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Adams EL, Estradé M, Lewis EC, Poirier-Barna L, Smith MT, Gittelsohn J. Perceptions around sleep hygiene practices and beliefs among urban Black adolescents and their caregivers during the COVID-19 pandemic. Sleep Health 2024:S2352-7218(24)00168-2. [PMID: 39332925 DOI: 10.1016/j.sleh.2024.07.009] [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: 02/10/2024] [Revised: 07/12/2024] [Accepted: 07/18/2024] [Indexed: 09/29/2024]
Abstract
OBJECTIVE This study gathered adolescent and caregiver perspectives on sleep hygiene practices and beliefs for Black families living in low-resourced urban communities. METHODS Semistructured interviews were conducted with adolescents (n = 9) and caregivers (n = 9) from January-March 2021, during the COVID-19 pandemic. Interview questions included adolescent's current sleep habits, barriers, and home and neighborhood influences. Trained researchers coded data using inductive analysis and a constant comparative method to derive themes. RESULTS Two themes focused on sleep hygiene practices, including items used to facilitate sleep (e.g., melatonin, electronics) and COVID-19 consequences on sleep schedules. Two themes focused on sleep hygiene beliefs, including a common value on the importance of sleep and influences on caregiver's bedtime rules. CONCLUSIONS Findings provide important insights on sleep hygiene practices and beliefs in a historically marginalized population of Black adolescents and caregivers in urban communities to inform targeted sleep interventions, policies, and programs for optimal sleep and well-being.
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Affiliation(s)
- Elizabeth L Adams
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina, United States; Research Center for Child Well-Being, University of South Carolina, Columbia, South Carolina, United States
| | - Michelle Estradé
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States
| | - Emma C Lewis
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States
| | - Lisa Poirier-Barna
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States
| | - Michael T Smith
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Joel Gittelsohn
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States.
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2
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Kohyama J. Re-Evaluating Recommended Optimal Sleep Duration: A Perspective on Sleep Literacy. CHILDREN (BASEL, SWITZERLAND) 2024; 11:1098. [PMID: 39334630 PMCID: PMC11429570 DOI: 10.3390/children11091098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2024] [Revised: 09/03/2024] [Accepted: 09/04/2024] [Indexed: 09/30/2024]
Abstract
A significant number of adolescents experience sleepiness, primarily due to sleep deprivation. The detrimental effects of inadequate sleep on both physical and mental health are well documented, particularly during adolescence-a critical developmental stage that has far-reaching implications for later life outcomes. The International Classification of Diseases 11th Revision recently introduced the disorder termed 'insufficient sleep syndrome,' characterized by a persistent reduction in sleep quantity. However, diagnosing this condition based solely on sleep duration is challenging due to significant individual variation in what constitutes optimal sleep. Despite this, managing sleep debt remains difficult without a clear understanding of individual optimal sleep needs. This review aims to reassess recommended sleep durations, with a focus on enhancing sleep literacy. Beginning with an exploration of insufficient sleep syndrome, this review delves into research on optimal sleep duration and examines foundational studies on sleep debt's impact on the developing brain. Finally, it addresses the challenges inherent in sleep education programs from the perspective of sleep literacy. By doing so, this review seeks to contribute to a deeper understanding of the chronic sleep debt issues faced by adolescents, particularly those affected by insufficient sleep syndrome.
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Affiliation(s)
- Jun Kohyama
- Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu 279-0001, Japan
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3
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Manasse SM, Moussaoui JR, Lampe EW, Brown KL, Zhang F, Janicke DM, McCrea L, Cardel MI, Butryn ML. Evaluating an acceptance-based lifestyle modification program to address cardiovascular disease risk among adolescent girls with overweight and obesity: Protocol for a randomized controlled trial. Contemp Clin Trials 2024; 144:107634. [PMID: 39019153 DOI: 10.1016/j.cct.2024.107634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 07/03/2024] [Accepted: 07/13/2024] [Indexed: 07/19/2024]
Abstract
BACKGROUND Behavioral weight loss interventions achieve only limited weight loss in adolescent samples and weight regain is common. This limited intervention success may be attributed, in part, to adolescents' lack of self-regulation skills essential for lifestyle modification and use of a one-size fits-all approach to produce weight loss in boys and girls. Interventions which teach self-regulation skills, such as Acceptance-Based Therapy (ABT), and are tailored to meet gender-specific concerns, are critical to help adolescents adapt to pervasive biological and environmental influences toward weight gain. OBJECTIVE This trial tests the effect of an ABT intervention on cardiometabolic health, health-related behaviors, and psychological factors among adolescent girls with overweight or obesity (OW/OB). METHODS Girls 14-19 years (N = 148; ≥ 40% racial/ethnic minorities) with OW/OB (BMI: ≥ 85th percentile) will be enrolled in the study. Participants will be randomized to one of two 6-month interventions, consisting of either 18 sessions of ABT or 9 sessions of a health education control, an augmented version of standard care for adolescent OW/OB, both led by bachelor's level interventionists. RESULTS Recruitment is taking place in Philadelphia, USA, from January 2024 to January 2028. Cardiometabolic health markers (adiposity; blood pressure; blood lipids), health-related behaviors (dietary intake; physical activity; sleep), and psychological factors (quality of life; depression; disordered eating; psychological flexibility) will be measured at baseline, mid-treatment, post-treatment, 6-month follow-up, and 12-month follow-up. CONCLUSIONS This study will provide valuable information on a novel intervention tailored to the needs of adolescent girls with OW/OB to address self-regulation and cardiometabolic health.
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Affiliation(s)
- Stephanie M Manasse
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, United States; Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United States.
| | - Jannah R Moussaoui
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, United States
| | - Elizabeth W Lampe
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, United States; Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United States
| | - Kristal L Brown
- Department of Creative Arts Therapies, Drexel University, Philadelphia, PA, United States
| | - Fengqing Zhang
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United States
| | - David M Janicke
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Leon McCrea
- Department of Family, Community, and Preventive Medicine, Drexel University College of Medicine, United States
| | - Michelle I Cardel
- WW International, Inc., New York, NY, United States; Department of Health Outcomes and Biomedical Informatics, University of Florida College of medicine, Gainesville, FL, United States
| | - Meghan L Butryn
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, United States; Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United States
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4
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Spruyt K. Neurocognitive Effects of Sleep Disruption in Children and Adolescents. Psychiatr Clin North Am 2024; 47:27-45. [PMID: 38302211 DOI: 10.1016/j.psc.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
A main childhood task is learning. In this task, the role of sleep is increasingly demonstrated. Although most literature examining this role focuses on preadolescence and middle adolescence, some studies apply napping designs in preschoolers. Studies overall conclude that without proper sleep a child's cognitive abilities suffer, but questions on how and to what extent linger. Observational studies show the hazards of potential confounders such as an individual's resilience to poor sleep as well as developmental risk factors (eg, disorders, stressors). A better understanding of cognitive sleep neuroscience may have a big impact on pediatric sleep research and clinical applications.
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Affiliation(s)
- Karen Spruyt
- Université Paris Cité, INSERM - NeuroDiderot, Paris, France.
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5
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Peltz J, Zhang L, Sasser J, Oshri A, Doane LD. The Influence of Pubertal Development on Early Adolescent Sleep and Changes in Family Functioning. J Youth Adolesc 2024; 53:459-471. [PMID: 37816912 DOI: 10.1007/s10964-023-01882-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 09/28/2023] [Indexed: 10/12/2023]
Abstract
Pubertal development has been separately linked to adolescents' sleep problems and larger family functioning, but research connecting these inter-related processes remains sparse. This study aimed to examine how pubertal status and tempo were related to early adolescents' sleep and their family functioning. Using longitudinal data from the Adolescent Brain and Cognitive Development study, the study's sample (N = 4682) was 49.2% female, was an average of 9.94 years old at baseline, and was 60.1% white. Analyses in the current study modeled the indirect associations between pubertal change and changes in family conflict via adolescent sleep duration and variability of duration. The results suggested that pubertal status and tempo predicted shorter adolescent sleep durations and greater variability in those durations, which predicted residual increases in family conflict. The findings highlight the role of adolescents' pubertal changes in their sleep and how such changes can negatively affect family functioning.
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Affiliation(s)
- Jack Peltz
- Department of Psychology, State University of New York (SUNY) at Brockport, Brockport, NY, 14420, USA.
| | - Linhao Zhang
- Department of Human Development and Family Science, The University of Georgia, Athens, Greece
| | - Jeri Sasser
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Assaf Oshri
- Department of Human Development and Family Science, The University of Georgia, Athens, Greece
| | - Leah D Doane
- Department of Psychology, Arizona State University, Tempe, AZ, USA
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Martín-Piñón O, McWood LM, Erath SA, Hinnant B, El-Sheikh M. Maternal psychological control and adolescent adjustment: Sleep as a moderator. J Sleep Res 2024; 33:e13986. [PMID: 37434367 DOI: 10.1111/jsr.13986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/20/2023] [Accepted: 06/21/2023] [Indexed: 07/13/2023]
Abstract
Maternal psychological control has been linked consistently to poorer adjustment for adolescents, however, studies of variability in the association between psychological control and adjustment are rare. Sleep serves crucial bioregulatory functions that promote well-being and protect youths against poor adjustment associated with negative family environments. We hypothesised that the link between maternal psychological control and adolescent maladjustment would be strongest for youths with poorer actigraphy-based sleep. The current study included 245 adolescents (Mage = 15.79 years, 52.2% girls, 33.1% Black/African American and 66.9% White/European American; 43% at or below the poverty line). Adolescents reported on their mothers' psychological control toward them, as well as their internalising and externalising symptoms (aggressive and rule breaking behaviours). Several sleep variables were derived: minutes, onset time, and variability in each parameter over 1 week. For youths with shorter, less consistent sleep (both mean levels and variability in minutes and onset), maternal psychological control was associated with adjustment difficulties, especially externalising symptoms. This association was not significant for youth obtaining longer, more consistent sleep. The results were most evident for variability in sleep minutes and onset as moderators of effects. The findings suggest that longer and more consistent sleep is an important protective factor in the context of more controlling parenting.
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Affiliation(s)
- Olivia Martín-Piñón
- Department of Human Development and Family Science, Auburn University, Auburn, Alabama, USA
| | - Leanna M McWood
- Department of Human Development and Family Science, North Dakota State University, Fargo, North Dakota, USA
| | - Stephen A Erath
- Department of Human Development and Family Science, Auburn University, Auburn, Alabama, USA
| | - Benjamin Hinnant
- Department of Human Development and Family Science, Auburn University, Auburn, Alabama, USA
| | - Mona El-Sheikh
- Department of Human Development and Family Science, Auburn University, Auburn, Alabama, USA
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Chen IY, Radom-Aizik S, Stehli A, Palmer JR, Lui KK, Dave A, Chappel-Farley MG, Vinces KG, Gealer D, Lim A, Mander BA, Benca RM, Neikrug AB. Cardiorespiratory fitness and circadian rhythms in adolescents: a pilot study. J Appl Physiol (1985) 2024; 136:372-384. [PMID: 38126092 PMCID: PMC11213564 DOI: 10.1152/japplphysiol.00291.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 11/07/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023] Open
Abstract
Although cardiorespiratory fitness (CRF), an important marker of youth health, is associated with earlier sleep/wake schedule, its relationship with circadian rhythms is unclear. This study examined the associations between CRF and rhythm variables in adolescents. Eighteen healthy adolescents (10 females and 8 males; Mage = 14.6 ± 2.3 yr) completed two study visits on weekdays bracketing an ambulatory assessment during summer vacation. Visit 1 included in-laboratory CRF assessment (peak V̇o2) using a ramp-type progressive cycle ergometry protocol and gas exchange measurement, which was followed by 7-14 days of actigraphy to assess sleep/wake patterns and 24-h activity rhythms. During Visit 2, chronotype, social jetlag (i.e., the difference in midsleep time between weekdays and weekends), and phase preference were assessed using a questionnaire, and hourly saliva samples were collected to determine the dim light melatonin onset (DLMO) phase. All analyses were adjusted for sex, pubertal status, and physical activity. Greater peak V̇o2 was associated with earlier sleep/wake times and circadian phase measures, including acrophase, UP time, DOWN time, last activity peak (LAP) time, and chronotype (all P < 0.05). Peak V̇o2 was negatively associated with social jetlag (P = 0.02). In addition, the mixed-model analysis revealed a significant interaction effect between peak V̇o2 and actigraphy-estimated hour-by-hour activity patterns (P < 0.001), with the strongest effects observed at around the time of waking (0600-1000). In healthy adolescents, better CRF was associated with an earlier circadian phase and increased activity levels notably during the morning. Future studies are needed to investigate the longitudinal effects of the interactions between CRF and advanced rhythms on health outcomes.NEW & NOTEWORTHY In healthy adolescents, better cardiorespiratory fitness, as assessed by the gold standard measure [laboratory-based assessment of peak oxygen consumption (V̇o2)], was associated with earlier circadian timing of sleep/wake patterns, rest-activity rhythms and chronotype, and less social jetlag. These findings highlight the close interrelationships between fitness and rhythms and raise the possibility that maintaining higher cardiorespiratory fitness levels alongside earlier sleep/wake schedule and activity rhythms may be important behavioral intervention targets to promote health in adolescents.
