Nap Time Research Articles

Interaction effect of midday napping duration and depressive symptoms on subjective memory impairment among older people in China: evidence from the China health and retirement longitudinal study database

BackgroundSubjective memory impairment (SMI) is common in older people. The aim of this study was to investigate the factors influencing SMI among older people in China, with specific focus on the interaction effect of midday napping duration and depressive symptoms on the risk of SMI.MethodsUsing a dataset representative of the Chinese population from a longitudinal study of health and retirement in China, subjects with SMI were screened using the question “how do you feel about your memory now?” and the Mini-Mental State Examination. A logistic regression model was applied to explore the factors affecting SMI. Additive and multiplicative models were used to analyze the interaction effect of midday napping duration and depressive symptoms on the risk of SMI.ResultsWe enrolled 8,254 subjects included and the incidence of SMI was 63.9%. Depressive symptoms, nap time, and physical activity were influencing factors of SMI. Midday napping duration and depressive symptoms had positive additive interaction effects on the risk of SMI. When extended-length naps and depressive symptoms coexisted, the risk of SMI was 1.06 times greater than that for either alone (RERI, relative excess risk due to interaction = 0.27, 95% CI = 0.07–0.43; AP, attributable proportion = 0.14, 95% CI = 0.01–0.23; S, synergy index = 1.06, 95% CI = 0.57–1.62). When short naps and depressive symptoms coexisted, the risk of SMI was 1.2 times higher than that for either alone (RERI = 0.12, 95% CI=-0.14–0.39; AP = 0.13, 95% CI=-0.07–0.22; S = 1.20, 95% CI = 0.79–1.82).LimitationsSince this was a cross-sectional study, the cause-and-effect relationships between the associated variables cannot be inferred.ConclusionsThe interaction effect that exists between nap time and depressive symptoms in older people is important for the identification and early intervention of people at risk for SMI.

Impact of Commuting Time on Employees’ Job Satisfaction—An Empirical Study Based on China’s Family Panel Studies (CFPS)

In China, job satisfaction has become a significant concern. Previous research has mainly focused on the impact of working conditions and personal characteristics on job satisfaction, neglecting the influence of commuting. This study utilized the ordered logistic (Ologit) regression model and demonstrated that commuting time negatively affects job satisfaction. Through additional analysis, it was found that increasing the duration of nap time can enhance employees’ job satisfaction. Additionally, providing a monthly commuting allowance of more than CNY 40.00, along with increased nap time, can help alleviate the negative impact of commuting on job satisfaction. Moreover, a heterogeneity analysis was conducted to explore the potential variations in this impact by gender, marital status, the employer’s nature, and region. The outcomes indicated that gender does not significantly affect job satisfaction in relation to commuting. However, individuals who are married or cohabiting, those employed in the private sector, and those residing in the northeast or central regions of China experience a negative impact on job satisfaction due to commuting. Finally, we propose relevant suggestions to improve employees’ job satisfaction and enhance their work efficiency in order to achieve the sustainable development of the company.

Real-Time Cargo Loading Identification Based on Self-Powered Camera

In practice, the statistics of cargo loading capacity needs to be realized by counting the loading actions. Object detection algorithm may not meet the requirements of such tasks under the influence of environmental factors. And the current temporal action localization methods may ignore the spatial information of objects and identify the inaccurate action time boundary of multiple objects in the cargo loading task. To fill this technical gap, this paper designs a cargo loading identification framework. The core of this framework is the Target Area Rise-descend (TAR) algorithm, which is based on the object detection model and uses the regularity of object location and object size to realize real-time recognition of the cargo loading process. We ensure the real-time and robustness of the algorithm by some means like nap mechanism and time regularity. The garbage truck recycling task is taken as an example to complete the elaboration of the proposed method. Experiments show that the accuracy of the proposed method is higher than 99%, and the real-time performance is higher than 20fps on Neural Network Computing Unit (NPU). Considering the limitations of intelligent application scenarios and resources, self-powered camera is applied. For mechanical motion similar to the scene in this paper, the proposed algorithm can use extremely low computing power to capture the motion process and achieve data statistics.

Modeling the Effects of Napping and Non-napping Patterns of Light Exposure on the Human Circadian Oscillator.

