Wake Time Research Articles

Neuropeptidergic input from the lateral hypothalamus to the suprachiasmatic nucleus alters the circadian period in mice.

In mammals, the central circadian clock is located in the suprachiasmatic nucleus (SCN) of the hypothalamus, which transmits circadian information to other brain regions and regulates the timing of sleep and wakefulness. Neurons in the lateral hypothalamus (LH), particularly those producing melanin-concentrating hormone (MCH)- and orexin are key regulators of sleep and wakefulness. Although the SCN receives non-photic input from other brain regions, the mechanisms of functional input from the LH to the SCN remain poorly understood. Here, we show that orexin and MCH peptides influence the circadian period within the SCN of both sexes. When these neurons are ablated, the circadian behavioral rhythms are lengthened under constant darkness. Using anterograde and retrograde tracing, we found that orexin and MCH neurons project to the SCN. Furthermore, the application of these peptides to cultured SCN slices shortened circadian rhythms and reduced intracellular cAMP levels. Additionally, pharmacological reduction of intracellular cAMP levels similarly shortened the circadian period in SCN slices. These findings suggest that orexin and MCH peptides from the LH contribute to the modulation of the circadian period in the SCN.Significance statement In mammals, the central circadian clock is located in the suprachiasmatic nucleus (SCN) of the hypothalamus, where it regulates circadian rhythms, including sleep and wakefulness. The SCN receives both neuronal and humoral input signals from external brain regions, which can modify circadian rhythms within the SCN. While several brain regions that project to the SCN have been anatomically identified, the specific regions, neuronal cell types, and neurotransmitters that influence SCN circadian rhythms remain largely uncharacterized. This study identifies two neuronal populations within the lateral hypothalamus that project to the SCN and modulate the circadian period.

Associations of seasonally available global positioning systems-derived walkability and objectively measured sleep in the Nurses' Health Study 3 Mobile Health Substudy.

Sleep is influenced by the environments that we experience while awake and while asleep. Neighborhood walkability has been linked with chronic disease and lifestyle factors, such as physical activity; however, evidence for the association between walkability and sleep is mixed. Extant studies assign walkability based on residential addresses, which does not account for mobility. We examined the association between walkability and sleep in the Nurses' Health Study 3 (NHS3) Mobile Health Substudy (MHS). From 2018 to 2020, individuals in the United States-based NHS3 prospective cohort participated in the MHS, in which minute-level global positioning systems (GPS) data and objective sleep duration and efficiency measures were collected via a custom smartphone application and Fitbit, respectively, for four 7-day periods across a year to capture seasonal variability. Census tract walkability was calculated by summing z-scores of population density (2015-2019 American Community Survey), business density (2018 Infogroup), and intersection density (2018 TIGER/Line road shapefiles). We ran generalized additive mixed models with penalized splines to estimate the association between walkability and sleep, adjusting for individual-level covariates as well as GPS-based exposure to environmental and contextual factors. The average main sleep period duration was 7.9 hours and the mean sleep efficiency was 93%. For both sleep duration and sleep efficiency, we did not observe an association with daily average walkability exposure. In this study of women across the United States, we found that daily GPS-based neighborhood walkability exposure during wake time was not associated with objective wearable-derived sleep duration or sleep efficiency.

A cross-sectional study on the relationship between infant sleep, temperament, and bedtime practices.

We explored the interplay between infant temperament, sleep characteristics, and bedtime practices. We conducted a cross-sectional study involving a large sample of infants 9-13 months of age (n = 623). Sleep data were collected through auto-videosomnography, allowing for objective, noninvasive assessment of sleep in an infant's ecological environment. Infant temperament and bedtime practices were assessed with questionnaires completed by parents. Results revealed significant correlations between negative affectivity and disrupted sleep patterns, including shorter sleep duration, more night awakenings, and increased parental interventions. Infants falling asleep while being breast/bottle feeding or while being held/rocked had shorter nocturnal sleep duration, lower sleep efficiency, later bedtime, earlier wake-up time, and more parental interventions. Regression analyses indicated that bedtime practices accounted for a substantial portion of variance in sleep metrics, emphasizing their role in influencing infants' sleep. The study highlights the intricate interconnections between infants' temperament, sleep, and caregiving practices, emphasizing the need for a nuanced understanding of individual differences to tailor effective parenting strategies for promoting healthy sleep in infants. Breda M, Lucchini M, Barnett N, Bruni O. A cross-sectional study on the relationship between infant sleep, temperament, and bedtime practices. J Clin Sleep Med. 2024;20(12):1965-1974.

