High rates of mental ill-health in postgraduate researchers (PGRs) represent a significant barrier to life satisfaction and academic success. Nevertheless, there is little knowledge about the extent and origins of mental health problems of PGRs in the UK. The current study addresses this gap by investigating the prevalence and provenance of anxiety, depression, sleep problems, subjective mental wellbeing, and suicide behaviours of PGRs in the UK. An online survey (N = 479) was used to measure the mental health outcomes and assess their relationships with demographic, trait and academic variables, policy, and social support. We found a high prevalence of mental ill-health and low levels of wellbeing in the current sample. Factors associated with poorer outcomes were female and non-binary gender, non-heterosexual identity, maladaptive perfectionism, workaholism and being in the 5 th year of study or above. Resilience, adaptive perfectionism, higher levels of social support and positive evaluations of progress and preparation, departmental climate, and supervisory relationship were associated with more positive outcomes. The current findings contribute new knowledge about the prevalence of mental health symptoms in PGRs in the UK, implying that institutional efforts to improve PGR wellbeing should include strategies to promote equality, diversity, resilience, integration, social support, and work-life balance of PGRs.

Objective- In recent years, there has been a growing interest in understanding the relationship between sleep disturbance and suicide. The current study aimed to advance understanding regarding the psychological processes driving these relationships, by examining if insomnia symptoms are related to suicidal ideation via perceptions of defeat and entrapment. Method- Participants (n = 260) completed an anonymous self-report survey online assessing insomnia symptoms, chronotype, defeat, entrapment, suicidal ideation and behavior, and a range of covariates. Insomnia symptoms were associated with an increased suicide risk(independent of depression). Results- Bivariate associations found insomnia severity to be related to poorer affective outcomes. The relationship between insomnia and suicidal ideation was mediated by perceptions of defeat and entrapment. Conclusions- Taken together, these findings shed light on the psychological mechanisms linking sleep disturbance and suicidal ideation by highlighting the role of defeat and entrapment. These findings have the potential to improve suicide risk assessment and prevention in young adults experiencing difficulties initiating or maintaining sleep.

Study Objectives: The sleep of students contains several features rendering it worthy of independent investigation. Sleep duration is an important aspect of sleep health and wellbeing, however the assessment of psychiatric hypersomnia has been hampered by the absence of a single unitary scale of this construct. With the recent publication of the Hypersomnia Severity Index, research can now examine this condition in greater detail.Methods: Here we consider how the candidate variables of sleep propensity, fatigue, chronotype and insomnia may be associated with hypersomnia scores in a sample of 140 students. Results suggest that hypersomnia was significantly predicted by these measures, but not age or gender. We then model a pathway from chronotype to hypersomnia, including these factors as potential mediators.Results: Results suggest that hypersomnia was significantly predicted by these measures, but not age or gender. The proposed pathway from chronotype to hypersomnia warrants further study.Conclusions: Future studies should expand upon this preliminary report and consider longitudinally and prospectively how hypersomnia is linked to poor mental health in well-characterized samples of students and other young adults.

BACKGROUND:There is a pressing need to update sleep models, education and treatment to better reflect the realities of sleep in a 24/7 connected social world. Progress has been limited to date by available measurement tools, which have largely focused on the frequency or duration of individuals' social media use, without capturing crucial sleep-relevant aspects of this inherently social and interactive experience. METHODS:Survey data from 3008 adolescents (aged 10-18 years) was used to rigorously develop and validate a new self-report measure that quantifies difficulty disengaging from social media interactions at night: the index of Nighttime Offline Distress (iNOD). Exploratory and Confirmatory Factor analyses in a random split sample produced a ten-item two-factor solution, with subscales capturing concerns about Staying Connected and Following Etiquette (Cronbach's alphas = 0.91 and 0.92 respectively). RESULTS:Those with higher scores on these subscales tended to report using social media for longer after they felt they should be asleep (rs = 0.41 and 0.26, respectively), shorter sleep duration (rs = -0.24 and -0.17, respectively) and poorer sleep quality (rs = -0.33 and -0.31, respectively). Results also pointed towards a potentially fragmented process of sleep displacement for those who may struggle to disconnect - and to stay disconnected - from social interactions in order to allow sufficient uninterrupted sleep opportunity. CONCLUSIONS:These findings can inform current models for understanding normal and disordered sleep during adolescence, whilst highlighting specific social concerns as important potential targets for sleep education efforts.

