Sleep-wake Patterns Research Articles

Sleep-wake patterns in newborns are associated with infant rapid weight gain and incident adiposity in toddlerhood.

Rapid weight gain (RWG) by 6 months of life is a significant risk factor of childhood overweight (OW)/obesity. Infant sleep patterns are associated with incident OW in childhood, but few have examined its relationship with RWG. Examine associations between newborn sleep-wake patterns and incident RWG at 6 months of life and OW at 36 months. Low-income Mexican/Mexican-American women with OW/obesity and their infants (n = 126) enrolled in a 1-year randomized controlled trial designed to prevent incident, infant RWG and toddlerhood OW/obesity. Sleep pattern metrics at 1 month were extracted from the Brief Infant Sleep Questionnaire-Revised. Outcome measures included RWG (>0.67 positive change in weight-for-age Z-score) from birth to 6 months and incident OW (body mass index percentile ≥85) at 36 months. By 6 months, 35.7% (n = 45) of infants experienced RWG, and by 36 months 42.3% (n = 41) of toddlers were OW. Napping ≥5x/day at 1-month was significantly associated with decreased odds for RWG compared to napping <5x (OR = 0.11, 95%CI:0.02, 0.63). Each 1-hour increase in nocturnal vs diurnal sleep was associated with greater odds of incident OW at 36 mos (OR = 1.51, 95%CI:1.13, 2.03). Early-life sleep patterns related to infant nap frequency and nocturnal vs diurnal sleep distribution were associated with obesity outcomes and may be important intervention targets to prevent lasting consequences on infant growth.

The effects of career resilience and sleep-wake pattern on psychological distress of new employees: a longitudinal study

The effects of career resilience and sleep-wake pattern on psychological distress of new employees: a longitudinal study

Enhanced multi-source data analysis for personalized sleep-wake pattern recognition and sleep parameter extraction

Sleep behavior is traditionally monitored with polysomnography, and sleep stage patterns are a key marker for sleep quality used to detect anomalies and diagnose diseases. With the growing demand for personalized healthcare and the prevalence of the Internet of Things, there is a trend to use everyday technologies for sleep behavior analysis at home, having the potential to eliminate expensive in-hospital monitoring. In this paper, we conceived a multi-source data mining approach to personalized sleep-wake pattern recognition which uses physiological data and personal information to facilitate fine-grained detection. Physiological data includes actigraphy and heart rate variability and personal data makes use of gender, health status, and race information which are known influence factors. Moreover, we developed a personalized sleep parameter extraction technique fused with the sleep-wake approach, achieving personalized instead of static thresholds for decision-making. Results show that the proposed approach improves the accuracy of sleep and wake stage recognition, therefore offering a new solution for personalized sleep-based health monitoring.

Examining the day-to-day bidirectional associations between physical activity, sedentary behavior, screen time, and sleep health during school days in adolescents.

BackgroundAdolescence is a vulnerable period for experiencing poor sleep health. Growing studies have demonstrated lifestyle behaviors including physical activity (PA), screen time (SCT), and sedentary behaviors (SED) as the potential factors associated with sleep health in adolescents; yet, the evidence is inconclusive and the directionality of temporal associations across school days are not well understood. This study examined the day-to-day bidirectional associations of lifestyle behaviors with sleep health parameters in adolescents.MethodsA total of 263 adolescents (58% boys) in 6th - 8th grades wore an accelerometer for 24-hour across the three consecutive school days and completed recording SCT in time-diary and answering sleep quality (SQ) questions for each day. Sleep-wake patterns as well as time spent in moderate- and vigorous-intensity PA (MVPA) and SED were objectively quantified from the wrist-worn accelerometry data across the two segments of the day (during and after school hours). Mixed model analyses were conducted to test bidirectional associations between lifestyle factors and sleep health parameters in each temporal direction across the days. Additionally, indirect associations across the days were tested using an autoregressive cross-lagged model analysis in the framework of path analysis.ResultsMVPA minutes in a day did not predict sleep health parameters that night. The bidirectional associations were partially observed between SED and sleep health, but the significance and direction of the associations largely varied by the time segment of a day as well as types of sleep health parameters. Additionally, greater SCT during the day was associated with lower SQ that night (b = -0.010; P = .018), and greater SQ was associated with greater MVPA during school hours (b = 6.45; P = .028) and lower SED after school hours (b = -39.85; P = .029) the next day. Lastly, there were significant indirect associations of SCT with sleep health parameters across the days indicating multi-day lagged effects of SCT on sleep health the later nights.ConclusionThis study highlights the importance of lowering SCT for better sleep health in adolescents during school days. Additionally, perceived SQ is shown to be a potential significant predictor promoting healthy behaviors the next day independent of sleep-wake patterns. Further studies are warranted to confirm the observed temporal associations between SCT, SQ, and behavioral outcomes in this vulnerable population.

