Weekday Sleep Duration Research Articles

622 Bedtime, Sleep Duration, and Sleep Quality as Predictors of Externalizing Symptoms in Children in Foster Care

Abstract Introduction A strong association between sleep disturbances and externalizing symptoms has been found among school-aged children. In particular, there is a known association between sleep disturbances, irritability, emotional dysregulation, and hyperactivity (e.g., Coto et al., 2018). Limited research, however, has examined this association in a high-risk population of children, such as those in foster care who are at increased risk for sleep disturbances due to heightened exposure to trauma. Thus, the following study sought to assess the association between sleep quality and externalizing symptoms in a population of children in foster care. Methods Caregivers with children ages 4–11 were sampled from private Facebook community foster care groups across the United States (n = 410). Caregivers were provided a link to a survey powered by Qualtrics where they were asked to report on the children under their care’s weekday bedtime, overall sleep quality (e.g., “Please rate your child’s overall sleep quality over the last two weeks”), and sleep onset (e.g. “On weekdays, how long does it usually take for your child to fall asleep?”). Child behavioral issues were assessed via the Eyberg Child Behavior Inventory (ECBI) Parent Rating Form. Results A linear regression model was utilized to assess if child weekday bedtime, weekday total sleep duration, and overall sleep quality were unique predictors of externalizing symptoms when controlling for age. Results suggest that weekday sleep duration and bedtime were not significant unique predictors of child behavioral issues, though were significantly and positively correlated at the bivariate level (p=.02, p=.04). Sleep onset and overall sleep quality, irrespective of child age, were found to be significant unique predictors of child behavioral issues and accounted for 1% and 11% of the total variance, respectively. Conclusion Results suggest that delayed sleep onset and poorer sleep quality were predictive of increased behavioral issues for children in foster care. Findings persisted when controlling for age, which suggests that children in foster care experiencing sleep disturbances may benefit from more behaviorally focused sleep interventions to improve externalizing behaviors and increase sleep health. Support (if any):

213 Eating Patterns Associated with Sleep Duration, Insomnia, Daytime Sleepiness and Overall Sleep Quality at the US-Mexico Border

Abstract Introduction Previous studies have linked sleep to risk of diabetes and obesity, at least partially via alterations in food intake. Diabetes and obesity are common among Hispanics/Latinos, and studies are needed to better clarify the role of sleep for health among this group. Methods Data were collected from N=100 adults (age 18-60, 47% female) of Mexican descent in the city of Nogales, AZ (34% not born in the US). Surveys were presented in English or Spanish. Eating Patterns were assessed with the Three-Factor Eating Questionnaire (TFEQ), which resulted in a total score and subscales for “cognitive restraint,” “uncontrolled eating, “and “emotional eating.” Insomnia was assessed with the use of the Insomnia Severity Index (ISI), Sleepiness with the use of the Epworth Sleepiness Scale (ESS), Sleep quality with the use of the Pittsburgh Sleep Quality Index (PSQI), and weekday and weekend sleep duration with the use of the Sleep Timing Questionnaire (STQ). Covariates included: age, sex, Body Mass Index (BMI), education and immigrant status. Results When adjusted for age, sex and immigrant status (model-1), eating patterns were associated with greater insomnia (95%CI:[0.066,1.095];p=0.027), poorer sleep quality (95%CI:[0.170,1.456];p=0.014), sleepiness (95%CI[0.032,1.026];p=0.037), and weekend (but not weekday) sleep duration (95%CI:[-0.031,0.003];p=0.015). Further adjustment for education (model-2) revealed similar significant associations. Additional adjustment for BMI (model-3) revealed a change in daytime sleepiness, where no association was seen (95%CI:[-0.202,0.805];p=0.238). Regarding subscale scores, relationships were generally seen between sleep and both emotional eating and uncontrolled eating, but not cognitive restraint. However, after adjustment for BMI, there was a significant association between cognitive restraint and weekend sleep duration (95%CI:[-0.015,-0.001];p=0.030). Conclusion Greater insomnia, poorer sleep quality, increased daytime sleepiness and decreased weekend sleep duration were associated with eating patterns at the US Mexico border, particularly in terms of uncontrolled eating and emotional eating. This suggests possible mechanisms linking sleep and obesity in Hispanic/Latinos. Support (if any) Supported by T32HL007249, R01MD011600, R01DA051321

