The effect of sleep problems on core self-evaluations in undergraduate nursing students and the role of emotion regulation and resilience: A cross-sectional study.

BACKGROUND: Nursing students are prone to sleep problems that affect their core self-evaluations. However, little attention has been paid to the specific roles of emotion regulation (including cognitive reappraisal and expressive suppression) and resilience in this process. OBJECTIVES: This study aimed to explore 1) the direct effect of sleep problems on core self-evaluations among nursing students; 2) the chain-mediating effect of cognitive reappraisal and resilience on the relationship between sleep problems and core self-evaluations; 3) the moderating effect of expressive suppression on the direct relationship between sleep problems and core self-evaluations; and 4) the moderating effect of expressive suppression on the indirect relationship between sleep problems affecting core self-evaluations through resilience. METHODS: A total of 345 nursing students completed a survey conducted between September and October 2022. Data was analyzed using descriptive analysis, Fisher exact test, Kruskal-Wallis H test, Spearman correlation analysis, and hierarchical regression analysis. Additionally, the SPSS PROCESS V4.0 plug-in was used to verify the moderated chain-mediating effect. RESULTS: Sleep problems directly affected core self-evaluations among nursing students. Cognitive reappraisal and resilience played a partial chain-mediating role in the relationship between sleep problems and core self-evaluations, with expressive suppression having a direct moderating effect. CONCLUSIONS: Opportunities exist for enhancing the core self-evaluations of nursing students by addressing their sleep problems, promoting cognitive reappraisal strategies, and increasing resilience. Additionally, encouraging expressive suppression can mitigate the negative impact of sleep problems on nursing students' core self-evaluations.

The Connection Between Sleep Problems and Emotional and Behavioural Difficulties in Autistic Children: A Network Analysis.

The interactions between sleep problems, autism symptoms and emotional and behavioural difficulties were explored using network analysis in 240 autistic children (mean age: 8.8 years, range 5-13 years) with moderate to severe sleep problems. Findings revealed a highly connected and interpretable network, with three separate clusters identified of the modelled variables. Depression, anxiety and behavioural difficulties were the most central variables of the network. Depression, anxiety and restricted repetitive and stereotyped patterns behaviours (RRBs) were the strongest bridging variables in the network model, transmitting activation both within and between other symptom clusters. The results highlight that depression and anxiety were highly connected symptoms within the network, suggesting support in these areas could be helpful, as well as future research.

Association Between Bedroom Light Pollution With Subjectively and Objectively Measured Sleep Parameters Among Chinese Young Adults.

PURPOSE: To investigate the cross-sectional associations between real-world multiperiod bedroom light at night and sleep parameters among 365 Chinese young adults. METHODS: Bedroom light exposure was estimated at the individual level for two consecutive days using a portable illuminance meter. Subjective sleep parameters were measured with the Pittsburgh Sleep Quality Index, and objective sleep parameters were assessed by wrist-worn ActiGraph accelerometers for seven consecutive days. RESULTS: Compared with the low-exposure group (average light intensity < 3lx), the high-exposure group (average light intensity ≥ 3lx) was associated with decreased 1.15% in sleep efficiency (sleep efficiency, 95% CI: -1.78, -0.52; p < .001), increased 3.94 minutes in wake after sleep onset (wake after sleep onset, 95% CI: 1.55, 6.33; p = .001), increased 1.05 unit in movement index (95% CI: 0.20, 1.89; p = .015), and increased 2.16 unit in sleep fragmentation index ( 95% CI: 0.63, 3.68; p = .006). In comparison, each interquartile increase in 2h-average and 1h-average intensity of preawake light (PAL) (PAL-2h and PAL-1h) was associated with 7.04 minutes of increases in total sleep time (95% CI: 0.87, 13.22; p = .025) and 6.69 minutes of increases in total sleep time (95% CI: 0.51, 12.87; p = .034), respectively. DISCUSSION: Altogether, our results support the role of bedroom light exposure in sleep and imply the importance of bedroom light exposure management as a potential strategy to reduce the public health burden of sleep problems. Keeping the bedroom environment dark at night and allowing moderate morning light exposure may be important measures for improving the sleep quality of young adults.

