Weekend Nights Research Articles

Reasons for the continued decline in fertility intentions: explanations from overtime work

ABSTRACT China’s fertility rate continues to decline despite government fertility policies. This study aims to explore the micro-level causes of China’s declining fertility rate by examining the impact of changes in Chinese work patterns in recent years, particularly the prevalence of overtime work, on fertility intentions. Using data from the China Family Panel Studies (CFPS), this study examines the impact of overtime work on fertility intentions at both the provincial and urban levels. It also examines the specific mechanisms through which different types of overtime (e.g. weekend overtime, night shifts, on-call duty) affect fertility intentions. The results show that overtime work significantly inhibits fertility intentions, a trend that is consistent at both provincial and urban levels. Weekend overtime, night shifts, and on-call duties exhibit particularly pronounced inhibitory effects on fertility intentions. However, not all work arrangements negatively impact fertility intentions. Reasonable work schedules may even foster them. The research implies the need for policy measures to mitigate the negative effects of overtime work on fertility intentions.

The rate and predictors of violence against EMS personnel

BackgroundViolence against Emergency Medical Services (EMS) personnel vary between studies. Current studies are mainly based on self-reporting, thus other designs are needed to provide more perspective. The purpose of this study was to explore the rate and predictors of violent behavior targeted at EMS personnel by exploring the Electronic patient care records (ePCR) documentation by EMS personnel.MethodsThis was a retrospective cohort study of EMS patients in Finland. The data were collected from three regions between 1st June and 30th November 2018. Text mining and manual evaluation were used to identify and explore predictors of violence targeted at EMS personnel from the ePCR narratives. Multivariable logistic regressions were used to determine factors that were independently associated with violent behavior. The results are presented with odds ratios (ORs) with 95% confidence intervals (CIs).ResultsThe EMS personnel reported experiences of violence in a total of 297 identified missions (0.7%) of all EMS missions (n = 40,263). The violence was mostly verbal (62.3%) and the most common violence perpetrator was the patient (98.0%). The police were alarmed to many missions where violence was reported (40.7%). Sometimes violence occurred suddenly although the police were present. The multivariable logistic regression model indicates that violence occurred typically in urban areas (OR 1.699; 95% CI 1.283 to 2.248), at weekend nights (OR 1.357; 95% CI 1.043 to 1.765), by male (OR 1.501; 95% CI 1.160 to 1.942), and patients influenced by alcohol (OR 3.464; 95% CI 2.644 to 4.538). A NEWS2 score of 3 in any parameter (vs. score 0–4, OR 2.386; 95% CI: 1.788 to 3.185) and ALS unit type (vs. BLS, OR 1.373; 95% CI: 1.009 to 1.866) increased the likelihood as well.ConclusionsThe documentation in ePCRs show low rates of violence targeted at EMS personnel. However, violence is a multidimensional phenomenon connected to unfamiliar patients, rushed situations, and an uncontrolled environment. This means that the EMS personnels’ safety cannot be ensured in all situations. Therefore, a balance between safety margins and treating patients needs to be considered.

ASSESSMENT OF NOISE POLLUTION LEVELS IN AN ACADEMIC AREA OF AN ENGINEERING INSTITUTE IN INDIA

Present study focuses on typical noise assessment at 29 key locations in an academic area of a college during academic and non-academic hours, and comparison with Indian standards for sensitive zone. The equivalent continuous noise levels (L_Aeq) were observed to be exceeding the permissible limits of 50 dB L_Aeq during day time and 40 dB during night time on weekday as well as weekend of classrooms, corridors, central workshop and open spaces in academic area. The average L_Aeq values for the entire academic area on weekday during day time (65.88 dB), weekday night time (47.70 dB), weekend day time (57.73 dB) and weekend night time (45.77 dB) were also observed to be 31.77 %, 19.24 %, 15.45 % and 14.43 % respectively higher than the prescribed standards for educational/ academic institutes. Further, noise maps were created by ArcGIS using Inverse Distance Weighting (IDW) technique showing noise hotspots at a glance.

