Subjective Sleep Reports Research Articles

Sleep Physiology and Neurocognition Among Adolescents With Attention-Deficit/Hyperactivity Disorder

Few studies have characterized the nature of sleep problems among adolescents with attention-deficit/hyperactivity disorder (ADHD) using polysomnography (PSG). Additionally, although adolescents with ADHD and adolescents with sleep disturbances display similar neurocognitive deficits, the role of sleep in contributing to neurocognitive impairment in adolescent ADHD is unknown. This study investigated differences in PSG-measured sleep among adolescents with ADHD compared with non-psychiatric controls and associations with neurocognition. Medication-free adolescents aged 13 to 17 (N = 62, n= 31 with ADHD; mean age= 15.3 years; 50% female) completed a diagnostic evaluation, 3 nights of ambulatory PSG, the Cambridge Neuropsychological Test Automated Battery, and subjective reports of sleep and executive functioning. Linear regressions covarying for age, sex, and pubertal status examined group differences in sleep indices, and partial Pearson correlations assessed relations between sleep and neurocognition. Although adolescents with ADHD did not exhibit differences in PSG-measured sleep duration, awakenings, or latency (ps > .05) compared with non-psychiatric controls, they displayed lower slow wave sleep percentage (β=-.40) and non-rapid eye movement (NREM) electroencephalogram (EEG) delta power (β=-.29). They also exhibited greater stage 2 percentage (β= .41), NREM EEG sigma power (β= .41), and elevated self-reported sleep disturbances (ps< .05). Lower NREM EEG delta power, increased high-frequency power, and slower decline in NREM EEG delta power overnight were associated with poorer neurocognition among adolescents with ADHD. Adolescents with ADHD reported more sleep disturbances than non-psychiatric controls and exhibited differences in sleep stage distribution and NREM sleep EEG frequency. Sleep-EEG spectral indices were associated with impaired neurocognition, suggesting that physiological sleep processes may underlie neurocognitive deficits in ADHD. Future studies may clarify whether sleep plays a causal role in neurocognitive impairments in adolescent ADHD and whether interventions normalizing sleep improve neurocognition. Sleep Dysfunction and Neurocognitive Outcomes in Adolescent ADHD; https://clinicaltrials.gov/; NCT02897362. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote sex and gender balance in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list.

0120 Interactions between Temperament and Parent-Child Relationship Quality in Early Childhood and Sleep in Middle Childhood

Abstract Introduction Effects of child temperament on biopsychosocial outcomes, including sleep, are known to differ based on parent-child relationship quality (PCRQ). However, previous studies have primarily focused solely on early childhood, relied on subjective reports of PCRQ and sleep, and have neglected to examine variability in sleep, which is an important dimension of sleep health. We examined whether there were interactions between temperament and objectively measured PCRQ during early childhood in association with actigraphy measured sleep (average and variability) in middle childhood. Methods Participants included 90 preschoolers (mean age=4.24 years, SD=0.81) who were 47% female; 37% White, 17% Black, 47% other racial groups; and 46% Hispanic. Thirty-four percent experienced moderate to severe maltreatment. PCRQ was coded from a video-recorded free-play task between each child and their primary caregiver. Child temperament dimensions including Activity Level, Anger, Social Fear, Inhibitory Control, and Appropriate Attentional Allocation were measured with the parent-report Toddler Behavior Assessment Questionnaire. Child Mean and SDs of total sleep time (TST) and sleep efficiency (SE) were generated from actigraphy data collected for two weeks during a follow-up study when participants were ages 8-11. Results There were no direct effects of any of the temperament variables or PCRQ on sleep. In models adjusted for demographic characteristics and number of adversities experienced, greater attentional allocation was associated with greater average TST only among those children high in PCRQ (estimate = 20.59, 95% CI = 5.19, 35.99). For every one unit increase in attentional allocation score (possible range 1:7), there is a more than 20 min increase in mean TST. In contrast, greater activity levels were associated with better average sleep efficiency, only among those low in PCRQ (estimate = 2.35, 95% CI = 0.46, 4.24). For each unit increase in activity level score, there was a 2% increase in sleep efficiency. Conclusion Findings extend cross-sectional research in early childhood and provide support for models showing that children have differing susceptibility to the effects of temperament on sleep, depending on PCRQ. Support (if any) NIMH R01 MH083704, NICHD R01 HD086487, NICHD, R01 HD095837, SRCD Small Grant for Early Career Scholars, T32HD101392, NIGMS P20 GM139767.