Work hard and sleep better: Work autonomy attenuates the longitudinal effect of workaholism on sleep problem among Chinese working adults.

The prevalence of workaholism has negative consequences on human health. Lack of sleep, a well-known problem among adults in modern society, is often attributed to overwork as a result of workaholism. Yet there is a lack of empirical research examining how and when workaholism will lead to sleep problems. To answer this question and to examine the longitudinal effect of workaholism on sleep in China, we investigate the mediating role of perceived evening responsibilities of work and the moderating effect of work autonomy. Two hundred and five Chinese working adults (58.0% female) voluntarily completed the online questionnaires at Time 1 (T1) and Time 2 (T2; 1-month later). Results showed that workaholism at T1 had a significant and positive correlation with sleep problem at T2. Further analysis suggested that perceived evening responsibilities of work fully mediated the relationship between workaholism and sleep problem. Work autonomy was shown to buffer the positive effect of workaholism on perceived evening responsibilities of work and attenuate the indirect effect of workaholism on sleep problem. While workers should be made aware of the negative impact of workaholism on sleep, organizations should also consider interventions to enhance employees' autonomy and control of their work.

Reliability and validity of the Chinese version of the Athens insomnia scale for non-clinical application in Chinese athletes.

Purpose: This study aimed to revise and examine the reliability and validity of the Chinese version of the Athens Insomnia Scale for Non-clinical Application (AIS-NCA) among Chinese athletes. Additionally, the study tested the scale in non-athlete individuals with similar sleep management practices to further analyze its cultural specificity among Chinese athletes and make preliminary inferences about its applicability in other Chinese populations. Methods: Four hundred twenty-six Chinese professional athletes and 779 high school students participated in this research. Both athletes and students were divided into two parallel groups for exploratory and confirmatory factor analyses. Additionally, three athlete samples and one student sample were established for reliability and validity assessments. Among athletes, the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, the Athlete Sleep Screening Questionnaire, and the Warwick-Edinburgh Mental Well-Being Scale were employed to evaluate convergent and discriminant validity. Re-test reliability was evaluated at intervals of 1 and 2 weeks. In the case of students, convergent and discriminant validity were tested using the Pittsburgh Sleep Quality Index and the General Self-Efficacy Scale, with re-test reliability assessed at two-week intervals. Results: The Chinese version of the AIS-NCA consists of six items, categorized into two dimensions: sleep problems and daytime functioning. This structure explained 65.08% (athletes) and 66.22% (students) of the variance. Confirmatory factor analysis revealed good model fit, with values of χ2/df = 2.217, CFI = 0.975, AGFI = 0.929, TLI = 0.953, and RMSEA = 0.076 among athletes, and χ2/df = 3.037, CFI = 0.979, AGFI = 0.947, TLI = 0.961, and RMSEA = 0.072 among students. The scale demonstrated a reasonable degree of measurement invariance. The overall scale and two subscales exhibited strong reliability and validity among athletes. Similar results in terms of reliability and validity were also observed within the student sample. Conclusion: The Chinese version of the AIS-NCA shows promise as an assessment tool for evaluating the sleep quality of Chinese athletes. It effectively captures both sleep-related concerns and daytime functionality within the athlete population. The scale demonstrates solid reliability and validity in professional athletes and holds potential for application across various other demographic groups in China.

Health status of university football athletes through multidimensional screening.

