Self-reports Of Sleep Quality Research Articles

Improving Access to Behavioral Strategies to Improve Mental Well-being With an Entertaining Breakfast Show App: Feasibility Evaluation Study.

BackgroundAlthough mental ill-health is more prevalent among people from lower socioeconomic groups, digital mental well-being innovations are often developed for people from higher socioeconomic groups, who already have resources to maintain good mental and physical health. To decrease health inequalities and ensure that available solutions are appealing and accessible to people with fewer resources, new approaches should be explored. We developed the app Wakey!, which focused on creating engaging mental health content that is accessible, particularly among lower socioeconomic groups in the United Kingdom.ObjectiveThe aim of this study is to assess engagement with the app, investigate initial effectiveness data for 6 well-being outcomes, and explore participants’ subjective experiences of using Wakey!MethodsThe app Wakey! was publicly launched on January 20, 2020, and was free to download from Apple Store and Google Play. The app provided its users with entertaining and educational content related to mental well-being. Concurrently, a single-arm mixed methods feasibility trial was carried out from January to April 2020 among people who had downloaded the app and created an account. The primary outcome was engagement, which was collected passively from data logs. Secondary outcome measures were 6 well-being outcomes collected from self-report questionnaires. Individual interviews with 19 app users were carried out in April 2020.ResultsIn total, 5413 people fit the inclusion criteria and were included in the final sample—65.62% (3520/5364) women, 61.07% (3286/5381) aged between 25 and 44 years, 61.61% (2902/4710) in employment, 8.92% (420/4710) belonging to the lower socioeconomic group, and 8.09% (438/5413) were engaged users. There was no evidence of a difference in engagement regarding sociodemographic and socioeconomic characteristics. There was evidence that users with a higher average daily sleep score, who joined the study more recently, who had higher baseline self-report of sleep quality, and who found episodes more entertaining were more likely to be engaged users. Among 230 users who provided follow-up data, there was evidence of improvements on four of the six well-being outcomes: life satisfaction (P<.001), feeling that life is worthwhile (P=.01), ease of getting up in the morning (P<.001), and self-efficacy (P=.04). The app and its content were well received by those who were interviewed, and several people perceived a positive change in their mental well-being.ConclusionsThis study shows that the app Wakey! could potentially be engaging across different socioeconomic groups, and there is an indication that it could positively impact the mental well-being of those engaged with the app. However, this study was a pragmatic trial with a limited sample, and the selection bias was present in the qualitative and quantitative study. Further work is needed to make any generalizable conclusions.Trial RegistrationClinicalTrials.gov NCT04287296; https://clinicaltrials.gov/ct2/show/NCT04287296

Very-Short-Term Sleep Deprivation Slows Early Recovery of Lymphocytes in Septic Patients.

Sleep plays an important role in immune function. However, the effects of very-short-term sleep deprivation on the early recovery of immune function after sepsis remain unclear. This study was conducted in the intensive care unit to investigate the effects of 2 consecutive days of sleep deprivation (SD) on lymphocyte recovery over the following few days in septic patients who were recovering from a critical illness. The patients' self-reports of sleep quality was assessed using the Richards–Campbell Sleep Questionnaire at 0 and 24 h after inclusion. The demographic, clinical, laboratory, treatment, and outcome data were collected and compared between the good sleep group and poor sleep group. We found that 2 consecutive days of SD decreased the absolute lymphocyte count (ALC) and ALC recovery at 3 days after SD. Furthermore, post-septic poor sleep decreased the plasma levels of atrial natriuretic peptide (ANP) immediately after 2 consecutive days of SD. The ANP levels at 24 h after inclusion were positively correlated with ALC recovery, the number of CD3+ T cells, or the number of CD3+ CD4+ cells in the peripheral blood on day 5 after inclusion. Our data suggested that very-short-term poor sleep quality could slow down lymphocyte recovery over the following few days in septic patients who were recovering from a critical illness. Our results underscore the significance of very-short-term SD on serious negative effects on the immune function. Therefore, it is suggested that continuous SD or several short-term SD with short intervals should be avoided in septic patients.