Sleep Duration Irregularity is Associated with Elevated Blood Pressure During Submaximal Exercise in Young Adults.

Irregularity in nightly sleep duration is reported to associate with elevated blood pressure (BP), but it is unclear whether this association can be observed with BP measured during exercise after controlling for factors known to influence the exercise pressor reflex. Twenty-nine young adults (22±4y; 19 men, 10 women) performed cycling exercise until volitional fatigue to assess peak oxygen uptake (VO2). Actigraphy was used to monitor sleep duration and daily physical activity for seven consecutive days after which participants completed two bouts of moderate-intensity cycling while BP and VO2 were measured using a Tango+ device and indirect calorimetry, respectively. Systolic BP was averaged from the two bouts of exercise and expressed as a change from seated rest (∆SBP). Sleep duration regularity was calculated as standard deviation (SD) and coefficient of variation (CV). Systolic BP at seated rest, during exercise, and ∆SBP was 113±13, 152±21, and 38±13 mmHg, respectively. Sleep duration SD (range 10-146 min) and sleep duration CV (range 2-54%) when excluding weekend nights were significantly correlated with ∆SBP (r = 0.58 and r = 0.62, respectively; both p<0.01) after adjusting for age, sex, body mass index, peak VO2, physical activity, resting systolic BP, chronotype, and the VO2 response to exercise. Sleep duration regularity analyzed with weekend nights included (across all seven days) was also significantly correlated with ∆SBP (p≤0.01), but had weaker correlation coefficients. These results indicate that sleep regularity, especially when excluding weekend nights, is associated with the rise in systolic BP during moderate-intensity exercise in young adults. Sleep duration regularity may be a useful tool to capture the impact of intermittent nights of insufficient sleep on BP dysregulation.

COVID-19-Related Emotional Impact and Personal Experiences, Family Income, and Sleep Hygiene of Early Appalachian Adolescents

Objectives: The coronavirus disease 2019 (COVID-19) pandemic has negatively impacted the lifestyles and routines of adolescents, making it difficult to prioritize sleep. This has raised concerns regarding the sleep hygiene of young individuals, as good sleep is important for healthy youth development. Therefore, understanding how the pandemic has disproportionally affected the sleep of specific youth subgroups is essential for developing interventions to alleviate poor sleep and its adverse consequences. Methods: School-based survey data from the Young Mountaineer Health Study (YMHS) was used to create generalized estimating equation models to predict daytime sleepiness and the amount of sleep among early adolescents on weekday and weekend nights. The study included data from 2,322 students collected over three waves ~6 months apart. COVID-19-related emotional impact (scale range: 5–25) was considered the independent variable. Results: The average age of the participants in wave 1 was 11.50 (male, 44.1%). COVID-19-related emotional impact was positively associated with daytime sleepiness (estimate=0.25, &lt;i&gt;p&lt;/i&gt;&lt;0.001) and increased the odds of receiving less than the recommended average amount of sleep on weekdays (odds ratio [OR]=1.05, &lt;i&gt;p&lt;/i&gt;&lt;0.001) and weekends (OR=1.04, &lt;i&gt;p&lt;/i&gt;&lt;0.001). Conclusions: Thus, we recommend targeting proper sleep interventions for individuals deeply affected by the pandemic and young individuals from lower-income families. Moreover, despite a decrease in the emotional impact of COVID-19 over time, its potential negative effects on sleep persisted. Therefore, efforts should focus on educating young individuals regarding the health benefits of proper sleep, with an emphasis on integrating this information into the health curricula of secondary schools in the Appalachian region.

Effects of Time of Arrival on Trauma Patient Outcomes.