Relationships between postpartum depression, sleep, and infant feeding in the early postpartum: An exploratory analysis.

The study objectives were to determine the relationships between postpartum depression and maternal and infant sleep parameters and to examine the impact of infant feeding method on infant and maternal sleep and postpartum depression symptomatology. Participants were 61 new mothers aged 18 to 45 years old, and their full-term, normal birth-weight, singleton infants. Participants were recruited from a large teaching hospital in northeast England. Data collection took place in participants' homes. The study used a prospective longitudinal design, with data collected at six, 12 and 18 weeks postpartum. We collected data on total sleep time, longest sleep period, wake after sleep onset, and night waking for mothers and infants objectively from actigraphic records and subjectively from maternal sleep logs. Participants reported on sleep disturbances using the General Sleep Disturbances Scale, on maternal sleepiness, and on depression symptomatology using the Edinburgh Postnatal Depression Scale. Scores on the Edinburgh Postnatal Depression Scale and General Sleep Disturbances Scale were consistently correlated with each other (6 weeks r = 0.452, p < 0.01; 12 weeks r = 0.317, p < 0.05; 18 weeks r = 0.493, p < 0.01), and did not correlate with objective measures or subjective reports of maternal or infant sleep. Edinburgh Postnatal Depression Scale scores at six, 12 and 18 weeks were predicted by General Sleep Disturbances Scale, prior Edinburgh Postnatal Depression Scale score, or both, but not by sleep parameters. With regard to infant feeding method, EPDS score was not higher among exclusively breastfeeding than among exclusively formula-feeding participants at any time point (6 weeks t = 0.306, p = 0.762; 12 weeks t = 0.343, p = 0.733; 18 weeks t = 0.426; p = 0.673). Different pathways emerged to predict Edinburgh Postnatal Depression Scale score for exclusively breastfeeding and exclusively formula-feeding women. Postpartum depression may be associated with disturbed sleep due to negative perception of sleep among depressed women, rather than disrupted sleep causing postpartum depression. With regard to infant feeding method, exclusively breastfeeding women are not more likely to suffer from postpartum depression, and different pathways may predict development of postpartum depression symptoms in exclusively breastfeeding and exclusively formula feeding women.

Exploring the prevalence and burden of sleep disturbance in primary brain tumor patients.

Sleep disturbance (SD) is common in patients with cancer and has been associated with worse clinical outcomes. This cross-sectional study explored the prevalence of SD in a primary brain tumor (PBT) population, identified associated demographic and clinical characteristics, and investigated co-occurrence of SD with other symptoms and mood disturbance. Demographic, clinical characteristics, MD Anderson Symptom Inventory-Brain Tumor, and Patient Reported Outcome Measurement Information System Depression and Anxiety Short-Forms were collected from PBT patients at study entry. Descriptive statistics, Chi-square tests, and independent t-tests were used to report results. The sample included 424 patients (58% male, 81% Caucasian) with a mean age of 49 years (range 18-81) and 58% with high-grade gliomas. Moderate-severe SD was reported in 19% of patients and was associated with younger age, poor Karnofsky Performance Status, tumor progression on MRI, and active corticosteroid use. Those with moderate-severe SD had higher overall symptom burden and reported more moderate-severe symptoms. These individuals also reported higher severity in affective and mood disturbance domains, with 3 to 4 times higher prevalence of depressive and anxiety symptoms, respectively. The most frequently co-occurring symptoms with SD were, drowsiness, and distress, though other symptoms typically associated with tumor progression also frequently co-occurred. PBT patients with moderate-severe SD are more symptomatic, have worse mood disturbance, and have several co-occurring symptoms. Targeting interventions for sleep could potentially alleviate other co-occurring symptoms, which may improve life quality for PBT patients. Future longitudinal work examining objective and detailed subjective sleep reports, as well as underlying genetic risk factors, will be important.

