Poorer sleep health is associated with altered brain activation during cognitive control processing in healthy adults.

This study investigated how proactive and reactive cognitive control processing in the brain was associated with habitual sleep health. BOLD fMRI data were acquired from 81 healthy adults with normal sleep (41 females, age 20.96-39.58 years) during a test of cognitive control (Not-X-CPT). Sleep health was assessed in the week before MRI scanning, using both objective (actigraphy) and self-report measures. Multiple measures indicating poorer sleep health-including later/more variable sleep timing, later chronotype preference, more insomnia symptoms, and lower sleep efficiency-were associated with stronger and more widespread BOLD activations in fronto-parietal and subcortical brain regions during cognitive control processing (adjusted for age, sex, education, and fMRI task performance). Most associations were found for reactive cognitive control activation, indicating that poorer sleep health is linked to a "hyper-reactive" brain state. Analysis of time-on-task effects showed that, with longer time on task, poorer sleep health was predominantly associated with increased proactive cognitive control activation, indicating recruitment of additional neural resources over time. Finally, shorter objective sleep duration was associated with lower BOLD activation with time on task and poorer task performance. In conclusion, even in "normal sleepers," relatively poorer sleep health is associated with altered cognitive control processing, possibly reflecting compensatory mechanisms and/or inefficient neural processing.

Police employees working from home during COVID-19 lockdown: Those with higher score on extraversion miss their colleagues more and are more likely to socialize with colleagues outside work.

There is a general opinion that extraverted people suffer more than introverted people in home-office arrangement and the social distancing regulation imposed by the government during the Corona Virus Disease 2019 pandemic (COVID-19). However, scarce research exists concerning how extraversion is associated with satisfaction with home-office arrangement, to what extent individuals miss their colleagues, level of stress, and whether they meet colleagues outside work during lockdown. An online survey was distributed in six police districts in Norway during late May and beginning of June, right before the most stringent measures for constraining risk of COVID-infection was lifted. 1133 out of 1472 reported that their work-situation was home-office, or combined home-office and physical attendance at work. Contrary to what expected, extraversion was not related to satisfaction with home-office arrangement when controlling for other relevant variables (i.e. stress, home-office only, living alone, age, gender and civilian employment). As hypothesized, those with a higher score on extraversion missed their colleagues more than those with low scores. There was a marginal, although significant, negative association between extraversion and stress, and a significant positive relationship between stress and the extent the respondents missed their colleagues during lockdown, independent of extraversion. The results showed a dose-response relationship between extraversion and meeting colleagues outside the work during lockdown.

Parent-child interactions during traditional and interactive media settings: A pilot randomized control study.

Parent-child interactions are pivotal for children's socioemotional development, yet might suffer with increased attention to screen media, as research has suggested. In response, we hypothesized that parent-child play on a tablet computer, as representative of interactive media, would generate higher-quality parent-child interactions than toy play or watching TV. We examined the emotional availability of mothers and their 2-year-old child during the previous three contexts using a randomized crossover design (n = 22) in a laboratory room. Among other results, mothers were more sensitive and structuring during joint gaming on a tablet than when engaged in toy play or watching TV. In addition, mothers were more hostile toward their children during play with traditional toys than during joint tablet gaming and television co-viewing. Such findings provide new insights into the impact of new media on parent-child interactions, chiefly by demonstrating that interactive media devices such as tablets can afford growth-enhancing parent-child interactions.

Sleep Difficulties and Insomnia Symptoms in Norwegian Musicians Compared to the General Population and Workforce.

Sleep problems are reported as common among performing artists and musicians. However, epidemiological research comparing musicians to different groups of the general population is lacking. For this study, 4,168 members of the Norwegian Musician's Union were invited to an online survey regarding work and health. Of the 2,121 (51%) respondents, 1,607 were active performing musicians. We measured prevalence of insomnia symptoms using the Bergen Insomnia Scale (BIS), and compared this sample to a representative sample of the general Norwegian population (n = 2,645). Overall, musicians had higher prevalence of insomnia symptoms compared to the general population (Prevalence Difference 6.9, 95% Confidence Interval 3.9-10.0). Item response analysis showed that this difference was mainly explained by nonrestorative sleep and dissatisfaction with sleep among musicians. An additional analysis, comparing musicians to the general Norwegian workforce (n = 8,518) on sleep difficulties, confirmed this tendency (Prevalence Difference 6.2, 95% Confidence Interval 4.3-8.1). Musicians performing classical, contemporary, rock, and country music reported the highest prevalence of insomnia, and these genres might be of special interest when developing preventative measures, treatment strategies, and further research on sleep difficulties among musicians.