Arriving during "off hours" to the hospital can put patients at greater risk of complications or mortality given lesser staff. Our goal was to investigate this in trauma patients with an Injury Severity Score (ISS) of >15. We hypothesized that the patients admitted late at night and/or during the weekend, would have worse outcomes, delays to the operating room (OR), and longer lengths of stay (LOS) compared to those who arrive on a weekday during the day. We performed a retrospective study from 8/1/2019 to 8/1/2022 of all trauma patients with an ISS >15 at our Level 1 Trauma Center. Patients <18years, dead on arrival, or transferred out were excluded. Univariate and multivariable analysis were performed comparing weekday vs weekend arrivals, day vs night shift arrivals, and with patients grouped as weekday day, weekday night, weekend day, and weekend night. The primary outcome was mortality. 953 patients met inclusion criteria. The patients that arrived on the weekend and at night were significantly younger than their counterparts. A significantly greater percentage of Black patients arrived during night shift. Mortality, hospital LOS, and ICU LOS did not differ based on day or time of arrival. Contrary to our hypothesis, our study did not find a significant difference in outcomes when evaluating based on a patient's time of arrival. This gives credence that our mature trauma center can provide the same level of care despite the time of a severely injured patient's time of arrival.

Association between Delivery during Off-Hours and the Risk of Severe Maternal Morbidity: A Nationwide Population-Based Cohort Study.

This study evaluated the association between off-hour deliveries and the risk of severe maternal morbidity (SMM). Data regarding Korean deliveries between 2005 and 2019 obtained from the National Health Insurance Service were used. SMM was evaluated using an algorithm developed by the United States Centers for Disease Control and Prevention. Modified Poisson regression analyses were conducted to investigate the association between off-hour deliveries and SMM, with stratification by hospital region and the number of beds. Approximately 32.7% of the 3,076,448 nulliparous women in this study delivered during off-hours, including 2.6% who experienced SMM. Patients who delivered at night had the highest risk of SMM (weekday nights, adjusted risk ratio (aRR): 1.41, 95% confidence interval (CI): 1.38-1.44; weekend nights, OR: 1.40, 95% CI: 1.34-1.46). The SMM of night deliveries was higher at hospitals located in small cities and those with 100-499 beds (weekend night: small cities, aRR: 1.49, 95% CI: 1.40-1.59; 100-499 beds, aRR: 1.83, 95% CI: 1.67-2.01; weekday night: small cities, aRR: 1.46, 95% CI: 1.42-1.51; 100-499 beds, aRR: 1.70, 95% CI: 1.62-1.79). Therefore, nighttime deliveries are associated with a higher risk of SMM, especially at hospitals located in small cities and those with 100-499 beds.

Association of Time in Bed, Social Jetlag, and Sleep Disturbances With Cognitive Performance in Children With ADHD

Objectives: Children with ADHD commonly exhibit sleep disturbances, but there is limited knowledge about how sleep and sleep timing are associated with cognitive dysfunction in children with ADHD. Methods: Participants were 350 children aged 5 to 12 years diagnosed with ADHD. Three sleep-related constructs—time in bed, social jetlag (i.e., discrepancy in sleep timing pattern between school nights and weekend nights), and sleep disturbances were measured using a caregiver-report questionnaire. Linear regression models assessed the associations between sleep-related constructs and cognitive performance. Results: After adjustment for sociodemographic variables, there were few associations between time in bed or sleep disturbances and cognitive performance, however, greater social jetlag was negatively associated with processing speed (β = −.20, 95% CI [−0.35, −0.06]), visually-based reasoning (β = −.13, 95% CI [−0.27, 0.00]), and language-based reasoning (β = −.22, 95% CI [−0.36, −0.08]); all p < .05). Conclusion: Social jetlag, but not time in bed or disturbances, was associated with lower cognitive performance among children with ADHD.