Recreational cannabis use is associated with poorer sleep outcomes in young adult African Americans

IntroductionThe present study sought to determine the relationship between self-reported cannabis use dosage in grams per day with (1) objective sleep outcomes: sleep efficiency (SE), sleep onset latency SOL and number of night-time awakenings (NWAK) (2) if objective and subjective sleep measures, using the PSQI, differed between cannabis users and non-cannabis users. MethodsOur sample included 178 participants, aged 18–35 years. We collected demographic information, cannabis use in dosage per day and frequency of use, depressive symptoms through the CESD, and subjective sleep reports using the PSQI. After the survey assessment, we monitored sleep using the Phillips Actiwatch Spectrum watch for a minimum of 5 nights. ResultsThe amount of cannabis consumed per day was inversely related to SOL and SE, and positively related to NWAK. After controlling for covariates, regression models were statistically significant for predicting SOL (β = -0.369, p <.001), SE (β = -0.232, p <.05) and NWAK, (β = -0.318, p <.001), indicating cannabis dosage per day is the strongest predictor for the sleep parameters. Subjective sleep measures did not differ from cannabis users versus non-cannabis users. ConclusionRecreational cannabis use is beneficial for SOL but may be detrimental to SE as those who reported increased cannabis use also had more NWAK. Cannabis may be useful for sleep onset, results suggest that increased use does not aid in sleep maintenance.

Sleep Disturbances and Delayed Sleep Timing are Associated with Greater Post-Traumatic Stress Symptoms in Youth Following Hurricane Harvey.

Sleep patterns following a natural disaster are associated with mental health difficulties, but research in youth samples has been limited to subjective reports of sleep. Participants (N = 68, 8-17 years old) completed an assessment 6-9 months after Hurricane Harvey, which included subjective measures of sleep, chronotype, hurricane-related post-traumatic stress symptoms, and one week of actigraphy. Prior to the hurricane, parents provided reports on emotional symptoms. Controlling for age, sex, socioeconomic status, participation time, and pre-hurricane emotional symptoms, subjective sleep disturbances and an eveningness chronotype were associated with greater post-traumatic stress, with the strongest effects observed for re-experiencing, negative cognitions/mood, and arousal/reactivity symptoms. Later sleep timing as measured by actigraphy was associated with greater arousal/reactivity symptoms and shorter sleep duration was associated with greater avoidance symptoms. As extreme weather-related events are expected to become more frequent and severe, these findings contribute to models of youth risk and resilience.

The effects of cognitive processing therapy + hypnosis on objective sleep quality in women with posttraumatic stress disorder.

Objective: Insomnia, characterized by difficulty falling and staying asleep, is a common and debilitating symptom of posttraumatic stress disorder (PTSD) that is resistant to first-line, trauma-focused therapies. Previous research has found that sleep-directed hypnosis improves subjective sleep quality, particularly sleep onset latency, in women with PTSD. However, it cannot be assumed that improvements in subjective sleep reports correspond with objectively measured sleep improvements, because research has indicated a lack of agreement across these measures. The current study examined the effects of sleep-directed hypnosis plus cognitive processing therapy (hypCPT) on objective indices of sleep quality measured with actigraphy. Method: Forty-five women with PTSD were randomized to receive sleep-directed hypCPT or sleep and psychiatric symptom monitoring plus CPT (ssmCPT). Pre- and posttreatment, participants completed 1 week of daily actigraphy assessments of nocturnal sleep onset latency, waking after sleep onset, and total sleep time. Results: Overall improvement in objective sleep indices was not observed. Despite this, at posttreatment, treatment completers receiving hypCPT took significantly less time to fall asleep than did women receiving ssmCPT. Conclusions: More research is needed to understand and reduce the discrepancy between subjectively and objectively assessed sleep impairments in PTSD. Nevertheless, results indicate that adding sleep-directed hypnosis to trauma-focused therapy may be of some use for individuals with PTSD-related insomnia. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Seasonal variations in sleep duration and sleep complaints: A Swedish cohort study in middle-aged and older individuals.