In early childhood, consolidation of sleep from a biphasic to a monophasic sleep-wake pattern, that is, the transition from sleeping during an afternoon nap and at night to sleeping only during the night, represents a major developmental milestone. Reduced napping behavior is associated with an advance in the timing of the circadian system; however, it is unknown if this advance represents a standard response of the circadian clock to altered patterns of light exposure or if it additionally reflects features of the developing circadian system. Using a mathematical model of the human circadian pacemaker, we investigated the impact of napping and non-napping patterns of light exposure on entrained circadian phases. Simulated light schedules were based on published data from 20 children (34.2 ± 2.0 months) with habitual napping or non-napping sleep patterns (15 nappers). We found the model predicted different circadian phases for napping and non-napping light patterns: both the decrease in afternoon light during the nap and the increase in evening light associated with napping toddlers' later bedtimes contributed to the observed circadian phase difference produced between napping and non-napping light schedules. We systematically quantified the effects on phase shifting of nap duration, timing, and light intensity, finding larger phase delays occurred for longer and earlier naps. In addition, we simulated phase response curves to a 1-h light pulse and 1-h dark pulse to predict phase and intensity dependence of these changes in light exposure. We found the light pulse produced larger shifts compared with the dark pulse, and we analyzed the model dynamics to identify the features contributing to this asymmetry. These findings suggest that napping status affects circadian timing due to altered patterns of light exposure, with the dynamics of the circadian clock and light processing mediating the effects of the dark pulse associated with a daytime nap.

Nighttime sleep and daytime sleepiness patterns among left ventricular assist device patients.

Despite the high prevalence of sleep disturbance in the heart failure population, information about its consequence on daytime function in patients with left-ventricular assist devices (LVADs) is limited. This study examined the nighttime and daytime sleep patterns and changes from pre-implant to 6months post-implant. This study included 32 LVAD patients. Demographics, nighttime and daytime sleep variables were collected pre-implant and at 1, 3, and 6months post-implant. Wrist actigraphy and self-report questionnaires measured objective and subjective sleep, respectively. Objective nighttime sleep data were sleep efficiency (SE), sleep latency (SL), total sleep time (TST), wake after sleep onset (WASO), and sleep fragmentation (SF). Objective daytime sleep data were nap times. Self-reported Subjective Sleep Quality Scale (SSQS) and Stanford Sleepiness Scale (SSS) were subjective measures. Increased SF and WASO scores and decreased TST and SE scores were found pre-LVAD implant, indicative of poor sleep quality. TST, SE, naptime and SSQS scores were higher at 3 and 6months post-implant compared to baseline. Decreases in TST and SF scores were observed at 3 and 6months post-implant along with increases in SSS scores. Increasing SSS scores and decreasing overall scores from pre- and up to 6months post-implant suggest improvement in daytime function. This study provides information on sleep-daytime function in the LVAD patient population. Improvements in daytime sleepiness do not imply "good" sleep quality, consistent with the extant knowledge in LVAD literature. Future investigations should elucidate the mechanism by which sleep-daytime function influences quality of life.

Association of Self-Reported Nighttime Sleep Duration with Chronic Kidney Disease: China Health and Retirement Longitudinal Study

Introduction: The cohort study aimed to assess the association of nighttime sleep duration and the change in nighttime sleep duration with chronic kidney disease (CKD) and whether the association between nighttime sleep duration and CKD differed by daytime napping. Methods: This study included 11,677 individuals from the China Health and Retirement Longitudinal Study (CHARLS) and used data from the 2011 baseline survey and four follow-up waves. Nighttime sleep duration was divided into three groups: short (<7 h per night), optimal (7–9 h), and long nighttime sleep duration (>9 h). Daytime napping was divided into two groups: no nap and with a nap. We used Cox proportional hazards model to examine the effect of nighttime sleep duration at baseline and change in nighttime sleep duration on incident CKD and a joint effect of nighttime sleep duration and nap time on onset CKD. Results: With a follow-up of 7 years, the incidence of CKD among those with short, optimal, and long nighttime sleep duration was 9.89, 6.75, and 9.05 per 1,000 person-years, respectively. Compared to individuals with optimal nighttime sleep duration, short nighttime sleepers had a 44% higher risk of onset CKD (hazard ratio [HR]: 1.44, 95% confidence interval [CI]: 1.21–1.72). Compared to participants with persistent optimal nighttime sleep duration, those with persistent short or long nighttime sleep duration had an increased risk of incident CKD (HR: 1.44, 95% CI: 1.15–1.80). We found a lower incidence of CKD in participants with short nighttime sleep duration and a nap (HR: 0.74, 95% CI: 0.60–0.93), compared to those with short nighttime sleep duration and no nap. Conclusion: Short nighttime sleep duration and persistent long or short nighttime sleep duration were associated with a higher risk of onset CKD. Keeping persistent optimal nighttime sleep duration may help reduce CKD risk later in life. Daytime napping may be protective against CKD incidence.

