Sleep habits in adolescents of Saudi Arabia; distinct patterns and extreme sleep schedules

Background and Study ObjectivesThere is a need for comprehensive studies on adolescents' sleep habits in the Middle Eastern region. The aim of this study was to investigate the sleep–wake patterns, prevalence of excessive daytime sleepiness (EDS), and disturbed sleep among adolescents in Saudi Arabia and to identify the associated factors.MethodsThe study was a cross-sectional survey done on a random sample of 1035 high school students, ages 14–23 years, in Jeddah, Saudi Arabia. The response rate was 91%. Students filled a self-reported questionnaire that included sleep–wake questions, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Perceived Stress Scale, academic performance, and personal data.ResultsStudents slept an average of 7.0 hours on school nights, with an average delay of 2.8 and 6.0 hours in weekend sleep and rise times, respectively. Around 1 in 10 students stayed up all night and slept after returning from school (exhibiting a reversed sleep cycle) on weeknights. This pattern was more prevalent among boys and students with lower grade point averages. The prevalence of sleep disturbance was 65%, and EDS was found in 37% of the students. Predictors of EDS were school type, stress, napping and caffeine use, while gender was a predictor of disturbed sleep.ConclusionsAdolescents in Saudi Arabia showed a high percentage of poor sleep quality. Compared with adolescents from other countries, they had a larger delay in weekend sleep and rise times. An alarming reversed sleep cycle on weekdays is present and highlights the need for further assessment.     

Effects of sleep timing,sleep quality and sleep duration on school achievement in adolescents

ObjectiveThe aim of this study was to examine the effects of sleep timing, quality and duration on school achievement in adolescents.MethodsThirty-six Italian students (mean age: 18.14 ± 0.49 years) attending their last year of high school participated in the study. They completed the Morningness–Eveningness Questionnaire for Children and Adolescents (MEQ-CA). This was used to determine their ideal sleep timing by computing the total score, with higher scores corresponding to a greater tendency toward morningness. In addition, students underwent two non-consecutive weeks of actigraphy in one-month period to objectively assess: habitual sleep timing through the midpoint of sleep (MS); habitual sleep quality through the parameter of sleep efficiency (SE); and habitual sleep duration through the parameter of total sleep time (TST). Participants also completed the Mini Sleep Questionnaire, which allowed us to assess perceived sleep quality, at the end of each actigraphic-recording week. School performance was assessed using the grades obtained by students in their school leaving exams taken at the end of the school year.ResultsA significant positive correlation was observed between SE and exam grades, as well as MEQ-CA scores and grades. Multiple regression analysis showed that only SE was significantly and positively related to the final grade.ConclusionsExamining objective and ecological measures, SE (indicator of sleep quality) had the strongest effect on school achievement in adolescents.     

Last night's sleep in relation to academic achievement and neurocognitive testing performance in adolescents with and without ADHD

Objectives/backgroundObjectives were to (1) examine previous night's sleep in relation to next day performance on standardized academic achievement and neurocognitive assessments in adolescents, and (2) explore whether previous night's sleep is differentially associated with testing performance for adolescents with and without attention-deficit/hyperactivity disorder (ADHD).Participants/methodsParticipants were 300 adolescents (ages 12–14 years; 55% male). Approximately half (53.6%) were diagnosed with ADHD. Adolescents provided ratings of their previous night's sleep quality, sleep duration, and number of night wakings and were administered standardized tests of processing speed and working memory, as well as word reading, numerical operations, and math fluency academic achievement.ResultsIn analyses controlling for sex, race, medication use, time of testing, and ADHD group status, more night wakings the previous night were associated with significantly lower numerical operations and math fluency achievement scores and marginally lower working memory scores. Previous night's sleep was not associated with processing speed or reading achievement. ADHD status did not moderate sleep in relation to academic/neurocognitive performance. Participants reporting ≥2 night wakings the previous night had slightly over half a standard deviation lower scores on average compared to participants reporting 0 night wakings.ConclusionsThis preliminary study suggests that previous night's wakings are associated with poorer mathematics performance the next day, regardless of ADHD status. This may be due to the detrimental effect of interrupted and fragmented sleep on attention and executive control. These findings have implications for clinicians and educators when considering contextual factors that may impact academic and neurocognitive testing performance.     

