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  • 1
    Online Resource
    Online Resource
    Abstract MP70: Habitual Sleep Variability, Mediated by Energy Intake, is Associated with Abdominal Obesity in Adolescents
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Circulation Vol. 131, No. suppl_1 ( 2015-03-10)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 131, No. suppl_1 ( 2015-03-10)
    Abstract: Introduction: Although self-reported sleep duration has been associated with obesity, study of the association between objectively-measured habitual sleep pattern and the more metabolically relevant abdominal obesity, and the mediation factors for such an association, is limited. Hypothesis: We assessed the hypothesis that objectively-measured variability, mediated by excessive energy intake, is associated with abdominal obesity in adolescents. Methods: We used data from 421 adolescents in the Penn State Child Cohort follow-up examination. Actigraphy was used for 7 consecutive nights to calculate each participant’s mean sleep duration as habitual sleep duration (HSD) and the standard deviation of the mean as habitual sleep variability (HSV). Abdominal obesity was assessed by dual-energy x-ray absorptiometry as Android/Gynoid Fat Ratio and visceral fat area . Youth/Adolescents Food Frequency Questionnaire was used to obtain daily caloric, fat, carbohydrate, and protein intakes one year prior to the study. The R-based Mediation Effect Models were used to assess the association between sleep pattern and abdominal obesity, and quantitatively estimate the mediation effects of caloric intake and of other factors not analyzed in this report. Results: As shown in the table, after controlling for major confounders and BMI percentile, HSV was significantly and consistently associated with both abdominal obesity measures. The Mediation analysis consistently indicated a significant mediation effect of caloric intake, especially carbohydrate intake. For example, 20% of the association between HSV and visceral fat could be attributed to carbohydrate intake, while 80% by other factors not analyzed. HSD was not associated with abdominal obesity. Conclusions: Higher HSV, not HSD, is associated with abdominal obesity, which can be partially explained by increased caloric intake, especially from carbohydrate, in adolescents. More studies are needed to identify other mediation factors in the association.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.131.suppl_1.mp70
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
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  • 2
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    0219 Interplay of School Days and Free Days with Sleep Midpoint on the Association of Visceral Adiposity with Blood Pressure in Adolescents
    Oxford University Press (OUP) ; 2022
    In:  Sleep Vol. 45, No. Supplement_1 ( 2022-05-25), p. A99-A100
    Details
    In: Sleep, Oxford University Press (OUP), Vol. 45, No. Supplement_1 ( 2022-05-25), p. A99-A100
    Abstract: The circadian timing of sleep, including its variability, has emerged as an important contributor to obesity and cardiovascular health, such as elevated blood pressure. Adolescence is a particularly vulnerable period for circadian misalignment, which may express differently if youth are in school or on free-days. We examined whether deviations in sleep midpoint increase the impact of visceral adiposity on elevated blood pressure in adolescents as a function of being entrained to school or not. Methods We analyzed cross-sectional data from the Penn State Child Cohort follow-up study, a random population-based sample of 303 adolescents (16.2 ± 2.2 y; 47.5% female; 21.5% minority). Actigraphy-measured sleep midpoint was calculated as the midpoint (zeroed to midnight) of the sleep period for weekdays (5-nights) and weekends (2-nights). Actigraphy-measured sleep regularity was calculated as the intra-individual standard deviation of the 5-night weekdays sleep midpoint. Visceral adipose tissue (VAT) was measured via dual-energy X-ray absorptiometry scan. Systolic (SBP) and diastolic (DBP) blood pressure was measured three times in the seated position. Multivariable linear regression models were stratified by “in school” and “on break” to test sleep midpoint and sleep regularity as effect modifiers of VAT on SBP/DBP levels. Analyses were adjusted for sex, race/ethnicity, age, actigraphy-measured sleep duration and polysomnography-measured apnea/hypopnea index. Results When participants were studied while “in