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European Journal of Investigation in... Mar 2024Nocturnal smartphone use emits blue light, which can adversely affect sleep, leading to a variety of negative effects, particularly in children. Therefore, the present...
Nocturnal smartphone use emits blue light, which can adversely affect sleep, leading to a variety of negative effects, particularly in children. Therefore, the present study aimed to determine the effect of acute (AC) (one night) and repeated (RC) (five nights) nocturnal smartphone exposure on sleep, cortisol, and next-day performance in Tunisian children. Thirteen participants (seven girls and six boys, age 9 ± 0.6, height 1.32 ± 0.06, weight 34.47 ± 4.41) attended six experimental nights. The experiment started with a baseline night (BL) with no smartphone exposure, followed by repeated sessions of nocturnal smartphone exposure lasting 90 minutes (08:00 pm-09:30 pm). Actigraphy; salivary cortisol; the Stroop test (selective attention); choice reaction time (CRT); N-back (working memory); counter-movement jump (CMJ), composed of flight time (time spent in the CMJ flight phase) and jump height; and a 30 m sprint were assessed the morning after each condition. Both AC and RC shortened total sleep time (TST) ( < 0.01), with a greater decrease with RC (-46.7 min, ∆% = -9.46) than AC (-28.8 min, ∆% = -5.8) compared to BL. AC and RC significantly increased waking after sleep onset (3.5 min, ∆% = 15.05, to 9.9 min, ∆% = 43.11%) and number of errors made on the Stroop test (1.8 error, ∆% = 74.23, to 3.07 error, ∆% = 97.56%). Children made 0.15 and 0.8 more errors (∆% = 6.2 to 57.61%) and spent 46.9 s and 71.6 s more time on CRT tasks (∆% = 7.22 to 11.11%) with AC and RC, respectively, compared to BL. The high-interference index of the Stroop task, CMJ performance, and 30 m sprint speed were only altered ( < 0.01) following RC (0.36, Δ% = 41.52%; -34 s, Δ% = -9.29%, for flight time and -1.23 m, -8.72%, for jump height; 0.49 s, Δ% = 6.48, respectively) when compared to BL. In conclusion, one- or five-night exposure to smartphones disturbed the children's sleep quality and their performance, with more pronounced effects following RC.
PubMed: 38667810
DOI: 10.3390/ejihpe14040055 -
BMC Pediatrics Apr 2024Accurate assessment of physical activity and motor function in children with cerebral palsy is crucial for determining the effectiveness of interventions. This study...
Identifying the most representative actigraphy variables reflecting standardized hand function assessments for remote monitoring in children with unilateral cerebral palsy.
BACKGROUND
Accurate assessment of physical activity and motor function in children with cerebral palsy is crucial for determining the effectiveness of interventions. This study aimed to investigate the correlation between real-world activity monitoring outcomes and in-laboratory standardized hand function assessments in children with unilateral cerebral palsy.
METHODS
Actigraphy data were collected over 3 days from children aged 4-12 years with unilateral cerebral palsy before in-laboratory assessments. To tackle the high dimensionality and collinearity of actigraphy variables, we first applied hierarchical clustering using the Pearson correlation coefficient as the distance metric and then performed a principal component analysis (PCA) to reduce the dimensionality of our data.
RESULTS
Both hierarchical clustering and PCAs revealed a consistent pattern in which magnitude ratio variables (ln[affected side magnitude/less-affected side magnitude]) were more strongly associated with standardized assessments of hand function than with activity time and distance domain variables. Hierarchical clustering analysis identified two distinct clusters of actigraphy variables, with the second cluster primarily consisting of magnitude ratio variables that exhibited the strongest correlation with Melbourne Assessment 2, Pediatric Motor Activity Log, Assisting Hand Assessment, and Manual Ability Classification System level. Principal component 2, primarily representing the magnitude ratio domain, was positively associated with a meaningful portion of subcategories of standardized measures, whereas principal component 1, representing the activity time and distance component, showed limited associations.
CONCLUSIONS
The magnitude ratio of actigraphy can provide additional objective information that complements in-laboratory hand function assessment outcomes in future studies of children with unilateral cerebral palsy. TRIAL REGISTRATION IN CLINICALTRIALS.GOV: NCT04904796 (registered prospectively; date of registration: 23/05/2021).
