Self-report Measures Of Sleep Quality Research Articles

Deficits in brain default mode network connectivity mediate the relationship between poor sleep quality and anxiety severity.

Chronic insomnia disorder (CID) is a prevalent sleep disorder that frequently cooccurs with anxiety. The association between insomnia and anxiety has been established; however, the neurobiological basis of this relationship remains unclear. This study aimed to investigate the neural markers of CID patients with and without anxiety and to determine whether specific neural connectivity mediates the relationship between insomnia and anxiety. This study included 180 participants, comprising CID patients with anxiety (CID-A), CID patients without anxiety (CID-NA), and good sleep controls. All participants completed self-reported measures of sleep quality and anxiety severity and underwent functional magnetic resonance imaging. Brain functional integration was measured using functional connectivity density (FCD) and resting-state functional connectivity (rsFC). Correlation and mediation analyses were used to examine the relationships among brain connectivity, sleep quality, and anxiety severity. The CID-NA and CID-A groups showed decreased local FCD in the medial prefrontal cortex (mPFC) and disrupted rsFC between the precuneus and other brain regions. Only the CID-A group exhibited altered long-range FCD in the precuneus and the rsFC between the anterior default mode network (DMN, e.g. mPFC) and posterior DMN (e.g. precuneus). Mediation analysis revealed DMN dysconnectivity underlying the association between poor sleep quality and anxiety symptoms. This study identified shared and distinct brain circuit disruptions in the CID-NA and CID-A groups, with deficits in DMN connectivity as a potential neural mechanism through which disrupted sleep augments anxiety. These findings may facilitate the development of personalized therapies for insomnia and associated anxiety problems.

0958 Use of a Hybrid Mattress Improves Objective and Perceived Sleep Outcomes

Abstract Introduction Previous research has shown that comfort, including comfort of the sleep surface, is essential to sleep quality. In addition to comfort, the structure and firmness of a mattress may also play a role when it comes to sleep quality. More empirical research is needed to establish the impact of particular mattresses on both objective and self-reported measures of sleep quality. This study compared sleep on a hybrid mattress to participants’ prior sleep on their original mattress. Methods Healthy adults (81% female, ages 25-67) who reported sleeping hot participated in a 10-week field study, using a pre-post intervention design. During the 4-week baseline period, participants used their regular mattress at home. During the 4-week intervention period, which occurred following a 2-week adjustment period, they used a Serta iSeries mattress at home. This hybrid mattress includes materials designed to help the user feel cool. Sleep was measured objectively using SleepScore Max every night and by daily and pre-post self-report. Multilevel regression and paired t-tests were used to test for statistical significance. Results There were over 1,400 nights of tracked sleep across 39 participants. Objective sleep measurements showed increased time in bed (+10 minutes, p=.001) and total sleep time (+14 minutes, p=.002), as well as increased REM, both in duration (+6 minutes, p=.004) and proportion of the night (p=.023). Improvements also were observed in two objective sleep quality measures: SleepScore (p=.002) and MindScore (p=002). Self-report measures revealed that the hybrid mattress felt cooler (p<.001) and more comfortable (p<.001). Improvements also were found for a variety of perceived sleep outcomes, including time to fall asleep, waking less often, spending less time awake, longer sleep duration, better sleep quality, and feeling more rested in the morning (ps<.05). Conclusion Objectively-measured sleep and self-reported sleep improved when using the hybrid mattress compared to healthy adults’ original mattresses. Furthermore, qualitative and quantitative self-report results suggested that the intervention was perceived as comfortable and felt cool. These perceptions likely are what led to more time in bed, which in turn led to the key sleep improvements. Support (if any) Mattress Firm INC

