Abstract Objectives The Australian Children of the Digital Age (ACODA) study is a longitudinal cohort study investigating the digital lives of Australians during early childhood. This paper presents a comprehensive description of the study protocol and overview of children’s digital technology use in the home at the first wave of data collection. Methods Caregivers of children aged 6-months to 5-years completed a survey that captured the availability and use of digital technology within the home, and child- and caregiver-related factors that may influence children’s digital technology use. Results A total of 3,388 caregivers from across all Australian states and territories completed the survey. Majority (98%) of children had digital technology and internet access within their homes. Most children (93%) used at least one device in the last year, with televisions, tablets, and mobile phones most frequently used (89%, 47%, 42%, respectively). Digital technology use started early, with 61% of children aged <1-year having used a television. A greater proportion of older children used devices, and for longer durations than younger children. Across all ages, daily time was longest on televisions ( M = 1:20, SD = 1:14), tablets ( M = 1:06, SD = 1:36), and mobile phones ( M = 0:30, SD = 1:05). Digital technology was used most for entertainment and learning activities, and was used typically with a caregiver and in lounge/living rooms. Conclusions The ACODA study is the first longitudinal study to describe the digital technology use of Australians during early childhood and the context of this use. Data indicated that Australian children frequently used digital technology for entertainment and with their caregivers. Also, older children used digital technology more than younger children. Future waves allow for exploration of changes in children’s digital technology use over time, and associations with factors that may influence children’s digital technology use.

Abstract Background Adolescent sleep health is a growing public health concern, yet no culturally responsive sleep health program has been developed for Aboriginal and Torres Strait Islander (First Nations) young people. This study reports the outcomes and acceptability of Australia’s first co-designed sleep health program for First Nations adolescents. Methods The Let’s Yarn About Sleep adolescent program was co-designed with First Nations community members from 23 Traditional groups, involving 174 Elders, adolescents, parents, carers, and service providers. The program drew on an Aboriginal pedagogical framework and the COM-B behaviour change model, integrating Western and First Nations sleep science, and was delivered by Aboriginal Youth Workers trained as Sleep Coaches. Outcomes included self-reported improvements in sleep knowledge, sleep timing and continuity, sleep quality, overall sleep health, and psychological distress. Post-program changes in outcomes were assessed using linear mixed-effects regression analyses. Program ratings and yarning-based feedback assessed acceptability. Findings 70 First Nations young people participated in the program (median age 13.0 years, range 12–18; 67.1% female). Sleep knowledge improved substantially, with the mean composite score increasing from −0.65 (SD 1.23) at baseline to 0.82 (SD 1.27) at follow-up, a large effect (Cohen’s d = 1.18; p < 0.001). A significant improvement was observed in the overall sleep health score, representing a medium effect (Cohen’s d = 0.63; β = 0.68, 95% CI: 0.31–1.04; p < 0.001). Psychological distress showed a directional reduction that did not reach statistical significance (Cohen’s d = 0.32; β = −0.49, 95% CI: −1.08–0.09; p = 0.097), though a modest beneficial effect cannot be excluded. High acceptability was reflected in program ratings and qualitative feedback, with participants reporting greater sleep awareness, improved sleep behaviours, and strong community engagement with the program. Interpretation A culturally grounded, co-designed sleep health program can improve sleep knowledge and overall sleep health and achieve high acceptability among First Nations adolescents. Community leadership, local delivery, and the embedding of First Nations worldviews are likely central to achieving impact, highlighting a promising pathway to address sleep health inequities Funding Medical Research Future Fund (APP1201569). No competing interests. Research in context Evidence before this study We searched PubMed, Scopus, and PsycINFO for peer-reviewed studies published between January 2010 and Sep 2025 with language restrictions, using the search terms: “adolescent sleep health” , “sleep education” , “Indigenous” , “First Nations” , “co-design” , and “community-led delivery” . Reference lists of relevant reviews were also screened. Evidence from systematic reviews and meta-analyses showed that most adolescent sleep interventions are delivered in school or community settings and are grounded in behavioural or cognitive–behavioural approaches. The existing sleep health programs are mainly delivered by sleep health researchers or healthcare providers in school settings over short durations (four to six weeks) and have produced modest short-term improvements in some aspects of sleep health. None of these programs was co-designed or culturally adapted for First Nations communities or offered in community settings. Further, most tools used to assess sleep health and knowledge were developed in Western contexts, with little consideration of First Nations’ conceptualisation of sleep health or of cultural and contextual factors that impact it. No prior studies have integrated First Nations governance and culturally grounded learning frameworks to improve the sleep health of First Nations adolescents. Added value of this study This is Australia’s first sleep health program for First Nations adolescents. This co-designed program combined Western and First Nations sleep science and privileged First Nations cultural knowledge and practices to address the sleep health needs of First Nations adolescents holistically. This community-based program demonstrated significant improvements in sleep knowledge and sleep health, with strong community engagement and satisfaction. Implications of all the available evidence Co-designed and community-led approaches can help improve the sleep health of First Nations young people. Embedding First Nations leadership, local workforce development, and community governance structures into sleep health programs could improve program engagement and acceptability and potentially lead to improvements in sleep health. Future research should focus on integrating culturally responsive sleep health programs within school and community well-being systems to reduce sleep health inequities and improve life outcomes for First Nations adolescents.

