Sleep Health最新文献_第7页

Loneliness and sleep in everyday life: Using ecological momentary assessment to characterize the shape of daily loneliness experience 日常生活中的孤独感与睡眠：利用生态瞬间评估来描述日常生活中的孤独体验。

IF 3.4 2区医学 Q2 CLINICAL NEUROLOGY

Sleep Health

Pub Date : 2024-08-01 DOI: 10.1016/j.sleh.2024.04.003

Background

Loneliness has been linked to an increased risk of sleep problems. Past research has largely relied on trait loneliness or daily recall loneliness when evaluating associations with sleep.

Objective

The present study extended this work by evaluating the patterns of loneliness throughout the day, including a daily average of all reports, a maximum value, and daily variation. These loneliness patterns predicted daily subjective and objective sleep measures to evaluate whether they provide unique insight to this relationship.

Methods

Undergraduate students (n = 71; 77% female; age 18-28) completed 2 weeks of electronic surveys 4 times a day to assess loneliness. Each morning participants completed a diary of their prior night’s sleep quality, as well as wore actigraphy devices to objectively assess sleep parameters. A total of 778 momentary surveys and 565 days of actigraphy-assessed sleep data were collected. Multilevel models tested whether within-person daily aggregates of loneliness were associated with within-person daily sleep outcome variables.

Results

Subjective sleep duration, quality, and fatigue were significantly predicted by daily average loneliness. Subjective sleep latency, quality, and fatigue were significantly predicted by daily max loneliness. Only fatigue was significantly predicted by daily loneliness variability. No objective sleep measures were significantly predicted by daily loneliness measures.

Conclusions

Patterns of daily loneliness focusing on central tendency (average) or intensity (max) were more consistently associated with subjective (but not objective) assessments of sleep than variability.

背景：孤独与睡眠问题的风险增加有关。过去的研究在评估孤独与睡眠的关系时，主要依赖于特质孤独感或每日回忆孤独感：本研究通过评估全天的孤独感模式，包括所有报告的日平均值、最大值和日变化值，对上述工作进行了扩展。这些孤独感模式预测了每天的主观和客观睡眠测量结果，以评估它们是否为这种关系提供了独特的见解：本科生（n = 71；77% 为女性；年龄 18-28 岁）完成了为期两周的电子调查，每天 4 次，以评估孤独感。每天早上，参与者填写前一晚的睡眠质量日记，并佩戴行动记录仪对睡眠参数进行客观评估。共收集了 778 份瞬间调查和 565 天的动图评估睡眠数据。多层次模型检验了人体内每日孤独感总量是否与人体内每日睡眠结果变量相关：结果：主观睡眠持续时间、质量和疲劳度在很大程度上受每日平均孤独感的影响。主观睡眠潜伏期、质量和疲劳度受每日最大孤独感的影响较大。只有疲劳度能通过每日孤独感的变化进行显著预测。没有任何客观睡眠指标能显著预测每日孤独感指标：结论：以中心倾向（平均值）或强度（最大值）为重点的每日孤独感模式与睡眠的主观评估（而非客观评估）的相关性高于变异性。

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引用次数: 0

The impact of screen use on sleep health across the lifespan: A National Sleep Foundation consensus statement 屏幕使用对整个生命周期睡眠健康的影响：美国国家睡眠基金会共识声明。

IF 3.4 2区医学 Q2 CLINICAL NEUROLOGY

Sleep Health

Pub Date : 2024-08-01 DOI: 10.1016/j.sleh.2024.05.001

Objective

To achieve consensus on whether screen-based digital media (1) in general, (2) via prebedtime content, and (3) via prebedtime light impairs sleep health in (a) childhood, (b) adolescence, and (c) adulthood. Furthermore, to address whether employing behavioral strategies and interventions may reduce the potential negative effects of screens on sleep health.

Methods

The National Sleep Foundation convened a 16-person multidisciplinary expert panel (“Panel”). Panelists met virtually 5 times throughout 2023, during which they followed a modified Delphi RAND/UCLA Appropriateness Method to reach consensus.

