Sleep Disturbed Research Articles

A case study on the exposure-response relationship of sleep disturbance due to road traffic noise - As a case in Japan in the 2020s

A socio-acoustic survey was conducted among residents living along major arterial roads in Kanagawa Prefecture, Japan, to examine the occurrence of sleep disturbances due to road traffic noise. Lnight noise maps was introduced for estimating ranges from 30 dB to 80 dB. We asked the frequency of "difficulty falling asleep," "nocturnal awakenings," "early morning awakenings", "feeling unrefreshed in the morning",and "daytime sleepiness" due to road traffic noise. Cases experiencing any of these items more than three times a week were defined as "highly sleep disturbed (HSD)", and that one or twice a week were defined as "sleep disturbed (SD)", respectively. The exposure response relationships between those and Lnight were examined with the independent variables of noise sensitivity, gender, and age. The results of multiple logistic regression analysis revealed that Lnight, and noise sensitivity had a significant effect on SD, while noise sensitivity significantly affected HSD. We show the results of this study in comparison with previous surveys on sleep disturbances conducted in Japan and other regions.

Health impact assessment of exposure to road traffic noise and air pollution according to pre- and post-densification scenarios in Helsingborg, Sweden

A prevalent solution to accommodate population growth due to urbanization is densification. However, this often pushes new residential housing closer to roads, increasing exposure to both noise and air pollution. The present study’s aim was to estimate the health impacts of road traffic-related noise and air pollution for a low-income area (Drottninghög) in Helsingborg, Sweden, according to pre-densification (2012) and post-densification (2030) scenarios.Road traffic noise was simulated at the façade of residential buildings using the Nordic prediction method, and exposure was assessed using SoundPLAN. Exposure-response functions (ERF) from the WHO were utilized for the following health outcomes associated with noise: annoyance, adverse sleep disturbance, ischemic heart disease (IHD) incidence and IHD mortality. Air pollution (nitrogen dioxide, NO2) was assessed using a Gaussian dispersion model (AERMODE). Health outcomes associated with NO2 included natural cause mortality, pediatric asthma, respiratory hospitalizations and low birth weight (LBW). ERFs were derived from meta-analyses. Health impact assessments were then performed for both scenarios.Densifying Drottninghög according to the municipality’s planned strategy would lead to a 15 % unit increase in the proportion of residents exposed to road traffic noise above the WHO’s health-based guideline value (53 dB(A) Lden). This was estimated to markedly increase the proportion of residents highly annoyed by traffic noise (7.4–13.9 %) as well as those highly sleep disturbed (3.0–4.9 %). IHD incidence and IHD mortality attributed to noise would increase by an estimated 49 % and 44 %, respectively, post-densification. NO2 exposure was estimated to increase slightly (0.7 µg/m3) post-densification, which would contribute to an estimated 4–6 % increase in natural cause mortality, pediatric asthma, respiratory hospitalization and LBW.Urban planning initiatives need to consider these prevalent urban environmental exposures and integrate a public health perspective into densification strategies. Doing so can create synergies in the built environment that promote healthy, sustainable cities.

Population health implications of exposure to pervasive military aircraft noise pollution.

