Sleep duration in Mexican American children: Do mothers’ and fathers’ parenting and family practices play a role?

This study examined parenting styles, parenting practices and family practices that may be associated with weeknight sleep duration among 8‐ to 10‐year‐old Mexican American (MA) children. This cross‐sectional study of MA children used baseline data from a 2‐year cohort study of mother–child pairs (n = 308) with additional data on fathers (n = 166). Children's weeknight sleep duration was accelerometer estimated and averaged for 2 weeknights. Parents reported on their parenting styles and practices regarding food and family food‐related practices. Multivariable linear regression analysis was used to examine sleep duration with parenting styles and practices, and family practices, and adjusting for child gender and body mass index. Model 1 included mothers’ parenting styles and practices; Model 2 included both mothers’ and fathers’ parenting styles and practices. Children's average sleep duration was 9.5 (SD = 0.8) hr. Mothers who used pressure to encourage their children to eat and those who used food to control behavior had children with longer sleep duration (β = 0.21, p < 0.01; β = 0.15, p = 0.03, respectively). Mothers who reported their children ate dinner with the TV on and those who valued eating dinner as a family had children with shorter sleep duration (β = ?0.16, p = 0.01; β = ?0.18, p = 0.01, respectively). Fathers who restricted the amount of food their children ate had children with shorter sleep duration (β = ?0.27, p = 0.01). Mothers’ and fathers’ feeding practices, the child's eating dinner with the TV on, and valuing family dinners, played a role in children's weeknight sleep duration among Mexican American families. Parental feeding practices and family mealtime contexts may have an effect on children's weeknight sleep duration.     

Cognitive performance in DSWPD patients upon awakening from habitual sleep compared with forced conventional sleep

Difficult early morning awakening is one of the defining symptoms of delayed sleep–wake phase disorder. It is accompanied by low cognitive arousal and drowsiness resulting in difficulty concentrating and focusing attention upon awakening. We designed the current study to quantitate cognitive performance (i.e. omissions, commissions, reaction time [average and variability]) and cognitive domains (i.e. focused attention, sustained attention, impulsivity and vigilance) with Conners’ Continuous Performance Test II during both habitual and conventional (00:00–07:00 hr) sleep–wake schedule in young adult patients with delayed sleep–wake phase disorder (n = 20, mean age = 24.8 years, SD = 3.0) and controls (n = 16, mean age = 24.4 years, SD = 3.4). Conners’ Continuous Performance Test II was administered after awakening and in the afternoon during both habitual and conventional conditions. In‐laboratory polysomnography was performed for 2 nights. We assessed sleep, tiredness, chronotype and depression using questionnaires. Saliva was sampled for dim light melatonin onset measurements. Repeated‐measures ANOVAs were applied for the Conners’ Continuous Performance Test II measures with group (patient/control), time (afternoon/morning) and condition (habitual/conventional schedule) as fixed factors. Patients with delayed sleep–wake phase disorder had reduced reaction times, especially in the morning, greater response speed variability, and made more omission and commission errors compared with controls. Patients with delayed sleep–wake phase disorder also had reduced focused attention, especially upon forced early awakening. The short total sleep time of patients with delayed sleep–wake phase disorder could not statistically explain this outcome. In conclusion, we observed a state‐dependent reduced ability to focus attention upon early morning awakening in patients with delayed sleep–wake phase disorder. Patients also had more omissions, longer reaction time and increased RT variability after habitual sleep, suggesting a possible small cognitive trait dysfunction in delayed sleep–wake phase disorder.     

