Salivary Pubertal Hormones, Sleep Disturbance, and an Evening Circadian Preference in Adolescents: Risk Across Health Domains

Turn off that night light! Light-at-night as a stressor for adolescents

Light-at-night is known to produce a wide variety of behavioral outcomes including promoting anxiety, depression, hyperactivity, abnormal sociability, and learning and memory deficits. Unfortunately, we all live in a 24-h society where people are exposed to light-at-night or light pollution through night-shift work - the need for all-hours emergency services - as well as building and street-lights, making light-at-night exposure practically unavoidable. Additionally, the increase in screentime (tvs and smart devices) during the night also contributes to poorer sleep and behavioral impairments. Compounding these factors is the fact that adolescents tend to be "night owls" and prefer an evening chronotype compared to younger children and adults, so these teenagers will have a higher likelihood of being exposed to light-at-night. Making matters worse is the prevalence of high-school start times of 8 am or earlier - a combination of too early school start times, light exposure during the night, and preference for evening chronotypes is a recipe for reduced and poorer sleep, which can contribute to increased susceptibility for behavioral issues for this population. As such, this mini-review will show, using both human and rodent model studies, how light-at-night affects behavioral outcomes and stress responses, connecting photic signaling and the circadian timing system to the hypothalamic-pituitary adrenal axis. Additionally, this review will also demonstrate that adolescents are more likely to exhibit abnormal behavior in response to light-at-night due to changes in development and hormone regulation during this time period, as well as discuss potential interventions that can help mitigate these negative effects.

Transdiagnostic Sleep and Circadian Intervention for Adolescents Plus Text Messaging: Randomized Controlled Trial 12-month Follow-up

OBJECTIVE

The Transdiagnostic Sleep and Circadian Intervention for Youth (TranS-C) was developed to improve sleep and circadian functioning in adolescents. This study examined the 12-month effects for TranS-C compared with psychoeducation (PE). We also investigated whether a text messaging intervention can promote maintenance of treatment effects.

METHOD

At the baseline, adolescents (58% female, average age = 14.8 years) with an eveningness chronotype were randomized to TranS-C (n = 89) or PE (n = 87). At 6-month follow-up, participants were randomized to receive text messages that had repeated treatment information (n = 47), text messages that prompted the recall of treatment information (n = 50), or no text messages (n = 47).

RESULTS

Relative to PE, TranS-C was associated with a reduced eveningness (b = 2.06, p = .005, d = 0.29) from the baseline to a 12-month follow-up. TranS-C treatment effects, relative to PE, were augmented by receiving text messages, compared to no text messages, for eveningness from baseline to 12-month follow-up (b = 1.38, p = .008, d = 0.28) and from 6- to 12-month follow-up (b = 1.07, p = .046, d = 0.21). Neither TranS-C nor text messages were significantly associated with other primary outcomes. TranS-C and text messages were significantly associated with improvements on selected secondary sleep and health outcomes through follow-up.

CONCLUSIONS

For adolescents with an eveningness chronotype, improved sleep and circadian functioning on selected outcomes were maintained over 12 months for TranS-C compared with PE. Text messages boosted the effects of TranS-C through 12-month follow-up.

Sensation seeking, drinking motives, and going out mediate the link between eveningness and alcohol use and problems in adolescence

The present study was aimed at obtaining a more comprehensive understanding of the possible mediating factors in the morningness-eveningness → alcohol consumption relation. We explored the role of mediators such as sensation seeking, the frequency of going out in the evenings, and drinking motives. We tested the proposed mediation model via structural equation modeling based on cross-sectional research conducted among Hungarian adolescents and young adults (N = 1695, 42.5% male, Mage = 18.98, SDage = 1.89). The outcomes included the frequency of alcohol consumption and problematic drinking. Both alcohol consumption and problematic drinking were predicted in similar directions and magnitudes by sensation seeking, "going out," and coping drinking motives. However, eveningness still had a significant direct effect on alcohol consumption and problematic drinking after we controlled for sensation seeking, going out, and drinking motives. For problematic drinking, the possible role of drinking motives seems to be higher and more complex than it is for alcohol consumption. The mediators, such as sensation seeking, the amount of time spent out in the evenings, and drinking motives, can explain the eveningness → alcohol consumption relationship and should be targeted for alcohol prevention programs among evening-type adolescents.