Background Early childhood is a foundational period for establishing lifelong sleep health habits. In the context of increasing digital device use from infancy, understanding how screen use disrupts sleep is essential for informing public health guidelines and supporting families to develop healthy digital technology use and sleep routines. The present study seeks to examine how digital technology use, differentiated by device type and timing, relates to sleep patterns and problems in children aged 6-months to 6-years. Methods Cross-sectional, secondary data analysis of the first year (2023-24) online survey from the four-year longitudinal Australian Children of the Digital Age (ACODA) Study. Participants were 3,324 caregivers of Australian children aged between 6-months and 6-years. Caregivers completed an online survey assessing socio-demographics, child sleep and napping patterns, sleep problems, sleep disturbance and daytime impairment, and digital technology use. Screen use was assessed by parent report of device type (handheld devices vs. static devices), duration of use, bedroom use, and frequency of using devices in the 2-hours prior to bed in the evening. Results Almost 60% of 1-year-olds adhered to National 24-hour screen use guidelines, however, fewer than half of children across all other age groups adhered to these same guidelines, with adherence lowest among 2- and 3-year-olds. Handheld devices were the most common device-types used in bedrooms. Usage in bedrooms increased with age, reaching almost 40% among 5-year-olds. In adjusted models, greater handheld device use and frequent evening screen exposure were associated with shorter night sleep duration, later sleep time, and increased sleep problems across most age groups. The effects of static device use on sleep varied by age. Conclusion This study highlights that children in Australia are exposed to digital technologies early and often, and that there may be differential effects on sleep depending on device type, timing and age leading to reductions in sleep duration and later sleep time in children aged 6-months to 6-years. Findings support the need for clearer public health messaging and further research using objective measures to better understand mechanisms to inform policy and practice.

BackgroundAdolescent mental health outcomes are often poorer in rural areas of Australia, and most adolescents do not seek help, highlighting a critical gap in understanding help-seeking behaviours. This study examined mental health help-seeking patterns and associated factors among rural Australian adolescents.Methods Data from Wave 8 of the Longitudinal Study of Australian Children, including 4,837 adolescents aged 14-19 years, were analysed. The prevalence of help-seeking overall and by remoteness, as defined by the Australian Bureau of Statistics were estimated. Cluster-adjusted multiple logistic regression models were used to examine factors associated with help-seeking behaviours.ResultsHelp-seeking behaviours were generally lower among adolescents from rural areas compared to their urban counterparts. Seeking face-to-face mental health professional help was significantly less common in outer regional and remote areas (7.72%, 95% CI: 5.39-10.93) compared to urban areas (12.20%, 10.97-13.54). Furthermore, males reported significantly lower professional help-seeking behaviours (2.76%, 1.33-5.63) than females (13.53%, 9.08-19.70) in outer regional and remote areas. Similar sex disparities were observed in non-face-to-face (e.g., internet, phone) help-seeking. The most common predictors of help-seeking behaviours were ongoing anxiety or depression and good parent-child relationships. Other statistically significant predictors included suicidal thoughts and behaviours, single-parent family, community participation, social media exposure and drug use. Two predictors (i.e., financial hardship for formal help-seeking and community engagement for informal help-seeking) varied statistically significantly between rural and urban settings.ConclusionStrategies to address lower prevalence of mental health help seeking among rural male adolescents in Australia should be sensitive to context-specific barriers and designed to meet their unique needs. Adolescent-focused digital interventions and strengthened family and community engagement are vital to ensuring equitable access to mental health services for adolescents in rural Australia.