While the adverse health effects of civil aircraft noise are relatively well studied, impacts associated with more intense and intermittent noise from military aviation have been rarely assessed. In recent years, increased training at Naval Air Station Whidbey Island, USA has raised concerns regarding the public health and well-being implications of noise from military aviation. This study assessed the public health risks of military aircraft noise by developing a systematic workflow that uses acoustic and aircraft operations data to map noise exposure and predict health outcomes at the population scale. Acoustic data encompassing seven years of monitoring efforts were integrated with flight operations data for 2020-2021 and a Department of Defense noise simulation model to characterize the noise regime. The model produced contours for day-night, nighttime, and 24-h average levels, which were validated by field monitoring and mapped to yield the estimated noise burden. Established thresholds and exposure-response relationships were used to predict the population subject to potential noise-related health effects, including annoyance, sleep disturbance, hearing impairment, and delays in childhood learning. Over 74,000 people within the area of aircraft noise exposure were at risk of adverse health effects. Of those exposed, substantial numbers were estimated to be highly annoyed and highly sleep disturbed, and several schools were exposed to levels that place them at risk of delay in childhood learning. Noise in some areas exceeded thresholds established by federal regulations for public health, residential land use and noise mitigation action, as well as the ranges of established exposure-response relationships. This study quantified the extensive spatial scale and population health burden of noise from military aviation.We employed a novel GIS-based workflow for relating mapped distributions of aircraft noise exposure to a suite of public health outcomes by integrating acoustic monitoring and simulation data with a dasymetric population density map. This approach enables the evaluation of population health impacts due to past, current, and future proposed military operations. Moreover, itcanbemodified for application to other environmental noise sources and offers an improved open-sourcetool to assess the population health implications of environmental noise exposure, inform at-risk communities, and guide efforts in noise mitigation and policy governing noise legislation, urban planning, and land use.

Factors associated with melatonin use in child sleep disturbance: A survey of Australian parents

ObjectiveSleep disturbances are prevalent in Australian children and cause a significant amount of stress to both children and their parents. If sleep disturbances are left untreated, they can result in detrimental consequences to both child and parental wellbeing. While behavioural interventions are recognised as the gold standard treatment for paediatric insomnia, there is a growing use of melatonin from both prescription and non-prescription sources in paediatrics. However, empirical research on the efficacy and safety of melatonin for children is sparse, conflicting, and inconsistent. This first Australian study aimed to investigate correlates of melatonin use in a sample of children with sleep disturbance in Australia and assess whether melatonin is being administered to children contrary to Therapeutic Goods Administration Guidelines. MethodsAn exploratory online study was undertaken with 318 parents of Australian children with sleep disturbance (95.30% females). Logistic regression, mediation and descriptive analysis were conducted. ResultsAs hypothesised, higher parental stress, older child age, and a diagnosis of ADHD were significantly associated with melatonin use in this sleep disturbed sample. Other potential correlates such as financial stress, number of household dependents, child sleep disturbance, and autism were not significantly associated with melatonin use in adjusted analyses. ConclusionFindings show off-label melatonin use in children with sleep disturbance is prevalent. For the first time, this study showed an indirect path linking child sleep disturbances with melatonin use via parental stress. Overall, while the safety of melatonin use remains unknown, there is a clear need to mitigate parental stress to minimise potentially unmonitored and improper use of melatonin in children.

Spatial assessment of the attributable burden of disease due to transportation noise in England

BackgroundNoise pollution from transportation is one of the leading contributors to the environmental disease burden in Europe. We provide a novel assessment of spatial variations of these health impacts within a country, using England as an example. MethodsWe estimated the burden of annoyance (highly annoyed), sleep disturbance (highly sleep disturbed), ischemic heart disease (IHD), stroke, and diabetes attributable to long-term transportation noise exposures in England for the adult population in 2018 down to local authority level (average adult population: 136,000). To derive estimates, we combined literature-informed exposure-response relationships, with population data on noise exposures, disease, and mortalities. Long-term average noise exposures from road, rail and aircraft were sourced from strategic noise mapping, with a lower exposure threshold of 50 dB (decibels) Lden and Lnight. Results40 %, 4.5 % and 4.8 % of adults in England were exposed to road, rail, and aircraft noise exceeding 50 dB Lden. We estimated close to a hundred thousand (∼97,000) disability adjusted life years (DALY) lost due to road-traffic, ∼13,000 from railway, and ∼ 17,000 from aircraft noise. This excludes some noise-outcome pairs as there were too few studies available to provide robust exposure–response estimates. Annoyance and sleep disturbance accounted for the majority of the DALYs, followed by strokes, IHD, and diabetes. London, the South East, and North West regions had the greatest number of road-traffic DALYs lost, while 63 % of all aircraft noise DALYs were found in London. The strategic noise mapping did not include all roads, which may still have significant traffic flows. In sensitivity analyses using modelled noise from all roads in London, the DALYs were 1.1x to 2.2x higher. ConclusionTransportation noise exposures contribute to a significant and unequal environmental disease burden in England. Omitting minor roads from the noise exposure modelling leads to underestimation of the disease burden.