Background: There are increasing concerns about poor mental health in autistic individuals, and social vigilance and threat perceptions (“paranoia”) may be one aspect of this.Methods: Autistic adults (N = 39) were recruited online. As a first step towards assessing paranoia in autism, we report item-level frequency data on one measure of paranoia (i.e. the Green et al. Paranoid Thoughts Scale; GPTS).Results: Item-level data highlight items of particular relevance to this group, (e.g. “I have been upset by friends and colleagues judging me critically” and “I believed that certain people were not what they seemed”). These results suggest that the development of a questionnaire which can assess paranoia severity could be a useful asset.Conclusions: Further work is needed in order to provide validated assessment and effective treatments of paranoia in autism. Future studies should consider the nature and meaning of paranoia in this group, and its incorporation into mental health assessments.

Chronotype describes a person's general preference for mornings, evenings, or neither. It is typically conceptualized as a continuous unidimensional spectrum from morningness to eveningness. Eveningness is associated with poorer outcomes across a myriad of physical and mental health outcomes. This preference for later sleep and wake times is associated with increased risk of depression, anxiety, and suicidal ideation in both clinical and community samples. However, the mechanisms underlying the negative consequences of this preference for evenings are not fully understood. Previous research has found that sleep disturbances may act as a mediator of this relationship. The present study aimed to explore the associations between chronotype and affective outcomes in a sample of students. Additionally, it aimed to investigate the potential role of insomnia as a mediator within these relationships. Participants (n = 190) completed an anonymous self-report survey of validated measures online which assessed chronotype, insomnia symptoms, and a range of affective outcomes (defeat, entrapment, suicide risk, stress, and depressive and anxious symptomology). Eveningness was associated with more severe or frequent experiences of these outcomes, with participants that demonstrated a preference for eveningness more likely to report poorer affective functioning and increased psychological distress. Mediation analysis found the relationship between chronotype and these outcome measures was completely or partially mediated by insomnia symptom severity measured by the validated Sleep Condition Indicator insomnia scale. Taken together, these findings add further evidence for the negative consequences of increased eveningness. Additionally, our results show that chronotype and sleep disturbances should be considered when assessing mental well-being. Implementing appropriate sleep-related behavior change or schedule alterations can offer a tool for mitigation or prevention of psychological distress in students that report a preference for later sleep and wake times.

OBJECTIVES:Bedtime social media use is associated with poor sleep during adolescence, which in turn contributes to poor mental health, impaired daytime functioning and lower academic achievement. However, the underlying drivers for these bedtime social media habits remain understudied. This study adds an adolescent perspective on motivations for bedtime social media use and perceived impact on sleep.METHODS:Adolescents aged 11-17 years (n = 24) participated in focus group discussions exploring their experiences of using social media, particularly at night. Inductive reflexive thematic analysis produced themes that captured underlying drivers for social media use and associated impact on sleep.RESULTS:Our analyses produced two overarching themes: Missing Out and Norms & Expectations. Adolescents' nighttime social media use was driven by concerns over negative consequences for real-world relationships if they disconnected (often reporting delayed bedtimes, insufficient sleep and daytime tiredness). These concerns included the risk of offline peer exclusion from missing out on online interactions, and the fear of social disapproval from violating norms around online availability and prompt responses.CONCLUSIONS:These findings offer novel insight into why adolescents may choose to prioritize social media over sleep. Researchers and practitioners can respond to the evolving needs of today's adolescents by approaching social media use not as a technology-based activity, but as an embedded social experience underpinned by the same concerns as offline interactions.

While recent research has revealed high rates of mental ill-health among postgraduate researchers (PGRs) in the USA and Belgium, more knowledge is needed to understand the mental health and wellbeing of PGRs in the UK. The current study employs a qualitative approach to address this gap by focusing on the PGR experiences and perceptions. We used open-ended survey questions (N=459) and focus groups (N=20) to explore PGR wellbeing, the factors that affect it and the strategies to improve it. Thematic analysis resulted in four master themes: (1) “Department is where one starts from”; (2) “Supervisor; friend or foe?”; (3) “It was the best of times, it was the worst of times”; (4) “PGR coping and self-regulation”. Each theme culminates in participant suggestions on how issues in question could be addressed, which may help inform institutional strategies and efforts to improve student welfare.

Introduction: Growing evidence suggests a relationship between sleep disturbance and paranoid thinking, in both clinical and non-clinical populations. Research also suggests that this relationship is mediated by negative affect. The aims of this study were to 1) examine whether sleep disturbance predicted paranoia and the dimensions of paranoia, including distress, preoccupation and conviction and 2) to test whether there was a time-lagged, relationship between sleepiness and paranoia, and whether this was mediated by negative affect. Method: Sleep was measured subjectively via questionnaires, sleep diary and this was used to test the first aim. Experience sampling methods were also used and these were used to test the second aim. Momentary assessments of sleepiness, mood, and paranoia were measured 8 times a day, for 8 days, at semi-random intervals. Multi-level modelling was then used to assess relationships between the variables. Results: Twenty- three patients with a diagnosis of non-affective psychosis took part in the study, and 20 completed the experience sampling procedure. There was no relationship between sleep diary variables and paranoia, or its dimensions. There was no time-lagged relationship between sleepiness and paranoia. A subset of individuals in the sample were identified who did not report any variation or fluctuations in their measurements. Discussion: There was no relationship between subjective sleep and paranoia. Lack of power may be why no relationship was found. However sleep disturbances were common in people with non-affective psychosis. Our findings support the treatment of sleep problems in this sample, but not in relation to paranoia.