Daily mood and sleep: reciprocal relations and links with adjustment problems

Children's sleep problems are common and associated with increased risk for adjustment problems. We examined daily links between children's sleep and mood, using a daily diary method and actigraphy. We also tested children's daily mood as a mediator of relations among sleep and children's broader internalizing and externalizing symptoms. A community sample of 142 children (mean age = 10.69 years; 57% girls; 69% European American, 31% African American) and their parents participated. For 1 week, children wore actigraphs and parents completed a daily telephone interview about their child's mood. Following the week of actigraphy, mothers and fathers reported on their child's adjustment. Multi‐level models indicated within‐person relations between children's mood and subsequent sleep fragmentation (indicated by increased activity) and sleep latency, and between‐person relations between sleep latency and subsequent mood on the next day. Significant indirect effects were found such that a more negative daily mood (aggregated across diary days) mediated relations between poor sleep efficiency and longer sleep latency and parent‐reported internalizing and externalizing symptoms. Findings extend previous research by highlighting disruptions to children's daily mood as a potential mechanism linking sleep problems to children's mental health.     

Subjective–objective sleep discrepancy in patients with insomnia during and after cognitive behavioural therapy: An actigraphy study

Although patients with insomnia often show a discrepancy between self‐reported and objective sleep parameters, the role of and change in this phenomenon during treatment remain unclear. The present study aimed to assess the effect of cognitive behavioural therapy for insomnia on subjective and objective sleep discrepancy of total sleep time, sleep‐onset latency and wake after sleep onset. The total sleep time discrepancy was also assessed across the entire therapy. The second aim was to examine the treatment outcome of two insomnia groups differing in sleep perception. Thirty‐six adults with insomnia (mean age = 46.7 years, SD = 13.9; 22 females) were enrolled in the final analyses. Patients underwent a 6‐week group cognitive behavioural therapy for insomnia programme. Sleep diary and actigraphy measurements were obtained during the therapy. Patients who underestimated total sleep time (n = 16; underestimating group) were compared with patients who accurately perceived or overestimated total sleep time (n = 20; accurate/overestimating group). After cognitive behavioural therapy for insomnia, a significant decrease of total sleep time and sleep‐onset latency discrepancy was observed without a change in wake after sleep onset discrepancy in the total sample. Only the underestimating group reported decreased sleep‐onset latency discrepancy after the treatment, whereas total sleep time discrepancy significantly changed in both groups. The underestimating group showed a significant decrease of total sleep time discrepancy from Week 1 to Week 2 when the sleep restriction was implemented, whereas the accurate/overestimating group showed the first significant change at Week 4. In conclusion, both groups differing in sleep perception responded similarly to cognitive behavioural therapy for insomnia, although different In conclusion, both groups differing in sleep perception responded similarly to cognitive behavioural therapy for insomnia, although different therapeutic components could play important roles in each group. components could play important roles in each group.     

Associations between children's intelligence and academic achievement: the role of sleep

Sleep problems (long wake episodes, low sleep efficiency) were examined as moderators of the relation between children's intelligence and academic achievement. The sample was comprised of 280 children (55% boys; 63% European Americans, 37% African Americans; mean age = 10.40 years, SD = 0.65). Sleep was assessed during seven consecutive nights of actigraphy. Children's performance on standardized tests of intelligence (Brief Intellectual Ability index of the Woodcock–Johnson III) and academic achievement (Alabama Reading and Math Test) were obtained. Age, sex, ethnicity, income‐to‐needs ratio, single parent status, standardized body mass index, chronic illness and pubertal development were controlled in analyses. Higher intelligence was strongly associated with higher academic achievement across a wide range of sleep quality. However, the association between intelligence and academic achievement was slightly attenuated among children with more long wake episodes or lower sleep efficiency compared with children with higher‐quality sleep.     

Discrepancies in sleep diary and actigraphy assessments in adults with fibromyalgia: Associations with opioid dose and age