Sleep quality, neurocognitive performance, and memory self-appraisal in middle-aged and older adults with memory complaints.

Objective:Because of inconsistent findings regarding the relationship between sleep quality and cognitive function in people with age-related memory complaints, we examined how self-reports of sleep quality were related to multiple domains of both objective and subjective cognitive function in middle-aged and older adults.Design:A cross-sectional study involving analysis of baseline data, collected as part of a clinical trial.Measurements:Two hundred and three participants (mean age = 60.4 [6.5] years, 69.0% female) with mild memory complaints were asked to rate their sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and their memory performance using the Memory Functioning Questionnaire (MFQ), which measures self-awareness of memory ability. Neurocognitive performance was evaluated using the Continuous Performance Test (CPT), Trail Making Test, Buschke Selective Reminding Test, and the Brief Visuospatial Test – Revised (BVMT-R).Results:Total PSQI scores were significantly associated with objective measures of sustained attention (CPT hit reaction time by block and standard error by block) and subjective memory loss (MFQ frequency and seriousness of forgetting). The PSQI components of (poorer) sleep quality and (greater) sleep disturbance were related to (worse) sustained attention scores while increased sleep latency and daytime sleepiness were associated with greater frequency and seriousness of forgetting.Conclusions:Sleep quality is related to both objective measures of sustained attention and self-awareness of memory decline. These findings suggest that interventions for improving sleep quality may contribute not only to improving the ability to focus on a particular task but also in reducing memory complaints in middle-aged and older adults.

Sleep and development in adolescence in the context of socioeconomic disadvantage

IntroductionSleep problems are associated with negative developmental outcomes in youth, and identification of vulnerability and protective factors is needed to explicate for whom and under which conditions adolescents may be most at risk. Towards this end, we examined socio-economic status (SES) as a moderator of associations between multiple sleep parameters and adolescents’ socio-emotional adjustment and cognitive functioning. MethodsParticipants were 272 adolescents (M age = 17.3 years; 49% girls) and their parents, residing in the Southeastern U.S.A. The sample was socioeconomically diverse and included 41% Black/African American and 59% White/European American youth. Using a cross-sectional design, adolescents' sleep was assessed with actigraphy (total sleep minutes; efficiency indicated by % of time asleep from sleep onset to wake time) and self-reports of sleep quality (sleep-wake problems). Mothers reported on youths’ internalizing and externalizing symptoms, and cognitive functioning was assessed with a standardized test battery. ResultsModeration effects were found and illustrated that, for youth from families with lower SES, shorter and less efficient sleep and subjective sleep problems were associated with higher levels of internalizing and externalizing symptoms as well as lower cognitive performance. Conversely, longer and better-quality sleep protected against socio-emotional and cognitive difficulties otherwise observed for socioeconomically disadvantaged youth. Fewer relations between sleep and adjustment emerged for adolescents from families with higher SES. ConclusionsResults reinforce a growing literature indicating that the relation between sleep and adjustment is stronger for youth from families with lower SES, who may especially benefit from better sleep.