0960 Use of an Innerspring Mattress Improves Deep Sleep and WASO

Abstract Introduction Previous research has shown that comfort, including comfort of the sleep surface, is essential to sleep quality. In addition to comfort, the structure and firmness of a mattress may also play a role when it comes to sleep quality. More empirical research is needed to establish the impact of particular mattresses on both objective and self-reported measures of sleep quality. This study compared sleep on an innerspring mattress to participants’ prior sleep on their original mattress. Methods Healthy adults (68% female, ages 23-69) participated in a 10-week field study, using a pre-post intervention design. During the 4-week baseline period, participants used their regular mattress at home. During the 4-week intervention period, which occurred following a 2-week adjustment period, they used a Sleepy’s by Sealy mattress at home. Sleep was measured objectively using SleepScore Max every night and by daily and pre-post self-report. Multilevel regression and paired t-tests were used to test for statistical significance. Results There were over 757 nights of tracked sleep across 18 participants. Objective sleep measurements showed decreased WASO, both in duration (-13 minutes, p=.024) and proportion of the night (p=.025). Also, there was an increase in deep sleep (+12 minutes, p=040). Self-report measures revealed that the innerspring mattress felt more comfortable (p<.001). Improvements also were found for a variety of perceived sleep outcomes, including time to fall asleep, waking less often, spending less time awake, longer sleep duration, better sleep quality, and feeling more rested in the morning (ps<.05). Conclusion Objectively-measured sleep and self-reported sleep improved when using the innerspring mattress compared to healthy adults’ original mattresses. Furthermore, qualitative and quantitative self-report results suggested that the intervention was perceived as comfortable. Support (if any) Mattress Firm INC

0652 Subjective and objective sleep disturbances in individuals with psychotic disorders and their first-degree relatives

Abstract Introduction Sleep disturbances commonly precede or precipitate psychotic disorders. The primary goals of the present study are to compare self-reports of sleep quality and chronotype with objective measurements and to investigate their relations with clinical symptoms and psychotic-like experiences (PLEs) in early course, minimally treated patients with psychotic disorders (PSY), their young, first-degree relatives (familial high risk: FHR) and matched controls. Methods Seventy-three participants (13-35 yrs, n(PSY)=19, n(Controls)=30, n(FHR)=24) completed self-report measures of sleep quality (PSQI), chronotype (MEQ) and PLEs (Chapman Scales). Sleep quality and chronotype were objectively measured with actigraphy (average duration of measurements: 12 days). Psychosis and FHR groups were rated on the Positive and Negative Syndrome Scale (PANSS) by an expert clinician. Results PSQI was significantly different between the groups (F(2,67)= 11.8, p< .001), this reflected that compared to controls, both the psychosis (p<.001) and FHR (p=002) groups had worse self-reported sleep quality. For objective sleep quality, we observed a main effect of day-to-day variability in total sleep time (F(2,46)= 3.24, p=.048) , with significantly higher variability in PSY than controls (p= .038). Symptom severity in PSY and FHR correlated with PSQI (r=.31, p=.047), reflecting that those with higher psychotic symptoms had more sleep disturbances. PLEs in the entire sample also correlated with PSQI (r=.41, p<.001). We did not observe any correlations between objective sleep quality and symptoms. There were no group differences in chronotype (subjective or objective). Chronotype did not correlate with symptoms or PLEs. Conclusion While both early-course patients and their first-degree relatives report significant sleep disturbances, objective measurements corroborate this only for day-to-day variability in sleep duration in the patient group. Further, symptom severity and PLEs correlate only with subjective sleep disturbances. These findings highlight the importance of objective assessment of sleep quality in this population and are in line with our polysomnography work that reveals an isolated deficit in NREM sleep in the context of similar sleep duration and architecture in psychosis. Support (if any) K01 MH114012 (Baran)

Loneliness and problematic social networking sites use in young adults with poor vs. good sleep quality: The moderating role of gender

Despite the evidence of a relationship between loneliness, problematic social networking sites use (PSNSU), and sleep quality, associations between specific PSNSU symptoms and loneliness in individuals with poor vs. good sleep quality and possible gender differences have yet to be understood. We examined the relationships between loneliness and PSNSU symptoms (i.e., preference for online social interaction – POSI, mood regulation, deficient self-regulation, and negative outcomes), and possible moderating effects of gender for individuals with poor vs. good sleep quality. Seven hundred and sixty-three young adults completed an online survey including self-report measures of sleep quality, loneliness, and PSNSU symptoms. Individuals with poor sleep quality reported higher levels of loneliness and greater scores on all PSNSU domains than those with good sleep quality. Slope analyses revealed that in men vs. women with poor sleep quality, greater deficient self-regulation of social networking sites use was associated with lower levels of loneliness. Conversely, in men vs. women with good sleep quality, greater POSI was associated with higher levels of loneliness. Our findings showed that individuals with poor sleep quality are characterized by higher levels of loneliness and more severe PSNSU symptoms that may be the result of sleep disturbance-related metabolic, neural, and hormonal processes. Moreover, our results highlight gender differences for individuals with poor vs. good sleep quality which may help clarify the nature of the association between loneliness and PSNSU.