Decreases in self-reported sleep duration among U.S. adolescents 2009–2015 and association with new media screen time

Study objectivesInsufficient sleep among adolescents carries significant health risks, making it important to determine social factors that change sleep duration. We sought to determine whether the self-reported sleep duration of U.S. adolescents changed between 2009 and 2015 and examine whether new media screen time (relative to other factors) might be responsible for changes in sleep.MethodsWe drew from yearly, nationally representative surveys of sleep duration and time use among adolescents conducted since 1991 (Monitoring the Future) and 2007 (Youth Risk Behavior Surveillance System of the Centers for Disease Control; total N = 369,595).ResultsCompared to 2009, adolescents in 2015 were 16%–17% more likely to report sleeping less than 7 h a night on most nights, with an increase in short sleep duration after 2011–2013. New media screen time (electronic device use, social media, and reading news online) increased over this time period and was associated with increased odds of short sleep duration, with a clear exposure–response relationship for electronic devices after 2 or more hours of use per day. Other activities associated with short sleep duration, such as homework time, working for pay, and TV watching, were relatively stable or reduced over this time period, making it unlikely that these activities caused the sudden increase in short sleep duration.ConclusionsIncreased new media screen time may be involved in the recent increases (from 35% to 41% and from 37% to 43%) in short sleep among adolescents. Public health interventions should consider electronic device use as a target of intervention to improve adolescent health.     

The influence of school time on sleep patterns of children and adolescents

ObjectiveThis epidemiological study evaluated the impact of school time on sleep parameters of children and adolescents.MethodsThis cross-sectional study involved 639 elementary and high school students (mean age 13.03 years, range 8–18, 58.5% female) from the south of Brazil. Participants answered the Morningness-Eveningness Questionnaire (MEQ), and were asked about their sleeping habits on weekdays and weekends. Sleep deficit was defined as the difference between sleep duration on weekdays and weekends.ResultsThe morning-school-time students presented significantly higher age, bedtime and wake up differences, sleep deficits, and social jetlag. The sleep deficit presented by girls was greater than that observed in boys of the same age. The difference between weekday and weekend waking times was also significantly greater in girls than in boys aged 13–18 years. Sleep deficit was significantly positively correlated with age and differences in wake up times, and significantly negatively correlated with MEQ scores, social jetlag, difference between weekday and weekend bedtimes, midpoint of sleep on weekends, and midpoint of sleep on weekends corrected for sleep deficit. A step-by-step multivariate logistic regression identified social jetlag, the difference between waking times on weekdays and weekends, and the midpoint of sleep on weekends as significant predictors of sleep deficit (Adjusted R² = 0.95; F = 1606.87; p <0.001).ConclusionThe results showed that school time influences the sleep parameters. The association of school schedules and physiological factors influence the sleep/wake cycle.     

Is there an association between short sleep duration and adolescent anxiety disorders?

ObjectiveThe purpose of this study is to provide the first data on the prospective, reciprocal association between short sleep duration and DSM-IV anxiety disorders among adolescents.MethodsA community-based two-wave cohort study included 4175 youths aged 11–17 years at baseline, with 3134 of these followed up a year later, drawn from a metropolitan area with a population of over 4 million. Anxiety is defined as any DSM-IV anxiety disorder in the past year generalized anxiety: panic disorder, agoraphobia without panic, social phobia, and post-traumatic stress disorder. Short sleep duration is defined as ≤6 h of sleep per night.Results/ConclusionsIn multivariate analyses, short sleep duration every night at baseline predicted anxiety disorders at follow-up, controlling for anxiety at baseline. Examining the reciprocal association, anxiety disorders at baseline did not predict short sleep duration at follow-up. We are the first to examine the reciprocal effects for anxiety disorders and sleep duration among adolescents using prospective data. The data suggest that reduced quantity of sleep may increase risk for anxiety, but anxiety does not increase risk for decreased sleep duration.     