The relationship between sleep and menstrual problems in early adolescent girls

IntroductionAdolescence is marked by hormonal, physical, neural, and behavioral changes, including in sleep patterns and, in females, the onset of menarche. Menstrual problems, such as painful menses, are common and contribute to school absences, and could indicate gynecological conditions impacting reproductive health. While studies in adults have shown associations between sleep disturbances and menstrual problems, this relationship is less understood in adolescents. Our study explores the association between sleep, menstrual problems, and menarche in a diverse sample of early adolescent girls in the U.S.MethodsWe used linear mixed-effect models to analyze associations between sleep behavior (self- and caregiver-reported) and menstrual problems (self-reported cycle irregularity, premenstrual symptom and menstrual pain severity and their impact on daily life) and menstrual characteristics (menstrual flow) in 3,037 post-menarcheal adolescent girls (Mean age:13.03 years) from the ABCD Study®. Covariates included years since menarche, race, ethnicity, parental education, and body mass index. We also used longitudinal data to explore changes in sleep behavior as a function of menarche.ResultsOf the sample, 26.2% reported moderate-severe premenstrual symptoms and 20.8% reported moderate-severe menstrual pain. 23.3% reported irregular menstrual cycles, 15.9% reported heavy menstrual flow. Shorter sleep duration was associated with greater menstrual pain intensity (β =—0.19) and impact on daily activities (β = -0.15), irregular cycles (β = -0.17), and severe premenstrual symptoms (β = -0.04). Higher sleep disturbance scores correlated with greater menstrual pain (β = 0.18) and premenstrual symptom severity (β = 0.03). Later wake-up times were linked to greater menstrual pain intensity (β = 0.14). Shorter time since menarche was associated with lower menstrual flow (β = 0.07) and pain intensity (β = 0.51) and less severe premenstrual symptoms (β = 0.07). Being post-menarche was associated with later bedtimes and shorter sleep duration.ConclusionFindings of links between sleep behavior and menstrual problems in early adolescence underscore the importance of addressing sleep and menstrual issues in healthcare screenings and educational initiatives for adolescents. Future research should focus on longitudinal and intervention studies to clarify these relationships.

The association of zero walking cadence minutes with sleep quality in adults 18–65

PurposePhysical activity (PA) guidelines suggest a link between PA, sedentary time, and sleep quality (SQ). Step cadence is an emerging proxy for PA intensity, with zero cadence (ZC) indicating sedentary time. No research has explored the relationship between ZC and SQ. This study examines the relationship between ZC and SC, compared to traditional PA and sedentary metrics, all measured via accelerometry.MethodsSleep and PA was assessed in 138 adults (53 male, 85 female, age = 23.5 ± 8.0 year.) via accelerometry. Sedentary, light, moderate, vigorous intensity PA, and ZC minutes per day were measured. SQ variables included sleep efficiency (SE), total sleep time (TST), and minutes of awake time after sleep onset (WASO). Correlation analysis and analysis of covariance was used to assess relationships between study variables and to assess differences in PA and sedentary behavior between normal and poor sleepers.ResultsSedentary time was negatively associated with SE (r = -0.24, P < 0.05) and TST (r = -0.51, P < 0.001). ZC was negatively associated with SE (r = -0.25, P < 0.05), TST (r = -0.39, P < 0.001) and positively associated with WASO (r = 0.17, P < 0.001). Poor sleepers accumulated greater ZC minutes than normal sleepers when categorized by SE (555.9 ± 69.1 vs. 521.6 ± 83.7, P = 0.02)) or TST (570.4 ± 77.7 vs. 524.5 ± 76.7, P < 0.01).ConclusionResults suggest that zero cadence minutes is a viable metric for assessing sedentary time and may be of greater utility to more traditional measure of sedentary time.