How is circadian preference associated with cyber-victimization? A moderated mediation model of hostile recognition and online self-disclosure in Chinese early adolescent students

Although circadian preference is widely accepted to be a risk factor in the increase of adolescents’ negative experiences, little is known about its association with cyber-victimization. The current study sought to examine whether eveningness was significantly related to adolescents’ negative experiences. We further examined in-victimization events and whether hostile recognition and online self-disclosure played a vital role in eveningness and adolescents’ cyber-victimization. Study participants included 583 adolescents from four middle schools in China who completed questionnaires regarding their circadian preference, hostile recognition, online self-disclosure, and experience with cyber-victimization. Results indicated that adolescents with a high level of eveningness were more likely to experience cyber-victimization. Hostile recognition significantly mediated the relationship between eveningness and adolescents’ cyber-victimization. Furthermore, online self-disclosure moderated the indirect relationship between eveningness and cyber-victimization. Specifically, the paths from eveningness to hostile recognition and from hostile recognition to cyber-victimization became strengthened when adolescents experienced high levels of online self-disclosure. The results imply that researchers should pay more attention to remote factors, such as adolescents’ circadian preference and their relationship with cyber-victimization, to help them adapt to school requirements and reduce the frequency of victimization.

Associations of school night sleep duration and circadian preference with middle school-aged student attendance, tardiness, and suspension

OBJECTIVES

Research has associated both school night sleep duration (SNSD) and circadian preference (CP) with middle school-aged students' attendance and tardiness, but the interaction between these characteristics remains unexplored within this context, along with the impact of SNSD and CP on school suspension likelihood. Thus, this study investigated associations between SNSD, CP, and their interaction with middle school-aged student attendance, tardiness, and suspension, while accounting for sociodemographic characteristics.

PARTICIPANTS

About 4175 students from 12 middle schools in the Madison, Wisconsin, Metropolitan School District.

METHODS

Students completed a computer-based, sleep-related survey during class. Students reporting SNSD between 4 and 12 hours were included in the final analytical sample (N = 3860; mean age ± standard deviation = 12.0 ± 0.86 years; range = 10-16 years). CP was characterized using the single-item self-morningness/eveningness question. Linear mixed-effects regression estimated associations of SNSD and CP with tardiness and attendance. Logistic mixed-effects regression assessed associations with school suspension. Fully adjusted multilevel models included sociodemographic covariates, nesting students within schools.

RESULTS

About 3860 student responses comprised the final sample, which had a SNSD of 8.15 ± 1.37 hours and general eveningness preference. Short-and-long SNSD associated with lower attendance and increased out-of-school suspension. Greater eveningness preference was negatively associated with attendance and tardiness. No SNSD and CP interactions emerged. Associations between sociodemographic characteristics and attendance, tardiness, and suspension were observed.

CONCLUSIONS

Results support need for efforts to improve middle school-aged student sleep health and account for eveningness preference. Research clarifying the interactive influence of sleep, circadian, and sociodemographic characteristics on attendance and achievement is warranted.

IL-6, sTNF-R2, and CRP in the context of sleep, circadian preference, and health in adolescents with eveningness chronotype: Cross-sectional and longitudinal treatment effects

BACKGROUND

Inflammation-related processes have emerged as a biological pathway related to adolescent development. This study examined cross-sectional and longitudinal associations of baseline inflammatory markers with sleep, circadian preference, and health at baseline and following treatment.

METHODS

Participants included 165 adolescents (58.2% female, mean age 14.7 years, 42.4% taking medication) "at-risk" in at least one domain (emotional, cognitive, behavioral, social, and physical health) who received a sleep-based intervention. Self-reported eveningness as well as total sleep time (TST) and bedtime from sleep diary were assessed at baseline and following treatment. Baseline soluble tumor necrosis factor receptor-2 (sTNF-R2) and interleukin (IL)-6 were assayed from oral mucosal transudate. Baseline C-reactive protein (CRP) was assayed from saliva.

RESULTS

At baseline, shorter TST was associated with more emotional risk among adolescents with higher CRP (b = -0.014, p = 0.007). Greater eveningness was related to more behavioral risk in the context of lower IL-6 (b = -0.142, p = 0.005). Following treatment, lower baseline IL-6 was associated with reduced behavioral risk (Χ² = 8.06, p = 0.045) and lower baseline CRP was related to reduced physical health risk (Χ² = 9.34, p = 0.025). Baseline inflammatory markers were not significantly associated with sleep, circadian, or other health domain change following treatment.

CONCLUSIONS

There was cross-sectional evidence that sleep and circadian dysfunction differentially relate to emotional and behavioral health risk for high and low levels of inflammatory markers. Longitudinal analyses indicated that lower levels of baseline inflammatory markers may be related to better treatment response to a sleep-based intervention.

Association between problematic internet use and behavioral/emotional problems among Chinese adolescents: the mediating role of sleep disorders

Background

Studies that focus on the relationships of problematic Internet use (PIU), sleep disorders, and behavioral/emotional problems were limited. This study aimed to explore (1) the relationship between PIU and behavioral/emotional problems among Chinese adolescents and (2) whether sleep disorders mediate the relationship between PIU and behavioral/emotional problems.

