Associations Between Daily Affect and Sleep Vary by Sleep Assessment Type: What Can Ambulatory EEG Add to the Picture?

Objective/Background Disrupted sleep can be a cause and a consequence of affective experiences. However, daily longitudinal studies show sleep assessed via sleep diaries is more consistently associated with positive and negative affect than sleep assessed via actigraphy. The objective of the study was to test whether sleep parameters derived from ambulatory electroencephalography (EEG) in a naturalistic setting were associated with day-to-day changes in affect. Participants/Method Eighty adults (mean age = 32.65 years, 63% female) completed 7 days of affect and sleep assessments. We examined bidirectional associations between morning positive affect and negative affect with sleep assessed via diary, actigraphy, and ambulatory EEG. Results Mornings with lower positive affect than average were associated with higher diary- and actigraphy-determined sleep efficiency that night. Mornings with higher negative affect than average were associated with longer actigraphy-determined total sleep time that night. Nights with longer diary-determined total sleep time, greater sleep efficiency, and shorter sleep onset latency than average were associated with higher next-morning positive affect, and nights with lower diary-determined wake-after-sleep-onset were associated with lower next-morning negative affect. EEG-determined sleep and affect results were generally null in both directions: only higher morning negative affect was associated with longer rapid eye movement (REM) sleep that night. Conclusions Self-reported sleep and affect may occur in a bidirectional fashion for some sleep parameters. EEG-determined sleep and affect associations were inconsistent but may still be important to assess in future studies to holistically capture sleep. Single-channel EEG represents a novel, ecologically valid tool that may provide information beyond diaries and actigraphy

The effect of acute stress on salivary markers of inflammation: a systematic review protocol

Abstract Background There is an increasing interest in the ability to non-invasively assess biological markers of stress. Measures of inflammation following exposure to acute stress have been assessed in saliva, but a systematic review and meta-analysis of the reliability of changes in response to stress has not been conducted. The proposed review aims to update and extend a prior review of this literature by performing a systematic review and meta-analysis, conducting moderator analyses, summarizing and reviewing best practices, and providing recommendations for future research. Methods and analysis The adopted search strategy will involve the electronic databases PubMed, PsycINFO, and Embase. We will include the articles identified by a 2015 narrative review on a similar topic, as well as use reference treeing to identify additional potentially relevant articles. Identified articles will be independently screened by title and abstract. The full text of potentially relevant articles will then be retrieved and read for full inclusion criteria. Data will be extracted, and random-effects meta-analyses will be conducted in R for articles determined to meet all inclusion criteria. The primary outcome will be the magnitude of changes in inflammatory biomarkers following acute stress exposure, as indicated by Cohen’s d. Participant psychosocial or demographic (e.g., age, gender/sex, race/ethnicity, salivary flow rate, oral health status, health status) and methodological (e.g., stressor type, sample timing, assay technique, sample collection method, study quality) moderators of this response also will be examined using meta-regression. Discussion This systematic review will synthesize the evidence regarding salivary markers of inflammation in response to acute stress. We anticipate variation across studies but hypothesize that salivary markers of inflammation will increase in response to acute stress. The evidence obtained for this study will help guide future research by providing guidelines for the design and measurement of studies assessing salivary inflammation in response to acute stress. Findings will be disseminated with a peer-reviewed manuscript and an international conference presentation

Validity of two retrospective questionnaire versions of the Consensus Sleep Diary: the whole week and split week Self-Assessment of Sleep Surveys

Objective/Background: Prospective, daily sleep diaries are the gold standard for assessing subjective sleep but are not always feasible for cross-sectional or epidemiological studies. The current study examined psychometric properties of two retrospective questionnaire versions of the Consensus Sleep Diary. Participants/Methods: College students (N = 131, mean age = 19.39 +/- 1.65; 73% female) completed seven days of prospective sleep diaries then were randomly assigned to complete either the Self-Assessment of Sleep Survey (SASS), which assessed past week sleep (n = 70), or the SASS-Split (SASS-Y), which assessed weekday/weekend sleep separately (n = 61). Participants also completed psychosocial/sleep questionnaires including the Pittsburgh Sleep Quality Index (PSQI). Sleep parameters derived from SASS, SASS-Y, PSQI, and sleep diaries were assessed via Bland Altman plots, limits of agreement, mean differences, and correlations. Results: SASS-Y demonstrated stronger correlations with prospective sleep diaries and slightly less biased estimates (r = 0.51 to 0.85, alpha = -0.43 to 1.70) compared to SASS (r = 0.29 to 0.84, alpha = -1.63 to 2.33) for terminal wakefulness (TWAK), sleep onset latency (SOL), sleep efficiency (SE), and quality (QUAL). SASS resulted in slightly less bias for total sleep time (TST) and wake after sleep onset (WASO) (alpha = -0.65 and 0.93, respectively) compared to SASS-Y (alpha = 14.90 and 1.05, respectively). SASS and SASS-Y demonstrated greater convergence with sleep diary than PSQI. Conclusions: Results demonstrated good psychometric properties for the SASS and SASS-Y. When prospective sleep diaries are not feasible, the SASS and SASS-Y are acceptable substitutes to retrospectively estimate sleep parameters. Retrospective estimation of sleep parameters separately for weekdays/weekends may offer advantages compared to whole week estimation. (C) 2019 Published by Elsevier B.V.12 month embargo; published online: 12 June 2019This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Depressive Symptoms and Momentary Mood Predict Momentary Pain Among Rheumatoid Arthritis Patients.

