Sleep Duration Recommendations Research Articles

Sleep Irregularity and the Incidence of Type 2 Diabetes: A Device-Based Prospective Study in Adults.

To prospectively examine the association between device-measured sleep regularity and incidence of type 2 diabetes (T2D) in a population-based sample of adults. We also examined if meeting sleep duration recommendations attenuated or eliminated the effects of irregular sleep on T2D. We conducted a prospective cohort study of adults aged 40-79 years participating in the UK Biobank accelerometer substudy. Participants wore wrist-attached accelerometers for a duration of 7 days, which was used to compute the Sleep Regularity Index (SRI). Participants were categorized as irregular (SRI <71.6), moderately irregular (SRI between 71.6 and 87.3), and regular (SRI >87.3) sleepers. T2D diagnosis was obtained through self-reports and health records. We analyzed data from 73,630 individuals observed for 8 years, without a history of T2D and without an event in the first year of follow-up. Compared with regular sleepers, irregular (hazard ratio [HR] 1.38; 95% CI 1.20-1.59) and moderately irregular sleepers (HR 1.35; 95% CI 1.19-1.53) were at higher risk of T2D incidence. Dose-response analyses treating SRI as a continuous measure showed higher T2D incidence with SRI scores <80. Meeting current sleep duration recommendations did not counteract the adverse effects of irregular (HR 1.35; 95% CI 1.09-1.66) or moderately irregular (HR 1.29; 95% CI 1.08-1.54) sleep on T2D incidence. Moderate and high sleep irregularity were deleteriously associated with T2D risk, even in participants who slept ≥7 h per night. Future sleep interventions will need to pay more attention to consistency in bedtimes and wake-up times, in addition to sleep duration and quality.

Sleep and home parenteral nutrition in adults: A narrative review.

Infusions of home parenteral nutrition (HPN) are often cycled at night coinciding with sleep episodes. Adult consumers of HPN are known to experience poor sleep attributed to frequent awakenings and long durations of wakefulness after falling asleep. Consequently, most consumers do not meet recommendations for sleep duration and quality or daytime napping. The primary underlying pathophysiology resulting in sleep problems is nocturia; however, other factors also exist, including disruptions caused by medical equipment (ie, pump alarms), comorbid conditions, dysglycemia, and medication use. Early guidance on sleep is imperative because of the central role of sleep in physical health and wellbeing, including mitigating complications, such as infection risk, gastrointestinal problems, pain sensitivity, and fatigue. Clinicians should routinely inquire about the sleep of their patients and address factors known to perturb sleep. Nonpharmacologic opportunities to mitigate sleep problems include education on healthy sleep practices (ie, sleep hygiene); changes in infusion schedules, volumes, rates, and equipment; and, possibly, behavioral interventions, which have yet to be examined in this population. Addressing comorbid conditions, such as mood disorders, and nutrition deficiencies may also help. Pharmacologic interventions and technological advancement in HPN delivery are also needed. Research on sleep in this population is considered a priority, yet it remains limited at this time.

Social media use and sleep health among adolescents in Canada.

Public health concerns over the impact of social media use (SMU) on adolescent health are growing. We investigated the relationship between SMU and sleep health in adolescents in Canada aged 11 to 17 years. Data from the 2017-2018 Health Behaviour in School-aged Children study were available for 12 557 participants (55.2% female). SMU was categorized by frequency of use (non-active, active and intense) and the presence of addiction-like symptoms (problematic). Mixed effects logistic regression models identified associations between SMU and seven sleep health indicators (insomnia symptoms, daytime wakefulness problems, screen time before bed, meeting sleep duration recommendations, sleep variability and late bedtime on school and non-school days). Compared to active SMU, non-active SMU was associated with better sleep indicators, except for insomnia symptoms. Intense SMU was associated with greater odds of having poor sleep health indicators (adjusted odds ratio [aORs] from 1.09 to 2.24) and problematic SMU with the highest odds (aORs from 1.67 to 3.24). Associations with problematic SMU were greater among girls than boys, including having a later bedtime on school days (aOR = 3.74 vs. 1.84) and on non-school days (aOR = 4.13 vs. 2.18). Associations between SMU and sleep outcomes did not differ by age group. Intense and problematic SMU were associated with greater odds of poor sleep health among adolescents in Canada, with stronger associations among girls than boys. Further research is needed to understand the mechanisms underlying associations between SMU and sleep to inform public health recommendations.