0084 Napping in the morning is associated with risk of Alzheimer’s Dementia in older adults

Abstract Introduction Recent evidence suggests that older adults with more frequent and longer daytime naps have an increased risk of Alzheimer’s dementia (AD). We aim to further elucidate whether the timing of daytime napping impacts AD risk. Methods Data were from 1,203 participants in the Rush Memory and Aging Project (mean age at actigraphy=80.85±7.30; 77% female). Each participant wore an accelerometer (Actical) for up to 14 (mean 9.57±1.17) days and have been followed for up to 17 (mean 6.92±4.12) years with annual clinical assessment to determine AD status. We used a validated algorithm to identify daytime nap episodes between 9am-7pm and determined the timing of naps based on the midpoint of each nap. We computed the proportion of naps within each 2-h window for each participant, i.e., morning (9-11am), noon (11am-1pm), early afternoon (1-3pm), late afternoon (3-5pm), and early evening (5-7pm). Cox proportional hazards models were performed to examine the associations of napping timing with risk of AD, with adjustment for age, sex, education years, and nighttime sleep duration. Results Among all participants, 357 (30%) developed AD during the follow-up (mean time to AD: 6.34±3.98 years). Taking all naps in the morning, compared to taking all naps at other times, is associated with a 1.9-fold increased AD risk (HR [95%CI]=1.93[1.002-3.58], p=0.04). This association was only observed in women (HR=2.22[1.08-4.38], p=0.03) but not in men (HR=1.01[0.18-4.38], p=0.99). Moreover, the association between naps in the morning and AD risk was attenuated when additionally adjusted for total nap duration and frequency, BMI, and intradaily variability in rhythms (HR=1.71[0.85-3.43], p=0.13). The proportions of naps during other times of the day were not associated with AD risk (noon: HR=1.02[0.44-2.23]; early afternoon: HR=1.28[0.72-2.22]; late afternoon: HR=0.62[0.33-1.15]; early evening: HR=0.62[0.30-1.25]; ps&amp;gt;0.05). Conclusion More naps in the morning were associated with an elevated risk of developing AD in older adults. A higher propensity of napping in the morning may be an indicator of disturbances in sleep-wake regulation. Future studies are warranted to test whether interventions to consolidate nap timing or limit napping in the morning can improve neurocognitive outcomes. Support (if any) Alzheimer’s Association (AARFD-22-928372), NIA (R01AG17917), NIH (RF1AG064312), BrightFocus Foundation (A2020886S).

0625 Sleep when the baby sleeps? The effect of daytime nap behaviors on postpartum depression severity: a stress buffering hypothesis