school”, significant interactions were found between VAT and weekdays sleep midpoint on SBP (p-interaction=0.027) and DBP (p-interaction=0.046), so that the later the sleep midpoint on school days, the greater the association of VAT with SBP/DBP. When participants were studied while “on break”, a significant interaction was found between VAT and weekdays sleep regularity on SBP (p-interaction=0.039), so that the higher the sleep irregularity on weekdays, the greater the association of VAT with SBP. No other significant interactions were found. Conclusion A delayed and an irregular sleep midpoint during school days and during breaks, respectively, best identified those adolescents with greater cardiovascular risk associated with visceral obesity. These data suggest that not only the circadian timing of sleep contributes to adverse cardiovascular outcomes but its distinct biomarkers require measurement under different entrainment conditions in adolescents. Support (If Any) National Institutes of Health (R01HL136587, UL1TR000127)
    Type of Medium: Online Resource
    ISSN: 0161-8105 , 1550-9109
    URL: Article
    DOI: 10.1093/sleep/zsac079.217
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
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  • 3
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    0759 Multidimensional Sleep Health is Associated with Emotional Well-being in Adolescents
    Oxford University Press (OUP) ; 2023
    In:  SLEEP Vol. 46, No. Supplement_1 ( 2023-05-29), p. A335-A335
    Details
    In: SLEEP, Oxford University Press (OUP), Vol. 46, No. Supplement_1 ( 2023-05-29), p. A335-A335
    Abstract: Multidimensional sleep health (MSH) is a population-based approach to capture the 24-hour experience of sleep by incorporating measures of nighttime sleep and daytime functioning that promote physical and mental well-being. We have updated the existing adolescent MSH model to incorporate objective and subjective sleep measures and, in the present study, examined its utility in identifying associations between MSH and behavioral and emotional well-being. Methods We studied 377 adolescents (16.4 ± 2.3 yr; 46.4% female; 21.5% racial/ethnic minority) from the Penn State Child Cohort, a randomly-selected population-based sample. Using the RU-SATED framework – regularity, satisfaction, alertness, timing, efficiency, and duration – we derived an MSH composite score based on actigraphy-measured and self-reported sleep data. We examined the associations between MSH and scores on both the adolescent version of the Child Behavior Checklist (CBCL) and on the Pediatric Behavior Scale (PBS). CBCL’s internalizing, externalizing, thought and attention problems scores were self-reported, while similar behavioral and emotional cluster scores on the PBS were parent-reported. Results Higher MSH scores were associated with lower thought (r=-0.21, p & lt; 0.001), externalizing (r=-0.18, p & lt; 0.001), attention (r=-0.16, p & lt; 0.01) or internalizing (r=-0.12, p & lt; 0.05) problems. Higher MSH scores were associated with lower scores on the rule-breaking (r=-0.27, p & lt; 0.001) and aggressive (r=-0.21, p & lt; 0.001) externalizing subscales. For the internalizing subscales, higher MSH scores were associated with lower anxious-depressed (r = -0.17, p & lt; 0.01), withdrawn-depressed (r=-0.14, p & lt; 0.01), and somatic complaints (r=-0.12, p & lt; 0.05) scores. Analyses based on parent reports on the more fine-grained PBS cluster scores replicated CBCL’s associations; for example, higher MSH scores were associated with lower depression (r=-0.19, p & lt; 0.01) and inattention (r=-0.12, p & lt; 0.05) as observed by parents. Conclusion Optimal sleep health, when considered as a multidimensional construct, is associated with emotional well-being and better behavioral outcomes in adolescents. Our MSH model, derived from objective and subjective sleep metrics, is able to capture similar trends from self-report and parent-report measures of emotion and behavior. Support (if any) National Institutes of Health (R01HL136587, UL1TR000127)
    Type of Medium: Online Resource
    ISSN: 0161-8105 , 1550-9109
    URL: Article
    DOI: 10.1093/sleep/zsad077.0759
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
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  • 4
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    0769 Multidimensional Sleep Health in Adolescents from the General Population: Definition, Thresholds and Construct Validity
    Oxford University Press (OUP) ; 2023
