Sleep advances : a journal of the Sleep Research Society最新文献

Study objectives: We tested associations between serum 25-hydroxyvitamin D concentration ([25(OH)D]) and device-estimated sleep metrics, including sleep duration, sleep efficiency, sleep duration regularity, sleep timing regularity, and sleep regularity index (SRI), in young and early middle-aged adults (18-45 years). We also assessed the mediating effect of nighttime melatonin (urinary 6-sulfatoxymelatonin (aMT6s) excretion) on these associations.

Methods: Participants (n = 79) completed 14 days of wrist actigraphy. Fasted blood sampling was performed to quantify serum [25(OH)D]. First morning void was used to quantify overnight urinary aMT6s excretion, normalized to creatinine clearance. Associations between [25(OH)D] and sleep metrics were evaluated using linear regression (model 1). Separate models adjusted for age, sex, race, and body fat % (model 2), season of testing, caffeine consumption, and education level (model 3), and device-estimated moderate-to-vigorous physical activity (model 4; n = 68).

Results: Serum [25(OH)D] was positively associated with sleep duration, sleep efficiency, and SRI, and negatively associated with sleep duration regularity, sleep onset timing regularity, and sleep midpoint timing regularity in model 1 (all p < .03) and model 4 (all p < .02). In model 2, serum [25(OH)D] remained significantly associated with sleep duration only (p = .036). In model 3, serum [25(OH)D] remained significantly associated with all sleep metrics (p < .02) except sleep duration regularity and SRI. Serum [25(OH)D] was not associated with aMT6s:creatinine, indicating no grounds for performing mediation analyses.

Conclusions: Serum [25(OH)D] is independently associated with several sleep metrics in healthy adults. However, nighttime melatonin concentration did not mediate these associations, thus other mechanistic pathways must be considered.

[This corrects the article DOI: 10.1093/sleepadvances/zpaf036.].

Aviation is a global safety-sensitive industry that employs strict guidance about the monitoring and management of fatigue. Ecological sleep data is routinely collected to assess fatigue risk in flight crew during long-haul operations for safety and regulatory purposes. There is a growing body of scientific literature that supports the evaluation and use of consumer sleep technologies (CSTs) for ecological research. CSTs have the potential to facilitate longitudinal monitoring of sleep and fatigue in the aviation context and thus improve not only the health and well-being of flight crew but the safety of their passengers as well. However, CSTs have not been robustly studied for the measurement of in-flight sleep. Flight crew regularly take in-flight rest opportunities to mitigate fatigue when the opportunity arises and it is legally permitted. Technologies that cannot accurately capture in-flight sleep are not a reliable method to use for aviation research. The goal of this narrative review is to describe how CSTs could potentially be used to collect sleep data, specifically in the in-flight environment, based on existing guidance from the scientific and regulatory literature on fatigue risk management. Aviation stakeholders and the sleep science community should work together to develop criteria for the appropriate testing and use of CSTs as part of appropriate fatigue risk management systems (FRMS). This article is part of the Consumer Sleep Technology Special Collection.

Study objectives: Sleep problems have been identified as a risk factor for suicidal thoughts and behaviors during adolescence, yet a lack of longitudinal mechanistic investigation into contributing factors (e.g. cognitive functioning) limits understanding of the temporality and specificity of this relationship. This study investigates the impact of sleep problems on subsequent reported suicide attempt, and whether risk-taking and decision-making moderate this relationship.

Methods: This analysis utilized data from waves 6 (14 years) and 7 (17 years) in the Millennium Cohort Study (MCS; n = 8524, female = 4369 [51.26 per cent]), a UK population-representative longitudinal study of youth born between 2000 and 2002. Self-reported sleep items assessed at 14 years were used to calculate total time in bed on school and non-school nights, social jetlag, sleep onset latency, and frequency of night awakenings. Self-reported attempting suicide was measured at 17 years. The Cambridge Gambling Task assessed risk-taking and decision-making at 14 years.