Assessing bicycle crash risks controlling for detailed exposure: A Copenhagen case study

A better understanding of factors associated with bicycle crashes can inform future efforts to limit crash risks. Many previous studies have analysed crash risk based on crash databases. However, these can only provide conditional information on crash risks. A few recent studies have included aggregate flow measures in their crash risk analyses. This study incorporates detailed bicycle flow to investigate factors related to bicycle crashes. Specifically, the study assesses the relative crash risk given various conditions by applying Palm distributions to control for exposure.The study specifically investigates the relationship between weather and time conditions and the relative risk of bicycle crashes at a disaggregate level. The study uses bicycle crash data from police reports of bicycle crashes from 2017–2020 in the greater Copenhagen area (N = 4877).The relations between the bicycle crash risk and the air temperature and wind speeds are found to be highly non-linear. The relative risk of bicycle crashes is elevated at low and high temperatures (0 °C ¿ x, x ¿ 21 °C). The results also show how decreasing visibility relates to increasing bicycle crash risk. Meanwhile, cycling during the early morning peak (7–8) and afternoon peak hours (15–18) is related to an increased risk of bicycle crashes. While some of the effects are likely spurious, they highlight specific conditions associated with higher relative risk. Finally, the results illustrate the increased risk at weekend night times when cyclists are likely to bike under the influence of alcohol.In conclusion, the analysis confirms that visibility, slippery surfaces, and intoxication are all factors associated with a higher risk of bicycle crashes. Hence, it is relevant to consider how infrastructure planning and preventive measures can modify the bicycle environment to minimise these risks.

Comparison of actigraphy-measured and parent-reported sleep in association with weight status among preschool children.

This study compared weekday and weekend actigraphy-measured and parent-reported sleep in relation to weight status among preschool-aged children. Participants were 3-6 years old preschoolers from the cross-sectional DAGIS-study with sleep data for ≥2 weekday and ≥2 weekend nights. Parents-reported sleep onset and wake-up times were gathered alongside 24 h hip-worn actigraphy. An unsupervised Hidden-Markov Model algorithm provided actigraphy-measured night time sleep without the guidance of reported sleep times. Waist-to-height ratio and age-and-sex-specific body mass index characterised weight status. Comparison of methods were assessed with consistency in quintile divisions and Spearman correlations. Associations between sleep and weight status were assessed with adjusted regression models. Participants included 638 children (49% girls) with a mean ± SD age of 4.76 ± 0.89. On weekdays, 98%-99% of actigraphy-measured and parent-reported sleep estimates were classified in the same or adjacent quintile and were strongly correlated (rs = 0.79-0.85, p < 0.001). On weekends, 84%-98% of actigraphy-measured and parent-reported sleep estimates were respectively classified and correlations were moderate to strong (rs = 0.62-0.86, p < 0.001). Compared with actigraphy-measured sleep, parent-reported sleep had consistently earlier onset, later wake-up, and greater duration. Earlier actigraphy-measured weekday sleep onset and midpoint were associated with a higher body mass index (respective β-estimates: -0.63, p < 0.01 and -0.75, p < 0.01) and waist-to-height ratio (-0.004, p = 0.03 and -0.01, p = 0.02). Though the sleep estimation methods were consistent and correlated, actigraphy measures should be favoured as they are more objective and sensitive to identifying associations between sleep timing and weight status compared with parent reports.

Effectiveness of Sexual Assault Protective Behaviors on the Daily Level: The Roles of Intoxication and Executive Control.

Young adult women engage in a variety of behaviors aimed at reducing their risk of sexual assault (SA), termed sexual assault protective behavioral strategies (SA-PBS), yet the evidence demonstrating the effectiveness of SA-PBS in reducing SA risk has been relatively sparse and inconclusive. The current study examined the use of SA-PBS, the factor structure of a diverse array of SA-PBS, and their association with the occurrence of SA. The influence of state- and trait-level moderators on the association between SA-PBS and SA events was also examined. In a sample of community young adult women (N = 174), use of SA-PBS and the occurrence of same night SA were examined with a longitudinal burst design over 1 year that spanned 27 weekend nights when women were out in social contexts. We also examined the influence of state intoxication of alcohol use and trait effortful control (EC) on the relationship between SA-PBS factors and SA events. We found that SA-PBS cluster into two factors representing Proactive and Reactive SA-PBS. While Proactive PBS was not associated with SA, Reactive PBS were positively associated with a SA event occurring. There was no evidence in the current sample to support a moderating role of intoxication on the relationship between Proactive or Reactive PBS and SA. However, there was a marginal interaction effect found for the moderating role of EC on the relationship between Proactive PBS and SA. Our findings identify important differences in SA-PBS, and perhaps most importantly, suggest that not all strategies are created equal with respect to reducing risk.