    In:  SLEEP Vol. 46, No. Supplement_1 ( 2023-05-29), p. A339-A340
    Details
    In: SLEEP, Oxford University Press (OUP), Vol. 46, No. Supplement_1 ( 2023-05-29), p. A339-A340
    Abstract: The RU-SATED model – regularity, satisfaction, alertness, timing, efficiency, and duration – captures the 24-hour experience of sleep to asses multidimensional sleep health (MSH). However, most prior evidence comes from middle-aged adults. We provide updated MSH data in adolescents by leveraging objective and self-reported sleep measures. Methods We studied 377 adolescents (16.4±2.3 yr; 46.4% female; 21.5% racial/ethnic minority) from the Penn State Child Cohort, a randomly-selected population-based sample. Each MSH domain was categorized as “good” or “poor” using cut-offs informed by prior studies and expert consensus. Good cut-offs, assigned a score of 1, that were derived from actigraphy-measured data included: the standard deviation of sleep midpoint ≤1-h (RU), mean of sleep midpoint 2:00-4:00 (T), mean value of sleep efficiency ≥85% (E), and mean total sleep time ≥7.5-h (D). Good cut-offs derived from self-reported rating scales included the absence of insomnia symptoms (S) or excessive daytime sleepiness (A). Values considered poor based on these cut-offs were assigned a score of 0. Scores were summed across all domains to obtain a composite score ranging from 0 to 6, with higher scores indicating better MSH. Morningness and Tanner staging were self-reported, while Sleep and Arousal clusters scores on the Pediatric Behavior Scale were parent-reported. Results The mean composite score was 3.03 ± 1.30 and domains A and D were most commonly rated as poor (64.5% and 65.3%, respectively). Younger age (r=-0.13, p & lt; 0.05) and identifying as non-Hispanic white (r=-0.14, p & lt; 0.01) were significantly associated with higher MSH scores, while sex (r=-0.04, p=0.40), Tanner staging (r=-0.06, p=0.29) or BMI percentile (r=-0.07, p=0.15) were not. Greater morningness (r=-0.29, p & lt; 0.01), less disturbed sleep (r=-0.28, p & lt; 0.01) and higher arousal (r=-0.21, p & lt; 0.01) scores were associated with higher MSH scores. Conclusion Our data-driven approach can be used to assess MSH in the adolescent population. Our definition captures previously identified health disparities in MSH in adults and shows optimal construct validity against self-reports of circadian preference and parent observations of adolescents’ degree of sleep disturbance and arousal. Improving sleep duration and daytime alertness appear to continue to be the most relevant domains impacting overall MSH in adolescents. Support (if any) NIH (R01HL136587,UL1TR000127)
    Type of Medium: Online Resource
    ISSN: 0161-8105 , 1550-9109
    URL: Article
    DOI: 10.1093/sleep/zsad077.0769
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
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  • 5
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    0140 Nightmares are Associated with Increased Suicidality in Young Adulthood: A Population-based Cohort Study
    Oxford University Press (OUP) ; 2023
    In:  SLEEP Vol. 46, No. Supplement_1 ( 2023-05-29), p. A63-A63
    Details
    In: SLEEP, Oxford University Press (OUP), Vol. 46, No. Supplement_1 ( 2023-05-29), p. A63-A63
    Abstract: Childhood nightmares have a second increase in incidence in young adulthood, which has been attributed to trauma and psychopathology. As suicide rates are high in young adults and have been associated with nightmares, more research is needed regarding this relationship in this age range. This study aimed to examine the association of nightmares, independent of sleep disturbances, insufficient sleep or trauma-history, with suicidality in young adulthood. Methods The Penn State Child Cohort is a random, population-based sample of 700 children (5-12 years at baseline) studied in the sleep laboratory who returned for follow-up visits during adolescence and young adulthood. For the current study, 258 young adults (25.1±2.7 years old, 53.9% female, 24.8% racial/ethnic minority) completed their follow-up visit 15.9±2.0 years later. Nightmares were ascertained by self-report. The presence of suicidality was ascertained from responses on items querying suicidal ideation and/or attempts via clinically-relevant sources (i.e., MINI structured interview, Child Behavior Checklist Adult Self-Report, and Depression Anxiety and Stress Scale). General linear and logistic regression models adjusted for important covariates. Results Subjects reporting nightmares (n=109) had a significantly higher rate