This meta-analysis examines the bidirectional within-person association between sleep and affect using data from 118 studies. Focusing on intensive longitudinal designs such as daily diaries and ecological momentary assessments, this meta-analysis examines how daily variations in sleep, measured via subjective and objective methods, are associated with fluctuations in positive and negative affect. Results show small-to-moderate within-person correlations, with better subjective sleep quality and longer sleep duration predicting improved next-day affect. Conversely, more positive affect and less negative affect during the day were modestly associated with better subjective sleep quality but not total sleep time. The within-person correlations were generally stronger when aspects of sleep were self-reported rather than objectively measured, highlighting the importance of perceived sleep experiences. These findings were largely consistent across age groups and health status, suggesting that the relationship between sleep and affect may be universal. Overall, this study underscores the psychological significance of everyday sleep-affect dynamics.

OBJECTIVES:Sleep is a fundamental biological process, yet environmental and social factors can influence sleep health. This study aimed to advance a human rights perspective on sleep by developing the emerging concept of sleep security. METHODS:An in-person workshop and online modified Delphi study were conducted (2024-2025) to refine/revise the definition and primary domains of sleep security. Participants were primarily Australian experts with clinical or academic experience in sleep, social determinants of health, health equity, and/or environmental health. Participants rated level of agreement with proposed definitions and domains of sleep security and provided qualitative feedback to justify their choices. Iterative rounds evaluated refined definitions if (a) <75% of participants indicated they "agree" or "strongly agree" and/or (b) content analysis of qualitative data indicated conceptual ambiguity or inconsistent interpretation. RESULTS:Thirty-one experts participated in Round 1, and 19 in Round 2. Although the overarching definition of sleep security and 4 of its proposed 5 domains reached the a priori agreement threshold in the first round, content analysis of qualitative feedback led to an alternative definition of sleep security and revised descriptions for 2 domains in Round 2. An overall definition of sleep security and its 5 primary domains (Safety and security, conducive environment, policy and practice, opportunities and demands, and autonomy) was agreed upon. CONCLUSIONS:A preliminary conceptualization of sleep security provides a framework for guiding research and advocacy efforts to improve social, environmental, and structural conditions that support sleep health. Further work is needed to test and refine this framework globally.

Abstract Introduction People with central disorders of hypersomnolence (CDH), which include Narcolepsy Types 1 & 2, and Idiopathic Hypersomnia (IH), have high rates of mental health disorder symptoms and lower health-related quality of life (HRQoL), despite treatment with medications. Recent efforts have aimed to develop adjunctive non-pharmacological interventions. Lived experience involvement is now expected in research to enhance acceptability and relevance, but the application of lived experience involvement in CDH is unclear. This systematic review aims to evaluate the feasibility, acceptability, and effectiveness of non-pharmacological interventions for CDH on sleep and psychological outcomes and examine how people with CDH are involved across the research cycle. Methods This review was preregistered on OSF and followed PRISMA guidelines. A search was conducted on Medline, CINHAL, PsycINFO, Embase, CENTRAL, Web of Science, and ClinicalTrials.gov in July 2025. Studies reporting non-pharmacological intervention effects on mental health, HRQoL, functional, or sleep-related symptoms in confirmed CDH were included. Results From 7804 studies, 12 studies were included. Studies focused on napping and/or sleep schedules (n=7), cognitive behavioural therapy (CBT; n=3), mindfulness-based (MBI; n=1), and meditation-relaxation therapy (MR therapy; n=1) interventions. Extended nocturnal sleep interventions for narcolepsy generally reported improvements in daytime sleepiness. Napping intervention results for narcolepsy were inconsistent. Psychology interventions (CBT, MBI, and MR therapy) found generally positive results on their primary outcomes; CBT and MBI interventions significantly improved some mental health outcomes; CBT for Nightmares significantly improved nightmare severity; and MR therapy significantly improved sleep paralysis. All studies were pilot or feasibility studies with small sample sizes and good acceptability. One psychology intervention and no napping or sleep schedule interventions were tested with people with IH. People with narcolepsy were involved in three studies, but reporting was limited and did not use recommended reporting procedures. No people with IH were involved in the design of any interventions. Conclusion There has been recent progress in developing adjunctive non-pharmacological interventions for people with CDH that show promising effectiveness. However, involvement of people with CDH using standardised reporting, especially with people with IH, is absent and should be incorporated into future research. Support (if any) Sleep Disorders Australia; ARC Life Course Centre; Australian Government.

