STUDY OBJECTIVES:This study explored the preliminary effects of the quarter-of-an-hour-rule (QHR), a single instructional element of stimulus control therapy (SCT) for insomnia. METHODS:A total of 44 adults (n = 30, 68% female; mean age 47.4 ± 13.3 years), recruited in primary care and meeting diagnostic criteria for chronic insomnia, were randomized to QHR implemented either out of bed [QHR(Out)], in bed [QHR(In)], or to a self-monitoring control group (SMC). Intervention was delivered by a single in-person session, with telephone support (total time c.60 minutes). Sleep pattern was assessed throughout the study by sleep diary and 2 nights of home-based polysomnography (PSG) at pre- and post-treatment. Sleep quality was appraised using the Pittsburgh Sleep Quality Index (PSQI). Treatment adherence (self-reported and actigraphy-estimated) and treatment credibility data were collected. RESULTS:Significant group-time interaction effects confirmed that QHR(Out) and QHR(In) were associated with reductions in self-reported sleep-onset latency (SOL) and wake-time after sleep-onset (WASO), and improvements in sleep efficiency (SE), relative to no change in SMC. PSG-defined sleep outcomes did not improve. However, subjective-objective sleep discrepancy (SOSD) in the index measure, SE, reduced following both interventions. The interventions were regarded as credible, and overall, SE improvement was c.14% following treatment. Subjective adherence was higher than objectively estimated, although the differential was smaller in the QHR(In) group. CONCLUSIONS:The QHR, a simple and brief derivative of SCT, appears efficacious for insomnia on pre-post analysis. Longer-term clinical effectiveness studies on the QHR(Out) and QHR(In) protocols appear warranted. Experimental investigation of how the QHR addresses the fundamentals of sleep-related stimulus control would be valuable. TRIAL REGISTRATION:NCT00170391, https://clinicaltrials.gov/study/NCT00170391.
OBJECTIVES:African Americans experience health disparities and notably report poorer sleep than their non-Hispanic White counterparts. This study aimed to identify behavioral and physiological contributors of self-reported poor sleep among African Americans. METHOD:Eighty African Americans (50.1 ± 16.1 years [mean ± SD], 69 women) who reported poor sleep (<7 hr sleep/night, difficulty falling asleep or staying asleep, unrefreshing sleep, etc.) were enrolled. Sleep patterns were determined by 7-day accelerometry. Pittsburgh Sleep Quality Index (PSQI), Sleep Hygiene Index, Epworth Sleepiness Scale, and the Insomnia Severity Index (ISI) assessed sleep habits and disorders. Multidimensional Fatigue Inventory, Perceived Stress Scale, and Beck's Depression Inventory were also administered. RESULTS:Participants self-reported poor sleep quality (PSQI, 9.63 ± 3.89) and insomnia symptoms (ISI, 14.4 ± 5.9); 45% of participants had clinically significant insomnia symptoms (ISI score > 15). Short sleep duration was common, with 72.5% of participants sleeping less than 6.5 hours/night. Sleep continuity was lacking (wake after sleep onset: 54.1 ± 30.4 minutes; sleep fragmentation index 29.0 ± 9.9%). High ISI scores were correlated with larger body mass index and worse scores for sleep quality, sleep hygiene, stress, daytime sleepiness, fatigue, and depression (r range: 0.25-0.60). CONCLUSIONS:Insomnia symptoms were common among our cohort of African Americans. Considering the relationships observed with ISI, treatment of insomnia may be targeted to reduce health disparities.
