Pub Date : 2024-06-01DOI: 10.1016/j.sleh.2024.01.010
Andrea L. Fidler PhD, MPH , Gargi Rajput BS , Nanhua Zhang PhD , Dean W. Beebe PhD, ABPP
Objectives
Attrition and nonadherence are common concerns that can distort findings in clinical trials. This study examines the potential for systematic attrition in the largest sample to date of adolescents undergoing sleep manipulation.
Methods
Using pooled data across two trials involving 242 adolescents, a cumulative logistic regression tested whether demographics and baseline sleep predicted study completion/adherence.
Results
Race, a composite measure of socioeconomic status, and its elements (e.g., income, education) individually predicted completion/adherence. When entered concurrently into a multivariate predictive model, only socioeconomic status and study (trial A vs. B) were significant. Adolescents from households with higher socioeconomic status were more likely to complete or adhere to the protocol than those from households with lower socioeconomic status, p < .001.
Conclusions
Systematic attrition in sleep manipulation research could distort conclusions about under-resourced groups. Future sleep trials should intentionally measure systemic/structural factors and adopt strategies to recruit and retain participants from various backgrounds.
目的：减员和不坚持是临床试验中常见的问题，可能会扭曲试验结果。本研究在迄今为止最大的青少年睡眠操作样本中研究了系统性减员的可能性：利用涉及 242 名青少年的两项试验的汇总数据，采用累积逻辑回归法检验了人口统计学和基线睡眠是否能预测研究的完成/坚持情况：结果：种族、社会经济地位的综合衡量标准及其要素（如收入、教育程度）可单独预测研究的完成度/依从性。当同时输入多变量预测模型时，只有社会经济地位和研究（试验 A 与试验 B）具有显著性。与来自社会经济地位较低家庭的青少年相比，来自社会经济地位较高家庭的青少年更有可能完成或坚持方案，P 结论：睡眠操控研究中的系统性减员可能会扭曲有关资源不足群体的结论。未来的睡眠试验应有意识地测量系统性/结构性因素，并采取策略招募和留住来自不同背景的参与者。
{"title":"Which adolescents are more likely to complete home-based sleep manipulation trials?","authors":"Andrea L. Fidler PhD, MPH , Gargi Rajput BS , Nanhua Zhang PhD , Dean W. Beebe PhD, ABPP","doi":"10.1016/j.sleh.2024.01.010","DOIUrl":"10.1016/j.sleh.2024.01.010","url":null,"abstract":"<div><h3>Objectives</h3><p>Attrition and nonadherence are common concerns that can distort findings in clinical trials. This study examines the potential for systematic attrition in the largest sample to date of adolescents undergoing sleep manipulation.</p></div><div><h3>Methods</h3><p>Using pooled data across two trials involving 242 adolescents, a cumulative logistic regression tested whether demographics and baseline sleep predicted study completion/adherence.</p></div><div><h3>Results</h3><p>Race, a composite measure of socioeconomic status, and its elements (e.g., income, education) individually predicted completion/adherence. When entered concurrently into a multivariate predictive model, only socioeconomic status and study (trial A vs. B) were significant. Adolescents from households with higher socioeconomic status were more likely to complete or adhere to the protocol than those from households with lower socioeconomic status, <em>p</em> < .001.</p></div><div><h3>Conclusions</h3><p>Systematic attrition in sleep manipulation research could distort conclusions about under-resourced groups. Future sleep trials should intentionally measure systemic/structural factors and adopt strategies to recruit and retain participants from various backgrounds.</p></div>","PeriodicalId":48545,"journal":{"name":"Sleep Health","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140319542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.sleh.2023.10.012
Lisa Matricciani PhD , Dorothea Dumuid PhD , Ty Stanford PhD , Carol Maher PhD , Paul Bennett PhD , Larisa Bobrovskaya PhD , Andrew Murphy BBus(Prop) , Tim Olds PhD
Background
Sleep is increasingly recognized as a multidimensional construct that occurs within the 24-hour day. Despite advances in our understanding, studies continue to consider the relationship between sleep, sedentary time and physical activity separately, and not as part of the 24-hour day.
Aims
To determine the association between the 24-hour activity composition and dimensions of healthy sleep.
Methods
This study examined data on 1168 children (mean age 12 years; 49% female) and 1360 adults (mean age 44 years; 87% female) collected as part of the Child Health CheckPoint study. Participants were asked to wear a GENEActiv monitor (Activinsights, Cambs, UK) on their nondominant wrist for eight consecutive days to measure 24-hour time-use. Compositional data analysis was used to examine the association between time use (actigraphy-derived sleep duration, sedentary time, light physical activity and moderate-vigorous physical activity) and dimensions of healthy sleep. Healthy sleep was conceptualized in terms of continuity/efficiency, timing, alertness/sleepiness, satisfaction/quality, and regularity. Time allocations were also examined.