Topics: Humans; Cerebral Palsy; Child; Actigraphy; Female; Male; Child, Preschool; Hand; Principal Component Analysis; Cluster Analysis
PubMed: 38664706
DOI: 10.1186/s12887-024-04724-z -
BMJ Open Apr 2024Surgical patients over 70 experience postoperative delirium (POD) complications in up to 50% of procedures. Sleep/circadian disruption has emerged as a potential risk...
INTRODUCTION
Surgical patients over 70 experience postoperative delirium (POD) complications in up to 50% of procedures. Sleep/circadian disruption has emerged as a potential risk factor for POD in epidemiological studies. This protocol presents a single-site, prospective observational study designed to examine the relationship between sleep/circadian regulation and POD and how this association could be moderated or mediated by Alzheimer's disease (AD) pathology and genetic risk for AD.
METHODS AND ANALYSIS
Study staff members will screen for eligible patients (age ≥70) seeking joint replacement or spinal surgery at Massachusetts General Hospital (MGH). At the inclusion visit, patients will be asked a series of questionnaires related to sleep and cognition, conduct a four-lead ECG recording and be fitted for an actigraphy watch to wear for 7 days before surgery. Blood samples will be collected preoperatively and postoperatively and will be used to gather information about AD variant genes (-ε4) and AD-related pathology (total and phosphorylated tau). Confusion Assessment Method-Scale and Montreal Cognitive Assessment will be completed twice daily for 3 days after surgery. Seven-day actigraphy assessments and Patient-Reported Outcomes Measurement Information System questionnaires will be performed 1, 3 and 12 months after surgery. Relevant patient clinical data will be monitored and recorded throughout the study.
ETHICS AND DISSEMINATION
This study is approved by the IRB at MGH, Boston, and it is registered with the US National Institutes of Health on ClinicalTrials.gov (NCT06052397). Plans for dissemination include conference presentations at a variety of scientific institutions. Results from this study are intended to be published in peer-reviewed journals. Relevant updates will be made available on ClinicalTrials.gov.
TRIAL REGISTRATION NUMBER
NCT06052397.
Topics: Humans; Emergence Delirium; Prospective Studies; Delirium; Postoperative Complications; Cohort Studies; Sleep; Biomarkers; Observational Studies as Topic
PubMed: 38643014
DOI: 10.1136/bmjopen-2023-080796 -
The Journals of Gerontology. Series A,... Jul 2024The relationship of cognition and the 24-h activity cycle (24-HAC), encompassing physical activity, sedentary behavior, and sleep, in older adults with mild cognitive...
BACKGROUND
The relationship of cognition and the 24-h activity cycle (24-HAC), encompassing physical activity, sedentary behavior, and sleep, in older adults with mild cognitive impairment (MCI) remains uncertain. Distinct combinations of 24-HAC behaviors can characterize unique activity profiles and influence cognition. We aimed to characterize 24-HAC activity profiles in older adults with MCI and assess whether differences in cognition exist across profiles.
METHODS
We conducted a cross-sectional analysis utilizing baseline data from 3 randomized controlled trials involving 253 community-dwelling older adults (55 + years) with MCI (no functional impairment, dementia diagnosis, and Montreal Cognitive Assessment score <26/30). Using MotionWatch8© wrist-worn actigraphy (+5 days), we captured the 24-HAC. Cognition was indexed by the Alzheimer's Disease Assessment Scale Cognitive Plus (ADAS-Cog-Plus). Compositional data and latent profile analyses identified distinct 24-HAC activity profiles. Analysis of covariance examined whether 24-HAC activity profiles differed in cognition.
RESULTS
Four distinct activity profiles were identified. Profile 1 ("Average 24-HAC," n = 103) engaged in all 24-HAC behaviors around the sample average. Profile 2 ("Active Chillers," n = 70) depicted lower-than-average engagement in physical activity and higher-than-average sedentary behavior. Profile 3 ("Physical Activity Masters," n = 54) were the most active and the least sedentary. Profile 4 ("Sedentary Savants," n = 26) were the least active and the most sedentary. Sleep was similar across profiles. There were no significant differences in ADAS-Cog-Plus scores between 24-HAC activity profiles (p > .05).
CONCLUSIONS
Older adults with MCI exhibited four 24-HAC activity profiles conforming to recommended physical activity and sleep guidelines. Nonetheless, cognition was similar across these profiles.
Topics: Humans; Cognitive Dysfunction; Male; Cross-Sectional Studies; Female; Aged; Cognition; Actigraphy; Sedentary Behavior; Sleep; Activity Cycles; Exercise; Middle Aged; Independent Living; Aged, 80 and over
PubMed: 38642387
DOI: 10.1093/gerona/glae099 -
Nature and Science of Sleep 2024While there is a rising focus on sleep issues among athletes, a notable gap exists in the comparative analysis of sleep patterns between male and female athletes. This...