Sleep diary and actigraphy assessments of insomnia symptoms in patients with fibromyalgia (FM) are often discrepant. We examined whether opioid dose and age interact in predicting magnitude or direction of discrepancies. Participants (N = 199, M = 51.5 years, SD = 11.7) with FM and insomnia completed 14 days of diaries and actigraphy. Multiple regressions determined whether average opioid dose and its interaction with age predicted magnitude or direction of diary/actigraphy discrepancies in sleep onset latency (SOL), wake after sleep onset (WASO) and sleep efficiency (SE), controlling for sex, use of sleep medication, evening pain and total sleep time. Higher opioid dose predicted greater magnitude of discrepancy in SOL and SE. Opioid dose interacted with age to predict direction but not magnitude of discrepancy in SOL and SE. Specifically, higher opioid use was associated with better subjective (shorter SOL, higher SE) than objective reports of sleep among younger adults, and longer subjective than objectively measured SOL among older adults. Opioid dose did not predict magnitude or direction of WASO discrepancies. In FM, a higher opioid dose increases diary/actigraphy SOL and SE discrepancies, and direction of discrepancies may depend on age. We speculate that increased opioid use combined with age‐related factors, such as slow wave sleep disruption, increased awakenings and/or cognitive decline, may impact perceived sleep.     

Community violence concerns and adolescent sleep: Physiological regulation and race as moderators

Prior work has demonstrated that greater community violence concerns are associated with poor sleep quality among adolescents. However, these effects may not be uniform across all youth. The present study examined the role of individual difference variables, physiological regulation and race, as moderators of risk in the relation between adolescents’ community violence concerns and their sleep. Adolescents (N = 219; 55.3% female; 69.9% White/European American, 30.1% Black/African American) participated in the study when they were 18 years old (M = 17.7 years, SD = 1.0). Physiological regulation was assessed via respiratory sinus arrhythmia, a measure of parasympathetic regulation, at rest and in response to a stressor. Adolescents wore actigraphs for 7 nights to assess their sleep duration and quality, and reported on their community violence concerns via a well‐validated questionnaire. Results demonstrated a consistent pattern of interactions, such that African American adolescents who showed less adaptive patterns of regulating physiological arousal experienced shorter sleep duration and poorer sleep quality in the context of greater community violence concerns. Community violence concerns were not associated with sleep for White adolescents. The findings may suggest that race‐related stressors exacerbate risk for poor sleep among African American adolescents who experience more community violence concerns and have more difficulty regulating physiological arousal. Coping strategies for managing stress and arousal may be helpful for improving sleep for some youth.     

Development of sleep–wake rhythms during the first year of age

Circadian rhythms refer to biological rhythms that have an endogenous period length of approximately 24 hr. However, not much is known about the variance in the development of the sleep–wake rhythm. The study objectives were (a) to describe the normative variation in the development of a sleep–wake rhythm in infancy, (b) to assess whether slower development is related to sleep quality and (c) to evaluate factors that are related to the slower development of a sleep–wake rhythm. The study is based on a representative birth cohort. Questionnaires at the ages of 3 (n = 1,427) and 8 months (n = 1,302) and actigraph measurement at 8 months (n = 372) were available. Infants with significant developmental delays (n = 11) were excluded. The results are based on statistical testing and multivariate modelling. We found that the average percentage of daytime sleep was 36.3% (standard deviation [SD], 8.5%) at 3 months and 25.6% (SD, 6.6%) at 8 months. At both time‐points, infants with slower sleep–wake rhythm development slept more hours per day, had a later sleep–wake rhythm, more difficulties in settling to sleep and longer sleep‐onset latency; they also spent a longer time awake during the night. According to actigraph registrations, we found that the infants with slow development of a sleep–wake rhythm slept less and had a later start and end to night‐time sleep than the other infants. Infants’ sleep–wake rhythm development is highly variable and is related to parent‐reported and objectively measured sleep quality and quantity. Interventions to improve the sleep–wake rhythm might improve sleep quality in these infants.     

Sleep continuity and total sleep time are associated with task‐switching and preparation in young and older adults

