Turkish adaptation of the maternal cognition about infant sleep questionnaire

Background

Exploring early childhood sleep problems requires a detailed understanding of parental beliefs and cognitions related to infant sleep. There is a need for validated measures to investigate the cognitions of Turkish mothers about infant sleep however no scale measuring parental perceptions related to infant sleep behaviors in Turkish is available. We aimed to culturally adapt the Maternal Cognitions about Infant Sleep Questionnaire (MCISQ) in Turkish.

Methods

Subjects were recruited from an internet sample through social media. Internal consistency was evaluated by Cronbach's alpha, and test-retest reliability was determined by Pearson's correlation test and paired t-test. For factorial validity, the principal component factor analysis was performed for the components of MCISQ.

Results

A total of 417 mothers, most aged between 25 and 29 years (47.8 %), participated in the study. Infants' age ranged between 6 and 18 months, with a mean of 10.5 ± 3.9 months. Factor analysis revealed four factors after removal of item 11: Anger, doubt, safety, limit setting. Cronbach's alpha was 0.85. A subgroup of 32 mothers completed MCISQ three weeks after the initial administration. Total mean scores showed a significantly strong correlation (p:<0.01, r:0.82). Higher scores were noted in both total and subscale scores in infants with maternally reported sleep problems (p:<0.01).

Conclusion

Findings suggest a four-factor solution for MCISQ in Turkish mothers with infants aged 6-18 months. The adapted Turkish version is composed of 19 items with good reliability. Factor structure and items included in the subscales differed from the original study, highlighting the cultural factors related to maternal perceptions about infant sleep.

Results from the national AMADEUS study

BACKGROUND

Burnout and absenteeism are prevalent among healthcare workers, reflecting prolonged work-related stress and dissatisfaction with their job. Identifying poor sleep as a contributing factor can assist in developing targeted interventions. This study explored the relationship between burnout, absenteeism, and sleep among healthcare workers.

METHODS

A nationwide online cross-sectional study was conducted among healthcare professionals in France during the third wave of COVID-19, from May 2021 to June 2021. Recruitment strategies included outreach through social and professional networks and email invitations. Burnout was assessed using the Maslach Burnout Inventory, absenteeism through self-reported days absent in the preceding 12 months, and sleep quality using the Pittsburgh Sleep Quality Index. The association between burnout, absenteeism, and poor sleep was analyzed using multivariate logistic regression, accounting for individual and professional variables. The study also explored various sleep dimension abnormalities.

RESULTS

Of 10,087 healthcare workers, 55.2 % reported burnout, 20.5 % absenteeism, and 64.8 % poor sleep. Burnout and absenteeism were more frequent in individuals with poor sleep compared to those with good sleep (74.2 % vs. 25.8 % and 75.6 % vs. 24.4 %, respectively). The multivariate analyses confirmed the associations between burnout, absenteeism, and poor sleep (Adjusted Odds Ratio [aOR] = 2.15, 95 % CI [1.97-2.35], p < 0.001; and aOR = 1.49, 95 % CI [1.32-1.67], p < 0.001, respectively).

INTERPRETATION

The study highlighted the intricate relationship between burnout, absenteeism, and poor sleep among healthcare professionals, informing workforce management and policy decisions to foster a supportive work environment and enhance their well-being.

Sedative and hypnotic effects of the saponins from a traditional edible plant Liriope spicata Lour. in PCPA-induced insomnia mice

ETHNOPHARMACOLOGICAL RELEVANCE

Liriope spicata Lour., a species listed in the catalogue of 'Medicinal and Edible Homologous Species', is traditionally used for the treatment of fatigue, restlessness, insomnia and constipation.

AIM OF THE STUDY

This study is aimed to evaluate the sedative and hypnotic effect of the saponins from a natural plant L. spicata Lour. in vivo.

MATERIALS AND METHODS

The total saponin (LSTS) and purified saponin (LSPS) were extracted from L. spicata, followed by a thorough analysis of their major components using the HPLC-MS. Subsequently, the therapeutic efficacy of LSTS and LSPS was evaluated by the improvement of anxiety and depression behaviors of the PCPA-induced mice.

RESULTS

LSTS and LSPS exhibited similar saponin compositions but differ in their composition ratios, with liriopesides-type saponins accounting for a larger proportion in LSTS. Studies demonstrated that both LSTS and LSPS can extend sleep duration and immobility time, while reducing sleep latency in PCPA-induced mice. However, there was no significant difference in weight change among the various mice groups. Elisa results indicated that the LSTS and LSPS could decrease levels of NE, DA, IL-6, and elevate the levels of 5-HT, NO, PGD2 and TNF-α in mice plasma. LSTS enhanced the expression of neurotransmitter receptors, while LSPS exhibited a more pronounced effect in regulating the expression of inflammatory factors. In conclusion, the saponins derived from L. spicata might hold promise as ingredients for developing health foods with sedative and hypnotic effects, potentially related to the modulation of serotonergic and GABAAergic neuron expression, as well as immunomodulatory process.

The effect of slow wave sleep deprivation on mood in adolescents with depressive symptoms: A pilot study

BACKGROUND

There is an urgent need for safe, rapid-acting treatment strategies for adolescent depression. In depressed adults, slow wave sleep deprivation (SWSD) improved next-day mood without disrupting sleep duration, but SWSD has not been tested in adolescents. In a pilot study, the aim was to assess the effect of SWSD on sleep physiology and mood outcomes (depression, rumination, anhedonia) among adolescents with depressive symptoms.

METHODS

Sixteen adolescents (17.44 ± 1.46 yr, 12 female) completed three nights of polysomnographic sleep recording: Baseline, SWSD, and Recovery nights. Acoustic stimulation (tones of random pitch, duration, and volume) suppressed slow wave sleep (SWS) in real-time during SWSD. After each night, depression, rumination, and anhedonia severity were assessed.

RESULTS

SWSD successfully suppressed SWS, increased N2, and had minimal impact on Rapid Eye Movement (REM), nocturnal awakenings, and total sleep time. While SWSD did not improve depression or anhedonia severity overall, lower baseline non-REM alpha activity and greater SWS rebound during recovery sleep correlated with SWSD-related reduction in clinician-rated depression severity. Next-day rumination severity decreased after SWSD, with sustained improvements following recovery sleep. However, rumination improvement was not associated with SWS suppression, but rather reduction in total sleep time and REM in exploratory correlation models.

LIMITATIONS

Small sample size and large proportion of females.

CONCLUSION

SWSD did not improve depression in adolescents overall but a subset with low non-REM alpha activity and intact homeostatic sleep regulation may benefit from this approach. Findings from this pilot study also suggest that partial sleep deprivation may be a beneficial therapeutic strategy for rumination in adolescents.

Bipolar Disorder, Circadian Rhythm and Clock Genes

Sleep disturbance and abnormal circadian rhythm might be closely related to bipolar disorder. Several studies involving disturbed sleep/wake cycle, changes in rhythms such as melatonin and cortisol, clock genes, and circadian preference have shown the relationship between bipolar disorder and circadian rhythm. The results differed across different studies. In some studies, a delay in the circadian rhythm was observed in the depressive episode and advanced circadian rhythm was observed during the manic episode. In other studies, a delay in circadian rhythm was observed independent of mood episodes. Accordingly, circadian rhythm disorder was proposed as a trait marker for bipolar disorder. The altered circadian rhythm may represent a pathological mechanism that contributes to the mood episodes. However, a prospective cohort study is needed for further clarification.

Association between Maternal Personality Traits and Children's Sleep Disturbance: A Population-based Cohort Study in Republic of Korea

Objective

Sleep affects the development and severity of psychiatric symptoms in children, and maternal personality traits may influence children's sleep. We aimed to confirm the longitudinal effect of maternal personality traits on children's sleep disturbance using cohort data from the Panel Study on Korean Children.

Methods

Maternal personality traits were assessed using the Personality Assessment Inventory in 2009, and the sleep disturbance of children was assessed using parent survey data from 2010 to 2014 (2nd-6th waves). Among the 11 clinical scales of the Personality Assessment Inventory, the 5 scales that showed the most significant correlations were analyzed. Presence or absence of child sleep disturbance was evaluated with a chi-square test, and the effect of the Personality Assessment Inventory was assessed by a binary logistic regression analysis with child sleep disturbance as the dependent variable.

Results

Of the 171 mother-child dyads, 92 were classified into the sleep disturbance group and 79 were classified into the normal sleep group. Maternal somatic concerns showed a significant relationship with children's sleep disturbance at years 2 and 3. Maternal borderline features demonstrated a significant relationship with children's sleep disturbance from years 2 to 5. The binary logistic regression analysis revealed a significant association between high borderline features and children's sleep disturbance at years 2 and 3.

Conclusion

High maternal borderline features evaluated at child age 1 were related to sleep disturbance in early childhood. In assessing a children's sleep problems, it may be important to examine mothers' dysfunctional personality traits.

Characterization of circulating leptin-receptor levels following acute sleep restriction: A pilot study on healthy adult females

BACKGROUND

Insufficient sleep adversely affects energy homeostasis by decreasing leptin levels. The underlying physiological mechanisms; however, remain unclear. Circulating leptin is well described to be regulated by its soluble receptor (sOB-R). Intriguingly, the impact of short sleep duration on sOB-R levels has never been characterized.

AIM

In this study, we investigated, for the first time, the variation of sOB-R levels and its temporal relationship with circulating leptin upon acute sleep restriction.

METHODS

Five adult females were maintained on an 8-hour sleep schedule (bedtime at 00:00) for 1 week before restricting their sleep to 4.5 h (bedtime at 03:30) on 2 consecutive nights. Balanced meals were scheduled to specific hours and sleep was objectively measured. Four-hour blood samples were regularly collected during waking hours between 08:00 and 00:00.