Results
The 24-hour activity composition was significantly associated with all objectively measured and self-report dimensions of healthy sleep in both children and adults. Allocating more time to sleep was associated with earlier sleep onsets, later sleep offsets, less efficient and more consistent sleep patterns for both children and adults.
Conclusion
This study highlights the integral relationship between daily activities and dimensions of sleep. Considering sleep within the 24-hour day activity composition framework may help inform lifestyle decisions to improve sleep health.
{"title":"Time use and dimensions of healthy sleep: A cross-sectional study of Australian children and adults","authors":"Lisa Matricciani PhD , Dorothea Dumuid PhD , Ty Stanford PhD , Carol Maher PhD , Paul Bennett PhD , Larisa Bobrovskaya PhD , Andrew Murphy BBus(Prop) , Tim Olds PhD","doi":"10.1016/j.sleh.2023.10.012","DOIUrl":"10.1016/j.sleh.2023.10.012","url":null,"abstract":"<div><h3>Background</h3><p>Sleep is increasingly recognized as a multidimensional construct that occurs within the 24-hour day. Despite advances in our understanding, studies continue to consider the relationship between sleep, sedentary time and physical activity separately, and not as part of the 24-hour day.</p></div><div><h3>Aims</h3><p>To determine the association between the 24-hour activity composition and dimensions of healthy sleep.</p></div><div><h3>Methods</h3><p>This study examined data on 1168 children (mean age 12<!--> <!-->years; 49% female) and 1360 adults (mean age 44<!--> <!-->years; 87% female) collected as part of the Child Health CheckPoint study. Participants were asked to wear a GENEActiv monitor (Activinsights, Cambs, UK) on their nondominant wrist for eight consecutive days to measure 24-hour time-use. Compositional data analysis was used to examine the association between time use (actigraphy-derived sleep duration, sedentary time, light physical activity and moderate-vigorous physical activity) and dimensions of healthy sleep. Healthy sleep was conceptualized in terms of continuity/efficiency, timing, alertness/sleepiness, satisfaction/quality, and regularity. Time allocations were also examined.</p></div><div><h3>Results</h3><p>The 24-hour activity composition was significantly associated with all objectively measured and self-report dimensions of healthy sleep in both children and adults. Allocating more time to sleep was associated with earlier sleep onsets, later sleep offsets, less efficient and more consistent sleep patterns for both children and adults.</p></div><div><h3>Conclusion</h3><p>This study highlights the integral relationship between daily activities and dimensions of sleep. Considering sleep within the 24-hour day activity composition framework may help inform lifestyle decisions to improve sleep health.</p></div>","PeriodicalId":48545,"journal":{"name":"Sleep Health","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352721823002504/pdfft?md5=19f516acc4926e8d735630da22e1cd77&pid=1-s2.0-S2352721823002504-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139418344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.sleh.2024.02.005
Julia T. Boyle PsyD , Spencer A. Nielson MS , Michael L. Perlis PhD , Joseph M. Dzierzewski PhD
Introduction
Insomnia symptoms are associated with poor physical and mental health. Exercise is associated with good sleep while sedentary behavior is associated with poor sleep. This study investigated the longitudinal, dynamic associations among exercise, sedentary behavior, and insomnia symptoms.
Methods
Seven hundred and fifty-six adults (Mage = 47.2 years, 54.9% female) took part in an online longitudinal study investigating sleep and health across the lifespan. Participants reported duration of moderate-to-strenuous exercise, percentage of day spent sitting, and insomnia symptoms (Insomnia Severity Index [ISI]). The ISI was scored as a total score and two-factor scores: (1) Sleep Disturbance (items 1, 2, 3) and (2) Daytime Dysfunction (items 4, 5, 6, 7). Multilevel modeling was used to examine the typical (i.e., between-persons) and individual (i.e., within-persons) associations among sedentary behavior, exercise, and insomnia symptoms.
Results
Sedentary behavior was significantly associated with total ISI scores at both the between-person and within-person levels (β = 0.036, t = 3.23, p = .001; β = 0.014, t = 1.99, p = .048). Both between-persons and within-person levels of sedentary behavior were associated with Daytime Dysfunction (β = 0.028, t = 3.79, p < .001; β = 0.009, t = 2.08, p = .039). Exercise was associated with total ISI and Daytime Dysfunction scores at the between-persons level but not at the within-persons level (β = 0.028, t = 2.57, p = .01; β = − 0.002, t = − 3.02, p = .003).