Subjective sleep reports are widely used research tools in epidemiology. Whether sleep reports can differ between seasons is less clear. Using multivariable binary or multinomial logistic regression analyses, in the present Swedish cross-sectional two-centre cohort study (N=19,254; mean age 61years), we found that participants surveyed during the summer (June-August) were more likely to report short sleep duration (defined as ≤ 6hr) compared with those interviewed during the autumn (odds ratio [95% confidence interval]=1.14 [1.04-1.25]). Individuals interviewed in the winter (December-February) were less likely to report early awakenings compared with participants surveyed in the autumn (September-November; odds ratio [95% confidence interval]=0.85 [0.75-0.96]). Complaints of difficulties in falling asleep and disturbed sleep were less common among participants interviewed during spring (March-May) compared with those interviewed during the autumn (odds ratio [95% confidence interval]=0.86 [0.74-0.99] and 0.88 [0.79-0.98], respectively). No seasonal variations in reports of long sleep, difficulty maintaining sleep, or feeling not rested after sleep were observed. Additional subgroup analysis revealed that summer participants were more likely to report short sleep duration and early morning awakenings than individuals surveyed in winter. In conclusion, this Swedish study indicates that self-reported sleep characteristics may vary across seasons. Further studies are needed to confirm our findings.

Sleep Habits, Nutrition Quality, And Burnout In Division 1 College Athletes

PURPOSE: The purpose of this study was to evaluate sleep habits, nutrition quality, and burnout among college student-athletes. METHODS: Collegiate athletes were recruited to complete two surveys a month apart assessing sleep habits, nutrition quality, stress, and burnout. The Pittsburgh Sleep Quality Index (PSQI) assessed subjective sleep reports among athletes. The Rapid Eating Assessment for Patients-Short Form (REAP-S) assessed diet quality. The Athlete Burnout Questionnaire (ABQ) assessed burnout reports among athletes. One-way ANOVAs were examined differences between sleep, nutrition and burnout. Spearman’s correlations examined relationships between the independent and dependent variables of interest. Regression analyses determined if the variables of nutrition, burnout, and injury onset explained variance in sleep reports among athletes. All analyses were run in SAS v. 9.4. RESULTS: A total of 76 athletes participated in the study. Participants competed in baseball, soccer, softball, tennis, acrobatics and tumbling within a singular NCAA division 1 affiliated university. A negative correlation between improved PSQI scores and REAP-S scores was found within baseball athletes (r = -0.53, p = 0.004) and soccer athletes (r = -0.75, p = 0.005). The accomplishment scale of the ABQ was associated with increased sleep quality scores measured on the PSQI within the first month (b = 1.92, r = 0.04). 16.5% of the variance in month 1 sleep scores was explained by the variables entered into the regression model (r2 = 0.165). Decreased diet quality scores on the REAP-s were associated with decreased sleep scores in month 2 (b = -0.25, r = 0.01). 15% of the variance in month 2 sleep scores was explained by the variables enter the regression model (r2 = 0.150) CONCLUSIONS: Our study indicates that differences in sleep, nutrition quality, and burnout among various sports team exists. Additionally, reports of burnout and sleep quality revealed relationships with sleep reports in college athletes. Athletes reporting access to educational materials on sleep from their athletics department reported higher sleep quality.

