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Bauducco S, Pillion M, Bartel K, Reynolds C, Kahn M, Gradisar M. The difficult but crucial task of knowledge translation: The case of pre-sleep technology use. Reply to Reichenberger et al. and the National Sleep Foundation's screen use recommendations. Sleep Med Rev 2024; 76:101974. [PMID: 38996536 DOI: 10.1016/j.smrv.2024.101974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2024] [Accepted: 06/27/2024] [Indexed: 07/14/2024]
Affiliation(s)
- Serena Bauducco
- Örebro University, School of Behavioural, Social and Legal Sciences, Sweden; Flinders University, College of Education, Psychology and Social Work, Australia.
| | - Meg Pillion
- Flinders University, College of Education, Psychology and Social Work, Australia
| | - Kate Bartel
- WINK Sleep Pty Ltd, Adelaide, Australia; Riverland Academy of Clinical Excellence, Riverland Mallee Coorong Local Health Network, Australia; Flinders University, College of Medicine and Public Health, Australia
| | - Chelsea Reynolds
- Flinders University, College of Education, Psychology and Social Work, Australia; WINK Sleep Pty Ltd, Adelaide, Australia
| | - Michal Kahn
- Tel Aviv University, School of Psychological Sciences, Israel
| | - Michael Gradisar
- WINK Sleep Pty Ltd, Adelaide, Australia; Sleep Cycle AB, Gothenburg, Sweden
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Reichenberger DA, Hartstein LE, Mathew GM, Rodriguez IR, Dzierzewski JM, Hale L. Content contains multitudes - It's more than arousal before sleep. Sleep Med Rev 2024; 76:101954. [PMID: 38838544 DOI: 10.1016/j.smrv.2024.101954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Accepted: 05/17/2024] [Indexed: 06/07/2024]
Affiliation(s)
- David A Reichenberger
- Department of Biobehavioral Health, Pennsylvania State University, State College, PA, USA.
| | - Lauren E Hartstein
- Department of Psychiatry, University of Arizona College of Medicine, Tucson, AZ, USA
| | - Gina Marie Mathew
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, 11768-8338, USA
| | - Isaac R Rodriguez
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, 11768-8338, USA
| | | | - Lauren Hale
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, 11768-8338, USA
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Bauducco S, Pillion M, Bartel K, Reynolds C, Kahn M, Gradisar M. A bidirectional model of sleep and technology use: A theoretical review of How much, for whom, and which mechanisms. Sleep Med Rev 2024; 76:101933. [PMID: 38657359 DOI: 10.1016/j.smrv.2024.101933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 03/01/2024] [Accepted: 04/05/2024] [Indexed: 04/26/2024]
Abstract
The link between technology and sleep is more complex than originally thought. In this updated theoretical review, we propose a new model informed by the growing body of evidence in the area over the past 10 years. The main theoretical change is the addition of bi-directional links between the use of technology and sleep problems. We begin by reviewing the evidence to date for the originally proposed mechanisms of bright light, arousal, nighttime sleep disruptions, and sleep displacement. Then, in support of the new direction of effect (sleep problems preceding technology use), we propose two new mechanisms: technology before sleep might be used as a time filler and/or as an emotional regulation strategy to facilitate the sleep-onset process. Finally, we present potential moderators of the association between technology and sleep, in recognition of protective and vulnerability factors that may mitigate or exacerbate the effects of technology on sleep and vice versa. The goal of this theoretical review is to update the field, guide future public health messages, and to prompt new research into how much technology and sleep affect each other, for whom it may be problematic, and which mechanisms may explain their association.
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Affiliation(s)
- Serena Bauducco
- Örebro University, School of Behavioural, Social and Legal Sciences, Sweden; Flinders University, College of Education, Psychology and Social Work, Australia.
