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

This study examined the relationships between caffeine intake, screen time, and chronotype/sleep outcomes in adolescents, with a focus on differences between Hispanic and non-Hispanic groups and the influence of peer network health, school environment, and psychological factors, including perceived stress, depression, and anxiety. Data from the Adolescent Brain Cognitive Development (ABCD) study were analyzed using t-tests and structural equation modeling (SEM) to assess behavioral, social, and psychological predictors of chronotype, social jet lag, and weekday sleep duration, incorporating demographic covariates. Hispanic adolescents exhibited a later chronotype (Cohen's d = 0.42), greater social jet lag (Cohen's d = 0.38), and shorter weekday sleep duration (Cohen's d = -0.12) compared to non-Hispanic peers. They also reported higher caffeine intake (Cohen's d = 0.22), though caffeine was not significantly associated with sleep outcomes. Screen time was more prevalent among Hispanic adolescents, particularly on weekday evenings (Cohen's d = 0.27) and weekend evenings (Cohen's d = 0.35), and was strongly associated with later chronotype and greater social jet lag. Higher perceived stress was linked to later chronotype and greater social jet lag, while depressive symptoms were associated with earlier chronotype and lower social jet lag. The SEM model explained 12.9% of variance in chronotype, 10.5% in social jet lag, and 6.2% in weekday sleep duration. These findings highlight disparities in adolescent sleep health but should be interpreted cautiously due to methodological limitations, including low caffeine use and assessment timing variability. Targeted interventions addressing screen time, peer relationships, and stress may improve sleep, while longitudinal research is needed to clarify causality.

Study objectives: The aim of this study is to assess the performance of six different consumer wearable sleep-tracking devices, namely the Fitbit Charge 5, Fitbit Sense, Withings Scanwatch, Garmin Vivosmart 4, Whoop 4.0, and the Apple Watch Series 8, for detecting sleep parameters compared to the gold standard, polysomnography (PSG).

Methods: Sixty-two adults (52 males and 10 females, mean age ± SD = 46.0 ± 12.6 years) spent a single night in the sleep laboratory with PSG while simultaneously using two to four wearable devices.

Results: The results indicate that most wearables displayed significant differences with PSG for total sleep time, sleep efficiency, wake after sleep onset, and light sleep (LS). Nevertheless, all wearables demonstrated a higher percentage of correctly identified epochs for deep sleep and rapid eye movement sleep compared to wake (W) and LS. All devices detected >90% of sleep epochs (ie, sensitivity), but showed lower specificity (29.39%-52.15%). The Cohen's kappa coefficients of the wearable devices ranged from 0.21 to 0.53, indicating fair to moderate agreement with PSG.

Conclusions: Our results indicate that all devices can benefit from further improvement for multistate categorization. However, the devices with higher Cohen's kappa coefficients, such as the Fitbit Sense (κ = 0.42), Fitbit Charge 5 (κ = 0.41), and Apple Watch Series 8 (κ = 0.53), could be effectively used to track prolonged and significant changes in sleep architecture.

Study objectives: Persistent post-acute sequelae of SARS-CoV-2 infection, i.e. long COVID, impacts multiple organ systems. While lower blood oxygen is expected when SARS-CoV-2 infects the lungs, hypoxia without pulmonary symptoms may continue after the acute phase. Ventilation and blood oxygen are more vulnerable during sleep, but nocturnal hypoxemia hasn't been studied in people with long COVID in a facility setting using gold-standard polysomnography (PSG).

Methods: We conducted an observational study with 50 participants (25 long COVID, 25 age-sex-matched healthy controls) using in-laboratory overnight PSG. We calculated the average SpO₂, average SpO₂ after removing desaturations, the respiratory rate in different sleep periods, and the hypoxic costs using all desaturations.

Results: We found that average SpO₂ was lower in participants with long COVID: 1.0% lower after sleep onset (p = .004) and 0.7% lower during REM (p = .002); average SpO₂ after removing desaturations was also lower in participants with long COVID: 1.3% lower after sleep onset (p = .002), 0.9% lower during REM (p = .0004), and 1.4% lower during NREM (p = .003); and respiratory rate was 1.4/minute higher in participants with long COVID during REM (p = .005). There were no significant differences in SpO₂ and respiratory rate before sleep onset, the within-participant change from before to after sleep onset, or hypoxic costs.

Conclusions: The results suggest that long COVID had a persistent lower nocturnal blood oxygen saturation, and support the need for a large-scale study of nocturnal hypoxemia in people with long COVID compared to the general population.

Study objectives: To examine how sleep architecture changes over successive cycles of restricted and recovery sleep in young adults, and to determine whether sleep-restricted schedules with differing night-to-night variability in sleep durations lead to different sleep physiological responses.