Introduction Quality sleep is important for substance use recovery. Supporting and monitoring sleep during residential treatment poses challenges, but unobtrusive technologies like actigraphy or environmental sensors offer objective low burden measurement. We examined the feasibility and acceptability of these technologies, and associations between sleep and mental health outcomes. Methods This pilot and feasibility study employed a naturalistic design. Fifty-two adults in residential treatment for diverse substance-related issues wore actigraphs and completed daily sleep diaries over a period of up to 4 weeks during live-in treatment. Subjective assessments of pre-sleep arousal and sleep quality were collected alongside routine clinical measures at study entry and exit. Environmental sensors continuously recorded sleep environment (temperature, light) data. Results Of the 52 participants, thirty-three participants wore actigraphs for >14 days; 23 completed exit questionnaires, and 11 interviews. Significant positive associations were found between subjective pre-sleep arousal and symptoms of depression, anxiety, and post-traumatic stress. Objective sleep regularity was negatively associated with post-traumatic stress, anxiety, and pre-sleep somatic arousal. Later sleep midpoint was linked to greater subjective sleep disturbance and anxiety. Objective sleep duration was not associated with any mental health variables. Discussion Continuous, unobtrusive monitoring of sleep and bedroom environments is feasible in residential settings for many residents, though feasibility varied across longer-term actigraphy monitoring and questionnaire completion. This approach may offer a first step in identifying targets for future interventions to improve sleep and support recovery.

Sleep disturbance is highly prevalent in people with osteoarthritis (OA) yet it is rarely considered in routine care. Emerging evidence suggests that sleep disturbance contributes to heightened musculoskeletal pain and poorer physical and emotional outcomes in those with OA. This narrative review synthesises current knowledge on the epidemiology and impact of sleep disturbances in OA, including their associations with and impact on fatigue, depressive symptoms, pain catastrophising, and negative mood. It examines the effects of core OA treatments such as exercise, diet and weight loss on sleep, as well as the potential for sleep-focused therapies such as cognitive behavioural therapy for insomnia to improve pain in OA populations. The review also considers how addressing sleep may offer a novel pathway to enhance clinical outcomes and identifies health professionals who may be well placed to deliver sleep care to individuals living with OA. Incorporating sleep into OA management presents an innovative, high-impact, and low-risk opportunity to improve patient outcomes.

Limb movement is an important component of control during safety-critical tasks such as driving. Restricted movement, such as limitations associated with an injury or surgery to the upper limb, may impact driving safety. However, the degree of upper limb movement required for driving is not well described outside of traditional laboratory settings. There is a need for new affordable, accessible, reliable and accurate measures of normative limb movement to guide decisions about driving capacity. This feasibility study applied a volume estimation approach to wrist-worn triaxial accelerometry data to quantify upper limb movement during naturalistic driving in a young adult population. A sample of 89 participants wore accelerometers while engaging in daily driving activity over a two-week period. Results demonstrated a distribution of movement volumes, consistent with variation in individual driving behaviour. This volume estimation approach has strong potential for further development as both a research tool and clinical assessment method, particularly in rehabilitation and return-to-driving assessments following upper limb injury or surgery.