Abstract Introduction The early postpartum is a time of expected maternal sleep loss, normalized as part of infant care. While short duration and disrupted nocturnal sleep are posited risk factors for postpartum depression (PPD), the role of daytime sleep remains less understood, despite the widespread recommendation that mothers sleep when their baby is sleeping. This study examined associations between napping, stress, and longitudinal PPD in a sample of in a sample of healthy first-time mothers, using a prospective ambulatory field study design. Methods Fifty primiparous women (62% non-White; mean age=32 years) without a history of sleep disorders or psychopathology completed 10-days (9-nights) of actigraphy and sleep diaries at postpartum week 6. Sleep variables included nighttime duration and efficiency, and daytime nap frequency, timing and duration. Participants completed 3-days of superimposed ecological momentary assessment (EMA) rating naturalistic infant-related stressors (task demand; effort-reward-imbalance) at four daily intervals. Hierarchical mixed models tested whether daytime sleep characteristics predicted lower depression levels (via Edinburgh Postnatal-Depression Scale - EPDS) at 6-weeks, 8-weeks, and 3-months postpartum. Time-varying within-person covariates included time-of-day, baseline depression and anxiety (via Generalized-Anxiety-Disorder-7 scores), and previous night sleep. To test the putative stress-protective role of napping, we examined pre-post nap differences in EMA ratings. Results Sixty percent (n = 30/47) of women napped regularly (&amp;gt;3x/1 week, between 1-5 PM, &amp;lt; 90 min by both diary and actigraphy), rating 80% of these naps “intentional.” Women with greater nap regularity at 6-weeks had lower depression levels at all timepoints (Betas = -2.4(1.6); -1.4(.5), -.5(.01) ps&amp;lt;.001, respectively), and less of an increase in depression symptoms at 3-months postpartum, compared to non-nappers [Beta(SE)=-1.2 (.5); R^2=.21; p&amp;lt;.001]. At 6-weeks, regular nappers reported lower stress post-nap (effort-reward-imbalance; demand) [Beta(SE)=-6.3(1.4); 1.2(.12,), R^2=.27, .32, respectively; ps&amp;lt;.01]. Conclusion This study demonstrates a contemporaneous mood-protective role of daytime sleep in a perinatal sample, using 24-hr objective sleep assessment coupled with daily assessments of naturalistic stressors. Moreover, these results provide support for the protective role of regular daytime sleep on development of PPD over time. Among new mothers who regularly nap, lowered post-nap stress may be one pathway through which daytime sleep buffers against PPD severity. Support (if any) NIMH-1R36MH118000-01, CTSI89431, T32-HL007713

Daytime napping and the risk of atrial fibrillation in the SUN cohort

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): European Regional Development Fund (FEDER) and Spanish Ministry of Health. Introduction Previous research has identified a potential relationship between sleep patterns and atrial fibrillation (AF). Short daytime napping is a widespread healthy habit particularly in Mediterranean countries. However, as far as we know, daytime napping and the risk of developing AF has not been analysed before. Purpose Our objective was to assess the association between daytime napping and the incidence of AF in a Mediterranean cohort. Methods The SUN project is a dynamic, prospective cohort of Spanish university graduates. A total of 20,348 participants, free of AF at baseline, were followed-up for a median time of 13.8 years, with a retention proportion of 91%. Daytime napping was assessed at baseline and participants were categorised according to their average daily napping time. Incident cases of AF were confirmed by a cardiologist according to a prespecified protocol. Multivariable Cox regression models were used to estimate hazard ratios (HR) of AF according to daytime napping time. Results During follow-up, we identified 131 incident cases of AF. In comparison to participants with short daytime napping (&amp;lt;30 minutes/day), those who slept ≥30 minutes/day exhibited a significant 90% higher relative risk of incident AF (adjusted HR= 1.90; 95% CI: 1.26, 2.86), whereas no significant risk was observed for participants who did not have nap (adjusted HR = 1.26; 95% CI: 0.82, 1.93). After excluding participants that reported not having nap, those with shorter daytime napping had a lower risk of developing AF, with the greatest risk reduction between 15-30 minutes/day (adjusted HR = 0.44; 95% CI: 0.27, 0.72), in comparison to sleeping &amp;gt;30 minutes/day. Conclusions Daytime napping was significantly associated with the risk of developing AF. Sleeping a longer nap (≥30 minutes/day) was associated with an increased risk, while a shorter nap between 15-30 minutes/day was associated with a lower risk of incident AF. These findings suggest a potential novel healthy lifestyle habit in the primary prevention of AF.

Investigation on the Status of Middle School Students' Health Information Literacy and COVID-19 Infection after the Release of COVID-19