0302 Recovery Sleep in University Students

Abstract Introduction Poor sleep hygiene is common in American college students, with the majority reporting insufficient sleep. Previous studies suggest that many students extend sleep during the weekend to recover sleep debt accrued during the week. In the current study we objectively measured sleep to determine if weekend catch-up sleep was practiced. We also provided students with a 9h sleep opportunity in order to observe how an extended sleep period affected sleep architecture. Methods Students (N=36, 20 women, 19.9±1.7 years) participated in the study from September 2019-March 2020. Sleep-wake behavior was assessed for two weeks using wrist actigraphy and a twice-daily diary. During this two-week period, participants wore at-home polysomnography (PSG) on two non-consecutive nights. For these two nights, in counterbalanced order, participants were instructed to follow their typical sleep pattern or to extend their sleep opportunity to 9h. Within-subjects ANOVA were used to compare sleep between week (Sunday-Thursday) and weekend (Friday and Saturday) nights as well as between typical and 9h PSG nights. Results Compared to week nights, participants went to bed 35 minutes later and woke up 58 minutes later on weekend nights (ps<0.01). Measures of sleep duration and sleep continuity were comparable (ps>0.10) between week and weekend nights and indicated that students averaged less than 7h of sleep per night (6.3±1.0h on week nights and 6.7±1.1h on weekend nights). Self-report measures of sleep quality and daytime sleepiness were also comparable between week and weekend nights (ps>0.05). When instructed to extend their sleep opportunity to 9h, participants exhibited high adherence and increased total sleep time by 88 minutes compared to the typical night (p<0.05). This increase in sleep was due to significant increases in time spent in all four stages of sleep (NREM S1-3 and REM sleep, ps<0.05). Conclusion In this study, students did not utilize weekend nights to extend sleep in order to recover accumulated sleep debt from the week. When provided with a 9h sleep opportunity, participants were physically able to extend sleep and exhibited high quality sleep, suggesting that the primary driver of insufficient sleep in this population is a lack of sleep opportunity rather than impaired sleep ability. Support (If Any)

Associations between comorbid anxiety and sleep disturbance in people with bipolar disorder: Findings from actigraphy and subjective sleep measures

BackgroundStudies show that comorbid anxiety disorders are common in people with bipolar disorder. However, little is known about whether this anxiety is associated with sleep disturbance. We investigated, in individuals with bipolar disorder, whether comorbid anxiety disorder is associated with sleep disturbance. MethodsParticipants were 101 (64% female) currently euthymic individuals with a history of bipolar disorder. Sleep disturbances were assessed using self-report measures of sleep quality (Pittsburgh Sleep Quality Index, PSQI) and six weeks of sleep monitoring using actigraphy. Bipolar disorder and comorbid anxiety diagnoses were assessed using the Mini International Neuropsychiatric Interview. Multiple regression analyses examined associations between comorbid anxiety and sleep disturbance, whilst controlling for confounding covariates known to impact on sleep. ResultsA comorbid anxiety disorder was associated with increased sleep disturbance as measured using the PSQI global score (B = 3.58, 95% CI 1.85–5.32, P < 0.001) but was not associated with sleep metrics (total sleep time, sleep onset latency, sleep efficiency, and wake after sleep onset) derived using actigraphy. LimitationsObjective measures of sleep were limited to actigraphy, therefore we were not able to examine differences in sleep neurophysiology. ConclusionsClinicians should be aware that comorbid anxiety may increase the risk of experiencing subjective sleep disturbance in people with bipolar disorder. Research should assess for evidence of comorbid anxiety when examining associations between sleep and bipolar disorder. Future research should explore the mechanisms by which comorbid anxiety may contribute to subjective sleep disturbances in bipolar disorder using neurophysiological measures of sleep (i.e., polysomnography).

Investigating the relationship between objective measures of sleep and self-report sleep quality in healthy adults: a review.