Quantifying teenagers’ sleep patterns and sex differences in social jetlag using at-home sleep monitoring

Sleep plays an important role in the formative developmental processes occurring during the teenage years. At the same time, teenagers' changing bioregulatory mechanisms and psychosocial factors converge into the so-called social jetlag, a sleep timing misalignment between weekdays and weekends. The aim of this study was to quantify the course of day-to-day changes in sleep/wake patterns and sleep stage distributions, and the sex differences in social jetlag among teenagers. We observed the sleep of 156 teenagers (58.3% girls, 15–16 years) using a novel sleep monitor over the course of up to 10 consecutive days. 1323 nights of data were analyzed using multilevel modeling. On average, participants went to bed at 23:41, woke up at 07:48, slept for 7.7 h and had 85.5% sleep efficiency. Sleep stage distributions were in line with normative data. We found later sleep onset and offset, longer time in bed, sleep duration, and sleep onset latency (p = .001), greater proportion of light sleep and lower proportion of deep sleep, and poorer sleep efficiency (all p < .001) on weekend nights starting on Friday and Saturday. On Friday nights, girls had longer time awake after sleep onset (p = .020) than boys. On Friday and Saturday nights, girls fell asleep earlier (p < .001 and p = .006, respectively). On Saturday nights, girls had shorter sleep latency (p = .024), and better sleep efficiency (p = .019) than boys. In sum, teenagers’ sleep patterns reflected healthy, albeit somewhat short sleep. There was convincing evidence of social jetlag, and girls exhibited less severe social jetlag than boys.

Alcohol, drugs, and road traffic injuries in an emergency department in Mexico City

There have been no studies reporting on the use of biological specimens in Mexico to analyze the prevalence of alcohol and drug use among Emergency Department (ED) patients with a road traffic injury (RTI). We report here on a sample of 304 adult patients, admitted to the ED of a public hospital in Mexico City from January to April 2022, after being involved in an RTI. Patients gave informed consent for a breath test measuring breath alcohol concentration (BAC) and a saliva screening test for six classes of drugs (amphetamines, barbiturates, benzodiazepines, cannabis, cocaine, and methamphetamine). We found that at least one in every four patients (27.6%) had traces of alcohol or drugs in their body upon arrival in the ED. The breath test found a positive BAC in 16.1% of the sample; the most common substances detected in saliva were amphetamines or methamphetamine (8.6%), followed by cocaine (7.0%) and cannabis (6.9%). Only a few variables differentiated those with positive BAC from those with negative BAC (male, arriving on a weekend day or night, and arriving by ambulance), and even fewer variables differentiated those testing positives for drugs than those testing negative (less than 13 years of education and drivers of cars, bicycles, or other vehicles). While alcohol continues to be the single most used substance, our findings indicate that stimulants are of great concern. Since those testing positives for alcohol or drugs are so similar in their demographic pattern to those testing negative, the introduction of biological testing as a routine practice in the ED is highly recommended. Routine testing makes it possible to provide the patient with the best treatment and is also the best way to assess substance use.