RESULTS

Sleep restriction resulted in lower leptin (20.9 ± 1.7 vs 25.7 ± 1.7 ng/ml) and higher sOB-R concentrations (24.4 ± 1.2 vs 19.8 ± 1.6 ng/ml). Neither the discordant temporal relationship nor the pattern of leptin and sOB-R were altered in response to sleep restriction.

CONCLUSION

Our results suggest that sleep restriction may modulate circulating leptin levels and possibly metabolism via upregulating its soluble receptor. This observation may have valuable therapeutic implications when considering sOB-R as a potential target during the management of metabolic disturbances.

Cardiorespiratory effects of indoor ozone exposure during sleep and the influencing factors: A prospective study among adults in China

Ambient ozone (O3) is recognized as a significant air pollutant with implications for cardiorespiratory health, yet the effects of indoor O3 exposure have received less consideration. Furthermore, while sleep occupies one-third of life, research on the health consequences of O3 exposure during this crucial period is scarce. This study aimed to investigate associations of indoor O3 during sleep with cardiorespiratory function and potential predisposing factors. A prospective study among 81 adults was conducted in Beijing, China. Repeated measurements of cardiorespiratory indices reflecting lung function, airway inflammation, cardiac autonomic function, blood pressure, systemic inflammation, platelet and glucose were performed on each subject. Real-time concentrations of indoor O3 during sleep were monitored. Associations of O3 with cardiorespiratory indices were evaluated using linear mixed-effect model. Effect modification by baseline lifestyles (diet, physical activity, sleep-related factors) and psychological status (stress and depression) were investigated through interaction analysis. The average indoor O3 concentration during sleep was 20.3 μg/m3, which was well below current Chinese indoor air quality standard of 160 μg/m3. O3 was associated with most respiratory indicators of decreased airway function except airway inflammation; whereas the cardiovascular effects were only manifested in autonomic dysfunction and not in others. An interquartile range increases in O3 at 6-h average was associated with changes of -3.60 % (95 % CI: -6.19 %, -0.93 %) and -9.60 % (95 % CI: -14.53 %, -4.39 %) in FVC and FEF25-75, respectively. Further, stronger effects were noted among participants with specific dietary patterns, poorer sleep and higher level of depression. This study provides the first general population-based evidence that low-level exposure to indoor O3 during sleep has greater effects on the respiratory system than on the cardiovascular system. Our findings identify the respiratory system as an important target for indoor O3 exposure, and particularly highlight the need for greater awareness of indoor air quality, especially during sleep.

An Emerging 21st-Century Midlife Sleep Crisis? Cohort Differences in Sleeping Patterns Among Americans in Midlife and Older Adulthood

OBJECTIVES

To descriptively document birth cohort differences in sleeping patterns, self-reported age-specific sleep duration, and insomnia symptoms among adults aged 50+ from the National Health Interview Survey (NHIS) and the Health and Retirement Study (HRS).

METHODS

We analyzed respondents aged 50+ (born 1920-1969) from the 2006-2018 NHIS (n = 162,400) and HRS (n = 28,918). We fit multinomial models among the NHIS sample predicting age-specific optimal sleep duration (optimal for age vs short for age, and optimal for age vs long for age). For the HRS sample, we fit growth curve models predicting age-based insomnia symptom trajectories. The models for both samples adjusted for age, gender, race/ethnicity, and educational attainment.

RESULTS

Results regarding sleep duration in the NHIS, suggested that cohorts born in the 1950s and 1960s had significantly higher odds of reporting short sleep duration than cohorts before them. Results from the HRS similarly illustrated that cohorts born in the 1950s and 1960s had significantly higher levels of insomnia symptoms than those born before them. The worsening sleep among cohorts entering midlife was consistent regardless of alternative cohort specification, when age groups or periods were analyzed, and when more extensive covariates were modeled.

DISCUSSION

We observe a pronounced decline in healthy sleeping patterns among American cohorts in midlife, with consistent and striking results across data sets, methods, and measures. These findings have important implications for the well-being and longevity of Americans who have entered midlife in the 21st century.

A feasibility study on indoor therapeutic horticulture to alleviate sleep and anxiety problems: The impact of plants and activity choice on its therapeutic effect

INTRODUCTION

Therapeutic horticulture (TH) is increasingly being applied for sub-health or patient mental health care. Whether plant and activity type will affect TH's effectiveness is unclear.

AIM

To evaluate the feasibility of an indoor TH for alleviating the anxiety symptoms and sleeping problems of people with poor sleep quality, and explore the potential affection of plant and activity type on health benefits.

METHOD

Thirty subjects (all with sleep problems and half with anxiety problems) were randomly assigned to three groups to do horticultural activities with ornamental plants, general aromatic plants, or aromatic plants with reported mental health functions, respectively. Six indoor TH activities were then held sequentially within two weeks. Psychological scales, subjective feedback questionnaires, and physiological indicators were used as evaluation indexes before and after horticulture activities.

RESULTS

The TH relieved subjects' sleep and anxiety problems and was particularly effective in alleviating anxiety among people with high anxiety levels. Using ornamental plants was more effective in relieving stress while functional aromatic plants performed better in sleep improvement and satisfaction to TH. Each horticultural activity could improve mood state but showed different effects on the vitality of the participants.

CONCLUSION

The above findings provided some basis for the potential benefits of selecting plants and activities based on psychological care needs in the development of TH plans. Future research that expands upon the current project is warranted. A larger sample size is beneficial for obtaining more powerful statistical results.

Patient-centered mild traumatic brain injury interventions in the emergency department

INTRODUCTION

Traumatic brain injury (TBI) results in 2.5 million emergency department (ED) visits per year in the US, with mild traumatic brain injury (mTBI) accounting for 90% of cases. There is considerable evidence that many experience chronic symptoms months to years later. This population is rarely represented in interventional studies. Management of adult mTBI in the ED has remained unchanged, without consensus of therapeutic options. The aim of this review was to synthesize existing literature of patient-centered ED treatments for adults who sustain an mTBI, and to identify practices that may offer promise.

METHODS

A systematic review was conducted using the PubMed and Cochrane databases, while following PRISMA guidelines. Studies describing pediatric patients, moderate to severe TBI, or interventions outside the ED were excluded. Two reviewers independently performed title and abstract screening. A third blinded reviewer resolved discrepancies. The Mixed Methods Appraisal Tool (MMAT) was employed to assess the methodological quality of the studies.

RESULTS

Our search strategy generated 1002 unique titles. 95 articles were selected for full-text screening. The 26 articles chosen for full analysis were grouped into one of the following intervention categories: (1) predictive models for Post-Concussion Syndrome (PCS), (2) discharge instructions, (3) pharmaceutical treatment, (4) clinical protocols, and (5) functional assessment. Studies that implemented a predictive PCS model successfully identified patients at highest risk for PCS. Trials implementing discharge related interventions found the use of video discharge instructions, encouragement of daily light exercise or bed rest, and text messaging did not significantly reduce mTBI symptoms. The use of electronic clinical practice guidelines (eCPG) and longer leaves of absence from work following injury reduced symptoms. Ondansetron was shown to reduce nausea in mTBI patients. Studies implementing ED Observation Units found significant declines in inpatient admissions and length of hospital stay. The use of tablet-based tasks was found to be superior to many standard cognitive assessments.

CONCLUSION

Validated instruments are available to aid clinicians in identifying patients at risk for PCS or serious cognitive impairment. EDOU management and evidence-based modifications to discharge instructions may improve mTBI outcomes. Additional research is needed to establish the therapeutic value of medications and lifestyle changes for the treatment of mTBI in the ED.

The role of lifestyle factors in the association between early-life stress and adolescent psycho-physical health: Moderation analysis in two European birth cohorts

OBJECTIVE

Early-life stress (ELS) is an established risk factor for a host of adult mental and physical health problems, including both depression and obesity. Recent studies additionally showed that ELS was associated with an increased risk of comorbidity between mental and physical health problems, already in adolescence. Healthy lifestyle factors, including physical activity, sleep and diet have also been robustly linked to both emotional and physical wellbeing. However, it is yet unclear whether these lifestyle factors may moderate the association between ELS and psycho-physical comorbidity.

METHODS

We investigated whether (a) participation in physical activity, (b) sleep duration, and (c) adherence to a Mediterranean diet, moderated the relationship between cumulative ELS exposure over the first 10 years of life and psycho-physical comorbidity at the age of 13.5 years. Analyses were conducted in 2022-2023, using data from two large adolescent samples based in the UK (ALSPAC; n = 8428) and The Netherlands (Generation R; n = 4268).

RESULTS

Exposure to ELS was significantly associated with a higher risk of developing comorbidity, however this association was not modified by any of the three lifestyle factors investigated. Only physical activity was significantly associated with a reduced risk of comorbidity in one cohort (ORALSPAC [95%CI] = 0.73 [0.59;0.89]).

CONCLUSIONS

In conclusion, while we found some evidence that more frequent physical activity may be associated with a reduction in psycho-physical comorbidity, we did not find evidence in support of the hypothesised moderation effects. However, more research is warranted to examine how these associations may evolve over time.