Association between short time in bed,health-risk behaviors and poor academic achievement among Norwegian adolescents

ObjectiveTo investigate the prevalence of short time in bed (<8 h/day) and to examine the association between time in bed, overweight/obesity, health-risk behaviors and academic achievement in adolescents.MethodsThis study included a sample of adolescents (n = 2432) aged 15–17 years in the southern part of Norway (participation rate, 98.7%). A self-report questionnaire was used to assess time in bed, body mass index, dietary habits, physical activity habits, sedentary behavior, smoking and snuffing habits, and academic achievement.ResultsA total of 32.3% of the students reported short time in bed (<8 h/day) on an average school night. Several health-risk behaviors were associated with short sleep duration, including not being physically active for ⩾60 min for ⩾5 days/week (adjusted odds ratio, 1.33; 95% confidence interval, 1.05–1.68); using television/computer >2 h/day (1.63; 1.23–2.17); being a current smoker (2.46; 1.80–3.35) or snuffer (2.11; 1.57–2.85); having an irregular meal pattern (1.33; 1.05–1.68); intake of sweets/candy ⩾4 times/week (0.51; 0.32–0.83); and poor academic achievement (1.62; 1.26–2.09). All odds ratios were adjusted for sex, age and parental education.ConclusionsIn Norwegian adolescents, short time in bed is associated with several health-risk behaviors and poor academic achievement.     

Disturbed sleep in children born extremely preterm is associated with behavioural and emotional symptoms

AimTo determine whether children born extremely preterm are at increased risk for sleep disturbances and to explore relationships between extremely preterm birth, sleep and attention-deficit/hyperactivity disorder (ADHD) symptoms and emotional symptoms.MethodEPICure2 cohort study. Parents of 165 children born ≤26 weeks' gestation (53% male) and 121 children born at term (43% male) completed the Children's Sleep Habits Questionnaire, sleep disordered breathing subscale of the Pediatric Sleep Questionnaire, the emotional problems scale of the Strengths and Difficulties Questionnaire and the ADHD Rating Scale-5 at 11 years of age.ResultsExtremely preterm children had greater habitual snoring (adjusted odds ratio 6.8; 95% confidence interval 2.3, 20.3), less frequently fell asleep within 20 minutes (Cohen's d 0.33), higher night wakings (d 0.44) and daytime sleepiness scores (d 0.40) than term-born children; there was no between-group difference in sleep duration scores. Among children without severe disability, night wakings scores partially mediated the relationship between preterm birth and inattention (additional 5% of variance explained), hyperactivity/impulsivity (13%) and emotional problems (9%). Snoring partially mediated the relationship between preterm birth, hyperactivity/impulsivity and inattention (additional 1–5% of variance).ConclusionChildren born extremely preterm are at increased risk of disturbed sleep compared to term-born children. As night wakings partially mediated the relationship between preterm birth and ADHD symptoms and emotional problems, reducing sleep disturbance may improve sleep and reduce attention and emotional problems in this population.     

Association between short sleep duration and metabolic syndrome in Chinese children and adolescents

BackgroundThe relationship between short sleep duration and metabolic syndrome (MetS) in children and adolescents has been inconsistent. This study aimed to examine the association between short sleep duration and MetS in Chinese children and adolescents.MethodsData were from a cross-sectional survey conducted in Jinan, China between September 2013 and November 2014. A total of 1008 children and adolescents aged 6–17 years were included. Sleep duration was self-reported by participants and categorized as normal or short (<9 h in children aged 6–12 years or <8 h in adolescents aged 13–17 years) according to the recommendations of the American Academy of Sleep Medicine. MetS was defined based on the modified criteria of the National Cholesterol Education Program Adult Treatment Panel III.ResultsAfter adjusted for sex, age, parental education levels, and midpoint of sleep, compared with normal sleep duration, short sleep duration was associated with increased odds of MetS (odds ratio [OR]: 1.79, 95% confidence interval [CI]: 1.09–2.95) and abdominal obesity (OR: 1.60, 95% CI: 1.14–2.25). In the subgroups stratified by age and sex, compared with normal sleep duration, short sleep duration was associated with increased odds of abdominal obesity (OR: 2.34, 95% CI: 1.07–5.13) in girls aged 6–12 years; short sleep duration was associated with increased odds of MetS (OR: 2.49, 95% CI: 1.06–5.84), abdominal obesity (OR: 2.30, 95% CI: 1.10–4.82), and high TG (OR: 2.63, 95% CI: 1.11–6.21) in boys aged 13–17 years.ConclusionsShort sleep duration associated with higher odds for MetS in Chinese children and adolescents. Interventions to improve sleep duration could help prevent and control MetS among children and adolescents.     

Bullying involvement,psychological distress,and short sleep duration among adolescents

Purpose

Previous research has found links between involvement in bullying and sleep duration in adolescents. However, little is known about the factors that might mediate these relationships. This study examined the associations between cyberbullying victimization and school bullying involvement (bully, victim, bully–victim) with short sleep duration in a large sample of middle and high school students and tested whether psychological distress mediates these relationships.