Sleep duration, overweight status, and the modifying role of food insecurity in a sample of 10- to 14-year-old Mexican early adolescents

ObjectivesShort sleep duration has been associated with an increased risk of childhood overweight and obesity in high-income countries, but data from low- and middle-income countries are scarce. Independently, short sleep and food insecurity may increase the risk of overweight/obesity, but it is unknown whether they concurrently affect it. MethodsWe included 3350 adolescents aged 10-14 from the 2012 and 2016 Mexican National Health and Nutrition Survey. Short sleep was categorized as less than 9 hours for ages 10-12 and less than 8 hours for ages 13-14. Overweight/obesity was assessed via anthropometry. Modified Poisson regression models assessed prevalence ratios between short sleep and overweight, examining effect modification by food security status. Results86% met sleep duration recommendations. Short sleep was associated with an increased prevalence of overweight/obesity (prevalence ratio, 1.16; 95% CI, 1.05, 1.31). Multiplicative interaction was found between low and very low food security status and short sleep: adolescents in low food secure households with short sleep had 1.38 (95% CI: 1.10, 1.75) times the prevalence of overweight/obesity compared to adequate sleepers. Very low food secure households had 1.16 (95% CI: 1.14, 1.31) times the prevalence compared to adequate sleepers. This association was not significant in fully or marginally food secure households. ConclusionsShort sleep is associated with an increased obesity risk among Mexican adolescents 10-14years, particularly in the context of low and very low food security. These findings highlight the importance of addressing both sleep hygiene and food security in strategies to reduce obesity risk.

Telework and 24-hour movement behaviours among adults living in Canada during the COVID-19 pandemic

ObjectiveTo assess the association between work location and movement behaviours (physical activity [PA], screen time, sleep) and adherence to the Canadian 24-Hour Movement Guidelines (24-H Guidelines) among Canadian workers during the COVID-19 pandemic. MethodsUsing cross-sectional data from the 2021 Canadian Community Health Survey (n = 10,913 working adults 18–75 years), primary work location was categorized as: worked outside the home at a fixed location (fixed workplace), worked at home (telework), and worked outside the home at no fixed location (non-fixed workplace). Recreational, transportation and occupational/household PA, as well as leisure screen time and sleep duration were self-reported. Logistic regression assessed associations between work location and adherence to movement behaviour recommendations, adjusting for covariates. ResultsCompared to a fixed workplace, those teleworking reported more recreational PA (21.1 vs 17.0 min/day, p < 0.0001) and sleep (7.2 vs 7.1 h/night, p = 0.026) and were more likely to meet sleep duration recommendations (adjusted odds ratio [aOR] = 1.28, 95% CI: 1.08–1.51) and the 24-H Guidelines (aOR = 1.25, 95% CI: 1.04–1.51). Compared to fixed workplaces, those at non-fixed workplaces reported more occupational PA (62.7 vs 32.8 min/day, p < 0.0001) and less leisure screen time (2.5 vs 2.7 h/day, p = 0.021), and were more likely to meet the PA recommendation (aOR = 1.46, 95% CI: 1.15–1.85) and the 24-H Guidelines (aOR = 1.38, 95% CI: 1.09–1.75). ConclusionsResults suggest that adherence to the 24-H Guidelines varies by work location, and work location should be considered when developing strategies to promote healthy movement behaviours. Future studies could explore hybrid work arrangements, and longitudinal study designs.