217: IDENTIFICATION OF MODIFIABLE CAUSES OF HYPOGLYCEMIA IN THE ICU

Introduction: Hypoglycemia is associated with increased mortality in the ICU. Studies have shown that modifiable causes of hypoglycemia may include anti-hyperglycemic medication, reduced caloric intake & change in nutrition without insulin adjustment. The primary objective of the study was to identify modifiable risk factors for hypoglycemia in our ICUs in order to decrease its incidence. Methods: This was a retrospective review from July to September 2020 of adult ICU patients at a tertiary medical center with a hypoglycemic event (glucose < 80mg/dL) given intravenous rescue dextrose. Medical, surgical, cardiac & neuro ICU patients were included. Exclusion criteria were COVID-19, comfort measures & hyperkalemia. Descriptive statistics were used for statistical analysis. Results: A total of 56 out of 784 patients (median age 64; 60.7% male) had 180 discrete hypoglycemic events. Common risk factors were nothing by mouth orders (NPO) at the time of the event (69.2%), a timeframe of 1900 to 0700 (64.2%), active insulin orders (48.3%), being within 24 hours of a procedure (42.8%) or 24 hours of admission (33.9%), or having AKI (42.8%), diabetes (39.3%) or sepsis (41.1%). Of the 48.3% of patients on insulin, 40% were on an insulin infusion, 39% sliding scale & 21% long-acting. As compared to weekdays, hypoglycemia occurred 37.5%, 87.5%, and 137.5% more often on weekend days, weeknights, and weekend nights, respectively. Conclusions: The most common iatrogenic risk factors for hypoglycemia in the ICU identified in this review were the initial 24 hours of ICU admission, active insulin orders and both periprocedural and NPO status. Hypoglycemia was more common overnight but this is also when daily BMPs are collected. Interventions such as dextrose-containing maintenance fluids while NPO, removal of periprocedural NPO at midnight orders, the addition of fingerstick checks to ICU admission order sets and when a patient is NPO, and cautious insulin use are warranted to help mitigate these events. This pharmacy resident project led to a multidisciplinary policy change to hold tube feeds for patients with an ET tube or trach immediately before they travel to a procedural area instead of at midnight, or 6 hours prior to procedures with planned airway interruption or NPO status needed for bowel cases.

Association between lifestyle-related, psychosocial factors and obesity among female adolescents in Taiwan

PurposeTo examine a wide range of potential contributors to the risk of obesity in female adolescents. Design and methodsData for this study were collected using a cross-sectional design. A group of 175 female adolescents were recruited, and information on their demographic characteristics, lifestyle-related behaviors, and psychosocial factors was collected using a self-administered questionnaire during September 2018 to January 2019. Data were analyzed using SPSS 24.0. ResultsAn overestimation of body weight was negatively correlated with overweight in the female adolescents. Age at menarche was negatively correlated with the arisk of overweight. Adolescents who slept for >7 h on weekend nights were less likely to be overweight. Eating more cheese, fish, seafood, and organ meats was negatively correlated with obesity risk. The female adolescents were more likely to become overweight if they ate dinners prepared by family and experienced more disturbances from parents and other family members. ConclusionsFemale adolescents are a unique population affected by obesity. Although incorporating both lifestyle-related behavioral and psychosocial factors in future investigations and developing multicomponent interventions for obesity prevention are crucial, female adolescents should receive the utmost attention from researchers to alleviate the health burden of obesity. Practice implicationsThe intertwined nature of obesity-related factors warrants future investigations to elaborate their roles interplaying with the risk of obesity. Multicomponent interventions should be developed, and nurses and health-care providers should target their efforts on obesity prevention for this specific population.

Characteristics and costs of electric scooter injuries in Helsinki: a retrospective cohort study

Background and purposeThe incidence of electric scooter (e-scooter) injuries has increased drastically in numerous countries after widespread availability of shared e-scooters. The economic impact on society from a broader perspective has not been studied. We aimed to estimate the incidence of e-scooter injuries, describe the injury patterns, and estimate the costs of e-scooter injuries.Patients and methods:We performed a retrospective cohort study including all e-scooter-related injuries presented in the three adult emergency departments in Helsinki in 2021. We collected the patient data from the university hospital information system. Injury severity was evaluated based on the Abbreviated Injury Score. The cost of the hospital treatment was analyzed based on our hospital district’s service price listing. In addition, we recorded the total amount of sick leave days and estimated their economic impact.ResultsIn total, 446 e-scooter injuries were identified and taken into the analysis (434 affecting riders and 12 non-riders). The median age of the patients was 26 (IQR 22–33), and 59% were male. 257 (58%) of the of the injuries were minor, whereas 155 (35%) were moderate, 30 (7%) serious, 3 (0.7%) severe, and one (0.2%) critical. Furthermore, 220 (49%) of the patients sustained head injuries. A major spike in accident incidence was seen during the weekend (Friday to Sunday) nights, accompanied by a proportional increase in patients with alcohol intoxication. Including both the costs of the hospital care and absence from work, the approximated total cost of e-scooter injuries was 1.7 million euros, with a median cost of a single accident being 1148 euros (IQR 399–4263 €).Interpretation:Considerable number of the injuries are moderate, severe, or worse. Comprehensive preventive measures must be conducted to decrease the incidence of e-scooter injuries. The use of helmets should be strongly encouraged to prevent severe head injuries. The nighttime bans during weekends and speed limits on e-scooters appear to be justifiable.

