Associations of accelerometer-based sleep duration and self-reported sleep difficulties with cognitive function in late mid-life: the Finnish Retirement and Aging Study

ObjectivesPrior evidence suggests that sleep duration and sleep difficulties may be associated with cognitive function in old age, but little is known about the sleep–cognition association in late mid-life. Our aim was to examine the associations of accelerometer-based sleep duration as well as subjective sleep difficulties with different domains of cognitive function among aging workers.MethodsThe study population consisted of 289 participants (mean age 62.4 years, SD 1.02; 83% women) from the Finnish Retirement and Aging Study (FIREA). Sleep difficulties were measured using Jenkins Sleep Problem Scale (difficulties falling asleep, difficulties maintaining sleep, waking up too early in the morning, and nonrestorative sleep). Sleep duration was measured with wrist-worn accelerometer and self-report, and participants were divided into short (<7 h/night), mid-range (7–9 h/night) and long (≥9 h/night) sleepers. Participants underwent extensive cognitive testing covering three domains: (1) memory, (2) executive function, and (3) attention and information processing.ResultsGreater difficulties in waking up too early in the morning were associated with poorer executive function measured with Spatial Working Memory (SWM) test (p = 0.005). Additionally, nonrestorative sleep was associated with poorer executive function measured with Trail Making Test, B–A, (p = 0.036) and borderline significantly with lower SWM (p = 0.056). Compared to mid-range sleepers, long sleepers tended to have poorer cognitive function (all memory function tests and SWM), but the associations were not statistically significant due to small number of long sleepers.ConclusionsSubjective sleep difficulties may be linked to poorer executive function in a relatively healthy population of older workers in their 60 s. Thus, promoting good sleep quality may translate into better cognitive health in late mid-life.     

Relationships Among Factors Related to Childbirth and Breastfeeding Outcomes in Primiparous Women

ObjectivesTo explore the relationships among potentially modifiable factors related to childbirth and effective breastfeeding initiation at approximately 36 hours after birth and duration and exclusivity at hospital discharge, 2 weeks, 2 months, and 6 months after birth in primiparous women and to explore whether modifiable and nonmodifiable secondary factors and covariates influenced the relationships among factors related to childbirth and these breastfeeding outcomes.DesignA prospective, longitudinal, cohort study.SettingThe postpartum units of two general hospitals in eastern Canada.ParticipantsNinety-seven mother–infant dyads.MethodsWe recorded demographic, childbirth, obstetric history, and breastfeeding data through chart review. A breastfeeding observation was completed at approximately 36 hours after birth by unit nurses. Participants maintained breastfeeding logs in hospital and for 6 months after birth and completed three self-report questionnaires before discharge. We analyzed outcomes using backward stepwise linear and logistic regression.ResultsOne childbirth factor, labor induced with oxytocin, was negatively associated with effective initiation of breastfeeding, and none was related to breastfeeding duration and exclusivity at any time point. Maternal weight; professional support; and newborn’s gestational age at birth, 5-minute Apgar score, weight loss, LATCH score, and active feeds (newborn actively suckled at the breast) were significantly associated with breastfeeding outcomes.ConclusionInduction of labor with oxytocin should be used judiciously; when used, nurses must be hypervigilant to assess the mother–infant dyad for breastfeeding issues and to intervene to prevent or remediate them.     

The effect of immediate postpartum levonorgestrel contraceptive implant use on breastfeeding and infant growth: a randomized controlled trial

Objective

This study assessed whether immediate postpartum insertion of levonorgestrel contraceptive implants is associated with a difference in infant growth from birth to 6 months, onset of lactogenesis, or breastfeeding continuation at 3 and 6 months postpartum compared to delayed insertion at 6 to 8 weeks postpartum.

Local Landscapes of Breastfeeding: A comparison of breastfeeding amongst mothers in low- and high-income neighborhoods in Bristol,UK

This paper compares experiences of breastfeeding outside the home for women living in low-income and high-income neighborhoods of the same city. Our findings are based on an analysis of 22 interviews with breastfeeding mothers (11 in each of two study areas) undertaken in Bristol, UK in 2017. We extend existing scholarship by showing how experiences of breastfeeding vary not only at the regional level but between local areas of the same city, and outline how our findings can inform policy. We advance literature on maternal bodies by exploring how local “landscapes” of breastfeeding emerge as mothers encounter and negotiate different socio-material landscapes and locally-differentiated norms about “appropriate” maternal embodiment. We argue that these variegated interactions can lead to different orientations to space and forms of spatial practice on the part of breastfeeding mothers, as well as different kinds of maternal identities.     

The effect of short or long sleep duration on quality of life and depression: an internet-based survey in Japan

BackgroundTo date, no previous studies have evaluated the relationship between sleep duration and quality of life (QOL) or depression in the general population after controlling for daytime sleepiness and sleep disturbances.MethodsA web-based cross-sectional survey was conducted with 8698 subjects aged 20–69 years. We examined the relationships between weekday sleep duration and daytime sleepiness, sleep disturbance, QOL and depression, using the Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index (without the item for sleep duration), 8-item Short Form and Center for Epidemiological Studies Depression Scale (CES-D).ResultsDaytime sleepiness tended to increase in proportion to shorter weekday sleep durations. Sleep disturbances, physical and mental QOL, and CES-D scores were worse in both the shorter and longer sleep groups compared with the group with 7–8 h of sleep. Hierarchical logistic regression analyses revealed that short sleep duration but not long sleep duration was significantly associated with reduction of both physical and mental QOL, even after controlling for the presence of daytime sleepiness and sleep disturbance. Both short and long sleep duration were independently and significantly correlated with depression after controlling for daytime sleepiness; however, there was no statistically significant association after adjusting for the effects of sleep disturbance.ConclusionsThe results suggested adverse effects of short sleep but not long sleep on both physical and mental QOL. In addition, the negative impact of specific types of sleep disturbance on depression may be greater than the impact of shortening of sleep duration.