Through understanding the current situation of middle school students' health information literacy, explore the relationship between middle school students' health information literacy and COVID-19 infection, and provide information for epidemic response and epidemic reflection. [Methods/Process] On the basis of convenient sampling, a cluster questionnaire survey was conducted among 1268 middle school students in a town level middle school in Henan Province. Regression analysis was used to study the relationship between middle school students' health information literacy and COVID-19 infection. [Results/Conclusion] The reporting rates of middle school students who were not "positive", the first "positive", the second "positive", and those who had symptoms but did not undergo COVID-19 nucleic acid monitoring were 32.93% (413), 55.58% (697), 1.99% (25), and 9.49% (119), respectively. After adjusting the factors of grade, whether there are basic diseases, monthly income, parents' educational level, average accumulated daily sleep (including noon nap) time (hours) and daily exercise (including walking) time (hours) after the full liberalization of the COVID-19, it can be concluded that compared with high-level health information literacy, low-level health information literacy is not "positive" (OR=1.676,95% CI=1.038-2.705, and first "positive" symptoms (OR=2.147, 95% CI=1.357-3.399); while medium level of health information literacy had a higher relative risk for "first positive" symptoms (OR= 1.994,95%CI=1.113-3.572). Middle school students' health information literacy is related to COVID-19. Middle school students need to improve their personal health information literacy to achieve health promotion and promote the construction of a healthy power.

0754 Sleep Ecology in Low-Income Mexican American Toddlers

Abstract Introduction Healthy sleep is critical for child development, yet disparities exist, with Latino children disproportionately affected by deficient sleep. Most of what is known about sleep ecology and interventions to improve sleep in young children is based on studies of primarily White, non-Latino, and economically-advantaged families. To ensure the effectiveness of interventions, it is important to understand the contribution of socioecological factors on sleep among toddlers in low-income Mexican American families. Methods This study employed in-depth interviews with a purposeful sample of low-income Mexican American Spanish-speaking (n=10) and English-speaking mothers (n=10) of toddlers (18-34 months old). Interviews focused on daily sleep routines, perceptions of toddler sleep behaviors, and environmental contributors. Transcripts were coded by two investigators and analyzed using a content analytic approach. Results For sleep-related parenting practices, 70% of mothers reported late child bedtimes (≥9:00 pm), 75% reported room/bed sharing, and almost a third of children fell asleep at bedtime with a bottle or cup. Maternal beliefs about child sleep included concerns that child crying during the night might disturb neighbors or wake siblings, and child sleep quality improved when the child is not hungry. Contextual factors impacting sleep included schedules, neighbors, and siblings. Specifically, later weekday bedtimes were attributed to maternal (but not paternal) work schedules, while wake times were often a result of a sibling’s school schedule. Weekend bedtimes were commonly reported to be delayed for toddlers due to families watching movies. Noisy neighbors, in particular upstairs neighbors, were identified as disrupting children’s sleep. Siblings were identified as both facilitating sleep (e.g., helping with routines) and disrupting sleep (e.g., distracting child at nap time). Conclusion Findings provide insights on socioecological factors and parental beliefs about sleep ecology in low-income Mexican American toddlers that have implications for the design of interventions to improve child sleep. For example, commonly used behavioral sleep interventions have children sleeping in their own room, or require some crying during the night. However, these approaches may not be a good fit or feasible for this population. To address sleep health disparities, further work is needed to understand socioecological factors that require inclusive adaptations to pediatric sleep interventions. Support (if any) R01HL163859

Sleep duration at night affects daytime wake EEG spectra

BackgroundSleep deprivation leads to decreased performance, alertness and degradation in the health status of a person. Often the person remains unaware of the reduced alertness and may end up taking inaccurate decisions. There was a need to study the sleep duration of college goers and to study the effect of total night-time sleep duration on daytime Electroencephalogram (EEG) characteristics. MethodsA total of 30 asymptomatic volunteers were enrolled in a cross-sectional study. A baseline sleep diary for fourteen days was taken and one daytime recording was done while carrying out their normal daytime activity. EEG, electrooculography (EOG) and electromyography (EMG) were recorded, which were used for the scoring of their sleep-wake using the American Academy of Sleep Medicine criteria. EEG data were analysed using fast Fourier transform. Fast Fourier transform was done for sleep and wake durations using DOMINO software (©SOMNOMEDICS, Germany). A Python library was used to calculate power spectral density (PSD) in EEG frequency bands. ResultsA beta band was significantly reduced in the first 45 min of the recording as compared to the baseline. K means cluster showed clustering of two groups with a significant reduction of daytime sleep delta PSD values with reduced total sleep time and time in bed the previous night. The study concluded that subjects with reduced night-time sleep duration generated significantly lesser sleep delta PSD values. ConclusionReduced duration of night-time sleep was associated with worse nap time sleep delta PSD values and vice versa. Interestingly, good quality sleep at night correlated better with delta PSD values of daytime recording.

