Relations Between Toddler Sleep Characteristics, Sleep Problems, and Temperament

Two sources of information (parent reported sleep diaries and actigraph records) were used to investigate how toddler sleep characteristics (bed time/sleep onset, wake time/sleep offset, total nighttime sleep and total sleep time) are related to sleep problems and temperament. There were 64 toddler participants in the study. Consistent with studies of older children, parent reports differed from actigraph based records. The findings that parent reported and actigraph recorded sleep characteristics varied as a function of parent report of toddler sleep problems and temperament add needed information on toddler sleep. Such information may contribute to improving parents’ awareness of their child’s sleep characteristics and correlates of problem sleep

Psychophysiological assessment of stress under ecological settings: A systematic review

Stress can negatively impact one’s health and well-being, however despite the recent evolution in stress assessment research methodologies, little agreement still exist about stress conceptualization and assessment. In an attempt to summarize and reflect on this evolution this paper aimed to systematically review research evidence of ecological approaches on psycho-physiological stress assessment. Thus, a literature search of electronic databases was conducted spanning 22 years (1990 – 2012) and 55 studies were reviewed. Studies were considered for inclusion if they contemplated both psychological and physiological measures of stress under ecological settings. This review focused on five themes: methodologies terminology; research population; study design; measurement and technology. Findings support the need to use a common methodology terminology in order to increase scientific rigor. Additionally, there seems to be an increasing tendency for the use of these methods by multidisciplinary teams among both clinical and non-clinical populations aiming to understand the relationship between stress and disease. Most of the studies reviewed contemplated a time-based protocol and different conceptualizations of stress were found resulting in the use of different subjective measures. Findings reinforce the importance of combining subjective and objective measures while also controlling for possible time or situation dependent confounders. Advances in technology were evident and different assessment techniques were found. The benefits and challenges of ecological protocols to assess stress are discussed and recommendations for future research are provided, aiming to overcome previous limitations and advance scientific knowledge in the area

Ambulatory assessment for physical activity research. State of the science, best practices and future directions

Technological and digital progress benefits physical activity (PA) research. Here we compiled expert knowledge on how Ambulatory Assessment (AA) is utilized to advance PA research, i.e., we present results of the 2nd International CAPA Workshop 2019 "Physical Activity Assessment - State of the Science, Best Practices, Future Directions" where invited researchers with experience in PA assessment, evaluation, technology and application participated. First, we provide readers with the state of the AA science, then we give best practice recommendations on how to measure PA via AA and shed light on methodological frontiers, and we furthermore discuss future directions. AA encompasses a class of methods that allows the study of PA and its behavioral, biological and physiological correlates as they unfold in everyday life. AA includes monitoring of movement (e.g., via accelerometry), physiological function (e.g., via mobile electrocardiogram), contextual information (e.g., via geolocation-tracking), and ecological momentary assessment (EMA; e.g., electronic diaries) to capture self-reported information. The strengths of AA are data assessment that near real-time, which minimizes retrospective biases in real-world settings, consequentially enabling ecological valid findings. Importantly, AA enables multiple assessments across time within subjects resulting in intensive longitudinal data (ILD), which allows unraveling within-person determinants of PA in everyday life. In this paper, we show how AA methods such as triggered e-diaries and geolocation-tracking can be used to measure PA and its correlates, and furthermore how these findings may translate into real-life interventions. In sum, AA provides numerous possibilities for PA research, especially the opportunity to tackle within-subject antecedents, concomitants, and consequences of PA as they unfold in everyday life. In-depth insights on determinants of PA could help us design and deliver impactful interventions in real-world contexts, thus enabling us to solve critical health issues in the 21st century such as insufficient PA and high levels of sedentary behavior. (DIPF/Orig.

The Impact of Sleep Restriction (Nap Deprivation) On Preschool Children\u27s (Aged 3-5) Emotional Response

This study examined the effect of nap restriction on 3- to 5-year-old habitually napping children’s emotional responding. It was predicted that the intensity of emotional stimuli would moderate the relationship between nap restriction and the magnitude of emotional responding. Specifically, following nap restriction, the emotional responses to stronger stimuli would be amplified, while the emotional responses to weaker stimuli would be reduced. Emotional stimuli, were classified into four categories: strong negative, weak negative, weak positive, and strong positive. Facial electromyography was measured to reflect preschoolers’ emotional responses. The results indicated emotional responses to both strong negative and positive stimuli were amplified following nap deprivation. Planned analyses revealed no differences in emotional responses to weak stimuli with exploratory analyses suggesting actual amplification with nap deprivation. This study examined the effect of nap restriction on 3- to 5-year-old habitually napping children’s emotional responding. It was predicted that the intensity of emotional stimuli would moderate the relationship between nap restriction and the magnitude of emotional responding. Specifically, following nap restriction, the emotional responses to stronger stimuli would be amplified, while the emotional responses to weaker stimuli would be reduced. Emotional stimuli, were classified into four categories: strong negative, weak negative, weak positive, and strong positive. Facial electromyography was measured to reflect preschoolers’ emotional responses. The results indicated emotional responses to both strong negative and positive stimuli were amplified following nap deprivation. Planned analyses revealed no differences in emotional responses to weak stimuli with exploratory analyses suggesting actual amplification with nap deprivation