Sleep is one of the most common factors related to health, yet a standard definition of sleep quality has not been identified. Polysomnography provides important information about objective sleep variables. However, the relationship between objective sleep variables and perception of sleep quality remains unclear. The purpose of this review was to (1) summarize the current methods of measuring objective sleep macrostructure and microstructure, including electroencephalography arousals, spectral frequency, cyclic alternating pattern, and self-report sleep quality, and (2) investigate the relationship between objective measures of sleep physiology and self-report sleep quality in healthy adults. A literature search was conducted using Medline, PubMed, and PsycInfo databases and cited reference searches. Eligible studies included a comparison between self-report sleep quality and polysomnography sleep measures in healthy adults. Thirteen studies were identified. Measurement of self-report sleep quality varied widely across studies. Total sleep time and sleep efficiency were most consistently related to sleep quality, while other objective sleep variables, including electroencephalography spectral analysis, were not reliably predictive of self-report sleep quality in healthy adults. There is preliminary support that microstructural sleep analysis with cyclic alternating pattern may be related to self-reported sleep quality. Further research is needed to define and standardize self-report measures of sleep quality and investigate the microstructure of sleep. Objective measures of sleep and experiences of "quality" sleep are not as closely related as one may expect in healthy individuals, and understanding this relationship further is necessary to improve the clinical utility of sleep physiology. Cudney LE, Frey BN, McCabe RE, Green SM. Investigating the relationship between objective measures of sleep and self-report sleep quality in healthy adults: a review. J Clin Sleep Med. 2022;18(3):927-936.

Examining self-reported social functioning, sleep quality, and psychotic-like experiences in college students

Impairments in social and role functioning have been associated with the prodromal phase of psychosis. Additionally, sleep disturbances impacting daily functioning have been detected across the schizophrenia spectrum. Relationships between social functioning, sleep quality, and psychotic-like experiences (PLEs) in undergraduate-level student populations are less understood. The current project aimed to investigate whether self-reported measures of sleep quality would moderate the relationship between social functioning and PLE endorsement in a community sample of 3042 undergraduate student participants between the ages of 18–35. Participants completed the Social Functioning Scale, the Pittsburgh Sleep Quality Index, and the Prodromal Questionnaire, which indexed PLEs. Bivariate correlations revealed significant associations between social functioning, sleep, and PLEs. As expected, poor sleep and poor social functioning were associated with increased endorsement of PLEs. Contrary to expectation, poor sleep quality was associated with better social functioning. In hierarchical multiple regression models, the interaction between social functioning and sleep was not associated with PLE endorsement. Results indicated that both poor sleep and poor social functioning were significantly associated with PLEs when included in the same model. These findings suggest that poor social functioning and disrupted sleep may act additively to influence PLEs, and that they are both important contributors to psychotic symptoms. Due to deleterious effects of poor sleep on physical and emotional health, these findings provide impetus to further investigate relationships between sleep quality, social functioning, and PLEs using such high-resolution methods as actigraphy, mobile sensing, ecological momentary assessment, and neuroimaging.

Eligibility Classification as a Factor in Understanding Student-Athlete Responses to Collegiate Volleyball Competition.

The current study examined differences in heart rate variability (HRV) across student-athletes of different eligibility classifications and analyzed differences in HRV when competing at home or away. Fourteen female collegiate volleyball players volunteered for the study. Data collection encompassed an entire collegiate season, with comparisons in HRV made between home and away games, as well as pre-gameday, gameday, and post-gameday recordings for the whole squad. Comparisons were also made between student-athlete eligibility classification, with self-reported measures of sleep quality, fatigue, muscle soreness, stress, and mood recorded at the time of HRV measurement. Freshman athletes reported a significantly (p < 0.05, η2 = 0.17) lower HRV (80.3 ± 9.7) compared to sophomore (85.7 ± 7.2), junior (91.2 ± 8.3), and senior (86.5 ± 7.2) athletes, while junior athletes had a significantly higher HRV when compared to sophomore and senior athletes. All athlete classifications reported similar HRV for home and away games, and there was no difference in HRV for any athlete classification group when comparing pre-gameday, gameday, and post-gameday measures. Freshman athletes reported significantly (p < 0.05, η2 = 0.23) worse mood states compared to the other eligibility classifications, while self-reported stress was significantly (p < 0.05) worse in junior and senior athletes. Results suggest that monitoring the workload of student-athletes based on their eligibility classification holds merit. Collegiate coaching and support staff should be aware of the academic and competitive demands placed on their student-athletes. In particular, freshman athletes adjusting to the increased demands placed on them as collegiate student-athlete may warrant additional support.