| | - Meg Pillion
- Flinders University, College of Education, Psychology and Social Work, Australia
| | - Kate Bartel
- WINK Sleep Pty Ltd, Adelaide, Australia; Riverland Academy of Clinical Excellence, Riverland Mallee Coorong Local Health Network, Australia; Flinders University, College of Medicine and Public Health, Australia
| | - Chelsea Reynolds
- Flinders University, College of Education, Psychology and Social Work, Australia; WINK Sleep Pty Ltd, Adelaide, Australia
| | - Michal Kahn
- Tel Aviv University, School of Psychological Sciences, Israel
| | - Michael Gradisar
- WINK Sleep Pty Ltd, Adelaide, Australia; Sleep Cycle AB, Gothenburg, Sweden
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Pearson Ba AD, Young Phd CM, Shank Ma F, Neighbors Phd C. Flow mediates the relationship between problematic smartphone use and satisfaction with life among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:1018-1026. [PMID: 34242121 DOI: 10.1080/07448481.2021.1910274] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 03/16/2021] [Accepted: 03/21/2021] [Indexed: 05/31/2023]
Abstract
Smartphones, while useful, can also function as a source of distraction from daily life and may reduce life satisfaction by inhibiting concentration and interrupting attention to ongoing tasks, thoughts, and social interactions. OBJECTIVES The current study tested whether interruptions in flow mediate associations between problematic smartphone use (PSU) and life satisfaction among college students. PARTICIPANTS Two hundred and nine college student smartphone users screened in to the study. METHODS 188 individuals (90%) completed baseline and 158 individuals (76%) completed one week of Ecological Momentary Assessment surveys and a one-week follow-up survey. RESULTS Flow mediates the relationship between PSU and satisfaction with life such that PSU was negatively associated with flow, flow was positively associated with satisfaction with life, and the indirect effect of PSU on satisfaction with life through flow was significant and negative. CONCLUSION These findings suggest that the lack of flow college students experience due to PSU contributes to lower life satisfaction.
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Affiliation(s)
| | | | - Faith Shank Ma
- Department of Psychology, Rowan University, Glassboro, USA
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Pillion M, Gradisar M, Bartel K, Whittall H, Kahn M. What's "app"-ning to adolescent sleep? Links between device, app use, and sleep outcomes. Sleep Med 2022; 100:174-182. [PMID: 36084495 DOI: 10.1016/j.sleep.2022.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 08/05/2022] [Accepted: 08/06/2022] [Indexed: 01/12/2023]
Abstract
This study investigated the associations between adolescent evening use of technology devices and apps, night time sleep, and daytime sleepiness. Participants were 711 adolescents aged 12-18 years old (46% Female, Mage = 15.1, SD = 1.2). Time spent using technology devices and apps in the hour before bed, and in bed before sleep onset, was self-reported. Participants additionally completed a questionnaire about their sleep on school nights and next day sleepiness. In the hour before bed, 30 min of phone use was associated with a 9-min delay in bedtimes. Thirty minutes spent using laptops, gaming consoles, and watching YouTube was associated with later lights out times of 9 min, ∼16 min and ∼11 min respectively, while watching TV was associated with a 9 min earlier lights out times. Using gaming consoles and watching YouTube were associated with greater odds of receiving insufficient sleep (≤7 h TST). In bed before sleep onset, 30 min spent using laptops, phones, iPad/tablets, and watching YouTube were linked with later lights out times of ∼7 min for phones and laptops, 9 min for iPad/tablets, and ∼13 min for YouTube. Watching Netflix was associated with greater daytime sleepiness. YouTube at this time point was associated with increased odds of sleeping ≤7 h on school nights. Adolescents are engaging with a wide range of technology devices and apps in the evenings. However, certain devices and apps (e.g., phones, laptops, gaming and YouTube) might lead to more negative sleep outcomes for adolescents on school nights compared to others.
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Affiliation(s)
- Meg Pillion
- Flinders University, College of Education, Psychology, and Social Work, Adelaide, Australia.
| | | | - Kate Bartel
- Flinders University, College of Education, Psychology, and Social Work, Adelaide, Australia
| | - Hannah Whittall
- Flinders University, College of Education, Psychology, and Social Work, Adelaide, Australia
| | - Michal Kahn
- Flinders University, College of Education, Psychology, and Social Work, Adelaide, Australia
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Effectiveness of Digital Cognitive Behavior Therapy for the Treatment of Insomnia: Spillover Effects of dCBT. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159544. [PMID: 35954905 PMCID: PMC9367941 DOI: 10.3390/ijerph19159544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 07/27/2022] [Accepted: 08/02/2022] [Indexed: 02/04/2023]
Abstract
The effects of digital Cognitive Behavior Therapy for insomnia (dCBT-i) on sleep quality have been previously demonstrated but the spillover effects on fatigue, flow (a state of immersion in activities of interest), and cognitive flexibility remain unclear. The current study examined the effectiveness of dCBT-i. A total of 97 college students (20.96 ± 1.87 years, 73.1% female students) were randomly selected from a shortlist and divided into sleep intervention (n = 39), conventional education (n = 37), and healthy control (n = 21) groups. Task switching paradigm, Fatigue Severity Scale (FSS), Flow Experience Scale (FES), and the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI) were measured pre- and post-intervention. Results show that the sleep quality of the intervention group improved, and fatigue was relieved. Participants in the sleep intervention group had increased flow experience scores post-intervention and improved cognitive flexibility. The control group’s sleep quality deteriorated and fatigue level increased. dCBT-i can not only achieve a significant improvement in sleep quality and reduce fatigue, but also improve learning abilities, quality of life, flow, and cognitive flexibility. Future research should pay attention to indicators such as work efficiency, sedative use, and the durability and stability of such effects.
