Objective and subjective sleep patterns and biomarkers of stress among women with a history of sexual abuse in childhood.

OBJECTIVE: Childhood sexual abuse (CSA) is associated with posttraumatic stress symptoms (PTSSs) and sleep disturbance into adulthood. The latter is thought to emerge from dysregulation in biobehavioral systems, including nighttime hyperarousal; however, studies investigating specific mechanisms to explain these long-term sleep problems are limited. The present study examined presleep arousal, fear of sleep, and the cortisol awakening response (CAR) as putative mediators between PTSS and sleep disturbance in women with a history of CSA. METHOD: N = 64 cis-gendered women with a self-reported history of CSA completed a baseline diagnostic interview, self-reported mental health and sleep measures, 7 days of actigraphy monitoring with concurrent sleep diary, and 2 days of saliva sampling. RESULTS: PTSSs were not significantly associated with actigraphy-estimated sleep variables but were positively associated with self-reported sleep onset latency (SOL) and negatively associated with self-reported sleep quality. Similarly, PTSSs were not significantly associated with CAR but were associated with higher presleep arousal and fear of sleep ratings. Mediational models identified greater presleep cognitive arousal to partially explain the PTSS-SOL relationship. Specific features of CSA (i.e., age at time of abuse, location of abuse, relationship to the perpetrator) did not moderate this association. CONCLUSION: Findings suggest that targeting maladaptive cognitions (e.g., worries, rumination) that occur during the presleep period may be a potential intervention target in mitigating sleep disturbance and PTSSs in this population. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Neighborhood disadvantage is associated with sleep disturbance in a sample of trauma-exposed Veterans.

OBJECTIVES: This study examined associations among neighborhood disadvantage, all-night respiratory sinus arrhythmia, fear of sleep, nightmare frequency, and sleep duration in a sample of trauma-exposed Veterans. METHODS: Participants completed baseline assessments and slept on a mattress actigraphy system for seven nights. Neighborhood disadvantage was assessed with the Area Deprivation Index, a census-based socioeconomic index. Differences between the least and most disadvantaged groups on the sleep variables were analyzed. RESULTS: Data were available from 37 Veterans. Residing in neighborhoods with greater disadvantage was associated with elevated fear of sleep and reduced sleep-period respiratory sinus arrhythmia. No significant differences were observed for nightmare frequency or sleep duration. A regression confirmed that neighborhood context had a significant effect on respiratory sinus arrhythmia, after controlling for other baseline sleep variables. CONCLUSIONS: In this sample of Veterans, sleep context may increase hypervigilance in turn serving as a mechanism by which trauma-induced sleep disruptions are maintained.

Sleep Disturbances Associated With Posttraumatic Stress Disorder.

Sleep disturbances, namely insomnia and recurrent nightmares, are ubiquitous following trauma exposure and are considered hallmarks of posttraumatic stress disorder (PTSD). Other sleep disorders frequently co-occur with PTSD. This article describes research examining sleep problems most common in PTSD, including prevalence and clinical characteristics. Sleep disturbances are often robust to trauma-focused treatment; thus, evidence for psychological and pharmacological interventions for insomnia and nightmares in PTSD are discussed. Given the high prevalence of sleep problems in PTSD, more work is needed to empirically study putative mechanisms linking trauma exposure and sleep, as well as how to best target these symptoms in patients with PTSD.

Validation of the Mental Health Checklist (MHCL) during COVID-19 lockdown.

The COVID-19 pandemic resulted in unprecedented disruption to everyday life, including widespread social distancing and self-quarantining aimed at reducing the virus spread. The Mental Health Checklist (MHCL) is a measure developed to assess psychological health during extended periods of isolation and confinement, and has shown strong psychometric properties in community samples and during Antarctic missions. This study validated the MHCL in a sample of 359 U.S. and U.K adults during the peak of the COVID-19 lockdown. Confirmatory factor analysis (CFA) tested model fit, and convergent validity analyses were conducted to compare the MHCL with validated measures of depression, anxiety and stress, as well as insomnia. The MHCL exhibited good model fit for most CFA indices, and showed strong convergent validity with other measures of psychological well-being. Findings suggest that the MHCL is useful for assessing mental health in a variety of environments and conditions.

Prospective associations between pre-sleep electronics use and same-night sleep in healthy school-aged children.

Electronic devices are routinely associated with adverse effects on sleep; however, prospective studies among healthy children are unavailable. This study examined relationships among specific and total electronic device use within the hour before bed and same-night sleep patterns among 55 pre-pubertal children (7-11 years) without medical, psychiatric or sleep disorders. Sleep was assessed via subjective reports and actigraphy for 5 weeknights and pre-bed device use was assessed via daily diary. Neither total devices use nor any single type predicted sleep parameters the same night. The extent to which pre-bed electronics use impacts sleep in healthy children requires further investigation.

Main and Interactive Effects of Nicotine Product Type on Sleep Health Among Dual Combustible and E-Cigarette Users.