Results

The Panel conducted a literature review starting with 2209 articles, narrowed down to 522 relevant empirical articles and 52 relevant review articles. The search was refined to include 35 experimental/intervention studies that examined whether there was a causal link between screen-based digital media and sleep. In addition, panelists reviewed 5 recent relevant systematic review articles. After reviewing the summarized current literature, panelists voted on 10 candidate statements about whether screen use impairs sleep health. The Panel met virtually to discuss the results of the first round of votes, which was then followed by a second round of voting, ultimately achieving consensus on 5 out of the 10 statements.

Conclusions

The Panel achieved consensus that (1) in general, screen use impairs sleep health among children and adolescents, (2) the content of screen use before sleep impairs sleep health of children and adolescents, and (3) behavioral strategies and interventions may attenuate the negative effects of screen use on sleep health.

目标：就基于屏幕的数字媒体（1）一般情况下，（2）通过睡前内容，以及（3）通过睡前光线是否会损害（a）儿童期、（b）青春期和（c）成年期的睡眠健康达成共识。此外，还要探讨采用行为策略和干预措施是否可以减少屏幕对睡眠健康的潜在负面影响：美国国家睡眠基金会召集了一个 16 人的多学科专家小组（以下简称 "专家小组"）。专家小组成员在 2023 年期间召开了 5 次虚拟会议，在此期间，他们采用修改后的德尔菲兰德/加州大学洛杉矶分校适当性方法达成共识：专家小组进行了文献综述，从 2209 篇文章开始，筛选出 522 篇相关的实证文章和 52 篇相关的综述文章。经过改进，搜索结果包括 35 项实验/干预研究，这些研究探讨了屏幕数字媒体与睡眠之间是否存在因果关系。此外，专家组成员还查阅了 5 篇近期的相关系统综述文章。在审阅了总结的当前文献后，专家组成员对 10 个关于屏幕使用是否会损害睡眠健康的候选声明进行了投票。专家小组召开虚拟会议讨论第一轮投票结果，然后进行第二轮投票，最终就 10 项声明中的 5 项达成共识：专家小组达成的共识是：(1) 总体而言，使用屏幕会损害儿童和青少年的睡眠健康；(2) 睡前使用屏幕的内容会损害儿童和青少年的睡眠健康；(3) 行为策略和干预措施可减轻使用屏幕对睡眠健康的负面影响。

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引用次数: 0

The training times of athletes could play a role in clinical sleep problems due to their associations with sleep difficulty scores 由于运动员的训练时间与睡眠困难评分有关，因此可能会对临床睡眠问题产生影响。

IF 3.4 2区医学 Q2 CLINICAL NEUROLOGY

Sleep Health

Pub Date : 2024-08-01 DOI: 10.1016/j.sleh.2024.02.006

Objectives

Sleep is a key component of athletic recovery, yet training times could influence the sleep of athletes. The aim of the current study was to compare sleep difficulties in athletes across different training time groups (early morning, daytime, late evening, early morning plus late evening) and to investigate whether training time can predict sleep difficulties.

Methods

Athletes from various sports who performed at a national-level (n = 273) answered the Athlete Sleep Screening Questionnaire (ASSQ) along with several other questionnaires related to demographics, exercise training, and mental health. From the ASSQ, a Sleep Difficulty Score (SDS) was calculated. Transformed SDS (tSDS) was compared across different training time categories using multiple one-way ANOVAs. A stepwise regression was then used to predict tSDS from various sleep-related factors.

Results

SDSs ranged from none (31%), mild (38%), moderate (22%), and severe (9%). However, the one-way ANOVAs revealed training earlier or later vs. training daytime shifted the tSDS in a negative direction, a trend toward increased sleep difficulty. In particular, athletes training in the late evening (>20:00 or >21:00) had a significantly higher tSDS when compared to daytime training (p = .03 and p < .01, respectively). The regression model (p < .001) explained 27% of variance in the tSDS using depression score, age, training time, and chronotype score.

Conclusion

Among a heterogeneous sample of national-level athletes, 31% displayed moderate to severe SDSs regardless of their training time. However, when athletes trained outside daytime hours there was a tendency for the prevalence of sleep difficulties to increase.