Evaluation of a Low-Cost Commercial Actigraph and Its Potential Use in Detecting Cultural Variations in Physical Activity and Sleep

The purpose of the present study was to evaluate the performance of a low-cost commercial smartwatch, the Xiaomi Mi Band (MB), in extracting physical activity and sleep-related measures and show its potential use in addressing questions that require large-scale real-time data and/or intercultural data including low-income countries. We evaluated physical activity and sleep-related measures and discussed the potential application of such devices for large-scale step and sleep data acquisition. To that end, we conducted two separate studies. In Study 1, we evaluated the performance of MB by comparing it to the GT3X (ActiGraph, wGT3X-BT), a scientific actigraph used in research, as well as subjective sleep reports. In Study 2, we distributed the MB across four countries (Austria, Germany, Cuba, and Ukraine) and investigated physical activity and sleep among these countries. The results of Study 1 indicated that MB step counts correlated highly with the scientific GT3X device, but did display biases. In addition, the MB-derived wake-up and total-sleep-times showed high agreement with subjective reports, but partly deviated from GT3X predictions. Study 2 revealed similar MB step counts across countries, but significant later wake-up and bedtimes for Ukraine than the other countries. We hope that our studies will stimulate future large-scale sensor-based physical activity and sleep research studies, including various cultures.

The intra-day link between sleep disturbance and pain severity among individuals with temporomandibular joint disorder: Pain expectancy as a potential mechanism

Most individuals with temporomandibular joint disorder (TMD) report experiencing sleep disturbance, which can maintain and exacerbate pain severity. However, the factors underlying the sleep-pain link, especially at the within-person level, have not been fully elucidated. Previous studies suggest that sleep disruption can induce biased attentional and interpretative processes, which can potentially elevate pain expectancy—a potent psychological factor that shapes pain experience. We examined whether morning pain expectancy serves as a mediator in the association between previous night sleep disturbance and pain severity the following evening. The sample included 170 women (mean age=36.3 [SD=11.4]) with co-morbid TMD and insomnia. Sleep was assessed for 14 days using actigraphy. Sleep parameters, including total sleep time (TST), wake after sleep onset (WASO), and sleep onset latency (SOL), were extracted from the data. Subjective reports of previous night sleep and current pain expectancy were measured upon participant's waking, and subsequent pain-related reports were collected at end-of-day during the same 14-day period. Multilevel structural equation modeling was employed to analyze the nested data. The Rmediation software was used to test the significance of the mediated effects. Shorter previous night TST predicted higher pain expectancy (B=-.001, p=.021), such that shorter TST was associated with higher pain expectancy. TST (B=-.002, p=.007) and WASO (B=.002, p=.047) significantly predicted morning pain. Morning pain expectancy (B=.140, p

Sleep disturbances and physical health problems in caregivers of children with ASD

ObjectivesCaregivers of children with autism spectrum disorder self-report more physical health problems than controls. Sleep disturbances are also more prevalent in caregivers, and are positively associated with physical health problems. The negative impact of caring for a child with ASD on physical health therefore, might occur indirectly via poorer sleep. MethodsParticipants, of which n = 43 were caregivers and n = 17 were controls, completed self-report measures of physical health problems and, to capture objective measures of sleep, wore an actigraphy device. ResultsPhysical health problems were greater in caregivers, as were subjective reports of disturbed sleep. Objectively, waking after sleep onset (WASO) and average number of awakenings were higher, as was sleep latency, and sleep efficiency was poorer, in caregivers. Total sleep time however, was greater in caregivers, as was time in bed. Physical health problems, while unrelated to actigraphy measures, were positively associated with self-reported sleep disturbances. Caregivers’ increased risk for physical health problems occurred indirectly via greater self-reports of disturbed sleep. ConclusionsInterventions that help alleviate caregivers’ sleep disturbances might be effective, by reducing physical health problems, for improving quality of provided care, and this might be explored in future research.