BackgroundAlthough a relationship between mood and pain has been established cross-sectionally, little research has examined this relationship using momentary within-person data.PurposeWe examined whether baseline depressive symptoms and within-person levels of negative and positive mood predicted momentary pain among 31 individuals with rheumatoid arthritis (RA).MethodsDepressive symptomatology was measured at baseline. Mood and RA symptoms were self-reported via ecological momentary assessment five times a day for seven consecutive days. Analyses controlled for gender, age, weekend day, time of day, and experiences of stress.ResultsGreater momentary positive mood was associated with less momentary pain and fewer arthritis-related restrictions; negative mood was associated with more restrictions. Greater depressive symptomatology also predicted more pain and restrictions, an effect which was not accounted for by mood.ConclusionsResults suggest that both depression and mood are uniquely associated with momentary pain; as such, multi-component interventions may provide optimal disease management

Intraindividual variability in sleep and perceived stress in young adults

Objectives: Research suggests strong associations between habitual sleep parameters (eg, mean duration, timing, efficiency), perceived stress, and insomnia symptoms. The associations between intraindividual variability (IIV; night-to-night within-person variation) in sleep, perceived stress, and insomnia have not been explored. This study examined associations between IIV in subjectively and objectively determined sleep parameters and to perceived stress in young adults with and without insomnia. Design: Prospective longitudinal. Setting and participants: Participants were 149 college students (mean age = 20.2 [SD = 2.4], 59% female) either with insomnia (n = 81; 54%) or without insomnia (n = 68; 46%). Measurements: Participants completed 1 week of daily sleep diaries and actigraphy (to assess total sleep time [M], sleep efficiency [SE], and circadian midpoint [CM]), the Perceived Stress Scale, and a diagnostic interview for determination of insomnia as part of a parent study. Results: Greater IN in actigraphy-determined TST (but not SE or CM) was independently associated with greater perceived stress, regardless of insomnia status. Greater IIV in sleep diary-determined TST, SE, or CM was not associated with perceived stress. Insomnia status was the most robust predictor of elevated perceived stress. There was a significant interaction between IIV in sleep diary-determined TST and insomnia status on perceived stress: Only in those without insomnia was greater IIV in sleep diary-determined TST associated with higher perceived stress. Conclusion: Maintaining a more consistent sleep duration may be associated with lower stress in college students. Future research is needed to clarify the directionality and implications of this association for treatment.12 month embargo; available online: 28 September 2019This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Depressive Symptoms and Momentary Mood Predict Momentary Pain Among Rheumatoid Arthritis Patients.

BackgroundAlthough a relationship between mood and pain has been established cross-sectionally, little research has examined this relationship using momentary within-person data.PurposeWe examined whether baseline depressive symptoms and within-person levels of negative and positive mood predicted momentary pain among 31 individuals with rheumatoid arthritis (RA).MethodsDepressive symptomatology was measured at baseline. Mood and RA symptoms were self-reported via ecological momentary assessment five times a day for seven consecutive days. Analyses controlled for gender, age, weekend day, time of day, and experiences of stress.ResultsGreater momentary positive mood was associated with less momentary pain and fewer arthritis-related restrictions; negative mood was associated with more restrictions. Greater depressive symptomatology also predicted more pain and restrictions, an effect which was not accounted for by mood.ConclusionsResults suggest that both depression and mood are uniquely associated with momentary pain; as such, multi-component interventions may provide optimal disease management

Moderating effects of sleep difficulties on relations between posttraumatic stress disorder symptoms and positive memory count

Objectives: Posttraumatic stress disorder (PTSD) severity relates to positive memory retrieval difficulties. One variable potentially influencing this relation is sleep difficulties. We examined moderating effects of sleep difficulties (duration and quality) on relations between PTSD severity and count of specific positive memories covarying for age, gender, and depression. Methods: Participants were an Amazon Mechanical Turk-recruited trauma-exposed community sample of 205 respondents (Mage = 35.44; 61.40% women). Results: Moderated regression analyses indicated significant interaction effects between sleep quality (b = 0.03; p = 0.036) and PTSD severity on specific positive memory count. Among individuals reporting better sleep quality, there were negative associations between PTSD severity and specific positive memory count (b = −0.04, SE = 0.02, p = 0.010). Similar results were obtained for PTSD\u27s intrusion and arousal clusters. Conclusion: Results support targeting sleep quality and PTSD severity to improve positive memory retrieval in PTSD and memory interventions, and the importance of considering sleep when examining links between PTSD and positive memory retrieval

Associations between daily affect and sleep vary by sleep assessment type: What can ambulatory EEG add to the picture?