Early childhood sleep quantity, but not caregiver-reported sleep problems, predicts impulse control in children at age 8 years

Short duration of sleep and poor sleep quality have been linked to poor attention and impulse control in children. We aimed to determine the longitudinal predictive value of sleep quantity and quality during early childhood on objective and caregiver-report measures of attention, impulse control, and executive function in children at age 8 years. We used data from the Health Outcomes and Measures of the Environment (HOME) Study, a pregnancy and birth cohort. Caregivers reported on their child's sleep at ages 2, 2.5, 3, 4, and 5 years. Analysis included 410 participants. We used longitudinal growth curve models of early childhood sleep patterns to predict neurobehavioral functioning at age 8 years. Sleep problems did not predict any of our outcome measures at age 8 years. Sleep duration trended shorter as children matured, so predictive models examined both intercept and slope. Children with the least decline in sleep duration across early childhood had fewer impulsive errors at age 8 years on a continuous performance test (unadjusted p = .013; adjusted p = .013). Children with shorter duration of sleep across early childhood had worse caregiver-reported behavioral regulation at age 8 years (unadjusted p = .002; adjusted p = .043). Neither sleep duration slope nor intercept predicted inattention or metacognitive skills at age 8 years (p > .05). Total sleep time across early childhood predicts behavior regulation difficulties in school-aged children. Inadequate sleep during early childhood may be a marker for, or contribute to, poor development of a child's self-regulatory skills.

Night-to-night variability of objective sleep outcomes in youth Middle Eastern football players

OBJECTIVE

To describe components of night-to-night variation in objective measures of sleep.

METHODS

We conducted a secondary data analysis of consecutive and chronologically ordered actigraphy-based measurements for time in bed (min), time asleep (min), and wake-after-sleep onset (min). This investigation examined 575 individual night-based measures available for a sub-sample of fifty-two, male youth Middle Eastern football players tracked over a 14-day surveillance period (chronological age range: 12.1 to 16 years). Distinct multivariable-adjusted generalized additive models included each objective sleep outcome measure as dependent variable and disaggregated components of variation for night measurement-by-sleep period interaction, week part (weekday or weekend), and study participant random effects from within-subject night-to-night sleep variation.

RESULTS

The within-subject standard deviation (SD) of ±98 min (95% confidence interval [CI], 92 to 104 min) for time in bed, ±87 min (95%CI, 82 to 93 min) for time asleep, and ±23 min (95%CI, 22 to 25 min) for wake-after-sleep-onset overwhelmed other sources of variability and accounted for ∼44% to 53% of the overall night-to-night variation. The night measurement-by-fragmented sleep period interaction SD was ±83 min (95%CI, 44 to 156 min) for time in bed, ±67 min (95%CI, 34 to 131 min) for time asleep, and ±15 min (95%CI, 7 to 32 min) for wake-after-sleep-onset that accounted for ∼22% to 32% of each sleep outcome measure overall variability.

CONCLUSIONS

Substantial random night-to-night within-subject variability poses additional challenges for strategies aiming to mitigate problems of insufficient and inconsistent sleep that are detrimental to school learning and youth athlete development processes.

Sleep promotes T-cell migration towards CCL19 via growth hormone and prolactin signaling in humans

Sleep strongly supports the formation of adaptive immunity, e.g., after vaccination. However, the underlying mechanisms remain largely obscure. Here we show in healthy humans that sleep compared to nocturnal wakefulness specifically promotes the migration of various T-cell subsets towards the chemokine CCL19, which is essential for lymph-node homing and, thus, for the initiation and maintenance of adaptive immune responses. Migration towards the inflammatory chemokine CCL5 remained unaffected. Incubating the cells with plasma from sleeping participants likewise increased CCL19-directed migration, an effect that was dependent on growth hormone and prolactin signaling. These findings show that sleep selectively promotes the lymph node homing potential of T cells by increasing hormonal release, and thus reveal a causal mechanism underlying the supporting effect of sleep on adaptive immunity in humans.

The assessment of fatigue and sleep quality among children and adolescents with familial Mediterranean fever: A case-control and correlation study

To evaluate the sleep quality and fatigue levels in children with familial Mediterranean fever (FMF) in comparison to healthy children. The Pediatric Quality of Life Multidimensional Fatigue Scale (PedsQL-MFS) and the Pittsburgh Sleep Quality Index (PSQI) were the instruments utilized to assess fatigue and sleep quality in children with FMF and controls, respectively. Spearman's rank coefficient was decisive in determining the association between patient-reported outcome measures and disease-related features. Two hundred twenty-five (59.3% female) patients and 182 (51.6% female) healthy counterparts were enrolled in the study. In PSQI, where high scores indicate sleep disturbance, the median score was significantly higher in the patient group (5; 3-6) than the control group (3; 2-4) (p < 0.001). PEDsQL-MFS demonstrated significantly lower fatigue levels in the control group than patients (p = 0.01). The level of fatigue in the patient group was found to increase in correlation with sleep problems (r: - 0.750, p < 0.001). Additionally, a high correlation was present between the PSQI/PedsQL-MFS scores and the number of attacks in the last year (r: - 0.645, p < 0.001/r: 0.721, p < 0.001, respectively). There was no difference in terms of fatigue and sleep disorders between mutations (homozygous, heterozygous, or compound heterozygous) in the MEFV gene (p > 0.05).    Conclusion: High disease activity has a significant negative impact on the sleep quality and fatigue levels of patients with FMF. This study emphasizes the importance of assessing fatigue and sleep quality with objective outcome tools periodically in FMF patients throughout the disease course. What is Known: • Fatigue is a common matter that often accompanies rheumatic diseases and causes disability. • Chronic rheumatic diseases often experience poor sleep quality. What is New: • In high correlation with the disease severity of familial Mediterranean fever, sleep quality decreases and fatigue level increases significantly. • In familial Mediterranean fever patients, a negative correlation is present between age and the general fatigue and sleep/rest related fatigue scores (low scores indicating greater fatigue) and sleep quality is poorer in the adolescent age group.

Sleep and Healthy Aging: A Systematic Review and Path Forward

OBJECTIVES

The purpose of this systematic review was to synthesize research examining the cross-sectional and longitudinal associations between sleep and healthy aging in late-life.

METHODS

A systematic search was conducted via both PubMed and PsychINFO databases using terms related to "sleep" and "healthy aging." Studies which examined the association between healthy aging and one or more sleep parameters were included in the present review.

RESULTS

Fourteen relevant studies, nine cross-sectional and five longitudinal, were identified. Overall, cross-sectional studies revealed that positive indicators of sleep were generally associated with a greater likelihood of healthy aging. In contrast, a limited number of existing longitudinal studies revealed mixed and inconclusive results.

CONCLUSIONS

Findings suggest that adequate sleep is more likely to coincide with relevant markers of healthy aging in late-life and underscores the need for additional research investigating the longitudinal associations between sleep and healthy aging.

CLINICAL IMPLICATIONS

Healthy sleep, consisting of moderate sleep duration and good quality, shows promise for the promotion of healthy aging. Consequently, poor sleep should be identified and intervened upon when necessary.

navy shipboard infrastructure for sleep monitoring with wearable technology

Development of fatigue management solutions is critical to U.S. Navy populations. This study explored the operational feasibility and acceptability of commercial wearable devices (Oura Ring and ReadiBand) in a warship environment with 845 Sailors across five ship cohorts during at-sea operations ranging from 10 to 31 days. Participants were required to wear both devices and check-in daily with research staff. Both devices functioned as designed in the environment and reliably collected sleep-wake data. Over 10,000 person-days at-sea, overall prevalence of Oura and ReadiBand use was 69% and 71%, respectively. Individual use rates were 71 ± 38% of days underway for Oura and 59 ± 34% for ReadiBand. Analysis of individual factors showed increasing device use and less device interference with age, and more men than women found the devices comfortable. This study provides initial support that commercial wearables can contribute to infrastructures for operational fatigue management in naval environments.

Effects of daily sleep on physical activity after cardiac surgery

BACKGROUND

Maintaining physical activity is challenging after cardiac surgery. Postsurgical cardiac patients often experience sleep problems showing a reciprocal interaction with physical activity. As sleep and physical activity show day-to-day variations, their daily relationships need to be assessed. However, no studies have examined daily sleep-physical activity relationships in postsurgical cardiac patients.

OBJECTIVES

This study aimed to examine the effects of daily sleep factors on daily physical activity after cardiac surgery.

METHODS

Among 33 patients who underwent cardiac surgery at least 10 weeks earlier, 5 sleep and 4 physical activity variables were measured using a wrist-worn ActiGraph for 7 days. Mixed-effects models were applied for data analyses.

RESULTS

Most participants were male (57.6 %), non-Hispanic whites (63.6 %) who had coronary artery bypass graft surgery (54.6 %). Participants averaged 60.8 ± 10.1 years of age and 85.7 ± 91.2 months since surgery. They slept for an average of 385.6 ± 74.6 min (6.4 ± 1.2 h). Among sleep factors, greater number of awakenings (NOA) predicted lower next-day sedentary time. Higher sleep efficiency (SE) was associated with lower next-day sedentary time when not controlling for covariates. Among the psychosocial, demographic, and clinical covariates, higher comorbidity index was associated with fewer kcals expended, less daily moderate-to-vigorous physical activity, and more daily sedentary time.

CONCLUSIONS

Daily SE and NOA and individual health status, including comorbidity, should be assessed over time to support improvement of daily physical activity after cardiac surgery. Researchers should examine the relationship between NOA and next-day sedentary time with larger samples. Such research should address multiple psychosocial, demographic, and clinical factors and the potential mediating role of sleep.

Cardiac autonomic nervous activity during different sleep stages in individuals with spinal cord injury: The influence of physical training

OBJECTIVE

The present study assessed the influence of physical training on cardiac autonomic activity in individuals with spinal cord injury (SCI) during different sleep stages.

METHODS

Twenty-six volunteers were allocated into three groups: 9 sedentary individuals without SCI (control, CON); 8 sedentary tetraplegic individuals with chronic SCI (SED-SCI); 9 physically trained tetraplegic individuals with chronic SCI (TR-SCI). All participants underwent nocturnal polysomnography to monitor sleep stages: wakefulness, non-rapid eye movement (NREM) sleep (N1, N2, and N3 stages), and REM sleep. The electrocardiography data obtained during this exam were extracted to analyze the heart rate variability (HRV).