Methods

Data on 5061 students (49% females; mean age?=?15.1 years) from the 2015 Ontario Student Drug Use and Health Survey were used. Participants self-reported their sleep duration and their levels of bullying involvement over the past year. Psychological distress was assessed using the Kessler 6 (K6) scale. Covariates in multiple linear regression analyses included age, sex, racial background, socioeconomic status, and substance use.

Results

Being a victim of cyberbullying (β?=???1.179; 95% CI ??0.238; ??0.120) or school bullying (β?=???0.119; 95% CI ??0.190; ??0.049) was associated with short sleep duration. Mediation analyses suggested that psychological distress fully mediates the relationships between being cyberbullied, a school bullying victim or bully–victim with short sleep duration. There was a complementary mediation by psychological distress on the relationship between being a bully at school and short sleep duration.

Conclusions

These results suggest that higher levels of bullying involvement place adolescents at risk of developing higher psychological distress which, in turn, can lead to short sleep duration. Longitudinal research is necessary to confirm the mediating role of psychological distress on the relationship between bullying involvement and short sleep duration among adolescents.

     

Suboptimal sleep and incident cardiovascular disease among African Americans in the Jackson Heart Study (JHS)

BackgroundSuboptimal sleep, including insufficient/long sleep duration and poor sleep quality, is a risk factor for cardiovascular disease (CVD) common but there is little information among African Americans, a group with a disproportionate CVD burden. The current study examined the association between suboptimal sleep and incident CVD among African Americans.MethodsThis study included 4,522 African Americans without CVD at baseline (2000–2004) of the Jackson Heart Study (JHS). Self-reported sleep duration was defined as very short (<6 h/night), short (6 h/night), recommended (7–8 h/night), and long (≥9 h/night). Participants’ self-reported sleep quality was defined as “high” and “low” quality. Suboptimal sleep was defined by low quality sleep and/or insufficient/long sleep duration. Incident CVD was a composite of incident coronary heart disease and stroke. Associations between suboptimal sleep and incident CVD were examined using Cox proportional hazards models over 15 follow-up years with adjustment for predictors of CVD risk and obstructive sleep apnea.ResultsSample mean age was 54 years (SD = 13), 64% female and 66% reported suboptimal sleep. Suboptimal sleep was not associated with incident CVD after covariate adjustment [HR(95% CI) = 1.18(0.97–1.46)]. Long [HR(95%CI) = 1.32(1.02–1.70)] and very short [HR(95% CI) = 1.56(1.06–2.30)] sleep duration were associated with incident CVD relative to recommended sleep duration. Low quality sleep was not associated with incident CVD (p = 0.413).ConclusionsLong and very short self-reported sleep duration but not self-reported sleep quality were associated with increased hazard of incident CVD.     

Sleep duration in Chinese adolescents: biological,environmental, and behavioral predictors

ObjectiveTo examine sleep duration-related risk factors from multidimensional domains among Chinese adolescents.MethodsA random sample of 4801 adolescents aged 11–20 years participated in a cross-sectional survey. A self-reported questionnaire was used to collect information about the adolescents' sleep behaviors and possible related factors from eight domains.ResultsIn all, 51.0% and 9.8% of adolescents did not achieve optimal sleep duration (defined as <8.0 h per day) on weekdays and on weekends, respectively. According to multivariate logistic regression models, after adjusting for all possible confounders, 17 factors were associated with sleep duration <8 h. Specifically, 13 factors from five domains were linked to physical and psychosocial condition, environment, and behaviors. These factors were overweight/obesity, chronic pain, bedtime anxiety/excitement/depression, bed/room sharing, school starting time earlier than 07:00, cram school learning, more time spent on homework on weekdays, television viewing ≥2 h/day, physical activity <1 h/day, irregular bedtime, and shorter sleep duration of father.ConclusionBiological and psychosocial conditions, sleep environments, school schedules, daily activity and behaviors, and parents' sleep habits significantly may affect adolescents' sleep duration, indicating that the existing chronic sleep loss in adolescents could be, at least partly, intervened by improving adolescents' physical and psychosocial conditions, controlling visual screen exposure, regulating school schedules, improving sleep hygiene and daytime behaviors, and changing parents' sleep habits.     