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Gradisar M, Kahn M, Micic G, Short M, Reynolds C, Orchard F, Bauducco S, Bartel K, Richardson C. Sleep’s role in the development and resolution of adolescent depression. NATURE REVIEWS PSYCHOLOGY 2022; 1:512-523. [PMID: 35754789 PMCID: PMC9208261 DOI: 10.1038/s44159-022-00074-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/23/2022] [Indexed: 12/03/2022]
Abstract
Two adolescent mental health fields — sleep and depression — have advanced largely in parallel until about four years ago. Although sleep problems have been thought to be a symptom of adolescent depression, emerging evidence suggests that sleep difficulties arise before depression does. In this Review, we describe how the combination of adolescent sleep biology and psychology uniquely predispose adolescents to develop depression. We describe multiple pathways and contributors, including a delayed circadian rhythm, restricted sleep duration and greater opportunity for repetitive negative thinking while waiting for sleep. We match each contributor with evidence-based sleep interventions, including bright light therapy, exogenous melatonin and cognitive-behaviour therapy techniques. Such treatments improve sleep and alleviate depression symptoms, highlighting the utility of sleep treatment for comorbid disorders experienced by adolescents. Sleep problems are both a symptom and precursor of adolescent depression. In this Review, Gradisar et al. describe how the combination of adolescent sleep biology and psychology predisposes adolescents to develop depression, and describe interventions that improve sleep and depression symptoms in this population.
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Richardson C, Magson N, Fardouly J, Oar E, Johnco C, Rapee R. A longitudinal investigation of sleep and technology use in early adolescence: does parental control of technology use protect adolescent sleep? Sleep Med 2021; 84:368-379. [PMID: 34247125 DOI: 10.1016/j.sleep.2021.06.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/02/2021] [Accepted: 06/03/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE A bi-directional relationship between technology use and adolescent sleep is likely, yet findings are mixed, and it is not known whether parental control of technology use can protect sleep. The current study examined bi-directionality between technology use on school nights and morning/eveningness, sleep duration and daytime sleepiness in early adolescents. We also examined whether time spent using technology mediated the relationship between parental control of technology and adolescent sleep. METHODS Adolescents and their primary caregiver (96% mothers) completed questionnaire measures of sleep, technology use and parental control across three, annual waves: Wave 1 (N = 528, Mage = 11.18, SD = 0.56, range = 10-12, 51% male), Wave 2 (N = 502, Mage = 12.19, SD = 0.53, 52% male) and Wave 3 (N = 478, Mage = 13.19, SD = 0.53, 52% male). RESULTS When examining the direct relationship between sleep and technology use, cross-lagged panel models showed that time spent using technology predicted shorter sleep duration and greater daytime sleepiness in adolescence, and evening diurnal preference and shorter sleep duration contributed to increased technology use over time. The relationship between technology use and sleep duration was bi-directional. Time spent using technology and adolescent sleep predicted, yet were not predicted by, parental control of technology use. CONCLUSIONS While normative changes in sleep (eg, increased eveningness) may promote increased technology use, technology use may further impinge upon sleep. Results suggest it may be pertinent to instead find creative ways in which adolescents themselves can mitigate their risk of inadequate sleep.
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Affiliation(s)
- C Richardson
- Centre for Sleep Science, School of Psychological Science, University of Western Australia, Perth, WA, Australia; Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia.
| | - N Magson
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - J Fardouly
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - E Oar
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - C Johnco
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - R Rapee
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
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