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Affiliation(s)
- Ivy Y Chen
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, California, United States
| | - Shlomit Radom-Aizik
- Pediatric Exercise and Genomics Research Center, University of California, Irvine, Irvine, California, United States
| | - Annamarie Stehli
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, California, United States
- Pediatric Exercise and Genomics Research Center, University of California, Irvine, Irvine, California, United States
| | - Jake R Palmer
- School of Psychology, Faculty of Science, University of Sydney, Sydney, New South Wales, Australia
- Brain and Mind Centre and Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Kitty K Lui
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, California, United States
| | - Abhishek Dave
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, California, United States
| | - Miranda G Chappel-Farley
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, California, United States
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, California, United States
| | - Karla G Vinces
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, California, United States
| | - Daniel Gealer
- Pediatric Exercise and Genomics Research Center, University of California, Irvine, Irvine, California, United States
| | - Alexandra Lim
- Pediatric Exercise and Genomics Research Center, University of California, Irvine, Irvine, California, United States
| | - Bryce A Mander
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, California, United States
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, California, United States
| | - Ruth M Benca
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, California, United States
| | - Ariel B Neikrug
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, California, United States
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Garrett SL, Burnell K, Armstrong-Carter EL, Nelson BW, Prinstein MJ, Telzer EH. Links Between Objectively-Measured Hourly Smartphone Use and Adolescent Wake Events Across Two Weeks. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023:1-11. [PMID: 38039087 DOI: 10.1080/15374416.2023.2286595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
PURPOSE Psychosocial and bioregulatory pressures threaten sleep during adolescence. Although recent work suggests that the ubiquity of smartphone use throughout adolescence may also relate to poorer sleep outcomes, most existing research relies upon self-report and retrospective measures. This study drew upon objective measures of smartphone use and sleep at the hourly level to understand how smartphone use was associated with the duration of wake events during sleeping hours. METHODS Across a 14-day daily study, 59 racially and ethnically diverse adolescents ages 15 to 18 had their sleep assessed via Fitbit Inspire 2 devices and uploaded screenshots of their screen time, pickups, and notifications as logged by their iPhone's iOS. Multi-level modeling was performed to assess hourly level associations between adolescent smartphone use and wake-events during their sleep sessions (N = 4,287 hourly cases). RESULTS In hours during adolescents' sleep session with more screen time or pickups, adolescents had longer wake event duration. More notifications in a given hour were not associated with wake event duration in the same hour. CONCLUSIONS Using objectively measured smartphone and sleep data collected at the hourly level, we found that during sleeping hours, when adolescents are actively engaging with their smartphones, their sleep is disrupted, such that their wake events are longer in that hour.
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Affiliation(s)
- Shedrick L Garrett
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill
| | - Kaitlyn Burnell
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill
| | | | - Benjamin W Nelson
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill
| | - Mitchell J Prinstein
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill
| | - Eva H Telzer
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill
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9
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Mathew GM, Reichenberger DA, Master L, Buxton OM, Chang AM, Hale L. Actigraphic Sleep Variability is Associated With Lower Positive Mood in Adolescents. J Adolesc Health 2023; 73:478-485. [PMID: 37410005 PMCID: PMC10524712 DOI: 10.1016/j.jadohealth.2023.04.019] [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] [Received: 10/19/2022] [Revised: 03/11/2023] [Accepted: 04/11/2023] [Indexed: 07/07/2023]
Abstract
PURPOSE Poor sleep health is associated with lower positive mood in adolescents, and more variable sleep is associated with more negative mood. There is a lack of research on the associations between sleep variability and positive mood in adolescents. We investigated whether several types of sleep variability, measured with actigraphy, were associated with positive mood reported on a daily diary in adolescents. METHODS Data were collected from a substudy of the Year 15 wave of the Future of Families and Child Wellbeing Study (n = 580; 53% female, mean age ± standard deviation [SD] = 15.4 ± 0.5 years, range 14.7-17.7). Adolescents wore an actigraphy device (M ± SD = 5.6 ± 1.4 nights per adolescent, range: 3-10) and completed daily diaries (M ± SD = 5.5 ± 1.4 days per adolescent, range: 3-9) for ∼1 week, where they rated their levels of happiness and excitement during that day from 0 (not at all) to 4 (extremely). Happiness and excitement were averaged into "positive mood." Separate linear regression models assessed whether actigraphy-measured variability of sleep duration, onset, and offset (residual individual standard deviation, riSD), sleep regularity index, social jetlag, and free night catch-up sleep were associated with average positive mood per person. Analyses adjusted for age, birth sex, race/ethnicity, household income, and the primary caregiver's education level. RESULTS Greater variability in sleep duration (p = .011, β = -0.11) and lower sleep regularity index (p = .034, β = 0.09) were associated with lower ratings of positive mood. There were no other significant associations (p ≥ .10). DISCUSSION Variable and irregular sleep are associated with lower levels of positive mood in adolescence, which may increase the risk of poor emotional health in adulthood.
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Affiliation(s)
- Gina Marie Mathew
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York.
| | - David A Reichenberger
- Department of Biobehavioral Health, College of Health and Human Development, Pennsylvania State University, University Park, Pennsylvania
| | - Lindsay Master
- Department of Biobehavioral Health, College of Health and Human Development, Pennsylvania State University, University Park, Pennsylvania
| | - Orfeu M Buxton
- Department of Biobehavioral Health, College of Health and Human Development, Pennsylvania State University, University Park, Pennsylvania
| | - Anne-Marie Chang
- Department of Biobehavioral Health, College of Health and Human Development, Pennsylvania State University, University Park, Pennsylvania
| | - Lauren Hale
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York
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10
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Visser PM, Enes CC, Nucci LB. Association of health predictors with quality of life in children and adolescents. Int J Adolesc Med Health 2023; 35:339-346. [PMID: 37319352 DOI: 10.1515/ijamh-2023-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 06/04/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVES To evaluate the association of health-related quality of life (HRQOL) with physical activity, food consumption, sleep duration and screen time in children and adolescents. METHODS Cross-sectional study with 268 students aged 10-17 years from a public school in Brazil. The outcome variable was HRQOL score, evaluated by the Pediatric Quality of Life Inventory™ (PedsQL™). Exposure variables were habitual physical activity, food consumption, sleep duration, and screen time. A general linear model was used to estimate age-adjusted means and 95 % confidence interval (95 % CI) of HRQOL scores, and a multivariable analysis of variance to identify factors associated with lower/higher HRQOL scores. The study was approved by the Human Research Ethics Committee of the Pontifical Catholic University of Campinas. RESULTS Overall HRQOL score was 70.3 (95 % CI: 68.0-72.6). Multivariable analyses showed lower HRQOL scores for those adolescents who: 1-were physically inactive (67.3; p=0.014); 2-sleep less than 6 h per night (66.8; p=0.003); 3-eat fruits and vegetables less than five days/week (68.9; p=0.027); and 4-eat fast food twice/week or more (68.6; p=0.036) when compared to their opposite groups. Screen time was not statistically significantly associated with total HRQOL. CONCLUSIONS The joint association found in our study suggests that at least three habits must change to improve the HRQOL of children and adolescents (physical activity, food consumption, and sleep duration). Therefore, interventions in schools to promote a healthy lifestyle to achieve a better HRQOL should include a multidisciplinary team to properly guide children and adolescents about these habits simultaneously.
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Affiliation(s)
- Pâmela Mello Visser
- Center for Life Sciences, Postgraduate Program in Health Sciences, Pontifical Catholic University of Campinas (PUC-Campinas), Campinas, SP, Brazil
| | - Carla Cristina Enes
- Center for Life Sciences, Postgraduate Program in Health Sciences, Pontifical Catholic University of Campinas (PUC-Campinas), Campinas, SP, Brazil
| | - Luciana B Nucci
- Center for Life Sciences, Postgraduate Program in Health Sciences, Pontifical Catholic University of Campinas (PUC-Campinas), Campinas, SP, Brazil
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11
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Master L, Nahmod NG, Mathew GM, Hale L, Chang AM, Buxton OM. Why so slangry (sleepy and angry)? Shorter sleep duration and lower sleep efficiency predict worse next-day mood in adolescents. J Adolesc 2023; 95:1140-1151. [PMID: 37138384 PMCID: PMC10524335 DOI: 10.1002/jad.12182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 09/26/2022] [Accepted: 04/21/2023] [Indexed: 05/05/2023]
Abstract
PURPOSE The goal of this study was to evaluate the relationships of actigraphic nighttime sleep duration and quality with next-day mood among urban adolescents using a micro-longitudinal design. METHODS A subsample (N = 525) of participants from the Fragile Families & Child Wellbeing Study (mean age: 15.4 years; 53% female; 42% Black non-Hispanic, 24% Hispanic/Latino, 19% White non-Hispanic) in the United States between 2014 and 2016 concurrently wore a wrist actigraphic sleep monitor and rated their daily mood in electronic diaries for about 1 week. Multilevel models tested the within-person temporal associations of nightly sleep duration and sleep maintenance efficiency with next-day reports of happiness, anger, and loneliness. The models also tested the between-person associations of sleep variables and mood. Models adjusted for sociodemographic and household characteristics, weekend, and school year. RESULTS After nights when adolescents obtained longer sleep duration than their usual, they reported lower ratings of anger (B = -.03, p < .01) the next day. After nights when adolescents had higher sleep maintenance efficiency than their usual, they reported higher ratings of happiness (B = .02, p < .01) the next day. Adolescents who had longer average sleep duration reported lower ratings of anger (B = -.08, p < .01) and loneliness (B = -.08, p < .01) compared to others. There was no within-person association of sleep duration or efficiency with loneliness. Sleep duration was not associated with happiness between adolescents, and sleep maintenance efficiency was not associated with any mood measure between adolescents. CONCLUSIONS Improvements to nightly sleep may help increase happiness and decrease anger the following day in adolescents. Promoting sleep health is recommended to improve mood.
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Affiliation(s)
- Lindsay Master
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, USA
| | - Nicole G. Nahmod
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, 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, USA
| | - Lauren Hale
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Anne-Marie Chang
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, USA
| | - Orfeu M. Buxton
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, USA
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12
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Ordway MR, Sadler LS, Jeon S, Pierre JC, Canapari C, Redeker NS. Early emergence of racial and ethnic differences in sleep health among toddlers living in low-income families. Sleep Health 2023; 9:389-397. [PMID: 37453903 PMCID: PMC10517059 DOI: 10.1016/j.sleh.2023.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 01/08/2023] [Accepted: 02/22/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVES Emerging evidence suggests racial and ethnic and socioeconomic differences in children's sleep health, yet few have examined these differences among very young children. The purpose of this study is to identify potential racial, ethnic, and sociodeomographic factors associated with multiple dimensions of sleep health in toddlers living in very low-income families. PARTICIPANTS Sample included 110 racially and ethnically diverse dyads with toddlers aged 12-15 months living in low-income families. METHODS Actigraph data (9 days and nights), caregiver completed sleep diaries, Brief Infant Sleep Questionnaire-extended, and caregiver-reported socioeconomic characteristics were collected. RESULTS Toddlers' average sleep duration (10.25 hours; SD = 0.76) was less than the age-based recommendations. There were significant race and ethnic differences in toddler's actigraph-measured bedtime (p < .001) and variability in bedtimes (p = .004). Non-LatinX White toddlers had earlier bedtimes and less variability than Black and LatinX children. These between-group differences remained statistically significant after controlling for measured socioeconomic variables (p's < 0.001). Within racial and ethnic group differences in bedtime and bedtime variability by education, employment, and marital status were identified with medium to large effect sizes. CONCLUSIONS Racial and ethnic between-group differences in sleep occurred as early as 12 months of age and were not explained by sociodemographic variables (eg, income-to-needs, education, housing). Further research is necessary to determine structural and contextual factors that explain the racial and ethnic differences in sleep health in early childhood. Identifying these factors may inform the development of socially and culturally tailored interventions to reduce sleep health disparities.
