Self-reported Sleep Problems Research Articles

Sleeping for two: a randomized controlled trial of cognitive behavioral therapy for insomnia in pregnancy.

Insomnia and sleep problems are common in pregnancy and have potentially negative impacts on both parental and infant health. This study examined the sleeping for two adaptation of cognitive behavioral therapy for insomnia (CBT-I) in pregnancy. A parallel (1:1) randomized controlled trial evaluated CBT-I (n=32) compared to a treatment as usual (TAU) waitlist (n=32) among pregnant individuals from Alberta, Canada experiencing insomnia. Five weekly individual sessions of CBT-I pivoted from in-person delivery to telehealth due to COVID-19 pandemic physical distancing regulations. Insomnia symptom severity (primary outcome), insomnia diagnosis by structured interview, self-reported sleep problems, as well as sleep parameters measured by diary and actigraphy, were assessed pre-treatment at 12-28 weeks gestation (T1), one-week post-treatment (T2), and six months postpartum (T3). Birth information (secondary outcomes) were collected via delivery record and parent report of infant sleep (exploratory outcome) was taken at T3. Multilevel modeling using an intention-to-treat approach showed that CBT-I was associated with a decrease in insomnia symptoms and improved sleep quality across time compared to TAU. The CBT-I group had fewer diagnoses of insomnia post-treatment, but the difference did not reach statistical significance until 6-months postpartum. Participants with worse sleep quality at baseline benefitted substantially more from CBT-I vs. TAU waitlist. CBT-I delivered in pregnancy can reduce symptoms of insomnia and improve sleep quality, which could in turn minimize risk of negative consequences for birthing parent and infant health. Registry: ClinicalTrials.gov; Identifier: NCT03918057; Name: Sleeping for Two: RCT of CBT-Insomnia in Pregnancy; URL: https://www.clinicaltrials.gov/study/NCT03301727.

Latent classes of sleep problems and subjective cognitive decline among middle-aged and older adults in the United States

ObjectivePrevious studies have linked sleep problems to subjective cognitive decline (SCD) using a variable-centered approach (e.g., adding sleep symptoms to form a score); however, sleep problems may cluster differently between individuals. Thus, employing a person-centered approach, we aimed to: 1) identify profiles of self-reported sleep problems among U.S. middle-aged and older adults; 2) examine the cross-sectional association between these classes and SCD. MethodsWe studied 33,922 adults aged 45+ years from the 2017 U.S. Behavioral Risk Factor Surveillance System (BRFSS) with data on sleep problems, including short or long sleep duration, trouble falling or staying asleep, unintentionally falling asleep, snoring loudly, and observed apneas. Latent class analysis classified participants based on their responses to sleep items. We then used a subsample from Oregon, the only state that administered both sleep and SCD modules (n = 2,747), to examine the association between class membership and SCD using logistic regression, adjusting for sociodemographic and health-related characteristics. ResultsWe identified and labeled four classes: “Healthy Sleep” (48.0 %); “Primarily Apnea” (25.8 %); “Primarily Insomnia” (17.6 %); and “Comorbid Insomnia and Sleep Apnea (COMISA)” (8.6 %). In adjusted models, individuals in the “COMISA” class had almost twice the odds of SCD, compared to those in the “Healthy Sleep” class (OR=1.91, 95 % CI =1.15–3.15). ConclusionsCompared to U.S. middle-aged and older adults with healthy sleep, those with COMISA were significantly more likely to report SCD, which is a risk factor for dementia. Studies are needed investigating whether sleep interventions delay cognitive decline in these individuals.

Magnesium-L-threonate improves sleep quality and daytime functioning in adults with self-reported sleep problems: A randomized controlled trial