PURPOSE
While there is a rising focus on sleep issues among athletes, a notable gap exists in the comparative analysis of sleep patterns between male and female athletes. This study aims to evaluate the sleep patterns of collegiate swimmers during a specific period (pre-competition training phase) based on the National Sleep Foundation's recommendations and compares sleep differences between males and females.
PATIENTS AND METHODS
15 swimmers (6 males and 9 females) completed the Athlete Sleep Screening Questionnaire (ASSQ) and wore actigraphy devices for 8 consecutive nights to record objective sleep patterns including bedtime, wake time, sleep onset latency, total sleep time, wake after sleep onset, and sleep efficiency.
RESULTS
The total sleep time of collegiate male (5.0±0.4 h, 4.6 to 5.4h) and female (6.0±0.7 h, 5.5 to 6.5h) swimmers was less than 7 hours per night, and male swimmers' sleep efficiency (76.7±8.9%, 67.4 to 86.0%) was lower than the 85% standard. Male swimmers had less objectively measured sleep duration (p=0.006, d=1.66, large effect), lower sleep efficiency (p=0.013, d=1.51, large effect), and longer wake after sleep onset (p=0.096, d=0.94, moderate effect). Female swimmers had higher sleep difficulty scores (p=0.06, d=1.08, moderate effect), and there was a significant difference in the distribution of sleep difficulty scores between male and female swimmers (p=0.033, V=0.045, small effect).
CONCLUSION
Collegiate swimmers exhibited poor sleep patterns during pre-competition preparation, and the sleep fragmentation of male swimmers was more pronounced. There were sex differences in both subjective and objective measured sleep patterns, with male swimmers having less sleep and low efficiency, while female swimmers experienced more significant sleep disturbances.
PubMed: 38638411
DOI: 10.2147/NSS.S444472 -
Journal of Neurodevelopmental Disorders Apr 2024Overactivity is prevalent in several rare genetic neurodevelopmental syndromes, including Smith-Magenis syndrome, Angelman syndrome, and tuberous sclerosis complex,...
BACKGROUND
Overactivity is prevalent in several rare genetic neurodevelopmental syndromes, including Smith-Magenis syndrome, Angelman syndrome, and tuberous sclerosis complex, although has been predominantly assessed using questionnaire techniques. Threats to the precision and validity of questionnaire data may undermine existing insights into this behaviour. Previous research indicates objective measures, namely actigraphy, can effectively differentiate non-overactive children from those with attention-deficit hyperactivity disorder. This study is the first to examine the sensitivity of actigraphy to overactivity across rare genetic syndromes associated with intellectual disability, through comparisons with typically-developing peers and questionnaire overactivity estimates.
METHODS
A secondary analysis of actigraphy data and overactivity estimates from The Activity Questionnaire (TAQ) was conducted for children aged 4-15 years with Smith-Magenis syndrome (N=20), Angelman syndrome (N=26), tuberous sclerosis complex (N=16), and typically-developing children (N=61). Actigraphy data were summarized using the M10 non-parametric circadian rhythm variable, and 24-hour activity profiles were modelled via functional linear modelling. Associations between actigraphy data and TAQ overactivity estimates were explored. Differences in actigraphy-defined activity were also examined between syndrome and typically-developing groups, and between children with high and low TAQ overactivity scores within syndromes.
RESULTS
M10 and TAQ overactivity scores were strongly positively correlated for children with Angelman syndrome and Smith-Magenis syndrome. M10 did not substantially differ between the syndrome and typically-developing groups. Higher early morning activity and lower evening activity was observed across all syndrome groups relative to typically-developing peers. High and low TAQ group comparisons revealed syndrome-specific profiles of overactivity, persisting throughout the day in Angelman syndrome, occurring during the early morning and early afternoon in Smith-Magenis syndrome, and manifesting briefly in the evening in tuberous sclerosis complex.
DISCUSSION
These findings provide some support for the sensitivity of actigraphy to overactivity in children with rare genetic syndromes, and offer syndrome-specific temporal descriptions of overactivity. The findings advance existing descriptions of overactivity, provided by questionnaire techniques, in children with rare genetic syndromes and have implications for the measurement of overactivity. Future studies should examine the impact of syndrome-related characteristics on actigraphy-defined activity and overactivity estimates from actigraphy and questionnaire techniques.