Objective Explore physiotherapists’ experiences with Cognitive Behavioural Therapy for Insomnia (CBT-I) training to understand factors that may influence implementation and upscaling of CBT-I training for physiotherapists. Method Using a mixed-methods approach, data were collected through questionnaires and semi-structured interviews from twelve physiotherapists (3–27 years' experience) who completed a CBT-I training program consisting of online workshops and a pilot case. The Educational Course Assessment Toolkit (EDUCATOOL) evaluated reaction, learning, expected outcomes and behaviours in relation to the CBT-I training, and the Determinants of Implementation Behaviour Questionnaire (DIBQ), assessed barriers and enablers to the implementation of CBT-I. Interviews explored physiotherapists’ experiences of the training, guided by the theoretical framework of acceptability. Data were analysed thematically, with themes subsequently mapped to the Theoretical Domains Framework. Results The median EDUCATOOL overall score was 92.38 (IQR = 87.35–99.00) out of 100.87% of DIBQ items were rated favourably to their respective domains (>4 on 7-point Likert scale). Four themes were generated from the interviews. Physiotherapists reported confidence in their capability to deliver CBT-I, reflecting (1) readiness for implementation in their professional role. (2) Training delivery and design contributed positively to knowledge acquisition. (3) Experiential learning enhanced understanding and confidence. However, physiotherapists noted (4) barriers affecting the integration of CBT-I in physiotherapy practice, including stakeholder engagement, and feasibility considerations related to billing, and delivery. Conclusion Physiotherapists felt confident to deliver CBT-I following a training program. For successful upscaling, future initiatives must address identified systemic and practical barriers, including stakeholder engagement and delivery feasibility.

Background Sleep, psychological wellbeing, and musculoskeletal health are more closely interconnected than previously recognised. Shared neuroimmune pathways between these domains mean that changes in one can substantially impact the others—either beneficially or detrimentally. For clinicians, a thorough understanding of these relationships is imperative to inform more holistic and effective clinical strategies for managing and potentially preventing musculoskeletal conditions. Methods Narrative review of neuroimmune pathways that interconnect sleep, psychological wellbeing, and musculoskeletal health, highlighting clinical implications and identifying research gaps to guide future studies. Searches of PubMed, Scopus, EMBASE, Web of Science, and Google Scholar were performed using combinations of terms related to sleep, psychological factors (e.g., stress and depression), musculoskeletal conditions and pain, tissue health and pathology, pain mechanisms, inflammation, and the immune and nervous systems. Eligible articles were limited to those published in English. Results Research is increasingly revealing how the nervous and immune systems interact to mediate the interplay between poor sleep, psychological disturbances (such as depression), and musculoskeletal system pathologies and pain. This relationship is underpinned by two key concepts. First, both sleep and psychological functioning are highly sensitive to—and reciprocally influence—systemic inflammation. Second, systemic and local (tissue-level) inflammatory events interact with and affect each other, as well as the nervous system. Consequently, disruption in any one of these domains can potentially trigger and/or sustain a self-perpetuating cycle that adversely affects the others, leading to pathological outcomes such as recurrent or persistent pain and tissue changes (e.g., fibrosis). On the other hand, therapeutic interventions targeting any of these domains offer promising avenues to interrupt or prevent these detrimental cascades. Conclusions This review provides a foundation for understanding how neuroimmune interactions dynamically link sleep, psychological wellbeing, and musculoskeletal health. Understanding these connections will support more integrated, system-wide, and effective approaches to musculoskeletal care.

BACKGROUND:Sleep is a key public health issue, but insufficient or poor-quality sleep has traditionally been viewed as an individual health problem, with interventions targeted accordingly. A broader socioecological perspective suggests that sleep health is influenced by interacting individual, social, and societal-level factors. This exploratory study examines the prevalence and correlates of insufficient sleep, sleep disturbance, and napping within a socioecological framework, using a nationally representative sample of Australian households. METHODS:Data from 17,570 people aged over 15 from Wave 17 (2017) of the nationally representative Household, Income and Labour Dynamics in Australia (HILDA) Survey were used. Cross-sectional associations between a range of self-reported individual, sociodemographic, social, and societal-level factors with sleep outcomes (i.e., insufficient sleep duration, sleep disturbance, and napping) were examined using multiple logistic regression models. RESULTS:Eighteen percent of participants had insufficient sleep according to age-based guidelines, 20% met criteria for sleep disturbance, and 30% napped at least weekly. While most significant correlates of the sleep outcomes were individual-level health behaviour and functioning factors, several social and societal-level correlates were also identified. These include marital status, living with young children, geography, relative neighbourhood socioeconomic position, and housing tenure status. Each was significantly associated with at least one sleep outcome. CONCLUSION:These findings suggest that both individual and socio-environmental contextual factors influence sleep health, indicating potential for multi-level intervention strategies.