Conclusions
Sedentary behavior was a more consistent and robust predictor of insomnia symptoms than exercise. The association between sedentary behavior and insomnia symptoms was dynamic in that when an individual reported being more sedentary than their norm, they also reported more insomnia symptoms. Future analyses should examine potential moderator variables and comorbid conditions.
{"title":"Move your feet and sleep: A longitudinal dynamic analysis of self-reported exercise, sedentary behavior, and insomnia symptoms","authors":"Julia T. Boyle PsyD , Spencer A. Nielson MS , Michael L. Perlis PhD , Joseph M. Dzierzewski PhD","doi":"10.1016/j.sleh.2024.02.005","DOIUrl":"10.1016/j.sleh.2024.02.005","url":null,"abstract":"<div><h3>Introduction</h3><p>Insomnia symptoms are associated with poor physical and mental health. Exercise is associated with good sleep while sedentary behavior is associated with poor sleep. This study investigated the longitudinal, dynamic associations among exercise, sedentary behavior, and insomnia symptoms.</p></div><div><h3>Methods</h3><p>Seven hundred and fifty-six adults (M<sub>age</sub> <!-->=<!--> <!-->47.2<!--> <!-->years, 54.9% female) took part in an online longitudinal study investigating sleep and health across the lifespan. Participants reported duration of moderate-to-strenuous exercise, percentage of day spent sitting, and insomnia symptoms (Insomnia Severity Index [ISI]). The ISI was scored as a total score and two-factor scores: (1) Sleep Disturbance (items 1, 2, 3) and (2) Daytime Dysfunction (items 4, 5, 6, 7). Multilevel modeling was used to examine the typical (i.e., between-persons) and individual (i.e., within-persons) associations among sedentary behavior, exercise, and insomnia symptoms.</p></div><div><h3>Results</h3><p>Sedentary behavior was significantly associated with total ISI scores at both the between-person and within-person levels (<em>β</em> = 0.036, <em>t</em> = 3.23, <em>p</em> = .001; <em>β</em> = 0.014, <em>t</em> = 1.99, <em>p</em> = .048). Both between-persons and within-person levels of sedentary behavior were associated with Daytime Dysfunction (<em>β</em> = 0.028, <em>t</em> = 3.79, <em>p</em> < .001; <em>β</em> = 0.009, <em>t</em> = 2.08, <em>p</em> = .039). Exercise was associated with total ISI and Daytime Dysfunction scores at the between-persons level but not at the within-persons level (<em>β</em> = 0.028, <em>t</em> = 2.57, <em>p</em> = .01<em>; β</em> = −<!--> <!-->0.002, <em>t</em> = −<!--> <!-->3.02, <em>p</em> = .003).</p></div><div><h3>Conclusions</h3><p>Sedentary behavior was a more consistent and robust predictor of insomnia symptoms than exercise. The association between sedentary behavior and insomnia symptoms was dynamic in that when an individual reported being more sedentary than their norm, they also reported more insomnia symptoms. Future analyses should examine potential moderator variables and comorbid conditions.</p></div>","PeriodicalId":48545,"journal":{"name":"Sleep Health","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140319540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.sleh.2024.03.001
Faith S. Luyster PhD , Lynn M. Baniak PhD, RN , Christopher C. Imes PhD, RN , Bomin Jeon PhD, RN , Jonna L. Morris PhD, RN , Staci Orbell PhD(c), MSN, RN , Paul Scott PhD
Objectives
To investigate the association between comorbid obstructive sleep apnea and insomnia and major adverse cardiovascular events, including myocardial infarction, unstable angina, congestive heart failure, and stroke, in adults with suspected sleep disorders who underwent sleep apnea testing.
Methods
We conducted a retrospective analysis of electronic medical records data from patients with clinical encounters at sleep medicine centers to identify patients with comorbid obstructive sleep apnea and insomnia, obstructive sleep apnea only, insomnia only, and patients without a diagnosis of obstructive sleep apnea or insomnia (i.e., controls). Obstructive sleep apnea, insomnia, comorbidities, and new-onset major adverse cardiovascular events were ascertained by ICD-9-CM and ICD-10-CM codes. Multivariable adjusted Cox proportional regression models evaluated the risk of major adverse cardiovascular events over a 10-year follow-up period.
