevention and treatment.

Sleep Disorder Prevalence and Influencing Factors in Children with Cerebral Palsy

Children with cerebral palsy are considered a population at risk for sleep disturbance. Various factors can cause sleep disorders in children with cerebral palsy. This study investigates the relationship between endogenous factors and sleep disorders in children with cerebral palsy. It was a cross-sectional analytical study using randomized sampling on children with cerebral palsy who met the inclusion criteria for the period of May–August 2017. The location of the study was special schools in the Bandung area, Indonesia. All participants were screened with the Sleep Disturbances Scale for Children (SDSC) questionnaire to determine the prevalence of period of sleep disorders. Data analysis was then performed using the unpaired t test to compare the characteristics of two variables with a p value≤0.05 considered statistically significant. Sixty-six subjects aged 8–14 years were recruited. The results showed that the prevalence of sleep disorders was 67% (32 children), with insomnia as the most common type of sleep disorder (39%). There was a significant association between motor disabilities type and sleep disorders (p≤0.05). The most common type of sleep disorder in children with cerebral palsy is insomnia. In conclusion, there is a relationship between motor disability type and sleep disorders in cerebral palsy children.

Sleep Phenotypes of Caregivers for Persons Living With Dementia

Sleep disturbance is prevalent among caregivers of people living with dementia. Gaps exist regarding when caregivers begin to experience sleep disturbance along their caregiving trajectory. This study aimed to identify and describe phenotypes of current caregivers’ sleep patterns before and during caregiving and describe caregivers’ perception of their current sleep quality relative to their pre-caregiving sleep. We conducted semi-structured interviews with 19 caregivers participating in a larger, randomized controlled trial. Interviews were about caregivers’ sleep patterns and were conducted after caregivers completed the first 6 months of the study. Interviews were audio-recorded using a videoconferencing platform and ranged from 20 to 45 minutes. We conducted thematic analysis of the interview transcripts. Four distinct caregiver-sleep phenotypes emerged from the qualitative data: Changed and Dissatisfied, Changed and Satisfied, Unchanged and Dissatisfied, and Unchanged and Satisfied. Caregivers whose sleep was categorized as Changed experienced a difference in their pre-caregiving sleep, usually from good to poor sleep. Caregivers whose sleep was Unchanged had poor sleep pre-caregiving and continued to have poor sleep during caregiving. Caregivers also reported being Satisfied or Dissatisfied with their current sleep pattern, defined in terms of daily distress and impairment. These 4 subtypes highlight the heterogeneity of caregivers’ sleep experiences and debut a useful clinical framework with which to identify, categorize, and target caregivers at risk for sleep disturbance. Identifying caregivers’ sleep phenotypes will enable healthcare providers to determine caregivers’ needs and readiness for interventions.

Risk Factors of Sleep Disturbance in Older Adults With Dementia: An Actigraphy-Based Validation Study

Sleep disturbance is a common and significant symptom experienced by older adults with dementia. Early detection and timely treatment of sleep disturbance are critical to prevent adverse consequences including decreased quality of life for persons with dementia and increased caregiver burden. While direct observations and sleep diaries are often unreliable, actigraphy is a cost-effective method in measuring sleep problems in older adults with dementia and provides reliable and rich sleep data. Therefore, this study aimed to examine sleep disturbance objectively measured by actigraphy and its risk factors in community-dwelling older adults with dementia in Korea. This is a prospective study consisting of a two-wave dataset. The model was fitted using Wave 1 data (n=151) and then validated using Wave 2 data (n=59). Independent variables were demographics, cognitive and physical function, depressive symptoms, physical activity level, and neuropsychiatric symptoms measured by Neuropsychiatric Inventory(NPI), and clinical factors including dementia type, sedative use, and comorbidities. Sleep disturbance was defined as less than six nighttime sleep hours and sleep efficacy less than 75%. Using the Youden’s Index, the sample was dichotomized into sleep disturbance group (n=83) and sound sleep group (n=68). The results of the generalized linear mixed model showed that the risk factors for sleep disturbance included vascular dementia, age, step count, and having three neuropsychiatric symptoms (i.e., delusions, depression, and disinhibition). Individuals with dementia at risk for sleep disturbance should be identified to prioritize early prevention strategies and individualized interventions. Particularly, management of delusion, depression, disinhibition is critical in preventing disturbed sleep.

