Behavioral Sleep Medicine最新文献

Objective: Sleep is essential for children's cognitive development, with evidence linking poor quality to impairments in executive functions (EFs) such as working memory, inhibitory control, and cognitive flexibility. While sleep can be measured using objective methods like polysomnography and actigraphy, these techniques lack the subjective perspective that is provided by self-report tools. This study investigated the effects of self-reported sleep quality and age on EFs in typically developing children aged 7 to 12 years.

Methods: One hundred and seventy children completed working memory (WM), inhibitory control (IC), and cognitive flexibility (CF) tasks to measure EF performance. Sleep quality was assessed via the Children's Report of Sleep Patterns, which captured sleep duration and subjective experiences.

Results: Significant associations between age and EF across most EF components, reflected developmental trends. Sleep quality was significantly associated with IC-Performance and CF Shape Errors, meaning that as sleep quality improved, so did EF performance. Sleep was not associated with WM.

Conclusion: The findings highlight age-related developmental improvements in EF. These findings suggest that self-reported sleep quality may impact EF tasks requiring attentional control and flexibility. Sleep quality impacts children's cognitive functioning, therefore improvements in sleep may enhance developmental outcomes.

Objective: To examine the associations between parent perceived environmental factors, nighttime sleep duration and 24-h sleep duration among an international sample of preschool-aged children.

Methods: Secondary analyses of cross-sectional data from preschoolers across 23 countries (19 LMICs), collected during the third pilot phase (January 2021-August 2024) of the SUNRISE Study. Parents completed a questionnaire which asked about their child's sleep patterns and environmental factors that impacted their child's sleep in the previous 3 days.

Results: Data from 2,219 children were analyzed. A significant difference was observed between nighttime sleep (F = 14.27, p = <0.0001) and nap duration (F = 9.10, p = 0.0004) across country income level. Environmental factors such as heat (-12.87, 95% CI: -11.54, -0.61) and cold (-17.70, 95% CI: -34.53, -0.85) were negatively associated with nighttime sleep duration.

Conclusions: Public health researchers and professionals should prioritize context-specific strategies to minimize the impact of weather conditions on sleep to promote healthy levels of sleep among preschoolers from diverse settings.

Objective: Bedtime procrastination describes going to bed later than intended, leading to insufficient sleep. Although difficulty falling asleep and pre-sleep arousal are assumed to cause bedtime procrastination, the relationship has not been directly examined. In this study, we examined whether difficulty falling asleep and pre-sleep arousal lead to bedtime procrastination.

Methods: We conducted a longitudinal survey, administered three times at 1-month intervals, among participants aged 18-65 years; 1,102 participants were included in the final analysis. Participants were asked to complete questionnaires that included bedtime procrastination, difficulty falling asleep, and pre-sleep arousal (cognitive and somatic) measures. The random intercept cross-lagged panel model was used to test the hypothesis that difficulty falling asleep and pre-sleep arousal increased bedtime procrastination.

Results: No significant cross-lagged path was observed from difficulty falling asleep or pre-sleep cognitive arousal to bedtime procrastination. A significant positive path was observed from pre-sleep somatic arousal to bedtime procrastination between Times 2 and 3, but not Times 1 and 2.

Conclusion: Although difficulty falling asleep did not lead to bedtime procrastination, pre-sleep somatic arousal partially led to bedtime procrastination. These findings suggest that individuals with higher pre-sleep somatic arousal might develop more bedtime procrastination.

Objectives: This case series examined the feasibility and preliminary effects of group-based, videoconference-delivered cognitive-behavioral therapy (CBT) combined with morning light therapy (LT) in adolescents with delayed sleep timing.

Method: Five females aged 14-16 years (M = 15.0, SD = 0.7) completed clinician-administered screening interviews, and baseline and post-treatment assessments, including circadian phase measurement, and validated measures of chronotype, bedtime procrastination, pre-sleep arousal, daytime sleepiness, anxiety, depression, and quality of life. Actigraphy was used for the duration of the study. The intervention included six weekly CBT sessions and short-wavelength wearable LT assigned for 1 hr daily following an advancing wake time schedule.