Objective/BackgroundSleep problems challenge overall wellbeing. Magnesium has been implicated to benefit sleep, although the clinical evidences varied based on the magnesium source used. Magnesium L-threonate (MgT) is a promising intervention due to its brain bioavailability and effects on cognition, memory and mood. We investigated MgT supplementation on sleep quality and daily function. Patients/methodsEighty 35–55-year-olds with self-assessed sleep problems participated in a randomized, double-blind, placebo-controlled, parallel-arm study, taking 1 g/day of MgT or placebo for 21 days. Sleep and daily behaviors were measured subjectively using standardized questionnaires including the Insomnia Severity Index, Leeds Sleep Evaluation Questionnaire, and Restorative Sleep Questionnaire, and objectively using an Oura ring. The Profile of Mood States questionnaire and a daily diary were used to evaluate mood, energy and productivity, and record any safety concerns. ResultsThe MgT group maintained good sleep quality and daytime functioning, while placebo declined. From objective Oura ring measurements, MgT significantly (p < 0.05) improved vs placebo deep sleep score, REM sleep score, light sleep time, and activity and readiness parameters activity score, activity daily movement score, readiness score, readiness activity balance, and readiness sleep balance. From subjective questionnaires, MgT significantly (p < 0.05) improved vs placebo behavior upon awakening, energy and daytime productivity, grouchiness, mood and mental alertness. MgT was safe and well tolerated. ConclusionsThis showed MgT improved sleep quality, especially deep/REM sleep stages, improved mood, energy, alertness, and daily activity and productivity. These are consistent with how MgT works in neuron cells and animal models, suggesting broader positive impacts on overall brain health.

The role of sleep in the link between cannabis use and memory function: evidence from a cross-sectional study

ABSTRACT Background: It is known that cannabis use affects memory and sleep problems independently. However, to date, how memory and sleep problems may interact as a result of cannabis use remains unknown. Objectives: We performed a secondary analysis of existing data to determine whether sleep quality mediates the association between cannabis use and memory and whether sex moderated these effects. Methods: A total of 141 adults with cannabis use disorder (CUD) (83 men) and 87 without CUD (39 men) participated in this study. Outcome measures included self-reported sleep problems from the past 7 days (Marijuana Withdrawal Checklist), learning and memory performance via the short visual object learning task (sVOLT), short visual object learning task delayed (sVOLTd), and verbal memory via the N-back. Bootstrapped mediation and moderated mediation analyses were run to test if sleep quality mediated the association between cannabis use and memory outcomes and whether sex moderated these effects, respectively. Results: Sleep quality mediated the effect of group (i.e. adults with and without CUD) on sVOLT efficiency scores (indirect effect ß = −.08, 95% CI [−0.14, −0.04]) and sVOLTd efficiency scores (indirect effect ß = −.09, 95% CI [−0.14, −0.04]), where greater sleep difficulties was associated with poorer memory performance (decreased efficiency scores). Sex did not moderate these relationships. Conclusion: These initial findings of a mediating role of sleep in the association between CUD and visual learning memory highlight potential critical downstream effects of disrupted sleep in those with CUD and suggest the importance of investigating sleep in CUD.

Effects of Blast-and Impact-Related Concussion on Persistent Sleep Problems.

Examine whether concussion mechanism of injury (high-level blast [HLB] vs impact) affects the likelihood of persistent sleep problems in a post-deployment military population. Post-Deployment Health Assessment and Re-Assessment survey records completed upon return from deployment and approximately 6months later. Active duty enlisted US Marines who completed both assessments (N =64464). This retrospective cohort study investigated US Marines deployed between 2008 and 2012. Logistic regression was used to examine persistent sleep problems 6months after return from deployment. Self-reported sleep problems at reassessment were investigated as the outcome. Predictors included HLB-induced concussions (mbTBI vs none), impact-induced concussions (miTBI vs none), occupational risk of low-level blast, probable posttraumatic stress disorder (PTSD), depression, alcohol misuse, sleep problems upon deployment return, and relevant interactions, adjusting for sex and pay grade. With the exception of sex, all main effects in the model were associated with greater likelihood of reporting persistent sleep problems at reassessment. Sleep problems at return from deployment showed the strongest associations with likelihood of reporting sleep problems at reassessment, followed by mbTBI. The latter was exacerbated by PTSD and depression. mbTBI (vs miTBI) may be more strongly associated with persistent sleep issues that warrant additional monitoring and treatment, particularly among those with probable PTSD and/or depression.

Cognitive behavioural therapy for insomnia (CBT-I) in schizophrenia and schizoaffective disorder: protocol for a randomised controlled trial

IntroductionInsomnia is a common symptom among patients with schizophrenia and schizoaffective disorder, negatively impacting symptom severity, functioning and well-being; however, it is rarely the direct focus of treatment. The main...

Self-Reported Sleep Duration Is a Useful Tool to Predict Sarcopenia in Chilean Older Adults: Evidence from the ALEXANDROS Longitudinal Study.