目标：睡眠是运动恢复的关键组成部分，然而训练时间可能会影响运动员的睡眠。本研究旨在比较不同训练时间组（清晨、白天、傍晚、清晨加傍晚）运动员的睡眠困难情况，并探讨训练时间是否能预测睡眠困难：来自不同运动项目的国家级运动员（n = 273）回答了运动员睡眠筛查问卷（ASSQ）以及其他几份与人口统计学、运动训练和心理健康有关的问卷。根据 ASSQ 计算出了睡眠困难评分（SDS）。使用多重单因素方差分析比较了不同训练时间类别的转换后 SDS（tSDS）。然后使用逐步回归法从各种睡眠相关因素中预测 tSDS：SDSs 的范围包括无（31%）、轻度（38%）、中度（22%）和重度（9%）。然而，单因素方差分析显示，提前或延后训练与白天训练相比，tSDS呈负方向变化，有增加睡眠困难的趋势。特别是，与白天训练相比，在深夜（>20:00 或>21:00）训练的运动员的 tSDS 明显更高（p = 0.03 和 p 结论）：在国家级运动员的不同样本中，有 31% 的运动员无论训练时间长短都表现出中度至重度 SDS。然而，当运动员在白天以外的时间训练时，睡眠困难的发生率有增加的趋势。

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引用次数: 0

Sleep-wake behaviors associated with cognitive performance in middle-aged participants of the Hispanic Community Health Study/Study of Latinos 拉美裔社区健康研究》/《拉美裔研究》中年参与者的睡眠-觉醒行为与认知能力的关系。

IF 3.4 2区医学 Q2 CLINICAL NEUROLOGY

Sleep Health

Pub Date : 2024-08-01 DOI: 10.1016/j.sleh.2024.02.002

Objectives

Many sleep-wake behaviors have been associated with cognition. We examined a panel of sleep-wake/activity characteristics to determine which are most robustly related to having low cognitive performance in midlife. Secondarily, we evaluate the predictive utility of sleep-wake measures to screen for low cognitive performance.

Methods

The outcome was low cognitive performance defined as being >1 standard deviation below average age/sex/education internally normalized composite cognitive performance levels assessed in the Hispanic Community Health Study/Study of Latinos. Analyses included 1006 individuals who had sufficient sleep-wake measurements about 2 years later (mean age = 54.9, standard deviation = 5.1; 68.82% female). We evaluated associations of 31 sleep-wake variables with low cognitive performance using separate logistic regressions.

Results

In individual models, the strongest sleep-wake correlates of low cognitive performance were measures of weaker and unstable 24-hour rhythms; greater 24-hour fragmentation; longer time-in-bed; and lower rhythm amplitude. One standard deviation worse on these sleep-wake factors was associated with ∼20%-30% greater odds of having low cognitive performance. In an internally cross-validated prediction model, the independent correlates of low cognitive performance were: lower Sleep Regularity Index scores; lower pseudo-F statistics (modellability of 24-hour rhythms); lower activity rhythm amplitude; and greater time in bed. Area under the curve was low/moderate (64%) indicating poor predictive utility.

Conclusion

The strongest sleep-wake behavioral correlates of low cognitive performance were measures of longer time-in-bed and irregular/weak rhythms. These sleep-wake assessments were not useful to identify previous low cognitive performance. Given their potential modifiability, experimental trials could test if targeting midlife time-in-bed and/or irregular rhythms influences cognition.

目标许多睡眠-觉醒行为都与认知能力有关。我们研究了一系列睡眠-觉醒/活动特征，以确定哪些特征与中年认知能力低下的关系最为密切。其次，我们还评估了睡眠-觉醒测量对筛查认知能力低下的预测效用：结果：低认知能力的定义是低于西班牙裔社区健康研究/拉丁裔研究中评估的平均年龄/性别/教育程度内部标准化复合认知能力水平>1个标准差。分析对象包括约 2 年后进行了充分睡眠-觉醒测量的 1006 人（平均年龄=54.9，标准差=5.1；68.82% 为女性）。我们使用单独的逻辑回归评估了 31 个睡眠-觉醒变量与认知能力低下之间的关系：在单个模型中，与认知能力低下密切相关的睡眠-觉醒变量包括：24 小时节律较弱且不稳定；24 小时片段化程度较高；卧床时间较长；节律振幅较低。这些睡眠-觉醒因素每差一个标准差，认知能力低下的几率就会增加20%-30%。在一个内部交叉验证的预测模型中，认知能力低下的独立相关因素是：睡眠规律性指数得分较低；伪F统计量（24小时节律的可模拟性）较低；活动节律振幅较低；卧床时间较长。曲线下面积较低/中等（64%），表明预测效用较差：结论：与认知能力低下密切相关的睡眠-觉醒行为是较长的卧床时间和不规则/较弱的节律。这些睡眠-觉醒评估对于确定之前的认知能力低下并无用处。鉴于其潜在的可修改性，实验性试验可以测试针对中年睡眠时间和/或不规则节律是否会影响认知能力。