575 Sleep Duration in American Children with Autism Spectrum Disorder and the Role of Physical Activity

Abstract Introduction Sleep dysfunction is prevalent in autism spectrum disorder (ASD) and can have major daytime behavioral consequences. Emerging evidence suggests that physical activity may be associated with improved sleep in children, including those with ASD. We aimed to determine if there was an association between physical activity and sleep duration in American youth and if the association was consistent in children with and without ASD. Methods We analyzed data from children ages 6–17 years whose caregivers completed the 2018 National Survey of Children’s Health (N=20,980). ASD was self-reported (N=687), and we determined if reported ASD was mild, moderate, or severe, and if reported ASD occurred with intellectual disability (ID). Participants self-reported their weekday sleep duration and days of physical activity in the past week. We classified children as sleep sufficient or insufficient based on age-specific recommendations. Logistic regression was used to determine if physical activity and ASD were associated with sleep sufficiency. Physical activity-by-ASD interaction terms were used to determine if any physical activity association was modified by ASD status. Covariates included: age, sex, race, Hispanic ethnicity, highest caregiver education level, and overweight status. Results Compared to children without ASD, children with ASD were 29% less likely to have sufficient sleep (OR=0.71; 95% CI: 0.52–0.99), but this association attenuated to the null after adjusting for physical activity (OR=0.77; 95% CI: 0.55–1.07). Compared to zero days, being physically active for 1–3, 4–6 or 7 days in the past week was associated with increased odds of sufficient sleep, even with adjustment for ASD status (e.g., 4–6 days: OR=1.85; 95% CI: 1.48–2.32). We did not observe a statistically significant interaction between physical activity and ASD status with respect to sleep sufficiency (P-interaction=0.571), which remained consistent when using ASD severity and ASD with ID exposure variables. Conclusion Physical activity was associated with increased odds of meeting age-specific sleep duration recommendations in children with and without ASD. Our observations support pursuing physical activity in future studies as a potential intervention target to improve sleep duration in children, including those with ASD. Support (if any) NIH T32HL07713 and University of Pennsylvania’s Institute for Translational Medicine and Therapeutics

610 Self-Reported Sleep and Circadian Characteristics Predict Future Substance Use: A Longitudinal Analysis from the NCANDA Study

Abstract Introduction Growing evidence indicates that sleep characteristics predict later substance use and related problems during adolescence and young adulthood. However, most prior studies have assessed a limited range of sleep characteristics, studied only a narrow age span, and included relatively few follow-up assessments. Here, we used multiple years of data from the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study, which spans the adolescent period with an accelerated longitudinal design, to examine whether multiple sleep characteristics in any year predict substance use the following year. Methods The sample included 831 participants (423 females; age 12–21 years at baseline) from NCANDA. Sleep variables included the previous year’s circadian preference, sleep quality, daytime sleepiness, timing of midsleep (weekday and weekend), and sleep duration (weekday and weekend). Each sleep variable’s association with the subsequent year’s substance use (cannabis use or alcohol binge severity) across years 1–5 was tested separately using generalized linear mixed models (zero-inflated Negative Binomial for cannabis; ordinal for binge severity) with age, sex, race, visit, parental education, previous year’s substance use (yes/no) as covariates and subject as a random effect. Results With regard to cannabis use, greater eveningness and shorter weekday sleep duration predicted an increased risk for additional days of cannabis use the following year, while greater eveningness and later weekend midsleep predicted a greater likelihood of any cannabis use the following year. With regard to alcohol binge severity, greater eveningness, greater daytime sleepiness, and shorter sleep duration (weekday and weekend) all predicted an increased risk for more severe alcohol bingeing the following year. Post-hoc stratified analyses indicated that some of these associations may differ between high school-age and college-age participants. Conclusion Our findings extend prior work, indicating that eveningness and later sleep timing, as well as shorter sleep duration, especially on weekdays, are risk factors for future cannabis use and alcohol misuse. These results underscore a need for greater attention to sleep characteristics as potential risk factors for substance use in adolescents and young adults and may inform future areas of intervention. Support (if any) Grants from NIH: R01AA025626 (Hasler) and U01AA021690 (Clark) and UO1 AA021696 (Baker & Colrain)