Methods: In this 15-night laboratory-based study, 52 healthy young adults (25 males, age: 21-28) were randomly assigned to one of three sleep schedules: stable short, variable short, or control. They underwent two baseline nights of 8-h time-in-bed (TIB), followed by two cycles of "weekday" sleep opportunity manipulation and "weekend" recovery (8-h TIB). During each manipulation period, the stable short sleep and the control groups received 6-h and 8-h TIBs each night, respectively, while the variable short sleep group received 8-h, 4-h, 8-h, 4-h, and 6-h TIBs from the first to the fifth night. Polysomnography was conducted every night.

Results: Sleep architecture changes induced by both short sleep schedules returned to baseline levels following the first or second recovery night and were largely similar between the first and second periods of sleep restriction. Sleep parameters averaged across each sleep restriction or recovery period showed no significant differences between the two short sleep groups.

Conclusions: The similar sleep physiological responses in the two sleep restriction periods suggest that in young adults, sleep architecture does not adapt to recurrent weeks of moderate partial sleep loss, and such sleep patterns did not have compounding effects on sleep architecture. Furthermore, overall, increasing night-to-night variability in sleep duration did not have much additional impact on sleep physiological responses relative to a stable short sleep schedule.

Clinical trial: Performance, Mood, and Brain and Metabolic Functions During Different Sleep Schedules (STAVAR), https://www.clinicaltrials.gov/study/NCT04731662, NCT04731662.

This preliminary study investigates the potential for a technique that enables purposeful guiding of dream content (Targeted Dream Incubation; TDI) to change the degree to which an individual feels in control of their dreams (Dream Self-Efficacy; DSE). DSE is a subset of a larger concept of self-efficacy relating to one's belief in their own abilities and competencies. Examining DSE may be quite important, as past research has demonstrated that DSE may be linked to positive treatment outcomes in specific therapies, such as interventions for trauma-related nightmares. Furthermore, prior research has found that decreasing feelings of helplessness related to sleep has been shown to improve insomnia symptoms and daytime fatigue. Thus, our study sought to examine the relationship between TDI and DSE. We enrolled N = 25 participants in a TDI protocol conducted during a predominantly N1 sleep nap, where participants completed surveys before and after a TDI paradigm. Our results revealed that TDI was linked to DSE, with individuals reporting significantly higher levels of DSE after the TDI protocol. These results provide preliminary evidence for a technique (TDI) that could increase DSE with the overall aim of improving the efficacy of specific sleep-related interventions, such as treatments for trauma-related nightmares. Future research should aim to further confirm these results with a control condition and examine the effects of TDI within the context of behavioral sleep interventions.

Study objectives: To assess differences in sleep, well-being, sleep-related behaviors, and performance between sexes in active-duty Sailors in the U.S. Navy (USN).

Methods: Fit-for-duty Sailors (N = 1193, 21.6% females, median age 26 years) from 10 USN ships wore actigraphs for ~2 weeks, performed 3-minute Psychomotor Vigilance Tasks (PVTs), and logged daily habits while tending to their underway duties. At the end of the study, participants completed questionnaires to assess mood and well-being. Data were analyzed retrospectively.

Results: Compared to males, females slept 24 minutes/day more (p < .001, η² _p = 0.032), but their sleep was split into more episodes (p = .016, η² _p = 0.006). Females reported higher (worse) daytime sleepiness scores (p = .049, η² _p = 0.003) and more female sailors were identified with symptoms of excessive daytime sleepiness (p = .037, OR = 1.35). Females performed worse on the PVT (all p < .001, η² _p = 0.041 to 0.109) and reported worse vigor-activity scores (p = .005, η² _p = 0.009). The two sexes did not differ in the severity of insomnia symptoms (p = .323) and subjective sleep quality (p = .155). Even though the prevalence of drinking caffeinated beverages did not differ between sexes (p = .666), more females reported drinking tea (p < .001, OR = 2.12) and more males reported drinking energy drinks (p < .001, OR = 1.77). Fewer females reported having an exercise routine (p = .037, OR = 1.40).

Conclusions: We identified substantive sex differences in fit-for-duty sailors performing their underway duties. Taken together, our findings shed light on the expression of sex differences in the operational naval environment and emphasize the need to consider these differences to support Sailors as they meet the demands of military work.