Methods

A total of 1,976 adolescents were recruited by cluster sampling from ten secondary schools in Guangzhou between January and April 2019, and 1,956 of them provided valid information (response rate: 98.9% ). Among them, 50.8% were males and the mean age was 13.6±1.5 years, ranging from 11 to 18 years. Data on behavioral/emotional problems, sleep disorders, and PIU were collected using a self-reported questionnaire. Linear regression models and mediation analyses were performed.

Results

Of the participants, 14.5% (284/1,956) reported moderate to severe PIU, and their average score for total difficulties was significantly higher than the score for average users (14.9±5.5 Vs 9.8±4.7). After adjusting for controlled variables, PIU was further proven to be positively related to elevated levels of behavioral/emotional problems (unstandardized β = 0.16, p < 0.05). In addition, sleep disorders partially mediated the forgoing associations.

Conclusions

Adolescents with problematic Internet habits were at higher risk of developing behavioral and emotional problems than their normal-use peers, and sleep disorders partially mediated the effect. Close attention and effective guidance for adolescents with PIU and behavioral/emotional problems were recommended for parents and schools.

Estradiol and Women's Health: Considering the Role of Estradiol as a Marker in Behavioral Medicine

The sex hormone estradiol, as measured through saliva, represents a non-invasive and cost-effective approach to understanding the influence of hormonal factors on physical and psychological well-being among women. Estradiol levels dramatically change at hormonal transitions, such as puberty, menopause, and postpartum. It is at these transitions where women are at increased risk for psychological and somatic distress. Salivary estradiol also has implications for decision-making and has been broadly associated with engagement in health-compromising behaviors which can influence women's ability to cope with and manage chronic health conditions. This review summarizes the evidence for salivary estradiol as a marker of physical and psychological health, and discusses practical information regarding saliva collection and assay. The overall intent is to expand and clarify knowledge of the relation between changes in salivary estradiol and women's health as well as to provide a means of integrating salivary estradiol into future behavioral medicine research.

Hormonal responses in gambling versus alcohol abuse: A review of human studies

The endocrine system plays an essential role in communication between various organs of the body to maintain homeostasis. Both substance use disorders (SUDs) and non-substance abuse disrupt this system and lead to hormonal dysregulations. Here, we focus on the comparison between the function of the endocrine system in gambling disorders and alcohol addiction to understand the commonalities and differences in their neurobiological and psychological underpinnings. We review human research to compare findings on gambling addiction and alcohol dependence pertaining to the dynamic interplay between testosterone and cortisol. Understanding and classifying similarities in hormonal responses between behavioural addiction and SUDs may facilitate development of treatments and therapeutic interventions across different types of addictive disorders, while describing differences may shed light on therapeutic interventions for specific disorders. Although research on gambling addiction is in its infancy, such evaluation may still have a positive effect for addiction research, thereby stimulating discovery of "crossover" pharmacotherapies with benefits for both SUDs and nonsubstance addictions.

The Relationship Between Quality of Life and Pubertal Timing in Adolescence: The Toyama Birth Cohort Study, Japan

PURPOSE

Although pubertal timing is gradually becoming earlier in Japan, support as for physical and mental health among children experiencing earlier puberty than their peers is inadequate. To better understand health and life satisfaction in seventh grade students (age 12-13 years), examination of relationships between health outcomes and pubertal timing, socioeconomic status, and lifestyle factors is necessary.

METHODS

Participants of the Toyama Birth Cohort Study (4,752 males and 4,740 females) answered questions regarding school year of onset of voice break for boys and menarche for girls, sleep quality, mental health difficulties, overall health, quality of life (QOL), and lifestyle. Relationship between health outcomes and pubertal timing was examined using binary logistic regression analysis.

RESULTS

Earlier pubertal timing was associated with four health-related outcomes. For poor sleep quality, the adjusted odds ratio (OR) of fourth grade males and crude OR of fifth grade females were statistically significant. Regarding mental health difficulties, the crude OR of fifth grade males and adjusted OR of fourth, fifth, and sixth grade females were statistically significant. Associations between poor overall health and fourth grade males and fourth or fifth grade females were observed. For poor QOL, the adjusted OR of fourth grade males and females was statistically significant.

CONCLUSIONS

Relationships between earlier pubertal timing and poor sleep quality, mental health difficulties, poor physical health, and poor QOL were observed. To improve children's quality of life, support from teachers and school doctors and nurses is needed-especially for children with earlier pubertal timing.