Objectives This study examines associations between social media use and multiple sleep parameters in a large representative adolescent sample, controlling for a wide range of covariates.Design The authors used cross-sectional data from the Millennium Cohort Study, a large nationally representative UK birth cohort study.Participants Data from 11 872 adolescents (aged 13–15 years) were used in analyses.Methods Six self-reported sleep parameters captured sleep timing and quality: sleep onset and wake times (on school days and free days), sleep onset latency (time taken to fall asleep) and trouble falling back asleep after nighttime awakening. Binomial logistic regressions investigated associations between daily social media use and each sleep parameter, controlling for a range of relevant covariates.Results Average social media use was 1 to <3 hours per day (31.6%, n=3720). 33.7% were classed as low users (<1 hour; n=3986); 13.9% were high users (3 to <5 hours; n=1602) and 20.8% were very high users (5+ hours; n=2203). Girls reported spending more time on social media than boys. Overall, heavier social media use was associated with poorer sleep patterns, controlling for covariates. For example, very high social media users were more likely than comparable average users to report late sleep onset (OR 2.14, 95% CI 1.83 to 2.50) and wake times (OR 1.97, 95% CI 1.32 to 2.93) on school days and trouble falling back asleep after nighttime awakening (OR 1.36, 95% CI 1.10 to 1.66).Conclusions This study provides a normative profile of UK adolescent social media use and sleep. Results indicate statistically and practically significant associations between social media use and sleep patterns, particularly late sleep onset. Sleep education and interventions can focus on supporting young people to balance online interactions with an appropriate sleep schedule that allows sufficient sleep on school nights.

Entrainment of circadian rhythms (CR) to the light dark cycle has been well described under controlled, experimental conditions. However, studies in rodents have reported that rhythms in the laboratory are not always reproduced under field conditions. The aim of this study was to characterise the CR of sheep maintained under conditions of standard UK farm animal husbandry and to investigate the effects of environmental challenges presented by season, weaning and changes in housing on CR. Male sheep (n = 9) were kept at pasture, or group housed in barns, under natural photoperiod for one year. CR in locomotor activity were monitored using accelerometry, and 24 h patterns in plasma cortisol and melatonin were measured every 4 h by ELISA. CR was measured before and after weaning, in summer and winter, and at pasture and by barn housing. Cosinor analysis revealed high amplitude, diurnal rhythms in locomotor activity that were disrupted by weaning and by barn housing. Rhythms in winter showed an interrupted night time activity pattern, but only when the sheep were kept at pasture. Cortisol and melatonin secretion followed typical circadian patterns in winter and summer. The CR of the sheep under the field conditions of this study were strikingly robust under basal conditions, but easily disrupted by environmental challenges. Interrupted patterns of activity during the long nights of wintertime, not previously reported for sheep kept in experimental conditions were recorded. Based on these findings, we propose that animals require exposure to more complex environments than the laboratory in order to exhibit their true circadian phenotype.

Robust physiological circadian rhythms form an integral part of well-being. The aging process has been found to negatively impact systems that drive circadian physiology, typically manifesting as symptoms associated with abnormal/disrupted sleeping patterns. Here, we investigated the age-related decline in light-driven circadian entrainment in male C57BL/6J mice. We compared light-driven resetting of circadian behavioral activity in young (1-2 months) and old (14-18 months) mice and explored alterations in the glutamatergic pathway at the level of the circadian pacemaker, the suprachiasmatic nucleus (SCN). Aged animals showed a significant reduction in sensitivity to behavioral phase resetting by light. We show that this change was through alterations in N-Methyl-D-aspartate (NMDA) signaling at the SCN, where NMDA, a glutamatergic agonist, was less potent in inducing clock resetting. Finally, we show that this shift in NMDA sensitivity was through the reduced SCN expression of this receptor's NR2B subunit. Only in young animals did an NR2B antagonist attenuate behavioral resetting. These results can help target treatments that aim to improve both physiological and behavioral circadian entrainment in aged populations.