148 Sleep thief! Falling asleep with the TV on is related to shorter sleep duration among Latino/a children

Abstract Introduction Sleep duration is associated with obesity in Latino/a children. However, little is known about Latino/a children’s bedtime behaviors who have a higher prevalence of obesity compared to white children. An improved understanding of Latino/a children’s bedtime behaviors is warranted to inform health promotion programs in this population. The purpose of this study was to examine bedtime activities and behaviors with sleep characteristics of Latino/a children. Methods Children of Mexican descent (8-10 years old) and their mothers (N=32) from the San Francisco Bay Area were invited to participate in a 3-week crossover study. Mothers completed a questionnaire on sleep behaviors (e.g., duration, disturbances) and activities 1 hour before bed (e.g., television viewing in bed, eating or drinking). Mother and child anthropometrics were measured. Preliminary bivariate analyses included: (1) a linear regression examining child weekday sleep duration (dependent) with child behavior before bed (independent), and (2) a logistic regression examining child sleep disturbances (dependent) with child behavior before bed (independent). Results The average child age was 9.71 (SD = 0.96); almost half of children were obese (47%) and their mothers (53%). Children slept on average 10.07 (SD= 2.36) hours on weekdays and 10.31 on weekends (SD = 2.21); 26% of children experienced difficulty falling asleep ≥ 1per week, 52% watched television in the hour before bed, and 21% watched television to fall asleep ≥ 1 per week. Mothers slept on average 6.07 (SD = 1.57) on weekends and 6.99 (SD =5.75) on weekdays. In the hour before bed, children consumed/drank cereal and/or waffles (59%), drank plain milk (38%), drank flavored milk (19%), and juice (16%). Watching television to fall asleep was associated with shorter sleep duration (B = -0.45, P = 0.03), with a trend toward significance with increased odds of difficulty falling asleep (OR = 5.0, P = 0.09). Conclusion Watching television to fall asleep may be a risk factor for shorter sleep duration and difficulty falling asleep. A larger study to examine sleep related factors, such as unhealthy practices before bed, is warranted to understand the high obesity prevalence among Latino/a children. Support (if any) K01HL129087 (PI: Martinez)

Association Between Reading Habit and Sleep Among Age Over 40 Years Community Residents: A Population-Based Evidence Study.

PurposeSleep disturbance is a paramount public health concern that besets many modern middle-aged and elderly community residents. Reading is important to adults as it facilitates the completion of daily tasks, and might be associated with sleep issues. The present study aimed to analyze the association between reading and sleep using Chinese national survey data.Patients and MethodsThe 2018 China Family Panel Studies survey data were used, and the target sample was extracted according to age (>40 years). Reading behavior and reading quantity were chosen as independent variables, and sleep duration, sleep-onset time, and sleep quality were selected as dependent variables. A multilevel mixed linear/ordinal logistic regression model was employed to evaluate the association, and restricted cubic splines with 4 knots were employed to flexibly model the association of reading quantity and sleep duration.ResultsA total of 18,740 adults were selected, and the reading rate was 15.04%. Reading habit was significantly negatively associated with weekday sleep duration, but not with duration at weekends, as determined from the full set of confounders adjusted models. Reading behavior was also associated with delayed sleep-onset time (OR: 0.935, 95% CI: 0.908–0.964), but not with sleep quality. Reading quantity showed a nonlinear relationship with sleep duration, appropriate reading quantity was related with long sleep duration.ConclusionReading was associated with short sleep duration on weekdays, but not with sleep quality. Furthermore, reading was related to late sleep-onset time, and for the middle-aged and elderly Chinese populations, appropriate reading quantity was related with long sleep duration.

The association between sleep duration and risk of mortality in Chinese older adults: a national cohort study.

