Sleep Duration Time Research Articles

Patterns of daily activity among young people with epilepsy.

To: (1) explore how young people with epilepsy spend time on physical activity, screen-time, and sleep in a 24-hour period; (2) compare these findings to young people without epilepsy; and (3) evaluate the findings relative to the Canadian 24-hour movement guidelines for children and youth. The study is based on Canadian data from the 2013 to 2014 'Health Behaviour in School-aged Children study' (HBSC), a cross-sectional sample of young people aged 10 to 17years. Three groups participated: 163 young people with epilepsy, 3613 young people with non-neurological conditions, and 18339 population norms. Self-reported activity data were compared across groups. Demographics were similar across groups. Young people with epilepsy spent 5.8hours per week on moderate-to-vigorous physical activity versus 5.6hours per week in population norms; 32% met the recommended 1hour or more per day. Screen-time was 8.7hours per day versus 7.4hours per day in population norms; only 5.4% met the 2hours or less per day recommendation. Sleep duration was 10.2hours per day versus 9.8hours per day in population norms, and 50.7% met the recommendation. Overall, 25.7% of young people with epilepsy did not meet any of the guidelines, 60.5% met one, 13.5% met two, and 0.3% metall three recommendations; whereas 2.8% of population norms and 2% of young people with non-neurological conditions metall three recommendations. These data could inform future interventions and alert policy-makers, health care professionals, parents, educators, and advocacy-groups to the low adherence of young people with epilepsy with Canadian guidelines and their risk for poor health. Young people with epilepsy adhere poorly to Canadian guidelines for daily sleep duration, physical activity, and sedentary screen time. Young people with epilepsy accumulate more screen-time than those with non-neurological conditions or population norms.

Short Sleep in Pupils in Japan: Current Status and Associated Factors

Background: Japan is the most sleepless nation in the world. This study aimed to understand short sleep pupils in Japan. Since academic performance is known to worsen with sleep problems, self-reported academic performance (s-rAP) was also investigated. Methods: A total of 1766 completed questionnaires were obtained from grades 7 to 12 pupils in Japan. Queries included issues on sleeping, eating, defecation, physical activity, screen time, after-school activity (ASA), body mass index (BMI) and s-rAP. Multinomial logistic regression analysis, multiple comparison tests and multiple regression analysis were used adequately. Results: Short sleep pupils were defined as follows in reference to the mean minus 1.5 times the standard deviation of weekend night sleep duration: 7 hours or less for junior high school pupils and 6 hours or less for high school pupils. The rate of short sleep pupils for school nights was 49.9% in junior high school and 48.4% in high school. Multinomial logistic regression analysis revealed that longer weekday screen time and longer ASA were significantly associated with short sleep pupils for school and weekend nights. However, s-rAP was not associated with short sleep pupils. Multiple comparison tests revealed that school night sleep duration, school and weekend night bed time, weekend wake time, sleepiness, eating breakfast, screen time and BMI were significantly different among AP categories. There were no significant differences for s-rAP values between 10-15 and more than 15 hours ASA per week. According to multiple regression analysis, sleep duration was not selected as a significant predictor of s-rAP, while sleepiness, eating breakfast, grade, school day screen time and BMI were selected. Conclusions: The association between s-rAP and sleep duration remains inconclusive. A recommendation about sleep duration might be gauged from when pupils feel less sleepy.

Pharmacologic Treatments for Sleep Disorders in Children: A Systematic Review.