Results
A total of 3951 patients, 226 controls, 2107 with obstructive sleep apnea only, 276 with insomnia only, and 1342 with comorbid obstructive sleep apnea and insomnia, were included in the analysis. Compared to controls, comorbid obstructive sleep apnea and insomnia were associated with a significantly higher risk of developing major adverse cardiovascular events (hazard ratio 3.60, 95 CI%: 2.33-5.91) in unadjusted analyses. The relationship between comorbid obstructive sleep apnea and insomnia and major adverse cardiovascular events remained after adjustment for demographic and behavioral factors, but not after further adjustment for comorbidities. The greatest risk of major adverse cardiovascular events was found among younger adults with comorbid obstructive sleep apnea and insomnia. Obstructive sleep apnea only was associated with greater risk of major adverse cardiovascular events in unadjusted analyses only (hazard ratio 2.77, 95% CI: 1.80-4.54). Insomnia only was not significantly associated with increased risk of major adverse cardiovascular events.
Conclusions
Comorbid obstructive sleep apnea and insomnia may be a high-risk group for major adverse cardiovascular events, particularly younger adults. Further research is needed to better understand the association between comorbid obstructive sleep apnea and insomnia and major adverse cardiovascular events risk.
{"title":"Association of comorbid obstructive sleep apnea and insomnia with risk of major adverse cardiovascular events in sleep medicine center patients","authors":"Faith S. Luyster PhD , Lynn M. Baniak PhD, RN , Christopher C. Imes PhD, RN , Bomin Jeon PhD, RN , Jonna L. Morris PhD, RN , Staci Orbell PhD(c), MSN, RN , Paul Scott PhD","doi":"10.1016/j.sleh.2024.03.001","DOIUrl":"10.1016/j.sleh.2024.03.001","url":null,"abstract":"<div><h3>Objectives</h3><p>To investigate the association between comorbid obstructive sleep apnea and insomnia and major adverse cardiovascular events, including myocardial infarction, unstable angina, congestive heart failure, and stroke, in adults with suspected sleep disorders who underwent sleep apnea testing.</p></div><div><h3>Methods</h3><p>We conducted a retrospective analysis of electronic medical records data from patients with clinical encounters at sleep medicine centers to identify patients with comorbid obstructive sleep apnea and insomnia, obstructive sleep apnea only, insomnia only, and patients without a diagnosis of obstructive sleep apnea or insomnia (i.e., controls). Obstructive sleep apnea, insomnia, comorbidities, and new-onset major adverse cardiovascular events were ascertained by ICD-9-CM and ICD-10-CM codes. Multivariable adjusted Cox proportional regression models evaluated the risk of major adverse cardiovascular events over a 10-year follow-up period.</p></div><div><h3>Results</h3><p>A total of 3951 patients, 226 controls, 2107 with obstructive sleep apnea only, 276 with insomnia only, and 1342 with comorbid obstructive sleep apnea and insomnia, were included in the analysis. Compared to controls, comorbid obstructive sleep apnea and insomnia were associated with a significantly higher risk of developing major adverse cardiovascular events (hazard ratio 3.60, 95 CI%: 2.33-5.91) in unadjusted analyses. The relationship between comorbid obstructive sleep apnea and insomnia and major adverse cardiovascular events remained after adjustment for demographic and behavioral factors, but not after further adjustment for comorbidities. The greatest risk of major adverse cardiovascular events was found among younger adults with comorbid obstructive sleep apnea and insomnia. Obstructive sleep apnea only was associated with greater risk of major adverse cardiovascular events in unadjusted analyses only (hazard ratio 2.77, 95% CI: 1.80-4.54). Insomnia only was not significantly associated with increased risk of major adverse cardiovascular events.</p></div><div><h3>Conclusions</h3><p>Comorbid obstructive sleep apnea and insomnia may be a high-risk group for major adverse cardiovascular events, particularly younger adults. Further research is needed to better understand the association between comorbid obstructive sleep apnea and insomnia and major adverse cardiovascular events risk.</p></div>","PeriodicalId":48545,"journal":{"name":"Sleep Health","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.sleh.2024.01.007
Jenesse Kaitz PhD , Varsha G. Vimalananda MD , Martin P. Charns DBA , Gemmae M. Fix PhD
Objectives
Sleep disorders are wide-ranging in their causes and impacts on other physical and mental health conditions. Thus, sleep disorders could benefit from a multidisciplinary approach to assessment and treatment. An integrated care model is often recommended but is costly to implement. We sought to understand how, in the absence of an established organizational structure for integrated sleep care, providers from different clinics work together to provide care for sleep disorders.
Methods
A qualitative case study at one U.S. Department of Veterans Affairs (VA) medical center. We used a purposeful nested sampling strategy, combining maximum variation sampling and snowball sampling to recruit key staff involved in sleep care.
Results
We interviewed providers (N = 10) from sleep medicine, primary care, and mental health services. Providers identified the ubiquity of sleep disorders and a concomitant need for multidisciplinary care. However, they described limited opportunities for multidisciplinary interactions and consequently a negative impact on clinical care. Providers described fragmentation in two areas: among sleep specialists and between sleep specialists and other referring and managing providers.