Examining sleep characteristics in Canada through a diversity and equity lens

ObjectiveTo examine specific sleep characteristics of adults living in Canada according to sex, gender, ethnoracial background, socioeconomic status, immigration status, sexual orientation, and language spoken at home. MethodsThis cross-sectional and nationally representative study used self-reported data from the 2021 Canadian Community Health Survey (n = 39,346 adults aged 18 years and older). Sleep characteristics (sleep duration, nighttime insomnia symptoms, unrefreshing sleep, and difficulty staying awake) were assessed and compared across groups. ResultsFemales were more likely than males to report nighttime insomnia symptoms (23.1% vs. 14.8%) and unrefreshing sleep (17.2% vs. 13.5%). The same was also observed for gender identity. Although White respondents were more likely to meet sleep duration recommendations (58.3%), they had the highest prevalence of nighttime insomnia symptoms (20.9%) compared to respondents with other ethnoracial backgrounds. Respondents coming from lower socioeconomic backgrounds were more likely to report poorer sleep compared to those coming from higher socioeconomic backgrounds. Insomnia symptoms were lower among immigrants (13.9%) compared to nonimmigrants (21.1%). Respondents with a sexual orientation not classified as heterosexual, gay, or lesbian reported poorer sleep. Finally, for language spoken at home, those who responded “French only” were more likely to meet sleep duration recommendations (64.1%) and were less likely to report unrefreshing sleep (8.8%). Nighttime insomnia symptoms were the lowest among those who reported speaking a language other than French or English at home (9.5%). ConclusionThis study highlights important sleep disparities among Canadians. Future intervention strategies should aim to reduce sleep health disparities.

Exploring the prioritisation of sleep, diet, and physical activity as pillars of health: correlates and associations with health behaviours in Australian adults

BackgroundChronic disease is the leading cause of death globally. Sleep, diet, and physical activity are modifiable health behaviours that are key for reducing the burden of chronic disease. These health behaviours are collectively termed ‘The 3 Pillars of Health’ and are critical for populations who are at risk of poor health. Shiftworkers are one such at-risk population. To target behavioural change it is critical to first understand which of these health behaviours Australians currently prioritise. Therefore, this study aimed to investigate how Australians (including shift workers) prioritise sleep, physical activity, and diet, and examine the associations with correlates of health behaviours.MethodsTwo cohorts of Australian adults were sampled. A cohort of 1151 Australian adults (54% female, aged 18–65 years) including employed (in any work schedule), unemployed, studying, and retired completed a phone interview. A cohort of 533 Australian shiftwork-only adults (76% female, 18–72) completed an online survey. All participants were asked which health behaviour (sleep, physical activity, or diet) they prioritised in their own life. Behavioural correlates of sleep, diet, and physical activity (sleep duration, frequency of moderate to physical activity, healthy dietary behaviour), and years of shiftwork experience were also collected. Multinomial logistic regressions were used to investigate the association between the highest prioritised pillar of health and the behavioural correlates.ResultsDiet was prioritised by the Australian adults (49%), whereas sleep was prioritised by the shiftwork-only sample (68%). Australian adults who prioritised diet were significantly more likely to report diets with less fast-food consumption (p < 0.002) and more fruit consumption (p < 0.002) compared to those that prioritised sleep. For the shiftwork-only sample, those with 16–30 years of shiftwork experience were significantly more likely to prioritise sleep compared to diet (p < 0.05). However, prioritising sleep was not associated with meeting the sleep duration recommendations in the shiftwork-only sample.ConclusionsAcross two cohorts of Australians, prioritisation of health behaviour was only associated with actual behaviour for diet. This may reflect different motivations for prioritising different health behaviours, in addition to different capabilities to change different health behaviours. Future research should include longitudinal methodologies to understand how behaviour prioritisation changes over work- and life-span, and any associations with actual health behaviour.

The Association between 24 h Movement Guidelines and Internalising and Externalising Behaviour Problems among Chinese Preschool Children.