Sex Differences in Sleep and Physical Activity Patterns in Autism Spectrum Disorder.

Physical activity (PA) programs have been found to result in improved sleep in males with autism spectrum disorder (ASD), but little is known about the female characteristics. The aim of this work was to assess sex differences in sleep and PA indices using an accelerometer over 7 days and 7 nights. Sleep and PA variables were measured with questionnaires and with accelerometry in twenty-four children with ASD (16 boys, 10.3 ± 2.8; 8 girls, 11.1 ± 3.9). Some significant differences were reported between girls and boys. The total time in bed and wake time after sleep onset (WASO) were significantly higher in girls compared to boys (p < 0.01), whereas sleep efficiency was significantly lower in girls (p < 0.01). The results obtained from the sleep questionnaire (CSHQ) show averages above the threshold of 41 in both groups (the threshold indicates the presence of sleep disorders or low sleep quality). The number of daily steps was significantly lower in the girls' group (p < 0.01), and the PA volume for vigorous and strong vigorous intensities was significantly higher in the boys' group (p < 0.01 and p < 0.05, respectively). Our results show major alterations in girls, with a low level of PA and sleep alteration. PA is a relevant non-pharmacological approach to improve sleep quality and achieve sufficient sleep duration. However, particularly for girls with ASD, more personalized approaches to improve sleep may be needed to manage specific associated disorders.

The effects of rapid rehabilitation nursing on improving postoperative rehabilitation effect and life quality of early breast cancer patients.

This study was intended to determine whether rapid rehabilitation nursing can enhance postoperative rehabilitation and life quality for breast cancer (BC) patients. One hundred seventy-two patients with BC treated in our hospital from March 2020 to September 2022 were included in this retrospective study and divided into the observation group (n = 86) and control group (n = 86) based on the different nursing methods that they received. The control group accepted routine nursing care, and the observation group accepted rapid rehabilitation nursing intervention. The amount of intraoperative blood loss, anesthesia awake time, postoperative drainage tube removal time, postoperative time of getting out of bed, length of hospital stays, incidence of postoperative complications, and postoperative recovery rate of affected limb, Barthel index and quality of life instruments for cancer patients: breast cancer (QLICP-BR) of BC patients were analyzed. The amount of intraoperative bleeding in the observation group was less, and the difference was statistically significant (P < .05). The awake time of anesthesia, the time of pulling out the drainage tube after operation, the time of getting out of bed after operation and the time of hospitalization in the observation group were significant shorter (P < .05). The incidence of postoperative complications in the observation group was notably lower (P < .05). The excellent and good rate of postoperative rehabilitation of the affected limbs in the observation group was notably higher (P < .05). Before nursing, there exhibited no notable difference in the scores of Barthel index (P > .05). After 10 days of nursing, the score of Barthel index in the observation group was notably higher (P < .05). After 10 days of nursing, the QLICP-BR score of the observation group was significant higher (P < .05). Rapid rehabilitation nursing is beneficial to reduce the intraoperative blood loss of BC patients, shorten the recovery time of anesthesia, promote the excellent and good rate of rehabilitation of affected limbs, and improve the quality of life.

Association between physical activity patterns of working-age adults and social jetlag, depressive symptoms, and presenteeism.