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Affiliation(s)
- Monica R Ordway
- Yale School of Medicine, Department of Pediatrics, New Haven, Connecticut, USA; Yale School of Nursing, West Haven, Connecticut, USA.
| | - Lois S Sadler
- Yale School of Nursing and Yale Child Study Center, West Haven, Connecticut, USA
| | | | - Jasmyne C Pierre
- Yale University, Department of Psychology, New Haven, Connecticut, USA
| | - Craig Canapari
- Yale School of Medicine, Department of Pediatrics, New Haven, Connecticut, USA
| | - Nancy S Redeker
- University of Connecticut School of Nursing, Storrs, Connecticut, USA
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13
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Perez Zarate R, Colman O, Blake SC, Watson A, Lee YTH, Grooms K, Quader ZS, Welsh JA, Gazmararian JA. Factors That Influence Sleep Behaviors of High School Students: Findings From a Semi-Rural Community in Georgia. THE JOURNAL OF SCHOOL HEALTH 2023; 93:411-419. [PMID: 36807316 DOI: 10.1111/josh.13312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 11/12/2022] [Accepted: 02/05/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Inadequate sleep has been shown to have detrimental effects on academic performance, physical, mental, and emotional health among adolescents. Factors that influence sleep have been identified. However, most literature is currently limited to urban settings. This study sought to identify factors that influence sleep habits among high school students in a semi-rural community. METHODS Twelve focus groups were conducted in-person with separate groups of students, parents, and school staff in October 2019. Discussions focused on sleep experiences, knowledge, environment, and factors influencing sleep. Data were coded using grounded theory approach. Themes were identified through summative content analysis. RESULTS Four major themes were identified: (1) inadequate sleep adversely affects academic performance and emotional health; (2) students face a gap in knowledge regarding sleep duration; (3) academic and nonacademic activities compete with sleep needs; and (4) night-time use of technology negatively influences sleep habits. CONCLUSIONS Our findings suggest that high school students do not get adequate sleep, largely due to the demands of academic and extracurricular activities and the use of electronics at night. These results can guide the development of targeted sleep education and intervention programs.
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Affiliation(s)
- Raul Perez Zarate
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Olivia Colman
- Center for the Study of Human Health, College of Arts and Sciences, Emory University, Atlanta, GA
| | - Sarah C Blake
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Autumn Watson
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Yi-Ting H Lee
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Kya Grooms
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Zerleen S Quader
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Jean A Welsh
- Department of Pediatrics, School of Medicine; Children's Healthcare of Atlanta, Emory University, Atlanta, GA
| | - Julie A Gazmararian
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, Atlanta, GA
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14
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Gauthier-Gagné G, Saha S, Jensen J, Sommerville G, Gruber R. Associations Between Multidimensional Sleep Health Parameters and Adolescents' Self-reported Light Exposure in the Free-living Environment. J Biol Rhythms 2023:7487304231152987. [PMID: 36843359 DOI: 10.1177/07487304231152987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
The objective of this study was to characterize the associations between light exposure in the free-living environment and multiple dimensions of sleep health of typically developing adolescents. Fifty-six (29 girls, 27 boys) typically developing adolescents (mean age = 13.59, SD = 0.89, range = 12-17 years) participated. For six consecutive nights, sleep was assessed in the home environment using actigraphy. During the same period, participants were asked to fill out a daily sleep log and a daily light exposure log, and to complete questionnaires regarding their alertness and subjective sleep satisfaction. Longer self-reported exposure to daylight in the morning was associated with longer objectively measured sleep duration. Longer self-reported exposures to electronic devices in the evening were associated with later objectively measured sleep onset and offset times, shorter sleep duration, and greater day-to-day sleep variability. Longer morning exposure to outdoor light was associated with a longer sleep duration. Self-reported light exposure was not associated with sleep satisfaction, alertness/sleepiness, or sleep efficiency. Among the covariates, circadian preference accounted for the highest percentage of variance. Adolescents' sleep health is associated with the self-reported duration of exposure to daylight in the morning and to electronic devices in the evening.
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Affiliation(s)
- Gabrielle Gauthier-Gagné
- Attention, Behaviour and Sleep Lab, Douglas Mental Health University Institute, Montreal, QC, Canada.,Faculty of Medicine, Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
| | - Sujata Saha
- Riverside School Board, Saint-Hubert, QC, Canada
| | - Jana Jensen
- Riverside School Board, Saint-Hubert, QC, Canada
| | - Gail Sommerville
- Attention, Behaviour and Sleep Lab, Douglas Mental Health University Institute, Montreal, QC, Canada.,Riverside School Board, Saint-Hubert, QC, Canada
| | - Reut Gruber
- Attention, Behaviour and Sleep Lab, Douglas Mental Health University Institute, Montreal, QC, Canada.,Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada
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15
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Luo L, Zeng X, Cao Y, Hu Y, Wen S, Tang K, Ding L, Wang X, Song N. The Associations between Meeting 24-Hour Movement Guidelines (24-HMG) and Mental Health in Adolescents-Cross Sectional Evidence from China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3167. [PMID: 36833861 PMCID: PMC9966615 DOI: 10.3390/ijerph20043167] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/03/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: This study determined the prevalence of adolescents that meet 24-HMGs alone and in combination, and their association with the risk of developing adolescent anxiety and depression. (2) Methods: Participants were drawn from 9420 K8 grade adolescents (age 14.53 ± 0.69 years; 54.78% boys) from the China Education Tracking Survey (CEPS) 2014-2015 tracking data. Data on depression and anxiety were collected from the results of the questionnaire in the CEPS for the adolescent mental health test. Compliance with the 24-HMG was defined as: physical activity time (PA) ≥ 60 min/day was defined as meeting the PA. Screen time (ST) ≤ 120 min/day was defined as meeting the ST. Adolescents aged 13 years achieved 9-11 h of sleep per night and adolescents aged 14-17 years achieved 8-10 h of sleep per night, defined as meeting sleep. Logistic regression models were used to examine the association between meeting and not meeting the recommendations and the risk of depression and anxiety in adolescents. (3) Results: Of the sample studied, 0.71% of adolescents met all three recommendations, 13.54% met two recommendations and 57.05% met one recommendation. Meeting sleep, meeting PA+ sleep, meeting ST + sleep, and meeting PA + ST + sleep were associated with a significantly lower risk of anxiety and depression in adolescents. Logistic regression results showed that differences in the effects of gender on the odds ratio (ORs) for depression and anxiety in adolescents were not significant. (4) Conclusions: This study determined the risk of developing depression and anxiety in adolescents who met the recommendations for 24-HMG alone and in combination. Overall, meeting more of the recommendations in the 24-HMGs was associated with lower anxiety and depression risk outcomes in adolescents. For boys, reducing the risk of depression and anxiety can be prioritised by meeting PA + ST + sleep, meeting ST + sleep and meeting sleep in the 24-HMGs. For girls, reducing the risk of depression and anxiety may be preferred by meeting PA + ST + sleep or meeting PA+ sleep and meeting sleep in 24-HMGs. However, only a small proportion of adolescents met all recommendations, highlighting the need to promote and support adherence to these behaviours.
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Affiliation(s)
- Lin Luo
- College of Physical Education, Guizhou Normal University, Guiyang 550001, China
- Basic Education Research Center, Southwest University, Chongqing 400715, China
| | - Xiaojin Zeng
- College of Physical Education, Guizhou Normal University, Guiyang 550001, China
| | - Yunxia Cao
- College of Physical Education, Guizhou Normal University, Guiyang 550001, China
| | - Yulong Hu
- College of Physical Education, Guizhou Normal University, Guiyang 550001, China
| | - Shaojing Wen
- College of Physical Education, Guizhou Normal University, Guiyang 550001, China
| | - Kaiqi Tang
- College of Physical Education, Guizhou Normal University, Guiyang 550001, China
| | - Lina Ding
- College of Physical Education, Guizhou Normal University, Guiyang 550001, China
| | - Xiangfei Wang
- Research Institute of Sports Science, Wuhan Sports University, Wuhan 430079, China
| | - Naiqing Song
- Basic Education Research Center, Southwest University, Chongqing 400715, China
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16
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Baker AE, Tashjian SM, Goldenberg D, Galván A. Sleep variability over a 2-week period is associated with restfulness and intrinsic limbic network connectivity in adolescents. Sleep 2023; 46:zsac248. [PMID: 36223429 PMCID: PMC9905777 DOI: 10.1093/sleep/zsac248] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 09/20/2022] [Indexed: 11/05/2022] Open
Abstract
STUDY OBJECTIVES Sleep duration and intraindividual variability in sleep duration undergo substantial changes in adolescence and impact brain and behavioral functioning. Although experimental work has linked acute sleep deprivation to heightened limbic responding and reduced regulatory control, there is limited understanding of how variability in sleep patterns might interact with sleep duration to influence adolescent functioning. This is important for optimal balancing of length and consistency of sleep. Here, we investigated how objective indices of sleep duration and variability relate to stress, restfulness, and intrinsic limbic network functioning in adolescents. METHODS A sample of 101 adolescents ages 14-18 reported their stressors, after which they wore wrist actigraph watches to monitor their sleep and rated their restfulness every morning over a 2-week period. They also completed a resting-state fMRI scan. RESULTS Adolescents reporting more stress experienced shorter sleep duration and greater sleep variability over the 2-week period. Longer nightly sleep duration was linked to feeling more rested the next morning, but this effect was reduced in adolescents with high cumulative sleep variability. Sleep variability showed both linear and quadratic effects on limbic connectivity: adolescents with high sleep variability exhibited more connectivity within the limbic network and less connectivity between the limbic and frontoparietal networks than their peers, effects which became stronger once variability exceeded an hour. CONCLUSIONS Results suggest that cumulative sleep variability is related to stress and limbic network connectivity and shows interactive effects with sleep duration, highlighting the importance of balancing length and consistency of sleep for optimal functioning in adolescence.
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Affiliation(s)
- Amanda E Baker
- Department of Psychology, University of California, Los Angeles, 502 Portola Plaza, Los Angeles, CA 90095, USA
| | - Sarah M Tashjian
- Department of Psychology, University of California, Los Angeles, 502 Portola Plaza, Los Angeles, CA 90095, USA
| | - Diane Goldenberg
- Department of Psychology, University of California, Los Angeles, 502 Portola Plaza, Los Angeles, CA 90095, USA
| | - Adriana Galván
- Department of Psychology, University of California, Los Angeles, 502 Portola Plaza, Los Angeles, CA 90095, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, 757 Westwood Plaza, Los Angeles, CA 90095, USA
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17
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Orihuela CA, Mrug S, Evans RR. Associations between sleepiness, sleep duration, and academic outcomes in early adolescence. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Catheryn A. Orihuela
- Departments of Human Studies and Psychology University of Alabama at Birmingham Birmingham Alabama USA
| | - Sylvie Mrug
- Departments of Human Studies and Psychology University of Alabama at Birmingham Birmingham Alabama USA
| | - Retta R. Evans
- Departments of Human Studies and Psychology University of Alabama at Birmingham Birmingham Alabama USA
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18
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Dong Q, Zhou L, Wang W, Wei X, Pluess M, Ma X. Development and Validation of the Chinese Version of the Highly Sensitive Child Scale: Understanding environmental sensitivity and depressive symptoms in adolescents. Front Psychiatry 2022; 13:999150. [PMID: 36545039 PMCID: PMC9760681 DOI: 10.3389/fpsyt.2022.999150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022] Open
Abstract
Background Environmental sensitivity (ES) is considered a significant personality factor in the development and maintenance of depressive symptoms in adolescents. However, a clear instrument that can capture ES in Chinese adolescents is lacking. The current study aimed to investigate the psychometric properties of a Chinese version of the Highly Sensitive Child (HSC) Scale for assessing adolescent ES, and explore the potential moderation effect of ES on relationships between maternal behaviors and adolescent depressive symptoms. Methods In total, 2,166 students from four middle and high schools and 105 depressed adolescents completed measurements of environmental sensitivity, maternal behaviors, depressive emotions, sleep duration, and academic performance. Results First, exploratory factor and confirmatory factor analyses indicated that the HSC scale had a good model fit with the bifactor construct, total scale reliability was adequate-good, and measurement invariances across genders and different samples were supported. Furthermore, the results confirmed that the relationship between maternal behaviors and adolescent depressive symptoms had small effects. Compared to low environmentally sensitive adolescents, high environmentally sensitive adolescents exhibited less depressive emotions and better academic performance in the context of high-quality maternal behaviors. Low-quality maternal behaviors significantly predicted increased depressive emotions and worse academic performance in adolescents when environmental sensitivity was high. Moreover, on the contrary, maternal behaviors did not influence depressive emotions and academic performance in adolescents who were less sensitive to their environment. The relationship between maternal behaviors and adolescent depressive symptoms is influenced by different levels of environmental sensitivity. Conclusion Our findings support the HSC scale as a comprehensive and psychometrically robust tool to measure ES in Chinese adolescents. In addition, the present study clarifies the moderating role of environmental sensitivity underlying the relationship between maternal behaviors and adolescent depressive symptoms. It is important to consider the role of ES in prevention and intervention strategies targeting adolescent depressive symptoms.