OBJECTIVE:Restless legs syndrome (RLS) is a prevalent but frequently underrecognized neurological sleep disorder. It presents as an irresistible urge to move legs, often accompanied by unpleasant sensations. More than 25% of those affected report onset of symptoms between 10-20 years of age. This cross-sectional study examined the prevalence of RLS among adolescents and its association with sleep quality, daytime sleepiness, mood, and academic performance. METHODS:The study was conducted among school-going adolescents aged 10-19 years after obtaining approvals from school authorities, informed assent, and parental consent. They were assessed for sleep quality, daytime sleepiness, symptoms of RLS, and mood fluctuations using validated tools. RESULT:Among 2,289 adolescents with a mean age of 13.85 ± 1.92 years; (50.19% female), 29.18% (668) experienced restless leg sensations at night or during evening relaxation. Students with RLS reported poorer sleep quality (5.52 ± 2.70), increased daytime sleepiness (15.44 ± 5.31; p < .001), and a higher risk of depression (OR = 1.678; p < .001), anxiety (OR = 1.514; p < .001), and stress (OR = 1.706; p < .001). Mood derangements were significantly higher in both young (≤14 yrs) and old adolescents (>14 yrs) with RLS. Academically, students with RLS had lower scores in science (p = .033) in Grades 6-10 and in English (p = .018), mathematics (p = .035), economics (p = .026), and overall scores (p = .013) among commerce stream students of higher secondary school. CONCLUSION:RLS-related sleep difficulties and circadian issues combine with age-based circadian changes, leading to varied outcomes across the adolescent developmental spectrum.
OBJECTIVES:This scoping review aimed to determine the breadth of research and state of knowledge concerning the impact of sleep regularity on outcomes of interest among athletes, including other sleep variables, performance, and health. METHODS:The review was reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-analysis Extension for Scoping Reviews. A systematic search of PubMed, Web of Science, SportDiscus, and Scopus databases was undertaken on May 7, 2025. Studies were included if they reported on the impact of sleep regularity on variables indicative of other sleep aspects, performance, or health in athletes. RESULTS:Ten studies were included. Results were grouped based on the nature of the variables investigated alongside sleep regularity, including other sleep variables (N = 6; 60%), performance (N = 3; 30%), and wellbeing (N = 3; 30%). DISCUSSION:Evidence concerning the impact of sleep regularity on other sleep variables, performance, and wellbeing is scarce and inconsistent. To create a strong evidence base, normative values should be established, allowing regular and irregular sleepers to be better identified. Furthermore, improved understanding of fluctuations in sleep timing relative to scheduling and travel demands is encouraged before further exploring relationships between sleep regularity and other variables.
OBJECTIVES:To examine whether sleep quality mediates the relationship between perceived stress and blood pressure among older African American women (AAW). METHODS:A cross-sectional analysis was conducted using baseline data from older AAW (aged 50-75) enrolled in the Resilience, Stress, and Ethnicity (RiSE) study. Perceived stress was assessed using the 10-item Perceived Stress Scale, and sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Blood pressure was measured three times and averaged to calculate mean systolic and diastolic blood pressure. Structural equation modeling was used to test mediation, adjusting for age, body mass index, and antihypertensive medication use. RESULTS:Among 158 women (mean age 63.0 ± 6.7 years), 57.6% were taking antihypertensive medications, mean systolic blood pressure was 129.5 ± 15.4 mmHg, and mean PSQI score was 7.6 ± 3.5, indicating poor sleep quality. Perceived stress was associated with poorer sleep quality (b = 0.21, p < .001), and poorer sleep quality was related to higher systolic blood pressure (b = 0.81, p = .037). Sleep quality significantly mediated the effect of stress on systolic blood pressure (b = 0.17, p = .049), with no direct effect observed (b = 0.10, p = .594). CONCLUSION:Sleep quality mediated the relationship between perceived stress and systolic blood pressure in older AAW. These findings support the role of sleep as a behavioral mechanism linking stress to cardiometabolic risk and suggest the importance of developing culturally tailored sleep interventions to mitigate the adverse cardiometabolic effects of stress in this high-risk population.