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引用次数: 0

Associations between indoor fine particulate matter (PM_2.5) and sleep-disordered breathing in an urban sample of school-aged children. 城市学龄儿童样本中室内细颗粒物（PM2.5）与睡眠呼吸紊乱之间的关系。

IF 3.4 2区医学 Q2 CLINICAL NEUROLOGY

Sleep Health

Pub Date : 2024-08-01 DOI: 10.1016/j.sleh.2024.06.004

Jing Wang, Seyni Gueye-Ndiaye, Cecilia Castro-Diehl, Sanjana Bhaskar, Le Li, Meg Tully, Michael Rueschman, Judith Owens, Diane R Gold, Jarvis Chen, Wanda Phipatanakul, Gary Adamkiewicz, Susan Redline

Objectives: Environmental risk factors may contribute to sleep-disordered breathing. We investigated the association between indoor particulate matter ≤2.5µm in aerodynamic diameter (PM_2.5) and sleep-disordered breathing in children in an urban US community.

Methods: The sample consisted of children aged 6-12years living in predominantly low-income neighborhoods in Boston, Massachusetts. Indoor PM_2.5 was measured in participants' main living areas for 7days using the Environmental Multipollutant Monitoring Assembly device. High indoor PM_2.5 exposure was defined as greater than the sample weekly average 80th percentile level (≥15.6 μg/m³). Sleep-disordered breathing was defined as an Apnea-Hypopnea-Index (AHI) or Oxygen-Desaturation-Index (ODI) (≥3% desaturation) of ≥5 events/hour. Habitual loud snoring was defined as caregiver-report of loud snoring (most or all the time each week) over the past 4weeks. We examined the associations of PM_2.5 with sleep-disordered breathing or snoring using logistic regression adjusting for potential confounders.

Results: The sample included 260 children (mean age 9.6years; 41% female), with 32% (n = 76) classified as having sleep-disordered breathing. In a logistic regression model adjusted for socioeconomics and seasonality, children exposed to high indoor PM_2.5 levels (n = 53) had a 3.53-fold increased odds for sleep-disordered breathing (95%CI: 1.57, 8.11, p = .002) compared to those with lower indoor PM_2.5. This association persisted after additional adjustments for physical activity, outdoor PM_2.5, environmental tobacco smoke, and health characteristics. Similar associations were observed for snoring and indoor PM_2.5. CONCLUSIONS: Children with higher indoor PM_2.5 exposure had greater odds of sleep-disordered breathing and habitual loud snoring, suggesting that indoor air quality contributes to sleep disparities.

目的：环境风险因素可能会导致睡眠呼吸障碍。我们调查了美国城市社区中空气动力学直径≤2.5微米的室内颗粒物（PM2.5）与儿童睡眠呼吸障碍之间的关系：样本包括居住在马萨诸塞州波士顿低收入社区的 6-12 岁儿童。使用环境多污染物监测组件装置对参与者主要生活区的室内 PM2.5 进行了为期 7 天的测量。室内PM2.5暴露量大于样本周平均第80百分位数水平（≥15.6 μg/m3）即为PM2.5暴露量高。睡眠呼吸障碍的定义是呼吸暂停-低通气指数（AHI）或氧饱和指数（ODI）（≥3%）≥5 次/小时。习惯性大声打鼾是指在过去 4 周内由护理人员报告的大声打鼾（每周大部分时间或全部时间）。我们使用逻辑回归法研究了PM2.5与睡眠呼吸障碍或打鼾的关系，并对潜在的混杂因素进行了调整：样本包括260名儿童（平均年龄9.6岁；41%为女性），其中32%（n = 76）被归类为睡眠呼吸障碍。在调整了社会经济和季节性因素的逻辑回归模型中，与室内PM2.5水平较低的儿童相比，室内PM2.5水平较高的儿童（n = 53）患睡眠呼吸障碍的几率增加了3.53倍（95%CI：1.57, 8.11, p = .002）。在对体力活动、室外 PM2.5、环境烟草烟雾和健康特征进行额外调整后，这种关联依然存在。在打鼾和室内PM2.5方面也观察到类似的关联。结论：室内 PM2.5 暴露较高的儿童出现睡眠呼吸紊乱和习惯性大声打鼾的几率更高，这表明室内空气质量导致了睡眠差异。