Sleep disturbance and anxiety symptom among public during the second wave of COVID-19 in Beijing: A web-based cross-sectional survey

PurposeThe global coronavirus disease 2019 (COVID-19) epidemic has significantly impacted people's lives. This study aimed to examine the influence of the unexpected second wave of COVID-19 on sleep quality and anxiety of Chinese residents in Beijing in June 2020, compared with the initial outbreak at the beginning of 2020, and to investigate the associated factors. MethodsUsing a web-based cross-sectional survey, we collected data from 1,511 participants. assessed with demographic information, sleep quality and anxiety symptoms. The participants were asked to compare their recent sleep and sleep during the first outbreak. The Zung's Self-rating Anxiety Scale (SAS) was used to assess their current insomnia severity. Multivariable logistic regression models were used to analyze the association between COVID-19 epidemic and risk of sleep disturbance and anxiety symptom. ResultsThe overall prevalence of sleep disturbance and anxiety symptoms were 50.8% and 15.3% respectively. People had significantly shorter sleep duration during the second wave of COVID-19(7.3 ± 1.3) h than the first outbreak (7.5 ± 1.4)h (p < 0.001). During the second outbreak, people were less concerned about infection and more concerned about financial stress and occupational inferference. Beijing residents did not have significant differences in sleep disturbance and anxiety compared with other regions, nor were occupations and nucleic acid testing associated risk factors. Home quarantine, health administrators, history of insomnia and anxiety-depression were significantly associated with sleep disturbance. Female gender, home quarantine, history of insomnia and anxiety-depression were significantly associated with anxiety. ConclusionHigh prevalence of sleep disturbance and depression symptom was common during the second wave of COVID-19 crisis in Beijing. Home quarantine and previous history of insomnia and anxiety-depressive risk factors were associated with sleep disturbance and anxiety. Female gender was impacting predictor of anxiety. We need continuous assessment of the sleep quality and anxiety symptoms of this epidemic.

Sleep Habits of Early School-Aged Children with Type 1 Diabetes and Their Parents: Family Characteristics and Diabetes Management

ABSTRACT Study Objectives School-aged children with type 1 diabetes (T1D) and their parents are at risk for sleep disturbances, yet few studies have used objective measures to assess sleep characteristics in young children with T1D. Methods Forty children (ages 5–9) with T1D and their parents wore actigraph watches and completed sleep diaries for 7 nights. Parents also completed questionnaires about demographic information, diabetes distress, fear of hypoglycemia, and family routines. Children’s clinical data (HbA1c and blood glucose data) were extracted from the medical record. Results Most of the children and their parents obtained insufficient sleep. Based on actigraphy data, children slept an average of 7.9 hours/night and parents slept 6.7 hours/night, below the recommendations of 9–11 and 7–9 hours of sleep, respectively. Shorter child sleep latency was significantly associated with better glycemic levels, and parents’ sleep duration and efficiency were related to child’s glycemic levels. Parental fear of hypoglycemia and lack of family routines were associated with poorer sleep quality in parents and children, and with parental diabetes distress. Conclusions Sleep duration and quality is a modifiable target for potentially improving glycemic levels and parental distress in early school-aged children with T1D.