Fiat Lux: The Light Became Therapy. An Overview on the Bright Light Therapy in Alzheimer's Disease Sleep Disorders.

A system of photosensitive retinal ganglion cells provides 'non-visual' information on the circadian sequences of light to the suprachiasmatic nucleus (SCN), which, as the 'master clock', synchronizes the chronobiological mechanisms of all the biological clocks. Damage to SCN structure alters circadian behavioral and hormonal rhythms and interferes with a regular sleep-wake pattern. Several studies have shown that, in aging and in Alzheimer's disease (AD), circadian rhythms change their synchronization with the environment and behavior loses sync with light. The current overview aims to examine research studies showing the effect of bright light therapy (BLT) on sleep disorders and sleep-wake patterns in AD. A literature search was conducted, taking into consideration the relevant studies over the last 20 years. Fifteen studies have been thorough: seven followed an environmental-architectural approach and eight followed a treatment devices approach. Studies agree in considering BLT as a promising non-pharmacological intervention to compensate for circadian rhythm alterations and they support the need for standardized protocols that allow a comparison between multicenter studies. Interestingly, in an attempt to contain the spread of the COVID-19 pandemic, health authorities have forced the population to stay home. Therefore, AD people are not currently able to enjoy exposure to sunlight. It is predictable that they may experience an exacerbation of circadian disturbances and that the BLT can be an effective response to prevent such exacerbation.

Let there be blue-depleted light: in-patient dark therapy, circadian rhythms and length of stay

SUMMARYLight is the most important environmental influence (zeitgeber) on the synchronization of the circadian system in humans. Excess light exposure during the evening and night-time affects secretion of the hormone melatonin, which in turn modifies the temporal organization of circadian rhythms, including the sleep–wake cycle. As sleep disturbances are prominent in critically ill medical and psychiatric patients, researchers began to examine the impact of light exposure on clinical outcomes and length of hospitalization. In psychiatric inpatients, exposure to bright morning light or use of blue blocking glasses have proved useful interventions for mood disorders. Recently, knowledge about light and the circadian system has been applied to the design of inpatient facilities with dynamic lighting systems that change according to time of day. The installation of ‘circadian lighting’ alongside technologies for monitoring sleep–wake patterns could prove to be one of the most practical and beneficial innovations in inpatient psychiatric care for more than half a century.

Impact of COVID-19 lockdown on sleep-wake schedule and associated lifestyle related behavior: A national survey.

Background: Lockdowns to prevent the community transmission of COVID-19 pandemic has confined the people at home and imposed social restrictions, which is expected to cause alterations in circadian driven sleep-wake schedule and its associated lifestyle behaviors.Design and Methods: An online questionnaire-based survey was conducted to assess the impact of lockdown on the sleepwake pattern, meal timings and digital media exposure time on the Indian population during lockdown. Responses of 1511 participants (age ≥18 years) were analyzed to assess the effect of gender and age on these parameters before and during lockdown.Results: The sleep onset-wakeup times and meals’ time was significantly delayed during lockdown, which was more pronounced in younger subjects. However, young individuals reported increased sleep duration at this time. Increased digital media duration was evident in all age groups, mainly in males. However, females reported more delay in sleep onset-waking time and first meal timing with longer sleep duration during lockdown.Conclusions: Discord with social and natural cues due to complete lockdown during COVID-19 pandemic leads to a state of social jetlag with delayed sleep-wake, meal timings and excessive digital media exposure among Indians, which has differential impact on males and females as well as across different age groups. These findings have applied implications in sleep health and related behavior during longer social isolation conditions such as current COVID-19 or similar situations and may help to prepare better for any such future events.Significance for public healthIn the background of ongoing COVID-19 pandemic, and increased incidences of domestic violence and unrest, this study reflects a significant influence of prolonged lockdown on some of the basic indicators of lifestyle such as sleep-wakefulness, timing of meals and usage of electronic media. Increased sleep duration in younger age groups with increased screen time and delayed meal time indicate their increased susceptibility to stress and its psychological consequences such as depression, thereby potentially affecting professional productivity and personal relationships. The senior age groups are also adversely affected in relation to these aspects, being increasingly susceptible to associated health risks. On the other hand, across genders, women exhibit greater disruption of their lifestyle behavior in terms of sleep-wake pattern and meal timings which might lead to hormonal imbalance related health conditions over long time. These findings hold vital potential to mitigate any such associated adverse effects.