0983 Sleep Associated With Executive Functioning Among Adolescents Across The Adhd Continuum

Abstract Introduction Executive functioning (EF) deficits are a key feature of ADHD, and sleep disturbances may be an important contributor. Specifically, disturbed sleep is prevalent in ADHD and similar EF deficits are observed in ADHD and sleep disorders. Associations between disrupted sleep and EF in ADHD are poorly understood, particularly during adolescence. This study is among the first to examine relationships between sleep and EF using polysomnography (PSG) among adolescents across the ADHD symptom continuum. Methods In this ongoing study, 42 adolescents aged 13 to 17 (mean age = 14.86, 20 females) completed 3 nights of at-home PSG recording (total sleep time; TST) and self-reports of sleep quality, daytime sleepiness, and chronotype. Seventeen had ADHD and 25 were healthy controls (HC). Participants and parents also completed a measure of EF (BRIEF-2; global and behavioral, emotional, and cognitive subscales). Linear regressions controlling for age and sex evaluated associations between sleep and EF. Results Self-reported poorer sleep quality and greater daytime sleepiness and eveningness tendency (p’s&amp;lt;.05), but not TST, were associated with poorer self-reported global EF among adolescents. Shorter TST and greater eveningness were correlated with poorer parent-reported global EF (p’s&amp;lt;.05). Follow up analyses examine differential relationships between sleep and behavioral, emotional, and cognitive domains of EF and between ADHD and HC groups. Conclusion This study is among the first to examine relationships between sleep and EF across the ADHD continuum in an adolescent-specific sample using PSG. Objectively-measured TST as well as subjective measures of sleep were associated with poorer EF in adolescents across the ADHD continuum. Prevention/intervention strategies focused on sleep may support EF among adolescents, and future studies should examine this possibility. In addition, given variability in EF among individuals with ADHD, future studies should investigate whether sleep disturbances identify a phenotypic subgroup within ADHD at risk for EF deficits. Support This work was supported by NIMH K23 MH108704 (Dr. Lunsford-Avery)

Walk to a better night of sleep: testing the relationship between physical activity and sleep

ObjectivesMany do not sleep well, particularly middle-aged and older adults. Physical activity (PA) shows promise for improving sleep; however, populations with clinical sleep disturbances have been a research focus. It remains unclear whether low-impact daily PA, like walking, can affect sleep in healthy adults. DesignThe current study was embedded within a 4-week randomized controlled trial to increase PA. SettingParticipants from the greater Boston area were recruited to participate in a 4-week walking intervention on a rolling basis between October 2015 and August 2016. ParticipantsFifty-nine participants (72% female) were enrolled in the study, with an average age of 49.43 (±8.40) years. InterventionThe 4-week intervention was aimed at increasing participants’ daily steps as the primary outcome. The current, supplementary study examined relationships between monthly and daily PA and sleep. MeasurementsSteps and active minutes were measured daily using a Fitbit Zip. Self-reports of sleep quality and duration were assessed daily, along with before and after the intervention. Results and conclusionsAveraged across the month, daily active minutes were positively related to sleep quality but not duration. Sex moderated this relationship; women who took more steps and were more active reported sleeping better than those less active. Within persons, on days that participants were more active than average, they reported better sleep quality and duration in both sexes. Results suggest that low-impact PA is positively related to sleep, more so in women than men. Findings also showed that PA plays a greater role in predicting sleep quality than duration.

Sleep and Fatigue Scores Differ Between Cytokine Genotypes in Young People With Crohnʼs Disease

Introduction: Sleep disturbances and fatigue are among the most frequent and impairing symptoms in young people with Crohn's disease. Several clinical characteristics have been identified to contribute to variability in sleep disturbances and fatigue; yet, less is known about the contributions of biological mechanisms in this population. Inflammatory processes are involved in the development of these symptoms, however, no studies have evaluated for associations between polymorphisms in genes involved in inflammation and sleep disturbances or fatigue in Crohn's disease. The purpose of this exploratory study was to identify differences in self-reports of sleep quality and fatigue between cytokine genotypes in adolescents and young adults with Crohn's disease. Methods: Participant reports of sleep quality and fatigue were collected using the Pittsburgh Sleep Quality Index (PSQI) and Multidimensional Fatigue Inventory (MFI), respectively. We selected 20 functional SNPs in 9 cytokine genes to evaluate in this study. These genes have been linked to variability in sleep and fatigue in other chronic conditions. Genotype data was collected using either the Sequenom iPLEX MassArray platform or Taqman Genotyping Assays. Differences between genotypes of each SNP and PSQI and MFI scores were independently evaluated using t-tests. Results: Data from 42 participants (mean age: 23.9 years; 62% female) were included in this study. Participants who had one or two doses of the minor allele for NFKB2 rs12772374 (t(39)=-2.57, p=.014) and TNFA rs361525 (t(39)=-2.53, p=.016) had significantly poorer sleep quality than those homozygous wildtype. Likewise, participants who had one or two doses of the minor allele for IL-10 rs1800871 (t(40)= -2.14, p=.039), and TNFA rs3093662 (t(40)=-2.18, p=.035) had significantly worse fatigue than those homozygous wildtype. Participants who were homozygous wildtype for IL-10 rs1878672 had significantly worse fatigue than those with the presence of the minor allele (t(40)= 2.80, p=.008). Conclusion: This study identified the minor allele in several SNPs in cytokine genes likely contribute to the variability in sleep quality or fatigue. These SNPs have known consequences on associated gene products and could potentially serve as a stable biomarker to identify people at risk for poor sleep or fatigue and targets for pharmacological or non-pharmacologic interventions. Further investigation is necessary to confirm and extend findings in a larger sample.733_A Figure 1 No Caption available.733_B Figure 2 No Caption available.