Ageing is associated with changes in sleep and decline executive functions, such as task‐switching and task preparation. Given that sleep affects executive function, age‐related changes in executive function may be attributable to changes in sleep. The present study used a sleep detection device to examine whether or not wake time after sleep onset and total sleep time moderated age differences in task‐switching performance and participants' ability to reduce switch costs when given time to prepare. Participants were cognitively healthy [Mini Mental State Examination > 26] younger (n = 54; mean age = 22.9; 67.8% female) and older (n = 45; mean age 62.8; 71.1% female) adults. Using a task‐switching paradigm, which manipulated preparation time, we found that smaller global switch costs were associated with lower wake time after sleep onset and longer total sleep time. Greater preparation effects on local switch costs and adoption of a task‐set were associated with lower wake time after sleep onset, although this effect was significant only in older adults when stratified by age group. This association was independent of inhibition and working memory abilities. The lack of interactions between sleep and age group indicated that age differences in switch costs were not moderated by better sleep. Our results suggest that young and older adults may benefit similarly from lower wake time after sleep onset and longer total sleep time in overall performance, and individuals with less wake time after sleep onset are more likely to engage preparatory strategies to reduce switch costs and boost task‐switching performance.     

Self‐reported sleep quantity,quality and sleep hygiene in elite athletes

Sleep is essential for recovery and performance in elite athletes. While actigraphy‐based studies revealed suboptimal sleep in athletes, information on their subjective experience of sleep is scarce. Relatively unexplored is also the extent to which athletes’ sleep is adversely affected by environmental conditions and daytime behaviours, that is sleep hygiene. This study aimed to provide insight in sleep quantity, quality and its putative association with sleep hygiene. Participants were 98 elite (youth) athletes competing at the highest (inter‐)national level. Sleep quantity, quality and sleep hygiene were assessed once covering a 1‐month period by using established (sub)clinical questionnaires, and repeatedly during 7 consecutive days. Sleep quality was generally healthy, although 41% of all athletes could be classified as ‘poor sleeper’, and 12% were identified as having a sleep disorder. Daily self‐monitoring revealed sleep durations of 8:11 ± 0:45 h, but elevated wake after sleep onset of 13 ± 19 min. Sleep quality, feeling refreshed, and morning vigor were moderate at best. Regarding sleep hygiene, general measures revealed irregular sleep–wake patterns, psychological strain and activating pre‐sleep behaviours. At the daily level, blue‐light exposure and late‐evening consumption of heavy meals were frequently reported. General sleep hygiene revealed significant associations with sleep quality (0.45 < r > 0.50; P < 0.001). Results indicate that there is ample room for optimization, specifically in onset latency and in wake after sleep onset. Subtle improvements in sleep seem possible, and optimizing sleep hygiene, such as regular sleep–wake patterns and reducing psychological strain, may facilitate this sleep upgrading process.     

Discrepancy between wrist‐actigraph and polysomnographic measures of sleep in patients with stable heart failure and a novel approach to evaluating discrepancy

Wrist‐actigraphy is often used to measure sleep characteristics in a variety of populations, but discrepancies between actigraphic and polysomnographic measures have been noted in populations experiencing poor sleep quality. The purpose of this study is to examine the discrepancy between these measures and risk factors for discrepancy in people with heart failure using a novel index. We used sleep measures simultaneously recorded by actigraphy and polysomnography, and clinical data from a cross‐sectional study of 155 patients with heart failure (age = 60.5 [16.1] years; 65.2% male) recruited from evidence‐based heart failure disease management programmes. The discrepancy and consistency between the two measures were evaluated using Bland–Altman plots, intra‐class correlations and a newly developed index that represents activity counts in wake episodes. Overall, participants had short total sleep time (327.7 [95.9] min) and poor sleep efficiency (71.3 [16.0]%) on polysomnography. The discrepancies between sleep measures were small in patients less than 60 years old, and there was excellent consistency (intra‐class correlation = 0.81) compared with older patients who had poorer consistency (intra‐class correlation = 0.53) on total sleep time. Higher daytime motor activity, poor sleep quality and more severe insomnia were associated with smaller discrepancies in older, but not younger, patients, and associations were more sensitively detected by the new index. These findings suggest the importance of aging, disability and co‐morbidity that may influence motor activity from which sleep estimates are scored with actigraphy. The new index may be useful in identifying factors associated with the correspondence between actigraphy and polysomnography.     