RESULTS

Sleep stages influenced HRV in the time [RR interval and root mean square of successive RR interval differences (RMSSD)] and frequency [low-frequency (LF) and high-frequency (HF) powers and LF-to-HF ratio] domains (P < 0.05). SED-SCI individuals showed unchanged HRV compared to CON (P > 0.05). When comparing the TR-SCI and SED-SCI groups, no significant differences in HRV were reported in the time domain (P > 0.05). However, in the frequency domain, more accentuated HF power was observed in TR-SCI than in SED-SCI individuals during the N2 and N3 stages and REM sleep (P < 0.05). Moreover, TR-SCI had higher HF power than CON during the N3 stage (P < 0.05).

CONCLUSIONS

TR-SCI individuals have greater HF power, indicative of parasympathetic modulation, than sedentary (injured or not injured) individuals during different sleep stages. Therefore, enhanced parasympathetic activity induced by physical training may improve cardiac autonomic modulation during sleep in individuals with chronic SCI.

Effects of chronotype on sleep, mood and cardiovascular circadian rhythms in rotating night shift medical workers

PURPOSE

Whether chronotype affects the health outcomes of night shift work populations is unknown. This study aimed to assess the influence of different chronotypes in the rotating night shift population on sleep status, mood, blood pressure (BP), and heart rate variability (HRV), as well as the circadian rhythm of BP and HRV.

METHODS

A total of 208 rotating night shift workers were included. All participants completed structured questionnaires to assess chronotype, mood and sleep status. During their daily lives outside of the night shift, they underwent 24-hour Holter electrocardiogram monitoring and 24-hour ambulatory blood pressure monitoring. Day-time and night-time BP and BP dipping were obtained. Day-time and night-time HRV values (SDNN, RMSSD, LF, HF, LF nu, SD1, SD2 and SD2/SD1) were calculated and fitted to the cosine period curve. Three circandian parameters (mesor, amplitude and acrophase) were extracted to quantify the circadian rhythm of the HRV indices.

RESULTS

Among all three groups, E-type showed more fatigue and sleepiness. In addition, E-type showed blunted diastolic BP dipping. Notably, E-type showed association with higher RMSSD, LF, HF and SD1 in the night time, and higher mesors of RMSSD and LF and amplitude of SD2/SD1 in circadian analysis.

CONCLUSION

Chronotype is a factor affecting fatigue, sleepiness and cardiovascular circadian rhythms of rotating night shift workers. Chronotype should be taken into consideration for managing night-shift rotation to promote occupational health.

Associations between sleep and appetitive traits in higher-income preschoolers: A six-month study

BACKGROUND

Short sleep is consistently linked with childhood obesity, possibly via disrupting appetite hormones and increasing food responsiveness. Few studies have objectively examined this association in early childhood.

OBJECTIVE

To evaluate associations of sleep quantity and quality with child appetitive traits and eating in the absence of hunger (EAH) in a higher-income cohort of 86 preschool-age children (age 4.0 ± 0.8 years; 42% female; 93% non-Hispanic white, Northern New England, US).

METHODS

Children's sleep duration and quality were assessed via parent report (Children's Sleep Habits Questionnaire, CSHQ) at baseline and 6-month follow-up and via accelerometry at baseline. Parents also completed the Child Eating Behaviors Questionnaire to assess the child's appetitive traits. EAH, an objective measure of overeating, was observed at baseline during an in-person visit. Associations between sleep measures and appetitive traits were examined with linear mixed-effect or linear regression models, as appropriate, adjusting for child age, sex, and household income.

RESULTS

Shorter sleep duration per parent report was associated with less satiety responsiveness (standardized ß = 0.14, 95% CI: 0.01, 0.26; p = 0.03). Further, satiety responsiveness was inversely related to EAH (Pearson's r = -0.35, p = 0.02). No associations were found between accelerometer-measured sleep parameters and appetitive traits, and no sleep measures were related to EAH.

CONCLUSIONS

Shorter usual sleep, per the parent report, was cross-sectionally associated with reduced satiety responsiveness in this sample of higher-income preschoolers. Future studies should consider whether socioeconomic status may modify the impact of poor sleep on appetitive traits in early childhood.

Age Moderates the Relation between Sleep Problems and Suicide Risk

OBJECTIVES

This cross-sectional study examined whether age moderates the relation between sleep problems and suicide risk and investigated whether sleep problems are differentially associated with suicide risk in younger (18-40) and older (60+) adults.

METHODS

MTurk workers (N = 733) completed the Pittsburgh Sleep Quality Index, Suicidal Behavior Questionnaire-Revised, Patient Health Questionnaire, and demographic questions. Analysis of variance and linear regressions were utilized.

RESULTS

Older adults scored lower on four PSQI components, symptoms of depression, and suicide risk than younger adults. Age significantly moderated the relation between sleep problems and suicide risk after controlling for gender and depressive symptoms, F(5, 635) = 72.38, p < .001. Sleep problems significantly related to suicide risk in younger adults (t = 6.47, p < .001) but not in older adults (t = 0.57, p = .57). Sleep medication use was related to suicide risk in both groups, whereas daytime dysfunction was related to suicide risk in older adults and sleep disturbances were related to suicide risk in younger adults.

CONCLUSIONS

The relation between sleep problems and suicide risk differs between younger and older adults. This study adds to the literature suggesting that sleep medications may not be appropriate for older adults.

CLINICAL IMPLICATIONS

Sleep problems are significantly related to suicide risk in younger adults but not older adults. Sleep medication use is associated with suicide risk regardless of age.

Weight loss and lifestyle intervention for cardiorespiratory fitness in obstructive sleep apnea: The INTERAPNEA trial

INTRODUCTION

Although recent trials have shown benefits of weight loss and lifestyle interventions on obstructive sleep apnea (OSA) severity and comorbidities, the effect of these interventions on cardiorespiratory fitness (CRF) remains unknown. This study aimed to investigate the effects of an interdisciplinary weight loss and lifestyle intervention on CRF and self-reported physical fitness in adults with OSA.

METHODS

Eighty-nine men aged 18-65 years with moderate-to-severe OSA and a body mass index ≥25 kg/m2 were randomly assigned to a usual-care group or an 8-week interdisciplinary weight loss and lifestyle intervention. CRF was assessed through the 2-km walking test, and the International Fitness Scale (IFIS) was used to assess self-reported physical fitness.

RESULTS

As compared with usual-care, the intervention group had greater improvements at intervention endpoint in objective CRF (6% reduction in 2-km walking test total time, mean between-group difference, -1.7 min; 95% confidence interval, -2.3 to -1.1), and self-reported overall physical fitness (18% increase in IFIS total score, mean between-group difference, 2.3; 95% CI 1.2 to 3.3). At 6 months after intervention, the intervention group also had greater improvements in both 2-km walking test total time (10% reduction) and IFIS total score (22% increase), with mean between-group differences of -2.5 (CI 95%, -3.1 to -1.8) and 3.0 (CI 95%, 1.8 to 4.1), respectively.

CONCLUSIONS

An 8-week interdisciplinary weight loss and lifestyle intervention resulted in significant and sustainable improvements in CRF and self-reported physical fitness in men with overweight/obesity and moderate-to-severe OSA.

STUDY REGISTRATION

ClinicalTrials.gov registration (NCT03851653).

Associations of meeting 24-hour movement behavior guidelines with prescribed eyeglasses/contact lenses among children and adolescents

BACKGROUND

Vision health is crucial for many aspects of life especially in developing populations such as children and adolescents. However, there is a high proportion of children and adolescents who suffer from visual impairments. Notably, accumulating evidence indicates that meeting the 24-hour movement behaviors (24-HMB) guidelines is associated with positive physical and mental health outcomes in children and adolescents. However, the relationship between being prescribed eyeglasses/contact lenses and meeting the 24-HMB guidelines has yet to be investigated. Thus, this study aimed to address this gap in the existing literature by using the 2021 National Survey of Children's Health (NSCH) dataset.

METHODS

In this cross-sectional study, data was retrieved from the 2021 NSCH. A total of 14,193 U.S. children and adolescents aged between 6 and 17 years were included for data analyses. We used items of the NSCH concerning the 24-HMB guidelines (i.e., physical activity, screen time, and sleep duration) and prescription of eyeglasses/contact lenses that were answered by the legal guardian of the children. Binary logistic regression was performed to investigate whether meeting the 24-HMB guidelines is associated with prescription eyeglasses/contact lenses and whether wearing eyeglasses/contact lenses predicts adherence to the 24-HMB guidelines among children and adolescents.

RESULTS

More than half of the participants (59.53%) wore eyeglasses/contact lenses and only 8.40% of them met all three of the 24-HMB guidelines. Compared to meeting none of the 24-HMB guidelines, meeting one (OR = 0.76, 95% CI = 0.62-0.93, p = 0.008), two (OR = 0.54, 95% CI = 0.43-0.67, p < 0.001), and all three 24-HMB guidelines (OR = 0.47, 95% CI = 0.34-0.64, p < 0.001) were associated with a lower risk of being prescribed eyeglasses/contact lenses among children and adolescents.

CONCLUSIONS

The findings of the current study provided evidence that the prevalence of U.S. children and adolescents aged between 6 and 17 years who wore eyeglasses/contact lenses was relatively high. Furthermore, meeting the 24-HMB guidelines was associated with a lower risk of being prescribed eyeglasses/contact lenses. Future studies focusing on the effects of 24-HMB interventions on vision health among children and adolescents are needed to better inform public health actions.