OBJECTIVE: Adequate conditioning results from various physical, environmental, and psychological factors in sports activities. In this study, we aimed to clarify the concurrence and relevance of injuries, psychological problems, and sleep disturbance in university football (soccer) players. Biomechanical characteristics and risk factors for those injuries were also investigated. METHODS: Overall, 1,084 university football players participated in this cross-sectional study using a web-based health history questionnaire. Assessments were made via the presence of injuries for physical problems, the Athlete Psychological Strain Questionnaire (APSQ) for psychological problems, and the Athlete Sleep Screening Questionnaire (ASSQ) for sleep difficulties. RESULTS: There were 200 (19%) athletes with injuries; 413 (38%) of these were APSQ-positive, 246 (23%) were ASSQ-positive, and 468 (43%) athletes had no physical, psychological, or sleep problems. APSQ-positive respondents were significantly more likely to have a current injury than those who were APSQ-negative. No significant difference was observed between the number of ASSQ-positive and -negative respondents and current injuries. Those with sleep problems were significantly more likely to have psychological problems. CONCLUSION: More than 60% of university football players had one or more physical, psychological, or sleep problems. Players may have co-occurring problems, and it is important to address them for these athletes to reach peak performance.

Association of sleep behavior with depression: a cross-sectional study in northwestern China.

Background: This study aimed to examine the association between sleep duration, sleep problems, and depression in Northwest China. Method: Depression was diagnosed at the hospital and self-reported by the participants in the baseline survey. Sleep duration and problems, including difficulty initiating and maintaining sleep, early morning awakening, daytime dysfunction, use of sleeping pills or drugs, and any sleep problems, were obtained by a self-reported questionnaire. Logistic regression was used to estimate odds ratios (ORs) with corresponding 95% confidence intervals (CIs) for exploring the association between sleep duration, sleep problems, and depression, adjusting for demographic and socioeconomic characteristics and health behaviors. The association between depression and sleep duration was also evaluated continuously with restricted cubic spline curves based on logistic models. Results: 36,515 adults from Regional Ethnic Cohort Study in Northwest China were included. About 24.04% of participants reported short sleep duration (<7 h), and 15.64% reported long sleep duration (≥9 h). Compared with standard sleep duration (7-9 h), short sleep duration was associated with a higher risk of depression (OR: 1.69, 95%CI: 1.26-2.27, p = 0.001). Self-reported sleep problems were also related to four times depression risk increased (OR: 4.02, 95%CI: 3.03-5.35, p < 0.001) compared with no sleep problems. In addition, a nonlinear relationship was found between sleep duration and depression after adjusting covariates (p = 0.043). Conclusion: Sleep duration and sleep problems are associated with depression. Enough sleep time and healthy sleep habits in life course might be a practical health promotion approach to reduce depression risk in Northwest Chinese adults. A further study from cohort study is needed to verify the temporal association.

Sleep Problem in Post COVID-19 Patient, Its Impact on Quality of Life and Current Management: An Evidence-based of Case Report.

BACKGROUND: COVID-19 is a global health problem that affects both physical and psychological aspect of patients. Sleep problems were experienced by many patients during the acute phase of after COVID-19 recovery. It affects patient's quality of life and required comprehensive management. This evidence-based case report aims to study the effect of sleep disturbance on quality of life and what is the appropriate management in post COVID-19 patients. METHODS: searching were conducted in Pubmed, Cohcrane, EBSCO according to clinical questions. Study was selected based on inclusion and exclusion criteria, then it was critically appraised. Results: high score on the insomnia severity index and the Pittsburgh sleep quality index were found to be associated with quality of life. Cognitive Behavioural Therapy is currently the best evidence-based treatment in patient during and after COVID-19. CONCLUSION: sleep disturbance is a problem that many post COVID-19 patient face and CBT can improve their quality of life.