This study aimed to evaluate the association of physical activity with social jetlag, depressive symptoms, and presenteeism. This cross-sectional study included 8,247 working-age adults (females, 44.6%; age, 20-64 years). Social jetlag was defined as the absolute difference between the midpoint of bedtime and wake time on workdays and free days. Depression symptoms were assessed using the Center for Epidemiologic Studies Depression Scale, and presenteeism was evaluated using the Work Functioning Impairment Scale. Exercise habits were classified into four groups based on the World Health Organization guidelines: non-active (NA; n=4,223), insufficiently active (IA; n=3,009: exercise below guideline levels), weekend warriors (WW; n=220: exercise 1-2 times per week meeting guideline levels), and regularly active (RA; n=793: exercise at least 3 days per week meeting guideline levels). Using multiple and Poisson regression analyses, we examined the association between exercise habits and each outcome. Social jetlag, depression, and presenteeism were more favorable with shorter sedentary times and longer durations of moderate- and vigorous-intensity exercise. Compared with the RA group, the NA group had a significantly higher prevalence of social jetlag (prevalence ratio [PR]=1.30), depression (PR=1.31), and presenteeism (PR=1.35). The IA group had a significantly higher prevalence of depression (PR=1.33) and presenteeism (PR=1.38). Exercising with a certain frequency and intensity may help prevent symptoms of depression and social jetlag, and consequently prevent presenteeism.

Traffic Awareness-Based Target Wake Time Scheduling in 802.11ax WLANs

In recent years, the rapid growth of mobile communication has led to the continuous expansion of network scale, and the energy consumption of wireless communication has also increased rapidly. Under the high-density networking conditions, frequent communication activities greatly increase the energy consumption. In order to reduce channel competition, optimize resource scheduling and reduce equipment power consumption, the target wake-up time (TWT) mechanism in IEEE 802.11ax system plays an important role through timely scheduling and transmission. To improve channel efficiency for multi-user (MU) transmission and tackle with complicated traffic conditions, this paper presents a traffic awareness-based TWT scheduling scheme (TAT). The traffic is predicted and classified using a spatio-temporal series model for traffic-based TWT parameter generation. Subsequently, the time–frequency scheduling table is developed to adaptively assign Resource Units (RUs) and time slices to active STAs. Simulation results show that TAT can guarantee the Quality of Service (QoS) under dynamic changes in power service and delay requirements while reducing power consumption, effectively meeting the energy-saving demands in the intelligent access scenarios for power terminals.

Sleep schedules and MSLT-based diagnosis of narcolepsy type 2 and idiopathic hypersomnia: Exploring potential associations in a large clinical sample.

Differential diagnosis of narcolepsy type 2 and idiopathic hypersomnia relies on the frequency of sleep-onset rapid eye movement periods observed on the Multiple Sleep Latency Test. This study investigated whether variations in sleep schedules, particularly delayed sleep-wake patterns, contribute to the diagnostic distinction between narcolepsy type 2 and idiopathic hypersomnia. The study included 871 patients aged 18-39 years (316 with narcolepsy type 2, 555 with idiopathic hypersomnia). These patients were diagnosed based on MSLT results following polysomnography from November 2013 to November 2017. Patients' sleep habits, including bedtime and wake-up times on weekdays and weekends during the 2 weeks preceding the polysomnography/Multiple Sleep Latency Test, were assessed using self-reported sleep logs. A multivariate logistic regression analysis was conducted to identify factors associated with narcolepsy type 2 diagnosis. The analysis revealed that being male (p < 0.001), younger age (p < 0.001), shorter weekday sleep duration (p < 0.05), and a delayed weekday sleep midpoint time (p < 0.01) were significantly associated with a diagnosis of narcolepsy type 2. The study suggests that the conventionally fixed schedule of polysomnography and Multiple Sleep Latency Test administration may have contributed to the increased occurrence of sleep-onset rapid eye movement periods particularly in individuals with a delayed sleep-wake schedule.

Abstract 4134962: Association between Chronotype and Psychological Health in South Korean Adolescents