Sleep moderates symptom experience in combat veterans

BackgroundThough sleep disturbance has shown to negatively affect outcomes related to post-deployment conditions, it is unclear whether and how sleep disturbance affects mental health symptoms beyond these conditions. We evaluated the independent and moderating effects of sleep quality on posttraumatic stress disorder (PTSD), depressive, and neurobehavioral symptoms beyond mild traumatic brain injury (TBI) and PTSD diagnosis. MethodsParticipants were 274 US combat veterans who deployed after 9/11. All completed diagnostic TBI and PTSD interviews and self-report measures of sleep quality, as well as PTSD, depressive, and neurobehavioral symptoms. Only those who passed symptom validity were included in analyses. Hierarchical regression evaluated the contribution of sleep quality to outcomes beyond PTSD and mild TBI. Moderation analyses evaluated interactions between mild TBI, PTSD, and sleep quality on symptom outcomes. ResultsMild TBI was only significantly associated with PTSD (p = .006) and neurobehavioral (p = .003) symptoms. PTSD diagnosis was associated with PTSD (p < .001), depressive (p < .001), and neurobehavioral symptoms (p < .001) beyond mild TBI. Sleep quality explained additional significant variance in all three outcome measures (p < .001), and also significantly moderated the effects of PTSD diagnosis on neurobehavioral symptoms (ΔR2 = .01, p = .023). LimitationsSleep was evaluated subjectively and therefore must be interpreted in this context. ConclusionsThese results provide support that sleep quality is an independent contributing factor to health outcomes in post-deployment veterans and should be considered in etiology of complaints.

Gender moderates the relationship between media use and sleep quality.

With high screen time and poor sleep commonly reported in adolescents, it is important to more fully understand how screen time impacts sleep. Despite similar overall screen times, male and female media preferences and usages differ, making it critical to determine if different domains of screen time differentially affect sleep quality. The present study examined whether differing amounts and domains of screen-based media vary in impact on sleep quality of 16-year-old male and female adolescents over a 3-month period. A total of 98 adolescents (mean [SD] age 16.27[0.29]years; 51% female) completed two online surveys spaced 3months apart and comprised of well-validated self-reported measures of sleep quality, media usage, and depressive symptoms. The various domains of media were categorised into screen-based media with little-to-no peer-to-peer interaction involved (video-only) and screen-based media with interaction a predominant component to the usage (peer-to-peer interaction-involved). Self-reported sleep quality decreased across the 3-month study period. Gender moderated the effect of interactive screen time on sleep quality 3months later, with interactive screen time associated with better sleep quality in males, but remaining poorer in females. Screen time competes with sleep time and may do so differentially depending on the media domain. Compared to females, interactive components of screen time may lessen worsening sleep quality over time in males. Understanding the relationships among screen time, its content, age, and gender may inform guidelines for educators, parents, and adolescents to help improve sleep quality of adolescents.

A-130 An Exploratory Analysis of the Impact PTSD Related Sleep Disturbance has on Language Generativity in Veterans with mTBI

Abstract Objective Reviewed literature suggests that individuals with Posttraumatic Stress Disorder (PTSD) demonstrate cognitive deficits in attention, learning/memory, and executive functions. Less is known regarding the relationship between sleep disturbance and language abilities among individuals with PTSD. We hypothesized that subjective perceptions of PTSD-related sleep disturbance would impact language generativity in Veterans with PTSD. Methods 38 individuals (mean age = 46.58, SD = 13.55; 10% female) were administered a brief neurocognitive battery including measures of verbal generativity [i.e., Delis-Kaplan Executive Function System: Verbal fluency subtest], PTSD symptoms (i.e., clinically significant PTSD = &amp;gt; 35 on the PTSD Checklist for DSM-IV), self-report measures of sleep quality (Pittsburgh Sleep Quality Inventory; PSQI), and PTSD-related sleep disturbances (PSQI – Addendum for PTSD). All participants had a history of mild traumatic brain injury (mTBI). An analysis of covariance was used to assess the contribution of PTSD-related sleep disturbance on verbal fluency in Veterans with PTSD. Post-hoc analyses were conducted. Results Those without PTSD performed better on letter fluency than those with PTSD (p=.019). There was no significant effect of PTSD (presence or absence) on letter fluency performance after controlling for subjective sleep quality, F(1, 35) = 1.43, p = .239. Follow up analyses failed to show any associations between PTSD and other cognitive measures. Conclusions PTSD related sleep disturbance accounts for a significant portion of the variance in the relationship between PTSD and verbal generativity. Individuals with a history of mTBI and current PTSD symptoms, may have worse verbal generativity but is partially accounted for by PTSD related sleep disturbance.

