Sleep epidemiology最新文献

Objective

Adolescents are at greater risk for poor sleep compared to childhood; however, there is limited data regarding psychosocial determinants of adverse sleep health among semi-rural adolescents. We investigated associations of mood, stress, and social support with self-reported sleep duration and daytime sleepiness among adolescents.

Methods

Adolescents (n = 254) in semi-rural Georgia self-reported depressive and anxiety symptoms, stress, social support, sleep duration and daytime sleepiness in November 2020. Multinomial linear and logistic models were fit to examine associations of psychosocial factors with sleep duration and sleepiness; and effect modification by social support was tested after adjustment for covariates.

Results

Most participants were non-Hispanic White (55 %), female (53 %), and approximately 35 % were eligible for free-reduced lunch. Mean sleep duration (± SD) and daytime sleepiness was 8.04 ± 1.36 and 5.17 ± 2.37, respectively; and 42 % of participants reported insufficient sleep (<8 h). Depressive (β = 0.13, 95 % CI: 0.08, 0.18) and anxiety (β = 1.20, 95 % CI 0.51, 1.88) symptoms, and stress (β = 1.97, 95 % CI 1.21, 2.74) were associated with higher sleepiness scores. The psychosocial factors were associated with higher odds of insufficient sleep duration, but not continuous sleep duration. Higher social support was associated with lower sleepiness, but not sleep duration. There was no observed effect modification by social support.

Conclusions

Experiences of psychosocial factors were associated with more sleepiness and insufficient sleep, while social support was associated with less sleepiness. Future studies should explore intervention strategies to enhance mood and social support and reduce stress to improve sleep among semi-rural adolescents.

Introduction

The process of manually scoring actigraphy data can be subjective with few studies utilizing and reporting clear actigraphy scoring guidelines. Clinical populations often have challenges with accurately and consistently completing sleep diaries which support actigraphy scoring.

Objective

To promote internal consistency and replicability in actigraphy scoring procedures, this study developed a detailed actigraphy scoring protocol for cases without sleep diary data and performed an inter-rater reliability analysis using a sample of veterans with Gulf War Illness (GWI).

Methods

One hundred fifty-nine nights of actigraphy data from a random subsample of 25 veterans with GWI were independently, manually scored using the protocol. Mean values for the start and end of rest intervals and derived sleep parameters—time in bed (TIB), total sleep time (TST), and sleep efficiency (SE)—and mean differences were calculated. Inter-rater reliability was evaluated using intra-class correlation (ICC).

Results

ICC demonstrated excellent agreement between manual scorers for rest interval start (ICC = 0.98) and end times (0.99), TIB (0.94), TST (0.98), and SE (0.97). There were no clinically important differences (greater than 15 min) between manual scorers for the start of rest (average difference: 6 mins ± 28) or the end of rest (2 mins ± 23).

Conclusion

This protocol may serve as a reproducible set of guidelines for researchers manually scoring actigraphy and enhance internal consistency for studies, especially for those working with clinical populations with significant sleep disturbance and related difficulties yielding quality sleep diary data.

Background

Population-based evidence linking sleep characteristics with hearing is limited and how the associations change with age remains unknown. We aim to investigate cross-sectional associations between sleep characteristics and hearing by age in a nationally representative sample of U.S. adults.

Methods

We included 3,100 participants aged 40 years and older from the National Health and Nutrition Examination Survey 2015–18. Audiometric hearing thresholds at 0.5, 1, 2 and 4 kilohertz were averaged to calculate better-ear pure-tone average (PTA). Sleep questions were self-reported, including sleep duration on weekdays or workdays, snoring, snorting or stopping breathing, trouble sleeping, and daytime sleepiness. Multivariable-adjusted linear regression with an interaction term between sleep characteristic (categorical) and age (continuous in years) was used. Primary models adjusted for demographic and lifestyle factors with additional adjustment for cardiovascular factors in secondary models.

Results

There was no association of reported sleep duration with PTA at age 50; however, compared to those reporting 7–8 h of sleep, there was a borderline-significant association at age 60 (<7 h: 1.72 dB, 95 % confidence interval [CI], -0.21, 3.66; >8 h: 1.25 dB, 95 % CI, -0.01, 2.51), and a significant association at age 70 (<7 h: 2.52 dB, 95 % CI, -0.27, 5.31; >8 h: 2.67 dB, 95 % CI, 0.56, 4.79). No consistent associations for other sleep characteristics were found.