Objective/backgroundDisrupted sleep can be a cause and a consequence of affective experiences. However, daily longitudinal studies show sleep assessed via sleep diaries is more consistently associated with positive and negative affect than sleep assessed via actigraphy. The objective of the study was to test whether sleep parameters derived from ambulatory electroencephalography (EEG) in a naturalistic setting were associated with day-to-day changes in affect.Participants/methodEighty adults (mean age = 32.65 years, 63% female) completed 7 days of affect and sleep assessments. We examined bidirectional associations between morning positive affect and negative affect with sleep assessed via diary, actigraphy, and ambulatory EEG.ResultsMornings with lower positive affect than average were associated with higher diary- and actigraphy-determined sleep efficiency that night. Mornings with higher negative affect than average were associated with longer actigraphy-determined total sleep time that night. Nights with longer diary-determined total sleep time, greater sleep efficiency, and shorter sleep onset latency than average were associated with higher next-morning positive affect, and nights with lower diary-determined wake-after-sleep-onset were associated with lower next-morning negative affect. EEG-determined sleep and affect results were generally null in both directions: only higher morning negative affect was associated with longer rapid eye movement (REM) sleep that night.ConclusionsSelf-reported sleep and affect may occur in a bidirectional fashion for some sleep parameters. EEG-determined sleep and affect associations were inconsistent but may still be important to assess in future studies to holistically capture sleep. Single-channel EEG represents a novel, ecologically valid tool that may provide information beyond diaries and actigraphy

Intraindividual Variability in Sleep and Levels of Systemic Inflammation in Nurses

Objective: Disturbed sleep is common among nurses and is associated with morbidity and mortality. Inflammation may be one mechanism linking sleep and disease. Yet most studies have relied on retrospective questionnaires to assess sleep, which fail to account for night-to-night fluctuations in sleep across time (i.e., intraindividual variability (IIV]). We examined prospective associations between mean and IIV in sleep with inflammation markers in nurses. Methods: Participants were 392 nurses (Mage = 39.54, 92% female; 23% night-shift working) who completed 7 days of sleep diaries and actigraphy to assess mean and IIV in total sleep time (TST) and sleep efficiency (SE). Blood was drawn on day 7 to assess inflammation markers C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and interleukin-1 beta (IL-1β). Results: Greater intraindividual variability in TST — measured via both actigraphy and sleep diary — was associated with higher IL-6 (actigraphy β = 0.05, p = .046, sr2 = .01; diary β = 0.04, p = .030, sr2 = .01) and IL-1β (actigraphy β = 0.12, p = .008, sr2 = .02; diary β = 0.09, p = .025, sr2 = .01), but not CRP or TNF-α. IIV in actigraphy- and sleep diary-determined SE was not associated with inflammation biomarkers, nor were any mean sleep variables. Shift work did not moderate any associations. Conclusions: Nurses with more variable sleep durations had elevated levels of inflammation, which may increase risk for development of inflammatory-related diseases. Research should investigate how sleep regularization may change levels of inflammation and improve health.12 month embargo; published 16 July 2020This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Intraindividual Variability in Sleep and Levels of Systemic Inflammation in Nurses

OBJECTIVE: Disturbed sleep is common among nurses and is associated with morbidity and mortality. Inflammation may be one mechanism linking sleep and disease. Yet most studies have relied on retrospective questionnaires to assess sleep, which fail to account for night-to-night fluctuations in sleep across time (i.e., intraindividual variability (IIV]). We examined prospective associations between mean and IIV in sleep with inflammation markers in nurses. METHODS: Participants were 392 nurses (M(age) = 39.54, 92% female; 23% night-shift working) who completed 7 days of sleep diaries and actigraphy to assess mean and IIV in total sleep time (TST) and sleep efficiency (SE). Blood was drawn on day 7 to assess inflammation markers C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and interleukin-1 beta (IL-1β). RESULTS: Greater intraindividual variability in TST — measured via both actigraphy and sleep diary — was associated with higher IL-6 (actigraphy β = 0.05, p = .046, sr(2) = .01; diary β = 0.04, p = .030, sr(2) = .01) and IL-1β (actigraphy β = 0.12, p = .008, sr(2) = .02; diary β = 0.09, p = .025, sr(2) = .01), but not CRP or TNF-α. IIV in actigraphy- and sleep diary-determined SE was not associated with inflammation biomarkers, nor were any mean sleep variables. Shift work did not moderate any associations. CONCLUSIONS: Nurses with more variable sleep durations had elevated levels of inflammation, which may increase risk for development of inflammatory-related diseases. Research should investigate how sleep regularization may change levels of inflammation and improve health