Results: Shorter total time in bed on school days (OR = 0.88; 95% CI = 0.80 to 0.96; p = .004) and more frequent night awakenings (OR = 1.15; 95% CI = 1.07 to 1.23; p ≤ .001) were prospectively associated with subsequent reported suicide attempt, even when controlling for demographic and clinical covariates. Rational decision-making (OR = 2.12; 95% CI = 1.33 to 3.37; p = .002) moderated the association between night awakenings and attempted suicide.

Conclusions: Shorter total time in bed and more frequent night awakenings heightened suicide risk in adolescents, and this latter relationship was modified by rational decision-making. These results provide insight into the etiology of adolescent suicide behavior and highlight sleep deprivation and fragmentation as potential preventative targets for suicide attempts.

Study objectives: This study investigates the association between non-rapid eye movement parasomnias (NREMp) and health and socioeconomic outcomes in adults.

Methods: We estimated health and socioeconomic consequences of NREMp in the 7 and 4 years preceding diagnosis, respectively, and 2 years following diagnosis. The retrospective cohort included 159 Danish adults diagnosed with NREMp after age 18 years compared with 636 controls (matched for age, gender, marital status, and residential municipality at index year). Diagnoses, healthcare costs, and socioeconomic data were obtained from Danish nationwide health and administrative registers.

Results: Patients with NREMp had significantly more healthcare contacts and higher prevalence of comorbidity across several major disease groups: certain infectious and parasitic diseases; mental and behavioral disorders; diseases of the nervous system; diseases of the eye and adnexa; diseases of the digestive system; diseases of the respiratory system; diseases of the genitourinary system; and symptoms, signs, and abnormal clinical and laboratory findings, injury, poisoning, and external causes. Their healthcare costs were also higher than those of the matched controls. However, no significant differences in mortality were observed during the 2-year post-diagnosis follow-up. In addition, educational attainment and employment rates were comparable with the matched-control population.

Conclusion: Adults diagnosed with NREMp showed increased comorbidity and healthcare utilization in the years preceding diagnosis compared to matched controls, without corresponding differences in education or employment.

Introduction: Identifying factors that contribute to inadequate sleep in adolescents is important for developing interventions to improve sleep, learning, and well-being. The goal of our study was to estimate the strength of associations of individual and environmental factors with adolescents' sleep timing and duration.

Methods: Daily sleep onset, offset, and duration were measured by actigraphy in 133 Singaporean adolescents (13-18 years; 67 girls) during a typical school week in which individual students often had more than one school start time. Daily diaries recorded behaviors before and after nocturnal sleep. Linear mixed models were used to estimate associations of age, sex, ethnicity, socioeconomic status, chronotype, night of the week, bedtime reason, morning get-ready time, commute time, and school start time with nocturnal sleep.

Results: Later sleep onset was associated with older age, later chronotype, and homework/studying at bedtime. Earlier sleep offset was associated with longer get-ready and commute times and earlier school start time. Shorter sleep was associated with older age, later chronotype, homework/studying at bedtime, and earlier school start time. Adolescents obtained 45 min less sleep when their main reason for bedtime was finishing homework/studying versus feeling tired or sleepy. They obtained 50 min more sleep when school started from 08:30 to 08:59 am versus from 07:30 to 07:59 am.

Conclusions: Multiple factors influence adolescents' sleep on school nights. Modifiable factors that were strongly associated with short sleep included homework/studying at bedtime and early school start times. Avoiding schoolwork near bedtime and delaying school start time are potential strategies for improving sleep in adolescents.