Traffic-Related High Sleep Disturbance in the LIFE-Adult Cohort Study: A Comparison to the WHO Exposure-Response-Curves

Sleep is negatively affected by environmental noise. In the present study, we investigated self-reported high sleep disturbances (being "highly sleep disturbed"-HSD) from road traffic (primary and secondary road networks), rail (train and tram) and air traffic noise in the LIFE-Adult cohort study in Leipzig, Germany. For this, we used exposure data from 2012 and outcome data of Wave 2 (collected during 2018-2021). HSD was determined and defined according to internationally standardized norms. The highest risk for transportation noise-related HSD was found for aircraft noise: the odds ratio (OR) was 19.66, 95% CI 11.47-33.71 per 10 dB increase in Lnight. For road and rail traffic, similar risk estimates were observed (road: OR = 2.86, 95% CI 1.92-4.28; rail: OR = 2.67, 95% CI 2.03-3.50 per 10 dB Lnight increase). Further, we compared our exposure-risk curves with the curves of the WHO environmental noise guidelines for the European region. The proportion of individuals with HSD for a given noise level was lower for rail traffic but higher for aircraft noise in the LIFE study than in the WHO curves. For road traffic, curves are not directly comparable because we also included the secondary road network. The results of our study add to the body of evidence for increased health risks by traffic noise. Moreover, the results indicate that aircraft noise is particularly harmful to health. We recommend reconsidering threshold values for nightly aircraft exposure.

Functional Outcomes, Injury Variables, and Athlete Characteristics Associated with Post-Concussion Sleep Disturbance.

To examine the relationship between sleep disturbance and functional outcomes following a concussion. Also, to explore athlete and injury-related variables that may be related to risk factors for poor sleep following concussion. 124 collegiate athletes completed a neuropsychological evaluation within 14days of sustaining a sport-related concussion (SRC). Athletes were categorized as sleep disturbed (n= 52) or not sleep disturbed (n= 72). Outcome variables included symptom reports, cognitive performance (mean performance and variability), and mood (depression). Injury characteristics and athlete characteristics explored were loss of consciousness (LOC) associated with the injury, whether the athlete was immediately removed from play, and history of prior concussions. Sleep disturbed athletes reported more symptoms, F(4, 119) = 7.82, p< 0.001, ƞ2= 0.21, were more likely to be symptomatic at the time of testing, χ2(1, N= 124) = 19.79, p< 0.001, φ= 0.40, and were marginally more likely to experience clinically significant depression, χ2(1, N= 120) = 3.03, p= 0.08, φ= 0.16, than not sleep disturbed athletes. There were no cognitive differences between the groups, p> 0.05. A greater proportion of sleep disturbed athletes experienced LOC (30%) compared to not sleep disturbed athletes (13%), χ2(1, N= 118) = 4.99, p= 0.03, φ= -0.21. Sleep disturbances following SRC are associated with a broad range of self-reported symptoms. LOC may be associated with an increased risk of developing sleep disturbances; alternatively, sleep disturbances may increase the risk of LOC following concussion.

Geospatial modelling of road-traffic noise levels and frequency and the attributable burden of annoyance and sleep disturbance in Accra, Ghana