Determinants of Health Inequalities in Iran and Saudi Arabia: A Systematic Review of the Sleep Literature.

Sleep health inequalities represent an increasing public health concern. Among multiple determinants affecting sleep health, there is people's socioeconomic status (SES), and no systematic review on the relationship between SES and sleep health has been previously conducted in Iran and Saudi Arabia. Following the Prisma protocol, ten articles were selected. Findings revealed that the combined number of participants was N = 37,455 participants, including 73.23% of children and adolescents (n = 27,670) and 26.77% of adults (n = 10,026). The smallest sample was N = 715 and the larger was N = 13,486. In all these studies, sleep variables were assessed using self-reported questionnaires. The studies conducted in Iran assessed the risk of obstructive sleep apnea (OSA), while those in Saudi Arabia were interested in sleep duration, nap time, bedtime, rise time and insomnia. The studies performed on adult populations in Iran and Saudi Arabia concluded that there is no significant association between SES determinants and sleep components in adult populations. One study in Iran found a significant association between parent's low SES and children and adolescent insomnia; and one study in Saudi Arabia found a significant association between the father's education and the longer sleep duration of their children. More longitudinal studies are necessary to establish a causal relationship between public health policies and sleep health inequalities. An extension of the investigation to more sleep disturbances is required to cover the entirety of sleep health inequalities in Iran and Saudi Arabia.

Physical and psychosocial wellbeing of elderly during COVID-19

: Covid-19, the global pandemic has come and without differentiating, it altered the lifestyle of people everywhere and changed older people daily routines, the care and support they received, their ability to stay socially connected and how they were perceived. The present study aimed to find the physical and psychosocial wellbeing of elderly during covid 19 pandemic.: A quantitative approach with descriptive design was used. 100 elderly (aged between 60 -80) who were not diagnosed with Covid 19 were selected using a convenience sampling technique. Data was collected using semi structured questionnaire to find the physical and psychosocial wellbeing of elderly during COVID 19, using self-report technique. The physical health of only 44% of subjects was satisfactory during pandemic. Eighty percent reported changes in their weight. Majority had slept less than 7 hours and duration of day time naps increased among 13% of elderly. Thirty percent missed their regular exercise during pandemic. Majority followed COVID- 19 guidelines. Thirty percent missed their medical tests and 37% missed their medical check-ups. Eighty-six percent of elderly did not avail the telemedicine facility. Sixty-five percent were satisfied with their life during the pandemic. Forty percent found difficulties in maintaining close relationships during pandemic. More than half of elderly experienced anxiety and fear of death. Seventy-two percent were mentally exhausted. Fifty-four percent were worried when family, friends and neighbours tested positive for COVID 19. Forty-six percent felt hopeless and lonely during the pandemic. Fifty three percent were not able to attend religious services and 32% were not at all satisfied in performing religious practices through an online platform. Forty six percent of elderly used social media during COVID-19 pandemic.: The physical and psychosocial wellbeing of the elderly were affected during the pandemic. The physical health of most of the elderly were satisfactory but while considering their diet, exercise and sleep during the pandemic, most of them faced problems. The psychological wellbeing of elderly was also affected adversely. Majority of the elderly experienced anxiety, fear of death and hopelessness during the pandemic. Public health services should be equipped to handle social disengagement and loneliness through various means of connecting older adults with others, such as through telephone or video conversations or online social media platforms. Society need to be prepared with hybrid care platforms such as tele health and in-person treatment.

Perceptions and Use of Safe Sleep Baby Boxes at Hospital Discharge by New Mothers.

A large community hospital in South Texas began distributing safe sleep baby boxes to reduce sudden unexplained infant death (SUID) in 2017. To describe safe sleep practices among new mothers who received a safe sleep baby box at hospital discharge. An information sheet containing a link to an online survey was mailed to all women who received a safe sleep baby box prior to discharge from the hospital from January 2018 to January 2019. N = 84 women participated. Most reported using the safe sleep baby box only during nap time (n = 62, 88.6%). Only 70.2% of participants reported that baby always slept their back (n = 59). Most reported their baby did not use a pacifier (n = 62, 73.8%), and many reported they were not breastfeeding their baby (n = 38, 45.2%). Many women were not using the safe sleep baby box as intended and were not following many of the other safe sleep guidelines. Nurses should ask their patients about plans for infant safe sleep after discharge to provide individualized education or recommend specific resources to address the family's needs.