Habitual sleep variability,not sleep duration,is associated with caloric intake in adolescents

ObjectiveThe objective of this study was to investigate the associations between objectively measured habitual sleep duration (HSD), habitual sleep variability (HSV), and energy and snack intake in adolescents.MethodsWe used data from 324 adolescents who participated in the Penn State Child Cohort follow-up examination. Actigraphy was used over seven consecutive nights to estimate nightly sleep duration. The seven-night mean and standard deviation of sleep duration were used to represent HSD and HSV, respectively. The Youth/Adolescent Food Frequency Questionnaire was used to obtain the daily average total energy, protein, fat, and carbohydrate intake, and number of snacks consumed. Linear regression models were used to investigate the associations between habitual sleep patterns and caloric, protein, fat, and carbohydrate intake. Proportional odds models were used to associate habitual sleep patterns with snack consumption.ResultsAfter adjusting for age, sex, race, body mass index (BMI) percentile, and smoking status, an increased HSV was associated with a higher energy intake, particularly from fat and carbohydrate. For example, with a 1-h increase in HSV, there was a 170 (66)-kcal increase in the daily total energy intake. An increased HSV was also related to increased snack consumption, especially snacks consumed after dinner. For instance, a 1-h increase in HSV was associated with 65% and 94% higher odds of consuming more snacks after dinner during school/workdays and weekends/vacation days, respectively. Neither energy intake nor snack consumption was significantly related to HSD.ConclusionHigh habitual sleep variability, not habitual sleep duration, is related to increased energy and food consumption in adolescents. Maintaining a regular sleep pattern may decrease the risk of obesity in adolescents.     

Reciprocal dynamics between self-rated sleep and symptoms of depression and anxiety in young adult women: a 14-day diary study

ObjectivesThe objective of this study was to characterize the day-to-day associations among sleep disturbance, depression, and anxiety in a sample of young adult women.MethodsOne hundred and seventy-one women (20.1 ± 3.3 years) completed in-laboratory baseline assessment followed by daily online surveys across a two-week period. Daily measures included the Mood and Anxiety Symptom Questionnaire-Short Form to assess shared and disorder-specific symptoms of depression and anxiety (general distress, anhedonic depression, and anxious arousal), as well as self-reported total sleep time (TST), sleep-onset latency (SOL), and sleep quality (SQ).ResultsFindings supported bidirectional day-to-day relationships between sleep and affective symptoms. When women felt greater general distress (shared features of anxiety and depression), they experienced longer SOL and worse SQ at night. Specificity among depression, anxiety, and sleep disturbance was observed such that higher levels of depression-specific anhedonia presaged longer SOL, shorter TST, and poorer SQ. In the other direction, when women had poor-quality sleep, they later experienced greater anhedonic depression and anxious arousal. The influence of TST on anhedonia was complex such that a single night of short sleep led to less anhedonic depression the next day, whereas women who obtained shorter sleep across the two-week period reported greater anhedonia.ConclusionsReciprocal dynamics between nightly sleep disturbance and daily experiences of depression and anxiety may serve as a process by which insomnia, depression, and anxiety develop into comorbid clinical states over time in women. The associations of anhedonic depression with nightly sleep disturbance and chronic short sleep were especially toxic, offering insight into daily mechanisms driving the most prevalent phenotype of comorbid insomnia.     

The effect of short or long sleep duration on quality of life and depression: an internet-based survey in Japan

BackgroundTo date, no previous studies have evaluated the relationship between sleep duration and quality of life (QOL) or depression in the general population after controlling for daytime sleepiness and sleep disturbances.MethodsA web-based cross-sectional survey was conducted with 8698 subjects aged 20–69 years. We examined the relationships between weekday sleep duration and daytime sleepiness, sleep disturbance, QOL and depression, using the Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index (without the item for sleep duration), 8-item Short Form and Center for Epidemiological Studies Depression Scale (CES-D).ResultsDaytime sleepiness tended to increase in proportion to shorter weekday sleep durations. Sleep disturbances, physical and mental QOL, and CES-D scores were worse in both the shorter and longer sleep groups compared with the group with 7–8 h of sleep. Hierarchical logistic regression analyses revealed that short sleep duration but not long sleep duration was significantly associated with reduction of both physical and mental QOL, even after controlling for the presence of daytime sleepiness and sleep disturbance. Both short and long sleep duration were independently and significantly correlated with depression after controlling for daytime sleepiness; however, there was no statistically significant association after adjusting for the effects of sleep disturbance.ConclusionsThe results suggested adverse effects of short sleep but not long sleep on both physical and mental QOL. In addition, the negative impact of specific types of sleep disturbance on depression may be greater than the impact of shortening of sleep duration.     