Effects of digital cognitive behavioural therapy for insomnia on insomnia severity: a large-scale randomised controlled trial

Although several large-scale randomised controlled trials have shown the efficacy of digital cognitive behavioural therapy for insomnia (dCBT-I), there is a need to validate widespread dissemination of dCBT-I using recommended key outcomes for insomnia. We investigated the effect of a fully automated dCBT-I programme on insomnia severity, sleep-wake patterns, sleep medication use, and daytime impairment. We did a parallel-group superiority randomised controlled trial comparing dCBT-I with online patient education about sleep. The interventions were available through a free-to-access website, publicised throughout Norway, which incorporated automated screening, informed consent, and randomisation procedures, as well as outcome assessments. Adults (age ≥18 years) who had regular internet access and scored 12 or higher on the Insomnia Severity Index (ISI) were eligible for inclusion, and were allocated (1:1) to receive dCBT-I (consisting of six core interactive sessions to be completed over 9 weeks) or patient education (control group). Participants were masked to group assignment and had no contact with researchers during the intervention period. The primary outcome was the change in ISI score from baseline to 9-week follow-up, assessed in the intention-to-treat population. This trial is registered with ClinicalTrials.gov (NCT02558647) and is ongoing, with 2-year follow-up assessments planned. Between Feb 26, 2016, and July 1, 2018, 5349 individuals commenced the online screening process, of which 1497 were ineligible or declined to participate, 2131 discontinued the screening process, and 1721 were randomly allocated (868 to receive dCBT-I and 853 to receive patient education). At 9-week follow-up, 584 (67%) participants in the dCBT-I group and 534 (63%) in the patient education group completed the ISI assessment. The latent growth model showed that participants in the dCBT-I group had a significantly greater reduction in ISI scores from baseline (mean score 19·2 [SD 3·9]) to 9-week follow-up (10·4 [6·2]) than those in the patient education group (from 19·6 [4·0] to 15·2 [5·3]; estimated mean difference -4·7 (95% CI -5·4 to -4·1; Cohen's d -1·21; p<0·001). Compared with patient education, the number needed to treat with dCBT-I was 2·7 (95% CI 2·4 to 3·2) for treatment response (ISI score reduction ≥8) and 3·2 (2·8 to 3·8) for insomnia remission (ISI score <8). No adverse events were reported to the trial team. dCBT-I is effective in reducing the severity of symptoms associated with the insomnia disorder. These findings support the widespread dissemination of dCBT-I. Future research is needed to identify the moderators of response and to improve targeting. Norwegian Research Council; Liaison Committee for Education, Research and Innovation in Central Norway.

Actigraphy in sleep research with infants and young children: Current practices and future benefits of standardized reporting.

Actigraphy is a cost‐efficient method to estimate sleep–wake patterns over long periods in natural settings. However, the lack of methodological standards in actigraphy research complicates the generalization of outcomes. A rapidly growing methodological diversity is visible in the field, which increasingly necessitates the detailed reporting of methodology. We address this problem and evaluate the current state of the art and recent methodological developments in actigraphy reporting with a special focus on infants and young children. Through a systematic literature search on PubMed (keywords: sleep, actigraphy, child *, preschool, children, infant), we identified 126 recent articles (published since 2012), which were classified and evaluated for reporting of actigraphy. Results show that all studies report on the number of days/nights the actigraph was worn. Reporting was good with respect to device model, placement and sleep diary, whereas reporting was worse for epoch length, algorithm, artefact identification, data loss and definition of variables. In the studies with infants only (n = 58), the majority of articles (62.1%) reported a recording of actigraphy that was continuous across 24 hr. Of these, 23 articles (63.9%) analysed the continuous 24‐hr data and merely a fifth used actigraphy to quantify daytime sleep. In comparison with an evaluation in 2012, we observed small improvements in reporting of actigraphy methodology. We propose stricter adherence to standards in reporting methodology in order to streamline actigraphy research with infants and young children, to improve comparability and to facilitate big data ventures in the sleep community.