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Affiliation(s)
- Qian Dong
- Department of Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Lina Zhou
- Department of Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Wei Wang
- Department of Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Xin Wei
- Xi’an No.3 Middle School, Xi’an, Shaanxi, China
| | - Michael Pluess
- Department of Biological and Experimental Psychology, School of Biological and Chemical Sciences, Queen Mary University of London, London, United Kingdom
- Centre for Economic Performance, London School of Economics, London, United Kingdom
| | - Xiancang Ma
- Department of Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
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19
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Hamermesh DS, Pfann GA. The variability and volatility of sleep: An ARCHetypal behavior. ECONOMICS AND HUMAN BIOLOGY 2022; 47:101175. [PMID: 36054947 DOI: 10.1016/j.ehb.2022.101175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 08/10/2022] [Accepted: 08/17/2022] [Indexed: 06/15/2023]
Abstract
Using 1975-2005 Dutch time-diary data covering over 10,000 respondents for 7 consecutive days each, we show that sleep time exhibits non-constant variability, or volatility, characterized by stationary autoregressive conditional heteroscedasticity: The absolute values of deviations from a person's average sleep on one day are positively correlated with those on adjacent days. Sleep is more variable on weekends and among younger people, those without young children, or with less education. Volatility is greater among parents with young children, slightly greater among men, but independent of other demographics. Economic incentives to minimize the dispersion of sleep imply higher-wage workers will exhibit less dispersion, which we observe. Sleep volatility spills over onto volatility in other personal activities, with no reverse causation onto sleep. The results illustrate a novel dimension of inequality among people and could be applied to a wide variety of human behavior and biological processes.
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Affiliation(s)
- Daniel S Hamermesh
- University of Texas at Austin, Research Fellow, IZA, and Associate, NBER, United States; Sue Killam Professor Emeritus, University of Texas at Austin, United States; Royal Holloway University of London, United Kingdom.
| | - Gerard A Pfann
- Maastricht University, Research Fellow, IZA and CEPR, the Netherlands.
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20
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Witcraft SM, Wickenhauser ME, Russell KM, Mandrell BN, Conklin HM, Merchant TE, Crabtree VM. A Latent Profile Analysis of Sleep, Anxiety, and Mood in Youth with Craniopharyngioma. Behav Sleep Med 2022; 20:762-773. [PMID: 34719997 DOI: 10.1080/15402002.2021.1996363] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
UNLABELLED Craniopharyngioma is a histologically benign brain tumor that arises in the suprasellar region affecting critical neurovascular structures including the hypothalamic-pituitary-adrenal axis and optic pathways. Children with craniopharyngioma often experience excessive daytime sleepiness (EDS) which may be compounded by anxiety and depression. The current study investigated disparate sleep profiles to better understand psychological adjustment among children diagnosed with craniopharyngioma. METHOD Actigraphs recorded nightly sleep data, including measures of sleep onset latency (SOL) and wake after sleep onset (WASO), in a cohort of 80 youth between the ages of 2 and 20 years (median age = 9). Parent reports of behavioral and emotional functioning were included in the analysis. A latent profile analysis examined disparate sleep profiles, and a multinomial logistic regression examined differences of anxiety and depression among the sleep profiles. RESULTS The latent profile analysis revealed three sleep profiles: "healthy sleepers" (68.8%), "night wakers" (21.3%), and "prolonged onset sleepers" (10.0%). Contrary to expectations, sleep profiles were not associated with daytime anxiety (β = 2.26-4.30, p > .05) or depression (β = -5.87-4.74, p > .05). CONCLUSIONS Youth with craniopharyngioma demonstrate poor sleep and EDS. Those with delayed SOL and prolonged WASO are particularly vulnerable to disrupted nighttime sleep, which may significantly compound EDS. Disrupted sleep was not associated with anxiety or depression, which may be related to the overall poor sleep and daytime sleepiness or to timing, as patients were early in their treatment course. Further study should evaluate the factors underlying sleepiness and daytime function in patients with craniopharyngioma.
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Affiliation(s)
- Sara M Witcraft
- Department of Psychology, The University of Mississippi, University, Mississippi, USA
| | - Molly E Wickenhauser
- Department of Psychology, The University of Mississippi, University, Mississippi, USA
| | - Kathryn M Russell
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Belinda N Mandrell
- Department of Pediatric Medicine, Division of Nursing Research, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Heather M Conklin
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Thomas E Merchant
- Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
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21
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Shah AS, Zeitler PS, Wong J, Pena AS, Wicklow B, Arslanian S, Chang N, Fu J, Dabadghao P, Pinhas-Hamiel O, Urakami T, Craig ME. ISPAD Clinical Practice Consensus Guidelines 2022: Type 2 diabetes in children and adolescents. Pediatr Diabetes 2022; 23:872-902. [PMID: 36161685 DOI: 10.1111/pedi.13409] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 08/29/2022] [Indexed: 11/29/2022] Open
Abstract
Since the 2018 ISPAD guidelines on this topic, follow-up of large cohorts from around the globe have continued informing the current incidence and prevalence of co-morbidities and complications in young adults with youth-onset type 2 diabetes (T2D). This chapter focuses on the risk factors, diagnosis and presentation of youth-onset T2D, the initial and subsequent management of youth-onset T2D, and management of co-morbidities and complications. We include key updates from the observational phase of the multi-center Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) clinical trial, the SEARCH for Diabetes in Youth (SEARCH) study and new data from the Restoring Insulin Secretion (RISE) study, a head-to-head comparison of youth onset vs adult-onset T2D. We also include an expanded section on risk factors associated with T2D, algorithms and tables for treatment, management, and assessment of co-morbidities and complications, and sections on recently approved pharmacologic therapies for the treatment of youth-onset T2D, social determinants of health, and settings of care given COVID-19 pandemic.
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Affiliation(s)
- Amy S Shah
- Division of Pediatric Endocrinology, Cincinnati Children's Hospital Medical Center and the University of Cincinnati, Cincinnati, Ohio, USA
| | - Philip S Zeitler
- Division of Pediatric Endocrinology, Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Jencia Wong
- Department of Endocrinology, Royal Prince Alfred Hospital and Central Clinical School, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Alexia S Pena
- The University of Adelaide, Robinson Research Institute, North Adelaide, South Australia, Australia
| | - Brandy Wicklow
- Division of Endocrinology, Winnipeg Children's Hospital and University of Manitoba, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Silva Arslanian
- Division of Pediatric Endocrinology, Metabolism, and Diabetes Mellitus, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Nancy Chang
- Center for Endocrinology, Diabetes and Metabolism, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Junfen Fu
- Division of Endocrinology, The Children's Hospital of Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Preeti Dabadghao
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Orit Pinhas-Hamiel
- Edmond and Lily Safra Children's Hospital, Sackler School of Medicine, Tel-Aviv, Israel
| | - Tatsuhiko Urakami
- Department of Pediatrics, Nihon University School of Medicine, Tokyo, Japan
| | - Maria E Craig
- The Children's Hospital at Westmead, University of Sydney, Sydney, New South Wales, Australia.,Discipline of Pediatrics & Child Health, School of Clinical Medicine, University of NSW Medicine and Health, Sydney, New South Wales, Australia
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22
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Van Veen M, Lancel M, Şener O, Verkes R, Bouman E, Rutters F. Observational and experimental studies on sleep duration and aggression: A systematic review and meta-analysis. Sleep Med Rev 2022; 64:101661. [DOI: 10.1016/j.smrv.2022.101661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 06/02/2022] [Accepted: 06/05/2022] [Indexed: 10/15/2022]
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23
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Lunsford-Avery JR, Wang K(W, Kollins SH, Chung RJ, Keller C, Engelhard MM. Regularity and Timing of Sleep Patterns and Behavioral Health Among Adolescents. J Dev Behav Pediatr 2022; 43:188-196. [PMID: 34698705 PMCID: PMC9035469 DOI: 10.1097/dbp.0000000000001013] [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] [Received: 05/07/2021] [Accepted: 08/20/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Sleep is vital to supporting adolescent behavioral health and functioning; however, sleep disturbances remain under-recognized and undertreated in many health care settings. One barrier is the complexity of sleep, which makes it difficult for providers to determine which aspects-beyond sleep duration-may be most important to assess and treat to support adolescent health. This study examined associations between 2 sleep indices (regularity and timing) and adolescent behavioral health and functioning over and above the impact of shortened/fragmented sleep. METHOD Eighty-nine adolescents recruited from the community (mean age = 14.04, 45% female participants) completed 7 days/nights of actigraphy and, along with a parent/guardian, reported on behavioral health (internalizing and externalizing symptoms) and psychosocial functioning. Stepwise linear regressions examined associations between sleep timing and regularity and behavioral/functional outcomes after accounting for shortened/fragmented sleep. RESULTS Delayed sleep timing was associated with greater self-reported internalizing (F[6,82] = 11.57, p = 0.001) and externalizing (F[6,82] = 11.12, p = 0.001) symptoms after accounting for shortened/fragmented sleep. Irregular sleep was associated with greater self-reported and parent-reported externalizing symptoms (self: F[7,81] = 6.55, p = 0.01; parent: F[7,80] = 6.20, p = 0.01) and lower psychosocial functioning (self: F[7,81] = 6.03, p = 0.02; parent: F[7,78] = 3.99, p < 0.05) after accounting for both shortened/fragmented sleep and delayed sleep timing. CONCLUSION Sleep regularity and timing may be critical for understanding the risk of poor behavioral health and functional deficits among adolescents and as prevention and intervention targets. Future work should focus on developing and evaluating convenient, low-cost, and effective methods for addressing delayed and/or irregular adolescent sleep patterns in real-world health care settings.
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Affiliation(s)
| | - Ke (Will) Wang
- Duke University, Department of Biomedical Engineering; Durham, NC
| | - Scott H. Kollins
- Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences; Durham, NC
| | - Richard J. Chung
- Duke University School of Medicine, Department of Pediatrics; Durham, NC
| | - Casey Keller
- Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences; Durham, NC
| | - Matthew M. Engelhard
- Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences; Durham, NC
- Duke University School of Medicine, Department of Biostatistics and Bioinformatics; Durham, NC
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Nelson BW, Flannery JE, Flournoy J, Duell N, Prinstein MJ, Telzer E. Concurrent and prospective associations between fitbit wearable-derived RDoC arousal and regulatory constructs and adolescent internalizing symptoms. J Child Psychol Psychiatry 2022; 63:282-295. [PMID: 34184767 DOI: 10.1111/jcpp.13471] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/18/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Adolescence is characterized by alterations in biobehavioral functioning, during which individuals are at heightened risk for onset of psychopathology, particularly internalizing disorders. Researchers have proposed using digital technologies to index daily biobehavioral functioning, yet there is a dearth of research examining how wearable metrics are associated with mental health. METHODS We preregistered analyses using the Adolescent Brain Cognitive Development Study dataset using wearable data collection in 5,686 adolescents (123,862 person-days or 2,972,688 person-hours) to determine whether wearable indices of resting heart rate (RHR), step count, and sleep duration and variability in these measures were cross-sectionally associated with internalizing symptomatology. All models were also run controlling for age, sex, body mass index, socioeconomic status, and race. We then performed prospective analyses on a subset of this sample (n = 143) across 25 months that had Fitbit data available at baseline and follow-up in order to explore directionality of effects. RESULTS Cross-sectional analyses revealed a small, yet significant, effect size (R2 = .053) that higher RHR, lower step count and step count variability, and greater variability in sleep duration were associated with greater internalizing symptoms. Cross-lagged panel model analysis revealed that there were no prospective associations between wearable variables and internalizing symptoms (partial R2 = .026), but greater internalizing symptoms and higher RHR predicted lower step count 25 months later (partial R2 = .010), while higher RHR also predicted lower step count variability 25 months later (partial R2 = .008). CONCLUSIONS Findings indicate that wearable indices concurrently associate with internalizing symptoms during early adolescence, while a larger sample size is likely required to accurately assess prospective or directional effects between wearable indices and mental health. Future research should capitalize on the temporal resolution provided by wearable devices to determine the intensive longitudinal relations between biobehavioral risk factors and acute changes in mental health.