Investigating the relation among disturbed sleep due to social media use,school burnout,and academic performance

IntroductionPrevious studies have revealed the significant influence of electronic devices, especially social media use, on sleep difficulties among adolescents. In this study, disturbed sleep due to social media use (DSSM) was defined as reduced or troubled sleep caused by nighttime-specific behaviors such as waking to check updates, being notified by incoming messages, or postponed bedtime because of social media activities. Inadequate and disturbed sleep during youth interferes with daytime academic efficiency and may be associated with school burnout, which were examined in this study.MethodsUsing two data waves collected from questionnaires on school burnout and DSSM and school test scores of 2462 Taiwanese middle school students (52.5% males) from various school types with average ages of 13.9 (SD = 0.72) and 14.3 (SD = 0.66) at Time 1 and Time 2, we investigated the relationship between the variables across time.ResultsDSSM, academic performance, and school burnout were significantly correlated. Cross-lagged analyses to the group of adolescents with higher than the average DSSM scores revealed that burnout predicted lower academic achievements through DSSM as a mediator. Burnout did not have a direct effect on school performance but influenced the latter through disturbed sleep. Poor academic achievement in its turn showed a feedback effect on higher levels of burnout.ConclusionsThis research reveals a vicious cycle of burnout, disturbed sleep, and academic achievement. During adolescence, school burnout through DSSM increase can lead to a lower academic performance that may later cause even higher burnout.     

External validity of children's self-reported sleep functioning: associations with academic,social, and behavioral adjustment

ObjectiveSeveral child-report measures of sleep functioning have been developed but very few studies have examined the external validity of child self-reported sleep in relation to daytime functioning. This study examined child-reported sleep in relation to teacher-rated psychopathology symptoms and also tested the hypothesis that child-reported sleep would be associated with poorer child- and teacher-reported functioning after controlling for demographics and psychopathology symptoms that are known to be associated with adjustment.MethodsParticipants were 175 children (81 boys, 94 girls) in 1st–6th grades (ages 6–13) and their teachers. Children completed the Sleep Self-Report. Teachers completed a measure of attention-deficit/hyperactivity disorder (ADHD), oppositional/conduct, and anxiety/depression symptoms. Children and teachers completed multiple measures of academic, behavioral, and social/peer functioning.ResultsChild-reported sleep was significantly associated with teacher-rated inattentive and internalizing symptoms, even after controlling for child demographics, hyperactivity-impulsivity, and conduct problems. Multilevel modeling analyses further indicated that, after controlling for child demographics and psychopathology symptoms, child-reported sleep problems were significantly associated with poorer child- and teacher-reported academic, behavioral, and social functioning (including increased reactive aggression, peer rejection, loneliness, and lower friendship satisfaction and self-worth).ConclusionsFindings provide initial support for the external validity of children's self-reported sleep functioning. Results of this study suggest that it may be clinically useful to screen for sleep problems by assessing for children's own perceptions of their sleep. Future studies should include both child- and parent-reported sleep functioning to further examine the utility of children's ratings of sleep functioning.     

Trying to fall asleep while catastrophising: what sleep-disordered adolescents think and feel

ObjectiveCatastrophising is a repetitive cognitive process related to sleep disturbance in adult insomnia patients. More recently catastrophising has been associated with increased sleep disturbances in community samples of children and adolescents, with this association mediated by anxiety and depression. However, there currently is no evidence of these processes outside of community samples; impeding our ability to draw clinical conclusions. Knowledge on such dysfunctional cognitive processes in adolescents experiencing sleep disturbance would be clinically beneficial in aetiology and intervention. Our research examined the link between catastrophising, anxiety, depression and sleep latency in a sample of sleep-disordered adolescents. We also explored specific catastrophising themes which may impact the sleep latency of these adolescents.MethodForty adolescents (age = 15.1 ± 1.5 years, 53% boys) diagnosed with delayed sleep phase disorder completed a 7-day sleep diary, along with measures of anxiety and depression and a catastrophising interview with a trained sleep therapist.ResultsSeveral catastrophisation themes were generated, the most common concerning interpersonal and performance aspects of school. Bootstrapping analyses showed depression did not mediate the relationship between catastrophising and sleep; however, an indirect relationship was found between catastrophising, anticipatory anxiety, and sleep latency.ConclusionThese findings have implications for the role of dysfunctional thinking in prolonging sleep onset for adolescents and providing a clinical framework for health professionals when assessing and treating adolescents with delayed sleep timing.     