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引用次数: 0

Out of their control: College students’ beliefs in sleep myths, sleep problems, and psychological flexibility 身不由己：大学生对睡眠神话、睡眠问题和心理弹性的看法。

IF 3.4 2区医学 Q2 CLINICAL NEUROLOGY

Sleep Health

Pub Date : 2024-08-01 DOI: 10.1016/j.sleh.2024.05.002

Objectives

College students suffer from deficient sleep, and the pernicious factors that support this phenomenon are diverse. The aim of the current study was to better understand the role of sleep-related myths in college students’ sleep disturbance. A second aim was to examine if college students’ levels of sleep disturbance were similarly associated with their belief in sleep-related myths or if their capacity to be psychologically flexible might moderate this process.

Methods

The online sample consisted of 638 undergraduates (82.4% female; M_age = 21.3, SD = 1.6 years), who reported on their level of belief in sleep-related myths, sleep disturbance, sleep environment, sleep hygiene, and psychological flexibility.

Results

Controlling for critical sleep-related correlates, including melatonin usage, work hours and perceived sleep-related self-efficacy, we found that for students with below-average (− 1 SD) psychological flexibility, the greater their belief in the myth that their sleep schedules were out of their control was associated with greater levels of sleep disturbance.

Conclusions

These results not only highlight another important source of college students’ sleep problems, but they also speak to the widespread belief that college students have little control over their sleep. Findings from the current study raise the possibility that by developing students’ capacities to be more psychologically flexible and by empowering students to prioritize their sleep, they will be able to decrease the likelihood of experiencing sleep and sleep-related problems.

目的：大学生深受睡眠不足之苦，而导致这一现象的有害因素多种多样。本研究旨在更好地了解与睡眠有关的迷思在大学生睡眠障碍中所起的作用。第二个目的是研究大学生的睡眠障碍程度是否同样与他们对睡眠相关迷思的信念有关，或者他们的心理弹性能力是否可能缓和这一过程：在线样本包括638名大学生（82.4%为女性；年龄=21.3岁，SD=1.6岁），他们报告了自己对睡眠相关迷思的相信程度、睡眠障碍、睡眠环境、睡眠卫生和心理弹性：在控制了与睡眠相关的重要因素（包括褪黑激素的使用、工作时间和感知到的睡眠相关自我效能）后，我们发现，对于心理灵活性低于平均水平（-1 SD）的学生来说，他们越相信睡眠时间不受自己控制的说法，睡眠障碍的程度就越严重：这些结果不仅凸显了大学生睡眠问题的另一个重要来源，而且也说明了大学生对自己的睡眠几乎无法控制的普遍看法。本研究的结果提出了一种可能性，即通过培养学生更灵活的心理承受能力和增强学生优先考虑睡眠问题的能力，他们将能够降低出现睡眠和睡眠相关问题的可能性。

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引用次数: 0

The relationship between multiple concussions and multidimensional sleep quality in collegiate-aged, active athletes 大学适龄活跃运动员的多次脑震荡与多维睡眠质量之间的关系。

IF 3.4 2区医学 Q2 CLINICAL NEUROLOGY

Sleep Health

Pub Date : 2024-08-01 DOI: 10.1016/j.sleh.2024.04.005

Objectives

Determine the association of cumulative concussion and repetitive head impacts with self-reported sleep quality in healthy collegiate-aged athletes.

Methods

Collegiate-aged athletes (N = 212; mean age 21.00, 62.7% male) completed semistructured interviews for sport and concussion history and the Pittsburgh Sleep Quality Index (PSQI). Number of concussions was retrospectively determined based on the 1993 American Congress of Rehabilitation Medicine (ACRM) criteria; repetitive head impact was measured based on the cumulative years of contact sport exposure. Associations of number of concussions and repetitive head impact exposure with global PSQI score, overall poor (PSQI >5) vs. good sleep, and binarized subscale scores were tested. Secondary analyses were conducted using alternative concussion criteria and metrics of repetitive head impact.