Pre-drinking motives are directly associated with alcohol-related consequences even after adjusting for alcohol use on a given night: A consequence-specific analysis

IntroductionPre-drinking motives (PDM) are linked with different characteristics of pre-drinking occasions (e.g., fast-paced drinking, socializing, moving across locations) that are potentially related to adverse night-level consequences. This study examines the direct associations of three PDM dimensions (fun/intoxication, facilitation, and conviviality) with the occurrence of five consequences (hangover, impaired driving, blackout, risky sex, fight/injury) over and above amounts of alcohol consumed that night. MethodsA sample of 138 young adult nightlife goers (55.1 % men, Mage = 19.0 SD = 2.4) in Switzerland reported PDM at baseline, and subsequently reported night-level alcohol use and consequences the next morning on 12.1 weekend nights on average (N = 1,663 participant-nights). Correlational analyses and multilevel logistic regression models assessed associations between PDM and night-level consequences. ResultsAfter adjusting for amounts consumed, age, sex and monthly pre-drinking frequency, conviviality PDM were associated with higher odds of risky sex (OR = 2.68) and lower odds of blackout (OR = 0.57) while fun/intoxication PDM were associated with lower odds of risky sex (OR = 0.35). Interaction analyses per gender showed that fun/intoxication PDM were associated with lower odds of impaired driving among women (OR = 0.25). Results remained the same when adjusting for general drinking motives, which were not associated with night-level consequences. ConclusionPDM might better capture risk factors for experiencing night-level consequences than general drinking motives. Preventive intervention should make young people aware that pre-drinking is not only associated with higher amounts of alcohol consumed, but also with increased risks of specific night-level consequences, including blackouts and risky sexual behaviors, depending on the level of endorsement of each PDM.

Effects of dynamic lighting on circadian phase, self-reported sleep and performance during a 45-day space analog mission with chronic variable sleep deficiency.

Spaceflight exposes crewmembers to circadian misalignment and sleep loss, which impair cognition and increase the risk of errors and accidents. We compared the effects of an experimental dynamic lighting schedule (DLS) with a standard static lighting schedule (SLS) on circadian phase, self-reported sleep and cognition during a 45-day simulated space mission. Sixteen participants (mean age [±SD] 37.4 ± 6.7 years; 5 F; n = 8/lighting condition) were studied in four-person teams at the NASA Human Exploration Research Analog. Participants were scheduled to sleep 8 h/night on two weekend nights, 5 h/night on five weekday nights, repeated for six 7-day cycles, with scheduled waketime fixed at 7:00 a.m. Compared to the SLS where illuminance and spectrum remained constant during wake (~4000K), DLS increased the illuminance and short-wavelength (blue) content of white light (~6000K) approximately threefold in the main workspace (Level 1), until 3 h before bedtime when illuminance was reduced by ~96% and the blue content also reduced throughout (~4000K × 2 h, ~3000K × 1 h) until bedtime. The average (±SE) urinary 6-sulphatoxymelatonin (aMT6s) acrophase time was significantly later in the SLS (6.22 ± 0.34 h) compared to the DLS (4.76 ± 0.53 h) and more variable in SLS compared to DLS (37.2 ± 3.6 min vs. 28.2 ± 2.4 min, respectively, p = .04). Compared to DLS, self-reported sleep was more frequently misaligned relative to circadian phase in SLS RR: 6.75, 95% CI 1.55-29.36, p = .01), but neither self-reported sleep duration nor latency to sleep was different between lighting conditions. Accuracy in the abstract matching and matrix reasoning tests were significantly better in DLS compared to SLS (false discovery rate-adjusted p ≤ .04). Overall, DLS alleviated the drift in circadian phase typically observed in space analog studies and reduced the prevalence of self-reported sleep episodes occurring at an adverse circadian phase. Our results support incorporating DLS in future missions, which may facilitate appropriate circadian alignment and reduce the risk of sleep disruption.