Background and aim: Limited city-wide data on environmental noise and sources in rapidly growing sub-Saharan African (SSA) cities constitutes a major barrier for investigating health impacts as well as environmental policy making. In a first of its kind study in SSA, we modelled and predicted noise levels and road-traffic-specific sounds in Accra, Ghana, and estimated the attributable burden of being highly annoyed and sleep disturbed in high-spatial resolution. Methods: From 2019-2020, we collected measurements of sound levels and audio recordings along the roadside in a large-scale campaign. The audio was processed with a deep learning acoustic classifier to identify the frequency of road-traffic sounds. We combined the acoustic data with geospatial predictors in land use regression models (mixed models/random forest) to predict noise levels (Lden, Lnight) and the frequency of road-traffic-specific sounds across the city. Finally, by combining population exposures to predicted Lden and Lnight with literature informed exposure-response relationships and disability weights, we estimated the attributable burden of being highly annoyed and sleep disturbed in aggregate and by census enumeration area (median size: 0.03km2). Results: Predicted road-traffic sounds were prevalent throughout the day (median: 81% of the time present) and nighttime (median: 62%) in Accra. Furthermore, 99% of the population in lived in census enumeration areas where average Lden and Lnight surpassed WHO guidelines for road-traffic noise (Lden &amp;#x3c;53; Lnight &amp;#x3c;45). Noise exposures in Accra translated into 21% and 7% of the population highly annoyed and sleep disturbed, with significant variation across areas, and a combined 10,761 Disability Adjusted Life Years lost. Conclusions: In an area of the world where noise research is severely lacking, this work can support epidemiological studies, burden of disease assessments, and the development of policies and interventions that address noise exposure within Accra. Keywords: Noise, Africa, health burden, land-use-regression, audio processing, road-traffic noise

Environmental Noise and Effects on Sleep: An Update to the WHO Systematic Review and Meta-Analysis.

Background:Nighttime noise carries a significant disease burden. The World Health Organization (WHO) recently published guidelines for the regulation of environmental noise based on a review of evidence published up to the year 2015 on the effects of environmental noise on sleep.Objectives:This systematic review and meta-analysis will update the WHO evidence review on the effects of environmental noise on sleep disturbance to include more recent studies.Methods:Investigations of self-reported sleep among residents exposed to environmental traffic noise at home were identified using Scopus, PubMed, Embase, and PsycINFO. Awakenings, falling asleep, and sleep disturbance were the three outcomes included. Extracted data were used to derive exposure–response relationships for the probability of being highly sleep disturbed by nighttime noise [average outdoor A-weighted noise level () 2300–0700 hours] for aircraft, road, and rail traffic noise, individually. The overall quality of evidence was assessed using Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) criteria.Results:Eleven studies ( responses) were included in addition to 25 studies ( responses) from the original WHO analysis. When sleep disturbance questions specifically mentioned noise as the source of disturbance, there was moderate quality of evidence for the probability of being highly sleep disturbed per 10-dB increase in for aircraft [; 95% confidence interval (CI): 2.01, 2.36], road (; 95% CI: 2.28, 2.79), and railway (; 95% CI: 2.57, 3.43) noise. When noise was not mentioned, there was low to very low quality of evidence for being sleep disturbed per 10-dB increase in for aircraft (; 95% CI: 1.20, 1.93), road (; 95% CI: 1.08, 1.21), and railway (; 95% CI: 0.91, 1.49) noise. Compared with the original WHO review, the exposure–response relationships closely agreed at low (40 dB ) levels for all traffic types but indicated greater disturbance by aircraft traffic at high noise levels. Sleep disturbance was not significantly different between European and non-European studies.Discussion:Available evidence suggests that transportation noise is negatively associated with self-reported sleep. Sleep disturbance in this updated meta-analysis was comparable to the original WHO review at low nighttime noise levels. These low levels correspond to the recent WHO noise limit recommendations for nighttime noise, and so these findings do not suggest these WHO recommendations need revisiting. Deviations from the WHO review in this updated analysis suggest that populations exposed to high levels of aircraft noise may be at greater risk of sleep disturbance than determined previously. https://doi.org/10.1289/EHP10197

The Positive Effects of Poria cocos Extract on Quality of Sleep in Insomnia Rat Models.