Autistic children are more likely to experience challenges with poor diet quality or selective eating behaviours in comparison to neurotypical peers, which may predispose them to nutrient deficiencies and suboptimal weight status. Thus, it is crucial to identify factors associated with these two unfavourable dietary behaviours in autistic children. This cross-sectional study examined the associations between screen time and sleep quality with diet quality and food selectivity among autistic children, and the extent to which screen time was indirectly associated with diet quality and food selectivity through sleep quality. The parents of 628 autistic children aged 7–12 years in Australia reported on their child’s screen time, sleep quality, diet quality and food selectivity via an online questionnaire. Structural equation modelling of the hypothesised mediation model revealed significant associations between screen time and sleep disturbances (β = 0.118, 95

The first-ever comprehensive report on the sleep health of Aboriginal and Torres Strait Islander peoples (hereafter referred to as First Nations Australians) highlighted an 18% prevalence of poor sleep in First Nations youth. While sleep health is important across the lifespan, adolescence is a critical life stage with increased vulnerability to poor sleep. In adolescents, pubertal changes, social and academic commitments, and peer pressure significantly increase the risk of poor sleep, which often results in social and emotional well-being (SEWB) issues. In First Nations adolescents, high rates of SEWB issues demand effective prevention and management strategies. Evidence from non-First Nations adolescents suggests that timely prevention, identification, diagnosis, and management of poor sleep help reduce the risk and severity of SEWB issues in First Nations adolescents. A research program is proposed to be called "Let's Yarn About Sleep," which will co-design, deliver, and evaluate a tailored sleep improvement program for Australian First Nations adolescents (12-18 years). Co-design workshops will be conducted with First Nations community Elders, parents and carers, youth, and First Nations service providers to develop the sleep health program. The program will also include training Aboriginal Youth Workers (AYWs) to deliver the sleep health program. The program evaluation will be based on a mixed methods design, using self-reported (survey tools and focus group discussions) and technology-based measures (actigraphy data) to measure changes in First Nations adolescents' sleep and SEWB. The evaluation will focus on the impact of training AYWs on program delivery and uptake.

Objectives: The objective of this scoping review was to explore the body of knowledge that exists on the topic of sleep in adults experiencing homelessness. Background: Sleep is essential for health and wellbeing, and has an important role in cognition, decision making and life outcomes. The experience of homelessness increases exposure to risk factors that influence poor sleep health, including social and environmental exposures. People experiencing homelessness may not have the autonomy to mitigate these environmental and social impacts. Methods: For this scoping review, we searched for English language peer-reviewed articles in PubMed, Web of Science, Scopus, Sociological Abstracts, Social Science Database, Australian Public Affairs Full Text and PsycINFO. Forward and backward searching of included articles was also conducted. The methodology for this scoping review was guided by the scoping review framework in the Joanna Briggs Institute Manual for Evidence Synthesis. Eligibility Criteria: Studies were included if they examined the concept of any dimension of the sleep experience (including sleep-related daytime impairment) in adults 18 years and over experiencing homelessness in high income countries. Sources of Evidence: This review considered research-oriented literature, including original research, reviews, meta-analyses, practice guidelines, qualitative studies, conference abstracts, and government and nongovernment research-oriented reports. Charting Methods: Data were extracted on publication year, research design, geographical location, participant characteristics, measurement and key findings. Findings were narratively described or presented as frequencies. A thematic analysis was also completed for qualitative research studies. Results: This review extracted data from 101 studies. Of these, 45 were quantitative, 43 were qualitative, 6 were mixed-methods, and 7 were narrative reviews. The majority of studies included a focus on populations from the United States (56 studies), followed by the United Kingdom (18 studies). Only 34% of the included studies explicitly focussed on sleep as a core objective of the research. In the thematic analysis, the most frequently identified barriers to sleep across studies were safety and security, weather exposure and lack of comfort. Conclusions: This scoping review identified notable gaps in the literature, including a need for validated subjective and objective sleep measures for people experiencing homelessness, and a lack of research on sleep interventions in this population. Review findings can be used to stimulate and guide more targeted research, helping to identify appropriate intervention targets and approaches to improve sleep and related outcomes in this population.