Self-reported Stress And Well-being Impacts Immune Response To Maximal Exercise In Collegiate Swimmers

Exposure to acute psychological and physiological stressors is associated with impairments in immune function including reduced exercise-induced mobilization of naïve (NA) T-cells and increased mobilization of antigen-specific, highly differentiated T-cells following maximal exercise. However, the impact of sustained stressors on the immune response to maximal exercise is unknown. PURPOSE: Characterize the impact of self-reported stress and well-being on lymphocyte responses to acute bouts of exercise in collegiate swimmers over six months. METHODS: Blood samples were collected from fifteen NCAA D1 swimmers (7 M, 6 F: 19.8 ± 0.7 y) before and after maximal swims at two timepoints (V1: immediately post-season 1 and V3: early season 2). An additional mid-off season timepoint (V2) was collected in a subset of nine swimmers. T-cells were quantified by flow cytometry, and self-reported measures of sleep quality (PSQI), symptoms of upper respiratory tract infection (URTI, WURRS-21), and overtraining (DALDA) were collected. Linear mixed models were used to determine the effects of exercise, season timepoint, and their interaction on lymphocyte percentages (α=0.05). Pearson’s correlation coefficients were used to assess correlations between lymphocyte percentages and stress measures. RESULTS: Lower sleep quality was correlated with greater resting and post-exercise senescent CD4+ T-cell percentages (r= 0.44, p= 0.01; r= 0.47, p = 0.004, respectively). Low sleep quality was also correlated with lower post-exercise NA CD4+ T-cells (r= -0.35, p= 0.04). Higher ratings of self-reported symptoms of URTI (r= 0.38, p= 0.02) and overtraining (r= 0.38, p= 0.02) were correlated with greater post-exercise senescent CD4+ T-cell percentages. Compared to pre-exercise, post-exercise NA CD8+ T-cell percentages were lower at V1 and V2, while CD8+ T-cell percentages were higher post-exercise (p < 0.01). CONCLUSION: Elevations in stress and well-being at rest adversely impacted immune response to maximal exercise in collegiate swimmers. Impaired sleep quality and higher URTI and overtraining symptoms were associated with an exacerbated exercise-induced mobilization of senescent CD8+ T-cells, highlighting the importance of monitoring athlete stress level and overall well-being throughout the competitive season.

0736 Self-reported Sleep In OSA Patients: Roles Of Polysomnographic Measures And Depressive Symptoms

Abstract Introduction Sleep fragmentation is typical in OSA, which is commonly co-morbid with insomnia and depression. A complex interaction between these conditions may be also gender-dependent. Moreover, self-report measures of sleep quality and insomnia, such as PSQI and ISI, may relate to depression symptoms more than polysomnographic sleep disturbance. The present aim is to ascertain relative contributions of polysomnographic variables and depression symptoms to PSQI and ISI in a large sample of OSA patients. The interaction between depressive symptomatology and gender in their relationships with subjective sleep is also analyzed. Methods A total of 1,166 patients (923 women, 1136 minorities, 18-97 y.o., age M=53.1±15.2, BMI M=34.4±8.7) undergoing an overnight PSG filled out the Center for Epidemiologic Studies Depression Scale-Revised (CESDR), ISI and PSQI. ISI and PSQI were separately regressed onto age, sex and BMI, followed by PSG variables meeting p&amp;lt;0.1 criterion when tested individually, followed by CESDR and CESDR-by-sex interaction. Results Mean AHI=29.6±34.7, range 0-167/hr, 72.3% of patients had AHI≥5. The PSQI final model included total sleep time (TST), sleep efficiency (SEF), WASO, PLM index, CESDR and CESDR-by-sex. Only CESDR and CESDR-by-sex were significant (p&amp;lt;0.001, p=0.023, respectively). Higher CESDR predicted higher PSQI in both sexes (both p&amp;lt;0.001), accounting for a greater portion of PSQI variance in men (R2=39%) than in women (R2=29%). The ISI final model included TST, N3%, REM%, SEF, WASO, total arousal index, AHI, PLM index, CESDR and CESDR-by-sex. Higher ISI related to lower TST (p=0.042, R2&amp;lt;1%), higher REM% (p=0.016, R2&amp;lt;1%), and higher CESDR (p&amp;lt;0.001, R2=42%). CESDR-by-sex was not significant. Conclusion In this large sample, after controlling for demographic variables, PSG parameters had only minimal relationship with self-report insomnia and sleep quality measures. Higher depressive symptomatology was associated with higher subjective sleep disturbance on PSQI and worse insomnia symptoms on ISI in both sexes, accounting for 29-42% of the variance. Support none