622 Bedtime, Sleep Duration, and Sleep Quality as Predictors of Externalizing Symptoms in Children in Foster Care

Abstract Introduction A strong association between sleep disturbances and externalizing symptoms has been found among school-aged children. In particular, there is a known association between sleep disturbances, irritability, emotional dysregulation, and hyperactivity (e.g., Coto et al., 2018). Limited research, however, has examined this association in a high-risk population of children, such as those in foster care who are at increased risk for sleep disturbances due to heightened exposure to trauma. Thus, the following study sought to assess the association between sleep quality and externalizing symptoms in a population of children in foster care. Methods Caregivers with children ages 4–11 were sampled from private Facebook community foster care groups across the United States (n = 410). Caregivers were provided a link to a survey powered by Qualtrics where they were asked to report on the children under their care’s weekday bedtime, overall sleep quality (e.g., “Please rate your child’s overall sleep quality over the last two weeks”), and sleep onset (e.g. “On weekdays, how long does it usually take for your child to fall asleep?”). Child behavioral issues were assessed via the Eyberg Child Behavior Inventory (ECBI) Parent Rating Form. Results A linear regression model was utilized to assess if child weekday bedtime, weekday total sleep duration, and overall sleep quality were unique predictors of externalizing symptoms when controlling for age. Results suggest that weekday sleep duration and bedtime were not significant unique predictors of child behavioral issues, though were significantly and positively correlated at the bivariate level (p=.02, p=.04). Sleep onset and overall sleep quality, irrespective of child age, were found to be significant unique predictors of child behavioral issues and accounted for 1% and 11% of the total variance, respectively. Conclusion Results suggest that delayed sleep onset and poorer sleep quality were predictive of increased behavioral issues for children in foster care. Findings persisted when controlling for age, which suggests that children in foster care experiencing sleep disturbances may benefit from more behaviorally focused sleep interventions to improve externalizing behaviors and increase sleep health. Support (if any):

Effect of COVID-19 lockdown on noise pollution levels in an Indian city: a case study of Kanpur.

Noise pollution is an emerging environmental threat, prolonged exposure of which can cause annoyance, sleep disturbance, hypertension, psychiatric disorders, and also hormonal dysfunction. Among all the sources of noise pollution, the noise generated by road vehicle traffic significantly affects the quality of urban environments. Concerning the recent imposition of COVID-19 societal lockdown, this study attempts to investigate the impacts of COVID-19 lockdown on the changes in noise pollution levels before, during, and after lockdown phase in different residential, commercial, industrial, and silence zones of the city of Kanpur, India. Utilizing data collected from portable environmental sensors, the average noise levels before lockdown and during lockdown were found to be in the range of 44.85 dB to 79.57 dB and 38.55 dB to 57.79 dB, respectively, for different zones. Although a significant reduction in the noise levels was observed during lockdown, except for commercial zone, all other monitoring stations had reported sound levels quite higher than the recommended noise limits set by the Central Pollution Control Board (CPCB) of India. Results further indicated that the impact of road traffic noise on risk of high annoyance and sleep disturbance was found to be lower during lockdown as compared to that of pre-lockdown and unlock phase. While the annoyance level in residential (86.23%), industrial (87.44%), and silence (84.47%) was higher in pre-lockdown period, it reduced to 41.25, 50.28, and 43.07% in the lockdown phase. Even the risk of sleep disturbance in the residential zone was found to reduce from 37.96% during pre-lockdown to 14.72% during lockdown phase. Several noise mitigation strategies are also proposed, which may indeed pave the way for devising noise control measures in the local and regional level.

Irregular Work Hours and the Risk of Sleep Disturbance Among Korean Service Workers Required to Suppress Emotion.

Although a necessity in a modern society, irregular work schedule can lead to sleep problems. We investigated the effect of work schedule irregularity on sleep disturbance of 17,846 Korean service workers using the fifth Korean Working Conditions Survey. The odds ratio (OR) and 95% confidence interval (CI) for sleep disturbance occurrence were calculated through a multiple logistic regression model. The adjusted ORs for moderate and severe sleep disturbances for those with irregular work hours were 2.11 (95% CI 1.90–2.33) and 3.10 (95% CI 2.62–3.66), respectively. Work schedule irregularity and emotion suppression at work showed synergistic effect on both moderate and severe sleep disturbances. Sleep disturbances can lead to brain function deterioration and work-related injuries; therefore, appropriate measures should be addressed for the vulnerable population.