Sleep problems are common in children, especially those with neurodevelopmental disorders, and can lead to consequences in behavior, functioning, and quality of life. We systematically reviewed the efficacy and harms of pharmacologic treatments for sleep disorders in children and adolescents. We searched MEDLINE, Cochrane library databases, and PsycINFO through June 2018. We included 22 placebo-controlled randomized controlled trials (1-13 weeks' duration), involving 1758 children (mean age 8.2 years). Single randomized controlled trials of zolpidem and eszopiclone in children with attention-deficit/hyperactivity disorder (ADHD) showed no improvement in sleep or ADHD ratings. Clinical Global Impression Improvement/Severity scores significantly improved with zolpidem ( P = .03 and P = .006, respectively). A single, small randomized controlled trial of diphenhydramine reported small improvements in sleep outcomes (8-10 minutes' better sleep latency and duration) after 1 week. In 19 randomized controlled trials, melatonin significantly improved sleep latency (median 28 minutes; range 11-51 minutes), sleep duration (median 33 minutes; range 14-68 minutes), and wake time after sleep onset (range 12-43 minutes), but not number of awakenings per night (range 0-2.7). Function and behavior improvement varied. Improvement in sleep was greatest in children with autism or other neurodevelopmental disorders, and smaller in adolescents and children with chronic delayed sleep onset. Adverse events were infrequent with melatonin, but more frequent than placebo in children taking eszopiclone or zolpidem. These findings show that melatonin was useful in improving some sleep outcomes in the short term, particularly those with comorbid ASD and neurodevelopmental disorders. Other drugs and outcomes are inadequately studied.

Associations between meeting the Canadian 24-Hour Movement Guidelines for the Early Years and behavioral and emotional problems among 3-year-olds

ObjectivesPrimary: examine associations between meeting the 24-Hour Movement Guidelines for the Early Years and behavioral and emotional problems in a large sample of 3-year-old children. Secondary: determine the proportion of children meeting the Canadian 24-Hour Movement Guidelines. DesignCross-sectional. MethodsParticipants were 3-year olds (n=539) from the Edmonton site of the Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort. Physical activity and sleep duration were accelerometer-derived while screen time was parent-reported. Meeting the overall guidelines was defined as: (1) ≥180min/day of total physical activity, including 60min/day of moderate- to vigorous-intensity physical activity, (2) ≤1h/day of screen time, and (3) 10–13h of sleep per 24-hour period. Externalizing, internalizing, and total problem scores (lower scores representing fewer problems) were calculated from the parent-reported Child Behavior Checklist (CBCL). Descriptive statistics and linear regression models were completed. ResultsOnly 5% of children met the overall guidelines (all three recommendations), with 19.3%, 50.5%, and 83.1% meeting the physical activity, screen time, and sleep recommendations, respectively. Meeting more recommendations was associated with lower scores for total (B=−1.78, 95%CI: −3.03, −0.54), externalizing (B=−1.51, 95%CI: −2.80, −0.22) and internalizing (B=−1.35, 95%CI: −2.60, −0.01) problems. Similar findings were also observed for the specific combinations of: (1) physical activity and screen time and (2) sleep duration and screen time. ConclusionsMeeting more recommendations within the 24-hour Movement Guidelines was associated with fewer behavioral and emotional problems at 3-years. Few 3-year-olds met the overall guidelines. Findings support an integrated approach for healthy growth and development.

A Comparative Study Assessing Sleep Duration and Associated Factors among Adolescents Studying in Different Types of Schools in an Urban Area of Kerala, India.

Background:Sleep is essential for optimizing physical, cognitive, and emotional functioning of adolescents. Adolescents are one of the most sleep-deprived age groups in the society.Objectives:To assess sleep duration and associated factors among adolescent children studying in different types of schools in an urban area of Kerala.Methodology:This cross-sectional study was conducted in Pathanamthitta district, Kerala, from January to December 2017. All adolescent children studying in high school and higher secondary classes were included using stratified random sampling. Study tool included a questionnaire which collected sociodemographic information, sleep duration, and schedule.Results:In this study, 657 students were enrolled. The mean age of the participants was 15.09 ± 1.33 years. 201 students (30.6%) were from government school, 242 (36.8%) from aided, and 214 (32.6%) were from private school. The mean sleep duration among the students was 7.2 ± 1.26 h. Sleep duration was found to be inadequate in 60% of the children. The sleep duration was found to be longer during weekends compared to weekdays. Nearly 92% of students take a daytime nap of >1 h during weekends. Private school students had inadequate sleep duration, late bedtime, and early wake-up time compared to other students. Higher age, class, education of parents, family income, distance travelled to school, and female gender were the other factors associated with inadequate sleep among adolescents.Conclusion:Inadequate sleep duration and difference in sleep schedule during weekends were observed among adolescents, especially among private school students. Primary prevention approach aimed at spreading adequate awareness regarding the importance of sleep among students, parents, and teachers should be practiced.