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Affiliation(s)
- Benjamin W Nelson
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jessica E Flannery
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - John Flournoy
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Natasha Duell
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Mitchell J Prinstein
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Eva Telzer
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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25
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Rea-Sandin G, Breitenstein RS, Doane LD, Vakulskas E, Valiente C, Lemery-Chalfant K. Early Life Socioeconomic Differences in Associations between Childhood Sleep and Academic Performance. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2022; 79. [PMID: 35250138 PMCID: PMC8896821 DOI: 10.1016/j.appdev.2022.101392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Poor sleep can negatively impact children's academic performance. However, it is unknown whether early-life socioeconomic status (SES) moderates later sleep and academics. We tested associations between actigraphy-based sleep duration and midpoint time, and parent-reported sleep problems with objective and subjective measures of academic performance. We also examined whether relations varied by early and concurrent SES. Children (n=707; 52% female; M age=8.44 years; 28.7% Hispanic/Latinx; 29.7% at/below poverty line) were assessed at 12 months for SES and eight years for SES, sleep, and academics. There were no main effects of sleep on academics. More sleep problems predicted lower Applied Problems performance for low SES children (b=-.73, p<.05) and better performance for high SES children (b=.69, p<.05). For high SES children, greater sleep problems (b=-.11, p<.05) and longer sleep duration (b=-.11, p<.05) predicted lower academic achievement. However, most associations were consistent across SES, illustrating the complex interplay between sleep, academic outcomes, and SES.
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Affiliation(s)
- Gianna Rea-Sandin
- Department of Psychology, Arizona State University, Tempe, AZ, United States of America
| | - Reagan S Breitenstein
- Department of Psychology, Arizona State University, Tempe, AZ, United States of America.,Department of Psychology, Appalachian State University, Boone, NC, United States of America
| | - Leah D Doane
- Department of Psychology, Arizona State University, Tempe, AZ, United States of America
| | - Emily Vakulskas
- Department of Psychology, Arizona State University, Tempe, AZ, United States of America.,School of Medicine, Wake Forest University, Winston-Salem, NC, United States of America
| | - Carlos Valiente
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, AZ, United States of America
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26
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MacKenzie M, Scott H, Reid K, Gardani M. Adolescent perspectives of bedtime social media use: a qualitative systematic review and thematic synthesis. Sleep Med Rev 2022; 63:101626. [DOI: 10.1016/j.smrv.2022.101626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/14/2022] [Accepted: 03/14/2022] [Indexed: 11/28/2022]
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Abstract
Reciprocal relations between sleep and adjustment were investigated. Participants included 246 adolescents (M = 15.80 years; 67.5% White, 32.5% Black/African American; 53% female, 47% male) at Time 1 (data collected 2012-2013), 227 at Time 2 (M = 16.78 years) and 215 at Time 3 (M = 17.70 years). Sleep-wake variables were measured with self-reports (sleepiness) and actigraphy (average sleep minutes and efficiency, variability in sleep minutes and efficiency). Adolescents reported on depression and anxiety symptoms, and parents reported on externalizing problems. Greater variability in sleep duration and efficiency as well as sleepiness predicted adjustment problems (range of R2 : 36%-60%). Reciprocal relations were supported mostly for sleepiness (range of R2 : 16%-32%). Results help understand bidirectional relations between sleep and adjustment.
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Affiliation(s)
- Ryan J. Kelly
- Department of Individual, Family and Community Education, University of New Mexico
| | - Megan M. Zeringue
- Department of Human Development and Family Studies, Auburn University
| | - Mona El-Sheikh
- Department of Human Development and Family Studies, Auburn University
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28
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El-Sheikh M, Zeringue MM, Saini EK, Fuller-Rowell TE, Yip T. Discrimination and adjustment in adolescence: the moderating role of sleep. Sleep 2022; 45:zsab215. [PMID: 34495321 PMCID: PMC8754494 DOI: 10.1093/sleep/zsab215] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/28/2021] [Indexed: 02/03/2023] Open
Abstract
STUDY OBJECTIVES We examined multiple actigraphy-based sleep parameters as moderators of associations between experiences of general and racial discrimination and adolescent internalizing symptoms (anxiety, depression) and externalizing behavior (rule-breaking). Adolescent sex and race were examined as additional moderators. METHODS Participants were 272 adolescents (Mage = 17.3 years, SD = 0.76; 51% male; 59% White/European American, 41% Black/African American). Sleep was assessed using actigraphs for 7 consecutive nights from which sleep duration (minutes), efficiency, and variability in minutes over the week were derived. Youth reported on their experiences of general discrimination, racial discrimination, anxiety, depressive symptoms, and rule-breaking behavior. RESULTS Both types of discrimination were associated with poorer adjustment outcomes. Longer sleep duration, greater sleep efficiency, and less variability in sleep duration were protective in associations between race-specific and general discrimination and internalizing symptoms. Findings for duration and efficiency were more pronounced for females such that the adverse effects of discrimination were minimized among females with longer and more efficient sleep. Greater variability in sleep exacerbated rule-breaking behavior among adolescents experiencing general or racial discrimination. Associations did not differ by adolescent race. CONCLUSIONS Short and poor-quality sleep may exacerbate internalizing symptoms for adolescents experiencing discrimination, particularly females. Variability in sleep duration was a key moderator of associations between discrimination and internalizing symptoms as well as rule-breaking behavior. Findings illustrate that actigraphy-assessed sleep parameters play a key role in ameliorating or exacerbating adjustment problems associated with discrimination.
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Affiliation(s)
- Mona El-Sheikh
- Department of Human Development and Family Science, Auburn University, Auburn, AL, USA
| | - Megan M Zeringue
- Department of Psychology, Middle Tennessee State University, Murfreesboro, TN, USA
| | - Ekjyot K Saini
- Department of Human Development and Family Science, Auburn University, Auburn, AL, USA
| | | | - Tiffany Yip
- Department of Psychology, Fordham University, Bronx, NY, USA
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29
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Okely AD, Ghersi D, Loughran SP, Cliff DP, Shilton T, Jones RA, Stanley RM, Sherring J, Toms N, Eckermann S, Olds TS, Zhang Z, Parrish AM, Kervin L, Downie S, Salmon J, Bannerman C, Needham T, Marshall E, Kaufman J, Brown L, Wille J, Wood G, Lubans DR, Biddle SJH, Pill S, Hargreaves A, Jonas N, Schranz N, Campbell P, Ingram K, Dean H, Verrender A, Ellis Y, Chong KH, Dumuid D, Katzmarzyk PT, Draper CE, Lewthwaite H, Tremblay MS. A collaborative approach to adopting/adapting guidelines. The Australian 24-hour movement guidelines for children (5-12 years) and young people (13-17 years): An integration of physical activity, sedentary behaviour, and sleep. Int J Behav Nutr Phys Act 2022; 19:2. [PMID: 34991606 PMCID: PMC8734238 DOI: 10.1186/s12966-021-01236-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 12/08/2021] [Indexed: 12/20/2022] Open
Abstract
Abstract Background In 2018, the Australian Government updated the Australian Physical Activity and Sedentary Behaviour Guidelines for Children and Young People. A requirement of this update was the incorporation of a 24-hour approach to movement, recognising the importance of adequate sleep. The purpose of this paper was to describe how the updated Australian 24-Hour Movement Guidelines for Children and Young People (5 to 17 years): an integration of physical activity, sedentary behaviour and sleep were developed and the outcomes from this process. Methods The GRADE-ADOLOPMENT approach was used to develop the guidelines. A Leadership Group was formed, who identified existing credible guidelines. The Canadian 24-Hour Movement Guidelines for Children and Youth best met the criteria established by the Leadership Group. These guidelines were evaluated based on the evidence in the GRADE tables, summaries of findings tables and recommendations from the Canadian Guidelines. We conducted updates to each of the Canadian systematic reviews. A Guideline Development Group reviewed, separately and in combination, the evidence for each behaviour. A choice was then made to adopt or adapt the Canadian recommendations for each behaviour or create de novo recommendations. We then conducted an online survey (n=237) along with three focus groups (n=11 in total) and 13 key informant interviews. Stakeholders used these to provide feedback on the draft guidelines. Results Based on the evidence from the Canadian systematic reviews and the updated systematic reviews in Australia, the Guideline Development Group agreed to adopt the Canadian recommendations and, apart from some minor changes to the wording of good practice statements, maintain the wording of the guidelines, preamble, and title of the Canadian Guidelines. The Australian Guidelines provide evidence-informed recommendations for a healthy day (24-hours), integrating physical activity, sedentary behaviour (including limits to screen time), and sleep for children (5-12 years) and young people (13-17 years). Conclusions To our knowledge, this is only the second time the GRADE-ADOLOPMENT approach has been used to develop movement behaviour guidelines. The judgments of the Australian Guideline Development Group did not differ sufficiently to change the directions and strength of the recommendations and as such, the Canadian Guidelines were adopted with only very minor alterations. This allowed the Australian Guidelines to be developed in a shorter time frame and at a lower cost. We recommend the GRADE-ADOLOPMENT approach, especially if a credible set of guidelines that was developed using the GRADE approach is available with all supporting materials. Other countries may consider this approach when developing and/or revising national movement guidelines. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-021-01236-2.
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Affiliation(s)
- Anthony D Okely
- Faculty of Arts, Social Sciences and Humanities, School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia. .,Illawarra Health and Medical Research Institute, Wollongong, Australia.