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OBJECTIVES: To explore the sleep status and risk factors for sleep problems in infants and young children in Jilin Province. METHODS: A total of 1 080 healthy infants and young children aged 0-3 years from eight prefecture-level cities and one autonomous prefecture in Jilin Province were selected as subjects. A self-designed questionnaire was used to collect the general information of the subjects, and the Brief Infant Sleep Questionnaire was used to understand the sleep status of the subjects. Multivariate logistic regression analysis was used to analyze the risk factors for sleep problems. RESULTS: The total detection rate of sleep problems in the infants and young children was 38.24% (413/1 080). The total sleep time in the 4-11 month, 12-24 month, and 25-36 month age groups was higher than the recommended total sleep time (P<0.05). Multivariate logistic regression analysis showed that full-term birth, higher educational level of the main caregiver, and higher daytime activity intensity were protective factors for sleep problems in the infants and young children (P<0.05), while lower frequency of vitamin D supplementation, frequent night feeding, and maternal snoring were risk factors for sleep problems (P<0.05). CONCLUSIONS: The total sleep time of infants and young children over 4 months old in Jilin Province is higher than the recommended total sleep time, but the prevalence rate of sleep problems is higher. The occurrence of sleep problems is related to various factors. Strengthening follow-up on preterm infants, providing education on infant sleep knowledge to primary caregivers, and regularly supplementing with vitamin D can be beneficial in reducing sleep problems in infants and young children.

Association of vitamins with hearing loss, vision disorder and sleep problem in the US general population.

Based on nationally representative samples from US, we aimed to assess the associations of vitamins with hearing loss, vision disorder and sleep problem. A total of 25,312, 8425 and 24,234 participants were included in this study to investigate the relationship of vitamins with hearing loss, vision disorder and sleep problem from National Health and Nutrition Examination Survey, respectively. Vitamins including niacin, folic acid, vitamin B6, A, C, E and carotenoids were considered in our study. Logistic regression models were used to assess the associations between all included dietary vitamin intake concentrations and the prevalence of specific outcomes. Increased lycopene (odds ratio [OR]: 0.904, 95% confidence interval [CI]: 0.829-0.985) intake was associated with a deceased prevalence of hearing loss. Higher dietary intake of folic acid (OR: 0.637, 95% CI: 0.443-0.904), vitamin B6 (0.667, 0.465-0.947), alpha-carotene (0.695, 0.494-0.968), beta-carotene (0.703, 0.505-0.969) and lutein + zeaxanthin (0.640, 0.455-0.892) were associated with a decreased prevalence of vision disorder. The inversely associations of sleeping problem with niacin (OR: 0.902, 95% CI: 0.826-0.985), folic acid (0.882, 0.811-0.959), vitamin B6 (0.892, 0.818-0.973), vitamin C (0.908, 0.835-0.987), vitamin E (0.885, 0.813-0.963) and lycopene (0.919, 0.845-0.998) were also observed. Our findings provide evidence that increased specific vitamin intake is associated with decreased prevalence of hearing loss, vision disorder and sleep problem.

The trajectories and associations of insomnia symptoms with addictive behaviours in adolescents: A two-year longitudinal study.

Insomnia displays heterogeneous trajectories across adolescence, which may induce addictive behaviours, including internet gaming disorder and substance use. This study aimed to investigate the latent trajectory classes of insomnia symptoms over 2 years and to examine the associations between insomnia trajectories and these addictive behaviours. Participants were 910 adolescents from six middle schools in Shanghai, China (52.7% males; mean age = 13.17 years). The three-wave survey measured insomnia symptoms, internet gaming disorder, substance use, depressive symptoms, and sociodemographic characteristics from 7th to 9th grade. Latent class growth modelling was performed to identify the latent trajectory classes of insomnia symptoms. Then multivariable logistic regressions were conducted within the best-fitting latent class growth model to examine the associations of insomnia trajectories with internet gaming disorder and substance use. Two latent trajectory classes of insomnia symptoms were recognised: the non-insomnia group (71.8%) and the insomnia group (28.2%). In the multivariable analysis controlling for baseline demographic variables and depressive symptoms, the insomnia group had a higher risk of developing internet gaming disorder (OR = 2.203 [95% CI: 1.258-3.858]) and substance use (OR = 2.215 [95% CI: 1.324-3.705]) compared with the non-insomnia group. These findings add to a growing body of research on heterogeneous trajectories of insomnia symptoms during adolescence, suggesting that intervention strategies are needed to target the characteristics or developmental patterns of different insomnia subgroups. The ultimate goal is to mitigate the impact of insomnia symptoms on adolescent addictive behaviours.

