Adolescent sleep, distress, and technology use: weekday versus weekend.

BACKGROUND: In adolescents, technology use at bedtime is linked to disrupted sleep and psychological distress. Adolescents are known to sleep later on weekends compared to weekdays but whether this leads to greater technology use, and, hence, additional psychological distress is not known. At greater risk maybe adolescents with a late compared to early chronotype, that is a preference for late versus early sleep onset and offset times. METHOD: Self-reported measures of sleep timing, chronotype (early, neither early nor late, late), technology medium (social media/texting, TV/streaming, and gaming), and psychological distress (DASS-21) were collected from 462 students attending one Australian high school. RESULTS: Technology use at bedtime was greater on weekends and especially in adolescents with a late chronotype. Social media/texting on weekends was predictive of delayed sleep onset times (ß = .120), and shorter sleep (ß = -.172). Shorter sleep on weekdays but not on weekends was associated with greater psychological distress. Technology medium and chronotype were not predictive of psychological distress. CONCLUSIONS: This study confirmed that technology use and its impact on sleep differed on weekdays compared to weekends and that a late chronotype was associated with greater technology use. However, neither technology medium nor chronotype was found to affect psychological distress. While greater autonomy may be granted to adolescents over the weekend regarding sleep behaviour, young people, parents, and clinicians should be mindful of the link between technology use and sleep.

Giving sleep position advice in pregnancy: Will we make women anxious?

BACKGROUND: There is now robust evidence that when women settle to sleep on their back in late pregnancy (>28 weeks) they are at increased risk of stillbirth. Therefore, there are several stillbirth prevention programs worldwide that have begun advising pregnant women to adopt a side position when settling to sleep in late pregnancy. However, some hold concerns that giving women information about sleep position and stillbirth risk may make them anxious. AIM: This study aimed to determine what influences how 'safe sleep' messages are perceived by pregnant women and if there is anxiety associated with receiving this message. MATERIALS AND METHODS: An online survey of 537 Australian women (n = 97 were 'currently pregnant'). The survey examined participant's views regarding sleep position messages, type of information source as well as participant characteristics such as general anxiety and their fetal health locus of control (FHLC). RESULTS: Our findings suggest that the FHLC may influence how health messaging regarding sleep in pregnancy is perceived and acted upon. We have also shown a subset of pregnant women may feel anxiety associated with the sleep position in pregnancy message. This may not be related to history of anxiety, but rather to their higher 'internal' FHLC, ie those who reflect a greater sense of personal agency over fetal health. CONCLUSIONS: Our findings suggest most women will perceive information about settling into sleep position as informative rather than anxiety provoking. Therefore, maternity care providers should not be overly concerned about provoking anxiety when providing this information.

Associations between self-reported sleep measures and dietary behaviours in a large sample of Australian school students (n = 28,010).

This study examined the associations between self-reported sleep timing and quality, and the frequency of breakfast and junk food consumption in 28,010 Australian school students (mean ± SD age = 13.3 ± 1.2 years, 51% male). After controlling for age, sex and socioeconomic status, regression analyses revealed that the odds of missing breakfast were significantly higher in children who reported poor sleep or later bedtimes, while the odds of junk food consumption were significantly higher in children reporting later weeknight bedtimes (p < 0.001). These findings suggest that sleep timing and quality influence the dietary choices of adolescents.

An experimental study of adolescent sleep restriction during a simulated school week: changes in phase, sleep staging, performance and sleepiness.

This laboratory study investigated the impact of restricted sleep during a simulated school week on circadian phase, sleep stages and daytime functioning. Changes were examined across and within days and during a simulated weekend recovery. Participants were 12 healthy secondary school students (six male) aged 15-17 years [mean = 16.1 years, standard deviation (SD) = 0.9]. After 2 nights with 10 h (21:30-07:30 hours), time in bed was restricted to 5 h for 5 nights (02:30-07:30 hours), then returned to 10 h time in bed for 2 nights (21:30-07:30 hours). Saliva was collected in dim light on the first and last sleep restriction nights to measure melatonin onset phase. Sleep was recorded polysomnographically, and the Psychomotor Vigilance Task (PVT) and Karolinska Sleepiness Scale were undertaken 3-hourly while awake. Average phase delay measured by melatonin was 3 h (SD = 50 min). Compared to baseline, sleep during the restriction period contained a smaller percentage of Stages 1 and 2 and rapid eye movement (REM) and a greater percentage of Stage 4. PVT lapses increased significantly during sleep restriction and did not return to baseline levels during recovery. Subjective sleepiness showed a similar pattern during restriction, but returned to baseline levels during recovery. Results suggest that sustained attention in adolescents is affected negatively by sleep restriction, particularly in the early morning, and that a weekend of recovery sleep is insufficient to restore performance. The discrepancy between sleepiness ratings and performance may indicate a lack of perception of this residual impairment.

Normal Sleep in Children and Adolescence.

Adequate sleep is essential for healthy development in childhood and adolescence. Healthy sleep contributes to good physical health, immune function, mental health, and academic performance. The regulation and architecture of sleep change greatly across childhood and adolescence, and the ability to obtain sufficient sleep is impacted by a range of factors that change with maturation. This article describes normal sleep across childhood and adolescence and discusses some of the most common barriers to adequate sleep, including early school start times, technology use, and changes to circadian rhythms, and sleep homeostasis across puberty.

