Title: Objective and Subjective Intraindividual Variability in Sleep: Predisposing Factors and Health Consequences
We investigated the factors that predispose or precipitate greater intra-individual variability (IIV) in sleep. We further examined the potential consequences of IIV to overall sleep quality and health outcomes, including whether these relationships were found in both self-reported and actigraphy-measured sleep IIV. In Study 1, 699 US adults completed a Sleep Intra-Individual Variability questionnaire and self-reported psychosocial, sleep quality, and health outcomes. In Study 2, 100 university students wore actigraphy and completed psychosocial, sleep, and health surveys at multiple timepoints. In cross-sectional analyses that controlled for mean sleep duration, predisposing/precipitating factors to greater IIV were being an under-represented racial/ethnic minority, having greater stress or trait vulnerability to stress, and showing poorer time management. In addition, both studies showed that greater sleep IIV was associated with decreased overall sleep quality, independent of mean sleep duration. Concordance across subjective and objective IIV measures was modest and similar to concordance observed for subjective-objective mean sleep duration measures. Risk for irregular sleep patterns is increased in specific demographic groups and may be precipitated by, or contribute to, higher stress and time management inefficiencies. Irregular sleep may lead to poor sleep quality and adverse health outcomes, independent of mean sleep duration, underscoring the importance of addressing sleep consistency. more »« less
Haydon, Katherine C.; Moss, Corrin
(, Journal of Social and Personal Relationships)
null
(Ed.)
Attachment and sleep are linked across the lifespan, but attachment regulation of sleep among couples is understudied. This study aimed to replicate and extend prior research by testing whether romantic partners’ attachment orientations interacted to predict sleep, assessed via self-report and actigraphy over 14 days. Participants ( N = 208 couples) completed measures of attachment anxiety and avoidance and the Pittsburgh Sleep Quality Index. They also wore actigraphy monitors to assess nightly sleep quality and duration. Anxious people self-reported worse sleep quality, replicating two prior studies. In contrast to previous studies, anxious and low-avoidant people slept significantly worse with avoidant partners, while avoidant people slept somewhat better with avoidant partners. Results indicted dyadic regulation of several sleep outcomes and provided new insights regarding how partner avoidance can exacerbate or buffer sleep quality.
Background The physical and emotional well-being of women is critical for healthy pregnancy and birth outcomes. The Two Happy Hearts intervention is a personalized mind-body program coached by community health workers that includes monitoring and reflecting on personal health, as well as practicing stress management strategies such as mindful breathing and movement. Objective The aims of this study are to (1) test the daily use of a wearable device to objectively measure physical and emotional well-being along with subjective assessments during pregnancy, and (2) explore the user’s engagement with the Two Happy Hearts intervention prototype, as well as understand their experiences with various intervention components. Methods A case study with a mixed design was used. We recruited a 29-year-old woman at 33 weeks of gestation with a singleton pregnancy. She had no medical complications or physical restrictions, and she was enrolled in the Medi-Cal public health insurance plan. The participant engaged in the Two Happy Hearts intervention prototype from her third trimester until delivery. The Oura smart ring was used to continuously monitor objective physical and emotional states, such as resting heart rate, resting heart rate variability, sleep, and physical activity. In addition, the participant self-reported her physical and emotional health using the Two Happy Hearts mobile app–based 24-hour recall surveys (sleep quality and level of physical activity) and ecological momentary assessment (positive and negative emotions), as well as the Perceived Stress Scale, Center for Epidemiologic Studies Depression Scale, and State-Trait Anxiety Inventory. Engagement with the Two Happy Hearts intervention was recorded via both the smart ring and phone app, and user experiences were collected via Research Electronic Data Capture satisfaction surveys. Objective data from the Oura ring and subjective data on physical and emotional health were described. Regression plots and Pearson correlations between the objective and subjective data were presented, and content analysis was performed for the qualitative data. Results Decreased resting heart rate was significantly correlated with increased heart rate variability (r=–0.92, P<.001). We found significant associations between self-reported responses and Oura ring measures: (1) positive emotions and heart rate variability (r=0.54, P<.001), (2) sleep quality and sleep score (r=0.52, P<.001), and (3) physical activity and step count (r=0.77, P<.001). In addition, deep sleep appeared to increase as light and rapid eye movement sleep decreased. The psychological measures of stress, depression, and anxiety appeared to decrease from baseline to post intervention. Furthermore, the participant had a high completion rate of the components of the Two Happy Hearts intervention prototype and shared several positive experiences, such as an increased self-efficacy and a normal delivery. Conclusions The Two Happy Hearts intervention prototype shows promise for potential use by underserved pregnant women.