Sleep and 24-hour rhythm characteristics in preschool children born very preterm and full term.

STUDY OBJECTIVES: Sleep impacts the quality of life and is associated with cardiometabolic and neurocognitive outcomes. Little is known about the sleep of preterm-born children at preschool age. We, therefore, studied sleep and 24-hour rhythms of preschool children born very preterm compared with full-term children. METHODS: This was a prospective cohort study comparing sleep quality and quantity of children born very preterm (gestational age [GA] < 30 weeks) with full-term children at the (corrected) age of 3 years, using (1) 2 parent-reported questionnaires (Brief Infant Sleep Questionnaire and The Munich Chronotype Questionnaire) and (2) at least 3 days of triaxial wrist actigraphy combined with sleep diary. We performed regression analyses with adjustment for sex (corrected), age, and birth weight standard deviation (SD) score. RESULTS: Ninety-seven very-preterm-born (median GA 27+5; interquartile range 26 + 3;29 + 0 weeks) and 92 full-term children (GA 39 + 3; 38 + 4;40 + 4 weeks) were included. Sleep problems and other reported sleep parameters were not different between groups. As measured with actigraphy, sleep and 24-hour rhythm were similar between groups, except for very-preterm born children waking up 21 minutes (4;38) minutes later than full-term children (adjusted P = .001). CONCLUSIONS: Based on parent reports and actigraphy, very-preterm-born children sleep quite similar to full-term controls at the corrected age of 3 years. Reported sleep problems were not different between groups. Actigraphy data suggest that preterm-born children may wake up later than children born full term. Further studies are needed to explore how sleep relates to cardiometabolic and neurodevelopmental outcomes after preterm birth and whether early interventions are useful to optimize 24-hour rhythm and sleep. CITATION: Bijlsma A, Beunders VAA, Dorrepaal DJ, et al. Sleep and 24-hour rhythm characteristics in preschool children born very preterm and full term. J Clin Sleep Med. 2023;19(4):685-693.

Association between exposure to light at night (LAN) and sleep problems: A systematic review and meta-analysis of observational studies.

BACKGROUND: Accumulating evidence have investigated the effects of nighttime light exposure on sleep problems. Nevertheless, the evidence of the relationship between light at night (LAN) and sleep problems remains scarce and inconsistent. OBJECTIVE: Conducted a systematic review and meta-analysis based on observational studies to examine the association between LAN exposure and sleep problems among human subjects. METHODS: We systematically searched three databases (PubMed, Web of Science, and Embase) to identify potentially eligible studies through May 25, 2022. The risk of bias and the quality of the generated evidence were assessed by two authors using the National Toxicology Program's Office of Health Assessment and Translation (OHAT) risk of bias rating tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guideline. Random-effects model was applied to synthesize the risk estimates across eligible studies. The heterogeneity of included studies was quantified by the statistics of I2. RESULTS: A total of 7 cross-sectional studies comprising 577,932 participants were included. Individuals with higher levels of LAN exposure were associated with a 22 % (Summary Odds Ratio, SOR: 1.22, 95 %CI: 1.13-1.33) increased prevalence of sleep problems. The pooled effect size of indoor LAN exposure (SOR: 1.74, 95%CI: 1.27-2.37) associated with sleep problems was significantly higher than outdoor LAN exposure (SOR: 1.19, 95%CI: 1.11-1.29; P = 0.022). Additionally, dose-response analysis demonstrated that LAN intensity threshold exceeding 5.8 nW/cm2/sr (SOR: 1.04, 95%CI: 1.01-1.07) had a significant effect on sleep problems and the prevalence of sleep problems was increasing with increase in LAN intensity. CONCLUSIONS: Overall, our findings support the detrimental effects of LAN exposure on sleep. Maintaining bedroom darkness at night may be a feasible measure to reduce the prevalence of sleep problems. Future longitudinal studies with more advanced LAN assessment methods are required to move the field forward.