INTRODUCTION:Suboptimal response to CBTi is common in non-Western populations (e.g. Arabs). Aligning CBTi with culturally shaped beliefs and practices may improve outcomes. OBJECTIVES:A single-blind, three-arm randomized controlled trial was conducted to compare the efficacy of two-levels of cultural adaptations of CBTi against a wait-list condition for adults with insomnia disorder. METHODS:Fifty-four Arabs with insomnia were randomized to one of three conditions: (1) CBTi with surface-level adaptations (i.e. integration of socio-behavioral characteristics to foster treatment engagement and delivery); (2) CBTi with surface and deep-level adaptations (i.e. targeting sociocultural factors that may modulate perceptions of causes, prognosis and treatment); or (3) wait-list (WL). Cultural adaptations of CBTi were informed by findings from our previous qualitative study. Primary outcome was the Insomnia Severity Index (ISI), measured at four time points. Secondary outcomes included: sleep diaries, beliefs and attitudes about sleep (DBAS), anxiety, depression and fatigue scales (HADS and MFI). RESULTS:Both treatment conditions showed significant pre- to post-treatmentimprovements in insomnia severity compared to the wait-list (SD-CBTi ISI mean change: -9.5 [95% CI, -12.3 to -6.7]; S-CBTi: -10.7 [-13.3 to -8.1] and WL: -0.1 [-2.7 to 2.5]; p < .001). Compared to controls, both treatment conditions demonstrated improvements in sleep parameters, HADS and DBAS. No statistically significant differences were observed between active conditions. Improvements were maintained at three-month follow-up. CONCLUSION:Findings support the potential efficacy of culturally adapted CBTi compared to controls for Arabs. Future research comparing culturally adapted and standard CBTi is needed to determine the incremental benefit of cultural adaptations.
OBJECTIVES:Cognitive Behavioral Therapy for Insomnia (CBT-I) is the gold standard treatment for chronic insomnia. While CBT-I is highly effective at improving sleep, standard CBT-I protocols rarely target daytime symptoms directly. The objective of this overview is to provide clinicians with a practical, evidence-informed strategies to address daytime symptoms of insomnia. METHODS:The literature was reviewed to identify evidence-informed strategies that address daytime symptoms of insomnia and can be integrated into CBT-I protocols. Strategies considered were drawn from the fields of sleep and circadian sciences, as well as health psychology. RESULTS:Daytime strategies that were identified included specific cognitive, behavioral, and acceptance-based approaches to manage fatigue, sleepiness, and daytime impairment and distress. Specific interventions and recommendations for how these skills can be applied to daytime symptoms were presented and discussed using a case formulation approach. CONCLUSIONS:Insomnia is a 24-hour disorder, and it is important for clinicians to address both nighttime and daytime symptoms. Evidence-informed strategies to address daytime symptoms can be integrated within a CBT-I framework. These strategies carry implications for quality of life as well as overall treatment efficacy. Future research should assess the direct impact of intentional inclusion of these strategies on treatment outcomes.
BACKGROUND:Inadequate sleep prior to driving professionally is internationally recognized as a preventable crash risk. Nevertheless, insomnia in commercial drivers remains underrecognized both as a driving hazard and as a public health issue. To identify unmet sleep-health needs within this workforce, we explored the correspondence between driver sleep experiences and DSM-5 symptoms of insomnia disorder. MATERIALS AND METHODS:Semistructured interviews addressing the nature, causes, and consequences of impaired driver sleep quality were conducted with commercial freight drivers (n = 20, 19 male) and industry stakeholders (n = 11; 9 male) occupying managerial and executive roles. Interviews were transcribed verbatim and thematically analyzed. RESULTS:"Sleep symptoms and causal attributions" emerged as a dominant theme among drivers, with most describing insomnia symptoms linked to driving stress/anxiety, shift patterns and work schedules, and sleeping in vehicles. There was consensus in associating stress/anxiety with sleep onset problems, shift patterns/work schedules with disturbed sleep habits and uncertain bedtimes, and sleeping in vehicles with disturbed sleep habits and poor sleep hygiene. Although prioritizing driver wellbeing and alertness, most stakeholders were less likely to associate driver sleepiness with sleep quality prior to driving, emphasizing instead boredom, monotony, and stress. CONCLUSION:Driver narratives indicate high levels of untreated insomnia symptoms that align with factors known to precipitate and perpetuate insomnia disorder (e.g. cognitive arousal, degraded sleep routines, and poor sleep hygiene). These behavioral factors are amenable to digital (app-based) cognitive-behavioral sleep improvement programs. With appropriately informed management support, such programs could address an important and safety critical unmet need in this workforce.