Overnight Heart Rate Variability During Sleep Disturbance In Peri- And Postmenopausal Women

OBJECTIVES

Disturbed sleep, common during the climacteric, is associated with increased sympathetic activity, a cardiovascular risk factor. We evaluated sleep disturbance effect on autonomic nervous function in climacteric women.

METHODS

Seventeen perimenopausal and 18 postmenopausal women underwent a sleep study protocol: an adaptation night, a reference night, and a sleep disturbance night, with a hand loosely tied to the bed to allow blood sampling. This procedure was repeated after six months of menopausal hormone therapy (MHT) or placebo. Sleep disturbance and MHT effects on overnight heart rate variability (HRV) were analyzed.

RESULTS

At baseline, sleep disturbance increased vagal HRV in postmenopausal women, but no changes were seen in perimenopausal women. At six months, sleep disturbance increased total HRV power in the perimenopausal placebo group, and increased nonlinear vagal HRV in the postmenopausal placebo group, but no other changes were seen. MHT did not have any effects on HRV, neither at perimenopause nor at postmenopause.

CONCLUSIONS

External sleep disturbance had only minor effects on HRV across menopause. MHT had no detectable HRV effects.

Identifying infants at risk of sudden unexpected death with an automated predictive risk model

BACKGROUND/OBJECTIVE

Sudden unexpected infant death (SUID) is a common cause of infant death. We evaluated whether a predictive risk model (PRM) - Hello Baby - which was developed to stratify children by risk of entry into foster care could also identify infants at highest risk of SUID and non-fatal unsafe sleep events.

PARTICIPANTS AND SETTING

Cases: Infants with SUID or an unsafe sleep event over 5½ years in a single county.

CONTROLS

All births in the same county.

METHODS

Retrospective case-control study. Demographic and clinical data were collected and a Hello Baby PRM score was assigned. Descriptive statistics and the predictive value of a PRM score of 20 were calculated.

RESULTS

Infants with SUID (n = 62) or an unsafe sleep event (n = 37) (cases) were compared with 23,366 births (controls). Cases and controls were similar for all demographic and clinical data except that infants with unsafe sleep events were older. Median PRM score for cases was higher than controls (17.5 vs. 10, p < 0.001); 50 % of cases had a PRM score 17-20 vs. 16 % of controls (p < 0.001).

CONCLUSIONS

The Hello Baby PRM can identify newborns at high risk of SUID and non-fatal unsafe sleep events. The ability to identify high-risk newborns prior to a negative outcome allows for individualized evaluation of high-risk families for modifiable risk factors which are potentially amenable to intervention. This approach is limited by the fact that not all counties can calculate a PRM or similar score automatically.

Leptin moderates the relationship between sleep quality and memory function: A population-based study

Sleep is crucial for memory, as it promotes its encoding, consolidation, storage, and retrieval. Sleep periods following learning enhance memory consolidation. Leptin, a hormone that regulates appetite and energy balance, also influences memory and neuroplasticity. It plays a neurotrophic role in the hippocampus, enhancing synaptic function and promoting memory processes. Given these associations between sleep, memory, and leptin, this study aimed to evaluate the interplay between sleep quality, memory complaints and leptin levels. Using data from the São Paulo Epidemiologic Sleep Study (EPISONO) 2007 edition, we analyzed data from 881 participants who underwent evaluations for subjective sleep quality (Pittsburgh Sleep Quality Index), memory function (Prospective and Retrospective Memory Questionnaire), body mass index and plasmatic leptin levels. After confirming that subjects with poor sleep quality had more memory complaints in our cohort, we observed that leptin levels were increased in individuals with more memory complaints, but there was no association between leptin levels and sleep quality. Mediation analysis reinforced the direct effect of sleep quality on memory function, but leptin had no indirect effect as mediator over the sleep-memory association. Moderation analysis revealed that leptin acted as a moderator in the relationship between sleep quality and memory, with increased leptin levels enhancing the effect of sleep quality over memory function. These findings underscore the intricate interplay between sleep, memory, and metabolic factors like leptin, shedding light on potential mechanisms through which sleep influences memory and cognitive functions. Further research is needed to elucidate the exact mechanisms underlying these relationships and their implications for overall health and well-being.

A population-based study exploring association of parasomnia symptoms with sleep onset delay among school-aged children

OBJECTIVE

Parasomnia is potentially implicated in sleep pattern and sleep architecture, however, evidence is quite limited. This study aimed to investigate the association between parasomnia symptoms and sleep onset delay among children through a large epidemiological study.

METHODS

Two rounds of cross-sectional studies were conducted among 21,704 children aged 3-11; one taking place in Shanghai and the other in Sanya, Hainan province. Children's sleep characteristics were evaluated using the Children's Sleep Habits Questionnaire (CSHQ). Propensity score matching was adopted to balance the difference of covariates, and the logistic regression models were implemented to examine the associations between parasomnia symptoms and sleep onset delay.

RESULTS

A total of 38.2 % of children had sleep onset delay. Parasomnias, especially non rapid eye movement (NREM) and rapid eye movement (REM) parasomnia symptoms, were associated with an increased risk of sleep onset delay (Sleep Walking: OR = 1.55; Sleep Terror: OR = 1.34; Nightmare: OR = 1.37, all p˂0.001). The similar findings were observed in stratified analyses according to sleep duration, and the association was pronounced in sleep sufficiency group (Sleep Walking: OR = 1.62; Sleep Terror: OR = 1.35; Nightmare: OR = 1.35, all p˂0.001). Moreover, a dose-dependent pattern was observed, in which cumulative parasomnia symptoms were associated with increasing risk of sleep onset delay (2 symptoms: OR = 1.19; ≥3 symptoms: OR = 1.40; by comparison with ≤1 symptom). All these findings were also similarly observed in the propensity score matching sample. Moreover, the associations were generally established in both Shanghai and Sanya children.

CONCLUSIONS

Parasomnia symptoms were associated with a higher risk of sleep onset delay independently of sleep duration among children. More studies are needed to enrich the current evidence, thus further clarifying the association and interaction among different sleep parameters.

The effects of childhood trauma on stress-related vulnerability factors and indicators of suicide risk: An ecological momentary assessment study

BACKGROUND

Childhood trauma is experienced by approximately one third of young people in the United Kingdom and has been shown to confer an increased risk for mental health difficulties in adulthood. Understanding the associations between these factors before negative health outcomes manifest in adulthood is imperative to help inform the development of interventions. The aims of this study were two-fold; first, to investigate the effects of childhood trauma on daily stress-related vulnerability factors over a period of 7 days and to test whether any observed relationships were moderated by protective or risk factors. Second, to explore the indirect effects of childhood trauma on reasons for living, optimism, daily suicide ideation, defeat and entrapment through the daily stress-related vulnerability factors.

METHODS

212 participants were recruited to an ecological momentary assessment study to complete three diaries per day for a 7-day period. Participants completed daily measures of stress, hassles, executive functioning, impulsivity, sleep quality (stress-related vulnerability factors) as well as measures of reasons for living, optimism, daily thoughts of suicide, defeat and entrapment. The Childhood Trauma Questionnaire was also completed at baseline.

RESULTS

Analyses found that childhood trauma was significantly associated with higher scores on the daily stress-related vulnerability factors and positively related to each of the daily indicators of suicide risk. The study also uncovered key pathways whereby trauma had indirect effects on reasons for living, optimism, daily thoughts of suicide, defeat and entrapment through executive functioning, impulsivity, sleep quality and stress.

LIMITATIONS

The measures of executive function and sleep were self-reported and future research ought to replicate the current findings using more objective methods.

DISCUSSION

The findings from this study highlight the complexity of childhood trauma and its damaging effects on stress-related vulnerability factors and poorer mental health outcomes. Greater understanding of pathways by which trauma may impact later health outcomes is essential for development of interventions.

Associations between immune biomarkers and symptoms of anxiety, depression, and insomnia in paediatric inflammatory bowel disease: A preliminary longitudinal analysis

Innate immunity may influence the onset of affective symptoms and alter sleep patterns in chronic inflammatory conditions. Here, we tested the prospective associations between baseline serum C-reactive protein (CRP), albumin, and CRP/albumin ratio (CAR, i.e., an emerging biomarker of disease activity), and self-reported symptoms of anxiety, depression, and insomnia at 1-year follow up in paediatric inflammatory bowel disease (n = 17). After controlling for baseline values, CAR (ρ = 0.591, p = 0.026) predicted anxiety symptoms, while albumin predicted both anxiety (ρ = -0.687, p = 0.007) and insomnia symptoms (ρ = -0.648, p = 0.012). Current findings preliminarily suggest that inflammation may influence anxiety and sleep disturbance in paediatric IBD.

Association between sleep duration and quality with food intake, chrononutrition patterns, and weight gain during pregnancy

To analyse the association between sleep duration and quality with food intake, chrononutrition patterns, and weight gain during pregnancy. A prospective cohort study was conducted with 100 pregnant women. Data collection occurred once during each gestational trimester. The assessment of sleep quality and duration was performed using the Pittsburgh Sleep Quality Index. Food intake was assessed using three 24-h recalls in each trimester. Body weight was measured during the three trimesters, and height was measured only once to calculate the BMI. Linear regression analyses were performed to associate sleep duration and quality with food consumption and weight gain variables. Longer sleep duration was associated with a later dinner in the first trimester (β = 0·228, P = 0·025) and earlier in the third trimester (β = -0·223, P = 0·026), in addition to a later morning snack in the second trimester (β = 0·315, P = 0·026). Worse sleep quality was associated with higher total energy intake (β = 0·243, P = 0·044), total fat (β = 0·291, P = 0·015) and the chrononutrition variables such as a higher number of meals (β = 0·252, P = 0·037), higher energetic midpoint (β = 0·243, P = 0·044) and shorter fasting time (β = -0·255, P = 0·034) in the third trimester. Sleep quality was also associated with a higher BMI in the first trimester of pregnancy (β = 0·420, P = < 0·001). Most of the associations found in the present study show that poor sleep is associated with higher energy and fat intake and higher BMI. Longer sleep duration was associated with a later dinner in early pregnancy and an earlier dinner in late pregnancy, as well as with a later morning snack in the second trimester of pregnancy.

