Associations between the Dietary Inflammatory Index and Sleep Metrics in the Energy Balance Study (EBS).

(1) Background: Sleep, a physiological necessity, has strong inflammatory underpinnings. Diet is a strong moderator of systemic inflammation. This study explored the associations between the Dietary Inflammatory Index (DII®) and sleep duration, timing, and quality from the Energy Balance Study (EBS). (2) Methods: The EBS (n = 427) prospectively explored energy intake, expenditure, and body composition. Sleep was measured using BodyMedia's SenseWear® armband. DII scores were calculated from three unannounced dietary recalls (baseline, 1-, 2-, and 3-years). The DII was analyzed continuously and categorically (very anti-, moderately anti-, neutral, and pro-inflammatory). Linear mixed-effects models estimated the DII score impact on sleep parameters. (3) Results: Compared with the very anti-inflammatory category, the pro-inflammatory category was more likely to be female (58% vs. 39%, p = 0.02) and African American (27% vs. 3%, p < 0.01). For every one-unit increase in the change in DII score (i.e., diets became more pro-inflammatory), wake-after-sleep-onset (WASO) increased (ßChange = 1.00, p = 0.01), sleep efficiency decreased (ßChange = −0.16, p < 0.05), and bedtime (ßChange = 1.86, p = 0.04) and waketime became later (ßChange = 1.90, p < 0.05). Associations between bedtime and the DII were stronger among African Americans (ßChange = 6.05, p < 0.01) than European Americans (ßChange = 0.52, p = 0.64). (4) Conclusions: Future studies should address worsening sleep quality from inflammatory diets, leading to negative health outcomes, and explore potential demographic differences.

Behavioral Treatment of Sleep Problems using Wake-Time Fading with Individuals with Autism: A Brief Report.

Difficulties with sleep, such as delayed onset, night waking, and early waking, are pervasive among individuals with developmental disabilities and autism. Interventions that seek to improve sleep outcomes are particularly useful when these individuals have experienced extended hospitalizations where low activity levels and decreased exposure to light-dark cycles maintain or increase disturbance in sleep patterns. The current study examines the effects of wake-time phase advances on the sleep patterns of a 16-year-old male and 17-year-old female, both of whom presented with significant sleep disturbance, autism, developmental delays, and severe problem behavior in a hospital-based setting. For both individuals, clinically significant increases in appropriate sleep and decreases in latency to sleep were observed throughout the course of their admission as a result of wake-time phase advances. Together, these results replicate and extend limited research in this area by using behavioral interventions to decrease disrupted sleep in inpatient contexts.

Sleep Behavior and Self-Reported Infertility: A Cross-Sectional Analysis Among U.S. Women.

Objective: To investigate the associations between sleep behaviors and female infertility. Methods: We conducted a cross-sectional study composed of 2175 U.S. women 18-44 years of age from the National Health and Nutrition Examination Survey (NHANES) (2015-2018). Bedtime/waketime and sleep duration were extracted from the sleep disorder questionnaire. Self-reported infertility was defined as a binary variable based on the participants' response to the question, "Have you ever attempted to become pregnant over a period of at least a year without becoming pregnant?". Multivariate logistic regression analyses were done to explore the relationship between sleep behaviors and female infertility. Results: Bedtime (OR=1.24; 95% CI, 1.10-1.40, P = 0.001) and waketime (OR=1.14; 95% CI, 1.01-1.28, P = 0.037) were associated with infertility. Waketime of 08:00 was the inflection point, above which the probability of infertility increased rapidly (OR=1.41; 95% CI, 1.11-1.79, P = 0.004). Sleep-wake behavior was significantly associated with infertility (OR=1.34; 95% CI, 1.16-1.53, P < 0.001) and participants with early-bed/early-rise behavior had the lowest risk. Conclusions: Among U.S. women 18-44 years of age, bedtime and waketime were significantly linearly and non-linearly correlated with infertility, respectively. Early-bed/early-rise behavior was associated with the lowest infertility rate. Further study is needed because the timing of sleep behaviors are modifiable factors and could be a novel strategy to cope with infertility.

Oral behaviours and wake-time masseter activity in patients with masticatory muscle pain.

BACKGROUND: Little is known about wake-time masseter activity of patients with masticatory muscle pain in real-life settings. OBJECTIVES: The aims of this study were (1) to assess wake-time masseter activity of women with masticatory muscle pain (MMP) and compare it with that of pain-free women; and (2) to investigate the association between objectively measured masseter contractions and self-reported oral behaviours. METHODS: Adult women (N = 27) diagnosed with MMP were age-matched with pain-free women (N = 26). The electromyographic (EMG) activity of the masseter muscle when awake was recorded unilaterally for two consecutive days. The number of contraction episodes and relative contraction time (%) were calculated using cut-off thresholds of 3%, 5% and 10% of maximum voluntary contraction (MVC). Self-reported daytime oral activity was assessed using the Oral Behaviours Checklist (OBC, items 3-21). Data were analysed using univariate tests and mixed-model analyses. RESULTS: The number of contraction episodes was similar between groups for all detection thresholds, but the relative contraction time at the lower detection thresholds (i.e. 3% MVC and 5% MVC) was significantly longer (1.5-fold) in the MMP than in the pain-free group. The OBC scores were significantly higher in the women with MMP than in controls, but no positive association could be found between EMG variables and OBC scores. CONCLUSION: Women with MMP engage in low-level masseter muscle contractions, which last longer than those of pain-free controls. There was no relationship between self-reported oral behaviours and masseter activity when awake. These findings support the notion that prolonged low-level clenching when awake may play a role in the pathophysiology of MMP.