Investigating the application of motion accelerometers as a sleep monitoring technique and the clinical burden of the intensive care environment on sleep quality: study protocol for a prospective observational study in Australia

IntroductionSleep is a state of quiescence that facilitates the significant restorative processes that enhance individuals’ physiological and psychological well-being. Patients admitted to the intensive care unit (ICU) experience substantial sleep...

Relationships among sleep quality, coping styles, and depressive symptoms among college nursing students: A multiple mediator model.

Poor sleep quality and depressive symptoms are common among college nursing students, and may be associated with each other. However, the mechanism for this association has not been well understood. The study is to examine the potential mediating role of coping styles in the association between sleep quality and depressive symptoms among college nursing students. 242 undergraduate nursing students at a public university in the northeast United States completed an online survey delivered through SurveyMonkey® with self-reports of sleep quality, coping styles, and depressive symptoms from October to November 2015. Multivariate linear regression models suggested that poor sleep quality was significantly associated with depressive symptoms (β=1.00, p<0.01) in nursing students. The four coping styles (problem engagement, emotion engagement, problem disengagement, and emotion disengagement) together reduced the strength of the association between sleep quality and depressive symptoms by 41%. Specifically, emotion disengagement coping plays an important mediating role in this association. In addition to sleep promotion, effective interventions to facilitate the development of appropriate coping strategies among nursing students are needed to enhance their mental health and well-being.

Invited Commentary: "Bedroom Light Exposure at Night and the Incidence of Depressive Symptoms: A Longitudinal Study of the HEIJO-KYO Cohort".

In modern society, we are increasingly disconnected from natural light/dark cycles and beset by round-the-clock exposure to artificial light. Light has powerful effects on physical and mental health, in part via the circadian system, and thus the timing of light exposure dictates whether it is helpful or harmful. In their compelling paper, Obayashi et al. (Am J Epidemiol. 2018;187(3):427-434.) offer evidence that light at night can prospectively predict an elevated incidence of depressive symptoms in older adults. Strengths of the study include the longitudinal design and direct, objective assessment of light levels, as well as accounting for multiple plausible confounders during analyses. Follow-up studies should address the study's limitations, including reliance on a global self-report of sleep quality and a 2-night assessment of light exposure that may not reliably represent typical light exposure. In addition, experimental studies including physiological circadian measures will be necessary to determine whether the light effects on depression are mediated through the circadian system or are so-called "direct" effects of light. In any case, these exciting findings could inform novel approaches to preventing depressive disorders in older adults.

Sleep-Wake Profile in Dementia with Lewy Bodies, Alzheimer's Disease, and Normal Aging.