Results: One participant showed a 94-min circadian phase advance; others showed minimal phase advance, no change, or phase delays (n = 2). All participants reported earlier chronotype by post-treatment. Three advanced either sleep onset or wake time, with one showing both. Two showed increased total sleep time, primarily due to delayed wake time. Other objective sleep outcomes are presented. Bedtime procrastination, pre-sleep arousal, daytime sleepiness, depression, and quality of life improved, with modest reductions in anxiety. Challenges included napping, ADHD and anxiety comorbidity, scheduling barriers (homework, extracurricular activities, screen use), and resistance to earlier bedtimes.

Conclusions: Results suggest heterogeneous circadian and sleep responses but consistent behavioral improvements. Extended LT duration, motivational enhancement, executive function or time management strategies, and behavioral economics-informed interventions may improve engagement and treatment efficacy.

Objective: Research on the prevalence of bedtime procrastination (BtP) is currently focused on the breadth of BtP presentations, with limited insights into the severity of BtP in terms of its frequency, duration, and dysfunctional impacts. This study aimed to explore the BtP severity and its prevalence among Chinese college students. Moreover, correlates and outcomes of BtP were also examined.

Methods: A total of 20704 college students participated in a cross-sectional survey. BtP was measured by combining the bedtime procrastination scale with items related to BtP frequency, duration per episode, and dysfunctional impacts. Sociodemographics, lifestyles, trait- and state-like factors, and indicators of sleep and mental health were also evaluated.

Results: The prevalence of severe BtP was 10.5%. Poor family socioeconomic status, physical inactivity, alcohol use, pre-sleep media use, and perceived stress were identified as risk factors for severe BtP, while older age, self-control, and an earlier chronotype were protective factors. Moreover, severe BtP was associated with shorter sleep duration, greater social jetlag, and increased risks of daytime sleepiness and depressive symptoms.

Conclusions: The findings provided valuable insights for BtP screening. The associations between BtP and adverse outcomes underscore the importance of screening for severe BtP and offering appropriate interventions.

Objective: Research indicates a strong relationship between dietary inflammation and sleep; however, such research is limited among women postpartum. We studied whether prenatal and postnatal pro-inflammatory diets were associated with postpartum sleep quality and duration.

Methods: A secondary data analysis was conducted among 219 women from the Health in Pregnancy and Postpartum randomized controlled trial promoting healthy lifestyles in pregnant women with pre-pregnancy overweight and obesity. Data from ≤16 and 32 weeks gestation, and 6 and 12 months postpartum were used. Sleep was measured using BodyMedia's SenseWear® armband. Energy-adjusted Dietary Inflammatory Index (E-DII^TM) scores were calculated using micro and macronutrients intake collected from 24-hour dietary recalls. Linear mixed-effects models estimated the impact of the E-DII score on postpartum sleep parameters.

Results: Women consuming pro-inflammatory diets, compared to anti-inflammatory diets were more likely to have a later bedtime (p = .04) and a later waketime (p = .03). For every one-unit increase in the prenatal E-DII score, 6-months postpartum sleep latency increased by 0.57 minute (p = .03). Among those receiving the intervention, changes in E-DII scores led to a 7.3-minute earlier bedtime (p = .01), 5.2-minute longer sleep duration (p = .03) and additional 5.7-minute longer time-in-bed (p = .05) compared to controls.

Conclusions: Results suggest anti-inflammatory diets during pregnancy and postpartum may be beneficial for better sleep.

Objectives: Insomnia is highly comorbid with mental health conditions, yet graduate psychology students receive limited training in sleep and insomnia management. An online introductory sleep workshop focused on insomnia management with Cognitive Behavioral Therapy for Insomnia (CBT-I) was developed for Australian graduate psychology students to address this training gap. However, some students reported difficulties applying CBT-I knowledge to clinical practice. This study explored the barriers and facilitators to implementing CBT-I knowledge into graduate psychology students' practice post-workshop.

Methods: Semi-structured interviews were conducted with 15 graduate psychology students who attended an online introductory sleep and CBT-I workshop. Data were analyzed using reflexive thematic analysis.

Results: Facilitators of CBT-I implementation included: (1) Helpful workshop resources; (2) Increased awareness of the importance of sleep's role in mental health; (3) Enhanced self-efficacy with introductory sleep skills (e.g. sleep history taking); and (4) Knowing where to access further training. Barriers included: (1) Limited ongoing training and clinical supervision; (2) Accessibility challenges; (3) Clinical implementation challenges; and (4) Constraints of being a graduate student.

Conclusion: The introductory workshop facilitated the development of introductory CBT-I skills among graduate psychology students, but ongoing training and supervision are needed to enhance implementation and expand Australia's CBT-I workforce.