Pregnant women’s daily patterns of well-being before and during the COVID-19 pandemic in Finland: Longitudinal monitoring through smartwatch technology

Technology enables the continuous monitoring of personal health parameter data during pregnancy regardless of the disruption of normal daily life patterns. Our research group has established a project investigating the usefulness of an Internet of Things-based system and smartwatch technology for monitoring women during pregnancy to explore variations in stress, physical activity and sleep. The aim of this study was to examine daily patterns of well-being in pregnant women before and during the national stay-at-home restrictions related to the COVID-19 pandemic in Finland. A longitudinal cohort study design was used to monitor pregnant women in their everyday settings. Two cohorts of pregnant women were recruited. In the first wave in January-December 2019, pregnant women with histories of preterm births (gestational weeks 22-36) or late miscarriages (gestational weeks 12-21); and in the second wave between October 2019 and March 2020, pregnant women with histories of full-term births (gestational weeks 37-42) and no pregnancy losses were recruited. The final sample size for this study was 38 pregnant women. The participants continuously used the Samsung Gear Sport smartwatch and their heart rate variability, and physical activity and sleep data were collected. Subjective stress, activity and sleep reports were collected using a smartphone application developed for this study. Data between February 12 to April 8, 2020 were included to cover four-week periods before and during the national stay-at-home restrictions. Hierarchical linear mixed models were exploited to analyze the trends in the outcome variables. The pandemic-related restrictions were associated with changes in heart rate variability: the standard deviation of all normal inter-beat intervals (p = 0.034), low-frequency power (p = 0.040) and the low-frequency/high-frequency ratio (p = 0.013) increased compared with the weeks before the restrictions. Women's subjectively evaluated stress levels also increased significantly. Physical activity decreased when the restrictions were set and as pregnancy proceeded. The total sleep time also decreased as pregnancy proceeded, but pandemic-related restrictions were not associated with sleep. Daily rhythms changed in that the participants overall started to sleep later and woke up later. The findings showed that Finnish pregnant women coped well with the pandemic-related restrictions and lockdown environment in terms of stress, physical activity and sleep.

Mild Obstructive Sleep Apnea Tends to Be Associated with Sleep State Misperception

Objective Sleep state misperception (SSM) is a disorder that is characterized by insomnia or excessive sleepiness without objective evidence of sleep disturbance. The cause of SSM has not yet been elucidated. This study aimed to explore sleep perception tendencies by comparing polysomnography (PSG) data and subjective sleep reports in patients with and without obstructive sleep apnea (OSA). Methods We retrospectively analyzed 638 participants with PSG results. We classified the participants into three groups based on their OSA severity (non-OSA, n=174; mild OSA, n=214; moderate OSA, n=250), and compared the PSG parameters and various sleep questionnaires among the groups using an analysis of variance. Additionally, we identified the rapid eye movement (REM)-related OSA and compared the variables between the REM-related OSA and non-REM-related OSA groups using independent t and chi-square tests. Results The participants with less severe OSA presented better quality and quantity of sleep in PSG (longer total sleep time, higher sleep efficiency, fewer arousals, and more deep sleep), but reported much worse sleep disturbances based on sleep questionnaires. Those with REM-related OSA showed a larger discrepancy between subjective and objective sleep. Conclusion This study found that individuals with milder OSA and REM-related OSA tended to present larger discrepancies in objective and subjective sleep states. Further research based on our preliminary findings is warranted to better recognize SSM and treat complicated sleep disorders. Keywords: Obstructive sleep apnea; Paradoxical insomnia; REM-related obstructive sleep apnea; Sleep misperception