Amon, Mary Jean; Mattingly, Stephen; Necaise, Aaron; Mark, Gloria; Chawla, Nitesh; Dey, Anind; D'mello, Sidney
(, ACM Transactions on Computing for Healthcare)
Although some research highlights the benefits of behavioral routines for individual functioning, other research indicates that routines can reflect an individual's inflexibility and lower well-being. Given conflicting accounts on the benefits of routine, research is needed to examine how routineness versus flexibility in health-related behaviors correspond to personality traits, health, and occupational outcomes. We adopt a nonlinear dynamical systems approach to understanding routine using automatically sensed health-related behaviors collected from 483 information workers over a roughly two-month period. We utilized multidimensional recurrence quantification analysis to derive a measure of health regularity (routineness) from measures of daily step count, sleep duration, and heart rate variability (which relates to stress). Participants also completed measures of personality, health, and job performance at the start of the study and for two months via Ecological Momentary Assessments. Greater regularity was associated with higher neuroticism, lower agreeableness, and greater interpersonal and organizational deviance. Importantly, these results were independent of overall levels of each health indicator in addition to demographics. It is often believed that routine is desirable, but the results suggest that associations with routineness are more nuanced, and wearable sensors can provide insights into beneficial health behaviors.
Ito-Masui, Asami; Sakamoto, Ryota; Matsuo, Eri; Kawamoto, Eiji; Motomura, Eishi; Tanii, Hisashi; Yu, Han; Sano, Akane; Imai, Hiroshi; Shimaoka, Motomu
(, Journal of Medical Internet Research)
Background Shift workers are at high risk of developing sleep disorders such as shift worker sleep disorder or chronic insomnia. Cognitive behavioral therapy (CBT) is the first-line treatment for insomnia, and emerging evidence shows that internet-based CBT is highly effective with additional features such as continuous tracking and personalization. However, there are limited studies on internet-based CBT for shift workers with sleep disorders. Objective This study aimed to evaluate the impact of a 4-week, physician-assisted, internet-delivered CBT program incorporating machine learning–based well-being prediction on the sleep duration of shift workers at high risk of sleep disorders. We evaluated these outcomes using an internet-delivered CBT app and fitness trackers in the intensive care unit. Methods A convenience sample of 61 shift workers (mean age 32.9, SD 8.3 years) from the intensive care unit or emergency department participated in the study. Eligible participants were on a 3-shift schedule and had a Pittsburgh Sleep Quality Index score ≥5. The study comprised a 1-week baseline period, followed by a 4-week intervention period. Before the study, the participants completed questionnaires regarding the subjective evaluation of sleep, burnout syndrome, and mental health. Participants were asked to wear a commercial fitness tracker to track their daily activities, heart rate, and sleep for 5 weeks. The internet-delivered CBT program included well-being prediction, activity and sleep chart, and sleep advice. A job-based multitask and multilabel convolutional neural network–based model was used for well-being prediction. Participant-specific sleep advice was provided by sleep physicians based on daily surveys and fitness tracker data. The primary end point of this study was sleep duration. For continuous measurements (sleep duration, steps, etc), the mean baseline and week-4 intervention data were compared. The 2-tailed paired t test or Wilcoxon signed rank test was performed depending on the distribution of the data. Results In the fourth week of intervention, the mean daily sleep duration for 7 days (6.06, SD 1.30 hours) showed a statistically significant increase compared with the baseline (5.54, SD 1.36 hours; P=.02). Subjective sleep quality, as measured by the Pittsburgh Sleep Quality Index, also showed statistically significant improvement from baseline (9.10) to after the intervention (7.84; P=.001). However, no significant improvement was found in the subjective well-being scores (all P>.05). Feature importance analysis for all 45 variables in the prediction model showed that sleep duration had the highest importance. Conclusions The physician-assisted internet-delivered CBT program targeting shift workers with a high risk of sleep disorders showed a statistically significant increase in sleep duration as measured by wearable sensors along with subjective sleep quality. This study shows that sleep improvement programs using an app and wearable sensors are feasible and may play an important role in preventing shift work–related sleep disorders. International Registered Report Identifier (IRRID) RR2-10.2196/24799.