Cohort studies about the sleep duration on the risk of death among Chinese older adults are still lacking. The aim of this study was to examine whether extremely long or short sleep duration was associated with mortality in Chinese adults aged 65 years or older. We included participants aged 65 years or older in 2011 at baseline in 23 provinces from the Chinese Longitudinal Healthy Longevity Survey who were followed up in 2014/2018 in China. Sleep duration was categorized as short sleep duration (< 7 hours) and long sleep duration (> 8 hours). We used the Cox proportional hazards model and restricted cubic spline analysis to explore the association between sleep duration and mortality. Among 9578 participants, short sleep duration was associated with an 11% higher risk of death (adjusted hazard ratio [aHR]: 1.11; 95% confidence interval [CI]: 1.02-1.20) and long sleep duration was associated with a 24% higher risk of death (aHR: 1.24; 95% CI: 1.15-1.34), after adjustment for all covariates. There was a U-shaped association between sleep duration and all-cause mortality (nonlinear, P < .0001). Stratified analyses showed that the risk was higher among older people who smoked and with a higher level of education both for short and long sleepers than for those who never smoked and were illiterate (P value for interaction < .05). There was a U-shaped association between sleep duration and all-cause mortality in Chinese older adults, especially in more educated individuals and smokers. Du M, Liu M, Liu J. The association between sleep duration and the risk of mortality in the Chinese older adults: a national cohort study. J Clin Sleep Med. 2021;17(9):1821-1829.

Association of weekday-to-weekend sleep differences and stress response among a Japanese working population: a cross-sectional study

ObjectivesTo investigate the relationship between differences in weekday-to-weekend sleep habits and stress responses in a working population. MethodsThis cross-sectional study used data from university workers on sleep habits, differences in sleep duration between weekdays and weekends, and each midpoint of the sleep phase on weekdays and weekends. Social jetlag was defined as the difference in the midpoint of the sleep phase between weekdays and weekends. In addition, the Brief Job Stress Questionnaire assessed stress responses and stress-related factors. To examine sleep-related factors affecting stress responses, regression analysis was performed with adjustments for age, sex, and stress-related factors. ResultsAnalyzed were 2,739 participants. Sleep duration differences obtained by subtracting sleep duration on weekdays from that on weekends, social jetlag, and weekday sleep duration were significantly associated with an increased risk of stress responses in a univariate linear regression model. Adjusting for age, sex, job stressors, and stressor buffering factors did not change this trend. However, when additionally adjusting for all sleep parameters, only sleep duration differences and weekday sleep duration were significantly associated with stress responses (β 0.67 [95% CI 0.24, 1.10], p = 0.002), (−0.66 [-1.20, −0.13], p = 0.015). ConclusionsThis study provided further evidence that weekday sleep duration and weekday-to-weekend sleep duration differences were independently associated with stress responses even when considering stress-related factors. However, social jetlag was not clearly associated with stress responses. Our findings highlighted the necessity of securing sufficient sleep for stress management and mental health promotion in a working population.

Patterns of Eating Associated with Sleep Characteristics: A Pilot Study among Individuals of Mexican Descent at the US-Mexico Border

ABSTRACT Introduction: Previous studies have linked sleep to risk of diabetes and obesity, at least partially via alterations in food intake. Diabetes and obesity are common among Hispanics/Latinos, and studies are needed to better clarify the role of sleep in health among this group. Utilizing the revised TFEQ-R-18, this study will examine whether eating behaviors such as cognitive restraint, emotional eating and uncontrolled eating are related to self-reported sleep experiences. Specifically, we hypothesized that poor eating habits would be associated with (1) more insomnia symptoms, (2) overall worse sleep quality, (3) increased daytime sleepiness, and (4) shorter sleep duration. Methods: Data were collected from N = 100 adults (age 18–60, 47% female) of Mexican descent in the city of Nogales, AZ (34% not born in the US). Surveys were presented in English or Spanish. Eating Patterns were assessed with the Three-Factor Eating Questionnaire (TFEQ), which resulted in a total score and subscales for “cognitive restraint,” “uncontrolled eating,” and “emotional eating.” Insomnia was assessed with the use of the Insomnia Severity Index (ISI), Sleepiness with the use of the Epworth Sleepiness Scale (ESS), Sleep quality with the use of the Pittsburgh Sleep Quality Index (PSQI), and weekday and weekend sleep duration with the use of the Sleep Timing Questionnaire (STQ). Covariates included age, sex, Body Mass Index (BMI), education and immigrant status. Results: Overall TFEQ score (problematic eating) was positively associated with greater insomnia, poorer sleep quality, more sleepiness, and less weekend (but not weekday) sleep. Mean TFEQ score in the sample was 18.7 (range 0–51). In adjusted analyses, every point on the TFEQ was associated with 0.6 ISI points, 0.8 PSQI points, 0.5 ESS points, and 1.1 minutes of less weekend sleep duration. Regarding subscale scores, relationships were generally seenbetween sleep and emotional eating and unrestricted eating, and not cognitive restraint. Conclusions: Greater insomnia, poorer sleep quality, increased daytime sleepiness and decreased weekend sleep duration were associated with eating patterns at the US-Mexico border, particularly in the area of unrestricted eating and emotional eating. This suggests possible mechanisms linking sleep and obesity in Hispanic/Latinos.