Associations of Infant Sleep Duration with Body Composition and Cardiovascular Health to Mid-Adolescence: The PEAS Kids Growth Study.

Background: Short sleep duration in childhood has often been linked with obesity in later childhood or adolescence. However, whether infant sleep duration affects body composition trajectories and cardiovascular health through to mid-adolescence remains unknown. Methods: Participants were 336 adolescents from a community-based prospective birth cohort in Melbourne, Australia. Mothers completed 24-hour time diaries, including infant sleep in 5-minute intervals at ages 2, 4, and 12 months. BMI and body composition outcomes were measured 6-monthly between 4 and 6.5 years and at 10 and 14 years. Cardiovascular outcomes at 14 years comprised blood pressure, pulse wave velocity, retinal arteriole-to-venule ratio, and carotid intima-media thickness. We used multivariable linear regression and multinomial logistic regression analyses adjusted for sex, age, BMI at birth, gestational age, ethnicity, maternal education, maternal BMI, and neighborhood socioeconomic position. Results: At 2 months, infants slept on average 14.1 hours [standard deviation (SD) 1.9], decreasing to 13.4 hours (SD 2.0) by 12 months. We observed no associations between the different sleep duration time points in infancy and later BMI or body composition. Moreover, a shorter sleep duration did not increase the odds of being on a high body composition trajectory compared with longer sleep (e.g., odds ratio per hour of sleep at 4 months is 0.85, 95% confidence interval 0.65-1.11). Infant sleep duration was also not associated with cardiovascular function or large or small artery structure at 14 years of age. Conclusions: We found no evidence that sleep duration very early in life affects adolescent body composition or cardiovascular health.

The effect of socioeconomic deprivation on the association between an extended measurement of unhealthy lifestyle factors and health outcomes: a prospective analysis of the UK Biobank cohort

Combinations of lifestyle factors interact to increase mortality. Combinations of traditional factors such as smoking and alcohol are well described, but the additional effects of emerging factors such as television viewing time are not. The effect of socioeconomic deprivation on these extended lifestyle risks also remains unclear. We aimed to examine whether deprivation modifies the association between an extended score of lifestyle-related risk factors and health outcomes. Data for this prospective analysis were sourced from the UK Biobank, a prospective population-based cohort study. We assigned all participants an extended lifestyle score, with 1 point for each unhealthy lifestyle factor (incorporating sleep duration and high television viewing time, in addition to smoking, excessive alcohol, poor diet [low intake of oily fish or fruits and vegetables, and high intake of red meat or processed meats], and low physical activity), categorised as most healthy (score 0-2), moderately healthy (score 3-5), or least healthy (score 6-9). Cox proportional hazards models were used to examine the association between lifestyle score and health outcomes (all-cause mortality and cardiovascular disease mortality and incidence), and whether this association was modified by deprivation. All analyses were landmark analyses, in which participants were excluded if they had an event (death or cardiovascular disease event) within 2 years of recruitment. Participants with non-communicable diseases (except hypertension) and missing covariate data were excluded from analyses. Participants were also excluded if they reported implausible values for physical activity, sleep duration, and total screen time. All analyses were adjusted for age, sex, ethnicity, month of assessment, history of hypertension, systolic blood pressure, medication for hypercholesterolaemia or hypertension, and body-mass index categories. 328 594 participants aged 40-69 years were included in the study, with a mean follow-up period of 4·9 years (SD 0·83) after the landmark period for all-cause and cardiovascular disease mortality, and 4·1 years (0·81) for cardiovascular disease incidence. In the least deprived quintile, the adjusted hazard ratio (HR) in the least healthy lifestyle category, compared with the most healthy category, was 1·65 (95% CI 1·25-2·19) for all-cause mortality, 1·93 (1·16-3·20) for cardiovascular disease mortality, and 1·29 (1·10-1·52) for cardiovascular disease incidence. Equivalent HRs in the most deprived quintile were 2·47 (95% CI 2·04-3·00), 3·36 (2·36-4·76), and 1·41 (1·25-1·60), respectively. The HR for trend for one increment change towards least healthy in the least deprived quintile compared with that in the most deprived quintile was 1·25 (95% CI 1·12-1·39) versus 1·55 (1·40-1·70) for all-cause mortality, 1·30 (1·05-1·61) versus 1·83 (1·54-2·18) for cardiovascular disease mortality, and 1·10 (1·04-1·17) versus 1·16 (1·09-1·23) for cardiovascular disease incidence. A significant interaction was found between lifestyle and deprivation for all-cause and cardiovascular disease mortality (both pinteraction<0·0001), but not for cardiovascular disease incidence (pinteraction=0·11). Wide combinations of lifestyle factors are associated with disproportionate harm in deprived populations. Social and fiscal policies that reduce poverty are needed alongside public health and individual-level interventions that address a wider range of lifestyle factors in areas of deprivation. None.