1103 Understanding the Role of Sleep as a Risk Factor for Suicidal Ideation in Active Duty Service Members

Abstract Introduction Suicide is an important public health concern with many factors contributing to increased risk. Sleep is one such factor that may elevate risk, yet this association is not well understood. By identifying the strongest sleep-related predictors of suicidal ideation (SI), providers may be able to better intervene and reduce risk of suicide. Methods Data were obtained from the clinical database at the National Intrepid Center of Excellence (NICoE). Patients were active duty service members, predominantly male, and with a mean age of 38. As part of standard care, patients receive a polysomnography sleep study and complete a battery of intake measures offering a comprehensive view of sleep. Individual symptoms were analyzed in an effort to understand the role of each sleep symptom within the context of the many other factors that may contribute to SI in service members. Results Of the many data points collected during polysomnography, only rapid eye movement (REM) sleep latency and minimum sleeping heart rate were related to SI. REM latency was associated with increased odds of SI, while minimum sleeping heart rate was related to decreased odds. Subjective reports of bad dreams, trauma-specific bad dreams, sleepiness, and sleep quality were related to increased odds of SI. Notably, subjective reports of sleep were associated with greater odds than objective measures. Traumatic nightmares had the greatest odds, with these patients being much more likely to have SI. Conclusion These results support the importance of considering sleep factors when evaluating SI in service members. Subjective sleep reports, specifically, appear to be particularly important, as they were associated with increased odds of SI. These findings focus on the role of individual sleep factors in increasing the odds of SI and suggest it is important to evaluate sleep in combination with comorbid conditions when conducting risk assessments. Support N/A

0519 Mindfulness Based Therapy for Insomnia Improves Objective Markers of Sleep in the Elderly: Preliminary Data from the Mindfulness Sleep Therapy (MIST) Study

Abstract Introduction Mindfulness-based treatment for insomnia (MBTI) is a viable intervention for improving poor sleep. We report preliminary data from an ongoing pre-registered, randomized controlled trial which investigates the effect of MBTI on elderly adults. Methods Participants above 50 years old with PSQI ≥ 5 were recruited and randomised into either MBTI or an active control group (Sleep hygiene education and exercise program, SHEEP) in sequential cohorts with about 20 participants per cohort (10 per group). Before and after the intervention, 1 night of portable polysomnography (PSG) and 1 week of actigraphy (ACT) and sleep diary (DIARY) data were collected. We report the ACT and DIARY results of the first 3 cohorts (n = 46, male = 23, mean age = 62.3, std = 6.3) and PSG data of the first 2 cohorts (n = 29, male = 12, mean age = 62.5, std = 5.7). Time in bed (TIB), total sleep time (TST), sleep onset latency (SOL), wake after sleep onset (WASO), and sleep efficiency (SE) were analysed with mixed-model repeated-measures ANOVA. Results We observed increases in TIBDIARY (F1,44 = 5.151, p &amp;lt; .05) and SEDIARY (F1,44 = 22.633, p &amp;lt; .0001), and significant reductions in SOLDIARY (F1,44 = 7.031, p &amp;lt; .05) and WASODIARY (F1,39 = 7.411, p &amp;lt; .05). In the actigraphy data, we found a significant interaction in SOLACT (F1,39 = 4.273, p &amp;lt; .05) with an increase in SHEEP SOLACT (t18= 2.36, p &amp;lt; .05). Significant reductions were also observed in WASOACT (F1,44 = 16.459, p &amp;lt; .0001) Finally, we observed a reduction in SOLPSG (F1,26 = 5.037, p &amp;lt;. 05). All other tests were non-significant. Conclusion Preliminary results suggest that both interventions lead to improvements in sleep with more pronounced effects in subjective sleep reports. Objective sleep data suggest that improvements in sleep is a result of improved sleep quality and not simply extending sleep opportunity. These preliminary data shows that MBTI may be a promising intervention for elderly individuals with sleep difficulties. Support This study was supported by an award from the 7th grant call of the Singapore Millennium Foundation Research Grant Programme

Hormonal contraceptive use and subjective sleep reports in women: An online survey.