Many students self-report that they are “night owls,” which can result from neurodevelopmental delays in the circadian timing system. However, whether an individual considers themselves to be an evening-type versus a morning-type (self-reported chronotype) may also be influenced by academic demands (e.g. class start times, course load) and behavioral habits (e.g. bedtime social media use, late caffeine consumption, daytime napping). If so, then chronotype should be malleable. We surveyed 858 undergraduate students enrolled in demanding science courses at up to three time points. The survey assessed morning/evening chronotype, global sleep quality, academics, and behavioral habits. Evening and morning-type students showed similar demographics, stress levels, and academic demands. At baseline measurements, relative to morning-types, evening-types showed significantly worse sleep quality and duration as well as 22% greater bedtime social media usage, 27% greater daytime napping duration, and 46% greater likelihood of consuming caffeine after 5pm. These behavioral habits partially mediated the effects of selfreported chronotype on sleep quality/duration, even after controlling for demographic factors. Interestingly, 54 students reported switching from being at least moderate evening-types at baseline to being at least moderate morning-types later in the semester and 56 students showed the reverse pattern (6.3% of students switched from “definitely” one chronotype to the other chronotype). Evening-to-morning “chrono-switchers” consumed less caffeine after 5pm and showed significantly better sleep quantity/quality at the later timepoint. Thus, some students may consider themselves to be night owls in part because they consume caffeine later, take more daytime naps, or use more social media at bedtime. Experimental work is needed to determine whether nudging night owls to behave like morning larks results in better sleep health or academic achievement.
Gao, Chenlu, and Scullin, Michael K. Objective and Subjective Intraindividual Variability in Sleep: Predisposing Factors and Health Consequences. Retrieved from https://par.nsf.gov/biblio/10544189. Psychosomatic Medicine . Web. doi:10.1097/PSY.0000000000001301.
Gao, Chenlu, & Scullin, Michael K. Objective and Subjective Intraindividual Variability in Sleep: Predisposing Factors and Health Consequences. Psychosomatic Medicine, (). Retrieved from https://par.nsf.gov/biblio/10544189. https://doi.org/10.1097/PSY.0000000000001301
@article{osti_10544189,
place = {Country unknown/Code not available},
title = {Objective and Subjective Intraindividual Variability in Sleep: Predisposing Factors and Health Consequences},
url = {https://par.nsf.gov/biblio/10544189},
DOI = {10.1097/PSY.0000000000001301},
abstractNote = {We investigated the factors that predispose or precipitate greater intra-individual variability (IIV) in sleep. We further examined the potential consequences of IIV to overall sleep quality and health outcomes, including whether these relationships were found in both self-reported and actigraphy-measured sleep IIV. In Study 1, 699 US adults completed a Sleep Intra-Individual Variability questionnaire and self-reported psychosocial, sleep quality, and health outcomes. In Study 2, 100 university students wore actigraphy and completed psychosocial, sleep, and health surveys at multiple timepoints. In cross-sectional analyses that controlled for mean sleep duration, predisposing/precipitating factors to greater IIV were being an under-represented racial/ethnic minority, having greater stress or trait vulnerability to stress, and showing poorer time management. In addition, both studies showed that greater sleep IIV was associated with decreased overall sleep quality, independent of mean sleep duration. Concordance across subjective and objective IIV measures was modest and similar to concordance observed for subjective-objective mean sleep duration measures. Risk for irregular sleep patterns is increased in specific demographic groups and may be precipitated by, or contribute to, higher stress and time management inefficiencies. Irregular sleep may lead to poor sleep quality and adverse health outcomes, independent of mean sleep duration, underscoring the importance of addressing sleep consistency.},
journal = {Psychosomatic Medicine},
publisher = {Psychosomatic Medicine},
author = {Gao, Chenlu and Scullin, Michael K},
}
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