Does long sleep duration increase risk of metabolic syndrome in Azar cohort study population?

Background: We decided to assess the correlation between metabolic syndrome (MetS) risks,sleep and napping duration in Azar cohort population according to the increasing incidence of MetS in the world and inconsistence results about sleep duration and MetS. Methods: In this cross-sectional study, MetS and sleep habits of 14916 subjects (35-70 years old) who inhabited in Shabestar city were determined by ATPIII and Pittsburg questionnaire respectively. Inclusion criteria were subjects with 35-70 years old and living in Shabestar for at least 9 months of the year.Results: According to the results, age, living place, body mass index, hypnotic drug use, sleep and napping duration and TV time were the risk factors of MetS. In this regard, long sleep duration (>9 h/24 h), napping (0.25-2 h/day), hypnotic drug use and watching TV (2 h/day)increased the risk of MetS by 1.18 (1.05-1.33), 1.16(1.07-1.26), 1.35(1.13-1.60), and 1.13(1.04-1.23) respectively.Conclusion: According to these results, it appears that proper education for improvement of sleep habit is necessary to reduce incidence of MetS and its consequences. However, there is need for more longitudinal researches and using objective method of sleep habits evaluation for more precise results.

Sleep duration, timing, variability and measures of adiposity among 8- to 12-year-old children with obesity.

SummaryObjectivesSleep disruption in laboratory studies increases adiposity and decreases glucose tolerance. However, few epidemiological studies have used objective measures of sleep. This study aims to assess associations between sleep duration, timing and regularity with measures of adiposity.MethodsThis is a cross‐sectional study of 188 children with obesity (age: 10.50 ± 1.39 years; body mass index: 29.24 ± 5.04 kg m−2). Nightly sleep duration, bedtime and wake time were measured by multiple‐day actigraphy and parent reports. Per cent overweight (per cent over median body mass index for age and sex) was chosen as the primary measure of obesity status. Objective measures of height, weight, waist circumference, blood pressure, fasting blood lipids, glucose, insulin, glycated haemoglobin and C‐reactive protein were obtained. Television screen time and total caloric intake were assessed via parent questionnaire.ResultsEach hour later in weekday bedtime was associated with an additional 6.17 per cent overweight (95% confidence interval [CI]: 1.42–10.92). Each hour greater in day‐to‐day variability in weekday bedtime and weekday wake time was associated with an additional 10.20 (95% CI: 0.50–19.91) and 10.02 (95% CI: 1.55–18.50) per cent overweight, respectively. Associations were similar after controlling for other obesity‐related behaviours (television screen time, total caloric intake and physical activity.)ConclusionsAmong children with obesity, later bedtime and greater variability in bedtime and wake time are associated with greater adiposity, independent of other obesity‐related behaviours. Early bedtime and wake time and consistent day‐to‐day sleep timing may be strategies to reduce adiposity in high‐risk children.