of suicidality (29%) than those absent of nightmares (14%; p=0.002), after adjusting for sex, age, sleep disturbances, sleep duration and trauma history. This rate was even higher (46%) in those reporting moderate-to-severe nightmares (n=24; p & lt; 0.01). The odds of suicidality associated with nightmares were 2.3-fold (95%CI=1.1-4.7), after adjusting for sex, age, sleep disturbances, sleep duration and trauma history (p=0.023); a risk that increased to 6.1-fold (95%CI=2.0-18.6) in those reporting moderate-to-severe nightmares (p=0.001). Conclusion These findings further strengthen previous research that has established nightmares’ significant relationship to increased suicidality, even when controlling for other important risk factors such as sleep disturbances and trauma history. Furthermore, as these results come from a random, population-based sample, it also demonstrates the generalizability of the association between nightmares and suicide. As the search for effective prevention strategies for suicide continues, it will be important to assess for the presence and severity of nightmares in those who express suicidal ideation, especially given the treatable nature of nightmares. Support (if any) National Institutes of Health (R01HL136587, R01MH118308, UL1TR000127)
    Type of Medium: Online Resource
    ISSN: 0161-8105 , 1550-9109
    URL: Article
    DOI: 10.1093/sleep/zsad077.0140
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
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  • 6
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    Abstract MP56: Sleep Regularity Modifies The Association Of Visceral Adiposity With Elevated Blood Pressure In Adolescents
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Circulation Vol. 145, No. Suppl_1 ( 2022-03)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 145, No. Suppl_1 ( 2022-03)
    Abstract: Introduction: Although obesity, insufficient sleep and sleep apnea are known risk factors for elevated blood pressure, the circadian timing of sleep is also involved in metabolic and blood pressure regulation. As a result, sleep irregularity, which is highly prevalent in adolescents, may be a potential risk factor for obesity-related adverse cardiovascular outcomes. Hypothesis: We hypothesize that greater sleep irregularity increases the impact of visceral adiposity on elevated blood pressure in adolescents. Methods: We analyzed cross-sectional data from the Penn State Child Cohort follow-up study, a random population-based sample of 303 adolescents (16.2 ± 2.2 year old; 47.5% female; 21.5% racial/ethnic minority) who had complete at-home 7-night (at least 5) actigraphy (ACT) data and in-lab dual-energy X-ray absorptiometry (DEXA) scan and polysomnography (PSG) data. ACT-measured sleep duration and sleep midpoint were calculated as the intra-individual mean of the 7-night total sleep time and the midpoint (zeroed to midnight) of the sleep period, respectively. ACT-measured sleep regularity was calculated as the intra-individual standard deviation of the 7-night sleep midpoint. DEXA-measured visceral adipose tissue (VAT) was the primary predictor. Systolic (SBP) and diastolic (DBP) blood pressure, measured three times in the seated position, were the primary outcomes. Multivariable linear regression models tested sleep midpoint and sleep regularity as effect modifiers of VAT on SBP/DBP levels, while simultaneously adjusting for sex, race/ethnicity, age, ACT-measured sleep duration and PSG-measured apnea/hypopnea index. Results: Significant interactions were found between sleep regularity and VAT on SBP (p-interaction=0.009) and DBP (p-interaction=0.039), while not between mean sleep midpoint and VAT (p-interactions=0.210 and 0.883). These findings remained valid even after further adjusting for body mass index percentile (p-interactions=0.006 and 0.034). Among adolescents with high sleep irregularity (≥ 45 minutes; n=124), each standard deviation increase in VAT was associated with a 5.55 (0.91) and 3.07 (0.70) mmHg increase in SBP and DBP, respectively (both p 〈 0.001). Among those with low sleep irregularity ( 〈 45 minutes; n=179) VAT was not significantly associated with SBP [0.69 (0.99), p=0.488] or DBP [0.04 (0.77), p=0.956] . Conclusions: An irregular circadian timing of sleep may increase the impact of visceral adiposity on elevated blood pressure in adolescents. These data support that sleep irregularity, independent of sleep apnea and insufficient sleep, may contribute to the development of cardiovascular sequelae associated with central obesity.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.145.suppl_1.MP56