Results

The number of prior concussions was associated with higher PSQI global scores (B(SE) = 0.50(0.13), p < .001). Participants with more concussions were more likely to be poor sleepers (OR = 1.52, p < .001), report poorer sleep quality (OR = 1.29, p = .037), longer sleep latency (OR = 1.34, p = .005), more sleep disturbances (OR = 1.56, p = .001), increased use of sleep medications or sleep aids (OR = 1.35, p = .008), and more sleep-related daily dysfunction (OR = 1.38, p = .002). Similar results were observed for alternative definitions of concussion. No metric of repetitive head impact was associated with any sleep quality metric.

Conclusions

More prior concussions, but not repetitive head impact exposure, are associated with worse self-reported sleep, with subscale analyses showing concussion history associated with multiple aspects of subjective sleep quality rather than sleep quantity. Sleep represents an important factor to consider for future research aimed at characterizing and ultimately preventing adverse long-term health outcomes associated with concussion history.

目标：确定累积性脑震荡和重复性头部撞击与健康大学适龄运动员自我报告的睡眠质量的关系：确定健康大学适龄运动员的累积性脑震荡和重复性头部撞击与自我报告的睡眠质量之间的关系：大学适龄运动员（212 人；平均年龄 21.00 岁，62.7% 为男性）完成了有关运动和脑震荡病史以及匹兹堡睡眠质量指数（PSQI）的半结构化访谈。脑震荡次数根据 1993 年美国康复医学会 (ACRM) 标准进行回顾性测定；重复性头部撞击根据接触体育运动的累积年数进行测量。测试了脑震荡次数和重复性头部撞击与 PSQI 总分、总体睡眠质量差（PSQI >5）与睡眠质量好以及二元化子量表得分之间的关系。使用其他脑震荡标准和重复性头部撞击指标进行了二次分析：结果：既往脑震荡次数与较高的 PSQI 总分相关（B（SE）= 0.50（0.13），P 结论：既往脑震荡次数越多，PSQI 总分就越高，但并不意味着睡眠质量越好：更多的既往脑震荡（而非重复性头部撞击）与自我报告的睡眠质量较差有关，分量表分析表明脑震荡史与主观睡眠质量的多个方面而非睡眠量有关。睡眠是未来研究中需要考虑的一个重要因素，这些研究旨在确定脑震荡病史的特征，并最终预防与脑震荡病史相关的不良长期健康后果。

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引用次数: 0

Instructional approach, sleep, and perceived academic well-being in adolescents during COVID-19: Evidence from the NESTED study COVID-19期间青少年的教学方法、睡眠和学习幸福感：来自 NESTED 研究的证据。

IF 3.4 2区医学 Q2 CLINICAL NEUROLOGY

Sleep Health

Pub Date : 2024-08-01 DOI: 10.1016/j.sleh.2024.04.006

Objectives

At the peak of COVID-19, adolescent life was disrupted as schools adapted their instructional approaches such as online, in-person, or hybrid instruction. We and others have previously commented on how these shifts facilitated longer, later and (more developmentally appropriate) sleep. Here, we report how sleep contributed to associations between remote instruction and broader academic well-being (e.g., cognitive function, school connectedness, and stress).

Methods

Adolescents from all 50 U.S. states (n = 4068) completed online self-report surveys in fall 2020. Instructional approach was operationalized from fully in-person instruction to fully asynchronous online education. Sleep parameters included sleep timing and duration, sleep disturbances, and sleep-related impairments. Perceived academic well-being was defined as cognitive function, school connectedness, and school-related stress. Sleep and perceived academic well-being are examined across instructional approaches, in their association, and in structural models.

Results

Sleep and perceived academic well-being differed between hybrid and online instruction groups. Less variable or disturbed sleep was associated both with in-person instruction, and with positive outcomes in cognitive function, school connectedness, and stress domains. Sleep mediated a substantial portion of variance in perceived academic well-being attributable to instructional approach.

Conclusion

These data highlight the need to protect both healthy sleep and in-person instruction. Appropriate sleep timing and duration, fewer sleep disturbances and sleep-related impairments accounted for a substantial degree of variance in the association between remote instruction on academic outcomes. While many students experienced “lost learning” because of COVID-19, this study joins a broader discussion of ensuring developmentally appropriate school-start times to support both sleep and achievement.