Conclusions
A range of interventions, based on setting and resources, could improve care coordination both among sleep specialists and between sleep and nonsleep providers. While integrated sleep specialist clinics could reduce care fragmentation, they may not directly impact coordination with referring providers, like primary care and general mental health, who are essential in managing chronic conditions. Future work should continue to explore improving care coordination for sleep problems to ensure patients receive high-quality, timely, patient-centered care.
{"title":"Multidisciplinary providers’ perceptions of care delivery for sleep disorders: A qualitative case study","authors":"Jenesse Kaitz PhD , Varsha G. Vimalananda MD , Martin P. Charns DBA , Gemmae M. Fix PhD","doi":"10.1016/j.sleh.2024.01.007","DOIUrl":"10.1016/j.sleh.2024.01.007","url":null,"abstract":"<div><h3>Objectives</h3><p>Sleep disorders are wide-ranging in their causes and impacts on other physical and mental health conditions. Thus, sleep disorders could benefit from a multidisciplinary approach to assessment and treatment. An integrated care model is often recommended but is costly to implement. We sought to understand how, in the absence of an established organizational structure for integrated sleep care, providers from different clinics work together to provide care for sleep disorders.</p></div><div><h3>Methods</h3><p>A qualitative case study at one U.S. Department of Veterans Affairs (VA) medical center. We used a purposeful nested sampling strategy, combining maximum variation sampling and snowball sampling to recruit key staff involved in sleep care.</p></div><div><h3>Results</h3><p>We interviewed providers (N = 10) from sleep medicine, primary care, and mental health services. Providers identified the ubiquity of sleep disorders and a concomitant need for multidisciplinary care. However, they described limited opportunities for multidisciplinary interactions and consequently a negative impact on clinical care. Providers described fragmentation in two areas: among sleep specialists and between sleep specialists and other referring and managing providers.</p></div><div><h3>Conclusions</h3><p>A range of interventions, based on setting and resources, could improve care coordination both among sleep specialists and between sleep and nonsleep providers. While integrated sleep specialist clinics could reduce care fragmentation, they may not directly impact coordination with referring providers, like primary care and general mental health, who are essential in managing chronic conditions. Future work should continue to explore improving care coordination for sleep problems to ensure patients receive high-quality, timely, patient-centered care.</p></div>","PeriodicalId":48545,"journal":{"name":"Sleep Health","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140190252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.sleh.2023.12.009
Malin Jakobsson PhD, MSN, RN
Objectives
Lack of sleep is a common problem in children and adolescents of school age (students), and it is a health aspect that affects the ability to assimilate into the school's education and thereby falls within the school nurses promoting work. This study aimed to describe school nurses' experiences of sleep-promoting work.
Method
Data were collected by n = 61 school nurses' written narratives of their sleep-promotion work. Data were analyzed using qualitative content analysis.
Results
The results describe school nurses’ experiences of sleep-promoting work in three main categories: (1) Informing and providing knowledge is the primary task. School nurses do it systematically, through dialogs with an individual student, with several students simultaneously, or with parents. (2) Benefits take place when the needs of the student guide the work. Through curiosity about the personal story, the keys to sleep-promoting work can be found, appropriate strategies can be given, and the student can be guided further if needed. (3) Barriers challenge the outcome of the work. The school nurses experience these barriers in the form of unmotivated students, unsupportive parents, and lack of prerequisites, which make the school nurses unsure of their performance.
Conclusions
School nurses experience a significant benefit in their sleep-promoting work when the needs of the student guide the sleep-promoting information, strategies, and follow-ups. To avoid feeling insecure in sleep-promoting work, school nurses need updates on the state of knowledge and evidence-based tools. Further research on sleep-promoting work at school is necessary.