This study examined the relationship between adherence to 24 h movement guidelines (24 h MGs) and internalising and externalising behavioural problems in Chinese children aged 3-6 years, with a specific focus on the differences between weekdays and weekends. The guidelines include recommendations for physical activity (PA), screen time (ST), and sleep duration (SD). The results indicated a stronger association between adherence to these guidelines and behavioural problems on weekends compared to weekdays. Specifically, the odds of experiencing internalising problems were 1.33 higher (95% CI: 1.05-1.69) when not satisfying all three behaviours compared to not satisfying one or two. Moreover, on weekends, when ST was not fulfilled, there was a higher likelihood of externalising behaviour problems compared to when it was fulfilled (OR, 1.18, 95% CI, 1.01-1.38), and when all three behaviours were not met, the likelihood was even higher (OR, 1.50, 95% CI, 1.04-2.18). Children who met all three guidelines had fewer internalising and externalising behavioural problems, suggesting a potential beneficial effect on mental health. The study revealed that a higher adherence to these recommendations corresponded to a lower risk of mental health problems. Additionally, higher screen time was linked to an increase in externalising behavioural issues. These findings underscore the importance of adherence to 24 h MGs for optimal mental health in children. Future interventions should consider these behavioural factors and incorporate strategies to promote adherence to these guidelines, particularly on weekends.

Associations of sleep duration and sleep quality with indicators of mental health among youth and adults: findings from the 2015 Canadian Community Health Survey.

A growing number of Canadian studies have examined the link between sleep and mental health. This research builds upon that work by investigating associations of sleep duration and quality with positive mental health (PMH) and mental illness and suicidal ideation (MI/SI) outcomes among youth and adults from threeCanadian provinces (i.e. Ontario, Manitoba and Saskatchewan). Using cross-sectional data from respondents 12 years and older (n = 18 683) who were asked questions on their sleep in the 2015 Canadian Community Health Survey - Annual Component, we conducted unadjusted and adjusted logistic regressionswith self-reported measures of sleep duration and sleep quality as independent variables and a range of PMH (e.g. high self-rated mental health) and MI/SI indicators (e.g. mood disorder diagnosis) as dependent variables. Analyses were conducted of allcomplete cases and also stratified by sex and age group. Good sleep quality was associated with higher odds of PMH indicators (adjusted odds ratio [aOR]: 1.52-4.24) and lower odds of MI/SI indicators (aOR: 0.23- 0.47); associations remained significant when analyses were stratified. Meeting sleep duration recommendations was positively associated with PMH indicators (aOR: 1.27- 1.56) and negatively associated with MI/SI indicators (aOR: 0.41-0.80), but some associations did not remain significant when stratified. This study provides support for associations between sleep duration and quality and indicators of PMH and MI/SI. Findings can inform future research and surveillance efforts that monitor sleep behaviours and indicators of PMH and MI/SI.

The Link between Sleep Insufficiency and Self-Injury among In-School Adolescents: Findings from a Cross-Sectional Survey of Multi-Type Schools in Huangpu District of Shanghai, China

Both insufficient sleep and self-injury are rising public health issues among middle school students. Understanding their relationship may guide the intervention and policy making to help youths gain a healthy life. Thus, we analysed the data collected from the Shanghai Students Health Risk Behavior Surveillance (2015) in the Huangpu District. Self-injury was self-reported and categorized into ever or never. Sleep duration was classified as sufficient and insufficient according to the Health China 2030 Plan and the National Sleep Foundation's updated sleep duration recommendations. Crude OR and adjusted OR of sleep duration and covariates were estimated for self-injury using the logistic regression models with standard error clustered on school types. Results showed that 8.42% of the participants had conducted self-injury, with girls more than boys and ordinary school students more than key school students. After full adjustment, sleep insufficiency increased the odds of conducting self-injury by approximately two folds (AOR = 2.08, 95%CI = 1.40-3.07). The odds of self-injury were higher among students studying at ordinary schools (AOR = 3.58, 95%CI = 1.25-10.27) or vocational schools (AOR = 2.00, 95%CI = 1.77-2.26), with comparison to those at key schools. Interventions seeking to solve insufficient sleep need to be multifaceted, with consideration of changing the school environment and multiple social contexts, which create stressful burdens for adolescents' development.