Cross-sectional study on the sleep status and risk factors for sleep problems in infants and young children in Jilin Province / 中国当代儿科杂志

OBJECTIVES@#To explore the sleep status and risk factors for sleep problems in infants and young children in Jilin Province.@*METHODS@#A total of 1 080 healthy infants and young children aged 0-3 years from eight prefecture-level cities and one autonomous prefecture in Jilin Province were selected as subjects. A self-designed questionnaire was used to collect the general information of the subjects, and the Brief Infant Sleep Questionnaire was used to understand the sleep status of the subjects. Multivariate logistic regression analysis was used to analyze the risk factors for sleep problems.@*RESULTS@#The total detection rate of sleep problems in the infants and young children was 38.24% (413/1 080). The total sleep time in the 4-11 month, 12-24 month, and 25-36 month age groups was higher than the recommended total sleep time (P<0.05). Multivariate logistic regression analysis showed that full-term birth, higher educational level of the main caregiver, and higher daytime activity intensity were protective factors for sleep problems in the infants and young children (P<0.05), while lower frequency of vitamin D supplementation, frequent night feeding, and maternal snoring were risk factors for sleep problems (P<0.05).@*CONCLUSIONS@#The total sleep time of infants and young children over 4 months old in Jilin Province is higher than the recommended total sleep time, but the prevalence rate of sleep problems is higher. The occurrence of sleep problems is related to various factors. Strengthening follow-up on preterm infants, providing education on infant sleep knowledge to primary caregivers, and regularly supplementing with vitamin D can be beneficial in reducing sleep problems in infants and young children.

The association of smartphone screen time with sleep problems among adolescents and young adults: cross-sectional findings from India.

BACKGROUND: Although sleep problem is a growing public health issue with the advancement of technology, especially among adolescents and young adults, it received little attention. The study aimed to examine the association of screen time on smartphone with sleep problems among adolescents and young-adults in India. METHODS: We used data from the "Understanding the lives of adolescents and young-adults" (UDAYA, 2018). The effective sample size for the study was 16,292 adolescents and young adults (males-4428 and females-11,864). Descriptive statistics and bivariate analysis with percentages and chi-square test were used to report the preliminary results. Multivariable logistic regression analysis was conducted to examine the association between smartphone screen time and sleep problems, separately for adolescents and young adults. RESULTS: Nearly 15.6% of males and 23.5% of females had sleep problems in their adolescence in the last 15 days, while these percentage were high among young-adults (18.4% males and 33.24% females). Adolescents [AOR: 1.55; CI: 1.21-1.99] and young adults [AOR: 1.48; CI: 1.24-1.75], who spent more than 2 h on smartphone had higher odds of reporting sleep problems than those who did not use smartphone in the last 24 hours. Adolescent females who used smartphone for less or equal to 2 h and three or more hours respectively, had 2.11 [AOR: 2.11; CI: 1.63-2.73] and 2.94 times [AOR: 2.94; CI: 1.97-4.38] higher odds of reporting sleep problems than adolescent males who did not use smartphones. Additionally, among the young adult females, the odds of sleep problems were 1.66 times [AOR: 1.66; CI: 1.55-2.38] and 2.36 times [AOR: 2.36; CI: 1.59-3.51] greater than the non-users young adult males. CONCLUSION: The increased time spent on mobile phones's screen among adolescents and young-adults, particularly in females is associated with a higher likelihood of reporting sleeping problems. The current findings have important implications for adolescence and young-adults' mental health programmes. The findings can also be used to further inform how different strategies need to be developed for better sleep outcome during adolescence and young-adults.

Prevalence of mental illness in patients with obstructive sleep apnea - A cross-sectional study from Kashmir, India.