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
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  • 7
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    Abstract 039: Association Of A Cumulative Exposure To Sleep Disordered Breathing From Childhood Through Young Adulthood With Carotid Intima-media Thickness
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Circulation Vol. 145, No. Suppl_1 ( 2022-03)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 145, No. Suppl_1 ( 2022-03)
    Abstract: Introduction: Commensurate with studies in middle-aged adults, we have previously shown that a cumulative exposure to sleep disordered breathing (SDB) since childhood is associated, independent of obesity, with endothelial dysfunction in young adulthood. There is a lack of population-based studies that have examined the association of SDB with atherosclerosis using such a developmental approach. Hypothesis: Exposure to SDB since childhood is associated with long-term increased carotid intima-media thickness (CIMT) in young adulthood. Methods: We tested this hypothesis in a subsample of the Penn State Child Cohort, a population-based study of 700 children (median age 9y), of whom 421 were followed-up 7.4 years later during adolescence (median age 16y), and 204 have been followed-up 15.4 years later during young adulthood (median age 24y). Subjects (53% female, 23% racial/ethnic minority) underwent in-lab polysomnography to ascertain the apnea/hypopnea index (AHI) at all three time points, and ultrasound to assess CIMT in young adulthood. Based on the AHI truncated at ≥5 events/hour of sleep to include subjects already on positive airway pressure therapy, we averaged the exposure to AHI over the three time points (cAHI). The study outcome was total CIMT from right and left carotids as a continuous measure. Stepwise linear regression models first adjusted for sex, age, race/ethnicity, and length of follow-up and, thereafter, for body mass index (BMI). To test the robustness of the analysis, we applied the same linear models with the square root of CIMT (sqrt-CIMT) as the outcome. Results: The mean cAHI was 1.16 (standard deviation=0.99) ranging from 0 to 5 and the mean CIMT was 0.51 (0.07) ranging from 0.37 to 0.79. Although cAHI was positively associated with higher CIMT in young adulthood (β = 0.015; 95% CI = 0.005, 0.025; p = 0.003), the association was significantly diminished after further adjusting for BMI (β = 0.004; 95% CI = -0.004, 0.014; p = 0.424). The results were similar when using sqrt-CIMT (β = 0.010; 95% CI = 0.004, 0.017; p = 0.002 before BMI adjustment; β = 0.003; 95% CI = -0.004, 0.010; p = 0.415 after BMI adjustment). Conclusions: In contrast to endothelial dysfunction, the preliminary data of this ongoing longitudinal study indicates that obesity plays a key role in the association between SDB and atherosclerosis in young adulthood.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.145.suppl_1.039
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
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  • 8
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    327 Developmental Trajectories of Insomnia and Risk of Internalizing Disorders in Young Adulthood
    Oxford University Press (OUP) ; 2021
    In:  Sleep Vol. 44, No. Supplement_2 ( 2021-05-03), p. A131-A131
    Details
    In: Sleep, Oxford University Press (OUP), Vol. 44, No. Supplement_2 ( 2021-05-03), p. A131-A131
    Abstract: Internalizing disorders (ID) are the most common form of psychopathology and a large proportion of individuals experience their first onset after the age of 18. Childhood insomnia symptoms, i.e., difficulties initiating or maintaining sleep (DIMS), have been shown to be associated with ID. However, little is known about the developmental trajectories of insomnia symptoms and their associated risk of ID as the child transitions into adulthood. The present study examined the risk of ID in young adulthood associated with the longitudinal trajectories of insomnia symptoms across three developmental stages. Methods The Penn State Child Cohort is a population-based sample of 700 children (Mdn=9y), who were followed-up 8 years later as adolescents (N=421, Mdn=16y) and 15 years later as young adults (N=492, Mdn=24y). Insomnia symptoms were defined as parent-reported (childhood) or self-reported (adolescence and young adulthood) moderate-to-severe DIMS. The developmental trajectories of insomnia symptoms across