Age-related sleep disorders share common pathways with sarcopenia. Prospective data from Latin American populations are scarce, and the association between sleep disorders and sarcopenia in Chileans remains unknown. Thus, we aimed to study the longitudinal association between sleep disorders and sarcopenia in a cohort study of 1116 community-dwelling Chilean older people ≥60 years old from the ALEXANDROS cohorts. After the exclusion criteria, 318 subjects were followed. Sociodemographic data, self-reported chronic diseases, sedentarism, sleep characteristics, anthropometric measurements, handgrip strength, and muscle performance were assessed. Results indicated that at baseline, the prevalence of sarcopenia was 24.10% without gender differences, and the prevalence of self-reported sleep problems was 23.3%, higher in women (26.46% versus 17.15% in men). The adjusted Cox regression models for sarcopenia showed an association between sarcopenia, sleep disorders (HR = 2.08, 95% IC 1.14-3.80), and long sleep duration (HR = 2.42, 95% IC 1.20-4.91). After 8.24 years of follow-up, there were 2.2 cases of sarcopenia per 100 person-years. This study demonstrates that sleep disorders are an independent risk factor for sarcopenia in Chilean older people. The identification of sleep disorders through self-reported data provides an opportunity for early identification of risk and cost-effective sarcopenia prevention.

Sleep problem and its association with physical activity and functional limitation: Brazilian national health survey

ObjectivesTo evaluate the association of sleep problems with physical activity and functional limitations in Basic Activities of Daily Living (BADL) in non-institutionalized Brazilian older adults and to investigate if there is a moderating effect of functional limitations in the association between physical activity and sleep problems. MethodThis was a cross-sectional study of 22,728 older adults aged 60 or older interviewed in the National Health Survey in 2019. The outcome variable was self-reported sleep problems. The independent variables of interest were the practice of physical activity and functional limitations in BADL. The association between the independent variables and the outcome was assessed using logistic regression models adjusted for covariates. ResultsThe prevalence of sleep problems was 24.8% (95% CI 23.8–25.8). Physically active individuals were less likely to have sleep problems (OR 0.85; 95% CI 0.72–0.99), while those with functional limitations in BADL (OR 2.10; 95% CI 1.77–2.49) were more likely to have sleep problems, after adjustment for covariates. There was a significant interaction between physical activities and functional limitations in BADL. ConclusionsThe prevalence of sleep problems in the Brazilian older adults was associated with physical activity and functional limitations in BADL. Physical activity is associated with lower odds of sleep problems among older adults with functional limitations in BADL.

Association between sleep problems and functional disability in community-dwelling older adults

BackgroundSleep problems are frequently observed in older adults. They can lead to changes in the individual’s physical, occupational, cognitive, and social functioning, compromising the performance of activities of daily living and contributing to the occurrence of functional disability. This study evaluated the association between sleep problems and functional disability in community-dwelling older adults.MethodsThis was a cross-sectional study with data from 10,507 Brazilian community-dwelling older adults participating in the 2013 National Health Survey. The exposure variable was self-reported sleep problems in the last two weeks. The outcome measure was functional disability assessed from self-reported questionnaires, categorized into basic activities of daily living (BADL) and instrumental activities of daily living (IADL), and defined as not being able to perform or having little or a lot of difficulty in at least one of the activities investigated in the domain of interest.ResultsOlder adults who reported sleep problems had 1.53 (95%CI: 1.34; 1.75) and 1.42 (95%CI: 1.26; 1.59) greater odds of having a disability in BADL and IADL when compared to individuals who reported having no sleep problems.ConclusionsOlder adults with sleep problems were more likely to have a functional disability, both in BADL and IADL. Thus, it is important to implement strategies to screen for sleep problems in older adults in primary health care as a preventive strategy for functional disability.