In 1978, as a young pediatrician, I became interested in the developing field of clinical sleep medicine and set out on a journey into uncharted waters, namely into the previously non-existent field of pediatric sleep medicine. I describe my early training (in a specialty where no formal training programs existed), my excellent mentors, my early struggles to work with equipment that was both primitive by today's standards and not designed to work with children and infants, and various other obstacles I initially faced. I also share some of early findings in pediatric insomnia, sleepiness, parasomnias, and rhythm disorders, and I outline some of our efforts to develop new treatment approaches and techniques where scientifically based ones previously did not exist. Finally, I try to describe translating what I was learning about children and their sleep problems into a wide-ranging book to help parents, especially those who were sleep-deprived themselves.

The first-ever comprehensive report on the sleep health of Aboriginal and Torres Strait Islander peoples (hereafter referred to as First Nations Australians) highlighted an 18% prevalence of poor sleep in First Nations youth. While sleep health is important across the lifespan, adolescence is a critical life stage with increased vulnerability to poor sleep. In adolescents, pubertal changes, social and academic commitments, and peer pressure significantly increase the risk of poor sleep, which often results in social and emotional well-being (SEWB) issues. In First Nations adolescents, high rates of SEWB issues demand effective prevention and management strategies. Evidence from non-First Nations adolescents suggests that timely prevention, identification, diagnosis, and management of poor sleep help reduce the risk and severity of SEWB issues in First Nations adolescents. A research program is proposed to be called "Let's Yarn About Sleep," which will co-design, deliver, and evaluate a tailored sleep improvement program for Australian First Nations adolescents (12-18 years). Co-design workshops will be conducted with First Nations community Elders, parents and carers, youth, and First Nations service providers to develop the sleep health program. The program will also include training Aboriginal Youth Workers (AYWs) to deliver the sleep health program. The program evaluation will be based on a mixed methods design, using self-reported (survey tools and focus group discussions) and technology-based measures (actigraphy data) to measure changes in First Nations adolescents' sleep and SEWB. The evaluation will focus on the impact of training AYWs on program delivery and uptake.

Chronic insomnia is a prevalent sleep disorder where <1% of patients receive the recommended first-line treatment; Cognitive Behavioural Therapy for Insomnia. Digital technologies and self-managed therapies are scalable solutions to address this critical gap in patient care, but it is presently difficult to know which therapies are best. This study will test the comparative efficacy and cost-benefits of Intensive Sleep Retraining administered by the THIM sleep tracker, Sleep Healthy Using the Internet (SHUTi) treatment program, and their combination (THIM then SHUTi) versus a waitlist control group. This study is a 4 (treatment: +/- THIM and +/- SHUTi) × 3 (time: pretreatment, posttreatment, and 2-month follow-up) randomized controlled trial. Participants who meet the diagnostic criteria for Chronic Insomnia Disorder will be randomized to one of four groups. Sleep and daytime functioning symptoms will be assessed via self-report daily and weekly questionnaires, and objective sleep trackers during treatment and for 2 weeks at pre-treatment, post-treatment, and 2-month follow-up. The primary outcome is total wake time, with a reduction of ≥30 minutes considered a clinically meaningful difference. For the primary analysis, the interaction between the treatment group and time on total wake time will be analyzed using repeated measures analyses of variance (ANOVA). This project was approved by the Southern Adelaide Clinical Human Research Ethics Committee (2021/HRE00414) and registered in the Australian and New Zealand Clinical Trials Registry (ACTRN12622000778785). As the first study to investigate the comparative efficacy of two different technology-enabled treatments for insomnia, this study will help inform clinicians and public health policy regarding the use cases for public and private health-funded technology-enabled options for insomnia.

Diminished sleep health is a known warning sign for suicide. However, the contexts and time periods within which diminished sleep elevates suicide risk are unknown. Modeling the complex process by which diminished sleep health impacts daily functioning and establishing proximal suicide risk factors can aid in addressing these important knowledge gaps. This paper describes the methods and research protocol for a study that aims to elucidate the nature of the sleep-suicide relationship and develop an integrated model of proximal suicide risk. Participants will be 200 adults at high risk for suicide recruited from a psychiatric inpatient unit. They will complete a baseline assessment including clinical interviews and self-reports, and laboratory tasks with concurrent electroencephalography to phenotype-relevant risk processes. This baseline assessment will be followed by 4 weeks of ecological momentary assessment and digital phenotyping, coupled with assessments of sleep via a wearable used to generate a minute-by-minute metric of cognitive effectiveness using the Sleep Activity, Fatigue, and Task Effectiveness algorithm index. Follow-up assessments will be conducted 1-, 3-, and 6-months post-hospital discharge to determine how the developed proximal model of risk prospectively predicts suicidal ideation and behavior. The results of this study have the potential to greatly enhance understanding of how and why diminished sleep health is related to real-world fluctuations in suicide risk, knowledge that can inform efforts to better prevent, and intervene to reduce suicides.