Aim: The study aimed to evaluate the prevalence of mental illness in obstructive sleep apnea (OSA) and to examine whether patients with obstructive sleep apnea require screening for mental illness. Methods: We performed polysomnography studies of patients that were referred from various subspecialty clinics in Kashmir from Jan 2020-December 2020. using the Mini-International Neuropsychiatric Interview (MINI plus) scale to make a psychiatric diagnosis. We administered the General Health Questionnaire - 28 (GHQ - 28), Hamilton Depression Rating Scale (HAM-D), and Hamilton Anxiety Rating Scale (HAM-A) to patients. Descriptive statistics and correlations were used for data analysis. Results: 182 patients underwent polysomnography, 85 (46.7%) of which were suffering from mental illness Based on the Apnea-Hypopnea Index score, 8 (4.39%) patients had mild, 35 (41.1%) had moderate and 42 (49.4%) had severe OSA. The mean GHQ -28 score was significantly higher in patients with Obstructive sleep apnea (p < 0.001) (11.34 ± 8.2) as compared to non-Obstructive sleep apnea patients (1.98 ± 4.38). Conclusions: This study demonstrates the increased prevalence of anxiety and depression in patients with OSA. Therefore, we recommend timely screening for any mental health issues in patients with OSA and necessary interventions to address the issues, thus preventing mental health morbidities in patients with OSA this would help subsequently in an improved lifestyle.

The association of adverse childhood experiences and its subtypes with adulthood sleep problems: A systematic review and meta-analysis of cohort studies.

Adverse childhood experience (ACE) is a powerful risk factor for long-term sleep health. However, the degree to which ACE and its subtypes contribute to adulthood sleep problems remains unknown. For this systematic review and meta-analysis, PubMed, Embase, Web of Sciences, Cochrane library, and CNKI (Chinese) were searched from inception to 1 December 2021. Cohort studies that examined the association between ACEs (aged <18 y) and adulthood sleep outcomes (aged ≥18 y) were included. The most fully adjusted odds ratios (ORs) were extracted and pooled using the random-effects model. A total of nine articles involving 108 330 participants from five high-income countries were identified. Individuals with at least one ACE subtype were more likely to report adulthood sleep problems (OR = 1.14, 1.09-1.20, I2 = 77.5%, n = 9 studies) compared with those without ACE. The pooled ORs were approximately 1.20 for sexual, physical, and emotional abuse with high heterogeneity (I2 > 80%), 1.09 (95% CI: 0.99-1.19, I2 = 0%, n = 2) for neglect, and 1.21 (95% CI: 1.14-1.30, I2 = 73.6%, n = 3) for family dysfunction. Individuals with multiple ACEs were associated with a higher magnitude of the risk for sleep problems (OR = 1.33, 95% CI: 1.18-1.49, I2 = 87.3%, n = 3). In conclusion, the magnitude of the risk for sleep problems was similar across ACE subtypes except for childhood neglect. ACE may have cumulative detrime ntal effects on sleep health. More longitudinal evidence regarding ACE-sleep relationships, particularly in low- and middle-income countries, is needed. Furthermore, more policy efforts and evidence-based preventions are warranted to address ACEs among children.

Evaluation of the relationship between psychological distress and sleep problems with annoyance caused by exposure to environmental noise in the adult population of Tehran Metropolitan City, Iran.

Purpose: The aim of this study was to investigate the association between the psychological distress and sleep problems with environmental noise annoyance in adult population. Methods: This is a cross-sectional study on 822 adult population of Tehran City in 2016. Integrated cluster stratified random sampling and Kish grid method were used. Noise annoyance, the day-night average sound level (Ldn), nighttime average sound level (Lnight), and daytime average sound level (Lday) were selected as noise exposure indicators. The prevalence of psychological distress and sleep problems were assessed using the Kessler Psychological Distress Scale (K10) and the PSQI questionnaire, respectively. Multiple logistic regression analysis was applied for data analysis. Results: Among the participants 46.03%% were exposed to a sound level higher than the daytime standard level (55 dB) and 84.6% were exposed to a level higher than the nighttime standard limit (45 dBA). According to the results, 49% of the subjects had poor sleep quality and 66% were highly sensitive to noise. In addition, 17.73% had a high risk of mental disorders and 16.48% were found to have a mild risk of mental disorders. There was found a statistically significant association between psychological distress and the noise annoyance at home (OR = 1.3 CI 95% (1.17-1.44)) and at work environment (OR = 1.18 CI 95% (1.08-1.28)). Conclusion: The findings indicated that the study population was highly sensitive to noise. In addition, the relatively high percentage of people who exposed to non-standard levels of sound indicates that this exposure has the potential to cause physical and mental consequences among them.