Conclusions

Long sleep duration is associated with worse hearing among middle-aged and older adults and the association differs by age. Longitudinal evidence is needed to establish temporality and examine changes in hearing associated with sleep characteristics.

GT outcomes related to covid and insomnia are reviewed. Peaks in requests are noted during disease outbreaks. A machine-expert analysis of the vocabulary of tweets showed that in November 2021, users mainly complained of feeling unwell, insomnia, and headaches. In November 2022, problems related to the brain became important topics of discussion. Users actively discussed sleep problems, often using emoji. Comparison of the vocabulary of scientific articles and tweets showed a significant similarity of the topics discussed. Twitter users often complain about poor sleep and insomnia due to current covid, or a previous illness (long-term consequences of covid). At the same time, problems associated with the brain and neuropsychological state are often noted. At the same time, these topics are poorly represented in the scientific literature. Consequently, Twitter users may be exposed to distorted information, which may exacerbate their psychological stress.

Objectives

To evaluate the association of sleep problems with physical activity and functional limitations in Basic Activities of Daily Living (BADL) in non-institutionalized Brazilian older adults and to investigate if there is a moderating effect of functional limitations in the association between physical activity and sleep problems.

Method

This was a cross-sectional study of 22,728 older adults aged 60 or older interviewed in the National Health Survey in 2019. The outcome variable was self-reported sleep problems. The independent variables of interest were the practice of physical activity and functional limitations in BADL. The association between the independent variables and the outcome was assessed using logistic regression models adjusted for covariates.

Results

The prevalence of sleep problems was 24.8% (95% CI 23.8–25.8). Physically active individuals were less likely to have sleep problems (OR 0.85; 95% CI 0.72–0.99), while those with functional limitations in BADL (OR 2.10; 95% CI 1.77–2.49) were more likely to have sleep problems, after adjustment for covariates. There was a significant interaction between physical activities and functional limitations in BADL.

Conclusions

The prevalence of sleep problems in the Brazilian older adults was associated with physical activity and functional limitations in BADL. Physical activity is associated with lower odds of sleep problems among older adults with functional limitations in BADL.

Objectives

To assess the relationship between chronic pain and sleep quality in U.S. men and women.

Methods

Data included adults aged 25-84 from the 2013-2018 nationally representative National Health Interview Surveys (n=161,282). We examined three measures of sleep quality –self-reported days with difficulty falling asleep, difficulty staying asleep, and days not feeling rested. We analyzed multiple measures of chronic pain – any chronic pain, the location of chronic pain, and the count of chronic pain locations. Linear regression models of each sleep outcomes were estimated on the pooled sample, then by sex and age.

Results

The presence of any chronic pain, migraines/headaches, and the number of chronic pain sites were all associated with worse sleep quality across all three measures. Having migraines tended to be most strongly associated with sleep quality. Our findings also indicate sex differences in how chronic pain affects sleep, with women's sleep issues being associated with minor chronic pain while men's sleep problems are associated more with major chronic pain.

Conclusions

Chronic pain influences the sleep of the American population, with migraines in particular having a strong relationship. Future research should consider the bi-directionality in the relationship.

Objective

To characterize sleep/insomnia and sleep habits among adults with type 1 (T1D) and type 2 (T2D) diabetes.

Methods

Adults with T1D or T2D were invited to complete an anonymous cross-sectional online survey containing validated self-reported measures on sleep quality, sleep health, insomnia severity, and questions on sleep habits. Multivariate linear and logistic regression analyses were performed.