Boarding versus day-students: A mixed-methods analysis of sleep and its relationship with psychological distress.

BACKGROUND: Boarding students face unique challenges when entering school, including: adapting to a novel environment, where they are separated from family, friends and culture, for up to 40 weeks per year. A particular challenge is sleep. A further challenge is coping with the demands of boarding with its potential impact on psychological well-being. AIMS: To explore how boarders' sleep differs from that of their day-student peers, and how this relates to psychological well-being. SAMPLE AND METHODS: 309 students (59 boarding students and 250 day-students, at one Adelaide school) completed the School Sleep Habits Survey, Depression-Anxiety-Stress-Scale-21 (DASS-21), and Flourishing Scale. Boarding students additionally completed the Utrecht Homesickness Scale. Thirteen boarding students described experiences of sleeping in boarding through focus groups. RESULTS: Boarding students, compared to day-students reported 40 minutes more sleep per weeknight (p < .001), with earlier sleep onset (p = .026), and later wake-up (p = .008) times. No significant differences were observed between boarding' and day-students' DASS-21 scores. Hierarchical regression revealed longer total weekday sleep time predicted higher psychological well-being in both boarding and day-students. Additionally, in boarding students, low homesickness-loneliness and homesickness-ruminations further predicted psychological well-being. Thematic analysis of boarding students' focus group responses revealed that night-time routine, and restricting technology use at night facilitated sleep. CONCLUSIONS: This study supports - in both boarding and day-students - the importance of sleep for adolescent well-being. Sleep hygiene can play an important role in boarding student sleep, especially: regular night-time routine and restricting technology use at night. Finally, these findings suggest that poor sleep and homesickness have an adverse effect on boarding student psychological well-being. This study highlights the importance of strategies which promote sleep hygiene and minimize homesickness, in boarding school students.

The relationships between coping styles and food intake in shiftworking nurses and midwives: a pilot study.

Shiftworkers are more likely to suffer from gastrointestinal disease and Type 2 Diabetes than the general population, likely due to their altered dietary intakes. Previous research has suggested that coping strategies and health behaviours may be linked, however, questions remain regarding these relationships in shiftworking populations. The Standard Shiftwork Index and Food Frequency Questionnaire were completed by nurses/midwives working forward rotating shifts (N=27, female=24, age=38.4 ± 13.1 y). Greater engaged coping strategy usage was associated with lower total energy, fat, carbohydrate and sugar intake (ρs>-0.1). Greater disengaged coping strategy usage was associated with greater intake of these nutrients (ρs>0.1). Results suggest that engaged coping strategies may contribute to healthier dietary choices. A greater focus on coping styles, particularly during nursing education, may improve shiftworkers' health.

Normal Sleep in Children and Adolescence.

Adequate sleep is essential for healthy development in childhood and adolescence. Healthy sleep contributes to good physical health, immune function, mental health, and academic performance. The regulation and architecture of sleep change greatly across childhood and adolescence, and the ability to obtain sufficient sleep is impacted by a range of factors that change with maturation. This article describes normal sleep across childhood and adolescence and discusses some of the most common barriers to adequate sleep, including early school start times, technology use, and changes to circadian rhythms, and sleep homeostasis across puberty.

Changes in growth and sleep across school nights, weekends and a winter holiday period in two Australian schools.

Studies suggest that there may be an association between sleep and growth; however, the relationship is not well understood. Changes in biology and external factors such as school schedule heavily impact the sleep of adolescents, during a critical phase for growth. This study assessed the changes in sleep across school days, weekends and school holidays, while also measuring height and weight changes, and self-reported alterations in food intake and physical activity. The impact of morningness-eveningness (M-E) on height change and weight gain was also investigated. In a sample of 63 adolescents (mean age = 13.13, SD = 0.33, 31 males) from two independent schools in South Australia, height and weight were measured weekly for 4 weeks prior to the school holidays and 4 weeks after the school holidays. Participants also completed a Morningness/Eveningness Scale and 7-day sleep, diet and physical activity diaries prior to, during and after the school holidays. Participants at one school had earlier wake times during the weekends than participants attending the other school, leading to a significantly shorter sleep duration on weekends for those participants. Regardless of school, sleep was significantly later and longer during the holidays (p < 0.001) and those with a stronger morning preference fell asleep (F18,36 = 3.4, p = 0.001) and woke (F18,44 = 2.0, p = 0.027) earlier than evening types. Growth rate was lower during the holiday weeks. For those attending the school with limited sleep in opportunities, growth after the holidays was lower for those with greater evening preference, whereas for those at the other school, growth was greater for those with greater evening preference. The increase in average weight from pre- to post-holidays was greater for those attending the school with limited opportunities to sleep longer. Participants reported greater food intake during the holidays compared to school days and greater physical activity levels on weekends compared to school days, and school days compared to holidays. Results suggest that time of day preference may impact growth, with evening types who cannot sleep in growing at a slower rate than evening types who can or morning types. This may be related to sleep restriction. Despite sleep being both later and longer during the school holidays, participants' growth slowed during the holiday period. It is possible that this may be a reflection of other behavioural changes in the holidays (increased food intake and reduced physical activity), as sleep timing during the school period was related to growth.