PERSONALITY AND SELF-REPORTED AND ACTIGRAPHY-MEASURED SLEEP HEALTH IN ADULTHOOD

Personality may be associated with sleep health, however, the majority of existing studies rely on self-reported measures of sleep (often focusing on sleep duration). The purpose of this study is to examine the associations between Big Five personality traits and self-reported and actigraphy measured sleep. This study included 3928 participants and a subsample of 441 participants from the Midlife in the United States study. Linear regressions were used to analyze the relationships between personality traits and sleep. Neuroticism was associated with more frequent actigraphy-measured waking after sleep onset, and several self-reported measures of sleep quality, including shorter sleep duration, longer sleep latency, and a greater number of insomnia symptoms. Agreeableness was associated with shorter actigraphy-measured sleep duration and more self-reported insomnia symptoms. Our findings support an association between Neuroticism and poor sleep, and suggest that Agreeableness may be associated with worse sleep health.

Sleep quality is associated with psychosocial functioning and health-related quality of life in pediatric transplant recipients.

This study examined patient-reported sleep quality in a single-center cross-sectional sample of adolescents with solid organ transplants and evaluated associations between sleep quality, psychosocial functioning (ie, depression/anxiety symptoms), and HRQOL. Health disparities associated with minority race/ethnicity and socioeconomic variables were also examined. Sixty-nine adolescents (M=16.51years; SD=1.63) who received a solid organ transplant (kidney: n=25; liver: n=24; heart: n=20) completed self-report measures of sleep quality, psychosocial functioning, and HRQOL. Adolescent transplant recipients endorsed significantly lower levels of sleep quality (ie, falling asleep) compared with previously published norms of healthy peers (t=-3.60; P≤.001). Higher sleep quality was significantly associated with fewer anxiety and depressive symptoms (r=-.31 to -.40), and higher physical and psychosocial HRQOL (r=.33-.43). Adolescents from minority backgrounds had significantly worse sleep quality compared with non-Hispanic Whites. Adolescent transplant recipients, particularly those from minority backgrounds, may be at increased risk for experiencing poor sleep quality. Suboptimal sleep is a risk factor for higher levels of anxiety and depressive symptoms, as well as lower levels of physical and psychosocial HRQOL. Sleep is an important modifiable factor that, if improved, may contribute to lower anxiety/depressive symptoms and better HRQOL in adolescent transplant recipients.