BACKGROUND AND OBJECTIVES: E-cigarette use is associated with concurrent use of combustible cigarettes among adults and may increase the risk of future combustible cigarette use in adolescents and young adults. Detrimental effects of combustible cigarette use on sleep health are well documented, but little is known about the additive effects of concurrent e-cigarette use. The current study examined the main and interactive effects of daily nicotine product frequency on various components of sleep health. METHODS: Two hundred and twenty-seven dual-product users (54.2% female, Mage = 36.89, SD = 10.17) completed questionnaires regarding demographic information, average number of cigarettes smoked per day, average number of times e-cigarettes used per day, and sleep health. RESULTS: Combustible cigarette frequency uniquely predicted shorter sleep duration, whereas e-cigarette frequency uniquely predicted increased daytime dysfunction due to sleepiness. Further, there was an interactive effect of combustible and electronic cigarettes on the use of sleeping medications. DISCUSSION AND CONCLUSIONS: Findings may suggest differential adverse effects on sleep, depending on the type of nicotine product used, and highlight potential intervention targets for users. Future work should examine these associations prospectively and/or use objective measurements of sleep and nicotine use to further elucidate the nature of these relationships. SCIENTIFIC SIGNIFICANCE: This is the first study to explore the main and interactive effects of dual-product use on various dimensions of subjective sleep quality. This is important to investigate, given that dual nicotine users are at greater risk for physical health problems as well as the adverse effects of nicotine on sleep health. (Am J Addict 2020;00:00-00).

Which objective sleep elements predict children's perceptions of good sleep quality? A preliminary investigation based on polysomnography and actigraphy.

OBJECTIVES: Objective sleep elements that underlie child ratings of sleep quality are largely unknown. Child-based sleep recommendations, therefore, typically focus on duration. An expert panel recently provided specific recommendations regarding objective sleep parameters that correspond with higher quality sleep, but child-based studies from which to draw conclusions were notably limited. The present study used actigraphy and polysomnography to explore sleep continuity and architectural variables that correspond with higher ratings of sleep quality in a sample of school-aged children. METHODS: Fifty-two healthy, prepubertal children (aged 7-11 years) completed one night of unattended ambulatory polysomnography at home with concurrent actigraphy and provided sleep quality ratings the following morning. Associations between sleep variables and subjective ratings were examined using polynomial regression models to examine potential linear and nonlinear relationships. RESULTS: In contrast to findings among adults, total sleep time, sleep onset latency, and sleep efficiency values were unrelated to child ratings of sleep quality. Wake after sleep onset (WASO) showed a curvilinear (reversed j-shaped) relationship such that perceptions of sleep quality were high when WASO values were less than approximately 30 minutes. For sleep architecture, N1% showed a significant quadratic association with sleep quality such that N1% between 2% and 6% corresponded with high sleep quality ratings. CONCLUSIONS: Our findings support expert recommendations regarding WASO values that predict high quality sleep in children, but also await replication. There is need for additional research aimed at understanding objective sleep elements and other influences of children's perceptions of sleep quality using linear and nonlinear models.

Combat exposure, post-traumatic stress symptoms, and health-related behaviors: the role of sleep continuity and duration.

STUDY OBJECTIVES: Aggression, substance misuse, and other health risk behaviors are common among combat veterans. We examined whether sleep quality and quantity predict the association between combat exposure, post-traumatic stress symptoms, and adverse health-related behaviors. METHODS: Soldiers (N = 2420) from a brigade combat team completed surveys assessing combat experiences, and psychological and behavioral health factors, approximately 3 months following deployment to Afghanistan in 2011. RESULTS: Respondents were 93.5% male; 73% were age 18-29 years old. The response rate was 80% (3076/3832); 94% (2876/3076) of the soldiers who attended the recruitment briefings consented to participate in this research. Complete data were available across the variables used in this study for up to 2420 soldiers. Sleep continuity disturbance accounted for the association of combat exposure with post-traumatic stress symptoms and aggression, alcohol use, and risky behavior. Moreover, for soldiers who reported sleep duration of <6 hr per day, the indirect association of combat exposure and post-traumatic stress on aggression, alcohol use, risky behavior, and opioid use was strongest. CONCLUSIONS: This study is the first to model sleep problems as a predictor of the association between combat exposure and post-traumatic stress symptoms and frequently reported health-related behavior problems. Sleep disturbance is highly prevalent among Warfighters. While not fully preventable in operational contexts, these problems can be effectively mitigated postdeployment with appropriate policy and intervention resources. Improving the sleep characteristics of combat-exposed soldiers following deployment should reduce subsequent post-traumatic stress and related health compromising behavior, thereby enhancing force readiness.

Limited Efficacy of Caffeine and Recovery Costs During and Following 5 Days of Chronic Sleep Restriction.

Objectives: To investigate the effects of caffeine on psychomotor vigilance and sleepiness during sleep restriction and following subsequent recovery sleep. Methods: Participants were N = 48 healthy good sleepers. All participants underwent five nights of sleep satiation (time-in-bed [TIB]: 10 hours), followed by five nights of sleep restriction (TIB: 5 hours), and three nights of recovery sleep (TIB: 8 hours) in a sleep laboratory. Caffeine (200 mg) or placebo was administered in the form of chewing gum at 08:00 am and 12:00 pm each day during the sleep restriction phase. Participants completed hourly 10-minute psychomotor vigilance tests and a modified Maintenance of Wakefulness Test approximately every 4 hours during the sleep restriction and recovery phases. Results: Caffeine maintained objective alertness compared to placebo across the first 3 days of sleep restriction, but this effect was no longer evident by the fourth day. A similar pattern of results was found for Maintenance of Wakefulness Test sleep latencies, such that those in the caffeine group (compared to placebo) did not show maintenance of wakefulness relative to baseline after the second night of restriction. Compared to placebo, participants in the caffeine condition displayed slower return to baseline in alertness and wakefulness across the recovery sleep period. Finally, the caffeine group showed greater N3 sleep duration during recovery. Conclusions: Caffeine appears to have limited efficacy for maintaining alertness and wakefulness across 5 days of sleep restriction. Perhaps more importantly, there may be recovery costs associated with caffeine use following conditions of prolonged sleep loss.