Nonconforming gender expression and insufficient sleep among adolescents during COVID-19 school closure and after school reopening

BackgroundGender nonconformity (GNC) (i.e., gender expression that differs from gender role expectations for feminine or masculine appearance and behavior) is an under-researched area of adolescent sleep health. The COVID-19 lockdown offers an opportunity to understand how the effect of GNC on adolescent health outcomes changes between school closure and reopening.MethodsWe conducted a cross-sectional study in Shanghai, China, in 2020. The sample size for analysis was 3,265. The age-specific insufficient sleep was estimated according to National Sleep Foundation's sleep duration recommendations. The self-perceived and self-rated GNC were measured by the two items “On the same scale that goes from 100% as a girl to 100% as a boy, where do you think others see you?” and “On a scale that goes from feeling 100% like a girl to feeling 100% like a boy, where do you see yourself?”, and birth sex. In addition, we calculated sex-stratified adjusted odds ratios (AORs) of insufficient sleep for students with high and moderate GNC compared to students with low GNC. Finally, we measured the AORs with self-perceived and self-rated GNC during COVID-19 school closure and reopening.ResultsAmong 3,265 students in grade 6–12 in the analytic sample, 1,567(48.0%) were assigned female at birth (AFAB), 3,188 (97.6%) Han, and 1,921(58.8%) in grade 6–9. Among AFAB students, high self-perceived GNC was significantly associated with insufficient sleep (AOR,1.65; 95%CI,1.30–2.09) during school closure. Insufficient sleep was associated with high self-rated GNC (AOR,1.73; 95%CI,1.23–2.44) and moderate self-rated GNC (AOR,1.69; 95%CI,1.29–2.22) during school closure. After school reopening, neither self-perceived nor self-rated GNC was associated with insufficient sleep among AFAB students. Among assigned male at birth (AMAB) students, none of the two kinds of GNC was associated with insufficient sleep in the two periods during the COVID-19 pandemic.ConclusionsThis study suggests GNC is only associated with insufficient sleep among AFAB students during school closure. Furthermore, the association is nonsignificant among AMAB students. These findings indicate that GNC-related stigma within the family could be a risk factor for insufficient sleep among AFAB adolescents.

Investigating the association between sleep and aspects of mental health in children: findings from the Canadian Health Survey on Children and Youth.

Sufficient sleep and good quality sleep are crucial aspects of children's healthy development. While previous research has suggested associations between sleep and positive mental health, few studies have been conducted in Canadian children. This study used data from the 2019 Canadian Health Survey on Children and Youth. Parents of children aged 5 to 11 years (N = 16 170) reported on their children's sleep habits and mental health. Descriptive statistics were used to calculate means and percentages for sleep and mental health indicators. Logistic regression was used to compare mental health outcomes by meeting sleep duration recommendations (9-11 hours of sleep vs. < 9 or > 11 hours of sleep), sleep quality (difficulties getting to sleep) and having enforced rules for bedtime. Overall, 86.2% of children aged 5 to 11 years met sleep duration recommendations (9-11 hours of sleep), 90.0% had high sleep quality and 83.1% had enforced rules for bedtime. While 83.0% of children had high general mental health, mental health diagnoses were reported for 9.5% of children, and 15.8% of children required or received mental health care. High sleep quality was consistently associated with better mental health, enforced rules for bedtime were associated with some negative mental health outcomes and meeting sleep duration recommendations tended not to be associated with mental health outcomes. Sleep quality was strongly associated with mental health among children in this study. Future research should explore longitudinal associations between sleep and mental health in Canadian children.