A randomised controlled dismantling trial of sleep restriction therapies for chronic insomnia disorder in middle childhood: effects on sleep and anxiety, and possible contraindications.

Sleep restriction therapies likely drive improvement in insomnia in middle childhood via increases in homeostatic sleep pressure (e.g., evening sleepiness). Increased evening sleepiness may also dampen comorbid anxiety symptoms; and reduced wakefulness in bed may reduce worry. However, sleep restriction therapies have never been evaluated as a standalone intervention in this population. The mechanism of action needs testing, as do effects on anxiety, and cognitive performance and parasomnias (possible contraindications). This randomised controlled trial evaluated the efficacy of two "doses" of sleep restriction therapy (sleep restriction therapy, bedtime restriction therapy), compared to a control condition (time in bed regularisation). A total of 61 children (mean [SD, range] age 9.1 [2.1, 6-14] years; 54% female) with chronic insomnia disorder received two weekly 60-min treatment sessions with a psychologist. Sleep, sleepiness, anxiety, worry, cognitive performance, and parasomnias were measured pre-treatment, across treatment, and at 4-weeks post-treatment. Both the sleep and bedtime restriction groups experienced reductions in total sleep time (d = 1.38-2.27) and increases in evening sleepiness (d = 1.01-1.47) during the 2-week treatment, and improvements in insomnia (i.e., sleep onset latency; d = 1.10-1.21), relative to the control group. All groups reported improved anxiety and worry, yet there were no differences between the control and restriction groups (all p > 0.658). Time in bed increased at the 1-month follow-up, and benefits to sleep and insomnia were maintained. There were no adverse effects on cognitive functioning (all p > 0.259), nor parasomnia occurrence (all p > 0.740). These results suggest that sleep restriction therapies are brief, yet effective, standalone interventions for insomnia in middle childhood, and improvements are likely due to increased sleepiness, not sleep regularisation.

The Use of Caregivers' Smartphones to Assist Infants' Circadian Sleep-Wake Cycles.

Parents and caregivers lack knowledge regarding young children's sleep routines due to an absence of general guidelines about sleep development, and this knowledge gap has been associated with infants' sleep problems. Approximately 30% of infants develop sleep problems, including difficulty with falling asleep and night-waking. In this study, we sought to develop a new indicator of regularity in infants' circadian sleep-wake patterns. Our participants were healthy Japanese mothers and their infants (n = 172 infants; Mage = 4.9, SD = 3.5 months). Mothers used their smartphones to record the time when their infants fell asleep and woke up in their natural home environments over 7 days. We conducted least-squares spectrum analysis, a time-series analysis often used in chronobiology, to calculate the percentage variance (PVA) of the best-fitted cosine waves with a 24-hr periodicity in the infants' sleep records. We found that the PVA of the 24-hr cycles in the infants' sleep records were significantly correlated with the infants' age in months (r = 0.554, p < 0.001), variations in their waking-up (r = -0.316, p < 0.001) and falling asleep times (r = -0.430, p < 0.001), and sleep duration (r = -0.343, p < 0.001). Apart from these normative data, which are of potential comparative use by other investigators, we showed in this study that PVA data can be collected by infants' parents and caretakers through smartphones to provide parents an indicator of the regularity of an infant's 24-hr periodicity.