The interaction between sleep disturbances and anxiety sensitivity in relation to adolescent anger responses to parent adolescent conflict

IntroductionSleep disturbances are common among adolescents and are associated with elevated anxiety, and difficulties managing affect. Familial conflict is associated with both anxiety sensitivity and adolescent sleep disturbances. No work to date has examined how adolescent sleep disturbances may interact with anxiety sensitivity in relation to adolescent affective responding to parent-adolescent conflict. The current study was designed to address this gap in the literature by examining how adolescent sleep disturbances, anxiety sensitivity, conflict elicited anger, and conflict avoidance are associated.MethodSeventy-two American adolescents (n = 39 males) between the ages of 12 and 16 years (M_age = 13.84, SD = 1.38) completed a baseline assessment as well as a well-validated mother-adolescent laboratory-based conflict task.ResultsFor youth low in anxiety sensitivity, greater sleep disturbance related positively to conflict-elicited anger, which in turn predicted higher conflict avoidance. In contrast, this indirect effect was not significant for adolescents relatively higher in anxiety sensitivity. Instead, for these adolescents, increased sleep disturbances were associated with lower levels of conflict elicited anger.ConclusionsResults suggest that the effects of sleep disturbances on conflict elicited anger may vary as a function of adolescent anxiety vulnerability. These findings highlight the importance of considering the unique effects of sleep disturbances on adolescent affect as a function of adolescent anxiety vulnerability.     

Both habitual short sleepers and long sleepers are at greater risk of obesity: a population-based 10-year follow-up in women

Objective

 To assess how change in sleep duration is related to subsequent obesity.

Methods

 In this 10-year follow-up, 4903 non-pregnant participants answered a questionnaire on sleeping habits, obesity, and lifestyle factors (questions identical to baseline questionnaire). Habitual normal sleepers were defined as sleeping 6–9 h/night at both baseline and follow-up, whereas women sleeping <6 h/night or ≥9 h/night at both occasions were defined as habitual short sleepers and habitual long sleepers, respectively. Logistic regression was used to analyze associations between changes in sleep duration, general obesity (body mass index ≥30 kg/m²), weight gain (≥10 kg) and also, central obesity (waist circumference ≥88 cm), and increase in waist circumference (≥10 cm) at follow-up.

Results

 Among younger women (aged <40 years) both habitual short sleepers and habitual long sleepers had a higher prevalence of general (short: 31.3%, P < 0.0001; long: 38.1%, P = 0.01) and central obesity (short: 60.5%, P = 0.01; long: 82.4%, P = 0.01) compared with habitual normal sleepers (general obesity: 8.9%; central obesity: 35.9%) at follow-up. Younger women who were short sleepers at baseline but normal sleepers at the follow-up had a higher prevalence of both general (19.3%, P = 0.01) and central obesity (45.4%, P = 0.07) compared with habitual normal sleepers at follow-up. In adjusted analyses, both habitual short [adjusted odds ratio (aOR), 6.78; 95% confidence interval (CI), 2.71–17.0] and long (aOR, 4.64; 95% CI, 1.09–19.8) sleep durations were risk factors for general obesity in younger women. In younger women habitual long sleep duration was a risk factor also for central obesity (aOR, 6.05; 95% CI, 1.19–30.7) whereas habitual short sleep duration was not (aOR, 1.93; 95% CI, 0.87–4.81). Similar results were seen also for weight gain and increased waist circumference as dependent variables. In addition, decreased sleep duration from normal to short duration was a risk factor for both weight gain (aOR, 1.85; 95% CI, 1.14–3.02) and increased waist circumference (aOR, 1.84; 95% CI, 1.20–2.81). There were no associations between changes in sleep duration and any of the measures of obesity at the follow-up in women aged >40 years at baseline.

Conclusion

 In younger women, both habitual short and long sleep duration was a risk factor for obesity, whereas no such relationship was seen in older women.