| | - Davina Ghersi
- Research Policy and Translation, National Health and Medical Research Council, Canberra, Australia.,National Health & Medical Research Council Clinical Trials Centre, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Sarah P Loughran
- Faculty of Arts, Social Sciences and Humanities, School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia.,Illawarra Health and Medical Research Institute, Wollongong, Australia
| | - Dylan P Cliff
- Faculty of Arts, Social Sciences and Humanities, School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia.,Illawarra Health and Medical Research Institute, Wollongong, Australia
| | - Trevor Shilton
- National Heart Foundation (WA), 334 Rokeby Road, Subiaco, Australia
| | - Rachel A Jones
- Faculty of Arts, Social Sciences and Humanities, School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia.,Illawarra Health and Medical Research Institute, Wollongong, Australia
| | - Rebecca M Stanley
- Faculty of Arts, Social Sciences and Humanities, School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia.,Illawarra Health and Medical Research Institute, Wollongong, Australia
| | - Julie Sherring
- Faculty of Arts, Social Sciences and Humanities, School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Natalie Toms
- Preventive Programs, Commonwealth Department of Health, Canberra, Australia
| | - Simon Eckermann
- Australian Health Services Research Institute, University of Wollongong, Wollongong, Australia
| | - Timothy S Olds
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Zhiguang Zhang
- Faculty of Arts, Social Sciences and Humanities, School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Anne-Maree Parrish
- Faculty of Arts, Social Sciences and Humanities, School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Lisa Kervin
- Faculty of Arts, Social Sciences and Humanities, School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Sandra Downie
- Preventive Programs, Commonwealth Department of Health, Canberra, Australia
| | - Jo Salmon
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Melbourne, Australia
| | | | | | | | - Jordy Kaufman
- Swinburne University of Technology, Melbourne, Australia
| | - Layne Brown
- Faculty of Arts, Social Sciences and Humanities, School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Janecke Wille
- Federation of Ethnic Communities Council of Australia (FECCA), Canberra, Australia
| | - Greg Wood
- Australian Sports Commission, Leederville, Western Australia
| | - David R Lubans
- Priority Research Centre for Physical Activity and Nutrition, School of Education, University of Newcastle, Newcastle, Australia
| | - Stuart J H Biddle
- Centre for Health Research, University of Southern Queensland, Springfield Central, Toowoomba, Australia
| | - Shane Pill
- The Australian Council for Health, Physical Education and Recreation (ACHPER), Wayville, Australia and Flinders University, Adelaide, South Australia
| | | | - Natalie Jonas
- Australian Curriculum, Assessment and Reporting Authority (ACARA), SA, Sydney, Australia
| | - Natasha Schranz
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, Australia.,Active Healthy Kids Australia, Adelaide, Australia and National Heart Foundation, Adelaide, South Australia
| | - Perry Campbell
- Australian Children's Education & Care Quality Authority (ACECQA), Sydney, Australia
| | - Karen Ingram
- NSW Education Standards Authority (NESA), Sydney, Australia
| | - Hayley Dean
- NSW Education Standards Authority (NESA), Sydney, Australia
| | - Adam Verrender
- Faculty of Arts, Social Sciences and Humanities, School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Yvonne Ellis
- Faculty of Arts, Social Sciences and Humanities, School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Kar Hau Chong
- Faculty of Arts, Social Sciences and Humanities, School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Dorothea Dumuid
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | | | - Catherine E Draper
- SAMRC/Wits Developmental Pathways for Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Hayley Lewthwaite
- Australian Health Services Research Institute, University of Wollongong, Wollongong, Australia
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
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30
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Witcraft SM, Wickenhauser ME, Russell KM, Mandrell BN, Conklin HM, Merchant TE, Crabtree VM. Do Anxiety and Mood Vary among Disparate Sleep Profiles in Youth with Craniopharyngioma? A Latent Profile Analysis. Behav Sleep Med 2022; 20:100-111. [PMID: 33661060 DOI: 10.1080/15402002.2021.1892679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Craniopharyngioma is a histologically benign brain tumor that arises in the suprasellar region affecting critical neurovascular structures including the hypothalamic-pituitary-adrenal axis and optic pathways. Children with craniopharyngioma often experience excessive daytime sleepiness which may be compounded by anxiety and depression. The current study investigated disparate sleep profiles to better understand psychological adjustment among children diagnosed with craniopharyngioma. Method: Actigraphs recorded nightly sleep data, including measures of sleep onset latency and wake after sleep onset, in a cohort of 80 youth between the ages of 2 and 20 years (median age = 9). Parent reports of behavioral and emotional functioning were included in the analysis. A latent profile analysis examined disparate sleep profiles, and a multinomial logistic regression examined differences of anxiety and depression among the sleep profiles. Results: The latent profile analysis revealed three sleep profiles: "variable sleepers" (48.3%), "consistently poor sleepers" (45.4%), and "night wakers" (6.4%). Consistently poor sleepers had lower rates of anxiety (g = .76; p = .009) and depression (g = .81; p = .003) than variable sleepers and had significantly lower rates of anxiety than night wakers (g = .52; p = .05); all other differences were nonsignificant (ps > .05). Discussion: Youth with craniopharyngioma who have nightly variations in sleep may have worse psychological functioning than those with more consistent, albeit poor, sleep patterns. Patients with craniopharyngioma who report variable sleep should be assessed for anxiety and depression to prevent and intervene on emotional difficulties that may be reciprocally related to sleep.
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Affiliation(s)
- Sara M Witcraft
- Department of Psychology, The University of Mississippi, University, Mississippi
| | - Molly E Wickenhauser
- Department of Psychology, The University of Mississippi, University, Mississippi
| | - Kathryn M Russell
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennesse
| | - Belinda N Mandrell
- Department of Pediatric Medicine, Division of Nursing Research, St. Jude Children's Research Hospital, Memphis, Tennesse
| | - Heather M Conklin
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennesse
| | - Thomas E Merchant
- Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, Tennesse
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31
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Too Jittery to Sleep? Temporal Associations of Actigraphic Sleep and Caffeine in Adolescents. Nutrients 2021; 14:nu14010031. [PMID: 35010906 PMCID: PMC8746933 DOI: 10.3390/nu14010031] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 12/20/2021] [Accepted: 12/20/2021] [Indexed: 11/17/2022] Open
Abstract
Caffeine consumption has been linked to poor sleep health in adolescents, but it is unknown whether poor sleep predicts caffeine consumption, and/or whether caffeine consumption predicts poor sleep, particularly when sleep is measured objectively. Data were collected from a micro-longitudinal sub-study of the age 15 wave of the Fragile Families and Child Wellbeing Study (n = 589). Adolescents wore an actigraphy device and completed daily surveys for ~1 week. Daily surveys assessed subjective sleep quality and caffeinated beverage consumption (0 = no caffeine, 1 = any caffeine). Separate mixed models assessed whether actigraphy-measured sleep duration, timing, maintenance efficiency, and subjective quality predicted next-day caffeinated beverage consumption within and between adolescents. Variability (standard deviation) of sleep duration and timing, sleep regularity index, and social jetlag were tested as additional between-person predictors. Lagged models tested whether daily caffeinated beverage consumption predicted sleep that night (n = 458). Adolescents with more variable sleep duration and midpoint had higher average odds of consuming caffeinated beverages compared to others. After adolescents consumed ≥1 caffeinated beverage, they had later sleep onset that night and wake time the next morning than usual versus when they did not consume caffeine. Curbing caffeinated beverage consumption may aid in the maintenance of regular sleep schedules and advance sleep timing in adolescents.
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32
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McWood LM, Zeringue MM, Piñón OM, Buckhalt JA, El-Sheikh M. Linear and nonlinear associations between the sleep environment, presleep conditions, and sleep in adolescence: moderation by race and socioeconomic status. Sleep Med 2021; 93:90-99. [PMID: 34879983 PMCID: PMC9058149 DOI: 10.1016/j.sleep.2021.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/01/2021] [Accepted: 11/05/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVE/BACKGROUND The role of the sleep environment and presleep conditions that may influence adolescents' sleep are understudied. The aims of the current study were to examine linear and nonlinear associations between the sleep environment and presleep conditions and adolescents' daytime sleepiness and sleep/wake problems. METHOD Participants included 313 adolescents (Mage = 17.39 years, SD = 10.38 months; 51.4% girls, 48.6% boys; 59.1% White/European American, 40.3% Black/African American) from a wide range of socioeconomic backgrounds living in the southeastern United States. Adolescents completed surveys assessing the sleep environment (eg, light, bedding), four presleep conditions (ie, general worries, family concerns, arousal, somatic complaints), and sleep (daytime sleepiness, sleep/wake problems). RESULTS Sleep environment disruptions and worse presleep conditions were positively associated with sleepiness and sleep/wake problems in a linear fashion. Nonlinear associations emerged such that levels of sleepiness increased rapidly between low and average levels of the sleep environment and two presleep conditions (worries, arousal); the slope leveled off between average and high levels. Moreover, linear effects of environmental disruptions, family concerns, somatic complaints, and presleep arousal on sleep/wake problems were moderated by race and/or SES, indicating that positive associations between some presleep conditions and sleep/wake problems were more pronounced for Black and lower SES youth. CONCLUSIONS Results support the importance of the sleep environment and multiple presleep conditions and assessments of both linear and nonlinear effects for a better understanding of factors that may contribute to sleep. Additionally, results indicate the sleep environment and some presleep conditions may be more consequential for disadvantaged youth.
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Affiliation(s)
- Leanna M McWood
- Department of Human Development and Family Science, 261 Mell Street, Auburn University, Auburn, AL, 36849, USA
| | - Megan M Zeringue
- Department of Psychology, Middle Tennessee State University, Murfreesboro, TN, 37132, USA
| | - Olivia Martín Piñón
- Department of Human Development and Family Science, 261 Mell Street, Auburn University, Auburn, AL, 36849, USA
| | - Joseph A Buckhalt
- Department of Human Development and Family Science, 261 Mell Street, Auburn University, Auburn, AL, 36849, USA
| | - Mona El-Sheikh
- Department of Human Development and Family Science, 261 Mell Street, Auburn University, Auburn, AL, 36849, USA.
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33
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Tomasiello M, Temcheff CE, Martin-Storey A, Bégin V, Poirier M, Déry M. Self and parent-reported sleep problems of adolescents with childhood conduct problems and comorbid psychological problems. J Adolesc 2021; 92:165-176. [PMID: 34547674 DOI: 10.1016/j.adolescence.2021.09.005] [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: 04/06/2021] [Revised: 09/07/2021] [Accepted: 09/11/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Childhood conduct problems (CP) are characterized by maladaptive externalizing behaviors and are linked with poor sleep. CP are highly comorbid with other psychological problems, including attention deficit/hyperactivity disorder and depression, which are also associated with disturbed sleep. The present study examined if childhood CP and comorbid depressive and/or attentional-hyperactivity problems were prospectively associated with parent and self-reported sleep difficulties in adolescence. METHODS Participants (N = 744; 53% boys) from an ongoing longitudinal study in Québec, Canada were assessed for CP and comorbidities when they were between 6 and 9 years old. Participants were classified as without CP, CP only, CP and depressive symptoms, CP and attention-hyperactivity problems, or CP, depressive symptoms, and attention-hyperactivity problems. Regressions were conducted to examine the associations between comorbidity groups, parent, and self-reported sleep problems 7 years later (Median age = 15.33 years), controlling for sex, age, family income, primary caregiver education and medication. RESULTS Adolescents in all CP groups had higher self and parent-reported sleep problems compared to adolescents without histories of CP. Adolescents with histories of CP, depressive symptoms and attention-hyperactivity problems had more sleep problems than all other groups according to self-reports, but not parent-reports. CONCLUSION Childhood CP was prospectively linked to sleep problems in adolescence, and comorbid conditions exacerbated these problems, according to youth but not parents.
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Affiliation(s)
- Melina Tomasiello
- Department of Educational and Counselling Psychology, McGill University, Education Building, 3700 McTavish Street, Montreal, Québec, Canada.
| | - Caroline Elizabeth Temcheff
- Department of Educational and Counselling Psychology, McGill University, Education Building, 3700 McTavish Street, Montreal, Québec, Canada.
| | - Alexa Martin-Storey
- Groupe de recherche et d'intervention sur les adaptations sociales de l'enfance, Département de Psychoéducation, Université de Sherbrooke, Pavillon A7, 2500 Boul. de L'Université, Sherbrooke, Québec, Canada.
| | - Vincent Bégin
- Research group on psychosocial maladjustment in children, School of Criminology, Université de Montréal, 3150 Jean-Brillant, Montréal, Québec, Canada.
| | - Martine Poirier
- Département de Secteur Disciplinaire des Sciences de L'éducation, Université Du Québec à Rimouski, 300 Allée des Ursulines, Rimouski, Québec, Canada.
| | - Michèle Déry
- Groupe de recherche et d'intervention sur les adaptations sociales de l'enfance, Département de Psychoéducation, Université de Sherbrooke, Pavillon A7, 2500 Boul. de L'Université, Sherbrooke, Québec, Canada.
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34
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Tokur-Kesgin M, Kocoglu-Tanyer D. Pathways to adolescents' health: chronotype, bedtime, sleep quality and mental health. Chronobiol Int 2021; 38:1441-1448. [PMID: 34034610 DOI: 10.1080/07420528.2021.1931277] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The strong relationship between sleep and health is defined in the literature. While the need for sleep increases in adolescence with the effect of physiological and hormonal changes, the studies have highlighted the serious sleeping problems of adolescents compared to childhood and adulthood. This study aimed to examine the relationship between chronotype, bedtime, sleep quality and mental health among adolescents. This research was a descriptive-relational study. A total of 1083 students constituted the group of the research. The data were collected through the Morningness-Eveningness Questionnaire (MEQ) and General Health Questionnaire and a questionnaire consisting of some questions about sleep. In the evaluation of data, multiple regression, mediation and path analysis were performed. Age, having problems affecting sleep, difficulties falling asleep, sharing the room with someone else and lack of leisure activities were related to bedtime. It was found that determinants of sleep quality were the variables related to sleep itself. Being a male student, having problems affecting sleep, difficulties falling at sleep, waking up during the night, getting support in the morning for waking up and lack of leisure activities negatively affected mental health. MEQ scale was interpreted as a determinant of sleep time, sleep quality, and mental health level. Although the MEQ score directly affected sleep quality, bedtime had a partial mediation role between MEQ score and sleep quality. Sleep quality had a full mediation role between MEQ score and mental health score. School health workers, especially nurses, should consider chronotype-focused measures to improve adolescents' sleep quality and psychosocial health.