Up-phase-targeted auditory stimulation (up-PTAS) during slow-wave sleep has become a valuable tool for modulating slow oscillations and slow oscillation-spindle-coupling in favor of overnight memory retention. Developing effective, automated protocols for translation into more naturalistic and clinical settings is an ongoing challenge, especially because current PTAS protocols and their behavioral effects vary greatly between studies. Our study contributes to ongoing efforts in characterizing parameter choices in PTAS and compares two up-PTAS protocols with systematic variations of the interstimulus intervals (ISIs) and their effect on the consolidation of a finger-tapping sequence using a mobile PTAS device and an app-based behavioral task in a home setting. Participants tolerated both protocols well and showed high adherence to the study procedures. Electrophysiological stimulus responses and learning trajectories in the finger-tapping task replicated lab-based findings. We extend studies suggesting a nonlinear relationship between stimulus number and PTAS effects by showing that applying fewer stimuli with longer ISIs enhances overnight consolidation of a finger-tapping sequence more effectively than applying more stimuli with shorter ISIs. Exploratory electrophysiological analyses revealed that the behavioral response was positively correlated with the number of stimuli with auditory evoked K-complexes relative to the number of stimuli without K-complexes. PTAS stimuli with longer ISIs (>1.25) were associated with a higher likelihood of K-complex responses and increased spindle power. Our findings demonstrate the feasibility of mobile, at-home PTAS combined with app-delivered behavioral tasks in healthy participants and can inform the development of more effective memory enhancement protocols.

Study objectives: Individuals in close relationships often show similarities in health lifestyle behaviors. Here, we tested associations between friendship closeness and sleep patterns in university students. We hypothesized that daily actigraphy-estimated sleep timing and duration would be more similar in closer friendships with evidence of positive covariation.

Methods: Friend pairs (n = 300; 150 pairs) wore actigraphy watches and completed daily sleep diaries for 2 weeks during the school semester. Friendships were classified as close (78 pairs) or casual (72 pairs) based on rankings completed by each friend. Daily friend-pair differences in actigraphy-estimated sleep timing (onset, offset, midpoint) and duration were calculated separately for non-school nights and school nights. Linear mixed models were used to test associations of friendship closeness (close vs. casual) with daily friend-pair differences in sleep, and to test for daily covariation of sleep in friend pairs, adjusting for covariates.

Results: On non-school nights, friend-pair differences in sleep timing were about 30 min smaller in close friends compared with casual friends. On school nights, friend-pair differences in sleep timing were associated with dyadic differences in chronotype and class start times, but not friendship closeness. Sleep timing and duration covaried positively in close friends but not casual friends, irrespective of whether students had next-day classes.

Conclusions: Actigraphy-estimated sleep was more similar in university students who were close friends. Daily covariation of sleep in close friendships suggests that students influenced each other's sleep patterns. Close friendships, chronotype, and class start times play an important role in shaping social sleep behavior.

Study objectives: To investigate the relationships between Traditional Chinese Medicine (TCM) body constitution and sleep quality in a large population-based cohort.

Methods: This cross-sectional study included 8517 participants from the WELL China cohort. We used the Wang Qi Nine Body Constitution Questionnaire (WQ-9BC) to assess TCM body constitution and the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality. We used multivariable logistic regression analyses to estimate odds ratios (ORs) for the association between body constitution and poor sleep quality (PSQI score > 5), adjusting for demographics, lifestyle factors, and comorbidities.

Results: Compared with a balanced body constitution (1898; 22%), individuals with an unbalanced constitution had a 2.6-fold risk (95% CI = 2.3% to 3.0%), and those with an unbalanced tendency had a 1.5-fold risk of poor sleep quality (95% CI = 1.3% to 1.8%). All eight unbalanced constitutions were associated with a higher risk of poor sleep quality, with Qi stagnation (OR 4.0 [95% CI = 3.0% to 5.5%]) and blood stasis (OR 3.8 [95% CI = 2.3% to 6.2%]) having the highest ORs. About 52% of participants had multiple unbalanced constitutions and/or tendencies. The OR for poor sleep quality increased with the composite number of Yang deficiency, Yin deficiency, Qi deficiency, heat dampness, blood stasis, and Qi stagnation constitutions and/or tendencies.

Conclusions: All eight unbalanced constitutions are associated with poor sleep quality in a dose-dependent manner, with Qi stagnation and blood stasis displaying the strongest associations. Multiple unbalanced constitutions and/or tendencies are cumulatively associated with poor sleep quality. Identifying TCM body constitution could help in detecting high-risk groups and designing targeted interventions.