目标：在 COVID-19 高峰期，由于学校调整了教学方法，如在线、面对面或混合教学，青少年的生活被打乱了。我们和其他人曾就这些转变如何有助于延长睡眠时间、推迟睡眠时间和（更适合发育的）睡眠时间发表过评论。在此，我们将报告睡眠如何促进远程教学与更广泛的学业福祉（如认知功能、学校联系和压力）之间的联系：来自美国 50 个州的青少年（n = 4068）在 2020 年秋季完成了在线自我报告调查。教学方法从完全面对面教学到完全异步在线教育。睡眠参数包括睡眠时间和持续时间、睡眠障碍和睡眠相关损伤。感知到的学业幸福感定义为认知功能、与学校的联系以及与学校相关的压力。在不同的教学方法、它们之间的关联以及结构模型中，对睡眠和感知学业幸福感进行了研究：混合教学组和在线教学组的睡眠和学业幸福感有所不同。睡眠不稳定或睡眠紊乱较少与面对面教学有关，也与认知功能、学校联系和压力领域的积极结果有关。睡眠在很大程度上调节了因教学方法而产生的学业幸福感差异：这些数据强调了保护健康睡眠和面对面教学的必要性。适当的睡眠时间和持续时间、较少的睡眠障碍和与睡眠相关的损伤在很大程度上解释了远程教学与学习成绩之间的关系。虽然许多学生因 COVID-19 而 "失去了学习机会"，但这项研究也加入了更广泛的讨论，即确保适当的开学时间，以保证睡眠和学习成绩。

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引用次数: 0

Associations of prediabetes and sleep duration, and inflammation as a mediator in the China Health and Retirement Longitudinal Study 中国健康与退休纵向研究》中糖尿病前期与睡眠时间的关系，以及炎症作为中介的作用。

IF 3.4 2区医学 Q2 CLINICAL NEUROLOGY

Sleep Health

Pub Date : 2024-08-01 DOI: 10.1016/j.sleh.2024.01.011

Objective

The objective of this study was to examine the relationship between sleep duration and prediabetes, as well as to evaluate the influence of inflammation in mediating this association.

Methods

A total of 4632 participants from the China Health and Retirement Longitudinal Study (CHARLS) were included in this study, comprising both baseline and 4-year follow-up data. The prospective relationship between sleep duration and the risk of prediabetes was examined using logistic regression models. We used multinomial logistic regression to evaluate the impact of prediabetes on sleep duration changes over follow-up, assessing the role of C-reactive protein in the association using mediation analysis.

Results

Participants with short sleep duration (<5 hours) had a higher risk of prediabetes (odds ratios = 1.381 [95% CI: 1.028-1.857]) compared to those with normal sleep durations (7-8 hours). However, excessive sleep durations ( $\geq$ 9 hours) did not show a statistically significant association with prediabetes risk. Moreover, individuals at least 60 years old who experienced short sleep durations exhibited a higher risk of prediabetes. Individuals with prediabetes were more likely to have shorter sleep duration than excessive sleep duration (relative risk ratios = 1.280 [95% CI: 1.059-1.547]). The mediation analysis revealed a mediating effect of C-reactive protein on the association between prediabetes and reduced sleep duration.

Conclusions

Short sleep duration was identified as a risk factor for the incidence of prediabetes. Conversely, prediabetes was found to contribute to shorter sleep duration rather than excessive sleep duration. Moreover, elevated levels of C-reactive protein may serve as a potential underlying mechanism that links prediabetes with shorter sleep.

研究目的本研究的目的是探讨睡眠时间与糖尿病前期之间的关系，并评估炎症在调解这种关系中的影响：方法：本研究纳入了中国健康与退休纵向研究（CHARLS）的4632名参与者，包括基线数据和4年随访数据。我们使用逻辑回归模型研究了睡眠时间与糖尿病前期风险之间的前瞻性关系。我们使用多项式逻辑回归评估了糖尿病前期对随访期间睡眠时间变化的影响，并使用中介分析评估了 C 反应蛋白在两者关系中的作用：结果：睡眠时间短的参与者（结论：睡眠时间短被认为是糖尿病前期的一个风险因素：睡眠时间短被认为是糖尿病前期发病率的一个风险因素。相反，糖尿病是睡眠时间过短而不是睡眠时间过长造成的。此外，C 反应蛋白水平的升高可能是糖尿病前期与睡眠时间短之间的潜在联系机制。