Sleep-onset time variability and sleep characteristics on weekday and weekend nights in patients with COPD.

ABSTRACTObjective:To evaluate sleep-onset time variability, as well as sleep characteristics on weekday and weekend nights, in individuals with moderate-to-severe COPD. Methods:Sleep was objectively assessed by an activity/sleep monitor for seven consecutive nights in individuals with COPD. For analysis, individuals were divided into two groups according to sleep-onset time variability results, characterized by intrasubject standard deviation of sleep-onset time (SOTV) ≥ 60 min or < 60 min. Results:The sample comprised 55 individuals (28 males; mean age = 66 ± 8 years; and median FEV1 % of predicted = 55 [38-62]). When compared with the SOTV<60min group (n = 24), the SOTV≥60min group (n = 31) presented shorter total sleep time (5.1 ± 1.3 h vs. 6.0 ± 1.3 h; p = 0.006), lower sleep efficiency (73 ± 12% vs. 65 ± 13%; p = 0.030), longer wake time after sleep onset (155 ± 66 min vs. 115 ± 52 min; p = 0.023), longer duration of wake bouts (19 [16-28] min vs. 16 [13-22] min; p = 0.025), and higher number of steps at night (143 [104-213] vs. 80 [59-135]; p = 0.002). In general, sleep characteristics were poor regardless of the day of the week, the only significant difference being that the participants woke up about 30 min later on weekends than on weekdays (p = 0.013). Conclusions:Sleep-onset time varied over 1 h in a standard week in the majority of individuals with COPD in this sample, and a more irregular sleep onset indicated poor sleep quality both on weekdays and weekends. Sleep hygiene guidance could benefit these individuals if it is integrated with their health care.

Device-based and subjective measurements of sleep in children with cerebral palsy: a comparison of sleep diary, actigraphy, and bed sensor data.

To investigate how subjective assessments and device-based measurements of sleep relate to each other in children with cerebral palsy (CP). Sleep of children with CP, classified at Gross Motor Function Classification System levels I-III, was measured during 7 consecutive nights using 1 subjective (ie, sleep diary) and 2 device-based (ie, actigraphy and bed sensor) instruments. The agreement between the instruments was assessed for all nights and separately for school- and weekend nights, using intraclass correlation coefficients (ICC) and Bland-Altman plots. A total of 227 nights from 38 children with CP (53% male; median age [range] 6 [2-12] years), were included in the analyses. Sleep parameters showed poor agreement between the 3 instruments, except for total time in bed, which showed satisfactory agreement between (1) actigraphy and sleep diary (ICC > 0.86), (2) actigraphy and bed sensor (ICC > 0.84), and (3) sleep diary and bed sensor (ICC > 0.83). Furthermore, agreement between sleep diary and bed sensor was also satisfactory for total sleep time (ICC > 0.70) and wakefulness after sleep onset (ICC = 0.55; only during weekend nights). Researchers and clinicians need to be aware of the discrepancies between instruments for sleep monitoring in children with CP. We recommend combining both subjective and device-based measures to provide information on the perception as well as an unbiased estimate of sleep. Further research needs to be conducted on the use of a bed sensor for sleep monitoring in children with CP. van Rijssen IM, Hulst RY, Gorter JW, etal. Device-based and subjective measurements of sleep in children with cerebral palsy: a comparison of sleep diary, actigraphy, and bed sensor data. J Clin Sleep Med. 2023;19(1):35-43.