Alterations of the sleep-wake cycle are common features of neurodegenerative dementia. To study differences in sleep-wake profiles in dementia with Lewy bodies (DLB), Alzheimer's disease (AD), and healthy controls. 30 DLB and 32 AD patients, and 33 healthy elderly participants were studied. Patients were evaluated for global cognitive impairment, extrapyramidal signs, fluctuations of attention, and behavioral disorders. A comprehensive sleep-wake profile was obtained including a set of questionnaires [Pittsburgh Sleep Quality Index (PSQI), REM Sleep Behavior Disorder Single-Question screen (RBD1Q), Epworth Sleepiness Scale (ESS)] and 12-day sleep diaries. Patients were matched for age, gender, and disease severity. DLB patients showed more severe daytime somnolence/dysfunction due to somnolence, and a higher proportion of RBD-like symptoms (70%) compared to AD and controls (p < 0.001), regardless of the presence of psychoactive drug treatment. As for sleep timing, DLB patients had a greater number of daytime naps and longer night sleep, with the latter being associated with use of clonazepam. The severity of fluctuations was associated with the presence of RBD (Clinician Assessment of Fluctuation score = RBD+: 5.2±3.7; RBD-: 2.1±3.2, p = 0.04). AD patients reported the best sleep-wake profile, while healthy controls declared the poorest sleep quality, although sleep timing and the quality of wakefulness were comparable between AD and controls. RBD and daytime fluctuations of attention may coexist in DLB and even reciprocally potentiate each other. Self-reports of sleep quality may lead to an underestimation of sleep disturbances in AD, possibly influenced by anosognosia, compared to normal elderly individuals who complain mainly of insomnia.

Exploring the Association between Maternal Mood and Self‐Reports of Sleep during the Perinatal Period

To explore the psychological mechanisms involved in the close association between maternal mood and self-reports of sleep quality during the perinatal period using appraisal theory of emotions. Repeated measures. Antenatal clinics of a health center associated with the Northern Hospital in Melbourne, Australia. 122 pregnant women in their third trimester of gestation. Participants completed the Pittsburgh Sleep Quality Index (PSQI), the Edinburgh Postnatal Depression Scale, and an appraisal questionnaire during the third trimester of gestation, within 7 to 10days after childbirth, and at 10 to 12weeks postpartum. Correlational and regression analyses were used to explore the associations between sleep reports and appraisals. Self-reports of poor sleep quality, impaired daytime dysfunction due to poor sleep, and the global PSQI score were associated with a low perceived ability to cope practically and emotionally with motherhood-related issues as well as with negative expectations about the future. Appraisal dimensions associated with self-reports of poor sleep quality are similar to those related to maternal distress identified by previous research. This finding contributes to a better understanding of the association between self-reports of sleep and maternal mood. Practical implications are discussed.

Does sleep aggravate tension-type headache?: An investigation using computerized ecological momentary assessment and actigraphy

BackgroundBoth insufficient sleep and oversleeping have been reported as precipitating and aggravating factors of tension-type headache (TTH). However, previous studies relied on recalled self-reports, and the relationship has not been confirmed prospectively and objectively in a daily life situation. Recently, ecological momentary assessment (EMA) using electronic diaries, i.e., computerized EMA, is used to record subjective symptoms with the advantages of avoiding recall bias and faked compliance in daily settings. In addition, actigraphy has become an established method to assess sleep outside laboratories. Therefore, the aim of this study was to investigate the within-individual effect of sleep on the following momentary headache intensity in TTH patients during their daily lives utilizing EMA and actigraphy.MethodsTwenty-seven patients with TTH wore watch-type computers as electronic diaries for seven consecutive days and recorded their momentary headache intensity using a visual analog scale of 0-100 approximately every six hours, on waking up, when going to bed, and at the time of headache exacerbations. They also recorded their self-report of sleep quality, hours of sleep and number of awakenings with the computers when they woke up. Physical activity was continuously recorded by an actigraph inside the watch-type computers. Activity data were analyzed by Cole's algorithm to obtain total sleep time, sleep efficiency, sleep latency, wake time after sleep onset and number of awakenings for each night. Multilevel modeling was used to test the effect of each subjective and objective sleep-related variable on momentary headache intensity on the following day.ResultsObjectively measured total sleep time was significantly positively associated with momentary headache intensity on the following day, while self-reported sleep quality was significantly negatively associated with momentary headache intensity on the following day.ConclusionsUsing computerized EMA and actigraphy, longer sleep and worse sleep quality were shown to be related to more intense headache intensity on within-individual basis and they may be precipitating or aggravating factors of TTH.