Developmental effects on sleep\u2013wake patterns in infants receiving a cow\u2019s milk-based infant formula with an added prebiotic blend: a Randomized Controlled Trial

BackgroundFew studies have evaluated nutritive effects of prebiotics on infant behavior state, physiology, or metabolic status.MethodsIn this double-blind randomized study, infants (n = 161) received cow’s milk-based infant formula (Control) or similar formula with an added prebiotic blend (polydextrose and galactooligosaccharides [PDX/GOS]) from 14–35 to 112 days of age. Infant wake behavior (crying/fussing, awake/content) and 24-h sleep–wake actograms were analyzed (Baseline, Days 70 and 112). Salivary cortisol was immunoassayed (Days 70 and 112). In a subset, exploratory stool 16S ribosomal RNA-sequencing was analyzed (Baseline, Day 112).ResultsOne hundred and thirty-one infants completed the study. Average duration of crying/fussing episodes was similar at Baseline, significantly shorter for PDX/GOS vs. Control at Day 70, and the trajectory continued at Day 112. Latency to first and second nap was significantly longer for PDX/GOS vs. Control at Day 112. Cortisol awakening response was demonstrated at Days 70 and 112. Significant stool microbiome beta-diversity and individual taxa abundance differences were observed in the PDX/GOS group.ConclusionsResults indicate faster consolidation of daytime waking state in infants receiving prebiotics and support home-based actigraphy to assess early sleep–wake patterns. A prebiotic effect on wake organization is consistent with influence on the gut–brain axis and warrants further investigation.ImpactFew studies have evaluated nutritive effects of prebiotics on infant behavior state, cortisol awakening response, sleep–wake entrainment, and gut microbiome.Faster consolidation of daytime waking state was demonstrated in infants receiving a prebiotic blend in infant formula through ~4 months of age.Shorter episodes of crying were demonstrated at ~2 months of age (time point corresponding to age/developmental range associated with peak crying) in infants receiving formula with added prebiotics.Results support home-based actigraphy as a suitable method to assess early sleep–wake patterns.Prebiotic effect on wake organization is consistent with influence on the gut–brain axis and warrants further investigation.

Sleep Variability Is A Predictor Of Peripheral Vascular Function In Apparently Healthy Undergraduate College Students

Experimental studies suggest that highly variable sleep-wake patterns may impair vascular function, suggesting a potential mechanism for the increased risk of cardiovascular (CV) diseases seen in shift workers and those with sleep disorders. However, it is unclear if naturalistic, day-to-day variability in sleep-wake patterns of generally healthy individuals poses a risk to vascular function. PURPOSE: To examine the association between sleep variability (SLV) and vascular function in undergraduate college students. METHODS: SLV metrics were estimated in 39 healthy undergraduate students (20 ±0.2 years) using wrist actigraphy for 14 days and nights. Sleep timing was defined by sleep midpoint (halfway point between sleep onset and wake onset). Sleep timing variability (STV) was then quantified as the standard deviation (SD) of sleep midpoint, and sleep duration variability (SDV) as the SD of sleep duration across 14 days. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Peripheral vascular function was indexed as the magnitude of hyperemia in response to passive leg movement (PLM) and was performed immediately following the end of sleep monitoring. Blood velocity and femoral artery diameter were measured via Doppler ultrasound. RESULTS: In a linear regression model adjusting for sex and body mass, SDV predicted peak leg blood flow (LBF) (β=-0.49, p<0.01), change in LBF from baseline to peak (β=-0.50, p<0.01), and LBF area under the curve (AUC) (β=-0.57, p<0.01) during PLM. Associations remained significant when the model included PSQI score (all p<0.01). Similarly, models adjusting for sex and mass found that STV predicted LBF AUC (β=-0.30, p=0.05). CONCLUSION: In adjusted models, greater SLV is associated with less optimal peripheral vascular function in healthy college students. These data support the growing body of literature suggesting that regular sleep schedules may be important for CV health, even in otherwise healthy young adults. Supported, in part, by NIH P20GM113125.