Sleep disorders may have various causes and can incur mental and/or physical symptoms, and affect an individual’s quality of life. In this study, we confirm that the Poria cocos extract (PCET) can improve sleep quality and structure by promoting inhibitory neurotransmission via the γ-aminobutyric acid (GABA) type A (GABAA) receptors based on the mechanisms revealed in the experiment with superior cervical ganglion neurons. Pentobarbital-induced sleep tests were conducted in order to determine whether the PCET extract improves the sleep quality and structure in normal ICR mice. Sleep latency and duration were checked with the righting reflex. To simulate the state of awakening as well as a normal sleep state, caffeine was administered orally before the PCET diet. After oral gavage of PCET, sleep latency was decreased, and total sleep duration was increased in normal and caffeine-induced sleep disturbance state. In the ACTH-induced sleep disturbed models, administration of PCET significantly reduced the sleep latency and increased the non-REM sleep duration, which was analyzed in real-time EEG by implanting wireless electrodes in SD rats. PCET was found to improve the sleep quality under a normal sleep state through the GABAA receptor; it also promoted and improved the sleep quality and sleep structure in both the arousal activation state and stress-based sleep disturbance.

INVESTIGATION OF NOISE EXPOSURES, PERCEPTION, AND HEALTH EFFECTS IN DIFFERENT MICROENVIRONMENTS IN A UNIVERSITY COMMUNITY

This study aims to assess noise levels in selected outdoor and indoor microenvironments in a University community in Oman. The perception of noise levels within the Sultan Qaboos University campus was investigated through a survey study. Also, the effect of exposed noise levels on annoyance and sleep disturbance were predicted including their potential risk on cardiovascular health. Among all the measured parameters, it was found that outdoor (41.6%-50%) and indoor (38.5%-46.2%) microenvironments have exceeded the critical levels of 55 dB during morning and afternoon periods. The respondents (698 people) identified traffic and indoor building-related activities as the main sources of noise levels but the majority (44%) of them rated their impact as low. However, more than 30% of the respondents considered traffic as the main contributor to University noise levels. The percentage of highly annoyed persons was predicted to be high in outdoor areas especially in the residential (25%) and near the hospital (13%) areas. However, indoor environments including construction materials and structures labs (14%) showed similar annoyance rates. Also, the percentage of high sleep disturbed persons was found higher in residential areas (7.4%) areas compared to hospital areas (5.3%) locations. The study concluded that there might be an association between the exposed noise levels and the risk of developing cardiovascular diseases. This is the first study that has provided a high spatial variability noise exposure levels across a University environment in Oman, this will contribute to designing future sustainable mitigation strategies to improve the health and well-being of the exposed population. The study has provided a baseline knowledge needed for future epidemiological studies.

Sleep disturbance in clients attending a specialist addiction clinic.

Sleep problems are common amongclients attending alcohol and drug services, yet the specific components of sleep disturbed by primary drug of concern (PDOC), and their relationships to affective disorder symptoms are unclear. We examined sleep problems in clients (n = 32) attending a specialist addiction clinic. Global sleep quality was rated poor by >90% of participants (particularly disturbances, latency and efficiency components), with significant associations (p < .05) between poor sleep quality and depression (r = .517), anxiety (r = .571)and stress (r = .503). Sleep quality was significantly poorer among those with a nonalcohol PDOC compared with alcohol as PDOC, t(22) = 3.09, p = .005. Poor sleep is almost ubiquitous among clients attending alcohol and drug services. However, components of sleep quality disturbed differ in terms of PDOC, highlighting the need for individualised sleep interventions.

Auditory processing, co-morbidities, and parental report of sleep disturbance in children with auditory processing disorder (APD)