Background: Chronotype influences general health, with late chronotypes often linked to psychological problems. However, longitudinal studies on this topic are limited. This study assessed the association between chronotype and adolescent mental health, focusing on depression and somatic symptoms through cross-sectional and longitudinal analyses. Methods: This longitudinal study used data from the Korean Children and Youth Panel Survey (KCYPS), targeting middle school students aged 13. Participants were assessed annually over four years (2018-2021). Chronotype was determined by analyzing sleep onset and wake times. Depression and somatic symptoms were evaluated using preexisting questionnaires like the SCL-90. Multilevel linear regression analyses were conducted both concurrently and prospectively, with gender stratification. Covariates included sleep quality, physical activity, smartphone usage, breakfast and friendship. Results: The study included 1,882 students who completed all follow-ups. Students with a late chronotype, short sleep duration, and low sleep quality reported more mental health symptoms. Late chronotype was associated with higher levels of depression (β=0.062, p&lt;.001) and somatic symptoms (β=0.056, p=.018) within the same year, and predicted somatic symptoms one year later (β=0.055, p=.019). For males, insufficient sleep worsened the effects of late chronotype on depression one year later (β=0.100, p=.042), and late chronotype predicted somatic symptoms one year later (β=0.072, p=.024). In females, late chronotype was associated with depression (β=0.061, p=.025) and somatic symptoms (β=0.075, p=.005) within the same year but did not predict future symptoms. Conclusions: Late chronotype negatively impacted depression and somatic symptoms and predicted future somatic symptoms. In females, late chronotype was related only to current mental health issues, whereas in males, it predicted future mental health problems, especially when combined with insufficient sleep. These findings highlight the impact of chronotype on adolescent mental health and suggest that its negative effects can be moderated by factors like sleep duration.

Are the Sleep-Wake Cycle and Sleep Duration Ethnically Determined? A Comparison of Tibetan and Japanese Children's Sleep.

Several environmental factors affect sleep. We investigated the sleep and sleep-related habits of preschool children living in Tibet and conducted an international comparison with those in Japan. We conducted a community-based cross-sectional study using the Chinese version of the Japanese Sleep Questionnaire for Preschoolers (JSQ-P-C) and compared the results with previous data on Japanese children. The sleep status of 3113 children aged 3-6 years old in Qinghai province was evaluated. The average wake time and bedtime of the Tibetan children were 7:20 ± 0:31 and 21:16 ± 0:43, respectively. Their mean nocturnal sleep duration was 10.0 ± 0.7 h. In comparing 3-year-old children, the time for which they viewed TV in Tibet was shorter (65.5 ± 44.6 min) than that in Japan (149.7 ± 76.6 min), and the mother's bedtime was earlier in Tibet (21:28 ± 2:14) than in Japan (23:20 ± 1:05). However, the bedtime and sleep duration of the Tibetan children (21:17 ± 0:37 and 10.0 ± 0.7 h) were fairly similar to those of the Japanese children (21:24 ± 1:57 and 9.8 ± 0.8 h). The late bedtime and short nocturnal sleep duration of Tibetan toddlers were the same as those of Japanese toddlers despite considerable differences in their lifestyle and environment.

Association of family meals with sleep and quality of life in Japanese preschool and elementary school children: A cross-sectional study

ABSTRACT Sleep is crucial for children’s health and eating habits. The decline in family meals has raised concerns about its impact on children. Previous research indicated associations between family meals and psychological health and dietary habits, but their relationship with sleep behavior is less understood. This study examined the association between family meals (breakfast and dinner), sleep patterns, and quality of life among Japanese preschoolers and elementary school students (1st to 3rd grade). The cross-sectional study involved 6,177 children aged 3–8 years in Japan. Mothers completed an online survey on family meal habits, sleep patterns, and the KINDL-R questionnaire to assess quality of life. Results showed that family meals were associated with sleep behaviors and KINDL scores. Multiple regression analysis indicated that family breakfast was associated with earlier bedtime and wake-up time, shorter weekend sleep duration, reduced social jet lag, and a morning chronotype, as detected by the Munich ChronoType Questionnaire. Family dinners were linked to later sleep and wake-up times and an evening chronotype. Family breakfast and dinner were associated with higher KINDL scores, with dinner having a stronger positive impact. These findings underscore the significance of family meals in associating sleep patterns and quality of life among Japanese children.

