Sleep Health最新文献

Objectives: To investigate the association of infant sleep and sleep trajectories through the first year of life with infant neurodevelopment.

Methods: This study was conducted with 3251 infants in China. Sleep parameters were evaluated by the Brief Infant Sleep Questionnaire at 42days, 6months, and 1year of age. Neurodevelopment was evaluated at 1year of age using the Bayley Scales of Infant and Toddler Development, Third Edition. The latent variable growth curve model was used to evaluate the developmental trajectories of infant sleep, including total sleep duration trajectories, night awakening trajectories and sleep onset latency trajectories. Poisson regression was applied to assess the association between sleep parameters and sleep trajectories and infant neurodevelopment.

Results: Infants with frequent night awakenings at 6months had a higher risk of nonoptimal gross motor development. Additionally, infants with prolonged sleep onset latency at 1year had an increased risk of nonoptimal fine and gross motor development. A consistent frequent night-awakening trajectory increased the risk of nonoptimal gross motor development (adjusted relative risk, 1.52; 95% confidence interval, 1.09 to 2.10). Furthermore, an increasing trajectory in sleep onset latency was associated with an increased risk of nonoptimal fine (adjusted relative risk, 2.70; 95% confidence interval, 1.12 to 6.51) and gross motor development (adjusted relative risk, 2.76; 95% confidence interval, 1.70 to 4.48). However, no significant association was observed between total sleep duration, or its trajectory, and infant neurodevelopment.

Conclusions: Sleep problems or specific sleep trajectories during the initial year of life may increase risk of compromised neurodevelopment.

Objectives: Drowsy driving is a preventable form of impaired driving, represents a large public health concern, and accounts for a significant proportion of motor vehicle crashes, injuries, and deaths. There is a limited body of research documenting the prevalence and frequency of drowsy driving, alongside the public's perceptions and attitudes surrounding drowsy driving. The overarching goal of the present study was to document the prevalence, frequency, perceptions, attitudes, and associated sleep behaviors and beliefs related to drowsy driving.

Methods: The National Sleep Foundation conducted a national online survey of 1012 adults via the probability-based Ipsos Public Affairs KnowledgePanel. The survey was conducted in either English or Spanish, depending on participant preferred language. Respondents answered questions about the occurrence of drowsy driving, attitudes and beliefs about drowsy driving, and habitual sleep duration.

Results: Results indicated that the majority of US adults (95%) perceived drowsy driving as a risk; however, the lifetime prevalence of drowsy driving was high-62% of all drivers reported driving while so tired that they had a hard time keeping their eyes open. Individuals who obtained the NSF recommended sleep duration drove while drowsy less frequently.

Conclusions: Drowsy driving is a preventable and common behavior at the intersection of sleep health and public safety. Drivers who get adequate nighttime sleep are less likely to drive while they are so tired that they have a hard time keeping their eyes open. Public health campaigns encouraging adequate sleep to drive alert are needed.

Objectives: Social jetlag is a disturbance in the circadian rhythm caused by a desynchronization between an individual's biological rhythm and social commitments and responsibilities. It leads to sleep debt during the week and compensation on weekends. Social jetlag is associated with an increased risk of chronic diseases and cognitive dysfunction in adolescents. This study aims to assess the prevalence of social jetlag and associated factors in Brazilian adolescents.

Methods: Adolescents of both sexes, aged between 12 and 17years, participating in the Study of Cardiovascular Risks in Adolescents (ERICA), were included. The sleep duration on a typical weekday and weekend day was collected through a self-reported questionnaire. The occurrence of social jetlag was defined as the difference between the midpoint of sleep on weekends and weekdays, with differences equal to or higher than 1hour considered as an indicator of positive social jetlag. Factors associated with the prevalence of social jetlag were investigated using Poisson regression models.

Results: The sample included a total of 64,029 adolescents. Social jetlag affects more than 80% of Brazilian adolescents, with higher prevalence among girls in the age group of 16-17years, with white skin color, attending private schools, and those having morning classes. Additionally, unhealthy risk behaviors such as skipping breakfast, alcohol consumption, and increased screen time are associated with a higher prevalence of social jetlag.

Conclusion: The prevalence of social jetlag was high in Brazilian adolescents, and, among its associated factors, studying in the morning shift and engaging in unhealthy risk behaviors stand out.

Objective: Despite growing evidence of disparities in sleep quality between sexual minoritized and heterosexual youth, the reasons for these disparities are not well understood. LGBQ+ adolescents often experience challenging peer relationships, which could negatively impact their sleep quality. The current study examined the prospective relationship between sexual minority status and sleep quality over 12months and evaluated whether peer victimization and social support at 6months mediated this relationship among adolescents.