Occupational and socioeconomic differences in actigraphically measured sleep

Occupational conditions, together with socioeconomic status, may modulate sleep. This study examined the association of occupational conditions and socioeconomic status with actigraphic measures of sleep in workers. Fifty‐five employees (40 ± 12 years) wore a wrist actigraph during sleep for seven consecutive nights. Sleep variables addressed included total sleep time, sleep efficiency, mean activity during sleep, sleep‐onset latency, and wake after sleep onset. We also measured household income, occupational class, work schedule, weekly work hours, job demand, job control, worksite social support, effort–reward imbalance, organizational justice, and workplace social capital. Multiple linear regression models were used to determine the association of occupational indicators, socioeconomic status, as well as age and gender with each sleep variable. Higher workplace social capital was associated consistently with longer total sleep time (P < 0.001), higher sleep efficiency (P < 0.05) and lower mean activity during sleep (P < 0.07). Low occupational class (P < 0.01), higher job demand (P < 0.05) and lower job control (P < 0.05) were associated with longer total sleep time. No associations were significant for sleep‐onset latency or wake after sleep onset. These preliminary results suggest that enhanced workplace social capital is closely associated with better quality and quantity of sleep.     

Napping in older people ‘at risk’ of dementia: relationships with depression,cognition, medical burden and sleep quality

Sleep disturbance is prevalent in older adults, particularly so in those at a greater risk of dementia. However, so far the clinical, medical and neuropsychological correlates of daytime sleep have not been examined. The aims of this study were to investigate the characteristics and effects of napping using actigraphy in older people, particularly in those ‘at risk’ of dementia. The study used actigraphy and sleep diaries to measure napping habits in 133 older adults ‘at risk’ of dementia (mean age = 65.5 years, SD = 8.4 years), who also underwent comprehensive medical, psychiatric and neuropsychological assessment. When defined by actigraphy, napping was present in 83.5% (111/133) of participants; however, duration and timing varied significantly among subjects. Nappers had significantly greater medical burden and body mass index, and higher rates of mild cognitive impairment. Longer and more frequent naps were associated with poorer cognitive functioning, as well as higher levels of depressive symptoms, while the timing of naps was associated with poorer nocturnal sleep quality (i.e. sleep latency and wake after sleep onset). This study highlights that in older adults ‘at risk’ of dementia, napping is associated with underlying neurobiological changes such as depression and cognition. Napping characteristics should be more routinely monitored in older individuals to elucidate their relationship with psychological and cognitive outcomes.     

Unique sleep‐stage transitions determined by obstructive sleep apnea severity,age and gender

In obstructive sleep apnea, patients’ sleep is fragmented leading to excessive daytime sleepiness and co‐morbidities like arterial hypertension. However, traditional metrics are not always directly correlated with daytime sleepiness, and the association between traditional sleep quality metrics like sleep duration and arterial hypertension is still ambiguous. In a development cohort, we analysed hypnograms from mild (n = 209), moderate (n = 222) and severe (n = 272) obstructive sleep apnea patients as well as healthy controls (n = 105) from the European Sleep Apnea Database. We assessed sleep by the analysis of two‐step transitions depending on obstructive sleep apnea severity and anthropometric factors. Two‐step transition patterns were examined for an association to arterial hypertension or daytime sleepiness. We also tested cumulative distributions of wake as well as sleep‐states for power‐laws (exponent α) and exponential distributions (decay time τ) in dependency on obstructive sleep apnea severity and potential confounders. Independent of obstructive sleep apnea severity and potential confounders, wake‐state durations followed a power‐law distribution, while sleep‐state durations were characterized by an exponential distribution. Sleep‐stage transitions are influenced by obstructive sleep apnea severity, age and gender. N2 → N3 → wake transitions were associated with high diastolic blood pressure. We observed higher frequencies of alternating (symmetric) patterns (e.g. N2 → N1 → N2, N2 → wake → N2) in sleepy patients both in the development cohort and in a validation cohort (n = 425). In conclusion, effects of obstructive sleep apnea severity and potential confounders on sleep architecture are small, but transition patterns still link sleep fragmentation directly to obstructive sleep apnea‐related clinical outcomes like arterial hypertension and daytime sleepiness.     