Objective Measurement of Sleep by Smartphone Application: Comparison with Actigraphy and Relation to Cognition, Mood, and Self-Reported Sleep

Over the past six decades, polysomnography, actigraphy, and most recently smartphone technology have created a trifecta of options for measuring sleep. It remains to be seen whether smartphone applications are comparable to actigraphy in objectively monitoring sleep. The present study had 29 healthy adult participants fill out a sleep diary and use the Sleep Time app (Azumio, Inc.) to monitor their sleep for one week. A subset of 19 participants also wore an actigraphy bracelet. Self-report questionnaires characterized sleep habits and psychological profiles of participants, while cognitive assessments were implemented to examine potential correlations between total sleep time (TST) and/or sleep efficiency and executive functioning. The smartphone app overestimated TST when compared to actigraphy, yielding a significant difference, t(18) = -6.64, p = .01, r2 = .71. Moreover, a statistical trend indicated that the app also overestimated sleep efficiency, t(18) = -2.06, p = .06, r2 = .12 There were no correlations between self-reported sleep quality and performance on cognitive tasks or total number of caffeinated beverages consumed in this sample. Overall, results show that this smartphone app is not accurate in monitoring TST or sleep efficiency when compared to actigraphy. Future research is needed to investigate the utility of smartphone applications in monitoring sleep in clinical populations and across other smartphone apps and phone models

The Relation Among Sleep, Routines, and Behavior in Children With an Autism Spectrum Disorder

Children with an ASD have a propensity for routines and reportedly have a greater incidence of sleep disturbance and externalizing behaviors than typical children. In addition, significant relations have been identified among routines, sleep behavior, and externalizing behavior in a community sample of children, suggesting that a lack of routines maybe related to sleep disturbance and externalizing behaviors. However, to date, no known studies have thoroughly examined the relation between these variables in children with an ASD. The primary purpose of the present investigation was to examine relations among routines, sleep, and behavior in children with an ASD. Primary caregivers of 58 children with an ASD and 57 non-ASD children ages 6 - 1 2 participated in the study (ASD M= 9.0, SD = 2.09; Non-ASD M= 8.25, SD = 1.98). Most participants were recruited and completed the surveys on-line. Several significant relations were found, including correlations between bedtime routines and general routines, sleep hygiene, and sleep quality; general routines and sleep hygiene; and all pairings of sleep hygiene, sleep quality, and externalizing behavior. Other predicted relations were not supported. Diagnostic status significantly moderated the relation between general routines and externalizing behavior, but not between bedtime routines and either sleep quality or externalizing behavior. These results support relations between the variables of interest and indicate a need for additional research to further clarify the exact nature of the relations. Further research may be most pertinent within children with ASD who experience less consistent routines and children with ASD who exhibit sleep disturbance. In addition, the observed relation between bedtime routines and sleep behavior indicates implementation of consistent bedtime routines may be an appropriate intervention strategy for children with an ASD who experience sleep disturbance

Measuring physical activity using accelerometry in 13-15-year-old adolescents : the importance of including non-wear activities

Objective: The present study aimed to examine the impact of non-wear activities registered in diaries when using accelerometers to assess physical activity (PA) in young adolescents. Design: Data arise from a large-scale cross-sectional study on PA. PA was objectively assessed using Actigraph (TM) accelerometers (Actigraph MTI, Manufacturing Technology Inc., Pensacola, FL, USA) during seven consecutive days. Non-wear time activity diaries were provided to register the activities for which the accelerometer was removed. After correction to deal with over-reporting, the registered minutes of PA were used to replace periods of non-wear time measured by the accelerometer. Setting: Between October 2008 and May 2009 adolescents were recruited by home visits in Ghent (Belgium). Subjects: Young adolescents (n 513; 48.6% boys) aged 13 to 15 years. Results: Of the total sample, 49.9% registered at least one activity of moderate to vigorous intensity in the non-wear time activity diary. More adolescents registered an activity performed on a weekday than on a weekend day and the registered mean number of minutes of moderate to vigorous PA were higher on weekend days. Repeated-measures (M) ANOVA tests revealed a significant difference between the mean minutes with and without non-wear activities for all PA intensities, regardless of adolescents' socio-economic status or gender. More adolescents achieved the PA recommendations after inclusion of the non-wear activities irrespective of accelerometer thresholds used. Conclusions: The collection of information regarding non-wear time by non-wear time activity diaries when using accelerometers in 13-15-year-old adolescents can lead to different PA outcomes at the individual level and therefore can improve the ability to accurately measure PA

