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A composite measure of sleep health predicts concurrent mental and physical health outcomes in adolescents prone to eveningness.

ABSTRACT: BACKGROUND:Sleep health can be characterized using multiple dimensions, including regularity, satisfaction, alertness, timing, efficiency, and duration. This study provides a preliminary derivation of a Sleep Health Composite score in adolescents with eveningness chronotype and examined its associations with mental and physical health outcomes. METHODS:Participants were 176 adolescents (mean age 14.77?years, 58% female) who participated in a randomized controlled trial examining the Transdiagnostic Sleep and Circadian intervention. At study entry, the sample was characterized by evening circadian preference, later bedtime, and increased risk in 1 of 5 health domains (emotional, cognitive, behavioral, social, and physical). The Sleep Health Composite was derived using 7-day sleep diary and self-report rating scales. Each dimension was categorized as "good" or "poor" using cut-offs informed by prior studies and expert consensus. Mental and physical health outcomes were assessed using self-report rating scales, semistructured clinical interviews, parent report, or biometric measurement. RESULTS:Sleep duration and satisfaction dimensions were most commonly rated as poor. Greater sleep health, as indexed by greater Sleep Health Composite score, was concurrently associated with lower risk in emotional, cognitive, and social domains, as well as fewer physical symptoms and reduced odds for obesity and current mood or anxiety disorders. CONCLUSIONS:Sleep health is an important correlate of mental and physical health outcomes in adolescents. The Sleep Health Composite has potential application as an outcome measure in treatment studies of sleep and circadian problems.

SUBMITTER: Dong L

PROVIDER: S-EPMC6452900 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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A composite measure of sleep health predicts concurrent mental and physical health outcomes in adolescents prone to eveningness.

Dong Lu L Martinez Armando J AJ Buysse Daniel J DJ Harvey Allison G AG

Sleep health 20190111 2

<h4>Background</h4>Sleep health can be characterized using multiple dimensions, including regularity, satisfaction, alertness, timing, efficiency, and duration. This study provides a preliminary derivation of a Sleep Health Composite score in adolescents with eveningness chronotype and examined its associations with mental and physical health outcomes.<h4>Methods</h4>Participants were 176 adolescents (mean age 14.77 years, 58% female) who participated in a randomized controlled trial examining t ...[more]

PMID: 30928117

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Project description:Background Poor self-reported sleep health has been linked to not consuming breakfast in adolescents, but it is unknown whether poor sleep measured objectively predicts next-day breakfast consumption within adolescents. We investigated within- and between-person associations of objectively measured sleep dimensions and subjective sleep quality with adolescent breakfast consumption. Methods Data were collected from a micro-longitudinal substudy of the Year 15 wave of the Fragile Families and Child Wellbeing Study (n = 590). Adolescents wore an actigraphy device and completed daily diaries for ~ 1 week (M ± SD = 5.6 ± 1.4 nights per adolescent, range: 3–9), where they rated their sleep quality and reported whether they had eaten breakfast that day, with no specific definition of breakfast provided (M ± SD = 5.5 ± 1.4 days per adolescent, range: 3–9). Separate mixed models assessed whether actigraphy-measured sleep duration (linear and quadratic, sleep duration x sleep duration), timing, maintenance efficiency, and subjective quality predicted odds of breakfast consumption both within and between adolescents. Variability of sleep duration and timing (standard deviation per person), sleep regularity index (SRI), and social jetlag were tested as additional between-person predictors. Analyses with predictors other than sleep duration were adjusted for sleep duration. Results Following nights when adolescents had shorter or longer sleep duration (p = .005; curvilinear association), later sleep onset, or later sleep midpoint (both p = .025) than their own usual, they had lower odds of consuming breakfast the next day (within-person associations). Adolescents who on average had later sleep onset (p = .013) or midpoint (p = .013) or who reported lower sleep quality (p = .011) had lower average odds of consuming breakfast (between-person associations). Adolescents with greater variability of sleep duration (p = .005), midpoint (p = .004), or offset (p < .001) had lower average odds of consuming breakfast (between-person associations). Sleep maintenance efficiency (within or between adolescents), SRI, and social jetlag were not associated with breakfast consumption (all p > .10). Conclusions Multiple dimensions of sleep health are associated with breakfast consumption, both within and between adolescents. Poor sleep and dietary behaviors in adolescence may negatively impact future metabolic health. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01265-5.

Project description:BackgroundTo examine if a composite activity-sleep behaviour index (ASI) mediates the effects of a combined physical activity and sleep intervention on symptoms of depression, anxiety, or stress, quality of life (QOL), energy and fatigue in adults.MethodsThis analysis used data pooled from two studies: Synergy and Refresh. Synergy: Physically inactive adults (18-65 years) who reported poor sleep quality were recruited for a two-arm Randomised Controlled Trial (RCT) (Physical Activity and Sleep Health (PAS; n = 80), or Wait-list Control (CON; n = 80) groups). Refresh: Physically inactive adults (40-65 years) who reported poor sleep quality were recruited for a three-arm RCT (PAS (n = 110), Sleep Health-Only (SO; n = 110) or CON (n = 55) groups). The SO group was omitted from this study. The PAS groups received a pedometer, and accessed a smartphone/tablet "app" using behaviour change strategies (e.g., self-monitoring, goal setting, action planning), with additional email/SMS support. The ASI score comprised self-reported moderate-to-vigorous-intensity physical activity, resistance training, sitting time, sleep duration, efficiency, quality and timing. Outcomes were assessed using DASS-21 (depression, anxiety, stress), SF-12 (QOL-physical, QOL-mental) and SF-36 (Energy & Fatigue). Assessments were conducted at baseline, 3 months (primary time-point), and 6 months. Mediation effects were examined using Structural Equation Modelling and the product of coefficients approach (AB), with significance set at 0.05.ResultsAt 3 months there were no direct intervention effects on mental health, QOL or energy and fatigue (all p > 0.05), and the intervention significantly improved the ASI (all p < 0.05). A more favourable ASI score was associated with improved symptoms of depression, anxiety, stress, QOL-mental and of energy and fatigue (all p < 0.05). The intervention effects on symptoms of depression ([AB; 95%CI] -0.31; - 0.60,-0.11), anxiety (- 0.11; - 0.27,-0.01), stress (- 0.37; - 0.65,-0.174), QOL-mental (0.53; 0.22, 1.01) and ratings of energy and fatigue (0.85; 0.33, 1.63) were mediated by ASI. At 6 months the magnitude of association was larger although the overall pattern of results remained similar.ConclusionsImprovements in the overall physical activity and sleep behaviours of adults partially mediated the intervention effects on mental health and quality of life outcomes. This highlights the potential benefit of improving the overall pattern of physical activity and sleep on these outcomes.Trial registrationAustralian New Zealand Clinical Trial Registry: ACTRN12617000680369 ; ACTRN12617000376347 . Universal Trial number: U1111-1194-2680; U1111-1186-6588. Human Research Ethics Committee Approval: H-2016-0267; H-2016-0181.

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A composite measure of sleep health predicts concurrent mental and physical health outcomes in adolescents prone to eveningness.

Publications

A composite measure of sleep health predicts concurrent mental and physical health outcomes in adolescents prone to eveningness.

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