Relations between daytime pre‐ejection period reactivity and sleep in late childhood

The sympathetic nervous system and children's sleep serve critical arousal regulation functions. Shortened pre‐ejection period, a reliable indirect index of greater sympathetic nervous system activity, has been associated with reduced sleep duration and quality in adults, but limited evidence exists in children regarding associations between pre‐ejection period and sleep. We examined relations between pre‐ejection period reactivity in response to a laboratory‐based stressor and multiple parameters of actigraphy‐based sleep duration and quality in children. The sample included 123 boys and 112 girls [mean age = 11.31 years, standard deviation (SD) = 0.63 years]. Controlling for body mass index, sex and pre‐ejection period baseline, increased sympathetic nervous system reactivity, indexed by a lower level of pre‐ejection period during the challenge than the baseline, was associated with worse sleep quality indicated by lower sleep efficiency, greater sleep activity and greater long wake episodes. The findings add to a small literature on relations between sympathetic nervous system functioning and children's sleep, suggesting that poor sleep quality is related to dysregulation of this stress response system.     

Validity,potential clinical utility,and comparison of consumer and research‐grade activity trackers in Insomnia Disorder I: In‐lab validation against polysomnography

Consumer activity trackers claiming to measure sleep/wake patterns are ubiquitous within clinical and consumer settings. However, validation of these devices in sleep disorder populations are lacking. We examined 1 night of sleep in 42 individuals with insomnia (mean = 49.14 ± 17.54 years) using polysomnography, a wrist actigraph (Actiwatch Spectrum Pro: AWS) and a consumer activity tracker (Fitbit Alta HR: FBA). Epoch‐by‐epoch analysis and Bland?Altman methods evaluated each device against polysomnography for sleep/wake detection, total sleep time, sleep efficiency, wake after sleep onset and sleep latency. FBA sleep stage classification of light sleep (N1 + N2), deep sleep (N3) and rapid eye movement was also compared with polysomnography. Compared with polysomnography, both activity trackers displayed high accuracy (81.12% versus 82.80%, AWS and FBA respectively; ns) and sensitivity (sleep detection; 96.66% versus 96.04%, respectively; ns) but low specificity (wake detection; 39.09% versus 44.76%, respectively; p = .037). Both trackers overestimated total sleep time and sleep efficiency, and underestimated sleep latency and wake after sleep onset. FBA demonstrated sleep stage sensitivity and specificity, respectively, of 79.39% and 58.77% (light), 49.04% and 95.54% (deep), 65.97% and 91.53% (rapid eye movement). Both devices were more accurate in detecting sleep than wake, with equivalent sensitivity, but statistically different specificity. FBA provided equivalent estimates as AWS for all traditional actigraphy sleep parameters. FBA also showed high specificity when identifying N3, and rapid eye movement, though sensitivity was modest. Thus, it underestimates these sleep stages and overestimates light sleep, demonstrating more shallow sleep than actually obtained. Whether FBA could serve as a low‐cost substitute for actigraphy in insomnia requires further investigation.     

Event marker compliance in actigraphy

Actigraphy is a versatile tool for evaluating sleep?wake cycles over time in the home‐environment. Patients using the Phillips Actiwatch place an event marker when going to sleep and upon awakening. We investigate compliance in pressing the Actiwatch event marker button for patients referred for insomnia, hypersomnia and disorders of circadian rhythm. We retrospectively analysed event markers from 150 patients undergoing actigraphy for 2,117 nights combined. Compliance was evaluated from inspection of actigraphy records, and coded as full or partial. From patient records, a construct called the C‐factor, designed to describe poor social resources and chronic unemployment, was used together with age and sex to predict compliance. We found a mean compliance between 54.0% and 76.3% for a median monitoring duration of 14 days. There was an overall insignificant effect of age (p = .081), but when analysed only for females there was a significant effect of 0.56% pr. year (p = .0038). Compliance was higher for women, Cohen’s d = 0.65 (p = .01). The C‐factor predicts 18.3% (confidence interval 9%–27.5%) lower compliance. Morning and evening compliance are correlated at r = .65. In conclusion, actigraphy event marker compliance is generally moderate or high, with older women exhibiting the highest compliance. C‐factor predicts lower compliance, and this pattern may further translate to other circumstances. If compliance is important, clinicians may want to consider the effects of age, sex and C‐factor.     