Don't Miss the Moment:A Systematic Review of Ecological Momentary Assessment in Suicide Research

Suicide and suicide-related behaviors are prevalent yet notoriously difficult to predict. Specifically, short-term predictors and correlates of suicide risk remain largely unknown. Ecological momentary assessment (EMA) may be used to assess how suicidal thoughts and behaviors (STBs) unfold in real-world contexts. We conducted a systematic literature review of EMA studies in suicide research to assess (1) how EMA has been utilized in the study of STBs (i.e., methodology, findings), and (2) the feasibility, validity and safety of EMA in the study of STBs. We identified 45 articles, detailing 23 studies. Studies mainly focused on examining how known longitudinal predictors of suicidal ideation perform within shorter (hourly, daily) time frames. Recent studies have explored the prospects of digital phenotyping of individuals with suicidal ideation. The results indicate that suicidal ideation fluctuates substantially over time (hours, days), and that individuals with higher mean ideation also have more fluctuations. Higher suicidal ideation instability may represent a phenotypic indicator for increased suicide risk. Few studies succeeded in establishing prospective predictors of suicidal ideation beyond prior ideation itself. Some studies show negative affect, hopelessness and burdensomeness to predict increased ideation within-day, and sleep characteristics to impact next-day ideation. The feasibility of EMA is encouraging: agreement to participate in EMA research was moderate to high (median = 77%), and compliance rates similar to those in other clinical samples (median response rate = 70%). More individuals reported suicidal ideation through EMA than traditional (retrospective) self-report measures. Regarding safety, no evidence was found of systematic reactivity of mood or suicidal ideation to repeated assessments of STBs. In conclusion, suicidal ideation can fluctuate substantially over short periods of time, and EMA is a suitable method for capturing these fluctuations. Some specific predictors of subsequent ideation have been identified, but these findings warrant further replication. While repeated EMA assessments do not appear to result in systematic reactivity in STBs, participant burden and safety remains a consideration when studying high-risk populations. Considerations for designing and reporting on EMA studies in suicide research are discussed

Group‑delivered cognitive behavioural therapy versus waiting list in the treatment of insomnia in primary care: study protocol for a pragmatic, multicentre randomized controlled trial

Background Insomnia is common in the general population and is a risk factor for ill-health, which highlights the importance of treating insomnia effectively and cost-efficiently. Cognitive-behavioural therapy for insomnia (CBT-I) is recommended as first-line treatment due to its long-term effectiveness and few side-effects, but its availability is limited. The aim of this pragmatic, multicentre randomized controlled trial is to investigate the effectiveness of group-delivered CBT-I in primary care compared to a waiting-list control group. Methods A pragmatic multicentre randomized controlled trial will be conducted with about 300 participants recruited across 26 Healthy Life Centres in Norway. Participants will complete online screening and provide consent before enrolment. Those who meet the eligibility criteria will be randomized to a group-delivered CBT-I or to a waiting list according to a 2:1 ratio. The intervention consists of four two-hour sessions. Assessments will be performed at baseline, 4 weeks, 3- and 6 months post-intervention, respectively. The primary outcome is self-reported insomnia severity at 3 months post-intervention. Secondary outcomes include health-related quality of life, fatigue, mental distress, dysfunctional beliefs and attitudes about sleep, sleep reactivity, 7-day sleep diaries, and data obtained from national health registries (sick leave, use of relevant prescribed medications, healthcare utilization). Exploratory analyses will identify factors influencing treatment effectiveness, and we will conduct a mixed-method process evaluation to identify facilitators and barriers of participants’ treatment adherence. The study protocol was approved by the Regional Committee for Medical and Health Research ethics in Mid-Norway (ID 465241). Discussion This large-scale pragmatic trial will investigate the effectiveness of group-delivered cognitive behavioural therapy versus waiting list in the treatment of insomnia, generating findings that are generalizable to day-to-day treatment of insomnia in interdisciplinary primary care services. The trial will identify those who would benefit from the group-delivered therapy, and will investigate the rates of sick leave, medication use, and healthcare utilization among adults who undergo the group-delivered therapy.publishedVersio