Associations of Long-Term Exposure to Ambient Air Pollution, Physical Activity and Insomnia in China's Adults

Background: Insomnia is linked with poor quality of life and many adverse health outcomes. Air pollution is a potential environmental risk for sleep disturbance. However, the evidence is very limited in China. On the other hand, physical activity (PA) is a preventive behavior that can improve insomnia, but whether PA mitigates the negative impact of air pollution on insomnia is unknown. Therefore, we examined the association between air pollution and insomnia, as well as PA’s modification effect of on this association. Methods: We obtained data from the baseline of China Multi-Ethnic Cohort (CMEC) survey, conducted from 2018 to 2019. We included 70668 respondents (out of 99,556). We assessed insomnia symptoms using any of the following self-reported symptoms, 1) difficulty initiating sleep or staying asleep, 2) waking up early in the morning, and 3) taking medication to help with sleep. Using satellite data, we estimated the residence-specified, three-year average PM1, PM2.5, PM10 (particulate matter with aerodynamic diameters of ≤1 μm, ≤2.5 μm and 10 μm, respectively), O3 (ozone), and NO2 (nitrogen dioxide) concentrations. We established the associations between air pollutants and insomnia symptoms through logistic regression. We evaluated the modification impact of total and domain-specific PA (leisure, occupation, housework, transportation) by introducing an interaction term into the model. Findings: After adjusting for potential confounders, we found that long-term exposure to PM1, PM2.5, PM10, and O3 is significantly associated with insomnia symptoms, with ORs (95% confidence interval [CI]) of 1.09 (1.03-1.16), 1.11 (1.07-1.15), 1.07 (1.05-1.10) and 1.15 (1.11-1.20), respectively. As total PA increased, the ORs of air pollution for insomnia tended to decrease and then rise. We observed varying modification effects of domain-specific PA. Transportation PA generally had no significant modification impact on the association between air pollution and insomnia. With an increase in leisure PA, the ORs for PM2.5 and PM10 significantly declined. However, we detected increased ORs of air pollutants in relation to insomnia among participants with higher levels of occupational and housework PA. Interpretation: Long-term exposure to higher concentrations of PM1, PM2.5, PM10, and O3 increases the risk of insomnia symptoms. Moderate to high levels of leisure PA alleviate the harmful effects of air pollution on insomnia, while high levels of occupation and housework PA intensify the effects. Funding Statement: The National Key Research and Development Program of China (Grant No. 2017YFC0907303), the Sichuan Science and Technology Program (Grant No. 2019YFS0274), and the National Natural Science Foundation of China (Grant No. 81773548). Declaration of Interests: The authors declare that they have no conflicts of interests. Ethics Approval Statement: We received approval from the Sichuan University Medical Ethical Review Board (K2016038).

Cardio-vascular risk factors according to different profiles of night work and shift work

Abstract Background The shift-night work concerns around 17% workers in our modern society with evident need of this type of organisation for productivity and economic reasons for the companies. if the impact of this global organisation pattern on cardiovascular disease or risk factors is more and more documented, it remains unclear which types of rotating or night work are really involved and which are the impact on cardiovascular risk of being exposed currently or in the past to these different types of shift-night work. Purpose To study possible relationships between arterial blood pressure, anthropometric markers, fasting biomarkers, and sleep disturbances, and different exposure profiles of night work and/or shift work. Methods A cross-sectional study was conducted among 65.126 workers aged 18–70 at baseline in the French random population-based Constances cohort. Four exposure groups were defined: (1) workers with current permanent night work, (2) current night shift workers 3x8, (3) day workers with past night and/or shift work, (4) day workers without night and/or shift work during their work history (reference group). Logistic regression models adjusted for age, sex, socio-economic position, and personal history of ischemic cardiovascular disease (CVD) were performed to assess associations between clinical risk markers for CVD at baseline and these exposure groups. Results Compared with the reference group, current and past night workers had a significant higher risk of obesity (Body Mass Index≥30). Permanent night workers had a significant higher risk of metabolic syndrome, mostly due to abdominal obesity, hypertriglyceridemia (&amp;gt;1.7 mmol/l) and low level of high density lipoprotein. Even if day workers with past night/shift work had no statistically significant over-risk of metabolic syndrome, they presented significantly higher risks for the same three criteria as observed for the permanent night workers. However, only hypertriglyceridemia was significantly more frequent among 3x8 workers. Among current night workers, 3x8 had a higher risk of sleep disturbances while permanent had not. Sleep disturbances over-risk was also observed among day workers with past night/shift work. No over-risk of hypertension, hypercholesterolemia, hyperglycemia, and elevated levels of gamma-glutamyl-transferase was observed among the three groups. Conclusion The results support the need for enhanced cardiovascular follow-up of workers exposed to night and/or shift work. However, it is also necessary to follow regularly and specifically current day workers with a past night and/or shift work history. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): INRS: institut National de Recherche et de Sécurité