Regular, intermittent, and spontaneous: Patterns of preschool Children's nap behavior and their correlates

BackgroundDaytime sleep during the preschool years (i.e., 1-5-years-old) is characterized by high inter-child variability in several components of nap behavior, including nap duration, nap timing, and the proportion of sleep during daytime. We used an empirical approach to examine variations amongst children in these aspects of napping and investigated correlates of these components of nap behavior. MethodsA large, nationally representative sample (N = 702) of Canadian parents completed an online survey, including a one-month retrospective report of their 1.5–5 year old's daytime and nighttime sleep behavior and other questionnaires. To understand patterns of children's nap behaviors we applied Latent Profile Analysis (LPA) to typical nap duration, typical timing of naps, frequency of naps, proportion of sleep during the daytime, and the proportion of naps which were spontaneous (i.e., child just fell asleep). Then, multinominal logistic regression was used to examine correlates of profile membership. ResultsFour profiles of children emerged: (1) regular nappers; (2) intermittent nappers; (3) spontaneous nappers; and (4) non-nappers. After controlling for demographic variables (e.g., child age, sex, ethnicity) and known correlates of napping behaviors (e.g., birthweight, nighttime sleep duration), profile membership was related to parents' beliefs about napping, parents’ own nap behaviors, family functioning, and child nighttime sleep problems in a multinominal logistic regression. ConclusionsAn empirical approach aided in understanding the inter-child variability in napping amongst preschool-age children. Parental beliefs about napping and the home environment were shown to be critical factors influencing this variability.

Sleep Characteristics and Cancer-Related Outcomes: An Umbrella Review of Systematic Reviews and Meta-Analyses of Observational Studies.

Sleep is closely related to various diseases. Several meta-analyses have provided evidence of sleep and cancer, and yet the credibility of this evidence has not been comprehensively quantified. Thus, we conducted an umbrella review to quantify the evidence for systematic reviews and meta-analyses of observational studies on sleep characteristics (sleep duration, sleep quality, napping, bedtime, and wake-up time) and cancer-related outcomes. PubMed, Web of Science (Core Collection), and Embase databases were searched from inception until 29 July 2022. Assessment of Multiple Systematic Reviews, version 1, was used to evaluate the methodological quality of each eligible systematic review or meta-analysis. For each association, the summary effect with a 95% confidence interval was evaluated by fixed and random effects models. The 95% prediction interval, heterogeneity, small-study effects, and excess significance bias were also evaluated. Evidence of the associations from systematic reviews and meta-analyses was ranked based on the established criteria of published literature as convincing, highly suggestive, suggestive, weak, or non-significant. The umbrella review identified thirty meta-analyses on the aforementioned associations from six articles. The methodological quality of five articles was high or moderate. Suggestive evidence was found for associations between long sleep duration and a 21% increased risk of colorectal cancer, a 9% increased all-cancer mortality and a 65% increased mortality of lung cancer, and associations between short sleep duration and a 21% increased mortality of lung cancer. Additionally, the evidence of associations between short sleep duration and lung cancer mortality was upgraded to convincing, and between long sleep duration and lung cancer mortality was upgraded to highly suggestive, among the population reporting 24 h sleep duration. Abnormal sleep duration might be linked to several adverse cancer-related outcomes.

Sleep association between spousal caregiver and person with dementia having REM sleep behavior disorder: a case study using wearable technology