School start time changes in the COMPASS study: associations with youth sleep duration, physical activity, and screen time

BackgroundTo date, no longitudinal population-based studies of school start times have been conducted within Canada. School schedule changes provided an opportunity to examine start times in association with youth sleep, physical activity, and screen use over time. MethodsThis longitudinal study included grade 9–12 students attending 49 Ontario secondary schools that participated in at least two consecutive years of the COMPASS study (2012–2017). Fixed effects models tested whether differences in within-student change in self-reported sleep duration, moderate-to-vigorous physical activity, and screen time were associated with school start time changes, adjusting for student- (grade, sex, ethnicity, spending money) and school-level covariates (median income, urbanicity, geographical area). ResultsThirteen start time changes of 5–10 min were reported. Ten-minute advances at earlier clock times (8:30 AM–8:20 AM; 8:40 AM–8:30 AM) were associated with steeper sleep duration declines than schools with consistent start times but had no effect at later times (9:00 AM–8:50 AM). While sleep change did not differ with 5-min delays, 10-min delays (8:50 AM–9:00 AM) were associated with additional sleep (23.7 min). Apart from one school that shifted from 8:30 AM to 8:35 AM, in which screen time and physical activity decreased more steeply, no effect was found for screen time, and 5-min delays were associated with more physical activity (10.9 min) and advances with less activity (−8.0 min). ConclusionsResults support start time delays as a valuable strategy to help ameliorate sleep debt among youth. Interference with physical activity or increased screen time appear unlikely with modest schedule changes. Potential adverse impacts on sleep require consideration with 10-min advances.

Correlates of nocturnal sleep duration, nocturnal sleep variability, and nocturnal sleep problems in toddlers: results from the GET UP! Study

ObjectiveTo explore the correlates of nocturnal sleep duration, nocturnal sleep variability, and nocturnal sleep problems in a sample of Australian toddlers. MethodsParticipants were 173 toddlers (average age 19.7 ± 4.1 months) from the GET UP! Study. Nocturnal sleep duration, nocturnal sleep variability, nap(s) and physical activity were measured using 24-h accelerometry (Actigraph GT3X+) over seven consecutive days. Nocturnal sleep problems were assessed using the Tayside Children's Sleep Questionnaire. Screen time was reported by the parents. Logistic regression models were used to examine the associations between potential correlates (ie, age, sex, socio-economic status, weight status, physical activity, screen time, nap(s), bedtimes, and wake-up times) and nocturnal sleep characteristics. ResultsOlder children were more likely to have greater sleep variability (OR: 1.97; 95% CI: 1.08–3.61). Less physical activity (OR: 2.38; 95% CI: 1.27–4.45), shorter nap(s) (OR: 2.42, 95% CI: 1.29–4.55), and later wake-up times (OR: 4.42; 95% CI: 2.32–8.42) were associated with higher odds of having longer nocturnal sleep duration. Late bedtimes were associated with shorter nocturnal sleep duration (OR: 0.09; 95% CI: 0.04–0.18) and with greater nocturnal sleep variability (OR: 1.97; 95% CI: 1.06–3.68). None of the potential correlates were associated with nocturnal sleep problems. ConclusionThe present study identifies several correlates of nocturnal sleep duration (total physical activity, nap(s), bedtime, and wake-up time) and nocturnal sleep variability (age and bedtime), whereas no correlates were identified for nocturnal sleep problems. The association between late bedtimes and shorter nocturnal sleep duration and greater nocturnal variability suggests that these may be modifiable targets for future sleep interventions in early childhood. Trial registrationAustralian New Zealand Clinical Trials Registry: ACTRN12616000471482, 11/04/2016, retrospectively registered.

Comparison of Therapeutic Effects Between Thermosensitive Moxibustion and Medication in the Treatment of Insomnia of Liver-Qi Stagnation Pattern