Changes in effort-reward imbalance at work and risk of onset of sleep disturbances in a population-based cohort of workers in Denmark

Objective/backgroundAssociations between exposure to effort-reward imbalance at work (eg, high time pressure/low appreciation) and risk of sleep disturbances have been reported, but the direction of the effect is unclear. The present study investigated changes in effort-reward imbalance and risk of concomitant and subsequent onset of sleep disturbances. MethodsParticipants with sleep disturbances at baseline were excluded. We included participants from a population-based cohort in Denmark (n = 8,464, 53.6% women, mean age = 46.6 years), with three repeated measurements (2012 (T0); 2014 (T1); 2016 (T2)). Changes in effort-reward imbalance (T0-T1) were categorized into ‘increase’, ‘decrease’ and ‘no change’. Self-reported sleep disturbances (difficulties initiating or maintaining sleep, non-restorative sleep, daytime tiredness) were dichotomized (presence versus absence). We regressed concomitant (T1) and subsequent (T2) sleep disturbances on changes in effort-reward imbalance (T0-T1) and calculated odds ratios (OR) and 95% confidence intervals, adjusted for sex, age, education and cohabitation. ResultsAt follow-up, 8.4% (T1) and 12.5% (T2) reported onset of sleep disturbances. Increased effort-reward imbalance was associated with concomitant sleep disturbances (T1) (OR = 3.16, 2.56–3.81), whereas decreased effort-reward imbalance was not (OR = 1.22, 0.91–1.63). There was no association between increased effort-reward imbalance and subsequent sleep disturbances (T2) (OR = 1.00, 0.74–1.37). Results were similar for men and women. ConclusionsIncreased effort-reward imbalance was associated with a three-fold higher risk of concomitant onset of sleep disturbances at two-year follow-up, but not subsequent onset of sleep disturbances at four-year follow-up, indicating that changes in effort-reward imbalance have immediate rather than delayed effects on sleep impairment. It is possible that the results from the two-year follow-up were to some extent affected by reverse causality.

Comorbid Sleep Disturbance in Adolescents with Functional Abdominal Pain

ABSTRACT Objective/Background Sleep disturbances have been commonly reported as comorbid in youth with pain conditions, but prior research specific to functional abdominal pain (FAP) is limited. This study describes individual factors associated with increased risk for sleep disturbance and characterizes the relationship between sleep disturbance and pain-related variables. Participants Participants included 278 adolescents (age 11 to 17 years, M age = 15 years; 89% Caucasian; 65% female) with FAP. Methods Participants reported on sleep disturbances, abdominal pain severity, functional disability, somatic symptoms, and healthcare utilization. Results Female adolescents reported greater sleep disturbance than male adolescents (t(276) = 5.52, p < .001, Cohen’s d = 0.70) and increased age was associated with greater sleep disturbance (r =.20, p =.001). In hierarchical regressions controlling for age, sex, and abdominal pain, greater sleep disturbance was significantly associated with greater functional disability (β =.32), non-gastrointestinal somatic symptoms (β =.35), and emergency department visits (β =.29). Conclusions Results suggest that sleep disturbance is common and should be assessed in youth presenting with FAP and may be a potential target for intervention.