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Affiliation(s)
- Makbule Tokur-Kesgin
- Faculty of Health Science, Department of Public Health Nursing, Abant Izzet Baysal University, Bolu, Turkey
| | - Deniz Kocoglu-Tanyer
- Faculty of Nursing, Department of Public Health Nursing, Selcuk University, Konya, Turkey
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35
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Sleep Assessment for Sleep Problems in Children. Nurs Clin North Am 2021; 56:299-309. [PMID: 34023123 DOI: 10.1016/j.cnur.2021.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The breadth of childhood sleep problems is broad and can be associated with biologic, psychiatric, behavioral, social, and environmental processes. Unrecognized childhood sleep problems may threaten daytime behaviors and negatively impact school and psychosocial functioning. Left unattended, overall child biopsychosocial development may be impaired. Thus, identifying and addressing sleep problems has potential to optimize childhood health, development, and overall well-being. Nurses need to be cognizant of detrimental impacts of child sleep deprivation and advocate for appropriate sleep assessments while offering sleep education to parents and children.
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A daily diary study of sleep chronotype among Mexican-origin adolescents and parents: Implications for adolescent behavioral health. Dev Psychopathol 2021; 33:313-322. [PMID: 32308171 DOI: 10.1017/s0954579419001780] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The current study used daily assessments of sleep to examine stability and change in sleep chronotype in adolescents and their parents. The study assessed adolescent sleep chronotype according to age, gender, and parent chronotype, and evaluated its associations with emotional and behavioral problems in youth. Participants included of 417 Mexican American adolescents (Mage = 16.0 years, Range = 13.9-20.0) and 403 caregivers, who reported bed and wake times daily for 2 consecutive weeks at two time points spaced 1 year apart. In addition, adolescents completed established self-report questionnaires of emotional and behavioral problems. Chronotype was computed as the midsleep point from bed to wake time on free days, correcting for sleep debt accumulated across scheduled days. Multilevel modeling showed a curvilinear association between adolescent age and chronotype, with a peak eveningness observed between ages 16 to 17. Adolescent and parent chronotypes were contemporaneously correlated, but each was only moderately stable over the 1-year period. Later adolescent chronotype was contemporaneously associated with more substance use in all adolescents. Individual development and the family context shape sleep chronotype in adolescents and parents. Sleep chronotype is implicated in adolescent behavioral health.
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Associations between sleep and academic performance in US adolescents: a systematic review and meta-analysis. Sleep Med 2021; 83:71-82. [PMID: 33991893 DOI: 10.1016/j.sleep.2021.04.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/08/2021] [Accepted: 04/10/2021] [Indexed: 11/23/2022]
Abstract
This systematic review and meta-analysis aim to investigate the relationship between sleep and academic performance in students enrolled in secondary education programs in the United States. The study team conducted a literature search of 4 databases-PubMed, Embase, CINAHL, and ERIC-on September 19 and repeated December 17, 2020. Studies were included if they were observational, published in a peer-reviewed, non-predatory journal, available in full-text, written in English, included adolescents enrolled in an organized academic program, took place in the US, and evaluated the effect of sleep duration and/or sleep quality on academic performance. After excluding reviews, editorials, interventions, and those targeting diagnostic groups, 14 studies met inclusion criteria. Risk of bias was assessed using the NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies; 12 studies were found to be good or high quality, 2 were adequate/fair or poor quality. A meta-analysis of 11 of the included studies revealed that sleep duration (r = 0.03; 95%CI -0.027, 0.087; p = 0.087) and sleep quality (r = 0.089; 95%CI 0.027, 0.151; p = 0.005) had negligible correlations with academic performance (non-significant and significant, respectively). Inconsistencies in definitions, methods, and measures utilized to assess sleep duration, sleep quality, and academic performance constructs may offer insight into seemingly conflicting findings. Given the pivotal role sleep plays in development, future investigations utilizing validated and objective sleep and academic performance measures are needed in adolescents.
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Ng E, Wake M, Olds T, Lycett K, Edwards B, Le H, Dumuid D. Equivalence Curves for Healthy Lifestyle Choices. Pediatrics 2021; 147:peds.2020-025395. [PMID: 33771915 DOI: 10.1542/peds.2020-025395] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/06/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Understanding equivalence of time-use trade-offs may inform tailored lifestyle choices. We explored which time reallocations were associated with equivalent changes in children's health outcomes. METHODS Participants were from the cross-sectional Child Health CheckPoint Study (N = 1179; 11-12 years; 50% boys) nested within the population-based Longitudinal Study of Australian Children. Outcomes were adiposity (bioelectrical impedance analysis, BMI and waist girth), self-reported health-related quality of life (HRQoL; Pediatric Quality of Life Inventory), and academic achievement (standardized national tests). Participants' 24-hour time use (sleep, sedentary behavior, light physical activity, and moderate-to-vigorous physical activity [MVPA]) from 8-day 24-hour accelerometry was regressed against outcomes by using compositional log-ratio linear regression models. RESULTS Children with lower adiposity and higher HRQoL had more MVPA (both P ≤ .001) and sleep (P = .001; P < .02), and less sedentary time (both P < .001) and light physical activity (adiposity only; P = .03), each relative to remaining activities. Children with better academic achievement had less light physical activity, relative to remaining activities (P = .003). A 0.1 standardized decrease in adiposity was associated with either 52 minutes more sleep, 56 minutes less sedentary time, 65 minutes less light physical activity, or 17 minutes more MVPA. A 0.1 standardized increase in HRQoL was associated with either 68 minutes more sleep, 54 minutes less sedentary time, or 35 minutes more MVPA. CONCLUSIONS Equivalent differences in outcomes were associated with several time reallocations. On a minute-for-minute basis, MVPA was 2 to 6 times as potent as sleep or sedentary time.
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Affiliation(s)
- Emily Ng
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Melissa Wake
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.,Liggins Institute, University of Auckland, Grafton, New Zealand
| | - Timothy Olds
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Kate Lycett
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Ben Edwards
- Centre for Social Research and Methods, College of Arts and Social Sciences, The Australian National University, Canberra, Australia; and
| | - Ha Le
- Deakin Health Economics, School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
| | - Dorothea Dumuid
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia;
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Fuligni AJ, Chiang JJ, Tottenham N. Sleep disturbance and the long-term impact of early adversity. Neurosci Biobehav Rev 2021; 126:304-313. [PMID: 33757816 DOI: 10.1016/j.neubiorev.2021.03.021] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 02/04/2021] [Accepted: 03/18/2021] [Indexed: 12/24/2022]
Abstract
Sleep disturbance may be a central, yet underappreciated mechanism by which early adversity has a long-term impact upon mental and physical health. The fundamental regulatory processes shaped by early adversity - neural, neuroendocrine, and immune - are also central to sleep. Sleep problems, in turn, lead to a similar constellation of chronic health problems that have been linked to early adversity. We bring together work from the fields of early adversity and sleep in order to suggest a model by which sleep disturbance plays a critical role in the far-reaching impacts of early adversity on health. Future research should employ more longitudinal designs and pay particular attention to the impact of developmental periods such as adolescence and midlife when maturational and environmental factors conspire to create a unique time of sleep disturbance. We also suggesting that intervening to minimize sleep disturbance may be a promising means by which to test the model, as well as potentially blunt the long-term impact of early adversity on health.
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Persistent Low Positive Affect and Sleep Disturbance across Adolescence Moderate Link between Stress and Depressive Symptoms in Early Adulthood. Res Child Adolesc Psychopathol 2021; 48:109-121. [PMID: 31446530 DOI: 10.1007/s10802-019-00581-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The purpose of this study was to characterize the association between recent major life events and depressive symptoms during early adulthood, and to determine whether adolescents with chronically low positive affect or persistent sleep disturbance were more vulnerable to the link between stress and depressive symptoms. Adolescents (n = 147; 63.9% female; 33.7% non-Hispanic white) were recruited in 10th-11th grade and re-assessed 2 and 4 years later. At each assessment, adolescents completed measures of positive affect and sleep disturbances. At the final assessment, participants reported on their exposure to major life events in the past 12 months. Exposure to more major life events in the past year was associated with greater depressive symptoms in early adulthood. Chronically low positive affect and persistent sleep disturbances throughout adolescence each independently moderated this relationship. Specifically, only participants reporting low positive affect across the three assessments showed a positive and significant association between major life events and depressive symptoms. Further, only participants reporting sleep disturbances at all three assessments showed a positive and significant association between major life events and depressive symptoms. Chronically low positive affect and persistent sleep disturbances during adolescence may be useful indicators of risk for depression during early adulthood. Further, interventions targeting adolescent sleep disturbances and improving positive affect may be useful in reducing the risk for depression following life stress during this high risk developmental phase.
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41
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Wang H, He L, Gao Y, Gao X, Lei X. Effects of physical activity and sleep quality on well-being: A wrist actigraphy study during the pandemic. Appl Psychol Health Well Being 2021; 13:394-405. [PMID: 33615735 DOI: 10.1111/aphw.12255] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 12/09/2020] [Accepted: 12/13/2020] [Indexed: 12/15/2022]
Abstract
Previous studies identified the effects of daytime activity, sleep quality and ambient light exposure on individual well-being. These factors have been greatly changed as people are required to stay home during the COVID-19 pandemic; thus, it is necessary to verify whether these factors effect well-being during the pandemic. We recruited 70 adults (females: 46; age range: 31-60) during a high incidence of COVID-19 in China (17-27 February 2020). Both subjective measurements based on self-report scales and objective measurements collected using wrist actigraphy were employed to investigate the effects of night-time sleep and daytime activity on subjective well-being. The actigraphy data show that participants' total sleep time (>8 hr) is sufficient. Self-reported sleep quality was significantly worse than pre-pandemic, and self-reported daytime activity levels significantly decreased during the pandemic. Physical activity was positively related to well-being, both for self-reported daytime activity (r = .346, p = .003) and for objective measurements (r = .234, p = .051). Our study found that sleep and daytime activity levels were negatively affected by the pandemic. However, increased daytime physical activity could potentially reduce these negative effects.
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Affiliation(s)
- Haien Wang
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, China.,Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China
| | - Ling He
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, China.,Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China
| | - Yuan Gao
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China
| | - Xiao Gao
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China
| | - Xu Lei
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, China.,Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China
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Vuholm S, Teisen MN, Mølgaard C, Lauritzen L, Damsgaard CT. Sleep and physical activity in healthy 8-9-year-old children are affected by oily fish consumption in the FiSK Junior randomized trial. Eur J Nutr 2021; 60:3095-3106. [PMID: 33515093 DOI: 10.1007/s00394-021-02490-7] [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: 05/25/2020] [Accepted: 01/08/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE Studies indicate that long-chain n-3 PUFA (n-3LCPUFA) affect sleep and physical activity (PA) in childhood. However, few studies used objective tools and none studies examined the effect of fish per se. We aimed to explore if fish consumption affected sleep and PA assessed by accelerometry in children, and if effects were modified by sex. METHODS In a randomized 12-week trial, 199 healthy 8-9-year-old children received ~ 300 g/week of oily fish or poultry. Sleep and PA were pre-specified explorative outcomes examined by accelerometers that the children wore on their hip for 7 days at baseline and endpoint, while parents registered sleep. Compliance was verified by erythrocyte n-3LCPUFA. RESULTS The children slept 9.4 ± 0.5 h/night but the sleep duration variability across the week was 6.0 (95%CI: 0.8, 11.1) min lower in the fish vs poultry group. Furthermore, children in the fish group exhibited increased spare time sedentary activity [9.4 (95%CI: 1.8, 16.9) min/day] at the expense of light PA [- 8.2 (95%CI: - 14.4, - 2.0) min/day]. These effects were supported by dose-dependency with n-3LCPUFA. Additionally, latency to sleep onset was reduced by 3.6 (95%CI: 1.0, 6.3) min on weekends and moderate-vigorous PA during school hours was 3.5 (95%CI: 0.1, 6.8) min longer in fish vs poultry. P values for sex interactions were all > 0.05 but the effects tended to be most pronounced on sleep in girls and PA in boys. CONCLUSION Oily fish intake altered sleep and PA patterns among healthy schoolchildren, with some slight indications of sex differences. These findings warrant further investigation. CLINICAL TRIAL REGISTRY At clinicaltrials.gov (NCT02809508) and a published protocol in Trials [Damsgaard et al. in Trials, 2016].