Efficacy of a fish hydrolysate supplement on sleep quality: A randomized, double-blind, placebo-controlled, crossover clinical trial

Background & AimsSleep disturbances are widespread in modern societies and linked to a variety of diseases, creating an urgent need for the development of products that help combat sleep difficulties. One suitable nutritional supplement may be a fish hydrolysate composed of low molecular weight peptides. MethodsThis two-arm, double-blind, randomized, placebo-controlled crossover study investigated the effect of a 4-week fish hydrolysate intervention on sleep in a healthy German population reporting poor sleep quality, assessed with the Pittsburgh Sleep Quality Index (PSQI). Further sleep parameters were measured using an online diary and a wrist wearable device. Additionally, questionnaires related to stress, anxiety, depression, and well-being were evaluated and salivary cortisol and product satisfaction were assessed. ResultsThe 4-week fish hydrolysate supplementation significantly improved subjective sleep quality measured with the PSQI-score (p = .002). Moreover, individuals reported improvements in sleep efficacy and a reduction in sleep disturbances and daytime sleepiness during fish hydrolysate intake (p = .013, p = .046, p = .004 respectively), but not during placebo phase (all p > .05). No significant intra-individual differences were found between fish hydrolysate and placebo supplementation (p > .05). ConclusionsAlthough no significant intra-individual differences were found between fish hydrolysate and placebo supplementation, the significant improvement in subjective sleep quality from baseline to treatment phase suggests that fish hydrolysate is a safe nutritional supplement to support individuals with self-reported sleep problems. Clinical trial registrationThe study is registered at ClinicalTrials.gov with the Identifier NCT04983355.

Association between self-perception of the neighborhood environment and sleep problems in older Brazilian adults: findings from ELSI-Brazil.

This study aimed to investigate associations between neighborhood perception and sleep problems in older Brazilian adults. A cross-sectional study was conducted with 5,719 community-dwelling older adults (≥ 60 years) from the Brazilian Longitudinal Study of Aging (ELSI-Brazil, 2019-2021). The outcomes were self-reported sleep problems: poor sleep quality, daytime sleepiness, primary insomnia complaints, difficulty staying asleep, and waking up at dawn. The exposure variables were questions about the perception of participants about the physical and social environment of the neighborhood. Logistic regression was used in data analysis. Garbage, rubbish, or tall grass on the streets and the desire to move were associated with higher odds of poor sleep quality. Concern about falling due to damaged sidewalks, concern about having difficulties taking transportation, and concern about having difficulties crossing the street were associated with higher odds of all sleep problems. Sound/noise of buses and cars was associated with higher odds of some sleep problems. Perceiving the neighborhood as a good place to live was associated with lower odds of daytime sleepiness and primary insomnia complaints. Trusting most people in the neighborhood and perceiving that kids and younger people treat adults with respect were associated with lower odds of daytime sleepiness, primary insomnia complaints, and waking up at dawn. Being a good place for kids to play and raise teenagers was associated with lower odds of daytime sleepiness. These results can assist public administrators in creating urban planning policies aimed at improving neighborhood environments as a means of health promotion.

Self-reported sleep status and influencing factors: a web-based national cross-sectional survey in China

Objectives To investigate self-reported sleep duration, sleep timing, sleep status and influencing factors in the Chinese population. Methods This web-based cross-sectional survey was conducted in 2022, covering 31 provinces (91%) in China. 11,000 questionnaires were collected, of which 8970 were valid for analysis. Self-reported sleep habits, problems and quality were investigated. Good or fair sleep ratings, enough duration, regular, with no sleep disturbances and <30 min sleep latency was defined as a composite variable: ‘Good sleep’. Factors influencing sleep patterns and ‘Good sleep’ were analyzed by multivariate logistic regression. Results Most participants sleep less than 7 h per night (55.13%), usually go to bed at 10–12 pm (47.99%), wake up at 6–8 am (49.86%), and take less than 30 min to fall asleep (66.30%) with regular sleep schedule (76.01%). Only 12.36% have ‘Good sleep’. In the past 3 months, 46.80% of the participants reported symptoms of insomnia, and 21.54% had snoring problems. Among the adults, the young, males, college students, freelancers, and those who resided in urban areas and pandemic-free areas slept later, and the northerners woke up earlier. The adults with low-moderate and moderate income and the minors at elementary and middle school slept earlier and woke up earlier. Mid-aged adults who often napped at noon were more likely to have ‘Good sleep’ than any other age group, and urban dwellers with the same habit were more likely to have ‘Good sleep’ than people dwelled in other regions. While people who slept late, woke up too early or too late, slept too little or too much, resided at GMT 7–8 area or pandemic area, had high income, or took up some occupations (entrepreneurs/individuals, professionals, manual and non-manual workers, housewives) were less likely to get a ‘Good sleep’. Conclusions The national survey provided a sleep profile of the Chinese population. Both socio-economic status and personal sleep hygiene habits had an impact on ‘Good sleep’.