Reliability and validity of rapid assessment tools for measuring 24-hour movement behaviours in children aged 0-5 years: the Movement Behaviour Questionnaire Baby (MBQ-B) and child (MBQ-C)

BACKGROUND

The development of validated "fit-for-purpose" rapid assessment tools to measure 24-hour movement behaviours in children aged 0-5 years is a research priority. This study evaluated the test-retest reliability and concurrent validity of the open-ended and closed-ended versions of the Movement Behaviour Questionnaire for baby (MBQ-B) and child (MBQ-C).

METHODS

300 parent-child dyads completed the 10-day study protocol (MBQ-B: N = 85; MBQ-C: N = 215). To assess validity, children wore an accelerometer on the non-dominant wrist (ActiGraph GT3X+) for 7 days and parents completed 2 × 24-hour time use diaries (TUDs) recording screen time and sleep on two separate days. For babies (i.e., not yet walking), parents completed 2 × 24-hour TUDs recording tummy time, active play, restrained time, screen time, and sleep on days 2 and 5 of the 7-day monitoring period. To assess test-retest reliability, parents were randomised to complete either the open- or closed-ended versions of the MBQ on day 7 and on day 10. Test-retest intraclass correlation coefficients (ICC's) were calculated using generalized linear mixed models and validity was assessed via Spearman correlations.

RESULTS

Test-retest reliability for the MBQ-B was good to excellent with ICC's ranging from 0.80 to 0.94 and 0.71-0.93 for the open- and closed-ended versions, respectively. For both versions, significant positive correlations were observed between 24-hour diary and MBQ-B reported tummy time, active play, restrained time, screen time, and sleep (rho = 0.39-0.87). Test-retest reliability for the MBQ-C was moderate to excellent with ICC's ranging from 0.68 to 0.98 and 0.44-0.97 for the open- and closed-ended versions, respectively. For both the open- and closed-ended versions, significant positive correlations were observed between 24-hour diary and MBQ-C reported screen time and sleep (rho = 0.44-0.86); and between MBQ-C reported and device-measured time in total activity and energetic play (rho = 0.27-0.42).

CONCLUSIONS

The MBQ-B and MBQ-C are valid and reliable rapid assessment tools for assessing 24-hour movement behaviours in infants, toddlers, and pre-schoolers. Both the open- and closed-ended versions of the MBQ are suitable for research conducted for policy and practice purposes, including the evaluation of scaled-up early obesity prevention programs.

Analyzing the Quality of Life in Individuals with Fragile X Syndrome in Relation to Sleep and Mental Health

The purpose of this paper was to examine the physical, emotional, social and school functioning domains of quality of life of individuals with Fragile X Syndrome, in relation to mental health and sleep patterns to gain a better understanding of how these aspects are affected by the disorder. This study included 119 individuals with Fragile X Syndrome who were given different cognitive examinations by a neuropsychologist or by parent-proxy questionnaires. This study focused on the Pediatric Quality of Life Inventory (PedsQoL), the Anxiety, Depression and Mood Scale (ADAMS), the Children's Sleep Habits Questionnaire (CSHQ), but did include other cognitive tests (Vineland Adaptive Behaviour Scales, Nonverbal IQ, Autism Diagnostic Observation Schedule). We identified significant associations between decreases in emotional, social and school domains of PedsQoL and the ADAMS subtests of Generalized Anxiety, Manic/Hyperactivity and Obsessive/Compulsivity, with the subtest of Depressed Mood having associations with lower physical and emotional domains. We also identified a significant impact between CSHQ subtests of Sleep Anxiety, Night Wakings, Daytime Sleepiness, and Parasomnia with the emotional and school domains of PedsQoL. There were associations connecting school functioning with Bedtime Resistance, and additional associations connecting emotional functioning with Sleep Duration and Sleep Onset Delay. Physical functioning was also associated with Sleep Anxiety. Our study shows how mental health and sleep defects impact improper sleep patterns and mental health which leads to decreases in the quality of life for individuals with FXS, and how it is important to screen for these symptoms in order to alleviate issues.

Testing the Reliability and Validity of the Korean Version of the Pittsburgh Sleep Quality Index Using Fitbit Devices: A Cross-Sectional Analysis

Background

Sleep disorders and insomnia are prevalent worldwide, with negative health outcomes. The Pittsburgh Sleep Quality Index (PSQI) is a widely used self-report assessment tool for evaluating sleep quality, comprising seven subdomains. The Korean version of the PSQI (PSQI-K) has been tested for reliability and validity in small sample sizes but lacks large-scale validation using objective measures.

Methods

This study was conducted with 268 Korean adults attending health check programs. Participants completed the PSQI-K questionnaire and wore Fitbit devices (Fitbit Inc., USA) to ascertain sleep parameters. Reliability was analyzed using the Cronbach's α coefficient, and construct validity was determined through factor analysis. Criteria validity was assessed by correlating their index scores with Fitbit sleep parameters. We identified the optimal cutoff for detecting sleep disorders.

Results

The Cronbach's α coefficient was 0.61, indicating adequate internal consistency. Factor analysis revealed three factors, explaining 48.2% of sleep quality variance. The index scores were negatively correlated with Fitbit sleep efficiency, total sleep time, and number of awakenings (P<0.05). The optimal cutoff point for identifying sleep disorder groups was ≥6.

Conclusion

The PSQI-K demonstrated good reliability and validity when correlated with Fitbit sleep parameters, offering a practical screening tool for identifying sleep disorders among Korean adults. Cutoff scores can help identify patients for sleep interventions. However, further large-scale studies are required to validate these findings.

The association of the 24-hour activity cycle profiles with cognition in older adults with mild cognitive impairment: A cross-sectional study

BACKGROUND

The relationship of cognition and the 24-hour activity cycles (24-HAC), encompassing physical activity, sedentary behaviour, and sleep, in older adults with mild cognitive impairment (MCI) remains uncertain. Distinct combinations of 24-HAC behaviours can characterize unique activity profiles and influence cognition. We aimed to characterize 24-HAC activity profiles in older adults with MCI and assess whether differences in cognition exist across profiles.

METHODS

We conducted a cross-sectional analysis utilizing baseline data from three randomized controlled trials involving 253 community-dwelling older adults (55+ years) with MCI (no functional impairment, dementia diagnosis, and Montreal Cognitive Assessment score <26/30). Using MotionWatch8© wrist-worn actigraphy (+5 days), we captured the 24-HAC. Cognition was indexed by the Alzheimer's Disease Assessment Scale Cognitive Plus (ADAS-Cog-Plus). Compositional data and latent profile analyses identified distinct 24-HAC activity profiles. Analysis of covariance examined whether 24-HAC activity profiles differed in cognition.

RESULTS

Four distinct activity profiles were identified. Profile 1 ("Average 24-HAC," n=108) engaged in all 24-HAC behaviours around the sample average. Profile 2 ("Active Chillers," n=64) depicted lower-than-average engagement in physical activity and higher-than-average sedentary behaviour. Profile 3 ("Physical Activity Masters," n=56) were the most active and the least sedentary. Profile 4 ("Sedentary Savants," n=25) were the least active and the most sedentary. Sleep was similar across profiles. There were no significant differences in ADAS-Cog-Plus scores between 24-HAC activity profiles (p>0.05).

CONCLUSION

Older adults with MCI exhibited four 24-HAC activity profiles conforming to recommended physical activity and sleep guidelines. Nonetheless, cognition was similar across these profiles.

Exploring relationship of poor sleeping habits with prenatal stress among pregnant women in Pakistan: a cross-sectional study

OBJECTIVE

Pregnancy is a complex phenomenon accompanied by biological, physiological and psychosocial changes for a mother. It is also regarded as a stressful life event where a woman's role, identity and interpersonal relationships are restructured. The present study from Pakistan explores the association of sleep quality and poor sleeping habits with prenatal stress using Pittsburgh Sleep quality Index.

RESULTS

There were a total of 516 women (mean age = 29.82 years), with more than half reporting poor sleep quality. Ethnically, a majority (395, 76.6%) were natives of the Punjab province while rest were non-natives. A high percentage of respondents reported poor subjective sleep quality (22.1%), sleep latency (44.1%), habitual sleep efficiency (27.5%), sleep disturbance (30.1%), use of medications (7.1%) and daytime dysfunction (29.5%). According to logistic regression analysis, respondents with poor sleep quality were 2.24 (95% CI = 1.55-3.22, P < 0.001) times more likely to have high stress levels (P < 0.001).

Effectiveness of an online recovery training for employees exposed to blurred boundaries between work and non-work: Bayesian analysis of a randomised controlled trial

BACKGROUND

Blurred work-non-work boundaries can have negative effects on mental health, including sleep.

OBJECTIVES

In a randomised control trial, we aimed to assess the effectiveness of an online recovery training programme designed to improve symptoms of insomnia in a working population exposed to blurred boundaries.

METHODS

128 participants with severe insomnia symptoms (Insomnia Severity Index ≥15) and working under blurred work and non-work conditions (segmentation supplies <2.25) were randomly assigned to either the recovery intervention or a waitlist control group (WLC). The primary outcome was insomnia severity, assessed at baseline, after 2 months (T2) and 6 months (T3).