Hardiness, psychosocial factors and shift work tolerance among nurses - a 2-year follow-up study.

AIM: To examine the predictive power of the subfactors of hardiness (commitment, control and challenge) on shift work tolerance (measured with sleepiness, fatigue, anxiety and depression) over 2 years in nurses working shifts. We also investigated the direct effects of psychosocial variables such as role conflict, social support and fair leadership on shift work tolerance, as well as their moderating role on the relationship between hardiness and shift work tolerance. BACKGROUND: Several scholars have discussed the role of individual differences and psychosocial variables in predicting shift work tolerance. The conclusions are not clear. DESIGN: Longitudinal questionnaire study. METHODS: A sample of Norwegian nurses employed in shift work including nights participated in this longitudinal questionnaire study: 1877 at baseline, 1228 at 1-year follow-up and 659 nurses at 2-year follow-up. Data were collected in three waves, first wave in 2008 and third in 2011 and were analysed with a series of hierarchical multiple regression analyses. RESULTS: We found that the subfactor commitment could predict fatigue over 1 year and anxiety and depression over 2 years. Challenge could predict anxiety over 1 year. Control was unrelated to shift work intolerance. Hardiness did not predict sleepiness. Social support, role conflict and fair leadership were important for some aspects of shift work tolerance; however, hardiness seemed to be more eminent for shift work tolerance than the psychosocial variables. Social support moderated the relationship between hardiness and shift work tolerance to some degree, but this interaction was weak. CONCLUSION: Hardiness can to some degree predict shift work tolerance over 2 years among nurses.

Individual, situational and lifestyle factors related to shift work tolerance among nurses who are new to and experienced in night work.

AIM: To identify individual, situational and lifestyle variables related to shift work tolerance among nurses who have worked night shifts for less than 1 year and nurses who have worked night shift for more than 6 years, all engaged in rotating shift work. BACKGROUND: Working shifts is related to negative health consequences. Factors related to shift work tolerance may differ between nurses with little experience and nurses with extensive experience in night work. DESIGN: Cross-sectional questionnaire study. METHODS: A questionnaire including established instruments measuring shift work tolerance, personality, work schedule and lifestyle factors was administered between November 2008-May 2010. Randomly selected Norwegian nurses (n = 749) participated in the study; 322 were new and 427 were experienced in night work. RESULTS: There were no statistically significant differences in shift work tolerance between the new to night work nurses and the nurses who were experienced in night work. Young age was related to higher shift work tolerance. Hardiness was positively related to shift work tolerance in both groups. For the new to night work nurses, morningness was positively related to shift work tolerance. For the experienced in night work nurses, languidity, work hours per week and caffeine consumption were negatively, but flexibility was positively, related to shift work tolerance. CONCLUSION: Several variables were related to shift work tolerance among rotating shift working nurses, especially hardiness. Somewhat different variables were related to shift work tolerance for nurses who were new to night work than for nurses with more experience in night work.

The effect of immersion on sense of presence and affect when experiencing an educational scenario in virtual reality: A randomized controlled study.

Virtual reality (VR) technology has been used to learn skills for decades. While no standardized measure exists for learning outcomes in VR training, commonly explored outcomes are immersion, sense of presence and emotions. Methods: In this paper, the objective was to investigate these outcomes in two VR conditions, immersive and desktop in a randomized controlled trial with a parallel design. The sample consisted of 134 university students (70 women, mean age 23 years, SD = 2.99). These were randomized using a covariate-adaptive randomization procedure based on stratification by gender into two interventions; play out a VR scenario in either desktop (control group) or immersive VR (intervention group). The setting was a university lab. Results: There was a significant within subject effect for positive affect and a significant between-group effect for the immersive compared to desktop VR groups. Positive affect was reduced after interacting with the VR scenario in both the immersive and desktop versions, however, positive affect was overall higher in the immersive, compared to the desktop version. The results show higher scores for sense of presence (d = 0.90, p < 0.001) and positive affect pre- and post-scenario in the immersive VR condition (d = 0.42, p = 0.017 and d = 0.54, p = 0.002) compared to the desktop condition. Conclusion: Immersive VR may be beneficial in higher education as it promotes high levels of sense of presence as well as positive emotions. When it comes to changing the immediate emotions of the students, type of VR does not seem to matter. The project was funded by the Norwegian Directorate for Higher Education and Skills.