Results

A total of 303 adults (20–86 years; 75.3 % female) with T1D (n = 121) and T2D (n = 182) completed the whole survey. Sleep quality was associated with type of diabetes (β=1.27; 95 % CI: 0.28, 2.27) and income (β=-1.18; 95 % CI: -2.11, -0.26) when adjusted for sex and age. Adults with T2D and with a lower income reported poorer sleep quality. Sleep timing variability (r_s=0.25–0.33; p < 0.05) and caffeine consumption before bedtime (r_s=0.14–0.17; p < 0.05) were the sleep habits that were correlated with sleep quality, sleep health, and insomnia severity when adjusted for sex, age, and income. Sleep timing variability ≥3 times/week was associated with age (OR=0.97; 95 % CI: 0.94, 0.99). Caffeine consumption before bedtime ≥3 times/week was associated with sex × age (p = 0.0165). Younger males were the most likely to indicate adopting this sleep habit.

Conclusions

Adults with T2D and those reporting a lower income seem at high risk for poor sleep quality. Adults with diabetes mentioning sleep issues, especially those with T2D and with a lower income, should have access to inexpensive behavioral sleep interventions. Younger adults with diabetes should receive counseling promoting healthy sleep habits, especially males in the case of caffeine consumption before bedtime.

ChatGPT has played a prominent role in the media narrative on artificial intelligence over the past year. However, the potential applications of this popular chatbot have also been studied from a medical-health perspective. There are more than 600 papers published on this topic in 2023. The undisputed qualities of this form of AI, which is one of the deep-learning machines, are due to its ability to simulate conversation that is almost indistinguishable from that with another human being. We know how important communication is in medicine. That is why the many studies presented investigate ChatGPT's ability to answer public health questions or assist patients with certain diseases. We can say that communication is a therapeutic intervention, but can AI do it better than doctors?

Background

Males and females present different sleep alterations, so the aim of the study was to investigate gender differences in residual excessive sleepiness (RES) post continuous positive airway pressure (CPAP) treatment in a population with obstructive sleep apnea (OSA).

Methods

The study was conducted on consecutive subjects with moderate-severe OSA treated by CPAP for one year. Clinical and sleep data were collected from the sample, including RES calculated according to an Epworth sleepiness scale (ESS) threshold score >10 points at yearly follow-up. Of this sample, gender differences were investigated.

Results

157 patients (125 males and 32 females) with a mean age of 62,84±11,81 years were included in the study. Overall, females were more obese (p = 0,001) with no differences in OSA severity compared to males.

At yearly follow-up, sleepiness was significantly reduced in both sexes but 25 % of males reported RES compared to 13 % of females (p = 0,03). In addition, females were more adherent to CPAP (p = 0,008) than males.

However, by observing the residual sleepiness data, it was noticed that sleepy females were more elderly and obese than sleepy males. Females also presented a higher nocturnal time with oxygen saturation <90 % (T90) with more cognitive symptoms. Conversely, sleepy males reported higher number of OSA-related symptoms and more history of comorbidities.

Conclusion

The report suggests that sleepy males have many symptoms with history of multimorbidity, while sleepy females are elderly, obese and have more cognitive symptoms maybe due to worse hypoxia during sleep. Nonetheless, larger sample studies are needed to confirm our findings.

Purpose

The international DBAS-16 questionnaire is an instrument that measures dysfunctional beliefs and attitudes toward sleep in the general population. It was initially developed in English in Canada by Charles Morin's team.

Objective

This study aims to translate and adapt the DBAS-16 questionnaire on beliefs and attitudes toward sleep into Moroccan languages (Tamazight and Arabic) and validate it on 174 participants.

Materials and methods

From September 2019 to March 2020, 174 Moroccan participants in three cities -Fes, Kénitra, and Khémisset- participated in the adaptation and validation of DBAS-16. We translated, adapted, and validated the test into Moroccan Tamazight and Arabic according to the recommendations of “Beaton et al.” We evaluated the acceptability, reliability, central tendency, and validity of DBAS-16 in the Moroccan Arabic dialect version.

Results

Acceptability and reproducibility were satisfactory. The internal coherence was strong (Cronbach α = 0.773). The average overall score (standard deviation) on the Moroccan DBAS-16 scale was 1.71. The sub-scale scores were 2.20 for Consequences, 2.07 for Worry/Helplessness, 2.75 for Sleep Expectation, and 2.23 for Medication.

Conclusion

Our study's results were similar to those of other countries. Moroccan versions of DBAS-16 will facilitate further studies on sleep attitudes in Morocco and elsewhere.