OBJECTIVE:Sleep health is a multifaceted concept encompassing six core dimensions: satisfaction, alertness, timing, regularity, efficiency, and duration. Individual and age-related differences in sleep health are associated with both mental and physical health. Comprehensive measures are needed to evaluate these differences and tailor treatment and preventive approaches. METHODS:The present study developed and validated the Sleep Health Dimensions Questionnaire (SHDQ), a multidimensional measure of sleep health inadults. 1273 college students filled out the SHDQ and measures of insomnia, depression, anxiety, emotion regulation, and health-related quality of life. We evaluated the reliability, validity and factor structure of the questionnaire. RESULTS:The SHDQ demonstrated strong psychometric properties, including internal consistency (Cronbach's α = 0.80), item-to-total correlations (r > 0.30), and convergent and divergent validity. The SHDQ effectively discriminated clinically relevant insomnia cases. The SEM model showed a good fit, indicating that the dimensions of sleep health are effective indicators of a main latent variable (multi-dimensional sleep health). CONCLUSIONS:The SHDQ comprehensively evaluates sleep health dimensions. As a research tool, it is useful for exploring the relationship between sleep health and mental and physical health across various adult populations.
OBJECTIVE:Alcohol and cannabis are commonly used as sleep aids that inadvertently perpetuate symptoms of insomnia over time, but substance use is not a standard component of sleep assessments. This pre-registered study aimed to expand the validity and clinical utility of the Dysfunctional Beliefs about Sleep Scale (DBAS) by incorporating substance use expectancies for sleep. METHOD:After using cognitive interviewing to improve the content validity of items (N = 24, age M = 33.3y, 83% female), iterative factor analyses and tests of external validation were used to refine and psychometrically evaluate the revised scale (full sample N = 966, age M = 42.6, 60% female, 65% with at least mild insomnia). RESULTS:The final set of 11 items was best represented by two factors (9 sleep and 2 substance use items; r = 0.15). The sleep subscale was strongly correlated with the DBAS-16 (r = 0.95, p < .001) and demonstrated measurement invariance across those who did (n = 309) and did not (n = 318) drink alcohol. The substance use subscale (β = 0.16, p < .001) accounted for a small but significant amount of unique variance in insomnia severity (sleep subscale β = 0.59, p < .001) and demonstrated concurrent and prospective associations with alcohol/cannabis use. Surprisingly, the single cannabis belief item was more strongly associated with cannabis use than longer validated scales of cannabis sleep expectancies. CONCLUSIONS:The substance use version of the DBAS (DBAS-S) is a brief, reliable, and valid measure of dysfunctional sleep beliefs and substance use expectancies that will improve clinical practice by flagging substance use as a potential contributor to insomnia for clinicians.
OBJECTIVES:Cognitive behavioral therapy for insomnia (CBT-I) is widely recommended, but access remains limited, particularly among rural adults. Medications to treat insomnia, including zolpidem and trazodone, are widely used but can have significant side effects. Empirical evidence remains sparse to support the choice of CBT-I, medication, or combined treatment in clinical practice. METHOD:This paper describes the Comparative Effectiveness of Zolpidem/Trazodone and Cognitive Behavioral Therapy for Insomnia (COZI) study, which aimed to compare the effectiveness of medications and behavioral interventions for chronic insomnia. RESULTS:COZI was a multi-center randomized trial in rural adults (aged 18-80) with chronic insomnia. The effects of three insomnia treatments were compared: digital CBT-I (dCBT-I), medication (patient/provider choice of zolpidem or trazodone), and the combination of medication plus dCBT-I. Treatment outcomes were measured at 9 weeks, 6 months, and 12 months. The primary outcome was change in severity of insomnia symptoms (ISI) over 6 months. Secondary outcomes included change in insomnia symptom severity at 9 weeks and 12 months, adverse events, and other patient-centered outcomes. CONCLUSIONS:Study results will provide support for clinical decision-making in insomnia treatment.
