Sleep epidemiology最新文献

It is well-established that sleep and behavior are interrelated. Although studies have investigated this association, not many have evaluated the bidirectional relationship between the two. To our knowledge this is the first systematic review providing a comprehensive analysis of a reciprocal relationship between sleep and externalizing behavior. Five databases (PsycINFO, PubMed, Web of Science, Scopus, and Google Scholar) were utilized to yield a total of 3,762 studies of which 20 eligible studies, empirical articles examining bidirectionality of sleep and externalizing behavior, were selected for analysis. According to the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis, the varying methodological approaches used in these studies were analyzed and synthesized, including examining differences and similarities in outcomes between distinct study designs (longitudinal vs cross-sectional), sleep measures (objective vs subjective vs a combination of both), informants (parents, self-report, teachers), and recruited participants (clinical, subclinical and typical populations). The assessment of risk of bias and quality of studies was guided by the instruments employed in research on sleep and behavior in the past. This review establishes that a bidirectional relationship between sleep problems and externalizing behavior clearly exists, and identifies limitations in the existing literature. Furthermore, the importance of early interventions that target both externalizing behaviors and sleep problems is highlighted as a potentially effective way of breaking the sleep-externalizing behavior relationship. Nonetheless, causality cannot be claimed until more trials that manipulate sleep and evaluate changes in externalizing behavior are conducted.

There is limited knowledge on the characteristics of employees who engage in catch-up sleep, the extension of sleep duration on free days to compensate for sleep loss accumulating during workdays. This study examined associations of accelerometer-measured free day catch-up sleep with sleep duration, sleep timing, and socio-demographic, health and lifestyle factors among older employees. We measured sleep repeatedly with accelerometers among 824 public sector employees in Finland (mean age 63 years; 86% women). On average, the participants provided 1.7 annual accelerometer measurements and 1,437 person-observations in total. Catch-up sleep was defined as longer average sleep duration on free days compared with average sleep duration on workdays. Prevalence of catch-up sleep was 78%. On average, the catch-up sleep group extended their sleep on free days by 1 hour 22 min (95% confidence interval [CI] 1 h 19 min – 1 h 26 min), whereas the non-catch-up sleep group reduced their sleep duration by 45 min (95% CI -50 min – -40 min). Catch-up sleep was mainly associated with delayed awakening time on free days (by 1 h 57 min, 95% CI 1 h 52 min – 2 h 2 min). We also observed a greater social jetlag in the catch-up sleep group in comparison to the non-catch-up sleep group, whereas no differences were observed in chronotype, self-reported sleep, or other individual characteristic. In conclusion, accelerometer-measured catch-up sleep is common among older employees in Finland and major differences in duration and timing of sleep occur between those with and without catch-up sleep.

Objective

To describe daytime sleepiness and insomnia among adults in Samoa and identify modifiable factors associated with these measures.

Design/setting

Cross-sectional analysis of data from the Soifua Manuia (“Good Health”) study (n = 519, 55.1% female); Upolu island, Samoa.

Methods

Daytime sleepiness and insomnia were assessed with the Epworth Sleepiness Scale (ESS) and the Women's Health Initiative Insomnia Rating Scale (WHIIRS), respectively. Detailed physical, sociodemographic, and behavioral factors were collected. Sleep measures were characterized using multiple linear regression with backwards elimination and a bootstrap stability investigation.

Results

Excessive daytime sleepiness (ESS>10) and insomnia (WHIIRS>10) were reported by 20% and 6.3% of the sample, respectively. ESS scores were higher in individuals reporting more physical activity (Estimate=1.88; 95% CI=1.12 to 2.75), higher material wealth (0.18; 0.09 to 0.28), and asthma (2.85; 1.25 to 4.51). ESS scores were lower in individuals residing in periurban versus urban regions (-1.43; -2.39 to -0.41), reporting no work versus day shift work (-2.26; -3.07 to -1.41), and reporting greater perceived stress (-0.14; -0.23 to -0.06). WHIIRS scores were lower in individuals reporting “other” shift work (split/irregular/on-call/rotating) versus day shift work (-1.96; -2.89 to -1.14) and those who perceived their village's wealth to be poor/average versus wealthy (-0.94; -1.50 to -0.34).

Conclusions

Participants had a generally higher prevalence of excessive daytime sleepiness, but lower prevalence of insomnia, compared with individuals from high-income countries. Factors associated with sleep health differed compared with prior studies, emphasizing potential cultural/environmental differences and the need for targeted interventions to improve sleep health in this setting.

Purpose

The aim of this study was to systematically review the literature about the relationship between sleep duration and cognitive, academic and socioeconomic outcomes.

Methods

We performed a systematic search in PubMed, Psyinfo, Scopus, Web of Science, ERIC, and Socindex up to June 2022, independently by two researchers. Original studies testing the association between sleep duration (as exposure) and academic, cognitive and socioeconomic variables (as outcomes) among all age groups in population-based studies were included. We excluded studies assessing participants with specific diseases or specific populations. Quality assessment was evaluated considering three domains: internal validity, study design, and adjustments.