目的：睡眠不足是学龄儿童和青少年（学生）的常见问题，也是影响融入学校教育能力的健康问题，因此属于校医促进工作的范畴。本研究旨在描述校医在促进睡眠工作方面的经验：方法：通过 n = 61 名校医对其促进睡眠工作的书面叙述收集数据。采用定性内容分析法对数据进行分析：结果：学校护士在促进睡眠工作中的经验主要分为三类：（1）告知和提供知识是首要任务。校医通过与单个学生、同时与多个学生或与家长对话，系统地开展这项工作。(2) 以学生的需求为工作导向，才能产生效益。通过对学生个人经历的好奇心，可以找到促进睡眠工作的关键，提供适当的策略，并在必要时进一步指导学生。(3) 障碍挑战工作成果。校医在工作中遇到的障碍有：学生不积极、家长不支持、缺乏先决条件等，这些都让校医对自己的工作表现没有信心：如果以学生的需求为导向来提供促进睡眠的信息、策略和跟进，校医在促进睡眠的工作中会受益匪浅。为了避免在促进睡眠工作中感到不安全，学校护士需要了解最新的知识和循证工具。有必要对学校促进睡眠工作进行进一步研究。
{"title":"“I'm not sure if it works”: School nurses’ experiences of sleep-promoting work in Sweden","authors":"Malin Jakobsson PhD, MSN, RN","doi":"10.1016/j.sleh.2023.12.009","DOIUrl":"10.1016/j.sleh.2023.12.009","url":null,"abstract":"<div><h3>Objectives</h3><p>Lack of sleep is a common problem in children and adolescents of school age (students), and it is a health aspect that affects the ability to assimilate into the school's education and thereby falls within the school nurses promoting work. This study aimed to describe school nurses' experiences of sleep-promoting work.</p></div><div><h3>Method</h3><p>Data were collected by n = 61 school nurses' written narratives of their sleep-promotion work. Data were analyzed using qualitative content analysis.</p></div><div><h3>Results</h3><p>The results describe school nurses’ experiences of sleep-promoting work in three main categories: (1) <em>Informing and providing knowledge is the primary task</em>. School nurses do it systematically, through dialogs with an individual student, with several students simultaneously, or with parents. (2) <em>Benefits take place when the needs of the student guide the work</em>. Through curiosity about the personal story, the keys to sleep-promoting work can be found, appropriate strategies can be given, and the student can be guided further if needed. (3) <em>Barriers challenge the outcome of the work</em>. The school nurses experience these barriers in the form of unmotivated students, unsupportive parents, and lack of prerequisites, which make the school nurses unsure of their performance.</p></div><div><h3>Conclusions</h3><p>School nurses experience a significant benefit in their sleep-promoting work when the needs of the student guide the sleep-promoting information, strategies, and follow-ups. To avoid feeling insecure in sleep-promoting work, school nurses need updates on the state of knowledge and evidence-based tools. Further research on sleep-promoting work at school is necessary.</p></div>","PeriodicalId":48545,"journal":{"name":"Sleep Health","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352721823003273/pdfft?md5=7db8cd9b12943aad90af2fbe81edc6f1&pid=1-s2.0-S2352721823003273-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139511731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.sleh.2024.02.007
Adrian R. Willoughby PhD, Hosein Aghayan Golkashani MD, PhD, Shohreh Ghorbani MSc, Kian F. Wong BA, Nicholas I.Y.N. Chee BSc, Ju Lynn Ong PhD, Michael W.L. Chee MBBS
Goal and aims
To test sleep/wake transition detection of consumer sleep trackers and research-grade actigraphy during nocturnal sleep and simulated peri-sleep behavior involving minimal movement.
Focus technology
Oura Ring Gen 3, Fitbit Sense, AXTRO Fit 3, Xiaomi Mi Band 7, and ActiGraph GT9X.
Reference technology
Polysomnography.
Sample
Sixty-three participants (36 female) aged 20-68.
Design
Participants engaged in common peri-sleep behavior (reading news articles, watching videos, and exchanging texts) on a smartphone before and after the sleep period. They were woken up during the night to complete a short questionnaire to simulate responding to an incoming message.
Core analytics
Detection and timing accuracy for the sleep onset times and wake times.
Additional analytics and exploratory analyses
Discrepancy analysis both including and excluding the peri-sleep activity periods. Epoch-by-epoch analysis of rate and extent of wake misclassification during peri-sleep activity periods.
Core outcomes
Oura and Fitbit were more accurate at detecting sleep/wake transitions than the actigraph and the lower-priced consumer sleep tracker devices. Detection accuracy was less reliable in participants with lower sleep efficiency.
Important additional outcomes
With inclusion of peri-sleep periods, specificity and Kappa improved significantly for Oura and Fitbit, but not ActiGraph. All devices misclassified motionless wake as sleep to some extent, but this was less prevalent for Oura and Fitbit.
Core conclusions
Performance of Oura and Fitbit is robust on nights with suboptimal bedtime routines or minor sleep disturbances. Reduced performance on nights with low sleep efficiency bolsters concerns that these devices are less accurate for fragmented or disturbed sleep.