Screening for Comorbidity of Sleep Disorders in Career Firefighters.

The purpose of this study was to assess the prevalence and sequelae of insomnia, obstructive sleep apnea (OSA), and comorbid OSA and insomnia (COMISA). In the morning, after a shift end, Midwest career firefighters ( N = 89) in a midsized city completed an electronic battery of questionnaire to screen for OSA, daytime sleepiness, insomnia, presleep arousal, nightmares, mental and physical health symptoms, and a one-night sleep diary. Prevalence of firefighters exceeding screening thresholds: OSA: 54%; insomnia: 30%; COMISA: 17%; four or more nightmares per month: 15%. Firefighters who met criteria for COMISA had shorter total sleep time, less restful and worse sleep quality, higher depression and anxiety symptoms, and presleep arousal symptoms than firefighters without self-reported sleep problems. Many firefighters are at elevated risk of individual behavioral sleep disorders, COMISA, and daytime dysfunction.

A - 107 The Association between Sleep Disorders and Sleep Problems and Resilience in Persons with Multiple Sclerosis.

To examine the relationship between sleep disorders and self-reported sleep problems and resilience in persons with multiple sclerosis (PwMS). We hypothesized that PwMS with sleep disorders would report lower resilience than those with self-reported sleep problems with no formal diagnosis or those without sleep disorder/problems. Participants (n = 112) were PwMS from a larger study conducted at a specialized MS Center. Medical record review was conducted to categorize PwMS into three groups: sleep disorders (n = 27), sleep problems with no formal diagnosis (n = 39), or no sleep disorder/problems (n = 46). Resiliency was measured using the Multiple Sclerosis Resiliency Scale (MSRS), which has five subscales. Differences between the groups on the overall MSRS and subscales were examined with ANOVAs or Kruskal-Wallis tests, with Bonferroni-corrected post-hoc tests. PwMS with sleep disorders reported significantly lower overall resilience (M = 72.00, SD = 9.12) than those without sleep disorders (M = 79.15, SD = 10.85; p = 0.014). Analysis of MSRS subscales showed PwMS without sleep disorders (Mdn = 17.00) reported more support from family and friends than the sleep problems group (Mdn = 15.00; p = 0.009) and the sleep disorder group (Mdn = 14.00; p < 0.001). There were no significant group differences on the four other subscales (Emotional and Cognitive Strategies, Physical Activity and Diet, MS Peer Support, or Spirituality). PwMS with sleep disorders reported lower resilience than those without sleep disorders. Specifically, Support from Family and Friends was significantly different between groups, indicating that support may be particularly important in the relationship between sleep disorders/problems and resilience in MS.

Association of sleep behavior with depression: a cross-sectional study in northwestern China.

This study aimed to examine the association between sleep duration, sleep problems, and depression in Northwest China. Depression was diagnosed at the hospital and self-reported by the participants in the baseline survey. Sleep duration and problems, including difficulty initiating and maintaining sleep, early morning awakening, daytime dysfunction, use of sleeping pills or drugs, and any sleep problems, were obtained by a self-reported questionnaire. Logistic regression was used to estimate odds ratios (ORs) with corresponding 95% confidence intervals (CIs) for exploring the association between sleep duration, sleep problems, and depression, adjusting for demographic and socioeconomic characteristics and health behaviors. The association between depression and sleep duration was also evaluated continuously with restricted cubic spline curves based on logistic models. 36,515 adults from Regional Ethnic Cohort Study in Northwest China were included. About 24.04% of participants reported short sleep duration (<7 h), and 15.64% reported long sleep duration (≥9 h). Compared with standard sleep duration (7-9 h), short sleep duration was associated with a higher risk of depression (OR: 1.69, 95%CI: 1.26-2.27, p = 0.001). Self-reported sleep problems were also related to four times depression risk increased (OR: 4.02, 95%CI: 3.03-5.35, p < 0.001) compared with no sleep problems. In addition, a nonlinear relationship was found between sleep duration and depression after adjusting covariates (p = 0.043). Sleep duration and sleep problems are associated with depression. Enough sleep time and healthy sleep habits in life course might be a practical health promotion approach to reduce depression risk in Northwest Chinese adults. A further study from cohort study is needed to verify the temporal association.

Association between vasomotor symptom frequency and weight gain in the Study of Women's Health Across the Nation.

