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- Amid Hägg, Shadi, et al.
(författare)
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Nocturnal gastroesophageal reflux increases the risk of daytime sleepiness in women
- 2019
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Ingår i: Sleep Medicine. - : Elsevier BV. - 1389-9457 .- 1878-5506. ; 53, s. 94-100
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Daytime sleepiness is common in women and has negative health effects. Nocturnal gastroesophageal reflux (nGER) and snoring are risk factors for daytime sleepiness, but the effect of their interaction remains unknown. The aim of this study was to examine how nGER and snoring combined affected daytime sleepiness and involuntary falling asleep in women.METHODS: A questionnaire was sent to randomly selected women in 2000 and 2010. Participants who answered questions regarding both nGER and snoring in both questionnaires were included (N = 4882). Daytime sleepiness was defined as severe or very severe problems with daytime sleepiness. Involuntary falling asleep was defined as sometimes, often or very often falling asleep involuntarily during the day. Respondents snoring loudly and disturbingly sometimes, often or very often were defined as snorers. Having nocturnal heartburn or acid reflux sometimes, often or very often was defined as having nGER.RESULTS: Daytime sleepiness was reported by 14% of the participants, involuntary falling asleep by 11%. After adjustment for age, smoking, physical activity, caffeine intake and alcohol dependency, increased odd ratios (ORs) for both daytime sleepiness (adjusted OR 4.2, 95% confidence interval (CI): 1.9-9.2) and involuntary falling asleep (adjusted OR 3.1, 95% CI: 1.5-6.4) were seen in women with the combination of nGER and snoring at both baseline and follow-up. The association with daytime sleepiness was also strong for those with only persistent nGER but not for those with only persistent snoring.CONCLUSION: Women with nGER were at increased risk of developing daytime sleepiness and snoring augmented this association. In addition, women with both nGER and snoring were also at increased risk of developing involuntary falling asleep.
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- Bauducco, Serena, 1988-, et al.
(författare)
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Adolescents' sleep trajectories over time : school stress as a potential risk factor for the development of chronic sleep problems
- 2019
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Ingår i: Sleep Medicine. - : Elsevier. - 1389-9457 .- 1878-5506. ; 64:Suppl. 1, s. S27-S27
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Sleep is a complex behavior affected by biological, psychosocial and contextual factors typically present during adolescent development (Becker, Langberg, & Byars, 2015), including increasing autonomy from parents, increasing school demands, and socializing more with peers. However, these normative changes do not explain temporary vs chronic sleep disturbances. Who are the adolescents at risk for developing chronic sleep problems? Some risk factors have been identified as crucial, such as poor sleep hygiene and family stressors, others are not as clear, such as technology use (Bartel et al., 2015). The impact of another important stressor for youths other than family, the school context, has received less attention (Meldrum, 2018). The aim of this study was twofold; first, we explored sleep trajectories from early to mid-adolescence to be able to identify a risk group showing persistent sleep problems (including insomnia and short sleep duration); then, we investigated the role of school stressors (i.e., conflicts with teachers, performance, school-leisure conflict, attendance), controlling for well-established risk factors, in the development of chronic sleep problems in a large cohort of adolescents.Materials and methods: We used three longitudinal waves of questionnaire data collected annually from a sample of Swedish adolescents (n = 1457; Mage = 13.2 [range: 12- 15 years], SD = .43; 52.7% boys). We collected the data from all schools in three communities in central Sweden, during school hours. Using established measures, the students reported on their sleep duration (calculated from reported bedtime, wake-time, and sleep onset latency; SSHS [Wolfson & Carskadon, 1998]), insomnia symptoms (ISI; Morin, 1993), sleep hygiene (ASHS; LeBourgeois, Giannotti, Cortesi, Wolfson, & Harsh, 2005), technology use, and perceived stress (including school, home and peer related stress) (ASQ; Byrne, Davenport, & Mazanov, 2007).First we used latent class analysis (LCA) to identify adolescents' sleep trajectories, then we used regression analyses to predict the risk-group trajectory of chronic insomnia and short sleep duration, controlling for gender.Results: We found four trajectories for adolescents' insomnia; 1) low-stable (69%), 2) low-increasing (18%), 3) high-decreasing (8%), 4) high-increasing (5%; 'risk-group'). For sleep duration, we found two trajectories; 1) ∼8 h slightly decreasing (79%), 2) ∼7 h decreasing (21%; 'risk-group').School stressors including stress of fitting in with peers, stress of schoolwork leaving too little leisure time, a stressful home environment, poor sleep hygiene, and being female were risk factors for chronic insomnia symptoms. Conflicts with teachers, poor sleep hygiene, and being female were risk-factors for chronic insufficient sleep.Conclusions: Over and above well-known risk-factors for poor sleep, such as poor sleep hygiene, (Bartel et al., 2015), school-related stress was a significant predictor of persistent sleep problems in adolescents. Therefore, helping adolescents to handle school stress might be a promising strategy to improve sleep health in this population.
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- Bauducco, Serena, 1988-, et al.