Adolescent Sleep Quality as Critical Component of Healthy Lifestyle

Background and purpose Adolescence is a critical period for physical, emotional, and cognitive development. High-quality sleep during this phase is essential for healthy growth, emotional well-being, optimal weight, and learning. These factors significantly influence the academic achievements of young people. Purpose: to develop and experimentally justify the methodology of training basketball teams of humanitarian higher educational institutions, taking into account the psychophysiological capabilities of the players. Material and methods The sample consisted of 626 secondary vocational school students aged 17 years from the Central Slovakia region (353 girls and 273 boys). Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). The questionnaires were distributed electronically via Google Forms from October 2023 to March 2024. The results were analyzed with an emphasis on gender differences using the chi-square test (χ2), F-test, and independent t-test at significance levels of p&lt;0.01 and p&lt;0.05, respectively. Results The majority of students, both boys and girls, fell asleep between 11:00 PM and midnight. The average bedtime was 10:54 PM for girls and 10:50 PM for boys, with no significant differences between genders. Significant differences were found in wake-up times, with nearly 40% of girls waking up before 6:00 AM, compared to only 24% of boys (p&lt;0.01). Boys experienced fewer difficulties falling asleep, with 21% falling asleep within 15 minutes (p&lt;0.05). The average sleep duration was 6 hours and 28 minutes for girls and 6 hours and 55 minutes for boys, a statistically significant difference (p&lt;0.01). Sleep efficiency was higher in boys (84.25%) compared to girls (78.75%). Sleep problems, daytime dysfunction, and mood changes were more frequent among girls (p&lt;0.01). Only 28.33% of girls and 39.19% of boys had good sleep quality (p&lt;0.01), while 17.00% of girls and 4.40% of boys exhibited severe sleep disturbances Conclusions Our findings indicate significant gender differences in sleep habits and quality, consistent with existing literature. These results highlight the need for increased attention to sleep issues among adolescents and the implementation of preventive and intervention measures to improve sleep quality, which could have a positive impact on their overall health and well-being.

Association between screen time, homework and reading duration, sleep duration, social jetlag and mental health among Chinese children and adolescents

ObjectivesTo examine the associations of screen time, homework and reading duration, sleep duration, social jetlag with mental health in children and adolescents, as well as its gender differences.MethodsFrom December 2023 to April 2024, a total of 62 395 children and adolescents were selected from 51 schools in 17 cities of China by stratified cluster sampling. Screen time, homework and reading duration, sleep duration, and social jetlag were calculated by answering the questions about watching TV time, playing smartphones time, doing homework time, reading extracurricular books time, bedtime, wake-up time, and nap time during weekdays and weekends. Mental health was assessed by the Revised Mental Health Inventory-5 (MHI-5). The generalized linear model was used to determine the association between screen time, homework and reading duration, sleep duration, social jetlag, and mental health in children and adolescents.ResultsThe generalized linear model results showed that longer watching TV time, longer playing smartphones time, longer homework time, and greater social jetlag were correlated with poorer mental health in children and adolescents, while longer nighttime sleep duration, and longer daytime nap duration were correlated with better mental health. Moreover, in primary school and junior high school, we found that this association was stronger during the weekdays. However, in senior high school, this association was stronger during the weekends. After according to gender stratified, we found that the strength of this association was different in boys and girls at different study phases. Furthermore, our findings also revealed a significant quadratic relationship, indicating the association of better mental health with an optimal amount of sleep duration.ConclusionsThere was a significant association between screen time, homework and reading duration, sleep duration, social jetlag, and mental health in children and adolescents. This study has the potential to offer useful insights for the prevention and control of mental health issues in children and adolescents.

Association Between Chrononutrition Patterns and Multidimensional Sleep Health.