Interaction Between Circadian Rhythms, Energy Metabolism, and Cognitive Function.

The interaction between meal timing and light regulates circadian rhythms in mammals and not only determines the sleep-wake pattern but also the activity of the endocrine system. Related with that, the necessity to fulfill energy needs is a driving force that requires the participation of cognitive skills whose performance has been shown to undergo circadian variations. These facts have led to the concept that cognition and feeding behaviour can be analysed from a chronobiological perspective. In this context, research carried out during the last two decades has evidenced the link between feeding behaviour/nutritional habits and cognitive processes, and has highlighted the impact of circadian disorders on cognitive decline. All that has allowed hypothesizing a tight relationship between nutritional factors, chronobiology, and cognition. In this connection, experimental diets containing elevated amounts of fat and sugar (high-fat diets; HFDs) have been shown to alter in rodents the circadian distribution of meals, and to have a negative impact on cognition and motivational aspects of behaviour that disappear when animals are forced to adhere to a standard temporal eating pattern. In this review, we will present relevant studies focussing on the effect of HFDs on cognitive aspects of behaviour, paying particular attention to the influence that chronobiological alterations caused by these diets may have on hippocampaldependent cognition.

0966 Sleep-Wake Patterns in Mothers and Children in a Rural Community With Limited Access to Electricity: Results from the Ghana Randomized Air Pollution and Health Study

Abstract Introduction Studies measuring objective sleep duration in rural/indigenous populations are limited, showing sleep duration similar to that of industrialized countries. Little is known about sleep duration in women of reproductive age, and children within these populations. Our study is the first to objectively characterize sleep in mothers and children in an agrarian community with limited access to electricity, utilizing data from the Ghana Randomized Air Pollution and Heath Study (GRAPHS). Methods The GRAPHS cohort, a cluster-randomized trial, evaluated the efficacy of clean fuels on birthweight and infant pneumonia incidence in central Ghana. The study initially recruited pregnant women and newborns in 2013. This study is now utilizing wrist-actigraphy to analyze sleep-wake patterns among mothers and children of GRAPHS. We have thus far analyzed actigraphy in 39 mothers and 49 children (including 25 mother-child pairs), using the Motionlogger-MicroWatch with the Cole-Kripke algorithm to assess total sleep time (TST). We report baseline characteristics and sleep-wake patterns of our sample. Results Mean age of mothers was 33.5 years, (range 22-48), and mean age of children was 3.9 years (3-4). Average nights recorded were 4 (standard deviation [SD] 2.1). For mothers, average median time-in-bed was 7.9 (SD 1.2) hours, TST was 6.4 (SD .9) hours, and sleep efficiency was 82% (SD 7.9). Median bedtime was 9:33pm (SD 1.5 hours), and median wake-time was 5:56am (SD 1.4 hours). For children, average median time-in-bed was 9.9 (SD 1.0) hours, TST was 8.2 (SD 0.9) hours, and sleep efficiency was 83% (SD 6). Median bedtime was 8:03pm (SD 0.8 hours), and median wake-time was 6:06am (SD 0.6 hours). There was no correlation between sleep measures in mother-child pairs. Conclusion In an agrarian Ghanaian community with limited access to electricity, objective sleep measures in women were similar to prior studies conducted in indigenous/rural populations of developing African countries (Ndiaye et.al.2007, Samson et.al.2016), though data in children is lacking for comparison. When compared with post-industrialized countries, objective sleep measures for this age group of non-gravid women are sparse. In toddlers however, TST was lower in our cohort when compared with objective sleep amongst toddlers in industrialized nations. Support 2K24HL109156-06A1