Parasympathetic nervous system activity and children's sleep

We examined indices of children's parasympathetic nervous system activity (PNS), including respiratory sinus arrhythmia during baseline (RSAB) and RSA reactivity (RSAR), to a laboratory challenge, and importantly the interaction between RSAB and RSAR as predictors of multiple parameters of children's sleep. Lower RSAR denotes increased vagal withdrawal (reductions in RSA between baseline and task) and higher RSAR represents decreased vagal withdrawal or augmentation (increases in RSA between baseline and task). A community sample of school‐attending children (121 boys and 103 girls) participated [mean age = 10.41 years; standard deviation (SD) = 0.67]. Children's sleep parameters were examined through actigraphy for 7 consecutive nights. Findings demonstrate that RSAB and RSAR interact to predict multiple sleep quality parameters (activity, minutes awake after sleep onset and long wake episodes). The overall pattern of effects illustrates that children who exhibit more disrupted sleep (increased activity, more minutes awake after sleep onset and more frequent long wake episodes) are those with lower RSAB in conjunction with lower RSAR. This combination of low RSAB and low RSAR probably reflects increased autonomic nervous system arousal, which interferes with sleep. Results illustrate the importance of individual differences in physiological regulation indexed by interactions between PNS baseline activity and PNS reactivity for a better understanding of children's sleep quality.     

Delay discounting and response disinhibition moderate associations between actigraphically measured sleep parameters and body mass index

Previous research suggests that the sleep–obesity association varies significantly across individuals. This study examined the associations between actigraphically measured sleep parameters and body mass index and hypothesized that the associations would be stronger in individuals with greater delay discounting, the devaluation of future rewards and response disinhibition and the difficulty in withholding previously rewarded responses. Seventy‐eight college students carried a wrist‐worn actigraph and completed diaries reporting bedtime, wake time and covariates including physical activity, alcohol and caffeine consumption, daytime nap duration and perceived stress for 7 days and completed the delay discounting and go/no‐go response disinhibition tasks. Their height and weight were measured. Only bedtime variability was significantly associated with body mass index in the main effect model controlling for all covariates (B = 0.03, P = 0.001). Delay discounting moderated associations of bedtime (B = 0.03, P < 0.001), sleep duration variability (B = 0.05, P = 0.002), bedtime variability (B = 0.03, P = 0.002) and wake time variability (B = 0.02, P < 0.001) with body mass index; these associations were significant only when the delay discounting rate was high. Response disinhibition moderated the association between bedtime variability and body mass index in a similar pattern (B = 0.01, P = 0.004). The findings suggest that, using actigraphy measures of sleep, circadian desynchrony rather than sleep duration is a risk factor for higher body mass index. The findings support the hypothesis that delay discounting and response disinhibition moderate the associations between sleep and body mass index. Delay discounting and response disinhibition might characterize individuals who are vulnerable to the influence of circadian desynchrony on weight.     

The sleep environment and its association with externalizing behaviors in a sample of low‐income adolescents

This study examined the sleep environment and its association with externalizing problems in adolescents attending an alternative high school. Participants included 114 students (56% female, 91% Black, mean age = 18.03, standard deviation [SD] = 1.49) from an alternative high school in a southeastern city. Most participants reported sleeping in a bed (83%) and at their house (72%) for 7 nights in the past week. Participants reported an average of 2.34 (SD = 1.86) past‐week ambient sleep disruptions. Sleeping fewer nights in their own home and experiencing higher levels of ambient sleep disruptions were associated with delinquency engagement. Fewer nights sleeping in a bed and higher levels of ambient sleep disruptions were associated with a significant arrest history. The sleep environment is important to consider when assessing sleep problems, particularly among low‐income adolescents living in urban environments. This information may inform comprehensive interventions to address behavioral health concerns.