Sleep health has been associated with diet quality, but the relationship between chrononutrition patterns and multidimensional sleep health is unclear. This study identifies chrononutrition patterns among U.S. adults and examines their associations with multidimensional sleep health. This cross-sectional analysis used data from the 2017-2020 National Health and Nutrition Examination Survey. Chrononutrition behaviors were assessed using two 24 h dietary recalls. Latent profile analysis was used to identify chrononutrition profiles. Multivariable survey regression models determined the associations between chrononutrition patterns and sleep health dimensions. The sample included 5228 subjects with a median age of 49 years. Of the sample, 52% of the participants were female, and 65% were White. In adjusted models, each additional hour between wake time and first instance of eating was associated with a 19% increase in the odds of poor timing (sleep midpoint < 2:00 a.m. or >4:00 a.m.; 95% CI: 1.07-1.33) and a 21% increase in poor duration (<7 or >9 h/night; 95% CI: 1.09-1.33). Each additional hour between last eating and bedtime was associated with 9% higher odds of poor duration (95% CI: 1.03-1.16). A one-hour longer eating window was associated with 10% lower odds of poor timing (95% CI: 0.84-0.98). We identified five chrononutrition profiles: Typical Eating (reference), Early Finished Eating, Later Heavy Eating, Extended Window Eating, and Restricted Window Eating. The Later Heavy Eating profile exhibited 96% higher odds of poor timing (95% CI: 1.09-3.51) and the Restricted Window Eating profile had 94% higher odds of poor duration (95% CI: 1.10-3.43). These findings highlight the importance of unique chrononutrition patterns in relation to multidimensional sleep health. We provide a framework for future studies to identify personalized chrononutrition interventions and their role in improving sleep health.

The interplay among sleep patterns, social habits, and environmental cues: insights from the Spanish population and implications for aligning daily rhythms.

The interplay among sleep patterns, social habits and environmental cues is becoming increasingly more important for public health and wellbeing due to its connection to circadian desynchronization. This paper explores said connections in Spain (which has an official and solar time mismatch), introducing the "Three Times Score" ‒which is based on questions widely used in the field‒ as a complementary tool for exploring the interplay of daily rhythms. The questionnaire covers sleep-related habits, social time, and environmental time. The study includes 9,947 participants (34.89 ± 12.15 y/o, mean ± SD; 5,561 women) from different Spanish regions. Sleep parameters were obtained for work and free days, as well as a modified version of the sleep-corrected midsleep on free days (MBFbc) and a parameter similar to social jet lag, both derived from bed time rather than sleep time. A number of indexes were computed to compare bed and work-related habits, together with natural light/dark cycle, along with the Three Times Score. Mixed-effect regression analysis was used to test whether the biological, social and environmental factors included in the study significantly predicted the sleep-related parameters: bedtime, wake-up time, time in bed and mid-bedtime. Temporal differences were found between work and free days, with waking-up occurring 2 h earlier on work days (7:10 ± 0:01) than on free days (9:15 ± 0:01). Bed times were 1 h earlier on work days (23:46 ± 0:01) than on free days (00:45 ± 0:01), whereas time in bed was over 1 h shorter on work (7 h 23 min) versus free (8 h 29 min) days. Strong correlations were found between work starting time and waking-up and bedtimes on workdays. Women went to bed earlier and woke up later, spending more time in bed. Differences in sleep habits were observed between work and free days across all age groups. The group of younger adults (18-30) reported going to bed later than older and younger groups, especially on free days. Adolescents and young adults also woke-up later than other age groups, especially on free days. Social jet lag (relative to bed time) and desynchronization indexes also varied with age, with younger adult participants exhibiting higher levels. Seasonal differences were limited, with minor variations between winter and summer. According to the multiple regression analysis, social (day type, work start time, alarm clock usage), biological (age, gender, in most cases related to sex) and environmental (sunset time) factors significantly contribute to predicting sleep/bed related schedules. This study provides insights into sleep habits in the Spanish population, introducing the Three Times Score as a complementary tool for exploring the interactions between sleep/bed-related habits, natural darkness and work-related schedules. Understanding this interplay is crucial for developing tailored interventions to improve sleep and wellbeing.

Telehealth based parental support over 6 months improves physical activity and sleep quality in children with autism: a randomized controlled trial.

