A Three-Level Mixed Model to Account for the Correlation at both the Between-Day and the Within-Day Level for Ecological Momentary Assessments.
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SUBMITTER: Ma Q
PROVIDER: S-EPMC7591130 | biostudies-literature | 2020 Dec
REPOSITORIES: biostudies-literature
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A Three-Level Mixed Model to Account for the Correlation at both the Between-Day and the Within-Day Level for Ecological Momentary Assessments.
Ma Qianheng Q Mermelstein Robin R Hedeker Donald D
Health services & outcomes research methodology 20200923 4
Ecological Momentary Assessment (EMA) studies aim to explore the interaction between subjects' psychological states and real environmental factors. During the EMA studies, participants can receive prompted assessments intensively across days and within each day, which results in three-level longitudinal data, e.g., subject-level (level-3), day-level nested in subject (level-2) and assessment-level nested in each day (level-1). Those three-level data may exhibit complex longitudinal correlation s ...[more]
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Project description:BackgroundRecent studies have found bi-directional relations between stress and sleep. However, few studies have examined the daily associations between stress and electroencephalography (EEG) measured sleep.PurposeThis study examined the temporal associations between repeated ecological momentary assessments of stress and EEG-estimated sleep.MethodsNinety-eight international or interstate undergraduate students (Mage = 20.54 ± 1.64, 76.5% female, 84.7% Asian) reported their stress levels four times daily at morning awakening, afternoon, evening, and pre-bedtime across 15 consecutive days (>4,000 total observations). Next-day stress was coded as an average of morning, afternoon, and evening stress. Z-Machine Insight+ recorded over 1,000 nights EEG total sleep time (TST), sleep onset latency, wake after sleep onset, sleep efficiency (SE), slow-wave sleep (SWS), and rapid eye movement (REM) sleep duration. Multilevel models, adjusted for covariates (i.e., sociodemographic, health factors, and daily covariates) and lagged outcomes, tested the daily within- and between-level stress-sleep associations.ResultsAfter adjusting for covariates, within-person shorter TST (b = -0.11 [-0.21, -0.01], p = .04), lower SE (b = -0.02 [-0.03, 0.00], p = .04), less SWS (b = -0.38 [-0.66, -0.10], p = .008), and less REM sleep (b = -0.32 [-0.53, -0.10], p = .004) predicted higher next-day stress. Pre-bedtime stress did not predict same-night sleep. No significant results emerged at the between-person level.ConclusionsThese findings demonstrate that poor or short sleep, measured by EEG, is predictive of higher next-day stress. Results for sleep architecture support the role of SWS and REM sleep in regulating the perception of stress. Given that only within-person effects were significant, these findings highlight the importance of examining night-to-night fluctuations in sleep affecting next-day stress and its impact on daytime functioning.
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Project description:In studies using ecological momentary assessment (EMA), or other intensive longitudinal data collection methods, interest frequently centers on changes in the variances, both within-subjects and between-subjects. For this, Hedeker et al. (Biometrics 2008; 64: 627-634) developed an extended two-level mixed-effects model that treats observations as being nested within subjects and allows covariates to influence both the within-subjects and between-subjects variance, beyond their influence on means. However, in EMA studies, subjects often provide many responses within and across days. To account for the possible systematic day-to-day variation, we developed a more flexible three-level mixed-effects location scale model that treats observations within days within subjects, and allows covariates to influence the variance at the subject, day, and observation level (over and above their usual effects on means) using a log-linear representation throughout. We provide details of a maximum likelihood solution and demonstrate how SAS PROC NLMIXED can be used to achieve maximum likelihood estimates in an alternative parameterization of our proposed three-level model. The accuracy of this approach using NLMIXED was verified by a series of simulation studies. Data from an adolescent mood study using EMA were analyzed to demonstrate this approach. The analyses clearly show the benefit of the proposed three-level model over the existing two-level approach. The proposed model has useful applications in many studies with three-level structures where interest centers on the joint modeling of the mean and variance structure.
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Project description:Introduction: Coronavirus 2019 (COVID-19) quickly evolved into a global pandemic in early 2020, and most countries enforced social confinements to reduce transmission. This seems to dovetail with increasing, potentially problematic, screen use habits, such as gaming and "binge-watching." Yet, the subjective experience of the common confinements may vary not only between individuals depending on age, sex, and living conditions (i.e., living alone) but also within individuals from day to day: confinements might interfere with habitual activity schedules more strongly on some days than on others. Such dynamic confinement experience has not been studied in relation to screen use yet but might guide targeted intervention. Method: In total, 102 participants (n = 83 female, n = 80 university students) completed 14 days of ecological momentary assessment during a COVID-19-related lockdown in Germany and Austria. Each evening, they indicated the extent to which they felt restricted by confinements in their social and work lives and whether they engaged in unusually high and intense levels of television watching, social media use, news consumption, internet surfing, and gaming. They also reported on how much they experienced their day to be structured. Results: Experienced work confinements were positively associated with social media usage. Further, work confinements were positively associated with gaming in males and with news consumption, especially in individuals living alone. Social confinements were positively associated with watching television especially in younger participants and with social media consumption in younger participants. Higher experienced day structure was related to less television watching, gaming, and internet surfing but more news consumption. Discussion: Screen use behaviors increased with higher confinements within person, dependent on sex, age, and living situation. Such knowledge allows tailoring on the person level (who should be addressed?) and the time level (when should interventions be scheduled?) as the negative consequences of excessive screen use behaviors on mental and physical health are well-documented. One potential low-threshold intervention might be day-structuring.
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