Movement behaviours, breakfast consumption, and fruit and vegetable intake among adolescents

BackgroundIt is recommended that children and adolescents spend ≥ 60 min per day of moderate-to-vigorous physical activity, ≤ 2 h per day of recreational screen time, and 9–11 h of sleep per night for school-aged children or 8–10 h per night for adolescents. The objective of this study was to examine the associations of compliance with physical activity, screen time, and sleep duration recommendations with the frequencies of breakfast consumption and fruit and vegetable intake among adolescents.MethodsData from a cross-sectional and province-wide survey of students in grades 7–12 in Ontario (Canada) were used for this analysis (n = 12,759 students; 15.2 ± 1.8 years; 56% females). Movement behaviours and eating habits were self-reported. Multivariable ordered logistic regression analyses were adjusted for age, sex, ethnoracial background, subjective socioeconomic status, and body mass index z-score.ResultsCompliance with all three recommendations was associated with more frequent breakfast consumption (OR: 2.77; 95% CI: 2.17–3.55) and fruit and vegetable intake (OR: 2.95; 95% CI: 2.41–3.62) compared with compliance with none of the recommendations. Compliance with the different combinations of recommendations was also associated with more frequent breakfast consumption and fruit and vegetable intake, with some exceptions. There was a dose–response gradient between the number of recommendations met (3 > 2 > 1) and more frequent breakfast consumption (p < 0.001) and fruit and vegetable intake (p < 0.001), with compliance with all three recommendations being the best combination.ConclusionsThese findings suggest that compliance with the physical activity, screen time, and sleep duration recommendations is associated with more frequent breakfast consumption and fruit and vegetable intake among adolescents.

Lifestyle Behaviours of Children and Adolescents During the First Two Waves of the COVID-19 Pandemic in Switzerland and Their Relation to Well-Being: An Observational Study.

Objectives: To describe changes in adherence to recommendations for physical activity (PA), screen time (ST), and sleep duration over the first two waves of the pandemic in Switzerland, and to assess the associations of these lifestyle behaviours with life satisfaction and overall health as well-being indicators. Methods: In this observational study, we included 2,534 participants (5–16 years) from four Swiss cantons. Participants, or their parents, completed repeated questionnaires and reported on their (child’s) lifestyle and well-being, between June 2020 and April 2021. We used linear and logistic regression models to assess the associations between lifestyle and well-being. Results: The percentage of children meeting the recommendations for PA and ST decreased from the pre-pandemic period to the first wave, with a slight recovery during the second wave. Participants meeting all three recommendations during the second wave were more likely to report excellent health (OR: 1.65 [95% CI: 1.00–2.76]) and higher life satisfaction (β: 0.46 [0.16–0.77]) in early 2021 than participants not meeting any recommendation. Conclusion: We showed a substantial impact of the COVID-19 pandemic on children’s and adolescents’ lifestyle, and a positive association between meeting lifestyle recommendations and well-being.

Sleep health among U.S. Hispanic/Latinx children: An examination of correlates of meeting sleep duration recommendations

ObjectivesThe objective of this study was to examine the association between sociodemographic, behavioral, and environmental factors and adherence to sleep duration recommendations among 1165 U.S. Hispanic/Latinx children. MethodsIn this cross-sectional study, the following parent-reported variables were examined as correlates of whether children met age-appropriate nightly sleep duration recommendations: caretaker and child demographics (eg, gender, age, poverty level), presence of TV in child's bedroom, child's daily screen time and bedtime. ResultsMost (61.4%) children (mean age: 6.39 years, SD = 2.66) met sleep duration guidelines. Multivariable regression results revealed the odds of meeting recommendations were significantly higher among children 6-12 years old living above the poverty threshold (odds ratio [OR] = 1.57; 95% confidence interval [95%CI]: 1.08, 2.31) and those with a regular bedtime (“Some of the time:” OR = 2.05; 95%CI: 1.07, 3.92; “Most of the time:” OR = 3.19; 95%CI: 1.77, 5.74; “Always:” OR = 4.46; 95%CI: 2.43, 8.13). ConclusionsSleep health disparities must be addressed through culturally and contextually appropriate interventions that combine individual-level strategies with those that address social and environmental factors.