Quantifying teenagers' sleep patterns and sex differences in social jetlag using at-home sleep monitoring.

Sleep plays an important role in the formative developmental processes occurring during the teenage years. At the same time, teenagers' changing bioregulatory mechanisms and psychosocial factors converge into the so-called social jetlag, a sleep timing misalignment between weekdays and weekends. The aim of this study was to quantify the course of day-to-day changes in sleep/wake patterns and sleep stage distributions, and the sex differences in social jetlag among teenagers. We observed the sleep of 156 teenagers (58.3% girls, 15-16 years) using a novel sleep monitor over the course of up to 10 consecutive days. 1323 nights of data were analyzed using multilevel modeling. On average, participants went to bed at 23:41, woke up at 07:48, slept for 7.7 h and had 85.5% sleep efficiency. Sleep stage distributions were in line with normative data. We found later sleep onset and offset, longer time in bed, sleep duration, and sleep onset latency (p = .001), greater proportion of light sleep and lower proportion of deep sleep, and poorer sleep efficiency (all p < .001) on weekend nights starting on Friday and Saturday. On Friday nights, girls had longer time awake after sleep onset (p = .020) than boys. On Friday and Saturday nights, girls fell asleep earlier (p < .001 and p = .006, respectively). On Saturday nights, girls had shorter sleep latency (p = .024), and better sleep efficiency (p = .019) than boys. In sum, teenagers' sleep patterns reflected healthy, albeit somewhat short sleep. There was convincing evidence of social jetlag, and girls exhibited less severe social jetlag than boys.

Associations between burnout symptoms and sleep among workers during the COVID-19 pandemic.

BACKGROUND: The aim of this study was to investigate the relations between underlying dimensions of burnout (ie exhaustion, mental distance, cognitive impairment and emotional impairment) and sleep reactivity in occupations that maintain critical societal functions during the COVID-19 pandemic. Sleep reactivity refers to the vulnerability of experiencing sleep disturbances during stressful and challenging situations, and manifests as difficulties with falling and staying asleep. Previous research has highlighted the importance investigating psychological factors that may influence or trigger vulnerability to stress induced sleep problems, including factors at work. METHODS: Longitudinal self-report data was collected using an online survey administered to Norwegian workers employed in health care, education, social services, emergency services and other sectors with critical tasks during the COVID-19 pandemic at two different time points three months apart. The sample in the present study (N = 1331) consisted of 76% females and 24% males with a mean age of 44 years. RESULTS: The results showed that work-related exhaustion measured at baseline was the strongest symptom of burnout associated with higher sleep reactivity three months later, followed by emotional impairment. Mental distance and cognitive impairment at work were not associated with sleep reactivity, indicating that these burnout dimensions have less of an impact on sleep than exhaustion and emotional impairment. CONCLUSION: Work-related exhaustion and emotional impairment can lower the individual's tolerance to perceiving events as stressful as well as reinforce the stress response, and contribute to difficulties with initiating and/or maintaining sleep. Workers employed in occupations with critical tasks during the pandemic may be more susceptible to exhaustion, emotional strain and poorer sleep due to increased and prolonged work pressure. Organizational and individual measures that can decrease stress and increase coping should be offered to employees working in high-stress conditions.

Insomnia among employees in occupations with critical societal functions during the COVID-19 pandemic.

OBJECTIVE: This study investigates insomnia among employees in occupations critical to the functioning of society (e.g health, education, welfare and emergency services) during the COVID-19 pandemic. Many of these workers experience higher job pressure and increased risk of infection due to their work. It is crucial to investigate which factors that can contribute to insomnia in these important sectors. METHODS: Data was collected using an online survey administered in June 2020. The questionnaire measured demographic variables, sleep, stress, psychosocial factors and health concerns (i.e worrying about health consequences related to the pandemic). The sample in the present study consisted of 1327 (76% females) employees in organizations with societal critical functions. RESULTS: The employees reported higher levels of insomnia symptoms compared to normative data collected before the pandemic. Health concerns specifically related to COVID-19 had the strongest association to insomnia, followed by work stress. Job demands (i.e workload, time pressure and overtime) had merely a weak association to insomnia. CONCLUSION: Worrying about consequences the pandemic can have on your own health and the health of your family or colleagues have a stronger negative impact on sleep than work pressure during the COVID-19 pandemic. