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Johnson KT, Zawadzki MJ, Kho C. Loneliness and sleep in everyday life: Using ecological momentary assessment to characterize the shape of daily loneliness experience. Sleep Health 2024:S2352-7218(24)00068-8. [PMID: 38839482 DOI: 10.1016/j.sleh.2024.04.003] [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: 08/26/2023] [Revised: 04/05/2024] [Accepted: 04/12/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Loneliness has been linked to an increased risk of sleep problems. Past research has largely relied on trait loneliness or daily recall loneliness when evaluating associations with sleep. OBJECTIVE The present study extended this work by evaluating the patterns of loneliness throughout the day, including a daily average of all reports, a maximum value, and daily variation. These loneliness patterns predicted daily subjective and objective sleep measures to evaluate whether they provide unique insight to this relationship. METHODS Undergraduate students (n = 71; 77% female; age 18-28) completed 2weeks of electronic surveys 4 times a day to assess loneliness. Each morning participants completed a diary of their prior night's sleep quality, as well as wore actigraphy devices to objectively assess sleep parameters. A total of 778 momentary surveys and 565days of actigraphy-assessed sleep data were collected. Multilevel models tested whether within-person daily aggregates of loneliness were associated with within-person daily sleep outcome variables. RESULTS Subjective sleep duration, quality, and fatigue were significantly predicted by daily average loneliness. Subjective sleep latency, quality, and fatigue were significantly predicted by daily max loneliness. Only fatigue was significantly predicted by daily loneliness variability. No objective sleep measures were significantly predicted by daily loneliness measures. CONCLUSIONS Patterns of daily loneliness focusing on central tendency (average) or intensity (max) were more consistently associated with subjective (but not objective) assessments of sleep than variability.
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Affiliation(s)
- Kayla T Johnson
- University of Wisconsin Milwaukee, Department of Psychology, Milwaukee, Wisconsin, USA; University of Minnesota, Division of Epidemiology and Community Health, Minneapolis, Minnesota, USA
| | - Matthew J Zawadzki
- University of California, Merced, Department of Psychological Sciences, Merced, California, USA.
| | - Carmen Kho
- North Dakota State University, Department of Human Development and Family Sciences, Fargo, North Dakota, USA
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Dickman KD, Thomas MC, Chin BN, Kamarck TW. Bidirectional Associations Between Loneliness, Emotional Support, and Sleep in Daily Life. Psychosom Med 2024; 86:252-260. [PMID: 38724036 PMCID: PMC11090452 DOI: 10.1097/psy.0000000000001291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/15/2024]
Abstract
OBJECTIVE Evidence suggests a link between positive social relationship perceptions and improved sleep (e.g., quality, efficiency) across the life span. Less work has probed the directionality of these relationships. Here, we report findings from the first study to examine bidirectional between- and within-person associations between loneliness and emotional support with daily life measures of sleep. METHODS Participants were 389 healthy adults aged 40 to 64 years (61% female) who completed hourly surveys assessing loneliness and perceptions of emotional support over the course of 4 days. Measures of actigraphy-assessed sleep and nightly sleep quality were also assessed for 7 to 10 days. RESULTS Individuals with lower average daily loneliness showed higher sleep quality and efficiency than individuals with higher loneliness (r = -0.19, p < .001; r = -0.14, p = .008, respectively), and greater average emotional support was likewise linked with better sleep quality (r = 0.18, p < .001). Controlling for neuroticism attenuated the effects of average loneliness on sleep. Within-person analyses showed unexpected bidirectional effects. Specifically, days in which people felt relatively lonelier were followed by nights with greater sleep efficiency (γ = 1.08, p = .015), and nights when people reported relatively poorer sleep quality were followed by days with greater emotional support (γ = -0.04, p = .013). These unexpected findings are probed in exploratory analyses. CONCLUSIONS Individuals with higher loneliness and lower emotional support report poorer sleep quality and efficiency, on average. Day-to-day fluctuations in perceptions of social relationships may affect the following night's sleep, and vice versa.
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Affiliation(s)
- Kristina D Dickman
- From the Department of Psychology, University of Pittsburgh (Dickman, Kamarck); VISN4 Mental Illness Research, Education, and Clinical Center, VA Pittsburgh Healthcare System (Thomas), Pittsburgh, Pennsylvania; and Department of Psychology, Trinity College (Chin), Hartford, Connecticut
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Thomas VE, Metlock FE, Hines AL, Commodore-Mensah Y, Brewer LC. Community-Based Interventions to Address Disparities in Cardiometabolic Diseases Among Minoritized Racial and Ethnic Groups. Curr Atheroscler Rep 2023; 25:467-477. [PMID: 37428390 DOI: 10.1007/s11883-023-01119-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2023] [Indexed: 07/11/2023]
Abstract
PURPOSE OF REVIEW Cardiometabolic diseases (CMDs) are leading causes of death and disproportionally impact historically marginalized racial/ethnic groups in the United States. The American Heart Association developed the Life's Essential 8 (LE8) to promote optimal cardiovascular health (CVH) through eight health behaviors and health factors. The purpose of this review is to summarize contemporary community-engaged research (CER) studies incorporating the LE8 framework among racial/ethnic groups. REVIEW OF FINDINGS Limited studies focused on the interface of CER and LE8. Based on synthesis of articles in this review, the application of CER to individual/collective LE8 metrics may improve CVH and reduce CMDs at the population level. Effective strategies include integration of technology, group activities, cultural/faith-based practices, social support, and structural/environmental changes. CER studies addressing LE8 factors in racial/ethnic groups play an essential role in improving CVH. Future studies should focus on broader scalability and health policy interventions to advance health equity.
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Affiliation(s)
- Victoria E Thomas
- Division of Cardiovascular Medicine, Department of Internal Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Faith E Metlock
- John Hopkins University School of Nursing, Baltimore, MD, USA
| | - Anika L Hines
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA
| | - Yvonne Commodore-Mensah
- John Hopkins University School of Nursing, Baltimore, MD, USA
- Department of Epidemiology, John Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - LaPrincess C Brewer
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA.
- Mayo Clinic Center for Health Equity and Community Engagement Research, Rochester, MN, USA.
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Ehlers CL, Karriker-Jaffe KJ, Bernert R. Poor self-reported sleep quality associated with suicide risk in a community sample of American Indian adults. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2023; 4:zpad024. [PMID: 37293513 PMCID: PMC10246582 DOI: 10.1093/sleepadvances/zpad024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/18/2023] [Indexed: 06/10/2023]
Abstract
Study Objectives Although American Indian/Alaska Native (AI/AN) have high suicide rates few studies have systematically investigated sleep quality and its association with suicidal behaviors in AI/AN. This study is a cross-sectional investigation of self-reported sleep quality and suicidal behaviors in an adult AI population. Methods A semi-structured interview was used to collect data on suicidal ideation, suicidal plans, and suicidal attempts and the Pittsburgh Sleep Quality Index (PSQI) was collected to assess sleep quality in American Indian adults. Results In this sample (n = 477), 91 (19%) of the participants endorsed suicidal ideation (thoughts and plans), and 66 (14%) reported suicidal attempts, including four who subsequently died by suicide. More women reported suicidal thoughts or acts than men. Those endorsing suicidal thoughts slept fewer hours during the night, reported more nocturnal awakenings, and showed poorer subjective sleep quality according to PSQI total scores compared to those with no suicidal thoughts or acts. Participants with suicidal acts (n = 66) reported more bad dreams and higher PSQI total scores compared to those with no suicidal thoughts or acts. When those with any suicidal thoughts or acts (n = 157, 33%) were compared to those without, they were more likely to endorse nocturnal awakenings and bad dreams and demonstrated significantly higher PSQI total scores. Conclusions Although additional research is needed to evaluate sleep disturbances as a proximal, causal risk factor for suicidal behaviors in AI, findings highlight need for further study of sleep as a warning sign and intervention tool for suicide prevention among American Indian adults.
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Affiliation(s)
- Cindy L Ehlers
- Neurosciences Department, The Scripps Research Institute, La Jolla, CA, USA
| | | | - Rebecca Bernert
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, CAUSA
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A two-mediator serial mediation chain of the association between social isolation and impaired sleep in old age. Sci Rep 2022; 12:22458. [PMID: 36577767 PMCID: PMC9797554 DOI: 10.1038/s41598-022-26840-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 12/21/2022] [Indexed: 12/29/2022] Open
Abstract
Poor sleep is a long-term public health issue that has become increasingly prevalent among socially isolated older adults. However, research on the mechanisms explaining the link between social isolation and impaired sleep (IS) remains limited, particularly in low- and middle-income countries. This study explored the serial mediating effects of loneliness and mental distress on the association of social isolation with IS among Ghanaian older adults. We analyzed data from 1201 adults aged ≥ 50 from Ghana's AgeHeaPsyWel-HeaSeeB study (mean age = 66.14, SD = 11.85, age range = 50-111; women = 63.28%). Measures included the UCLA 3-item Loneliness Scale, modified Berkman-Syme Social Network Index, Sleep Quality Scale, and Mental Distress Questionnaire. We used bootstrapping techniques from Hayes' PROCESS macro program to estimate the hypothesized serial mediation. Social isolation was significantly associated with IS (β = 0.242, p < 0.001). Crucially, social isolation indirectly predicted IS via three significant mediating pathways. Loneliness accounted for 17.6% (β = 0.054, CI = 0.096, 0.016), mental distress accounted for 6.5% (β = 0.020, 95% CI = 0.004, 0.040), and loneliness and mental distress accounted for 32.2% (β = 0.099, 95% CI = 0.065, 0.138) of the overall effect. The total mediating effect was 56.4%. These findings suggest that the social isolation-sleep link is respectively and serially explained by loneliness and mental distress. Social integrative interventions for sleep quality in old age should target mental and emotional well-being.
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Luo X, Hu C. Loneliness and sleep disturbance among first‐year college students: The sequential mediating effect of attachment anxiety and mobile social media dependence. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Xiao Luo
- Mental Health Education Center Sichuan University Chengdu China
| | - Chunnan Hu
- Mental Health Education and Counseling Center Zhejiang University Hangzhou China
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John-Henderson NA, Oosterhoff B, Hall B, Johnson L, Lafromboise ME, Malatare M, Salois E, Carter JR. Covid-19 and changes in sleep health in the Blackfeet Community. Sleep Med 2021; 85:87-93. [PMID: 34284315 PMCID: PMC8429142 DOI: 10.1016/j.sleep.2021.06.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/22/2021] [Accepted: 06/23/2021] [Indexed: 10/25/2022]
Abstract
We examined changes in psychological outcomes related to the COVID-19 pandemic (ie psychological stress, perceived control, and perceived ability to cope) and changes in sleep health in the American Indian Blackfeet community over 4 months (August 24, 2020-November 30, 2020). American Indian adults residing on the Blackfeet reservation (n = 167) completed measures of perceived control over contracting COVID-19, perceived ability to cope with pandemic stressors, psychological stress linked to the pandemic, and a measure of sleep health each month. Linear-effects mixed models were used to examine changes in our outcomes. Community members who reported more control over contracting the virus had better sleep health relative to those who reported less control (B = 0.72, SE = 0.29, p = 0.015). Further, during months when individuals felt they had more control over contracting the virus compared to their average perceived control levels, they had better sleep health relative to their own average (B = 1.06, SE = 0.13, p < 0.001). Average sleep health was the lowest in October, 2020, the month during which COVID-19 incidence was at its highest on the reservation. Declines in sleep health linked to low levels of control over contracting COVID-19 may exacerbate high incidence of chronic mental and physical health conditions in tribal communities. Interventions which highlight strategies known to reduce risk of contracting the virus, may increase perceived control and sleep health, and thus may improve downstream health outcomes for this at-risk population.
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Affiliation(s)
| | - Benjamin Oosterhoff
- Montana State University, Department of Psychology, Bozeman, MT, United States
| | - Brad Hall
- Community Members with No Affiliation, Browning, MT, United States
| | - Lester Johnson
- Community Members with No Affiliation, Browning, MT, United States
| | | | | | - Emily Salois
- Montana State University, Department of Psychology, Bozeman, MT, United States
| | - Jason R Carter
- Montana State University, Department of Psychology, Bozeman, MT, United States; Montana State University, Department of Health and Human Development, Bozeman, MT, United States
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