the three time-points were identified as never, remitted, waxing-and-waning, persistent and incident. The presence of ID was defined as a self-report of a diagnosis or treatment for mood and/or anxiety disorders. Cox regression models were adjusted for sex, race/ethnicity, age and childhood/adolescent history of ID or psychoactive medication use. Results A persistent developmental trajectory was associated with a 2.8-fold increased risk of adult ID (HR=2.83, 95%CI=1.79–4.49) and an incident trajectory with a 1.9-fold risk (HR=1.88, 95%CI=1.10–3.20), while a waxing-and-waning trajectory was marginally associated with adult ID (HR=1.70, 95%CI=0.99–2.91). A remitting trajectory was not associated with an increased risk of adult ID (HR=0.92, 95%CI=0.38–2.24). Conclusion This 15-year longitudinal study with three developmental stages shows that childhood-onset insomnia symptoms that persist across the life-course are strong determinants of ID in young adulthood, independent of past diagnosis or medication use. In contrast, childhood insomnia symptoms that remit in the transition to adolescence do not confer increased risk of ID in young adulthood. Given that insomnia symptoms may precipitate and/or maintain ID, these data further reinforce the need for early sleep interventions to prevent mental health disorders. Support (if any) NIH Awards Number R01HL136587, R01MH118308, R01HL97165, R01HL63772, UL1TR000127
    Type of Medium: Online Resource
    ISSN: 0161-8105 , 1550-9109
    URL: Article
    DOI: 10.1093/sleep/zsab072.326
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
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  • 9
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    0114 Interplay of School and Free Days on the Association of Circadian Misalignment with Heart Rate Variability in Adolescents
    Oxford University Press (OUP) ; 2023
    In:  SLEEP Vol. 46, No. Supplement_1 ( 2023-05-29), p. A51-A51
    Details
    In: SLEEP, Oxford University Press (OUP), Vol. 46, No. Supplement_1 ( 2023-05-29), p. A51-A51
    Abstract: The circadian timing system, which governs the sleep-wake cycle, is involved in cardiometabolic and autonomic regulation. Heart rate variability (HRV), a marker of cardiac autonomic modulation (CAM), is known to predict cardiovascular morbidity. Therefore, circadian misalignment of the sleep-wake cycle, which is highly prevalent in adolescents and may express differently if youth are in school or free-days, is likely to impact CAM. We examined whether deviations in the circadian timing of sleep are associated with blunted HRV in adolescents as a function of being entrained to school or not. Methods We studied 337 population-based randomly-selected adolescents from the Penn State Child Cohort (median 16 years; 47% female; 21% racial/ethnic minority) who had at least 3-night at-home actigraphy (ACT), in-lab 9-h polysomnography (PSG) and 24-h Holter-monitoring heart rate variability (HRV) data. ACT-measured sleep midpoint (SM) was calculated as the midpoint of the sleep period for weekdays (5-nights) and weekends (2-nights), whereas ACT-measured sleep regularity (SR) was calculated as the intra-individual standard deviation of the SM across 5- and 7-nights. Frequency and time-domain HRV indices were primary outcomes. Linear regression models were stratified by “in school” and “on break” to test SM and SR as predictors of HRV indices while accounting for sex, race/ethnicity, age, BMI percentile, ACT-sleep duration, ACT-sleep variability, and PSG-apnea/hypopnea index. Results Lower SR on schooldays was associated with lower nighttime Log-HF, Log-LF and SDNN, yet higher HR (all p & lt; 0.01); e.g., each standard deviation increase in SR on schooldays (i.e., 45m higher) was associated with -7.15ms (2.57) in nighttime SDNN (p=0.006). A later SM on free weekends was associated with lower nighttime Log-HF, Log-LF, SDNN and RMSSD, yet higher HR and LF-HF ratio (all p & lt; 0.03); e.g., each standard deviation increase in SM on free weekends (i.e., 1.5h later) was associated with -7.33ms (2.85) in nighttime RMSSD (p=0.011). Conclusion A delayed and an irregular sleep midpoint during breaks and during schooldays, respectively, were associated with impaired CAM in adolescents. These data suggest that not only circadian misalignment contributes to adverse cardiovascular outcomes but its distinct metrics require measurement under different entrainment conditions in adolescents. Support (if any) NIH (R01HL136587,R01MH118308,UL1TR000127), American Heart Association (23PRE1011962).