To compare the therapeutic effect of thermosensitive moxibustion (TSM) and medication in the treatment of insomnia patients with the syndrome of stagnation of liver-qi. A total of 60 insomnia patients with the syndrome of liver-qi stagnation were randomly divided into TSM group and medication group (n ＝ 30 in each). Mild moxibustion was applied to bilateral Taichong (LR 3) and Qiuxu (GB 40) alternatively till the patient experienced an intense warmth (diathermic, heat transmission, etc.) feeling in the local region. The treatment was conducted once daily for 15 d. Patients of the medication group were ordered to take Estazolam tablets (1 mg/d) 1 h before sleeping, once daily for successive 15 days. The sleep quality (sleeping quality, falling asleep time, sleep duration, sleep efficiency, sleep disorders, hyponotic and day time dysfunction, 0－21 points) was evaluated by using Pittsburgh Sleep Quality Index (PSQI). The therapeutic effect was assessed in accordance with the "Guide Principles for Clinical Trials on New Drugs of Chinese Materia Medica (1993)" and international united sleep efficiency value. Following the treatment, the PSQI of both groups were significantly decreased relevant to their own pre-treatment (P<0.05), but without significant difference between the two groups (P>0.05). Of the two 30 cases in the medication and moxibustion groups, 12 (40.00%) and 20 (66.67%) had marked improvement, 7 (23.33%) and 6 (20.00%) were effective, and 11(36.67%) and 4 (13.33%) were invalid, with the effective rates being 63.33 % (19/30) and 86.67% (26/30), respectively. The effective rate of the TSM group was significantly higher than that of the medicine group (P <0.05). Thermosensitive moxibustion applied to the source points of the Liver and Gallbladder Meridians can improve the quality of sleep in insomnia patients with syndrome of liver-qi stagnation.

Accuracy of Patient Perception of Supine Sleep.

For clinicians involved in investigating and treating sleep disorders, understanding the accuracy of patient recall of supine sleep would allow informed comparisons between polysomnography (PSG) and patient-reported sleep in patients with supine-predominant obstructive sleep apnea. This study aims to assess the accuracy of patient perception of supine sleep. Prospective observational cohort study, assessing patient perception of total sleep and supine sleep, including duration. Data were analyzed utilizing descriptive statistics, bias-plot (Bland-Altman) analysis, and Spearman correlation (rs) to analyze relationships among continuous data. Total number of patients who underwent PSG was 518, with data from 368 of these patients analyzed. Most of these patients underwent diagnostic PSG (49.2%). Patients were excluded because of missing or incomplete data (n = 133) or immobility (n = 17). Some patients (n = 97, 26%) did not perceive supine sleep, with 34 (35% of those with unperceived supine sleep or 9% of whole group) of these having more than 60 minutes of PSG supine sleep (range 0-305.5 minutes). All "unsure" patients (n = 8, 2.2%) had significant supine sleep recorded (31.5-257.5 minutes). For the presence of any PSG supine sleep, questioning had a sensitivity of 77.9%, specificity 72.7% with positive predictive value of 96.7% and negative predictive value of 24.5%. There was a significant correlation (rs = 0.63, P < .0001) between perceived and PSG supine sleep, but wide limits of agreement (-246.9 to 194.2 minutes). In patients undergoing in-laboratory PSG, the perception of supine sleep predicts the presence of PSG supine sleep. However, questioning patients has a poor negative predictive value and patient estimates of supine sleep duration are inaccurate.

Teenage night owls or early birds? Chronotype and the mental health of adolescents.

Evidence suggests that the timing of sleep (chronotype) impacts mental health in young people, but previous studies have not accounted for sleep duration or school start time in this association, or examined a broad range of mental outcomes. In this study, we investigated the association between chronotype and mental health in a representative sample of adolescents from the 2014 Canadian Health Behaviour in School-Aged Children survey (29,635 students, 362 schools). We examined positive and negative aspects of mental health, using scores for emotional problems (range 0-33), emotional well-being (0-22), behavioural problems (0-28) and prosocial behaviours (0-25). We estimated chronotype using the time of mid-sleep on weekends and examined the associations using multilevel regressions, adjusted for sleep duration, school start time, individual, family and geographic characteristics. The average time of mid-sleep (chronotype) was 04:11hr. An hour delay in mid-sleep time was associated with more emotional problems (0.34 [95% confidence interval 0.23, 0.45] point higher score), more behavioural problems (2.0% [95% confidence interval 1.4%, 2.6%] higher score), less emotional well-being (0.19 [95% confidence interval 0.09, 0.20] point lower score), and fewer prosocial behaviours (0.18 [95% confidence interval 0.08, 0.29] point lower score). A later chronotype was associated with poorer mental health, independent of sleep duration and school start time, and across internalizing and externalizing mental health domains. Further research is needed to clarify the mechanisms underlying this association. The timing of sleep, and not just its duration, may be an additional consideration for youth mental health.