FINDINGS

A greater reduction in insomnia was observed in the intervention compared with the WLC group at both T2 (d=1.51; 95% CI=1.12 o 1.91) and T3 (d=1.63; 95% CI=1.23 to 2.03]. This was shown by Bayesian analysis of covariance (ANCOVA), whereby the ANCOVA model yielded the highest Bayes factor (BF 10=3.23×e60] and a 99.99% probability. Likewise, frequentist analysis revealed significantly reduced insomnia at both T2 and T3. Beneficial effects were found for secondary outcomes including depression, work-related rumination, and mental detachment from work. Study attrition was 16% at T2 and 44% at T3.

CONCLUSIONS

The recovery training was effective in reducing insomnia symptoms, work related and general indicators of mental health in employees exposed to blurred boundaries, both at T2 and T3.

CLINICAL IMPLICATIONS

In addition to demonstrating the intervention's effectiveness, this study exemplifies the utilisation of the Bayesian approach in a clinical context and shows its potential to empower recipients of interventional research by offering insights into result probabilities, enabling them to draw informed conclusions.

TRIAL REGISTRATION NUMBER

German Clinical Trial Registration (DRKS): DRKS00006223, https://drks.de/search/de/trial/DRKS00006223.

Parents' perceptions of factors influencing sleep in pediatric intensive care units: A qualitative study

PURPOSE

The purpose of this study is to explore factors influencing sleep in pediatric intensive care units as perceived by parents of critically ill children.

DESIGN AND METHODS

This descriptive qualitative study used individual semistructured interviews. Parents were recruited through purposive sampling from two pediatric intensive care units at two locations in one university hospital in Norway. Ten parents were interviewed. The interviews were analyzed using a six-phase reflexive thematic analysis.

FINDINGS

The analysis produced 17 subthemes under four main themes: environmental factors in the pediatric intensive care unit disturb children's sleep, children need trust and safety to sleep, nurses' cooperation with parents influences children's sleep, and nurses' structuring of their practices is fundamental to sleep promotion.

CONCLUSION

The parents found that the environment disturbed their children's sleep, and environmental factors were easier to control in single rooms than in multibed rooms. Children slept better when they felt safe and trusted the nurses, and parents desired more cooperation in promoting sleep for their children, which may be an essential and overlooked part of sleep promotion. Nurses varied considerably in how they prioritized sleep and structured their practices to promote sleep.

PRACTICE IMPLICATIONS

Nurses should take parents' experiences into account to better promote sleep for patients. By limiting environmental disturbances, building relationships with children to make them feel safe, including parents in sleep promotion, and prioritizing sleep in their practices, nurses could improve sleep quality and limit the consequences of sleep disturbance.

Sleep quality and screen time among university professors: impact of emergency remote teaching amidst COVID-19 crisis

PURPOSE

Sleep plays a crucial role in maintaining physical and mental health. The COVID-19 pandemic has brought about unprecedented global changes, and disruptions in sleep quality have emerged as a challenge. The pandemic prompted a dramatic shift in the working landscape for university professors, necessitating emergency remote teaching (ERT). This transition substantially increased professors' screen time for academic and research endeavors. This study explores the relationship between screen time and sleep quality among university professors during the pandemic and examines associated factors, including psychological well-being.

METHODS

An electronic survey, covering demographics, education, screen time, sleep quality, and mental health, was administered to professors who worked during the spring semester of 2020. Standardized measures were used to assess sleep quality and mental health. Correlations, Mann-Whitney tests, and multivariate regression explored associations between screen time, sleep quality, and other variables.

RESULTS

One hundred sixty participants exhibited poor sleep quality, subthreshold insomnia, and mild depression. Increased screen time correlated with poorer sleep quality, elevated stress levels, and heightened depression severity. Evening screen users reported more insomnia than daytime users. Depression emerged as a significant predictor of poor sleep quality and insomnia, along with evening screen use.

CONCLUSION

This study among university professors underscores the impact of screen time on sleep quality during the COVID-19 pandemic. Participants faced poor sleep, largely influenced by heightened screen time due to ERT. Considering these findings, this study emphasizes the importance of curbing daytime screen exposure and abstaining from screens in the evening, especially for university professors reliant on technology for their professional responsibilities.

Clusters of 24-hour movement behavior and diet and their relationship with health indicators among youth: a systematic review

Movement-related behaviors (physical activity [PA], sedentary behavior [SB], and sleep) and diet interact with each other and play important roles in health indicators in youth. This systematic review aimed to investigate how PA, SB, sleep, and diet cluster in youth by biological sex; and to examine which cluster are associated with health indicators. This study was registered in PROSPERO (number: CRD42018094826). Five electronic databases were assessed. Eligibility criteria allowed studies that included youth (aged 19 years and younger), and only the four behaviors {PA, SB, sleep, and diet (ultra-processed foods [UPF]; fruits and vegetables [FV])} analyzed by applying data-based cluster procedures. From 12,719 articles screened; 23 were included. Of these, four investigated children, and ten identified clusters by biological sex. Sixty-six mixed cluster were identified including, 34 in mixed-sex samples, 10 in boys and 11 in girls. The most frequent clusters in mixed-sex samples were "High SB UPF Low Sleep", "Low PA High SB Satisfactory Sleep", and "High PA". The main difference in profiles according to sex was that girls' clusters were characterized by high sleep duration, whereas boys' clusters by high PA. There were a few associations found between cluster types and health indicators, highlighting that youth assigned to cluster types with low PA exhibited higher adiposity. In conclusion, the youth presented a range of clusters of behaviors, typically exhibiting at least one unhealthy behavior. Similar patterns were observed in both sexes with the biggest difference in time of sleep for girls and PA for boys. These findings underscore the importance of intervention strategies targeting multiple behaviors simultaneously to enhance health risk profiles and indicators in children and adolescents.

Carpal tunnel syndrome and sleep, a systematic review and meta-analysis

BACKGROUND

The most common symptom and reason patients seek treatment for carpal tunnel syndrome is lack of sleep. Our purpose was to determine how much sleep-related symptoms of carpal tunnel syndrome improve after carpal tunnel release using validated patient-reported outcome measures (PROMs) and objective sleep data as primary measures of interest.

METHODS

A PRISMA-guided literature search was conducted using Ovid MEDLINE, PubMed, Cochrane, and ClinicalTrials.gov. Only interventional clinical trials that examined primary outcome measures of interest were included. Patient-reported outcome measures underwent meta-analysis to determine how much scores improved following carpal tunnel release.

RESULTS

The Pittsburgh Sleep Quality Index improved significantly after carpal tunnel release, by 4.43 points and 6.02 points at 1-3 and 6-12 months postoperatively, respectively, and continued to improve up to 2 years. Improvement on the Insomnia Severity Index after carpal tunnel release was also significant, with improvement up to 1 year postoperatively, by 8.54 points and 9.05 points at 1-3 and 6-12 months, respectively. Insomnia Severity Index scores improved significantly after splinting as well.

CONCLUSIONS

The present meta-analysis determined to what extent patients can expect their sleep to improve after operative and non-operative intervention, as measured by various patient-reported outcome measures that assess sleep. The Pittsburgh Sleep Quality Index and Insomnia Severity Index correlated very well between studies and across hundreds of patients with carpal tunnel syndrome. Data are lacking to define the minimal clinically important difference and assess whether patients achieve a minimal clinically important difference for sleep questionnaires; more information on this topic is needed.

LEVEL OF EVIDENCE

III.

Elevated periodic limb movement index is associated with hypoxemia in children with early onset scoliosis

PURPOSE

Patients with early onset scoliosis are at high risk of sleep disordered breathing, sleep disruption, and adverse consequences of poor sleep. In this study, we aim to assess the prevalence of periodic limb movements of sleep in a cohort of children with early onset scoliosis and identify factors that correlate with the presence of periodic limb movements.

METHODS

This is a retrospective chart review of 40 patients with EOS (ages 1-17 years) who underwent a PSG from 2003 through 2019. Data collected included age, sex, and polysomnography parameters. Descriptive statistics were used: independent T test and Pearson correlation.

RESULTS

The average age was 9.6 years (SD 5.2); 22 were female. Eleven patients (27.5%) had elevated periodic limb movement index (PLMI) (≥ 5). Those with PLMI ≥ 5 had arousal index of 15.4 (SD 7.2) and those with normal PLMI having an arousal index of 9.4 (SD 4.9); this reached statistical significance (p < 0.05). Those with elevated PLMI spent 4.9 (SD 8.3) minutes with saturations below 88%, while those with normal PLMI spent 1.0 (SD 1.8); this was statistically significant. There was a moderate positive correlation between arousal index, hypoxemia, and PLMI.

CONCLUSION

The study suggests that children with early onset scoliosis have higher frequency of periodic limb movements during sleep, and these may be correlated with increased arousal and with hypoxemia.

Validation of actigraphy sleep metrics in children aged 8 to 16 years: considerations for device type, placement and algorithms

BACKGROUND

Actigraphy is often used to measure sleep in pediatric populations, despite little confirmatory evidence of the accuracy of existing sleep/wake algorithms. The aim of this study was to determine the performance of 11 sleep algorithms in relation to overnight polysomnography in children and adolescents.

METHODS

One hundred thirty-seven participants aged 8-16 years wore two Actigraph wGT3X-BT (wrist, waist) and three Axivity AX3 (wrist, back, thigh) accelerometers over 24-h. Gold standard measures of sleep were obtained using polysomnography (PSG; Embletta MPRPG, ST + Proxy and TX Proxy) in the home environment, overnight. Epoch by epoch comparisons of the Sadeh (two algorithms), Cole-Kripke (three algorithms), Tudor-Locke (four algorithms), Count-Scaled (CS), and HDCZA algorithms were undertaken. Mean differences from PSG values were calculated for various sleep outcomes.