Associations between meeting 24-hour movement guidelines and quality of life among children and adolescents with autism spectrum disorder

BackgroundThe Canadian 24-hour movement behavior (24-HMB) guidelines suggest that a limited amount of screen time use, an adequate level of physical activity (PA), and sufficient sleep duration are beneficial for ensuring and optimizing the health and quality of life (QoL) of children and adolescents. However, this topic has yet to be examined for children and adolescents with autism spectrum disorder (ASD) specifically. The aim of this cross-sectional observational study was to examine the associations between meeting 24-HMB guidelines and several QoL-related indicators among a national sample of American children and adolescents with ASD. MethodsData were taken from the 2020 U.S. National Survey of Children's Health dataset. Participants (n = 956) aged 6–17 years and currently diagnosed with ASD were included. The exposure of interest was adherence to the 24-HMB guidelines. Outcomes were QoL indicators, including learning interest/curiosity, repeating grades, adaptive ability, victimization by bullying, and behavioral problems. Categorical variables were described with unweighted sample counts and weighted percentages. Age, sex, race, preterm birth status, medication, behavioral treatment, household poverty level, and the educational level of the primary caregivers were included as covariates. Odds ratio (OR) and 95% confidence interval (95%CI) were used to present the strength of association between adherence to 24-HMB guidelines and QoL-related indicators. ResultsOverall, 452 participants (45.34%) met 1 of the 3 recommendations, 216 (22.65%) met 2 recommendations, whereas only 39 participants (5.04%) met all 3 recommendations. Compared with meeting none of the recommendations, meeting both sleep duration and PA recommendations (OR = 3.92, 95%CI: 1.63–9.48, p < 0.001) or all 3 recommendations (OR = 2.11, 95%CI: 1.03–4.35, p = 0.04) was associated with higher odds of showing learning interest/curiosity. Meeting both screen time and PA recommendations (OR = 0.15, 95%CI: 0.04–0.61, p < 0.05) or both sleep duration and PA recommendations (OR = 0.24, 95%CI: 0.07–0.87, p < 0.05) was associated with lower odds of repeating any grades. With respect to adaptive ability, participants who met only the PA recommendation of the 24-HMB were less likely to have difficulties dressing or bathing (OR = 0.11, 95%CI: 0.02–0.66, p < 0.05) than those who did not. For participants who met all 3 recommendations (OR = 0.38, 95%CI: 0.15–0.99, p = 0.05), the odds of being victimized by bullying was lower. Participants who adhered to both sleep duration and PA recommendations were less likely to present with severe behavioral problems (OR = 0.17, 95%CI: 0.04–0.71, p < 0.05) than those who did not meet those guidelines. ConclusionSignificant associations were found between adhering to 24-HMB guidelines and selected QoL indicators. These findings highlight the importance of maintaining a healthy lifestyle as a key factor in promoting and preserving the QoL of children with ASD.

Comparison of adult shift and non-shift workers’ physical activity and sleep behaviours: cross-sectional analysis from the Household Income and Labour Dynamics of Australia (HILDA) cohort

AimThis study compares the pattern of physical activity and sleep between shift and non-shift workers using a novel physical activity–sleep index. By drawing from a diverse occupational population, this research aims to reduce any occupational specific biases which are prevalent in shift-work research.Subject and methodsCurrent data included 7607 workers (shift workers n = 832) from the Household Income and Labour Dynamics of Australia cohort study. The combined physical activity–sleep index comprised three physical activity components and three sleep health components: achieving moderate (1pt) or high (2pts) IPAQ classification; accruing ≥30% of physical activity as vigorous intensity (1pt); meeting sleep duration recommendations on a work night (1pt); and non-work night (1pt); and reporting no insomnia symptoms (1pt) (higher score = healthy behaviour, max. 6). Generalised linear modelling was used to compare behaviours of shift and non-shift workers.ResultsFindings showed shift workers reported significantly lower activity–sleep scores (3.59 vs 3.73, p < 0.001), lower sleep behaviour sub-score (2.01 vs. 2.22, p < 0.001) and were more likely to report insomnia symptoms (p < 0.001) compared to non-shift workers. No difference was reported for overall physical activity (shift = 1.58 vs. non-shift = 1.51, p = 0.383).ConclusionWhen viewed in conjunction using the combined activity–sleep index, shift workers displayed significantly poorer combined behaviours when compared to non-shift workers.