PURPOSE:To describe clinical characteristics, comorbidities, diagnostic approaches, and treatment outcomes in six pediatric cases of non‑24‑hour sleep‑wake disorder (N24SWD). METHODS:We conducted a single‑center retrospective case series of children and adolescents diagnosed with N24SWD clinically evaluated by histories, sleep diaries, actigraphy, and available treatment outcomes. RESULTS:Six sighted children with N24SWD were identified; five had autism spectrum disorder, three had attention-deficit/hyperactivity disorder, and two had anxiety disorders. All demonstrated free‑running sleep cycles (24-29 hours) with progressive delays in sleep and periodic daynight reversal. Behavioral and functional impairments were exacerbated during circadian misalignment. Entrainment strategies utilizing melatonin, bright light therapy, and behavioral interventions showed variable success; long‑term entrainment was rarely achievable due to adverse effects, inconsistent adherence, and family burden. Several families opted to maintain flexible, free‑running schedules, reporting improved mood and function when natural sleep patterns were accommodated. CONCLUSION:Pediatric N24SWD in sighted individuals is frequently associated with neurodevelopmental comorbidities. In all of our reported cases, children with N24SWD were sighted and had neurodevelopmental disorders. Standard circadian‑based treatments may be difficult to sustain. Management should be individualized, family‑centered, and supported by improved diagnostic tools and research into long‑term therapeutic strategies.
INTRODUCTION:Chronic insomnia is associated with negative effects for children (impaired academic performance, mood and behavioral dysregulation) and their caregivers (poor sleep, stress, fatigue). Chronic insomnia is also common (up to 20% of children, 50-80% in the context of comorbidities), but underdiagnosed/treated in pediatric primary care (<10% treated). Cognitive behavioral treatment for insomnia (CBTi) is the recommended "first-line" treatment for insomnia and systematic reviews and meta-analyses provide evidence of its short-term efficacy and safety in children with chronic insomnia. Unfortunately, in-person CBTi is not widely available due to a lack of and limited access to behavioral providers. Digital forms of CBTi (dCBTi) have shown promise to improve sleep and secondary outcomes in children and have the potential to rapidly increase treatment accessibility and feasibility. However, while randomized controlled trials (RCTs) of dCBTi in adolescents and adults exist, these are lacking in children. This trial will be the first to investigate the impact of a moderated dCBTi on sleep and associated outcomes of school-aged children and their caregivers compared to a waitlist control. METHODS & ANALYSIS:Dyads of caregivers and children (N = 40) 6-12 years of age with insomnia will be recruited from pediatric clinics, social media, and community outreach in Tampa, FL, Gainesville, FL, Columbia, MO, Charlotteville, VA, Boston, MA, and surrounding areas. Participants will be randomized to immediate dCBTi (LAMBISM) or dCBTi a month later (waitlist control). Participants will be assessed at baseline, post-treatment, 1 and 3-month follow-ups. Child assessments include objective/subjective sleep measures, daytime functioning (mood, executive functioning), quality of life (QOL), and physiological arousal (heart rate variability). Caregiver assessments include: objective/subjective sleep measures, daytime functioning (anxiety, depression, fatigue), physiological arousal, and caregiver stress. ETHICS & DISSEMINATION:Ethics approval was obtained in February 2025 from the University of South Florida. All data are expected to be collected by Spring 2027. Full trial results are planned to be published in 2027. Secondary analyses of baseline data will be subsequently published. CLINICAL TRIAL REGISTRATION NUMBER:NCT07091149.