ObjectivesTo evaluate the prevalence of sleep disturbance and its relationship with auditory processing (AP) and co-morbidities in children diagnosed with auditory processing disorder (APD). MethodsData from 109 children (Males = 59, Females = 50) with mean non-verbal intelligence quotient (NVIQ) of 89.44 (SD:18.16), aged between 6 and 16 years (mean: 10 years 7 months; SD: 2 years 9 months) with a diagnosis of APD were analysed. Participants performed ≤1.33 SD below the mean in two or more out of five SCAN-3 diagnostic APD tests that included ‘Filtered Words’ (FW), ‘Auditory Figure Ground 0 dB’ (AFG0), ‘Competing Words-Directed Ear’ (CW-DE), ‘Competing Sentences’ (CS) and ‘Time Compressed Sentences’ (TCS). Concern about sleep in addition to other symptoms and medical history were documented from structured parental history sheet which forms part of the routine APD assessment. Language impairment (LI), attention-deficit-hyperactivity-disorder (ADHD) and oppositional defiant disorder (ODD), and anxiety were evaluated using the ‘Children's Communication Checklist-2’ (CCC-2), ‘Swanson Nolan and Pelham rating scale’ (SNAP-IV) and ‘Anxiety Scale for Children-Autism Spectrum Disorder’ (ASC-ASD) respectively. ResultsSixty children had sleep disturbance, a prevalence of 55% (95% CI 45.2%–64.6%). The two groups of APD children, with (n = 49) and without sleep (n = 60) disturbance, did not vary in their auditory processing abilities. The sleep disturbed group had significant issues with pragmatic language impairment, hyperactivity/impulsivity, oppositional defiant symptoms and anxiety compared to the group without sleep disturbance when they were analysed separately. After the variables were considered in step wise fashion in binary logistic regression analyses, only pragmatic language impairment and anxiety predicted sleep disturbance (p < .01). ConclusionIn APD the prevalence of sleep disturbance is high, justifying screening within a transdisciplinary APD assessment protocol. Sleep disturbance in APD is predicted by pragmatic language impairment and anxiety, but not by ADHD symptoms or ODD.

Sleep quality and its effect on event related potential P300 in adolescents with and without sleep disturbances.

The present study aimed: (i) to investigate the sleep quality and cortical arousal (ERP P300) in adolescents with and without sleep disturbances, and (ii) to examine whether P300 vary as a function of quality of the previous night's sleep in sleep disturbed adolescents and to compare the findings with healthy controls. Fifteen sleep disturbed adolescents and 15 age-matched controls were recruited. Participants filled 10 days of sleep logs to identify their good (GN) and bad nights (BN). GN and BN were scored as a measure of sleep efficiency (SE), with nights having greater SE defined as GN and nights with lower SE scores labelled as BN. Afterwards, subjects were summoned to the lab for recording ERP P300 once after a night of good sleep (GN) and once after a night of bad sleep (BN). The findings demonstrate that sleep disturbed adolescents exhibited poorer quality of sleep than controls. The ERP P300 also revealed significant difference in participants with and without sleep disturbance. Moreover, the P300 amplitude was higher and the latency was shorter after a GN in sleep disturbed as well as in controls, however, the values were better for adolescents without disturbed sleep. Similarly, amplitude and latency of P300 was lower and longer, respectively, after a BN in both the groups, however, participants with sleep disturbance demonstrated very penurious scores for amplitude and latency than the controls. Adolescents with sleep disturbance have poorer sleep quality and ERP characteristics than their healthy counterparts. Moreover, the quality of the previous night sleep determines cortical arousal in both sleep disturbed and healthy controls.

Circadian variation in cognition: a comparative study between sleep-disturbed and healthy participants

ABSTRACT Aims: To understand the circadian variation in cognition over the course of the day in sleep-disturbed (SD) participants and to compare the findings with healthy controls. Methods: Subjects were screened using Pittsburgh sleep quality index (PSQI), and a total of 24 participants (12 SD and 12 controls) were recruited for the study. P300 was recorded five times a day (8 a.m., 11 a.m., 2 p.m., 5 p.m. and 8 p.m.) for all the participants in both the groups. Results: The results revealed significant variations in P300 wave in both the groups at different time points. The P300 amplitude at 5 p.m. was significantly higher than that at 8 a.m. and 11 a.m., and the lowest peak was recorded at 8 p.m. preceded by that at 2 p.m. for healthy participants. In SD subjects, the highest amplitude was recorded at 8 p.m., followed by 5 p.m., whereas the lowest deflection was recorded at 2 p.m. preceded by 11 a.m. and 8 a.m. Similarly, P300 latency showed the longest value at 8 a.m. followed by 2 p.m., and further followed by 8 p.m. Shortest latency was recorded at 5 p.m. in non-SD participants, whereas SD participants demonstrated a contrasting trend with the longest latency being recorded at 2 p.m., followed by 8 a.m. and 5 p.m. Shortest latency was observed at 8 p.m. preceded by 11 a.m. Conclusion: These results suggest that P300 characteristics vary along the span of the day between SD and non-SD participants. Clinical trial registry: CTRI/2019/05/019154