Background: This study employed a multilevel autoregressive mediation model to clarify the longitudinal role of poor sleep quality in the association between mobile-phone addiction and depressive symptoms among Chinese college students.

Methods: 3,662 freshmen (976 Male/2,686 Female) from two Anhui colleges were assessed at T₁ (November 2019, N = 4,211), T₂ (May 2020, N = 4,193) and T₃ (November 2020, N = 3,662) for sleep quality, mobile-phone addiction and depressive symptoms.

Results: Correlation analysis revealed significant associations between smartphone addiction (β = 0.493, 0.391, p <0.001), sleep problems (β = 0.336, 0.318, p <0.001), and depressive symptoms (β = 0.488, 0.431, p <0.001) across T1, T2 and T3 . Positive associations were observed between smartphone addiction and both sleep problems and depressive symptoms (β = 0.343, 0.329 at T1; β = 0.381, 0.402 at T2; β = 0.315, 0.261 at T3; all p < 0.001). A simple mediation model revealed that poor sleep quality partially mediated the association between mobile phone addiction and depressive symptoms among college students (indirect effect β = 0.0505, p < 0.001; total effect β = 0.237, p < 0.001). The multilevel autoregressive mediation model further confirmed that poor sleep quality partially mediated this association (indirect effect β = 0.002, p < 0.05; total effect β = 0.047, p < 0.001).

Conclusion: This study underscores poor sleep quality as a critical mediating factor in the long-term relationship between mobile phone addiction and depressive symptoms among Chinese college students.

Objective: To explore the attitudes and experiences of people with chronic low back pain (LBP) on sleep, health care, and digital health.

Method: Participants completed a survey about LBP, sleep, health care, and digital health. All data collected was self-reported by participants. Survey completers were invited for semi-structured interviews comprising open-ended questions exploring LBP and sleep interplay, health care experiences, and digital health preferences. Interviews were analyzed using a thematic framework approach.

Results: Six-hundred and sixty-nine participants completed the survey. n = 501 female, mean age = 56.7 ± 14.4 years. Most participants (90%) reported LBP-related sleep disturbance. More than half (61%) were not satisfied with their current LBP-related health care Sixty-one percent of participants were willing to use a sleep-specific digital health intervention (DHI) if recommended by a health care professional. Interviews (n = 26) revealed three themes: (i) living with LBP and poor sleep, (ii) health-seeking behaviors, and (iii) implementing sleep and back pain DHIs. Participants were concerned with the legitimacy of non-health professional advice and preferred evidence-based DHIs.

Conclusions: Sleep disturbance and health care dissatisfaction was highly prevalentin individuals with chronic LBP. Participants were willing to use evidence-based self-directed DHIs for LBP and sleep disturbance management but wanted clinical authority. These findings reveal opportunities for clinical implementation and intervention studies for individuals with chronic LBP and sleep disturbance.

Objectives: This study examined the effects of bedroom lighting with pre-bedtime activities two hours before bedtime on sleepiness and polysomnography (PSG) sleep in community-dwelling adults with poor sleep.

Methods: A balanced crossover design was used with 24 healthy adults. Four lighting conditions under two activity situations (unrestricted (A1) and restricted (A2) electronic device use two hours before bedtime) were tested using adjustable LED lights: (E2: 3000K, 160 lux; E3: 5000K → 3000K, 160 → 30 lux; E4: 5000K, 160 lux) and compared to standard fluorescent lighting (E1: 5000K, 160 lux). The protocol lasted 8 nights (4 lightings × 2 activity conditions), with the whole night PSGmeasure, subjective sleep perception at wake-up, and sleepiness (Stanford Sleepiness Scale) measured hourly 2 hr before bedtime.

Results: Results showed that sleep latency was 10.62 min longer when exposed to 5000k LED light than to 5000k FL. Exposure to other lower color temperature lights did not have a significant difference in sleepiness and PSGsleep. However, participants felt drowsier and had a shorter PSG sleep latency of 6.08 min when the use of electronic devices was not allowed.

Conclusion: A 5000k LED light leads to longer sleep latency compared to a 5000k fluorescent light. Restriction of electronic device use before bedtime improves sleep onset in healthy adults. Managing ambient light exposure with lower color temperature LED light and reducing electronic device use 2 hr before bedtime may improve sleep quality in healthy adults.