Years of life gained when meeting sleep duration recommendations in Canada

ObjectiveTo estimate the years of life gained when meeting the sleep duration recommendations across the adult lifespan. MethodsThree pieces of information were used to estimate and compare life expectancy at each age of adult life among Canadian adults who did and did not meet sleep duration recommendations: (i) the prevalence of self-reported short sleep duration, recommended sleep duration, and long sleep duration; (ii) the relative risks of all-cause mortality associated with sleep duration obtained from recent meta-analyses; and (iii) the probability of death during each year of life obtained from life tables. ResultsAdults who meet the sleep duration recommendations have an estimated life expectancy at age 20 years that is 1.2 years longer than short sleepers and 2.6 years longer than long sleepers. Differences between men and women were minimal. ConclusionMeeting sleep duration recommendations is associated with increases in longevity in Canada.

Identifying the most proximal multi-level factors associated with meeting each of the 24-h movement behavior recommendations in a sample of autistic adults

BackgroundAutistic adults have poorer 24-h movement behaviors, including lower levels of physical activity, more time spent being sedentary, and shorter sleep duration than neurotypical adults. Social ecological frameworks posit that 24-h movement behaviors are determined by multi-level domains; however, not known is which multi-level factors are most important to meeting each of the 24-h movement behavior guidelines among autistic adults. ObjectiveThis study examined the relative importance of a range of multi-level determinants on meeting guidelines for the 24-h movement behaviors of aerobic physical activity, sedentary behavior, and sleep. MethodsWe administered at cross-sectional electronic survey to a national self-selecting, convenience sample of autistic adults and caregivers of autistic adults residing in the USA. We used machine learning to examine the relative variable importance (VIMP) of 55 multi-level variables with meeting recommendations for physical activity, sedentary behavior, and sleep duration. VIMPs >0 indicate predictive variables/domains. ResultsA greater number of group activities attended in the last 3-months, and greater independence in completing activities of daily living were most important to meeting aerobic physical activity guidelines. Group activity participation and marital status were important to meeting sedentary behavior guidelines while having a fewer number of comorbidities was most important to achieving adequate sleep. ConclusionsThese data support hypotheses about the role of family and social level interventions targeting movement behaviors in autistic adults.

The effects of hormonal contraceptive use on sleep patterns in women of reproductive age

PurposeHormonal contraceptives alter hormone levels in women and have been linked to alterations in sleep patterns; however, previous studies yielded inconsistent results and lacked generalizability. This study examines hormonal contraceptive use and its impact on sleep outcomes, including sleep duration and sleep disturbances. MethodsWomen self-reported their sleep patterns and use of contraceptives in the 2017 population-based Behavioral Risk Factor Surveillance System Survey (n=1,970). Participants were categorized by use of hormonal or non-hormonal contraceptives for the purpose of pregnancy prevention. Sleep duration was defined as having met the recommended sleep levels of 7-9 hours per 24 hours. Sleep disturbances were defined as trouble falling asleep, staying asleep, or sleeping too much ≥ 6 days within a 14-day period. Prevalence ratios (PRs) and 95% confidence intervals (CIs) were calculated to examine the association between contraceptive use and each sleep outcome. SAS-callable SUDAAN was used for analyses to account for the complex sampling design. ResultsWomen who used hormonal contraceptives had 6% higher prevalence of sleep disturbances (PR: 1.06, 95% CI: 0.99, 1.14) and 17% lower prevalence of not meeting sleep duration recommendations (PR: 0.83, 95% CI: 0.71, 0.98) compared to those who used non-hormonal contraceptives after adjustment for age. ConclusionThese findings suggest the use of hormonal contraceptives may have negative impacts on sleep disturbances, and positive effects on sleep duration among women using contraceptives for preventing pregnancy. Future studies should be conducted in diverse populations utilizing objective measurements of sleep patterns.