Sleep variability and nighttime activity among Tsimane forager-horticulturalists.

A common presumption in sleep research is that "normal" human sleep should show high night-to-night consistency. Yet, intra-individual sleep variation in small-scale subsistence societies has never been studied to test this idea. In this study, we assessed the degree of nightly variation in sleep patterns among Tsimane forager-horticulturalists in Bolivia, and explored possible drivers of the intra-individual variability. We actigraphically recorded sleep among 120 Tsimane adults (67 female), aged 18-91, for an average of 4.9 nights per person using the Actigraph GT3X and Philips Respironics Actiwatch 2. We assessed intra-individual variation using intra-class correlations and average deviation from each individual's average sleep duration, onset, and offset times ( ɛ¯). Only 31% of total variation in sleep duration was due to differences among different individuals, with the remaining 69% due to nightly differences within the same individuals. We found no statistically significant differences in Tsimane sleep duration by day-of-the-week. Nightly variation in sleep duration was driven by highly variable sleep onset, especially for men. Nighttime activities associated with later sleep onset included hunting, fishing, housework, and watching TV. In contrast to nightly sleep variation in the United States being driven primarily by "sleeping-in" on weekends, Tsimane sleep variation, while comparable to that observed in the United States, was driven by changing "bedtimes," independent of day-of-the-week. We propose that this variation may reflect adaptive responses to changing opportunity costs to sleep/nighttime activity.

Polygonatum sibiricum rhizome promotes sleep by regulating non-rapid eye movement and GABAergic/serotonergic receptors in rodent models.

The aim of this study is to investigate the sleep-promoting effect of a water extract of the Polygonatum sibiricum rhizome (PSE) in rodent models. PSE contained oleamide (0.10 mg/g extract) and glyceryl monolinoleate (0.17 mg/g extract), which are recognized as sleep-promoting substances. In pentobarbital-induced sleep model at hypnotic level, PSE (160 mg/kg) administration significantly decreased sleep latency time by 29% (2.7 min) and increased sleep duration time by 70% (68.4 min) compared with the normal control (3.8 min and 40.7 min, respectively). In the electroencephalography (EEG) analysis of rats, PSE-mediated sleep promotion accompanied the change of sleep architecture including increase of non-rapid eye movement (NREM) and decrease of REM. This sleep promoting effect was more obvious in caffeine-induced awakening model; total sleep time was increased by 40% along with increased NREM by PSE treatment at 160 mg/kg. In addition, PSE significantly increased the protein and mRNA levels of GABAA-R2 and 5-HT1A receptor, the major sleep-related neurotransmitter receptors. Furthermore, glyceryl monolinoleate and oleamide effectively bound to GABAA receptor in a competitive binding assay. These results indicate that PSE-mediated sleep-promoting effect is associated with the extension of NREM and upregulation of GABAA-R2 and 5-HT1A, and is mediated by binding to the GABAA receptor in vertebrate models.

Melatonin and Sleep in Preventing Hospitalized Delirium: A Randomized Clinical Trial

PurposeStudies suggest that melatonin may prevent delirium, a condition of acute brain dysfunction occurring in 20%-30% of hospitalized older adults that is associated with increased morbidity and mortality. We examined the effect of melatonin on delirium prevention in hospitalized older adults while measuring sleep parameters as a possible underlying mechanism. MethodsThis was a randomized clinical trial measuring the impact of 3 mg of melatonin nightly on incident delirium and both objective and subjective sleep in inpatients age ≥65 years, admitted to internal medicine wards (non-intensive care units). Delirium incidence was measured by bedside nurses using the confusion assessment method. Objective sleep measurements (nighttime sleep duration, total sleep time per 24 hours, and sleep fragmentation as determined by average sleep bout length) were obtained via actigraphy. Subjective sleep quality was measured using the Richards Campbell Sleep Questionnaire. ResultsDelirium occurred in 22.2% (8/36) of subjects who received melatonin vs in 9.1% (3/33) who received placebo (P = .19). Melatonin did not significantly change objective or subjective sleep measurements. Nighttime sleep duration and total sleep time did not differ between subjects who became delirious vs those who did not, but delirious subjects had more sleep fragmentation (sleep bout length 7.0 ± 3.0 vs 9.5 ± 5.3 min; P = .03). ConclusionsMelatonin given as a nightly dose of 3 mg did not prevent delirium in non-intensive care unit hospitalized patients or improve subjective or objective sleep.