Topics: Child; Humans; Smith-Magenis Syndrome; Angelman Syndrome; Tuberous Sclerosis; Intellectual Disability
PubMed: 38637764
DOI: 10.1186/s11689-024-09535-y -
MedRxiv : the Preprint Server For... Apr 2024The study aimed to investigate sex differences in the relationship between sleep quality (self-report and objective) and cognitive function across three domains...
STUDY OBJECTIVES
The study aimed to investigate sex differences in the relationship between sleep quality (self-report and objective) and cognitive function across three domains (executive function, verbal memory, and attention) in older adults.
METHODS
We analyzed cross-sectional data from 207 participants with normal cognition or mild cognitive impairment (89 males and 118 females) aged over 60. The relationship between sleep quality and cognitive performance was estimated using generalized additive models. Objective sleep was measured with the GT9X Link Actigraph, and self-reported sleep was measured with the Pittsburgh Sleep Quality Index.
RESULTS
We found that females exhibited stable performance of executive function with up to about 400 minutes of total sleep time, with significant declines in performance ( = 0.02) when total sleep time was longer. Additionally, a longer total sleep time contributed to lower verbal memory in a slightly non-linear manner ( = 0.03). Higher self-reported sleep complaints were associated with poorer executive function in females with normal cognition ( = 0.02). In males, a positive linear relationship emerged between sleep efficiency and executive function ( = 0.04), while self-reported sleep was not associated with cognitive performance in males with normal cognition.
CONCLUSIONS
Our findings suggest that the relationships between sleep quality and cognition differ between older males and females, with executive function being the most influenced by objective and self-reported sleep. Interventions targeting sleep quality to mitigate cognitive decline in older adults may need to be tailored according to sex, with distinct approaches for males and females.
PubMed: 38633788
DOI: 10.1101/2024.01.08.24300996 -
The International Journal of Behavioral... Apr 2024Actigraphy is often used to measure sleep in pediatric populations, despite little confirmatory evidence of the accuracy of existing sleep/wake algorithms. The aim of...
BACKGROUND
Actigraphy is often used to measure sleep in pediatric populations, despite little confirmatory evidence of the accuracy of existing sleep/wake algorithms. The aim of this study was to determine the performance of 11 sleep algorithms in relation to overnight polysomnography in children and adolescents.
METHODS
One hundred thirty-seven participants aged 8-16 years wore two Actigraph wGT3X-BT (wrist, waist) and three Axivity AX3 (wrist, back, thigh) accelerometers over 24-h. Gold standard measures of sleep were obtained using polysomnography (PSG; Embletta MPRPG, ST + Proxy and TX Proxy) in the home environment, overnight. Epoch by epoch comparisons of the Sadeh (two algorithms), Cole-Kripke (three algorithms), Tudor-Locke (four algorithms), Count-Scaled (CS), and HDCZA algorithms were undertaken. Mean differences from PSG values were calculated for various sleep outcomes.
RESULTS
Overall, sensitivities were high (mean ± SD: 91.8%, ± 5.6%) and specificities moderate (63.8% ± 13.8%), with the HDCZA algorithm performing the best overall in terms of specificity (87.5% ± 1.3%) and accuracy (86.4% ± 0.9%). Sleep outcome measures were more accurately measured by devices worn at the wrist than the hip, thigh or lower back, with the exception of sleep efficiency where the reverse was true. The CS algorithm provided consistently accurate measures of sleep onset: the mean (95%CI) difference at the wrist with Axivity was 2 min (-6; -14,) and the offset was 10 min (5, -19). Several algorithms provided accurate measures of sleep quantity at the wrist, showing differences with PSG of just 1-18 min a night for sleep period time and 5-22 min for total sleep time. Accuracy was generally higher for sleep efficiency than for frequency of night wakings or wake after sleep onset. The CS algorithm was more accurate at assessing sleep period time, with narrower 95% limits of agreement compared to the HDCZA (CS:-165 to 172 min; HDCZA: -212 to 250 min).
CONCLUSION
Although the performance of existing count-based sleep algorithms varies markedly, wrist-worn devices provide more accurate measures of most sleep measures compared to other sites. Overall, the HDZCA algorithm showed the greatest accuracy, although the most appropriate algorithm depends on the sleep measure of focus.