OBJECTIVES:This multi-method study examined the feasibility, acceptability, and initial benefit for a brief, group CBT-I adapted for adolescents in treatment for suicidality (CBT-IAsi). METHOD:Measures of subjective and objective (actigraphy) sleep and suicidality were collected from adolescents (N = 242, M = 14.6 years) in both intervention (CBT-IAsi) and control groups, at four time points across treatment. RESULTS:Feasibility findings indicated high rates of subjective measures completion (75.2%) and CBT-IAsi attendance (88.0%), but lower compliance with actigraphy (18.8%). Acceptability was high, with almost all adolescents reporting CBT-IAsi as helpful and enjoyable. Generalized Estimating Equations models evidenced benefit via significant improvements of suicidality and subjective sleep quality, but not objective sleep, over treatment. Adolescents in the CBT-IAsi group showed significantly greater reductions in suicidal thoughts compared to the active treatment control group. CONCLUSIONS:This real-world study supports CBT-IAsi as a promising intervention that augments reductions in suicidal thoughts, with the potential to reduce health care burden and enhance access to care.
OBJECTIVE:In recent times, Fear of Missing Out (FoMO) has emerged as a significant psychological construct adversely impacting the well-being and emotional health of social media users. Among the many psychological and physiological impacts of FoMO, its relation with sleep is frequently examined, considering its influence on disruption of sleep. This study intended to explore the association between FoMO, Psychological Capital (PsyCap), and sleep quality among college students and to determine whether PsyCap moderates the relationship between FoMO and sleep quality. METHOD:A total of 110 college students aged between 18 and 25 participated in the study. Standardized self-report measures, including the Fear of Missing Out Scale (FoMOs), Psychological Capital Questionnaire (PCQ-24), and Pittsburgh Sleep Quality Index (PSQI), were employed to assess FoMO, PsyCap, and sleep quality. Descriptive statistics, Pearson correlations, independent sample t-tests, and moderation analysis using the Hayes PROCESS macro (Model 1) were executed. RESULTS:Findings demonstrated that FoMO was positively correlated with poor sleep quality. PsyCap, on the other hand, was negatively correlated to FoMO and poor sleep quality. Further, it was observed that FoMO significantly correlates with poorer sleep in those students with low PsyCap levels. CONCLUSION:PsyCap appears to play a moderating role against the effects of FoMO on sleep. The study highlights the need to conduct PsyCap-based interventions for enhancing the sleep quality and overall well-being among young adults.
BACKGROUND:Polysomnography (PSG) is the reference method for characterizing sleep architecture, but it is resource-intensive and difficult to scale for large cohort assessments. This has in creased interest in wearable devices for naturalistic sleep monitoring. This systematic review and meta-analysis evaluated how wearable sleep-tracking devices compare with laboratory PSG in healthy adults across standard sleep metrics and sleep stage durations. METHODS:PubMed, Scopus, Scielo, Web of Science, and the Cochrane Library were searched following PRISMA guidelines. Eligible studies included healthy adults undergoing simultaneous wearable and PSG recordings. Mean differences were synthesized for total sleep time, sleep latency, sleep efficiency, wake after sleep onset, and time spent in light (N1+N2), deep (N3), and REM sleep using fixed or random effects models based on heterogeneity, with significance set at p < .01. Risk of bias and applicability were assessed using QUADAS-2. RESULTS:Sixteen studies met the inclusion criteria, and ten contributed to the meta-analysis. Wearable devices overestimated total sleep time and sleep efficiency and underestimated wake after sleep onset, with substantial variability between devices. No device demonstrated consistently superior performance. In individual studies, the closest agreement with PSG was observed for the Oura Ring (third generation) for sleep latency and sleep efficiency, and for selected Fitbit models for deep and REM sleep. CONCLUSIONS:Wearable devices provide reasonable estimates of global sleep metrics and may complement PSG for population monitoring and longitudinal self-tracking. However, variable performance, methodological heterogeneity, and risk-of-bias considerations currently limit their use as stand-alone diagnostic tools or for detailed sleep-stage characterization.