Association between social jetlag and presenteeism in Japanese industry: A cross-sectional study

Research suggests that misalignment of the biological clock and social time, referred to as social jetlag (SJL), can induce physical and mental disorders. SJL may also be associated with presenteeism (i.e., a state in which workers are unable to perform sufficiently due to mental and physical health problems, even though they are going to work). However, the association between SJL and presenteeism among workers in Japan remains unclear. This study aimed to verify the following hypotheses in a sample of workers in an industrial setting in Japan: "Workers exhibiting SJL have a high degree of work functioning impairment due to presenteeism" and "An association between SJL and presenteeism exists, even when taking work style and sleep-related factor into consideration." A self-administered questionnaire survey was conducted with 1,573 workers in the manufacturing industry. Of these, 1,501 participants responded (response rate: 95.4%). Individuals who provided invalid answers or used alarm clocks to wake on work-free days were excluded, according to the Munich Chronotype Questionnaire (MCTQ) guidelines. The final sample comprised 980 participants (80.7% male; average age: 44.4 [SD 11.3] years). SJL was assessed using the MCTQ. Presenteeism was measured using the work functioning impairment scale. Using presenteeism as the dependent variable, we conducted hierarchical multiple regression analyses to compare the explanatory power of the different models. Independent variables were SJL, daily rest period between workdays, weekday sleep duration, and subjective insomnia. Models 2 and 3 were adjusted for age, sex, employment position, occupation, employment status, and working regulations. Multiple regression analyses indicated that SJL was significantly and individually associated with presenteeism (β = .066, p = .038). After adjusting for work- and sleep-related variables (Models 2 and 3), SJL no longer contributed significantly to presenteeism. In the final model, daily rest periods (β = .076, p = .017) and subjective insomnia (β = .470, p < .001) remained significantly associated with presenteeism (adjusted R2 = .239). The hypothesis "Workers experiencing SJL have a high degree of work functioning impairment due to presenteeism" was supported in our univariate analysis. However, after considering the influence of subjective insomnia and daily rest periods, the association disappeared. Therefore, a direct relationship between SJL and presenteeism is not supported. Thus, the risk of presenteeism should be considered in two stages, first confirming the perception of insomnia among workers who experience SJL, and then considering the possibility of presenteeism occurring.

Work Habit-Related Sleep Debt; Insights From Factor Identification Analysis of Actigraphy Data.

The present study investigates the factors of “Weekday sleep debt (WSD)” by comparing activity data collected from persons with and without WSD. Since it has been reported that the amount of sleep debt as well the difference between the social clock and the biological clock is associated with WSD, specifying the factors of WSD other than chronotype may contribute to sleep debt prevention. We recruited 324 healthy male employees working at the same company and collected their 1-week wrist actigraphy data and answers to questionnaires. Because 106 participants were excluded due to measurement failure of the actigraphy data, the remaining 218 participants were included in the analysis. All participants were classified into WSD or non-WSD groups, in which persons had WDS if the difference between their weekend sleep duration and the mean weekday sleep duration was more than 120 min. We evaluated multiple measurements derived from the collected actigraphy data and trained a classifier that predicts the presence of WSD using these measurements. A support vector machine (SVM) was adopted as the classifier. In addition, to evaluate the contribution of each indicator to WSD, permutation feature importance was calculated based on the trained classifier. Our analysis results showed significant importance of the following three out of the tested 32 factors: (1) WSD was significantly related to persons with evening tendency. (2) Daily activity rhythms and sleep were less stable in the WSD group than in the non-WSD group. (3) A specific day of the week had the highest importance in our data, suggesting that work habit contributes to WSD. These findings indicate some WSD factors: evening chronotype, instability of the daily activity rhythm, and differences in work habits on the specific day of the week. Thus, it is necessary to evaluate the rhythms of diurnal activities as well as sleep conditions to identify the WSD factors. In particular, the diurnal activity rhythm influences WSD. It is suggested that proper management of activity rhythm may contribute to the prevention of sleep debt.