AbstractBackgroundRapid eye movement sleep behavior disorder (RBD) is manifested by dreams associated with recurrent abnormal behaviors during sleep including punching, running, jumping out of bed with potential injuries to partners and more often found in persons with dementia (PWD). This is significantly associated with increased caregiver’s sleep disturbances, stress, and health problems that has not been measured objectively. The purpose of this case study was to identify sleep characteristics of a spouse caregiver and dyadic sleep diary for both PWD and caregiver. Furthermore, using Wearable Internet of Things (WIOT) technology (smartring and smartphone) for the caregiver, we examined sleep parameters (e.g., resting heart rate, heart rate variability (HRV), sleep efficiency, deep sleep, REM sleep, and awake time at night) for 4 weeks.MethodsThis case study used mixed methods. A spouse caregiver (wife) and a PWD with RBD (both aged in 70s) living together were recruited. The caregiver wore the smartring 24/7 for 4 weeks. Additionally, the caregiver reported sleep diaries for herself and PWD for 4 weeks including nap time, feeling on wakening, and descriptions of their sleep experiences. At the end, the caregiver was interviewed to understand the perceived sleep experience in relation to PWD’s sleep. T‐tests were used to compare means of sleep parameters–continuous longitudinal data collected by WIOT device.ResultsSleep efficiency, HRV, and awake time of the caregiver were significantly better in the nights when PWD did not have disruptive sleep behaviors compared to those nights with them (all Ps&lt;0.05). The subjective Pittsburg‐sleep‐quality‐index(PSQI) score for the caregiver was 4 at both baseline and 4 weeks. Caregiver’s sleep diary notes showed PWD’s disruptive sleep behaviors for 8/28 days (28.6%), including bed soiling, multiple awakenings, excessive movement during sleep, aggressive behaviors – throwing out things while dreaming. In the exit interview, the caregiver expressed that RBD symptoms interrupted her sleep, however she wanted to care for PWD during the night by sleeping together.ConclusionThis case report using WIOT objective measures found PWD’s disruptive behaviors caused the caregiver to have less sleep efficiency and greater awakenings. Subjectively using PSQI the caregiver did not acknowledge her disruption.

Evaluation of a Daily Nine-Item "Handbook for Self-Care at Work" for Palliative Care Clinicians.

Context: A daily nine-item "Handbook for Self-Care at Work" was created to increase the well-being and satisfaction of the staff at the department of palliative care of a tertiary oncological center in the United States. Objectives: To evaluate the perceived usefulness of and adherence to the Handbook. Design, Setting and Participants: An anonymous survey was conducted among the palliative care staff asking for the frequency of utilization and the perception of usefulness of the Handbook. Additional data collected included demographics, satisfaction with professional life, frequency of burnout, and frequency of callousness toward people. We also compared the use and perception of the Handbook before and during the COVID-19 pandemic. Results: Of 52 palliative care clinicians, 39 (75%) completed the survey. Most participants were women and were <49 years. Most respondents (59%) found the Handbook useful or very useful. Offer help, ask for help, and hydration were perceived as the most useful items. The items most frequently achieved were movement, hydration, and eat light. The least useful perceived item was nap time, which was rarely achieved. During the COVID-19 pandemic, 32 (82%) respondents found the Handbook to be as/somewhat more/much more useful, and 29 (75%) were able to adhere to the items as/somewhat more/much more often than before. Conclusion: Most respondents found the Handbook useful and were able to accomplish the items most of the days. During the COVID-19 pandemic, the staff felt that the Handbook was more useful.

Impact of COVID-19 on the sleep-wake patterns of preschool children

ObjectiveTo explore the impact of the COVID-19 pandemic on the sleep-wake patterns of preschool children. MethodsA cohort of preschoolers established before the COVID-19 pandemic was invited to participate in this study. Data including children's demographics, their own and parental sleep-wake patterns, physical activities, and screen time were collected through an online questionnaire from August to September 2020. A comparison was made on the collected data from the same cohort of children before and during the pandemic. ResultsThe cohort which was established before the pandemic consisted of 3720 preschoolers. For this current study, 642 (17%) participated, and 497 (13%) children who fulfilled the eligibility criteria were included in the final analysis. They showed a delay in their bedtime and wake time on both weekdays and weekends with a 15–30 min increase in nocturnal sleep duration. However, with a reduction in nap time, the average daily sleep duration was shortened by 16.3 ± 64.3 min (p < 0.001) and 27.5 ± 72.9 min (p < 0.001) during weekdays and weekends, respectively. Screen time was increased while outdoor activity duration was decreased. Parental sleep/wake times were also delayed with an increase in sleep duration. Children's sleep habits were associated with screen time and parental sleep/wake patterns. ConclusionDespite school suspension during the COVID-19 pandemic, preschoolers were not sleeping longer. Screen time and parental sleep/wake patterns were the major factors driving the preschoolers' sleep habits. Health education is required to control screen time in children and to promote sleep hygiene among all family members.