{"title":"Performance of wearable sleep trackers during nocturnal sleep and periods of simulated real-world smartphone use","authors":"Adrian R. Willoughby PhD, Hosein Aghayan Golkashani MD, PhD, Shohreh Ghorbani MSc, Kian F. Wong BA, Nicholas I.Y.N. Chee BSc, Ju Lynn Ong PhD, Michael W.L. Chee MBBS","doi":"10.1016/j.sleh.2024.02.007","DOIUrl":"10.1016/j.sleh.2024.02.007","url":null,"abstract":"<div><h3>Goal and aims</h3><p>To test sleep/wake transition detection of consumer sleep trackers and research-grade actigraphy during nocturnal sleep and simulated peri-sleep behavior involving minimal movement.</p></div><div><h3>Focus technology</h3><p>Oura Ring Gen 3, Fitbit Sense, AXTRO Fit 3, Xiaomi Mi Band 7, and ActiGraph GT9X.</p></div><div><h3>Reference technology</h3><p>Polysomnography.</p></div><div><h3>Sample</h3><p>Sixty-three participants (36 female) aged 20-68.</p></div><div><h3>Design</h3><p>Participants engaged in common peri-sleep behavior (reading news articles, watching videos, and exchanging texts) on a smartphone before and after the sleep period. They were woken up during the night to complete a short questionnaire to simulate responding to an incoming message.</p></div><div><h3>Core analytics</h3><p>Detection and timing accuracy for the sleep onset times and wake times.</p></div><div><h3>Additional analytics and exploratory analyses</h3><p>Discrepancy analysis both including and excluding the peri-sleep activity periods. Epoch-by-epoch analysis of rate and extent of wake misclassification during peri-sleep activity periods.</p></div><div><h3>Core outcomes</h3><p>Oura and Fitbit were more accurate at detecting sleep/wake transitions than the actigraph and the lower-priced consumer sleep tracker devices. Detection accuracy was less reliable in participants with lower sleep efficiency.</p></div><div><h3>Important additional outcomes</h3><p>With inclusion of peri-sleep periods, specificity and Kappa improved significantly for Oura and Fitbit, but not ActiGraph. All devices misclassified motionless wake as sleep to some extent, but this was less prevalent for Oura and Fitbit.</p></div><div><h3>Core conclusions</h3><p>Performance of Oura and Fitbit is robust on nights with suboptimal bedtime routines or minor sleep disturbances. Reduced performance on nights with low sleep efficiency bolsters concerns that these devices are less accurate for fragmented or disturbed sleep.</p></div>","PeriodicalId":48545,"journal":{"name":"Sleep Health","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352721824000329/pdfft?md5=c81256f091c134f651746535f2e5851a&pid=1-s2.0-S2352721824000329-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140789719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.sleh.2023.12.006
Giovanni Alvarado MS, Ashleigh Hilton BS, Alexandria Montenegro BS, Cara A. Palmer PhD
Objectives
The purpose of this study is to examine adolescent attitudes about the importance of sleep and how they relate to adolescent sleep behaviors and parent sleep attitudes.
Methods
Participants included families with adolescents aged 10-17 years and a parent (N = 170 dyads) who completed a virtual assessment. Adolescents reported on their sleep impairment and sleep hygiene behaviors, and all participants completed a newly developed scale to assess attitudes toward the importance of prioritizing sleep over other activities/responsibilities.
Results
Results suggest that older adolescents reported more negative sleep attitudes, and adolescents reported more negative sleep attitudes compared to adult/parent participants. More negative sleep attitudes were associated with poorer sleep hygiene behaviors. Parent sleep attitudes significantly predicted their adolescent’s sleep attitudes, even after adjusting for family income, education, and adolescent age and sex.
Conclusions
This is the first study to our knowledge to quantitatively examine adolescent sleep attitudes. Findings suggest that sleep attitudes are important for adolescent sleep, and may develop within the family system via parental socialization. Future research and implications for intervention are discussed.
{"title":"Passing on the Zzz’s: Adolescent sleep attitudes are associated with sleep behaviors and parental prioritization of sleep","authors":"Giovanni Alvarado MS, Ashleigh Hilton BS, Alexandria Montenegro BS, Cara A. Palmer PhD","doi":"10.1016/j.sleh.2023.12.006","DOIUrl":"10.1016/j.sleh.2023.12.006","url":null,"abstract":"<div><h3>Objectives</h3><p>The purpose of this study is to examine adolescent attitudes about the importance of sleep and how they relate to adolescent sleep behaviors and parent sleep attitudes.</p></div><div><h3>Methods</h3><p>Participants included families with adolescents aged 10-17<!--> <!-->years and a parent (N = 170 dyads) who completed a virtual assessment. Adolescents reported on their sleep impairment and sleep hygiene behaviors, and all participants completed a newly developed scale to assess attitudes toward the importance of prioritizing sleep over other activities/responsibilities.</p></div><div><h3>Results</h3><p>Results suggest that older adolescents reported more negative sleep attitudes, and adolescents reported more negative sleep attitudes compared to adult/parent participants. More negative sleep attitudes were associated with poorer sleep hygiene behaviors. Parent sleep attitudes significantly predicted their adolescent’s sleep attitudes, even after adjusting for family income, education, and adolescent age and sex.</p></div><div><h3>Conclusions</h3><p>This is the first study to our knowledge to quantitatively examine adolescent sleep attitudes. Findings suggest that sleep attitudes are important for adolescent sleep, and may develop within the family system via parental socialization. Future research and implications for intervention are discussed.</p></div>","PeriodicalId":48545,"journal":{"name":"Sleep Health","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139984174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1016/j.sleh.2023.10.008
Dina Sarsembayeva MRes , Catharina A. Hartman PhD , Raniere Dener Cardoso Melo MRes , Marieke J. Schreuder PhD
Objectives
This study investigated (non)linear associations between different eveningness characteristics (bedtime, wake time, morning affect, and peak performance time) and insomnia symptoms (difficulties initiating sleep, difficulties maintaining sleep, and nonrestorative sleep) in a large general population sample.