Differences between male and female university students in sleepiness, weekday sleep loss, and weekend sleep duration

IntroductionWomen and men experience sleep differently and the difference in intrinsic desire for sleep might underlie some of the observed male-female differences. The objective of this cross-sectional questionnaire study of university students was to determine male-female differences in self-reported sleepiness and sleep-wake patterns. MethodsFive questionnaires were completed by 1650 students at four Russian universities. ResultsCompared to male students, female students reported a lower subjective sleep quality score, had a higher morning sleepability score and lower nighttime and daytime wakeability scores. They more often reported excessive daytime sleepiness and expected to be sleepier at any time of the day with the largest male-female difference around the times of sleep onset and offset. On free days, they reported a longer sleep duration and an earlier sleep onset. Free-weekday difference was larger for sleep duration and smaller for sleep onset. Such male-female differences showed similarity to the differences observed in university and high school students from different countries around the globe. There was no significant male-female difference in weekly averaged sleep duration, weekday sleep duration, hours slept, midpoint of sleep on free days, free-weekday difference in sleep offset, social jetlag, and morningness-eveningness score. Therefore, when studies rely on these self-reports, the most salient male-female differences might not be immediately evident. ConclusionsIt seems that the intrinsic desire for longer sleep duration might contribute to a higher susceptibility of female students to weekday sleep loss. Among these students, negative effects of reduced sleep duration might be more common and more detrimental.

Relationships between Extra-School Tutoring Time, Somatic Symptoms, and Sleep Duration of Adolescent Students: A Panel Analysis Using Data from the Korean Children and Youth Panel Survey.

As private tutoring has expanded worldwide, it has been noted that private tutoring and associated emotional distress can affect sleep duration and the health of adolescent students. However, the relationships between extra-school tutoring time, somatic symptoms, defined as physical symptoms of emotional distress, and sleep duration in adolescents has rarely been determined. The aim of this study was to identify these relationships in adolescent students. Data from the Korean Children and Youth Panel Survey were analyzed to address the research questions. Weekday sleep duration, extra-school tutoring time, and somatic symptoms were measured using adolescents’ self-report questionnaires. A multilevel, structural equation model was utilized to test the relationships between these variables and was deemed appropriate considering the repeated measure of the panel data. After controlling for respondent sex, parent working status and education level, and family structure, adolescents’ extra-school tutoring time and level of somatic symptoms were associated with sleep duration during weekdays. Furthermore, the association between extra-school tutoring time and sleep duration was partially mediated by somatic symptoms. Korean adolescent students slept less than the recommended duration. Intervention programs that increase parental interest and attention in adolescent students’ lives, not only focused on academic achievement but also emotional distress is needed. Researchers and policymakers should understand recommended age-appropriate sleep duration and the educational culture and provide balanced strategies between the consideration of the effect of private education on academic achievement and the need to guarantee physical and mental health in adolescent students.

The effect of short or long sleep duration on quality of life and depression: an internet-based survey in Japan

BackgroundTo date, no previous studies have evaluated the relationship between sleep duration and quality of life (QOL) or depression in the general population after controlling for daytime sleepiness and sleep disturbances. MethodsA web-based cross-sectional survey was conducted with 8698 subjects aged 20–69 years. We examined the relationships between weekday sleep duration and daytime sleepiness, sleep disturbance, QOL and depression, using the Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index (without the item for sleep duration), 8-item Short Form and Center for Epidemiological Studies Depression Scale (CES-D). ResultsDaytime sleepiness tended to increase in proportion to shorter weekday sleep durations. Sleep disturbances, physical and mental QOL, and CES-D scores were worse in both the shorter and longer sleep groups compared with the group with 7–8 h of sleep. Hierarchical logistic regression analyses revealed that short sleep duration but not long sleep duration was significantly associated with reduction of both physical and mental QOL, even after controlling for the presence of daytime sleepiness and sleep disturbance. Both short and long sleep duration were independently and significantly correlated with depression after controlling for daytime sleepiness; however, there was no statistically significant association after adjusting for the effects of sleep disturbance. ConclusionsThe results suggested adverse effects of short sleep but not long sleep on both physical and mental QOL. In addition, the negative impact of specific types of sleep disturbance on depression may be greater than the impact of shortening of sleep duration.