Sleep disturbances are prevalent in autistic children. The emergence of telehealth offers new possibilities for remote professional intervention. By combining telehealth with parental support, this study aims to explore a novel family-based model to enhance moderate-to-vigorous physical activity (MVPA) and improve sleep quality in children with autism. Thirty-four autistic children (mean age = 15.7 years) were randomly assigned to either a 6-month intervention group or a control group. Both groups received standard physical education classes at school. The intervention group received additional after-school telehealth support. MVPA and sleep quality were assessed 1 week before the intervention and at the 6-month follow-up. After 6 months, children in the intervention group nearly doubled their daily MVPA compared to the control group (Cohen's d = 8.34, CI95% = 6.17-10.52). Actigraphy-assessed sleep efficiency was notably higher (d = 2.35, CI95% = 1.44-3.26), and there were reductions in wake time (d = 1.65, CI95% = 0.84-2.46), sleep fragmentation (d = 0.80, CI95% = 0.07-1.52), and sleep latency (d = 0.82, CI95% = 0.09-1.54) were all reduced. These improvements in objective sleep metrics were corroborated by subjective assessments using the Sleep Disturbance Scale for Children (d = 0.86, CI95% = 0.13-1.59). Telehealth combined with parental support addresses barriers to enhancing health behaviors at home. This innovative model not only improves after-school MVPA and sleep quality in autistic children but also holds significant potential for benefiting other populations requiring remote support. https://clinicaltrials.gov/study/NCT06444659?id=NCT06444659&rank=1 (NCT06444659).

A replicate crossover trial on the inter-individual variability of sleep indices in response to acute exercise undertaken by healthy men.

Using the necessary replicate-crossover design, we investigated whether there is inter-individual variability in home-assessed sleep in response to acute exercise. Eighteen healthy men (mean(SD): 26(6) years) completed two identical control (8-h laboratory rest, 08:45-16:45) and two identical exercise (7-h laboratory rest; 1-h laboratory treadmill run [62(7)% peak oxygen uptake], 15:15-16:15) trials in randomised sequences. Wrist-worn actigraphy (MotionWatch 8) measured home-based sleep (total sleep time, actual wake time, sleep latency, sleep efficiency) two nights before (nights 1-2) and three nights after (nights 3-5) the exercise/control day. Pearson's correlation coefficients quantified the consistency of individual differences between the replicates of control-adjusted exercise responses to explore: (1) immediate (night 3 minus night 2); (2) delayed (night 5 minus night 2); and (3) overall (average post-intervention minus average pre-intervention) exercise-related effects. Within-participant linear mixed models and a random-effects between-participant meta-analysis estimated participant-by-trial response heterogeneity. For all comparisons and sleep outcomes, the between-replicate correlations were non-significant, ranging from trivial-to-moderate (r range = -0.44 to 0.41, P≥0.065). Participant-by-trial interactions were trivial. Individual differences SDs were small, prone to uncertainty around the estimates indicated by wide 95% confidence intervals and did not provide support for true individual response heterogeneity. Meta-analyses of the between-participant, replicate-averaged condition effect revealed that, again, heterogeneity (τ) was negligible for most sleep outcomes. Control-adjusted sleep in response to acute exercise was inconsistent when measured on repeated occasions. Inter-individual differences in sleep in response to exercise were small compared to the natural (trial-to-trial) within-subject variability in sleep outcomes.

Threshold-dependent association between non-rapid eye movement obstructive sleep apnea and interictal epileptiform discharges: A hospital study.

Obstructive sleep apnea frequently coexists with epilepsy, potentially influencing its pathophysiology. However, the effect of obstructive sleep apnea severity on interictal epileptiform discharges is not well understood. To explore this, we studied 108 Asian patients with epilepsy who underwent single-night polysomnography. We utilized generalized linear models, adjusting for age, sex, epilepsy type (focal versus generalized), antiepileptic medication use and disease duration, to analyse the relationship between obstructive sleep apnea severity, as measured by the apnea-hypopnea index, and interictal epileptiform discharge frequency during non-rapid eye movement and rapid eye movement sleep. Our analysis revealed that severe obstructive sleep apnea (apnea-hypopnea index ≥ 30) was associated with a higher frequency of interictal epileptiform discharges during non-rapid eye movement sleep (p = 0.04), but no such association was observed during rapid eye movement sleep. Additionally, the frequency of interictal epileptiform discharges in non-rapid eye movement sleep was positively correlated with the wake time between sleep onset and offset (p = 0.03). Further studies are warranted to validate our findings across diverse ethnicities, and over multiple nights of sleep and interictal epileptiform discharge recordings.