0244 Sleep Duration Time Trends and Averages Among Adults In The U.S. Population: 2005 –2014

0244 Sleep Duration Time Trends and Averages Among Adults In The U.S. Population: 2005 –2014

Sleeping, TV, Cognitively Stimulating Activities, Physical Activity, and Attention-Deficit Hyperactivity Disorder Symptom Incidence in Children: A Prospective Study.

To analyze associations between time spent sleeping, watching TV, engaging in cognitively stimulating activities, and engaging in physical activity, all at 4 years, and (1) attention-deficit/hyperactivity disorder (ADHD) symptoms and (2) behavior problems, both assessed at 7 years, in ADHD-free children at baseline. In total, 817 participants of the Infancia y Medio Ambiente birth cohort, without ADHD at baseline, were included. At the 4-year follow-up, parents reported the time that their children spent sleeping, watching TV, engaging in cognitively stimulating activities, and engaging in physical activity. At the 7-year follow-up, parents completed the Conners' Parent Rating Scales and the Strengths and Difficulties Questionnaire, which measure ADHD symptoms and behavior problems, respectively. Negative binomial regression models were used to assess associations between the activities at 4 years and ADHD symptoms and behavior problems at 7 years. Children (48% girls) spent a median (p25-p75) of 10 (10-11) hours per day sleeping, 1.5 (0.9-2) hours per day watching TV, 1.4 (0.9-1.9) hours per day engaging in cognitively stimulating activities, and 1.5 (0.4-2.3) hours per day engaging in physical activity. Longer sleep duration (>10 hours per day) was associated with a lower ADHD symptom score (adjusted incidence rate ratio = 0.97, 95% confidence interval, 0.95-1.00). Longer time spent in cognitively stimulating activities (>1 hours per day) was associated with lower scores of both ADHD symptoms (0.96, 0.94-0.98) and behavior problems (0.89, 0.83-0.97). Time spent watching TV and engaging in physical activity were not associated with either outcomes. A shorter sleep duration and less time spent in cognitively stimulating activities were associated with an increased risk of developing ADHD symptoms and behavior problems.

Sleep and physical activity: a cross-sectional objective profile of people with rheumatoid arthritis.

Regular physical activity (PA) is important for people with rheumatoid arthritis (RA). Poor sleep is a common complaint among people with RA, which may have an influence on their PA levels. There is a lack of objective information regarding total sleep time (TST) and PA duration in this population. A cross-sectional study design was used. SenseWear Pro3 Armband(R)TM is used to measure TST and total PA duration. Four valid days, with 95% wear time necessary for inclusion in final results. Disease activity and function were measured using the DAS-28, HAQ and VAS. Data analysis carried out using SPSS v22. Seventy-five (75) participants completed monitoring period, with 51 (68%) meeting modified PA duration guidelines. Data with 95% wear time over a minimum of 4days were available for 32 recorded participants, with a mean TST of 5.7 (SD_1.11) hours per night and a median 1.25 (IQR_1.88) hours of daily PA. TST had a positive significant relationship with PA (p = 0.018); PA demonstrated a negative significant relationship with functional limitations (p = 0.009) and correlated with lower CRP levels; CRP levels had in turn a significant relationship to global health (p = 0.034). Total sleep time was low for people with RA. People with RA who are more physically active have longer TST. These findings provide an objective profile of TST and PA duration in people with RA and suggest a relationship between increased PA duration and longer TST. Further research is needed to confirm these novel findings.