Methods
The data came from digital surveys about insomnia (Minimal Insomnia Scale) and circadian preferences (Children’s Chronotype Questionnaire/Composite Scale of Morningness) completed by the Dutch general population (37,389 participants aged 4-91 years, 42.4% men) in the Lifelines cohort substudy Comorbid Conditions of ADHD.
Results
Using generalized additive modeling, we found that different characteristics of eveningness related to insomnia either exponentially (later wake time/peak performance time, worse morning affect) or quadratically (early and late bedtime/midpoint of sleep). While difficulties initiating sleep and nonrestorative sleep were strongly associated with all eveningness characteristics, difficulties maintaining sleep related only to earlier bedtimes. These relationships were similar for men and women but varied partly in shapes and strengths across the lifespan. Additional analyses showed that bedtime and wake time were associated with insomnia symptoms only when their combination would result in an unusually long or short preferred time in bed.
Conclusion
The association between eveningness and insomnia symptoms highly depends on whether eveningness is reflected by daytime performance or sleep-wake time. The pattern and strength of these associations also vary depending on age and insomnia symptom, but less so on sex. Future sleep-related research and policies relying on circadian preferences should account for the nonlinearity, dimension/symptom-related specificity and age-related differences in the association between eveningness and insomnia symptoms.
{"title":"Nonlinear associations between insomnia symptoms and circadian preferences in the general population: Symptom-specific and lifespan differences in men and women","authors":"Dina Sarsembayeva MRes , Catharina A. Hartman PhD , Raniere Dener Cardoso Melo MRes , Marieke J. Schreuder PhD","doi":"10.1016/j.sleh.2023.10.008","DOIUrl":"10.1016/j.sleh.2023.10.008","url":null,"abstract":"<div><h3>Objectives</h3><p>This study investigated (non)linear associations between different eveningness characteristics (bedtime, wake time, morning affect, and peak performance time) and insomnia symptoms (difficulties initiating sleep, difficulties maintaining sleep, and nonrestorative sleep) in a large general population sample.</p></div><div><h3>Methods</h3><p>The data came from digital surveys about insomnia (Minimal Insomnia Scale) and circadian preferences (Children’s Chronotype Questionnaire/Composite Scale of Morningness) completed by the Dutch general population (37,389 participants aged 4-91<!--> <!-->years, 42.4% men) in the Lifelines cohort substudy Comorbid Conditions of ADHD.</p></div><div><h3>Results</h3><p>Using generalized additive modeling, we found that different characteristics of eveningness related to insomnia either exponentially (later wake time/peak performance time, worse morning affect) or quadratically (early and late bedtime/midpoint of sleep). While difficulties initiating sleep and nonrestorative sleep were strongly associated with all eveningness characteristics, difficulties maintaining sleep related only to earlier bedtimes. These relationships were similar for men and women but varied partly in shapes and strengths across the lifespan. Additional analyses showed that bedtime and wake time were associated with insomnia symptoms only when their combination would result in an unusually long or short preferred time in bed.</p></div><div><h3>Conclusion</h3><p>The association between eveningness and insomnia symptoms highly depends on whether eveningness is reflected by daytime performance or sleep-wake time. The pattern and strength of these associations also vary depending on age and insomnia symptom, but less so on sex. Future sleep-related research and policies relying on circadian preferences should account for the nonlinearity, dimension/symptom-related specificity and age-related differences in the association between eveningness and insomnia symptoms.</p></div>","PeriodicalId":48545,"journal":{"name":"Sleep Health","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352721823002449/pdfft?md5=ad126929061139f97f70910d0a39725a&pid=1-s2.0-S2352721823002449-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138441501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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