    Type of Medium: Online Resource
    ISSN: 0161-8105 , 1550-9109
    URL: Article
    DOI: 10.1093/sleep/zsad077.0114
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
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  • 10
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    0363 Insomnia with Short Sleep Duration Is Associated with Increased Catecholamine Secretion in Young Adults
    Oxford University Press (OUP) ; 2024
    In:  SLEEP Vol. 47, No. Supplement_1 ( 2024-04-20), p. A156-A157
    Details
    In: SLEEP, Oxford University Press (OUP), Vol. 47, No. Supplement_1 ( 2024-04-20), p. A156-A157
    Abstract: Prior studies have shown insomnia to be associated with increased sympatho-adrenal-medullary (SAM) axis activity, as indexed by higher 24-hour urinary catecholamine secretion. These studies also showed that the activity of both axis of the stress system in those with insomnia is positively related to the degree of polysomnography (PSG)-measured sleep disturbance, ascertained by four consecutive nights. However, these pathophysiologic findings have not been replicated in population-based samples. Methods We studied 270 young adults (median 25y, 53% female, 24% racial/ethnic minority) from the Penn State Child Cohort who underwent a 9-hour PSG recording, clinical history, self-report scales and provided a urine sample upon awakening from the PSG to assay for 8-hour release of catecholamines (i.e., epinephrine, norepinephrine, and dopamine). Insomnia symptoms were defined as difficulties initiating or maintaining sleep, insomnia diagnosis or complaint, and/or sleep medication use. PSG-measured short sleep duration was defined by the median total sleep time of the sample (i.e., & lt; 7-h), and identified normal sleep duration (NSD), short sleep duration (SSD), insomnia with normal sleep duration (INSD) and insomnia with short sleep duration (ISSD). A multivariate general linear model tested mean differences in catecholamine levels across the four groups while adjusting for sex, race/ethnicity, age, waist circumference, sleep apnea, cardiometabolic disorders, medication and substance use. Results Compared to NSD (18.8±1.5) and INSD (20.9±1.1), ISSD showed significantly higher total epinephrine/norepinephrine levels (24.0±1.1; p=0.007 and p=0.046, respectively). This association was primarily driven by higher norepinephrine levels in ISSD (3.1±0.3) compared to NSD (2.2±0.5; p=0.018). Neither INSD (p=0.260) nor SSD (21.4±1.7; p=0.255) showed significantly elevated levels compared to NSD. There were no significant differences in dopamine levels across groups [e.g., NSD (238.1±10.8) vs. ISSD (241.6±7.6); p =0.809]. Conclusion ISSD, but not INSD, is associated with higher morning norepinephrine levels, suggesting hyperactivity of the SAM axis of the stress system and increased risk for cardiovascular and psychiatric disorders. Support (if any) NIH (R01HL136587, R01MH118308, UL1TR00127)
    Type of Medium: Online Resource
    ISSN: 0161-8105 , 1550-9109
    URL: Article
    DOI: 10.1093/sleep/zsae067.0363
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2024
    detail.hit.zdb_id: 2056761-3
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