Methods: This study involved a secondary analysis of data from a community sample of 800 adolescents (57.5% female; M_age=14.42years, SD=0.83). Data were collected using web-based surveys over 12months with three time-points: baseline, 6-, and 12-month.

Results: Approximately 19.4% of adolescents self-identified as LGBQ+. Compared to heterosexual adolescents, LGBQ+ adolescents reported poorer global sleep quality, lower perceived social support, greater peer victimization, childhood victimization, and were more likely to be female (all ps < .001). In a longitudinal, parallel mediation analysis adjusting for baseline age, gender, global sleep quality, and childhood victimization, LGBQ+ adolescents reported higher rates of peer victimization (b=0.262 [0.049], p < .001) and less social support (b=-0.385 [0.146], p = .008) at 6months compared with heterosexual peers, predicting poor global sleep quality (b=0.495 [0.191], p = .010 for peer victimization and b=-0.161 [0.068], p = .018 for social support) at 12months.

Conclusion: These findings highlight that sexual minority adolescents face increased risks of peer victimization and reduced social support from peers, which contribute to poorer sleep quality. The findings may guide the development of adolescent sleep interventions that also improve social health and relationships.

Objectives: Examine very short sleep among adolescents across multiple intersecting social positions and experiences of sexual orientation-based bullying and cyberbullying in two statewide samples.

Methods: A harmonization of two large statewide school-based datasets from grades 9-12 (2019 Minnesota Student Survey, and 2018-2019 California Healthy Kids Survey) was utilized for the analysis (N = 379,710). Exhaustive chi-square automatic interaction detection (an approach for quantitative intersectionality research) explored variability in very short sleep (≤5 hours/night) among adolescents from multiple intersecting social positions (race/ethnicity, gender identity, sexual orientation, and sex assigned at birth), grade, state, and two types of bullying experiences (sexual orientation-based bullying and cyberbullying). Intersectional groups reporting the highest prevalence of very short sleep were identified. We compared very short sleep rates among adolescents from the same social positions who experienced bullying with those who did not experience bullying.

Results: Very short sleep was common among this sample of adolescents (19.2%), especially among those holding multiple marginalized social positions (36.9%-51.4%). Adolescents who were transgender or gender diverse or questioning gender identity, and with minoritized sexual and racial/ethnic identities were overrepresented among high prevalence groups of very short sleep. Bullying experiences were reported by all highest prevalence groups. Adolescents who were bullied had 24.9%-51.3% higher rates of very short sleep than adolescents from the same intersecting social positions who were not bullied.

Conclusions: Very short sleep is pervasive among marginalized adolescents. Findings suggest that victimization contributes to adolescents' very short sleep rates. Individual-level interventions may fall short of promoting better sleep among adolescents; systemic interventions addressing bullying are needed.

Clinical trial registration: N/A.

Study objectives: Recent data has indicated that Black Americans experience more severe insomnia compared to their White counterparts. Although previous studies have identified psychosocial mechanisms driving this disparity, little is known about the structural determinants of insomnia disparities. This study tested neighborhood social vulnerability as a mechanism driving Black-White disparities in insomnia severity in the United States.

Methods: Participants with a previous diagnosis of insomnia (N = 196) reported their race and insomnia severity (Insomnia Severity Index). As a measure of the neighborhood environment Social Vulnerability Index was calculated by geocoding home address at the time of participation to the respective census tract from the 2020 US Census. A mediation analysis tested the indirect effect of the Social Vulnerability Index between race and insomnia severity.

Results: Black participants reported worse insomnia severity compared to White participants. Black participants also had 3.3 times the odds of living in neighborhoods with higher social vulnerability compared to White participants, with a group median difference of 0.26 percentile points (scale 0 to 1). As hypothesized, results revealed a significant indirect effect of the Social Vulnerability Index, which accounted for 31.1% of the variance between race and insomnia severity.

Conclusion: Living in a socially vulnerable neighborhood environment may be a mechanism driving racial disparities in insomnia severity. Interventions that consider structural determinants of health, including community-based and policy-level interventions could have an enhanced impact on addressing insomnia and its public health consequences.

Objectives: This retrospective cohort study examined clinically diagnosed insomnia and sleep apnea and analyzed associations with deployment and combat exposure in active-duty soldiers (n=1,228,346) from 2010 to 2019.

Methods: Retrospective data were obtained from the Soldier Performance, Health, and Readiness database.