OBJECTIVE:Individuals with insomnia show increased concentrations of pro-inflammatory biomarkers including C-reactive protein (CRP), interleukin-1β (IL-β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) compared to controls. Insomnia-related inflammation may contribute to poorer health outcomes and may need to be clinically addressed. Whether guideline-recommended insomnia treatment (i.e. cognitive behavior therapy for insomnia, CBT-I) can reduce inflammation is unclear. METHOD:This systematic review synthesize and assessed the risk of bias of randomized controlled trials (RCTs) reporting on the effects of CBT-I on CRP, IL-1β, IL-6, and TNF-α. PubMed, Scopus, CINAHL, and PsycINFO were searched up to June 2025. RESULTS:From the initial 2206 records retrieved, 11 RCTs were included. IL-6 (k = 7) and CRP (k = 5) were the most assessed markers of inflammation while fewer RCTs assessed TNF-α (k = 4) and IL-1β (k = 3) in the context of CBT-I. Results from RCTs largely varied, with CBT-I more consistently reported to decrease CRP than cytokines. The synthesis of outcome using meta-analysis was precluded by considerable differences in population, measurement, and outcome reporting. CONCLUSIONS:We conclude that research on CBT-I and inflammation is still developing and propose a research agenda aimed at advancing our understanding of the potential anti-inflammatory properties of CBT-I, the mediators of change, and implications for comorbidity prevention.
OBJECTIVES:Step count is linked to better mental health and sleep outcomes for middle-aged and older adults, but less research has been done among young adults. The purpose of this study was to investigate how step count is associated with mental health and sleep outcomes in college students. METHOD:College students (N = 217) from two universities wore a commercial activity tracker and completed daily diaries across 14 days. Linear mixed-effect modeling was used to test if step counts were associated with mental health (i.e. anxiety, depression, stress) and sleep outcomes (i.e. sleep duration, sleep efficiency, sleep onset latency, wake after sleep onset, sleep midpoint, sleep quality). Receiver operating characteristic (ROC) curves were used to identify the minimum step count connected with better outcomes. RESULTS:Greater average step count was associated with lower anxiety (B = -0.06, p < .01), depression (B = -0.07, p < .01), and stress (B = -0.14, p < .01), in addition to earlier sleep midpoint (B = -0.08, p < .01) and better sleep quality (B = 0.02, p < .01). ROC curve analyses yielded non-significant results, limiting step count recommendations for mental health and sleep. CONCLUSIONS:More steps, on average, were linked to less mental health symptoms, earlier sleep timing, and better sleep quality among college students. Future research needs to account for sedentariness, walking location and intensity.
OBJECTIVES:We examine whether parental incarceration is associated with multiple domains of poor sleep in adolescence, a developmental period when circadian rhythms shift and sleep deprivation is widespread. METHOD:We used multivariable regression to examine whether a history of father-only incarceration, mother-only incarceration, or both-parent incarceration was associated with sleep duration (hours of sleep per night), timing (bedtime and waketime), disturbance (difficulty falling or staying asleep), and regularity (social jetlag, the absolute difference in sleep midpoint between school nights and weekends). Our sample included 15-year-olds in the Future of Families and Child Wellbeing Study, a survey of children born in midsize or larger U.S. cities. RESULTS:Father-only incarceration and both-parent incarceration were each associated with 1-2 additional days of disturbed sleep per month. Both-parent incarceration was also associated with more irregular sleep, amounting to 17 minutes more social jetlag. Short sleep duration was pervasive regardless of parental incarceration history. CONCLUSIONS:As children of incarcerated parents age into adolescence, they no longer get less sleep but continue to get worse sleep than peers with never-incarcerated parents. Practitioners and policymakers addressing health among adolescents of incarcerated parents should consider the importance of poor sleep, particularly sleep irregularity and sleep disturbance.