Sleep quality and quantity in Italian University students: an actigraphic study.

According to international recommendations, young adults should sleep at least 7 h per night and experience good sleep quality to avoid physical and mental health problems. University students are particularly exposed to the risk of sleep issues due to their tendency to go to bed late at night and other social and environmental factors. Here, we aimed to objectively characterize the weekly sleep habits using actigraphy (in terms of quantity, quality, and timing) in 82 Italian university students (mean age = 23.89, SD = 2.51 yrs, 44 women). Exploratory analyses were performed using linear mixed-effect regression to account for several factors (e.g., gender, circadian preferences, depressive symptomatology). We showed that participants spent in bed (TIB) about 7 h and 31 min during weekdays and 7 h and 46 min during the weekend, with 76.83% of the sample showing a TIB longer than 7 h. Women students spent more time in bed than men (~25 min) and went to bed earlier (~29 min). One-third of the sample showed a sleep efficiency <85%, whereas 70.73% of the sample showed a wake after sleep onset >40 min, with no differences between men and women. Depressive symptoms, alcohol and coffee consumption affected sleep onset latency, whereas circadian preference was strongly associated with bed and waketime. Moreover, most of the students did not take daytime naps to catch-up with sleep loss. Overall, our sample spent adequate time in bed, but they experienced a moderate low sleep quality, mainly due to high wake after sleep onset.

A different rhythm of life: sleep patterns in the first 4 years of life and associated sociodemographic characteristics in a large Brazilian birth cohort.

OBJECTIVE: Sleep is an important marker of healthy development and has been associated with emotional, behavioral, and cognitive development. There is limited longitudinal data on children's sleep with only a few reports from low- and middle-income countries (LMICs). We investigate sleep parameters and associated sociodemographic characteristics in a population-based longitudinal study in Pelotas, Brazil. METHODS: Data from the Pelotas 2004 Birth Cohort were used (N = 3842). Infant sleep was collected through maternal report at 3, 12, 24, and 48 months: sleep duration, bed and wake time, nighttime awakenings, co-sleeping and sleep disturbances (24 and 48 months). RESULTS: Compared to children in high-income countries (HICs), children in Brazil showed a substantial shift in rhythms with later bed and wake times by approximately 2 hours. These remain stable throughout the first 4 years of life. This population also shows high levels of co-sleeping which remain stable throughout (49.0-52.2%). Later bedtime was associated with higher maternal education and family income. Higher rates of co-sleeping were seen in families with lower income and maternal education and for children who were breastfed. All other sleep parameters were broadly similar to data previously reported from HICs. CONCLUSION: The shift in biological rhythms in this representative community sample of children in Brazil challenges our understanding of optimal sleep routine and recommendations.

The effects of sleep restriction and altered sleep timing on energy intake and energy expenditure.

Experimental evidence suggests that sleep restriction increases energy intake (EI) and may alter energy expenditure (EE). However, it is unknown whether the timing of a sleep restriction period impacts EI and EE the following day. Hence, we examined the effects of sleep restriction with an advanced wake-time or delayed bedtime on next day EI and EE. Twelve men and 6 women (age: 23±4years, body fat: 18.8±10.1%) participated in 3 randomized crossover sessions: control (habitual bed- and wake-times), 50% sleep restriction with an advanced wake-time and 50% sleep restriction with a delayed bedtime. Outcome variables included sleep architecture (polysomnography), EI (food menu), total EE and activity times (accelerometry). Carbohydrate intake was greater on day 2 in the delayed bedtime vs. control session (1386±513 vs. 1579±571kcal; P=0.03). Relative moderate-intensity physical activity (PA) time was greater in the delayed bedtime session vs. control and advanced wake-time sessions on day 1 (26.6±19.9 vs. 16.1±10.6 and 17.5±11.8%; P=0.01), whereas vigorous-intensity PA time was greater following advanced wake-time vs. delayed bedtime on day 1 (2.7±3.0 vs. 1.3±2.4%; P=0.004). Greater stage 1 sleep (ß=110kcal, 95% CI for ß=42 to 177kcal; P=0.004), and a trend for lower REM sleep (ß=-20kcal, 95% CI for ß=-41 to 2kcal; P=0.07), durations were associated with greater EI between sleep restriction sessions. These findings suggest that the timing of a sleep restriction period impacts energy balance parameters. Additional studies are needed to corroborate these findings, given the increasing prevalence of shift workers and incidences of sleep disorders and voluntary sleep restriction.