A comparative study of screen time, sleep duration and behavioural disturbances in urban and rural high school children

Background: Sleep disturbance is a common but unrecognized problem in adolescents. Light emitting electronic devices negatively influence sleep quality, leading to reduced alertness, increased fatigue, compromised daytime functioning and impaired mood. Aims: The current study aimed to assess the impact of screen viewing on sleep duration, sleep quality and behavioural disturbances in high school students. Methods: This was a cross sectional community-based study involving sixty urban and sixty rural high school students in Karnataka, India. The Pittsburgh sleep quality index (PSQI), Epworth Sleepiness scale (ESS), Aberrant Behaviour Checklist (ABC) were used to assess sleep quality in the past one-month, daytime drowsiness and behavioural disturbances respectively. A self-designed, semi-structured proforma was used to assess demographics, medical information, screen viewing duration, patterns and content of device use. Results: Television use was prevalent in 95% urban and 76% rural students, and cell-phone use in 70% urban and 51.6% rural students almost every night. The total screen duration in the urban group was nearly double that of the rural group. We observed a significant positive correlation of total screen duration with weekday sleep duration, weekend catch-up sleep, PSQI, ESS and ABC scores in urban school adolescents. All behaviour subscale scores of ABC were significantly higher in the urban compared to rural group. Conclusions: Adolescents in in both groups had sleep durations considered insufficient for age. The recommendations for healthy media use needs updating, with development of age-specific guidelines regarding the quantity and timing of electronic media.

Acculturation Associated with Sleep Duration, Sleep Quality, and Sleep Disorders at the US-Mexico Border.

Sleep disparities exist among Hispanics/Latinos, although little work has characterized individuals at the United States (US)–Mexico border, particularly as it relates to acculturation. This study examined the association of Anglo and Mexican acculturation to various facets of sleep health among those of Mexican descent at the US–Mexico border. Data were collected from N = 100 adults of Mexican descent in the city of Nogales, Arizona (AZ). Surveys were presented in English or Spanish. Acculturation was assessed with the Acculturation Scale for Mexican-Americans (ARSMA-II). Insomnia was assessed with the Insomnia Severity Index (ISI), sleepiness was assessed with the Epworth Sleepiness Scale (ESS), sleep apnea risk was assessed with the Multivariable Apnea Prediction (MAP) index, weekday and weekend sleep duration and efficiency were assessed with the Sleep Timing Questionnaire, sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI), and sleep duration and sleep medication use were assessed with PSQI items. No associations were found between Mexican acculturation and any sleep outcomes in adjusted analyses. Anglo acculturation was associated with less weekend sleep duration and efficiency, worse insomnia severity and sleep quality, and more sleep apnea risk and sleep medication use. These results support the idea that sleep disparities may depend on the degree of acculturation, which should be considered in risk screening and interventions.

The Longitudinal Association between Sleep Duration and Suicidal Behavior among Chinese Adolescents: The Role of Nonmedical Use of Prescription Drug

ABSTRACT Objective/Background Abnormal sleep and nonmedical use of prescription drugs are known to be factors associated with suicidal behavior, but the nature of the association between weekday sleep duration and suicidal behavior has not been elucidated. Nonmedical use of prescription drugs may play a mediator role in the association mentioned above. Participants There were a total of 3,273 high school students interviewed at baseline with a response rate of 96.8% and followed up at one year (retention rate, 96.1%). The mean (SD) age of the students was 13.7 (1.0) years. Methods Data were drawn from the longitudinal data of the School-based Chinese Adolescents Health Survey. A total of 12 high schools were selected in Guangzhou. Suicidal behavior, weekday sleep duration, and nonmedical use of prescription drugs were measured. Results Sleeping < 7 hours/day at time 0 was positively associated with suicidal ideation (Adjusted odds ratio [AOR] = 1.51, 95% CI = 1.21–1.89) and suicide attempts (AOR = 2.35, 95% CI = 1.02–5.38) at time 1. The mediation analyses showed that baseline opioids misuse or sedatives misuse partially mediated the associations of baseline short weekday sleep duration with suicidal ideation and suicide attempts at one-year follow-up. Conclusions Baseline short weekday sleep duration was positively associated with subsequent suicidal ideation and suicide attempts, and nonmedical use of opioids or sedatives partially mediated the associations mentioned above. Suicidal behavior can be prevented, short weekday sleep duration and nonmedical use of prescription drugs may be risk factors for suicidal behavior, and the respective roles of these factors are needed to be better understood.