Sleep disturbances in Wolfram syndrome

BackgroundWolfram syndrome is a rare disorder associated with diabetes mellitus, diabetes insipidus, optic nerve atrophy, hearing and vision loss, and neurodegeneration. Sleep complaints are common but have not been studied with objective measures. Our goal was to assess rates of sleep apnea and objective and self-reported measures of sleep quality, and to determine the relationship of sleep pathology to other clinical variables in Wolfram syndrome patients.MethodsGenetically confirmed Wolfram syndrome patients were evaluated at the 2015 and 2016 Washington University Wolfram Syndrome Research Clinics. Patients wore an actigraphy device and a type III ambulatory sleep study device and completed the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index (PSQI) and/or the Pediatric Sleep Questionnaire (PSQ). PSQI and PSQ questionnaire data were compared to a previously collected group of controls. Patients were characterized clinically with the Wolfram Unified Rating Scale (WURS) and a subset underwent magnetic resonance imaging (MRI) for brain volume measurements.ResultsTwenty-one patients were evaluated ranging from age 8.9–29.7 years. Five of 17 (29%) adult patients fit the criteria for obstructive sleep apnea (OSA; apnea-hypopnea index [AHI] ≥ 5) and all 4 of 4 (100%) children aged 12 years or younger fit the criteria for obstructive sleep apnea (AHI’s ≥ 1). Higher AHI was related to greater disease severity (higher WURS Physical scores). Higher mixed apnea scores were related to lower brainstem and cerebellar volumes. Patients’ scores on the PSQ were higher than those of controls, indicating greater severity of childhood obstructive sleep-related breathing disorders.ConclusionsWolfram syndrome patients had a high rate of OSA. Further study would be needed to assess how these symptoms change over time. Addressing sleep disorders in Wolfram syndrome patients would likely improve their overall health and quality of life.

The Association of Optimism with Sleep Duration and Quality: Findings from the Coronary Artery Risk and Development in Young Adults (CARDIA) Study

Optimism is associated with better health outcomes with hypothesized effects due in part to optimism’s association with restorative health processes. Limited work has examined whether optimism is associated with better quality sleep, a major restorative process. We test the hypothesis that greater optimism is associated with more favorable sleep quality and duration. Main analyses included adults aged 32–51 who participated in the Coronary Artery Risk Development in Young Adults (CARDIA) study (n = 3,548) during the fifth (Year 15: 2000–2001) and sixth (Year 20: 2005–2006) follow-up visits. Optimism was assessed using the revised Life-Orientation Test. Self-report measures of sleep quality and duration were obtained twice 5 years apart. A subset of CARDIA participants (2003–2005) additionally provided actigraphic data and completed the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Multivariate regression analyses were used to examine associations of optimism and sleep indicators. In cross-sectional analyses of 3548 participants, each standard deviation (SD) higher optimism score resulted in 78% higher odds of self-reporting very good sleep quality. Prospectively, a 1-SD higher optimism score was related to higher odds of reporting persistently good sleep quality across 5-years relative to those with persistently poor sleep [OR = 1.31; 95%CI:1.10,1.56]. In participant with supplementary data, each SD higher optimism score was marginally associated with 22% greater odds of favorable sleep quality [OR = 1.22; 95%CI:1.00,1.49] as measured by the PSQI, with possible mediation by depressive symptoms. Optimism was unrelated to objective actigraphic sleep data. Findings support a positive cross-sectional and prospective association between optimism and self-reported sleep behavior.

Examining Relationships between Multiple Self-Reported Sleep Measures and Gait Domains in Cognitively Healthy Older Adults

Background: Gait-related changes in older adulthood may be related to changes in cognition (e.g., executive functioning), and recent work suggests that different self-reported measures of sleep may be tied to contrasting aspects of executive functioning. However, the relationship between these self-reported sleep measures and gait domains has not been explored. Such an investigation would be useful in helping to determine which older adults might exhibit changes in gait as well as experience other gait-associated changes (e.g., increased fall risk). Objective: To examine associations between different aspects of self-reported sleep and gait domains in a sample of cognitively healthy older adults. Method: A total of 423 older adults (mean age 69.9 years, range 50–92) completed self-report measures of sleep quality, daytime sleepiness, and sleep-related distress. The participants also completed an objective, electronic measure of both single-task and dual-task gait (i.e., GAITRite). Principal component analyses were used to elucidate the solution for each gait condition, and multiple linear regression was used to examine the contributions of sleep measures to variability in gait performance. Results: A 5-component solution of the single-task condition and a 4-component solution of the dual-task condition were identified. Multiple linear regressions revealed that a poorer sleep quality was associated with greater single-task and dual-task asymmetry. Greater daytime sleepiness was associated with increased dual-task gait variability and postural control. After controlling for the effects of other facets of sleep, sleep-related distress was not associated with any gait domain. Conclusions: Among cognitively healthy older adults,sleep quality and daytime sleepiness, but not sleep-related distress, are associated with aspects of gait. Patients who report these symptoms should be assessed and monitored for possible changes in gait.