BACKGROUND:Disruption of sleep and circadian rhythmicity is a core feature of mood disorders and might be associated with increased susceptibility to such disorders. Previous studies in this area have used subjective reports of activity and sleep patterns, but the availability of accelerometer-based data from UK Biobank participants permits the derivation and analysis of new, objectively ascertained circadian rhythmicity parameters. We examined associations between objectively assessed circadian rhythmicity and mental health and wellbeing phenotypes, including lifetime history of mood disorder.METHODS:UK residents aged 37-73 years were recruited into the UK Biobank general population cohort from 2006 to 2010. We used data from a subset of participants whose activity levels were recorded by wearing a wrist-worn accelerometer for 7 days. From these data, we derived a circadian relative amplitude variable, which is a measure of the extent to which circadian rhythmicity of rest-activity cycles is disrupted. In the same sample, we examined cross-sectional associations between low relative amplitude and mood disorder, wellbeing, and cognitive variables using a series of regression models. Our final model adjusted for age and season at the time that accelerometry started, sex, ethnic origin, Townsend deprivation score, smoking status, alcohol intake, educational attainment, overall mean acceleration recorded by accelerometry, body-mass index, and a binary measure of childhood trauma.FINDINGS:We included 91 105 participants with accelerometery data collected between 2013 and 2015 in our analyses. A one-quintile reduction in relative amplitude was associated with increased risk of lifetime major depressive disorder (odds ratio [OR] 1·06, 95% CI 1·04-1·08) and lifetime bipolar disorder (1·11, 1·03-1·20), as well as with greater mood instability (1·02, 1·01-1·04), higher neuroticism scores (incident rate ratio 1·01, 1·01-1·02), more subjective loneliness (OR 1·09, 1·07-1·11), lower happiness (0·91, 0·90-0·93), lower health satisfaction (0·90, 0·89-0·91), and slower reaction times (linear regression coefficient 1·75, 1·05-2·45). These associations were independent of demographic, lifestyle, education, and overall activity confounders.INTERPRETATION:Circadian disruption is reliably associated with various adverse mental health and wellbeing outcomes, including major depressive disorder and bipolar disorder. Lower relative amplitude might be linked to increased susceptibility to mood disorders.FUNDING:Lister Institute of Preventive Medicine.

Background The prevalence of sleep disturbance is high and increasing. The study investigated whether active, former and passive smoking were associated with sleep disturbance. Methods This cross-sectional study used data from the UK Biobank: a cohort study of 502 655 participants, of whom 498 208 provided self-reported data on smoking and sleep characteristics. Multivariable multinomial and logistic regression models were used to examine the associations between smoking and sleep disturbance. Results Long-sleep duration (> 9 h) was more common among current smokers [odds ratio (OR): 1.47; 95% confidence interval (CI): 1.17-1.85; probability value (P) = 0.001] than never smokers, especially heavy (> 20/day) smokers (OR: 2.85; 95% CI: 1.66-4.89; P < 0.001). Former heavy (> 20/day) smokers were also more likely to report short (< 6 h) sleep duration (OR: 1.41; 95% CI: 1.25-1.60; P < 0.001), long-sleep duration (OR: 1.99; 95% CI: 1.47-2.71; P < 0.001) and sleeplessness (OR: 1.47; 95% CI: 1.38-1.57; P < 0.001) than never smokers. Among never smokers, those who lived with more than one smoker had higher odds of long-sleep duration than those not cohabitating with a smoker (OR: 2.71; 95% CI: 1.26-5.82; P = 0.011). Conclusions Active and passive exposure to high levels of tobacco smoke are associated with sleep disturbance. Existing global tobacco control interventions need to be enforced.

INTRODUCTION:The risk of mortality from cardiovascular disease (CVD) is higher in wintertime throughout the world, but it is not known if this reflects annual changes in diet or lifestyle, or an endogenous photoperiodic mechanism that is sensitive to changes in day length.METHODS:Phenotypic data on cardiometabolic and lifestyle factors were collected throughout a 4 year time period from 502,642 middle-aged participants in UK Biobank. To assess the impact of seasonal environmental changes on cardiovascular risk factors, we linked these data to the outdoor temperature and day length at the time of assessment. Self-reported information on physical activity, diet and disease status were used to adjust for confounding factors related to health and lifestyle.RESULTS:Mortality related to CVD was higher in winter, as were risk factors for this condition including blood pressure, markers of inflammation and body mass index (BMI). These seasonal rhythms were significantly related to day length after adjustment for other factors that might affect seasonality including physical activity, diet and outdoor temperature.CONCLUSIONS:The risk of CVD may be modulated by day length at temperate latitudes, and the implications of seasonality should be considered in all studies of human cardiometabolic health. Key messages In this cross-sectional study in UK Biobank, we report annual variations in cardiovascular risk factors and mortality that were associated with day length independent of environmental and lifestyle factors. These seasonal changes in day length might contribute to annual patterns in cardiovascular disease and mortality.