Female sexual hormones have known hypnogenic effects and the use of hormonal replacement therapy in postmenopausal women leads to improvement in sleep quality. However, the effects of hormonal contraceptives in women of reproductive age are still scarcely understood. This study sought to evaluate the impact of hormonal contraceptive use on subjective self-reports of sleep through a web-based cross-sectional survey. A total of 2,055 women between 18 and 40years old participated by answering an online questionnaire evaluating hormonal contraceptive use, sleep-related characteristics and related features. Sleep assessment tools comprised the Epworth Sleepiness Scale (ESS) and the Insomnia Severity Index (ISI). Statistical comparisons were performed between hormonal contraceptive users and those who reported no current use. Analyses were repeated to compare users of combined contraceptives with users of progestagens only, as well as to compare users of different generations of contraceptives. Among the total sample, 1,286 participants met the inclusion criteria (918 of them were currently taking a hormonal contraceptive). Contraceptive users reported more frequent sleep complaints and had higher scores on ESS and ISI, which means increased excessive daytime sleepiness and more insomnia symptoms. Women using progestagen-only therapies reported lower total sleep duration compared with combined therapy. Users of third-generation contraceptives showed lower total sleep time and higher ISI score when compared with non-users. In conclusion, contraceptive users have more insomnia symptoms and increased excessive daytime sleepiness when compared with women who do not use any hormonal contraceptive method, and progestagen-only therapy was associated with lower sleep duration.

Impact of atopic dermatitis treatment on child and parent sleep, daytime functioning, and quality of life

BackgroundAtopic dermatitis (AD) is a common childhood disorder that is associated with a variety of negative health outcomes in children and parents, including poor sleep and daytime functioning. Despite this, few studies have examined the impact of treatment for AD on sleep, and even fewer have included validated sleep questionnaires, child report of sleep disturbance, or objective measures of sleep. ObjectiveTo address limitations in the literature by examining objective and subjective reports of sleep, as well as measures of daytime functioning before and after admission to an intensive treatment program for AD. MethodsTwenty-nine parent-child dyads who presented to an intensive day treatment program participated in this study. Sleep was objectively measured with 1 week of actigraphy both 1 week before admission and 1 month after discharge. Subjective questionnaires of sleep, daytime functioning, and quality of life were completed by children and parents at admission, discharge, 1 month after discharge, and 3 months after discharge. ResultsStudy results highlight the benefit of the treatment program on reducing AD severity, as well as improvements in objectively measured sleep duration and efficiency, self-reported measures of sleep, daytime functioning, and quality of life in children and parents up to 3 months after discharge. ConclusionThis study highlights the importance of treatment for child AD on both child and parent health outcomes.

Progestagen-based contraceptives and subjective sleep reports in premenopausal women

Progestagen-based contraceptives and subjective sleep reports in premenopausal women

Associations of informant-based sleep reports with Alzheimer's disease pathologies.

PurposeRecent studies have found associations of increased brain amyloid beta (Aβ) accumulation and several abnormal sleep-wake patterns, including shorter latency and increased fragmentation in preclinical Alzheimer’s disease (AD). There is little known about the relationship between sleep and tau. The objective of this study was to understand the associations of both tau and Aβ with early signs of sleep and night-time behavior changes in clinically normal elderly adults. Specifically, we have addressed the question of how informant-based subjective sleep reports are linked to regional [18F]flortaucipir and [18F]florbetapir uptake.MethodsImaging and behavioral data from 35 subjects were obtained from the Alzheimer’s Disease Neuroimaging Initiative. The Neuropsychiatric Inventory Sleep (NPI-sleep) Questionnaire was used to assess the sleep and night-time behavior changes. Regional tau-positron emission tomography (PET) (entorhinal, brainstem) and Aβ-PET (posterior cingulate, precuneus, medial orbitofrontal) uptake values were calculated. A series of linear regression analyses were used to determine the combination of sleep symptoms that built the best models to predict each pathology.ResultsInformant-based reports of abnormal night-time behavior (NPI questions k3, k5, and k8) were significantly associated with increased entorhinal tau and Aβ (all regions) accumulation. Interestingly, informant-based reports of sleep deficiencies without abnormal nigh-time activity (NPI questions k1, k2, and k6) were negatively associated with entorhinal tau burden.ConclusionDetection of abnormal night-time behaviors (wandering, pacing, other inappropriate activities) by family members indicates early signs of both AD pathologies and may encourage the affected individuals to seek help by health care providers for detailed cognitive/neurobehavioral assessments.