Survey Results of a Pilot Sleep Study Near Atlanta International Airport.

Aircraft noise can disturb the sleep of residents living near airports. To investigate potential effects of aircraft noise on sleep, recruitment surveys for a pilot field study were mailed to households around Atlanta International Airport. Survey items included questions about sleep quality, sleep disturbance by noise, noise annoyance, coping behaviors, and health. Of 3159 deliverable surveys, 319 were returned (10.1%). Calculated outdoor nighttime aircraft noise (Lnight) was significantly associated with lower sleep quality (poor or fair; odds ratio (OR) = 1.04/decibel (dB); p < 0.05), trouble falling asleep within 30 min ≥1/week (OR = 1.06/dB; p < 0.01), and trouble sleeping due to awakenings ≥1/week (OR = 1.04/dB; p < 0.05). Lnight was also associated with increased prevalence of being highly sleep disturbed (OR = 1.15/dB; p < 0.0001) and highly annoyed (OR = 1.17/dB; p < 0.0001) by aircraft noise. Furthermore Lnight was associated with several coping behaviors. Residents were more likely to report often or always closing their windows (OR = 1.05/dB; p < 0.01), consuming alcohol (OR = 1.10/dB; p < 0.05), using television (OR = 1.05/dB; p < 0.05) and using music (OR = 1.07/dB; p < 0.05) as sleep aids. There was no significant relationship between Lnight and self-reported general health or likelihood of self-reported diagnosis of sleep disorders, heart disease, hypertension or diabetes. Evidence of self-reported adverse effects of aircraft noise on sleep found in this pilot study warrant further investigation in larger, more representative subject cohorts.

Self-Reported Sleep Disturbance from Road, Rail and Aircraft Noise: Exposure-Response Relationships and Effect Modifiers in the SiRENE Study.

This survey investigates the cross-sectional association between nighttime road, rail and aircraft noise exposure and the probability to be highly sleep disturbed (%HSD), as measured by self-report in postal and online questionnaires. As part of the Swiss SiRENE study, a total of 5592 survey participants in the entire country were selected based on a stratified random sample of their dwelling. Self-reported sleep disturbance was measured using an ICBEN-style 5-point verbal scale. The survey was carried out in four waves at different times of the year. Source-specific noise exposure was calculated for several façade points for each dwelling. After adjustment for potential confounders, all three noise sources showed a statistically significant association between the nighttime noise level LNight at the most exposed façade point and the probability to report high sleep disturbance, as determined by logistic regression. The association was strongest for aircraft noise and weakest for road traffic noise. We a priori studied the role of a range of effect modifiers, including the “eventfulness” of noise exposure, expressed as the Intermittency Ratio (IR) metric, bedroom window position, bedroom orientation towards the closest street, access to a quiet side of the dwelling, degree of urbanization, sleep timing factors (bedtime and sleep duration), sleep medication intake, survey season and night air temperature. While bedroom orientation exhibited a strong moderating effect, with an Leq-equivalent of nearly 20 dB if the bedroom faces away from the nearest street, the LNight-%HSD associations were not affected by bedroom window position, sleep timing factors, survey season, or temperature.