The menopause transition is associated with weight gain in women. We examined whether changes in vasomotor symptom (VMS) frequency precede weight changes. This longitudinal retrospective analysis included data from the multisite, multiethnic Study of Women's Health Across the Nation. Women in premenopause or perimenopause aged 42 to 52 years at baseline self-reported VMS frequency (hot flashes/night sweats) and sleep problems at up to 10 annual visits. Menopause status, weight, body mass index, and waist circumference were compared across visits. The primary objective was to measure the association between VMS frequency and weight gain using a lagged approach with first-difference regression models. Secondary objectives were to statistically quantify mediation by sleep problems and moderation by menopause status and explore the association between cumulative, 10-year VMS exposure and long-term weight gain. The primary analysis sample included 2,361 participants (12,030 visits; 1995-2008). Increased VMS frequency across visits was associated with subsequently increased weight (0.24 kg), body mass index (0.08 kg/m 2 ), and waist circumference (0.20 cm). Cumulative exposure to a high frequency of VMS (≥6 d/2 wk) over 10 consecutive annual visits was associated with increases in weight measures, including a 3.0-cm increase in waist circumference. Contemporaneous sleep problems mediated no more than 27% of waist circumference increases. Menopause status was not a consistent moderator. This study demonstrates that increases in VMS, onset of a high frequency of VMS, and persistent VMS symptoms over time may precede weight gain in women.

0123 Sleep Problems and Externalizing Behaviors for Youth in Juvenile Justice Facilities

Abstract Introduction Adolescents who experience insufficient, poor quality sleep, and sleep problems might experience difficulties with externalizing behaviors including aggression and impulse control (Bauducco et al., 2019; Brown et al., 2022). Surprisingly, sleep and behavior for youth residing in long and short-term juvenile justice facilities is understudied. The present preliminary analysis explores self-reported sleep problems and aggressive and impulse control symptoms for youth under the care of the Department of Juvenile Services (DJS). Methods Participants (N=62, 86% male, mean age = 16.8, SD=1.2) were recruited from 11 DJS detention and treatment facilities in Maryland. Racial Backgrounds: 55% Black, 18% White, 14% Multiracial, and 12% Other. They completed an online questionnaire focused on sleep behaviors (daytime sleepiness, sleep-wake behavior problems) and daytime functioning including aggressive and impulse control behaviors (e.g., modified Aggression Questionnaire, Buss &amp; Perry, 1992; Weinberger Adjustment Inventory, WAI, 1990). Using Pearson correlations, associations between sleep problems, daytime sleepiness and externalizing behaviors were examined. Results Self-reported daytime sleepiness and sleep-wake behavior problems were associated with increased aggressive and impulse control difficulties. Youth with more sleep-wake behavior problems reported higher levels of aggressive behaviors (r = .39, p &amp;lt; .01) and impulse control behaviors as measured by the WAI (r = .33, p &amp;lt; .05). Similarly, youth with high levels of daytime sleepiness also reported more impulse control behaviors (r = .40, p &amp;lt; .01). Conclusion Preliminary findings suggest that youth residing in juvenile justice facilities with sleep difficulties are more likely to report aggressive and impulse control challenges. Further analyses will provide a greater understanding of the modifying factors to better understand the youth’s sleep-living environment. Support (if any) This research is made possible by the American Academy of Sleep Medicine (AASM) Foundation Award #22-CS-19 and Maryland Department of Juvenile Services’ supportive collaboration.

0738 Association of socio-demographic determinants, smoking, and obesity with sleep trouble among women of reproductive age