0249 Effects of Alcohol Consumption on Sleep-Wake Pattern of a Rat Model of Anxiety

Abstract Introduction Anxiety is an important factor for self-administered alcohol as a tool to reduce its symptoms. However, alcohol is capable to disrupt sleep-wake patterns in subjects with medium- to high-alcohol consumption. We have selectively bred two sublines from Sprague-Dawley rats that differ on its yawning frequency. High-yawning (HY) rats have a mean of 20 yawns/h, whereas the Low-yawning (LY) rats have only 2 yawns/hour. LY rats also showed anxious responses when evaluated on standardized tests. The aim of this study was to assess the changes on sleep-wake patterns after chronic alcohol consumption. Methods We used 8 males from HY and LY sublines at 3 months of age, they lived in acrylic cages with water and food pellets available ad libitum under a 12:12 light-dark cycle (lights on at 0700) and temperature of 21±1 °C. All subjects were implanted to record EEG, EMG and EOG to characterize sleep-wake phases. A baseline sleep-wake recording was obtained for 24 h. A solution of 9.6% alcohol was administered as a single source of hydration for seven days and then a second sleep-wake recording was obtained. After that period, an additional bottle containing purified water was available. Position of the bottles was randomly changed daily. Water and alcohol consumption were measured daily for a period of 3 weeks and then a third sleep-wake recording was obtained. Results LY rats consumed more alcohol than HY rats (P&amp;lt;0.05), and they had an increase of bouts and duration of slow wave sleep and REM sleep on their active phase after alcohol administration (P&amp;lt;0.05). Conclusion LY rats display an anxious behavior and therefore consumed more alcohol compared to HY rats, and only LY rats were susceptible to alcohol effects on sleep on their active phase. Support Partially supported by CONACYT grants 243333 and 243247 to CC and JRE, respectively. Grants from VIEP-BUAP 2018 and CA in Neuroendocrinología BUAP-CA-288.

0427 Bicuculine Increased the Cataplexy in the Male Taiep Rats: An Animal Model of Narcolepsy with an Inherent Tubulopathy

Abstract Introduction Narcolepsy is a hypersomnolence that is characterized by sleep fragmentation, sleep paralysis, hypnagogic hallucinations and cataplexy that is characterized by atonia induced by strong emotions. The amygdala is the trigger for cataplexy through GABAergic mechanisms. Taiep is a myelin mutant with TUBB4A tubulopathy which showed spontaneous episodes of atonia or induced by manipulations from the tail or the thorax. EEG recordings during immobility episodes (IE′s) had a cerebral cortex desynchronized associated to theta rhythm in the hippocampus. The aim of this sturdy was to analyze the effects of bicuculine administration on IE′s and sleep-wake pattern on adult male taiep rats. Methods We used 6 taiep male rats at 9 months of age. The subjects (Ss) lived in individual acrylic cages with water and food pellets available ad libitum, under a 12:12 light-dark cycle (lights on at 0700), with controlled temperature and humidity recording room. All Ss were implanted to record EEG, EMG and EOG to characterize EI′s. We evaluated a basal 24 h EEG recording and then after bicuculine i.p. administration of 0.5, 1 y 1.5 mg/Kg every 48h. We measured the number, mean duration and latency to the first IE′s. Results The duration of IE′s increased 527% with 1 mg/Kg and reach 700% with 1.5 mg/Kg of bicuculine (P&amp;lt;0.01) with respect to saline-treated control group. Importantly, the frequency of IEs did not differ among the groups and did not affect the number of awake, slow wave or rapid eye movements sleep phases. Conclusion Bicuculine, a specific GABA antagonist, modify the duration of IES but not their frequency supporting a role of GABAergic mechanism on IE′s. It is relevant because sodium oxybate, an indirect GABA agonist, reduced cataplexy and improved sleep quality on narcoleptic patients. Support CONACYT grants 243333 and 243247 to CC and JRE, respectively and from VIEP-BUAP 2019 to CA in Neuroendocrinología BUAP-CA-288.