(författare)
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Bidirectional associations between adolescents’ sleep problems and impulsive behavior over time
- 2019
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Ingår i: Sleep Medicine. - : Elsevier. - 1389-9457 .- 1878-5506 .- 2590-1427. ; 1
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Tidskriftsartikel (refereegranskat)abstract
- Objective/Background: Adolescents who experience sleep problems are less able to resist impulses. Furthermore, youths who show more impulsive behaviors are, in turn, assumed to have more sleep problems, which sets the stage for a negative cycle over time. Empirical research has shown some evidence that sleep problems affect impulse control, but the bidirectional link has previously not been tested. Therefore, the aim of this study was to test this assumption.Methods: In this study, we used cross-lagged models to investigate the bidirectional association between sleep problems (ie, insomnia and sleep duration) and impulsive behaviors over two years in a cohort of young adolescents (n = 2767, mean age ∼13.7, 47.6% girls). We also investigated the moderating role of age and gender.Results: The results showed that the links between sleep duration/insomnia and impulsive behavior are bidirectional. Youths who experienced sleep problems also experienced increased difficulties with impulse control, and problems regulating impulses were also linked with increases in sleep problems, and these effects were systematic over two years. Moreover, age did not moderate these associations but impulsive behaviors had a larger impact on girls’ insomnia as compared to boys.Conclusions: By confirming the bi-directionality of this association, this study supports the importance of developing interventions to promote sleep health in adolescents but also the need to tailor such programs to adolescents’ development because adolescents might not be able to prioritize sleep if they cannot control their impulses.
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- Cai, Gui-Hong, et al.
(författare)
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Insomnia symptoms and sleep duration and their combined effects in relation to associations with obesity and central obesity
- 2018
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Ingår i: Sleep Medicine. - : Elsevier BV. - 1389-9457 .- 1878-5506. ; 46, s. 81-87
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Previous studies have shown that both sleep duration and insomnia have an impact on obesity and central obesity. However, studies of the joint effects of these sleep disorders are still sparse. Methods: The present study utilized data from the Swedish EpiHealth cohort study. Participants (45 - 78 y) were asked to fill out an internet-based questionnaire. Body mass index (BMI) and central obesity (calculated from waist circumference) were based on measured data. Results: A total of 18,823 participants (mean age = 60 ys) were included in this study. The reported prevalence of short (<6 h/night) and long (>9 h/night) sleep duration was 8% and 4% respectively, and insomnia symptoms was 19%. Of the study population, 16% were obese (BMI >= 30 kg/m(2)) and 40% had central obesity. There was a U-shaped association between sleep duration and obesity and central obesity, and significant associations between insomnia symptoms and obesity. When stratifying sleep duration by concurrent insomnia symptoms, there were associations (odds ratios, (95% confidence intervals)) between the combination of both short (1.48, (1.22-1.80)) and long sleep duration (1.77 (1.00 - 3.16)) with insomnia symptoms and obesity and central obesity (1.36 (1.16-1.61) and 2.44 (1.41-3.24) respectively). However, there was no significant association between insomnia symptoms and obesity or central obesity in participants with normal sleep duration. For central obesity there was an association with long sleep duration regardless of insomnia symptoms, while the association with short sleep duration was significant only if insomnia symptoms were present. Conclusions: Both short and long sleep duration, as well as insomnia symptoms, are associated with obesity and central obesity. There is an important joint effect of sleep duration and insomnia symptoms and there is no association between insomnia symptoms and obesity, as long as a normal sleeping time can be attained. This indicates that sleep duration rather than insomnia symptoms per se is of importance for the relationship between sleep and obesity.
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- Dahlgren, A., et al.
(författare)
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Nurses' strategies for managing sleep when starting shift work – implications for interventions targeting sleep behaviours in a shift work population
- 2017
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Ingår i: Sleep Medicine. - : Elsevier BV. - 1389-9457 .- 1878-5506. ; 40:Suppl. 1
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Shift work is related to short and disturbed sleep. Various aspects of a shift schedule will produce different opportunities and conditions for sleep depending on how they interact with circadian rhythms and the homeostatic drive for sleep. A third factor influencing sleep between shifts is the activation of the stress system. The aim of the current study was to examine sleep behaviours and strategies that nurses used when starting shift work and determine which sleep behaviours should be promoted when developing a programme for sleep interventions for newly graduated nurses.Material and methods: 11 (mean age 29.1±8) newly graduated nurses (3–12 months work experience) from different hospitals in Sweden were recruited for a semi-structured interview (approx. 45 min). Deductive content analysis was used to examine sleep strategies related to the homeostatic and circadian regulation of sleep, and to managing stress.Results: In relation to morning shifts (starting 6:45 h) most nurses perceived sleep as somewhat disturbed. Some had a strategy of undertaking activities that helped them unwind before bedtime, such as having a shower, watching TV, surfing the Internet or using relaxation techniques. One nurse had a strategy of getting up early in the morning before a morning shift in order to facilitate sleep in the evening, thereby enhancing the homeostatic drive for sleep. One nurse tried to keep her bed times constant despite irregular work hours in order to maintain a stable circadian rhythm.In relation to evening shifts, few experienced problems with sleep. Most had a lie-in before starting an evening shift and were being quite inactive before the shift started.Most nurses reported sleep problems when an evening shift was followed by a morning shift, i.e. a quick return, with many having problems unwinding and stopping thinking about work before bedtime. A few nurses described experiencing stress from knowing that their sleep would be short. Many had a strategy of undertaking other activities to unwind (see examples from morning shifts) before going to bed. A few went to bed straight away but described experiencing difficulties falling asleep. A few who reported no problems with sleep during quick returns said that they undertook activities that made them detach from work, with one regularly using a relaxation technique. The five nurses who worked night shifts had strategies of either sleeping in the evening before the nightshift, or staying up as long as possible the night before, thereby reducing the homeostatic drive for sleep during the shift.Conclusions: Newly graduated nurses would probably benefit from a sleep programme based on cognitive behavioural therapy techniques that are modified to fit shift workers. Behaviours and strategies that should be targeted are: routines and techniques for unwinding before bed time; sleep behaviours that promote building up enough homeostatic pressure for initiating sleep (e.g. not having long lie-ins before evening shifts that are followed by morning shifts); and sleep behaviours that promote a stable circadian rhythm.
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