Results: Overseas soldier deployments peaked in 2010, decreasing thereafter as soldiers were withdrawn from Iraq and Afghanistan. From 2010 to 2012 insomnia incidence increased at a rate of 6.7 cases/1000 soldier-years, then decreased after 2012 at 5.3 cases/1000 soldier-years. Sleep apnea increased 2010-2016 at 1.9 cases/1000 soldier-years and generally declined thereafter. Risk of insomnia increased with deployment (hazard ratio=1.51; 95% confidence interval=1.49-1.52) and combat exposure (hazard ratio=1.15; 95% confidence interval=1.13-1.17). Risk of sleep apnea was increased by deployment (hazard ratio=1.89; 95% confidence interval, 1.86-1.92) and combat exposure (hazard ratio=1.09; 95% confidence interval, 1.07-1.11). Most relationships remained after accounting for other factors in multivariable analyses, except that the association between sleep apnea and combat exposure was reduced (hazard ratio=0.94; 95% confidence interval=0.92-0.97).

Conclusions: Insomnia risk decreased in the period nearly in parallel with a reduction in the number of deployments; nonetheless deployment and combat exposure increased insomnia risk in the period examined. Risk of sleep apnea increased in the period and was related to deployment but not combat exposure after accounting for demographics and comorbid conditions. Despite reductions in insomnia incidence and a slowing in sleep apnea incidence, sleep disorders remain highly prevalent, warranting continued emphasis on sleep-disorder screening and improving the soldier sleep habits.

Background: Neighborhood-level adverse social determinants may be a risk factor for sleep health disparities. We examined the associations between neighborhood factors and insomnia and explored their spatial clustering in the city of Philadelphia, Pennsylvania.

Methods: We conducted a cross-sectional analysis of data from Philadelphia residents who participated in online screening for insomnia-related research. Participants self-reported sex, age, body mass index, anxiety, post-traumatic stress disorder, depression, and insomnia symptoms. The sample was stratified as "No Insomnia" (≤7) and "Insomnia" (>7) based on the Insomnia Severity Index (range: 0-28). Neighborhood and participant data were merged using geospatial techniques. Multiple regression models and geospatial analysis were used to identify neighborhood variables that are associated with insomnia and their spatial distribution.

Results: The sample (N = 350) was predominantly female (53%), middle-aged (40.8 ± 13.8), overweight (body mass index=26.1 ± 5.54), and 53.7% had insomnia. The insomnia group had significantly higher depression scores (14.6 ± 5.5), a large percentage had anxiety (64.4%) and post-traumatic stress disorder symptoms (31.9%), and largely resided in high crime (p < .001) and highly deprived neighborhoods (p = .034). Within the insomnia group, a 1-point increase in the number of spiritual centers in the neighborhood was associated with lower insomnia symptoms (b=-1.02, p = .002), while a 1-point increase in depression scores (b=0.44, p < .001) and residence in a highly deprived neighborhood (b=1.49, p = .021) was associated with greater insomnia.

Conclusion: Disparities exist in the neighborhood determinants of insomnia and their spatial distribution in Philadelphia. Interventions targeting the spatial distribution of adverse social determinants may improve insomnia disparities.

Objectives: Obstructive sleep apnea is associated with alterations in slow-wave activity during sleep, potentially increasing the risk of Alzheimer's disease. This study investigated the associations between obstructive sleep apnea manifestations such as respiratory events, hypoxia, arousal, slow-wave patterns, and neurochemical biomarker levels.

Methods: Individuals with suspected obstructive sleep apnea underwent polysomnography. Sleep disorder indices, oxygen metrics, and slow-wave activity data were obtained from the polysomnography, and blood samples were taken the following morning to determine the plasma levels of total tau (T-Tau) and amyloid beta-peptide 42 (Aβ₄₂) by using an ultrasensitive immunomagnetic reduction assay. Subsequently, the participants were categorized into groups with low and high Alzheimer's disease risk on the basis of their computed product Aβ₄₂ × T-Tau. Intergroup differences and the associations and mediation effects between sleep-related parameters and neurochemical biomarkers were analyzed.

Results: Forty-two participants were enrolled, with 21 assigned to each of the low- and high-risk groups. High-risk individuals had a higher apnea-hypopnea index, oxygen desaturation index (≥3%, ODI-3%), fraction of total sleep time with oxygen desaturation (SpO_2-90% _TST), and arousal index and greater peak-to-peak amplitude and slope in slow-wave activity, with a correspondingly shorter duration, than did low-risk individuals. Furthermore, indices such as the apnea-hypopnea index, ODI-3% and SpO_2-90% _TST were found to indirectly affect slow-wave activity, thereby raising the Aβ₄₂ × T-Tau level.

Conclusions: Obstructive sleep apnea manifestations, such as respiratory events and hypoxia, may influence slow-wave sleep activity (functioning as intermediaries) and may be linked to elevated neurochemical biomarker levels. However, a longitudinal study is necessary to determine causal relationships among these factors.

Statement of significance: This research aims to bridge gaps in understanding how obstructive sleep apnea is associated with an elevated risk of Alzheimer's disease, providing valuable knowledge for sleep and cognitive health.