Postpartum Sleep and Breastfeeding Outcomes Among First-Time Mothers of Full-Term Newborns

To examine the impact of impaired sleep and its related health consequences (fatigue, hormone disruption, and mood changes) on two breastfeeding outcomes: milk volume and discontinued breastfeeding during the early postpartum period. A descriptive, correlational design was used. Participants were recruited via childbirth classes held at a large community hospital in the southeastern United States. The sample included 29 healthy women who were first-time mothers (ages 22–35 years) and exclusively breastfeeding healthy, full-term newborns. A home visit was conducted at 2-weeks postpartum. Data were collected using a sleep diary, General Sleep Disturbance Scale (GSDS), 7-item Lee Fatigue Scale (LFS-7), Edinburgh Postnatal Depression Scale (EPDS), Perceived Stress Scale (PSS-10), and State-Trait Anxiety Index (STAI). A test weight was performed during the visit, immediately before and after breastfeeding, and was repeated for two consecutive feedings. A follow-up phone interview was conducted to determine breastfeeding status at 1-month postpartum. All women were exclusively breastfeeding at 2-weeks postpartum, and most (90%) were breastfeeding exclusively at 1 month. At 2 weeks, participants in this study were sleep disturbed (69.2%), fatigued (82.8%), experiencing symptoms of anxiety (27.6%), and expressing more symptoms of depression (27.6%) compared with low-risk postpartum women in the United States. Stress was a significant predictor of poor sleep quality (β = .597, p = .001). Poor sleep quality was a significant predictor for lower breast milk production during the 2nd postpartum week (β = –.695, p = .02). Findings highlight a need to develop stress-reduction interventions that might lead to improved sleep during the postpartum period. Improved sleep may have a positive impact on breast milk production. Appropriate screening for depression symptoms and anxiety are also needed for early detection and assistance for postpartum women who develop mood disorders.

Chronic sleep disturbance, not chronic sleep deprivation, is associated with self-rated health in adolescents

Improving our understanding of the cumulative effects of persistent sleep problems on adolescent health has been identified as an important area of research. This prospective study aimed to ascertain prospectively gender-specific associations between quantity and quality of sleep and self-reported health. Data from a cohort of 3104 adolescents (13–18 y) with repeated measures of sleep deprivation and sleep disturbance (2011 fall, 2012 spring, 2012 fall), and self-reported health (SRH) (2011 fall, 2012 fall) were analysed with multivariable logistic regression models adjusted for confounders. The results of the regression models indicated that cumulative exposure to sleep disturbance was monotonically associated with SRH in both genders, however cumulative sleep deprivation was not associated with self-reported health among young people. Young women reporting chronic exposure to sleep disturbance had over twice the odds of reporting sub-optimal health at follow-up (OR 2.18 [CI95: 1.13, 4.22]), compared to those with no history. Similar results were found in chronically sleep disturbed young men (OR 2.41 [1.05, 5.51]). These findings suggest that chronic exposure to impaired quality of sleep, such as difficulty falling or staying asleep, is related to adolescent self-reported health and thus may be an important determinant of young people's wellbeing.

Evaluation of some health impact indices in two airports’ domain

Airports are the one of major contributors to noise pollution in cities. As feasible transportation to the airports is desired, cities have been enlarged very close to airports since their establishment. In this paper, noise levels around Izmir Adnan Menderes Airport and Ankara Esenboga Airport were evaluated according to the European Noise Directive (END) and by using annoyance and sleep-disturbance indices. These airports are two of the biggest ones in Turkey and both have similar flight statistics. Hot spot analysis results were used for land use planning, assessment of noise effects on public health and determination of noise reduction measures to be used for Noise Action Plans implemented by local authorities. The percentages of people annoyed (% A), highly annoyed (% HA) and highly sleep disturbed (% HSD) were estimated to determine the effects of both airports’ noise on people's health. Hot spot scores of two airports were calculated and compared with each other, which were determined by using the annoyance, sleep disturbances and Building Prioritization Score (BPS) indices. Experimental studies on humans acutely exposed to noise at very high level show increases in blood pressure and heart rate as a result of which induce hearing impairment, hypertension and ischemic heart disease, annoyance, sleep disturbance can be induced. According to results of this study, the urbanization near the airport increases the noise reduction cost and public health problems.