Long weekend sleep is linked to stronger academic performance in male but not female pharmacy students.

Poor sleep hygiene portends loss of physical and mental stamina. Therefore, maintaining a regular sleep/wake schedule on both weekdays and weekends is highly recommended. However, this advice runs contrary to the habits of university students who sleep late on weekends. Pharmacy students at Duquesne University sit for frequent examinations, typically commencing at 7:30 AM, and they complain about mental fatigue. Here, we tested the central hypothesis that longer sleep durations on both weekdays and weekends are linked to stronger academic performance in men and women. Students in their first professional year were administered three surveys to collect data on sleep habits and factors that might influence sleep, such as roommates, long commute times, and sleep interruptions. Grade point averages (GPAs) were collected from the Dean's office, with individual permissions from the students. Longer weekend-but not weekday-sleep durations were significantly correlated with higher cumulative GPAs in men and not in women. Women achieved slightly higher cumulative GPAs than men. Students who fell asleep within 15 min of going to bed had higher professional-phase GPAs than those who fell asleep after an hour or more. Our observations cannot establish causal links, but, given the body of prior evidence on the salutary properties of sleep, men may reap more benefit from recovery sleep on weekends. Rather than recommending that students force themselves awake early on weekends in an attempt to maintain a consistent sleep routine, the real-life habits of students should also be given consideration.

Sleep Problems and Drinking Frequency among Urban Multiracial and Monoracial Adolescents: Role of Discrimination Experiences and Negative Mood.

Mounting evidence suggests that multiracial adolescents may be at greater risk than their monoracial peers for both sleep problems and alcohol use. However, mechanisms underlying these uniquely-heightened risky health behaviors among multiracial adolescents remain a gap in the literature. This cross-sectional study examined a risk pathway involving discrimination experiences and negative mood underlying racial disparities in concurrent sleep problems and drinking frequency. Students at an urban, socioeconomically-disadvantaged high school (N=414; grades 9–11, Mage=16.00 [SD=1.08]; 57% female; 17% multiracial, 41% Black, 22% White, 18% Asian, 2% Other; 12% Hispanic/Latinx) completed a survey. Path analysis demonstrated that associations of multiracial status with sleep problems (insomnia symptom severity and insufficient weekday sleep duration), but not drinking frequencies (past-year drinking or past-2-week binge-drinking frequencies), were explained by discrimination experiences and, in turn, negative mood. In ancillary analysis excluding White students, the serial indirect risk pathway was significant for both insomnia symptom severity and past-year drinking frequency outcomes. Discrimination experiences and negative mood may function as intermediate factors contributing to racial disparities in adolescent sleep problems, although longitudinal replication is needed.

Testing the Bidirectional Associations of Mobile Phone Addiction Behaviors With Mental Distress, Sleep Disturbances, and Sleep Patterns: A One-Year Prospective Study Among Chinese College Students.

BackgroundMobile phone addiction behaviors (MPAB) are extensively associated with several mental and sleep problems. Only a limited number of bidirectional longitudinal papers have focused on this field. This study aimed to examine the bidirectional associations of MPAB with mental distress, sleep disturbances, and sleep patterns.MethodsA total of 940 and 902 (response rate: 95.9%) students participated at baseline and one-year follow-up, respectively. Self-reported severity of mobile phone addiction was measured using Mobile Phone Involvement Questionnaire (MPIQ). Mental distress was evaluated by using Beck Depression Inventory (BDI) and Zung Self-Rating Anxiety Scale (SAS). Sleep disturbances were assessed by using Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS). Sleep patterns were evaluated by using reduced Morningness-Eveningness Questionnaire (rMEQ), weekday sleep duration, and weekend sleep duration.ResultsCross-lagged analyses revealed a higher total score of BDI, SAS, and ISI predicted a greater likelihood of subsequent MPAB, but not vice versa. We found the bidirectional longitudinal relationships between MPAB and the total score of PSQI and ESS. Besides, a higher score of MPIQ at baseline predicts a subsequent lower total score of rMEQ and shorter weekday sleep duration.ConclusionsThe current study expands our understanding of causal relationships of MPAB with mental distress, sleep disturbances, and sleep patterns.