Night time aircraft noise exposure and children′s cognitive performance

Chronic aircraft noise exposure in children is associated with impairment of reading and long-term memory. Most studies have not differentiated between day or nighttime noise exposure. It has been hypothesized that sleep disturbance might mediate the association of aircraft noise exposure and cognitive impairment in children. This study involves secondary analysis of data from the Munich Study and the UK Road Traffic and Aircraft Noise Exposure and Children's Cognition and Health (RANCH) Study sample to test this. In the Munich study, 330 children were assessed on cognitive measures in three measurement waves a year apart, before and after the switchover of airports. Self-reports of sleep quality were analyzed across airports, aircraft noise exposure and measurement wave to test whether changes in nighttime noise exposure had any effect on reported sleep quality, and whether this showed the same pattern as for changes in cognitive performance. For the UK sample of the RANCH study, night noise contour information was linked to the children's home and related to sleep disturbance and cognitive performance. In the Munich study, analysis of sleep quality questions showed no consistent interactions between airport, noise, and measurement wave, suggesting that poor sleep quality does not mediate the association between noise exposure and cognition. Daytime and nighttime aircraft noise exposure was highly correlated in the RANCH study. Although night noise exposure was significantly associated with impaired reading and recognition memory, once home night noise exposure was centered on daytime school noise exposure, night noise had no additional effect to daytime noise exposure. These analyses took advantage of secondary data available from two studies of aircraft noise and cognition. They were not initially designed to examine sleep disturbance and cognition, and thus, there are methodological limitations which make it less than ideal in giving definitive answers to these questions. In conclusion, results from both studies suggest that night aircraft noise exposure does not appear to add any cognitive performance decrement to the cognitive decrement induced by daytime aircraft noise alone. We suggest that the school should be the main focus of attention for protection of children against the effects of aircraft noise on school performance.

CARDIORESPIRATORY FITNESS AND TWENTY-FOUR HOUR AMBULATORY BLOOD PRESSURE IN AFRICAN AMERICAN WOMEN WITH PARENTAL HYPERTENSION

A decrease from awake to sleeping blood pressure of less than 20\% is associated with hypertension and its related health consequences. Black Americans are more likely than other groups to exhibit a blunted nocturnal decline of blood pressure that is independent of blood pressure level. Increased cardiorespiratory fitness has been associated with lower resting blood pressure in hypertensive adults and in those at increased risk of future hypertension. However, the relationship between cardiorespiratory fitness and 24-hour blood pressure patterns is less clear. PURPOSE This study examined the moderating effects of cardiorespiratory fitness and parental history of hypertension on 24-hour ambulatory blood pressure in black women. METHODS Participants were normotensive (mean±SD: 109 ± 6/70 ± 6 mm Hg) college-aged (18.8 ± 1.1 years) women: 13 had a parental history of hypertension (+PH) and 12 did not (-PH). Participants performed a maximal cycle ergometry test and wore an ambulatory blood pressure monitor for a 24-hour period on a weekday during the follicular phase of the menstrual cycle. Blood pressure readings were taken approximately every 30 minutes over a 24-hour period. Participants recorded posture, activities, and any physical symptoms at the time of each awake blood pressure reading using a standard diary. Self-reports of sleep quality and perceived stress were also obtained for the measurement period. The influences of fitness and parental hypertension on blood pressure patterns were analyzed using multiple linear regression. RESULTS Participants in the +PH group had higher resting diastolic (DBP; p = .02) and mean arterial pressure (p = .01) and a smaller nocturnal decline of DBP (p = .02) compared to women in the -PH group. Cardiorespiratory fitness was not associated with resting blood pressure or the nocturnal decline of blood pressure. CONCLUSION There was evidence of a blunted nocturnal decline of blood pressure in normotensive +PH women. However, cardiorespiratory fitness did not influence resting blood pressure or the nocturnal decline in blood pressure in this sample of young black women.