Results

After the study selection process, a total of 56 manuscripts were selected. Most studies were from high-income countries with a large variability of instruments and cutoff points to measure sleep duration and outcomes. Cognitive outcomes were evaluated in 35 manuscripts, academic outcomes in 22, and socioeconomic outcomes in one. Long sleep seems to be associated with poor cognitive outcomes in older adults. In contrast, short sleep duration seems to be associated with poor cognitive and school outcomes among children and adolescents. Studies evaluating cognition in children and adolescents and academic outcomes presented lower scores in the quality assessment.

Conclusion

More well designed and well-adjusted studies evaluating cognitive and academic outcomes in children, adolescents, and mainly, in adult population are necessary. Furthermore, studies from low- and middle- income countries, evaluating sleep duration and exploring the relationship between sleep duration as exposure variable and human capital characteristics as outcomes variables should be included in the research agenda.

Objectives

This study examined socio-demographic factors of sleep reduction in adolescents and whether differences in sleep reduction were mediated by their sleep hygiene practices. It also provides more insight into the prevalence of sleep reduction in a sample of Dutch adolescents.

Design

Cross-sectional study using baseline data from the cluster-randomized controlled trial Charge Your Brainzzz.

Participants

972 adolescents in the second or third grade of secondary school, aged 13.3 (± 0.7) years, of which 55% were girls.

Methods

Socio-demographic differences (gender, age, education types, cultural groups) in sleep reduction and the mediating effects of sleep hygiene practices (i.e., caffeine use, behavioral arousal, cognitive/emotional arousal) were assessed with linear regression analyses and the product-of-coefficient test with percentile-based confidence intervals, respectively. Sleep reduction was measured using the Sleep Reduction Screening Questionnaire, whereas sleep hygiene practices were measured via the Adolescent Sleep Hygiene Scale.

Results

33% of adolescents reported sleep reduction. Girls and older-aged adolescents experienced more sleep reduction than boys and younger-aged adolescents, respectively. The association between gender and sleep reduction was mediated by cognitive/emotional arousal but suppressed by caffeine use, while behavioral arousal and cognitive/emotional arousal mediated the association between age and sleep reduction.

Conclusions

Sleep reduction was shown to be common in Dutch adolescents, especially in girls and older-aged adolescents. Sleep hygiene practices partly explained the differences in sleep health and sleep reduction between different socio-demographic risk groups. Further research is needed to provide more insight into the complexity of sleep reduction and its interrelated behaviors and risk factors.

Importance

Prognosis and understanding of sleep disorders in rare genetic syndromes is limited, despite being a common complaint of caregivers. Rett Syndrome (RTT) is a rare, progressive neurodevelopmental disorder with problematic sleeping being a clinical feature yet inconsistencies exist in the literature.

Objective

To examine the strength of evidence of a sleep disorder in RTT. To investigate the complaints reported based on a sleep disorders classification approach and to determine differences in rates per the RTT main clinical features.

Data sources

PubMed, Web of Science, PsycINFO, Ebsco, Scopus, and Cochrane Library up to November 4^th 2021 with no time or language limitation (CRD 42020198099) were searched.

Study selection

Original research published in peer-reviewed journals, with RTT clinical or genetic diagnosis reported and stating a sleep complaint with prevalence rate, were selected.

Data Extraction and Synthesis

We followed the PRISMA guideline for abstracting data and assessed risk of bias with the NIH quality assessment tools. The prevalence rates were meta-analyzed applying the mixed-effects model with measures of consistency.

Main Outcome(s) and Measure(s)

The International Classification of Sleep Disorders was used to summarize sleep complaints reported in the literature. Those that did not specify the precise sleep complaint were categorized as a not otherwise specified sleep problem. We further analyzed data per available RTT characteristics.

Results

We included 19 studies (n = 4298, 0.3 to 57.2 years old) across five countries involving predominantly observational study designs. Overall, 54.1% (95%CI: 43.8% to 64.5%) of individuals with RTT exhibit problematic sleeping, in particular, excessive somnolence (67.5%; 95%CI: 47.5% to 82.7%) and difficulties initiating and maintaining sleep (61%; 95%CI: 49.6% to 71.4%). Disturbed sleep not otherwise specified was reported in 57.1% (95%CI: 34.5% to 81.3%). Although studies could improve details reported, females with MECP2-RTT showed a higher prevalence rate of excessive somnolence and sleep-wake transition disorders than those diagnosed by CDKL5-RTT. Prevalence rates remain roughly unaltered across the lifespan. Sleep disorders are about two times more prevalent than in typically developing children.

Conclusions and Relevance

Findings indicate predominantly disorders regarding maintenance of sleep and wake state, which persist throughout their lifespan. Improved reporting of clinical features in cases with RTT phenotypes and of sleep behavior frequency and severity may lead to explicit prevalence rates. This is fundamental to progress in the pathophysiological investigation of altered sleep-wake mechanisms and to implement tailored sleep