Topics: Child; Adolescent; Humans; Actigraphy; Reproducibility of Results; Sleep; Polysomnography; Algorithms
PubMed: 38627708
DOI: 10.1186/s12966-024-01590-x -
Scientific Reports Apr 2024Mood swings, or mood variability, are associated with negative mental health outcomes. Since adolescence is a time when mood disorder onset peaks, mood variability...
Mood swings, or mood variability, are associated with negative mental health outcomes. Since adolescence is a time when mood disorder onset peaks, mood variability during this time is of significant interest. Understanding biological factors that might be associated with mood variability, such as sleep and structural brain development, could elucidate the mechanisms underlying mood and anxiety disorders. Data from the longitudinal Leiden self-concept study (N = 191) over 5 yearly timepoints was used to study the association between sleep, brain structure, and mood variability in healthy adolescents aged 11-21 at baseline in this pre-registered study. Sleep was measured both objectively, using actigraphy, as well as subjectively, using a daily diary self-report. Negative mood variability was defined as day-to-day negative mood swings over a period of 5 days after an MRI scan. It was found that negative mood variability peaked in mid-adolescence in females while it linearly increased in males, and average negative mood showed a similar pattern. Sleep duration (subjective and objective) generally decreased throughout adolescence, with a larger decrease in males. Mood variability was not associated with sleep, but average negative mood was associated with lower self-reported energy. In addition, higher thickness in the dorsolateral prefrontal cortex (dlPFC) compared to same-age peers, suggesting a delayed thinning process, was associated with higher negative mood variability in early and mid-adolescence. Together, this study provides an insight into the development of mood variability and its association with brain structure.
Topics: Adolescent; Female; Male; Humans; Adolescent Development; Mood Disorders; Sleep; Brain; Actigraphy
PubMed: 38609481
DOI: 10.1038/s41598-024-59227-9 -
JMIR Aging Apr 2024Sleep efficiency is often used as a measure of sleep quality. Getting sufficiently high-quality sleep has been associated with better cognitive function among older...
BACKGROUND
Sleep efficiency is often used as a measure of sleep quality. Getting sufficiently high-quality sleep has been associated with better cognitive function among older adults; however, the relationship between day-to-day sleep quality variability and cognition has not been well-established.
OBJECTIVE
We aimed to determine the relationship between day-to-day sleep efficiency variability and cognitive function among older adults, using accelerometer data and 3 cognitive tests.
METHODS
We included older adults aged >65 years with at least 5 days of accelerometer wear time from the National Health and Nutrition Examination Survey (NHANES) who completed the Digit Symbol Substitution Test (DSST), the Consortium to Establish a Registry for Alzheimer's Disease Word-Learning subtest (CERAD-WL), and the Animal Fluency Test (AFT). Sleep efficiency was derived using a data-driven machine learning algorithm. We examined associations between sleep efficiency variability and scores on each cognitive test adjusted for age, sex, education, household income, marital status, depressive symptoms, diabetes, smoking habits, alcohol consumption, arthritis, heart disease, prior heart attack, prior stroke, activities of daily living, and instrumental activities of daily living. Associations between average sleep efficiency and each cognitive test score were further examined for comparison purposes.
RESULTS
A total of 1074 older adults from the NHANES were included in this study. Older adults with low average sleep efficiency exhibited higher levels of sleep efficiency variability (Pearson r=-0.63). After adjusting for confounding factors, greater average sleep efficiency was associated with higher scores on the DSST (per 10% increase, β=2.25, 95% CI 0.61 to 3.90) and AFT (per 10% increase, β=.91, 95% CI 0.27 to 1.56). Greater sleep efficiency variability was univariably associated with worse cognitive function based on the DSST (per 10% increase, β=-3.34, 95% CI -5.33 to -1.34), CERAD-WL (per 10% increase, β=-1.00, 95% CI -1.79 to -0.21), and AFT (per 10% increase, β=-1.02, 95% CI -1.68 to -0.36). In fully adjusted models, greater sleep efficiency variability remained associated with lower DSST (per 10% increase, β=-2.01, 95% CI -3.62 to -0.40) and AFT (per 10% increase, β=-.84, 95% CI -1.47 to -0.21) scores but not CERAD-WL (per 10% increase, β=-.65, 95% CI -1.39 to 0.08) scores.
CONCLUSIONS
Targeting consistency in sleep quality may be useful for interventions seeking to preserve cognitive function among older adults.
Topics: Humans; Nutrition Surveys; Cross-Sectional Studies; Activities of Daily Living; Cognition; Alzheimer Disease; Sleep; Accelerometry
PubMed: 38596863
DOI: 10.2196/54353