RESULTS

Overall, sensitivities were high (mean ± SD: 91.8%, ± 5.6%) and specificities moderate (63.8% ± 13.8%), with the HDCZA algorithm performing the best overall in terms of specificity (87.5% ± 1.3%) and accuracy (86.4% ± 0.9%). Sleep outcome measures were more accurately measured by devices worn at the wrist than the hip, thigh or lower back, with the exception of sleep efficiency where the reverse was true. The CS algorithm provided consistently accurate measures of sleep onset: the mean (95%CI) difference at the wrist with Axivity was 2 min (-6; -14,) and the offset was 10 min (5, -19). Several algorithms provided accurate measures of sleep quantity at the wrist, showing differences with PSG of just 1-18 min a night for sleep period time and 5-22 min for total sleep time. Accuracy was generally higher for sleep efficiency than for frequency of night wakings or wake after sleep onset. The CS algorithm was more accurate at assessing sleep period time, with narrower 95% limits of agreement compared to the HDCZA (CS:-165 to 172 min; HDCZA: -212 to 250 min).

CONCLUSION

Although the performance of existing count-based sleep algorithms varies markedly, wrist-worn devices provide more accurate measures of most sleep measures compared to other sites. Overall, the HDZCA algorithm showed the greatest accuracy, although the most appropriate algorithm depends on the sleep measure of focus.

Circadian misalignment proxies, BMI, and chronic conditions: the role for weekday to weekend sleep differences

OBJECTIVE

To evaluate whether social jet lag (SJL) and weekend catch-up sleep (CUS), proxies of circadian misalignment, were associated with BMI and chronic conditions.

METHODS

Participants (n = 2,050,18-65y) were part of a virtual cross-sectional and population-based research. We examined CUS and SJL as continuous and categorical (< 1 h,1-2 h, > 2 h). Linear regression analyses were performed to assess the differences in BMI (outcome) associated with CUS and SJL. Restricted cubic splines were performed to explore the shape of the relationship between weekday-to-weekend variability in sleep duration, midpoint, wake time, and bedtime. Logistic regression models were used to estimate ORs(95%CIs) for chronic conditions and overweight related to CUS and SJL. Analyses were adjusted for sleep duration, biological and behavior-related variables.

RESULTS

We found a positive association of SJL and CUS with BMI. The effects remained even after adjustment for weekly sleep duration and demonstrated a proportional increase with the magnitude of sleep variability. Among participants with SJL > 2 h, BMI increased by 2.29 kg/m2 (95%CI:0.84;3.74,p:0.002). They also had 129% higher odds of chronic conditions (95%CI:1.16;4.52, p:0.01) and 119% higher odds of overweight (95%CI: 1.20;3.98,p:0.01). Individuals with CUS > 2 h presented 78% higher odds of overweight (95%CI:1.27;2.50,p:0.001) and an increase of 1.61 kg/m2 in BMI (95%CI: 0.81; 2.40,p < 0.001).

CONCLUSIONS

Our findings, which demonstrate that even a slight weekend sleep extension and variability of just 1 h is associated with higher values of BMI, suggest incorporating measures for sleep consistency and regularity into clinical protocols and public health guidelines to prevent and treat obesity and related diseases.

Recurring memory reactivation: The offline component of learning

One can be aware of the effort needed to memorize a new fact or to recall the name of a new acquaintance. Because of experiences like this, learning can seem to have only two components, encoding information and, after some delay, retrieving information. To the contrary, learning entails additional, intervening steps that sometimes are hidden from the learner. For firmly acquiring fact and event knowledge in particular, learners are generally not cognizant of the necessity of offline consolidation. The memories that persist to be available reliably at a later time, according to the present conceptualization, are the ones we repeatedly rehearse and integrate with other knowledge, whether we do this intentionally or unknowingly, awake or asleep. This article examines the notion that learning is not a function of waking brain activity alone. What happens in the brain while we sleep also impacts memory storage, and consequently is a critical component of learning. The idea that memories can change over time and become enduring has long been present in memory research and is foundational for the concept of memory consolidation. Nevertheless, the notion that memory consolidation happens during sleep faced much resistance before eventually being firmly established. Research is still needed to elucidate the operation and repercussions of repeated reactivation during sleep. Comprehensively understanding how offline memory reactivation contributes to learning is vital for both theoretical and practical considerations.

Development and psychometric properties of an instrument to measure sleep behavior self-regulation in adolescent students

Background

The prevalence of inadequate sleep among adolescents is a significant worry due to its potential to adversely affect their health and academic performance. Addressing this matter necessitates a comprehensive grasp of the underlying factors influencing sleep regulation and the formulation of evidence-based interventions to counteract its detrimental consequences. Hence, the central objective of this study is to create and assess a dependable questionnaire designed to evaluate adolescents' self-regulation of sleep behavior.

Methods

In this cross-sectional study, data from 401 high school students randomly selected from west Iran were incorporated and subjected to psychometric assessments. The average age of the participants was 16.5 ± 0.92. Initially, 136 preliminary items were formulated, drawing from a contextual framework and comprehensive literature review. The subsequent steps involved specialized analyses, including content validity analysis, item analysis, exploratory and confirmatory factor analysis, as well as convergent validity analysis.

Results

Both exploratory and confirmatory factor analyses support a strong structural model, including factors like self-control, outcome expectation, goal setting, and self-efficacy, which are linked to regulating sleep behavior. The model fit was satisfactory. The instrument had 22 items which demonstrated good internal consistency, adequate test-retest reliability, and evidence of convergent validity.

Conclusion

In future studies exploring sleep behavior, the present questionnaire, which has demonstrated initial validity and reliability, holds the potential to provide valuable assistance in evaluating and enhancing self-regulation in sleep behavior, particularly within school environments.

Supporting athletes during a challenging situation: recommendations from a global insight of COVID-19 home-based training experience

BACKGROUND

For athletes, overcoming obstacles in challenging situations like pandemic home training is crucial. Strategies and approaches in this context are not well-documented. Our study aims to investigate such a scenario from a performance standpoint, based on a major global crisis: the COVID-19 pandemic and lockdown.

METHODS

This cross-sectional study surveyed athletes without disabilities using online questionnaires (35 languages) from May to July 2020. Questions included aspects of alternative routines, training monitoring, recovery, sleep patterns, injury occurrence/prevention based on structured answers, and an open-ended question on lockdown training experiences.

RESULTS

Of the 11,762 athletes from 142 countries, 63% were male, including at World-Class, International, National, State and Recreational levels. During lockdown, 25% athletes used innovative or modern ways to maintain or improve fitness e.g., virtual reality and tracking devices (favoring World-Class level, 30%). Many athletes, regardless of gender (43%) watched video competitions to improve/maintain their mental skills and performance [World-Class (47%) and International (51%)]. Contact frequency between athletes and their coaches was mainly at least once a week (36%), more among higher-level (World-Class/International) than lower-level athletes (27 vs. 16%). Higher-level athletes (≥ 54%) monitored training load and were assisted by their coaches (21%). During lockdown, stretching (67%) was considered one of the primary means of recovery, especially for higher-level athletes (> 70%). Compared to pre-lockdown, about two-thirds of athletes reported "normal" or "improved" sleep quality and quantity, suggesting a low sleep quality pre-lockdown. On average, 40% utilized injury prevention exercises (at least) once a week [World-Class (51%) and International (39%)]. Most injury occurrences during lockdown involved the knee (18%), ankle (16%), and back (9%). Four key themes emerged regarding lockdown experiences: remote training adaptation (e.g., shifting training focus), training creativity (e.g., using household items), performance enhancement opportunities (e.g., refocusing neglected aspects), and mental and motivation challenges.

CONCLUSIONS

Both male and female athletes, particularly those of higher levels, displayed some adaptalibity during the COVID-19 lockdown, employing innovative approaches and technology for training. Many athletes implemented load monitoring, recovery, and attentive of injury prevention, while optimizing their sleep quality and quantity. Athletes demonstrated their abilities to navigate challenges, and utilized different coping strategies in response to the lockdown's constraints.

Cross-sectional association between 24-hour movement guidelines and depressive symptoms in Chinese university students

Background

The world's first 24-h movement guidelines for adults were released on 15 October 2020 in Canada, though evidence of their associations with health indicators in young adults is sparse. This study aimed to report the prevalence of meeting the 24-h movement guidelines and associations with depressive symptoms in a sample of Chinese university students.

Methods

Cross-sectional data from 1,793 Chinese university students (mean age = 20.7 years, 63.6% female) were used. Sociodemographic information, movement behaviors (physical activity, sedentary behavior, and sleep duration), and depressive symptoms were collected using a self-reported questionnaire.

Results

The prevalence of meeting the 24-h movement guidelines was 27.8% in Chinese university students. Logistic regression results show that compared to those who met the 24-h movement guidelines, odds ratio (OR) for depressive symptoms in those who met fewer recommendations contained in the 24-h movement guidelines were significantly higher (OR for none = 3.4, 95% CI [2.1-5.5], p < 0.001; OR for one = 2.7, 95% CI [2.0-3.8], p < 0.001; OR for two = 1.5, 95% CI [1.1-2.1], p = 0.013).

Conclusion

The prevalence of meeting the 24-h movement guidelines in Chinese university students was relatively low and should be enhanced through multiple strategies. Meeting the 24-h movement guidelines was associated with lower risk for depression in Chinese young adults. It is suggested that moving more, sitting less and sleeping well in this population may reduce the occurrence of depression.