0330 Sleep Hygiene in Preschoolers: Assessing Biopsychosocial Factors Associated with Preschoolers’ Readiness to Learn

Abstract Introduction Sleep is crucial during early development to promote health, education, growth, and quality of life. Insufficient sleep is a public health problem, and this is clearly true for young children. The National Institutes of Health reported that preschoolers need 11-12 hours of sleep daily. We hypothesized that more physically active children would experience better sleep quality which would be associated with higher scores on cognitive and socioemotional measures. We also hypothesized that increased parental awareness of their child’s sleep patterns would predict more successful sleep health indicators in their children, leading to positive impact on preschoolers’ readiness to learn. Methods 82 preschoolers (ages 3-5) completed memory tests, a sleep hygiene scale, and a socioemotional assessment. Following initial cognitive and socioemotional testing, Fitbit devices collected activity and sleep measures for 12 weeks. Additionally, parents recorded bedtimes, wake times, total sleep time, naps, and activity levels in daily sleep journals. We assessed the association between physical activity and sleep quality, bedtime, wake time, memory, sleep hygiene, and socioemotional measures. Results Physical activity was positively associated with better sleep habits, including earlier bedtimes, earlier wake times, more consistent sleep-wake patterns, socioemotional scores, and working memory capacity. Higher child and parent sleep hygiene scales were associated with more consistent bedtimes. On average, the 82 preschoolers tested fell short of the recommended 11-12 hours of sleep per night. Conclusion Greater child and parent awareness of practicing good sleep hygiene increased the likelihood for the child to practice better sleep habits. Since physical activity was positively associated with sleep health measures, it is critical that parents and teachers prioritize sleep and activity in young children. Results of this study provide greater knowledge regarding associations between sleep, physical activity, and biopsychosocial outcomes that may be useful in implementing better education for parents and children geared toward improving sleep. Support This research was generously supported by the Caplan Foundation for Early Childhood and the Hope College Psychology Department.

1193 Accuracy of a Commercial Wearable in Detecting Sleep Stages Compared to Polysomnography in Adults: Considering Sleep Classification Methods and Effects of Evening Alcohol Consumption

Abstract Introduction Commercial wearable devices have shown the capability of collecting and processing multisensor information (motion, cardiac activity), claiming to be able to measure sleep-wake patterns and differentiate sleep stages. While using these devices, users should be aware of their accuracy, sources of measurement error and contextual factors that may affect their performance. Here, we evaluated the agreement between Fitbit Charge 2™ and PSG in adults, considering effects of two different sleep classification methods and pre-sleep alcohol consumption. Methods Laboratory-based synchronized recordings of device and PSG data were obtained from 14 healthy adults (42.6±9.7y; 6 women), who slept between one and three nights in the lab, for a total of 27 nights of data. On 10 of these nights, participants consumed alcohol (up to 4 standard drinks) in the 2 hours before bedtime. Device performance relative to PSG was evaluated using epoch-by-epoch and Bland-Altman analyses, with device data obtained from a data-management platform, Fitabase, via two methods one that accounts for short wakes (SW, awakenings that last less than 180s) and one that does not (not-SW). Results SW and not-SW methods were similar in scoring (96.76% agreement across epochs), although the SW method had better accuracy for differentiating “light”, “deep”, and REM sleep; but produced more false positives in wake detection. The device (SW-method) classified epochs of wake, “light” (N1+N2), “deep” (N3) and REM sleep with 56%, 77%, 46%, and 62% sensitivity, respectively. Bland-Altman analysis showed that the device significantly underestimated “light” (~19min) and “deep” (~26min) sleep. Alcohol consumption enhanced PSG-device discrepancies, in particular for REM sleep (p=0.01). Conclusion Our results indicate promising accuracy in sleep-wake and sleep stage identification for this device, particularly when accounting for short wakes, as compared to PSG. Alcohol consumption, as well as other potential confounders that could affect measurement accuracy should be further investigated. Support This study was supported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) grant R21-AA024841 (IMC and MdZ). The content is solely the responsibility of the authors and does not necessarily represent the official views the National Institutes of Health.

SUN-691 Type 2 Diabetes Management in the Context of Smith-Magenis Syndrome: Case Report