OBJECTIVES:The built and social aspects of housing influence a broad range of health and social outcomes and may be important enablers of barriers to occupants accessing sufficient and good-quality sleep. The aim of this study was to examine the relationships between housing well-being (a conceptualization of housing-related [dis]advantage), with self-reported sleep outcomes in Australians. METHODS:We conducted a cross-sectional analysis of Wave 21 (2021) of the Household, Income and Labour Dynamics in Australia (HILDA) Survey, a longitudinal, population-based study of Australian households. Multilevel logistic regression models were used to examine the association between "housing well-being" and sleep outcomes. The sample analyzed consisted of 13,516 respondents. RESULTS:Greater housing insecurity (a composite score comprising tenure type, housing affordability stress, and housing mobility) was associated with higher odds of insufficient sleep (AOR: 1.28; 95% CI: 1.15, 1.41) and sleep disturbance (AOR: 1.13; 95% CI: 1.04, 1.22) after adjustment. Unsuitable housing (a composite score comprising dwelling type, occupant density, and housing quality) was associated with increased odds of insufficient sleep (AOR: 1.36; 95% CI: 1.19, 1.55), napping (AOR: 1.13; 95% CI: 1.02, 1.25), and sleep disturbance (AOR: 1.14; 95% CI: 1.03, 1.26) after adjustment. CONCLUSIONS:Improving housing condition and circumstances may support the sleep health of Australians. Future research should explore the ways in which sleep may play a mediating role through which built environments affect other health and well-being outcomes.

OBJECTIVE:This study assessed the feasibility and effectiveness of the Sharper Minds package, a mental health intervention designed for university students, co-developed with student input. The program included a weekly self-monitoring e-tool and/or a short course targeting six self-care areas: physical activity, diet, sleep, music to aid study, mood regulation, and social connection. METHOD:A non-randomised controlled trial involved 433 undergraduate students in three conditions: control, one-intervention (either e-tool or course), and two-intervention (both e-tool and course). Data were collected at baseline and after six weeks. Feasibility was measured by reach, retention, and acceptability, while primary outcomes focused on mental health indicators such as depression and anxiety, and secondary outcomes were somatic symptoms, wellbeing and academic motivation. RESULTS:Results indicated good retention (72 %) and positive feedback on acceptability. Students receiving both interventions (two-intervention condition) showed a 17.6 % reduction in the proportion screening positive for mental health issues, a change not seen in other conditions. A MANCOVA analysis identified a significant interaction between condition and time across combined outcomes (depression, anxiety, somatic symptoms, wellbeing, and motivation), with a small effect size. CONCLUSIONS:This is the first mental health promotion package for Australian university students addressing multiple health and self-care behaviours. Findings indicate students found the package components acceptable and experienced positive effects on mental health. ANZ CLINICAL TRIAL REGISTRATION:Retrospectively registered 1/09/2023, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=386141&isReview=true.

The aim of this study was to investigate sleep-wake behavior and gain insights into perceived impairment (sleep, fatigue, and cognitive function) of athletes competing in two international multi-day adventure races. Twenty-four athletes took part across two independent adventure races: Queensland, Australia and Alaska, USA. Individual sleep periods were determined via actigraphy, and racers self-reported their perceived sleep disturbances, sleep impairment, fatigue and cognitive function. Each of these indices was calculated for pre-, during- and post-race periods. Sleep was severely restricted during the race period compared to pre-race (Queensland, 7:46 [0:29] vs. 2:50 [1:01]; Alaska, 7:39 [0:58] vs. 2:45 [2:05]; mean [SD], hh:mm). As a result, there was a large cumulative sleep debt at race completion, which was not 'reversed' in the post-race period (up to 1 week). The deterioration in all four self-reported scales of perceived impairment during the race period was largely restored in the post-race period. This is the first study to document objective sleep-wake behaviors and subjective impairment of adventure racers, in the context of two geographically diverse, multi-day, international adventure races. Measures of sleep deprivation indicate that sleep debt was extreme and did not recover to pre-race levels within 1 week following each race. Despite this objective debt continuing, perceived impairment returned to pre-race levels quickly post-race. Therefore, further examination of actual and perceived sleep recovery is warranted. Adventure racing presents a unique scenario to examine sleep, performance and recovery.