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引用次数: 0

Inequities in adolescent sleep health in Aotearoa New Zealand: Cross-sectional survey findings 新西兰奥特亚罗瓦青少年睡眠健康的不平等：横断面调查结果。

IF 3.4 2区医学 Q2 CLINICAL NEUROLOGY

Sleep Health

Pub Date : 2024-08-01 DOI: 10.1016/j.sleh.2024.05.007

Objectives

To investigate ethnic inequities in, and social determinants of, adolescent sleep health in Aotearoa New Zealand.

Methods

Analysis of self-report data from a cross-sectional survey of secondary school students (12- to 18-year-olds). Analyses included weighted prevalence estimates of good and poor sleep health stratified by ethnicity, and multivariable logistic regression models concurrently adjusted for ethnicity, school year, gender, rurality, neighborhood deprivation, school decile, housing deprivation, sleeping elsewhere due to lack of adequate housing, unsafe environment, and racism.

Results

Inequities in social determinants of health were evident for Māori (Indigenous peoples of Aotearoa New Zealand; n = 1528) and minoritized (Pacific n = 1204; Asian n = 1927; Middle Eastern, Latin American, and African [MELAA] n = 210; and ‘Other' ethnicity n = 225) adolescents. A greater proportion of Māori, Pacific, Asian, MELAA, and ‘Other' adolescents had short sleep, compared to European (n = 3070). Māori, Pacific, Asian, and MELAA adolescents were more likely to report late bedtimes (after midnight), and Māori, Pacific, and ‘Other' adolescents were more likely to report early waketimes (5 AM-6 AM or earlier), on school days. Rurality, neighborhood deprivation, school-level deprivation, housing deprivation, sleeping elsewhere due to inadequate housing, unsafe environments, and racism partially, but not fully, explained associations between ethnicity and short sleep, late bedtimes, and early waketimes.

Conclusions

Ethnic inequities exist in adolescent sleep health in Aotearoa New Zealand. Socio-political actions are needed to address racism and colonialism as root causes of ethnic inequities in adolescent sleep, to ensure all young people are afforded the basic human right of good sleep health and associated mental and physical well-being.

目标：调查新西兰奥特亚罗瓦地区青少年睡眠健康的种族不平等和社会决定因素：调查新西兰奥特亚罗瓦地区青少年睡眠健康方面的种族不平等和社会决定因素：对中学生（12-18 岁）横断面调查的自我报告数据进行分析。分析包括按种族分层的睡眠健康良好和睡眠健康不良的加权流行率估计值，以及同时调整种族、学年、性别、乡村、邻里贫困、学校十分位数、住房贫困、因缺乏适当住房而睡在别处、不安全环境和种族主义的多变量逻辑回归模型：毛利人（新西兰奥特亚罗瓦土著居民；n = 1528）和少数民族（太平洋裔 n = 1204；亚裔 n = 1927；中东、拉美和非洲裔 [MELAA] n = 210；"其他 "族裔 n = 225）青少年在健康的社会决定因素方面存在明显的不平等。与欧裔青少年（n = 3070）相比，毛利青少年、太平洋裔青少年、亚裔青少年、中东、拉美和非洲裔青少年以及 "其他 "青少年睡眠时间较短的比例更高。毛利青少年、太平洋裔青少年、亚裔青少年和拉丁美洲及加勒比海地区青少年更有可能在上学日晚睡（午夜之后），而毛利青少年、太平洋裔青少年和 "其他 "青少年更有可能在上学日早醒（早上5点至6点或更早）。乡村、社区贫困、学校贫困、住房贫困、因住房不足而在其他地方睡觉、不安全的环境以及种族主义可以部分解释（但不能完全解释）种族与睡眠时间短、晚睡和早醒之间的关系：结论：在新西兰奥特亚罗瓦，青少年睡眠健康方面存在种族不平等。需要采取社会政治行动，解决导致青少年睡眠不平等的种族根源--种族主义和殖民主义问题，以确保所有青少年都能享有良好的睡眠健康及相关身心健康的基本人权。

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引用次数: 0