Abstract Introduction While sleep quality in women is well known to be affected by hormonal factors such as menstrual cycle, pregnancy, and postpartum period, the connections between their sleep and socio-demographic characteristics are not widely studied. Our study objective was to examine the self-reported sleep problems among women of reproductive age in the US and their association with socio-demographic determinants of health as well as other health-related factors using the National Health and Nutrition Examination Survey (NHANES). Methods We analyzed a secondary data with 5,610 female participants aged 15 to 49 years who participated in the NHANES conducted during 2013 – 2018 to examine for the prevalence of self-reported sleep trouble as well as socio-demographic determinants (age, ethnicity, marital status, education, and income) and the presence of smoking and obesity. A design-based F-test and survey-based generalized linear model with Poisson family and log link function were performed to estimate the adjusted and unadjusted prevalence ratio (PR) with statistical significance of associated factors. Results The likelihood of trouble sleeping for those in the age group of 41 to 49 were significantly higher than those in the age group of 15 to 20 (PR 1.77 [95% CI 1.14-2.77]). Significantly more minority women including non-Hispanic Asian (PR 0.46 [95% CI 0.32-0.67]), Hispanic (PR 0.63 [95% CI 0.46-0.86]), and non-Hispanic black (PR 0.73 [95% CI 0.54-0.99]) reported less likely to have trouble sleeping than non-Hispanic multiracial group. When looking at marital status, married individuals reported less trouble sleeping (PR 0.83 [95% CI 0.80-0.99]) as compared to those who never married. Smoking was also associated with more trouble sleeping (PR 1.43 [95% CI 1.27-1.61]). Prevalence of reporting trouble sleeping was significantly higher for obese women compared to those with normal weight (PR 1.25 [95% CI 1.07-1.46]). There were no statistically significant differences in reported sleep trouble based on education status and income. Conclusion Using the large-scale population-based cross-sectional survey analysis, we identified that the problem of sleep disturbance was independently and positively associated with the higher age, unmarried, smokers and obese women in the reproductive age group. Support (if any)

Association between sleep problems and multimorbidity patterns in older adults

BackgroundSleep problems are frequent in older adults and are associated with chronic diseases. However, the association with multimorbidity patterns is still unknown. Considering the negative impacts that multimorbidity patterns can have on older adults’ life, knowledge of this association can help in the screening and early identification of older adults with sleep problems. The objective was to verify the association between sleep problems and multimorbidity patterns in older Brazilian adults.MethodsThis was a cross-sectional study conducted with data from 22,728 community-dwelling older adults from the 2019 National Health Survey. The exposure variable was self-reported sleep problems (yes/no). The study outcomes were: multimorbidity patterns, analyzed by self-report of the coexistence of two or more chronic diseases with similar clinical characteristics: (1) cardiopulmonary; (2) vascular-metabolic; (3) musculoskeletal; (4) coexisting patterns.ResultsOlder adults with sleep problems had 1.34 (95%CI: 1.21; 1.48), 1.62 (95%CI: 1.15; 2.28), 1.64 (95%CI: 1.39; 1.93), and 1.88 (95%CI: 1.52; 2.33) greater odds of presenting vascular-metabolic, cardiopulmonary, musculoskeletal, and coexisting patterns, respectively.ConclusionsThese results suggest that public health programs aimed at preventing sleep problems in older adults are essential to reduce possible adverse health outcomes, including multimorbidity patterns and their negative consequences for older adults’ health.

Sleep Problems in Patients With Psoriatic Arthritis: A Systematic Literature Review and Metaanalysis.

The aim of this systematic review and metaanalysis is to summarize evidence regarding the relationship between psoriatic arthritis (PsA) and sleep problems. We identified 36 eligible studies-26 cross-sectional, 7 cohort, and 3 interventional studies-in PubMed and Embase. The prevalence of self-reported sleep problems in patients with PsA ranged from 30% to 85%. A metaanalysis of 6 studies that used the Pittsburgh Sleep Quality Index revealed a prevalence of poor sleep quality for patients with PsA of 72.9% (95% CI 63-81.8; I2 = 78%), which was statistically higher than in healthy controls (26.9%, 95% CI 11.7-45.4; I2 = 81%) but not significantly different than in patients with psoriasis (59.8%, 95% CI 46.9-72.1; I2 = 51%). Sleep disturbance was ranked in the top 4 health-related quality of life domains affected by PsA. One study suggested a bidirectional relationship between PsA and obstructive sleep apnea. Predictors of sleep problems included anxiety, pain, erythrocyte sedimentation rate, depression, fatigue, physical function, and tender or swollen joint count. Tumor necrosis factor inhibitors, guselkumab, and filgotinib (a Janus kinase inhibitor) were associated with improved sleep outcomes. Poor sleep quality is prevalent in patients with PsA. Objective sleep measures (ie, actigraphy and polysomnography) have not been used in PsA studies, and evidence on the validity of patient-reported sleep measures in PsA is lacking. Future studies should validate self-reported sleep measures in PsA, explore how sleep quality relates to PsA disease activity and symptoms using both objective and subjective sleep measures, assess the efficacy of strategies to manage sleep problems, and assess the effects of such management on symptoms and disease signs in patients with PsA.