Background: Smith-Magenis syndrome (SMS) is a rare condition caused by microdeletion chromosome 17p11.2 via RAI1 gene mutations, causing disrupted circadian sleep-wake patterns. Characteristic behaviors include: sleep disturbance, anxiety, maladaptive habits with self-injury (biting, picking, self-hugging, page-flipping) and outbursts. Characteristic features include: craniofacial abnormalities, short stature, 2/3 toe syndactyly, scoliosis, cardiac and genitourinary defects, hypotonia, peripheral neuropathy, epilepsy, childhood-onset truncal obesity, toileting difficulties. Management of adults with SMS span multiple disciplines: otolaryngology, audiology, ophthalmology, assessments of scoliosis, seizures, familial psychosocial health, sleep and behavioral changes with each medication. Annual assessments include: fasting lipids, thyroid panel, screening urinalysis. Patients should receive standard treatment for comorbid endocrine conditions, classically: hypercholesterolemia, hypothyroidism, growth hormone deficiency.Clinical Case: 49-year-old Hispanic female with history of SMS who presented to endocrinology for type 2 diabetes mellitus (T2DM) management. Past medical history includes T2DM with peripheral neuropathy, hypertension, hypercholesterolemia, intellectual disability, anxiety, recurrent genitourinary infections, sleep apnea. Physical exam is remarkable for macroglossia, truncal obesity, scoliosis, extremity excoriations evident of skin picking and xerosis, syndactyly of 2nd-3rd toes. Patient exhibited maladaptive behaviors like page-flipping, self-hugging, tantrums. Over the past 3 years, BMI remained in the obese range (>30 kg/m2) and A1c fluctuated from 7.0 to 10.6% averaging 8.8% (<5.7%). Patient is currently managed on insulin glargine, pioglitazone and liraglutide. She did not tolerate metformin due to dose-dependent diarrhea. Patient’s mother chose against SGLT2 inhibitors due to diminished genitourinary hygiene. T2DM management was complicated by patient behaviors, including nocturnal consumption of fructose-containing food and beverages, exercise intolerance, and associated caregiver fatigue.Conclusion: This case describes a patient managed for metabolic dysfunction in conjunction with a rare microdeletion disorder causing neurobehavioral disturbance with disrupted circadian sleep-wake patterns. The most difficult aspects of diabetes management included difficulty implementing lifestyle modifications to control the patient’s hyperglycemia.

Sleep and diurnal rest-activity rhythm disturbances in a mouse model of Alzheimer's disease.

Accumulating evidence suggests a strong association between sleep, amyloid-beta (Aβ) deposition, and Alzheimer's disease (AD). We sought to determine if (1) deficits in rest-activity rhythms and sleep are significant phenotypes in J20 AD mice, (2) metabotropic glutamate receptor 5 inhibitors (mGluR5) could rescue deficits in rest-activity rhythms and sleep, and (3) Aβ levels are responsive to treatment with mGluR5 inhibitors. Diurnal rest-activity levels were measured by actigraphy and sleep-wake patterns by electroencephalography, while animals were chronically treated with mGluR5 inhibitors. Behavioral tests were performed, and Aβ levels measured in brain lysates. J20 mice exhibited a 4.5-h delay in the acrophase of activity levels compared to wild-type littermates and spent less time in rapid eye movement (REM) sleep during the second half of the light period. J20 mice also exhibited decreased non-rapid eye movement (NREM) delta power but increased NREM sigma power. The mGluR5 inhibitor CTEP rescued the REM sleep deficit and improved NREM delta and sigma power but did not correct rest-activity rhythms. No statistically significant differences were observed in Aβ levels, rotarod performance, or the passive avoidance task following chronic mGluR5 inhibitor treatment. J20 mice have disruptions in rest-activity rhythms and reduced homeostatic sleep pressure (reduced NREM delta power). NREM delta power was increased following treatment with a mGluR5 inhibitor. Drug bioavailability was poor. Further work is necessary to determine if mGluR5 is a viable target for treating sleep phenotypes in AD.

The relationship between chronotype and intelligence: the importance of work timing

Sleep-wake patterns show substantial biological determination, but they are also subject to individual choice and societal pressure. Some evidence suggests that high IQ is associated with later sleep patterns. However, it is unclear whether the relationship between IQ and later sleep is due to biological or social effects, such as the timing of working hours. We investigated the association between habitual sleep timing during work days and work-free days, working time and membership in Mensa, an organization of highly intelligent individuals (IQ ≥130) using a sample of 1,172 adults split between Mensa members and age- and sex-matched volunteers from a large web-based database. We found no difference in chronotype, and the later sleep timing of Mensa members on work days was fully accounted for by later work start times. Our results indicate that later sleep timing in those with higher IQs is not due to physiological differences, but rather due to later work schedules. Later working times and the resulting lower social jetlag may be one of the reasons why higher IQ is associated with lower prospective morbidity and mortality.