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Affiliation(s)
- Stine Vuholm
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark
| | - Marie N Teisen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark
| | - Christian Mølgaard
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark
| | - Lotte Lauritzen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark.
| | - Camilla T Damsgaard
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark
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Dumuid D, Wake M, Burgner D, Tremblay MS, Okely AD, Edwards B, Dwyer T, Olds T. Balancing time use for children's fitness and adiposity: Evidence to inform 24-hour guidelines for sleep, sedentary time and physical activity. PLoS One 2021; 16:e0245501. [PMID: 33465128 PMCID: PMC7815105 DOI: 10.1371/journal.pone.0245501] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 01/04/2021] [Indexed: 12/18/2022] Open
Abstract
PURPOSE Daily time spent on one activity cannot change without compensatory changes in others, which themselves may impact on health outcomes. Optimal daily activity combinations may differ across outcomes. We estimated optimal daily activity durations for the highest fitness and lowest adiposity. METHODS Cross-sectional Child Health CheckPoint data (1182 11-12-year-olds; 51% boys) from the population-based Longitudinal Study of Australian Children were used. Daily activity composition (sleep, sedentary time, light physical activity [LPA], moderate-to-vigorous physical activity [MVPA]) was from 8-day, 24-hour accelerometry. We created composite outcomes for fitness (VO2max; standing long jump) and adiposity (waist-to-height ratio; body mass index; fat-to-fat-free log-ratio). Adjusted compositional models regressed activity log-ratios against each outcome. Best activity compositions (optimal time-use zones) were plotted in quaternary tetrahedrons; the overall optimal time-use composition was the center of the overlapping area. RESULTS Time-use composition was associated with fitness and adiposity (all measures p<0.001). Optimal time use differed for fitness and adiposity. While both maximized MVPA and minimized sedentary time, optimal fitness days had higher LPA (3.4 h) and shorter sleep (8.25 h), but optimal adiposity days had lower LPA (1.0 h) and longer sleep (10.9 h). Balancing both outcomes, the overall optimal time-use composition was (mean [range]): 10.2 [9.5; 10.5] h sleep, 9.9 [8.8; 11.2] h sedentary time, 2.4 [1.8; 3.2] h LPA and 1.5 [1.5; 1.5] h MVPA. CONCLUSION Optimal time use for children's fitness and adiposity involves trade-offs. To best balance both outcomes, estimated activity durations for sleep and LPA align with, but for MVPA exceed, 24-h guidelines.
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Affiliation(s)
- Dorothea Dumuid
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Melissa Wake
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - David Burgner
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Mark S. Tremblay
- Children’s Hospital of Eastern Ontario Research Institute and Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
| | - Anthony D. Okely
- Early Start, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
- Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
| | - Ben Edwards
- Centre for Social Research and Methods, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Terence Dwyer
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Oxford Martin School, University of Oxford, Oxford, United Kingdom
- Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Timothy Olds
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
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Abstract
PURPOSE OF REVIEW This paper presents a review of the current literature in support of a model explaining the relationships between sleep health and risk for type 2 diabetes in adolescents. RECENT FINDINGS Short sleep duration is associated with risk of developing obesity in youth. Sleep restriction increases energy expenditure, but also increases hunger, appetite, and food intake, causing positive energy balance, impacting appetite-regulating hormones, and leading to increased eating late at night. Insufficient sleep may lead to reduced physical activity and greater sedentary behaviors. In addition, short sleep duration is associated with reduced insulin sensitivity. The cumulative negative consequences of insufficient sleep increase risk for type 2 diabetes. Applications to clinical care, public policy, and future research are discussed. Insufficient sleep in adolescence increases risk for type 2 diabetes directly through impact on insulin sensitivity and indirectly through increased dietary intake, sedentary activity, and weight gain.
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Affiliation(s)
- Stacey L. Simon
- grid.430503.10000 0001 0703 675XUniversity of Colorado Anschutz Medical Campus, Aurora, CO USA
| | - Janine Higgins
- grid.430503.10000 0001 0703 675XUniversity of Colorado Anschutz Medical Campus, Aurora, CO USA
| | - Edward Melanson
- grid.430503.10000 0001 0703 675XUniversity of Colorado Anschutz Medical Campus, Aurora, CO USA
- Eastern Colorado Veterans Affairs Geriatric Research, Education, and Clinical Center, Denver, CO USA
| | - Kenneth P. Wright
- grid.430503.10000 0001 0703 675XUniversity of Colorado Anschutz Medical Campus, Aurora, CO USA
- grid.266190.a0000000096214564University of Colorado Boulder, Boulder, CO USA
| | - Kristen J. Nadeau
- grid.430503.10000 0001 0703 675XUniversity of Colorado Anschutz Medical Campus, Aurora, CO USA
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Abstract
A main childhood task is learning. In this task, the role of sleep is increasingly demonstrated. Although most literature examining this role focuses on preadolescence and middle adolescence, some studies apply napping designs in preschoolers. Studies overall conclude that without proper sleep a child's cognitive abilities suffer, but questions on how and to what extent linger. Observational studies show the hazards of potential confounders such as an individual's resilience to poor sleep as well as developmental risk factors (eg, disorders, stressors). A better understanding of cognitive sleep neuroscience may have a big impact on pediatric sleep research and clinical applications.
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Affiliation(s)
- Karen Spruyt
- INSERM, University Claude Bernard, School of Medicine, Lyon, France.
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Litsfeldt S, Ward TM, Hagell P, Garmy P. Association Between Sleep Duration, Obesity, and School Failure Among Adolescents. J Sch Nurs 2020; 36:458-463. [PMID: 31973678 PMCID: PMC7675773 DOI: 10.1177/1059840520901335] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The aim of this study was to investigate the association between sleep duration, overweight/obesity, and school failure using data obtained from self-reported questionnaires completed by 13- to 15-year-olds in Sweden (n = 1,363; 50.7% female). The height and weight of the participants were measured by school nurses. A multiple logistic regression analysis was used to analyze the association between sleep duration and overweight/obesity, school failure, and perceived economic situation. A short sleep duration (<7 hr) was associated with overweight/obesity (p = .001), school failure (p = .007), and poorer perceived economic situation (p = .004). Modifying the sleep habits of adolescents is a potential target for obesity intervention as well as for improving school success. This information is particularly well suited for school nurses to disseminate to students and their parents.
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Affiliation(s)
- Sofie Litsfeldt
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
| | - Teresa M. Ward
- Department of Psychosocial and Community Health, School of Nursing, University of Washington, Seattle, WA, USA
| | - Peter Hagell
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
| | - Pernilla Garmy
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
- Department of Health Sciences, Clinical Health Promotion Centre, Lund University, Lund, Sweden
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Sleep problems in adolescence are prospectively linked to later depressive symptoms via the cortisol awakening response. Dev Psychopathol 2020; 32:997-1006. [PMID: 31387652 DOI: 10.1017/s0954579419000762] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Sleep disturbance is a symptom of and a well-known risk factor for depression. Further, atypical functioning of the HPA axis has been linked to the pathogenesis of depression. The purpose of this study was to examine the role of adolescent HPA axis functioning in the link between adolescent sleep problems and later depressive symptoms. Methods: A sample of 157 17-18 year old adolescents (61.8% female) completed the Pittsburgh Sleep Quality Inventory (PSQI) and provided salivary cortisol samples throughout the day for three consecutive days. Two years later, adolescents reported their depressive symptoms via the Center for Epidemiological Studies Depression Scale (CES-D). Results: Individuals (age 17-18) with greater sleep disturbance reported greater depressive symptoms two years later (age 19-20). This association occurred through the indirect effect of sleep disturbance on the cortisol awakening response (CAR) (indirect effect = 0.14, 95%CI [.02 -.39]). Conclusions: One pathway through which sleep problems may lead to depressive symptoms is by up-regulating components of the body's physiological stress response system that can be measured through the cortisol awakening response. Behavioral interventions that target sleep disturbance in adolescents may mitigate this neurobiological pathway to depression during this high-risk developmental phase.
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48
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Social jetlag is associated with cardiorespiratory fitness in male but not female adolescents. Sleep Med 2020; 75:163-170. [DOI: 10.1016/j.sleep.2020.07.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/04/2020] [Accepted: 07/27/2020] [Indexed: 12/11/2022]
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Stefansdottir R, Gundersen H, Rognvaldsdottir V, Lundervold AS, Gestsdottir S, Gudmundsdottir SL, Chen KY, Brychta RJ, Johannsson E. Association between free-living sleep and memory and attention in healthy adolescents. Sci Rep 2020; 10:16877. [PMID: 33037281 PMCID: PMC7547704 DOI: 10.1038/s41598-020-73774-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/15/2020] [Indexed: 11/25/2022] Open
Abstract
In laboratory studies, imposed sleep restriction consistently reduces cognitive performance. However, the association between objectively measured, free-living sleep and cognitive function has not been studied in older adolescents. To address this gap, we measured one week of sleep with a wrist-worn GT3X+ actigraph in 160 adolescents (96 girls, 17.7 ± 0.3 years) followed by assessment of working memory with an n-back task and visual attention with a Posner cue-target task. Over the week, participants spent 7.1 ± 0.8 h/night in bed and slept 6.2 ± 0.8 h/night with 88.5 ± 4.8% efficiency and considerable intra-participant night-to-night variation, with a standard deviation in sleep duration of 1.2 ± 0.7 h. Sleep measures the night before cognitive testing were similar to weekly averages. Time in bed the night before cognitive testing was negatively associated with response times during the most challenging memory task (3-back; p = 0.005). However, sleep measures the night before did not correlate with performance on the attention task and weekly sleep parameters were not associated with either cognitive task. Our data suggests shorter acute free-living sleep may negatively impact difficult memory tasks, however the relationship between free-living sleep and cognitive task performance in healthy adolescents is less clear than that of laboratory findings, perhaps due to high night-to-night sleep variation.
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Affiliation(s)
- Runa Stefansdottir
- Centre for Sports and Health Sciences, University of Iceland, Stakkahlid, 105, Reykjavík, Iceland
| | - Hilde Gundersen
- Department of Sport, Food and Natural Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Vaka Rognvaldsdottir
- Centre for Sports and Health Sciences, University of Iceland, Stakkahlid, 105, Reykjavík, Iceland
| | - Alexander S Lundervold
- Department of Computer Science, Electrical Engineering, and Mathematical Sciences, Western Norway University of Applied Sciences, Bergen, Norway.,Mohn Medical Imaging and Visualization Centre, Haukeland University Hospital, Bergen, Norway
| | - Sunna Gestsdottir
- Centre for Sports and Health Sciences, University of Iceland, Stakkahlid, 105, Reykjavík, Iceland
| | | | - Kong Y Chen
- Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Robert J Brychta
- Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Erlingur Johannsson
- Centre for Sports and Health Sciences, University of Iceland, Stakkahlid, 105, Reykjavík, Iceland. .,Department of Sport, Food and Natural Sciences, Western Norway University of Applied Sciences, Bergen, Norway.
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Shimizu M, Gillis BT, Buckhalt JA, El-Sheikh M. Linear and Nonlinear Associations between Sleep and Adjustment in Adolescence. Behav Sleep Med 2020; 18:690-704. [PMID: 31537121 PMCID: PMC7080596 DOI: 10.1080/15402002.2019.1665049] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND & OBJECTIVES A growing body of work supports linear associations between sleep and socioemotional adjustment in adolescence. However, associations between sleep and adjustment are not necessarily linear and investigations of nonlinear effects are scarce. This study examined linear and nonlinear relations between several sleep-wake parameters and externalizing behavior and internalizing symptoms in adolescence, and assessed the role of adolescent sex as a moderator of effects. PARTICIPANTS Participants were high school students (N = 180; M age = 17.49, SD = .62; 59% female; 68% White/European American, 32% Black/African American) from a wide range of socio-economic backgrounds living in semirural communities and small towns in Alabama. METHODS Sleep-wake parameters were indexed by actigraphy-derived sleep minutes and adolescents' reports on morningness-eveningness (circadian preference), sleep-wake problems (sleep quality), and sleepiness. Adolescents completed questionnaires on externalizing behaviors and internalizing symptoms. RESULTS Controlling for sleep duration, a higher preference for eveningness and poor sleep quality were associated in a linear fashion with increased externalizing and internalizing symptoms. Nonlinear relations between sleepiness and internalizing symptoms emerged with pronounced sex-related effects, including somewhat delayed accelerating relations for males and rapidly accelerating associations that tended to plateau for females. CONCLUSIONS Results illustrate the importance of examining multiple sleep-wake and adjustment variables as well as linear and nonlinear associations.
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Affiliation(s)
- Mina Shimizu
- Department of Human Development and Family Studies, Auburn University, Auburn, Alabama
| | - Brian T. Gillis
- Department of Human Development and Family Studies, Auburn University, Auburn, Alabama
| | - Joseph A. Buckhalt
- Department of Special Education, Rehabilitation, and Counseling, Auburn University, Alabama, Auburn
| | - Mona El-Sheikh
- Department of Human Development and Family Studies, Auburn University, Auburn, Alabama
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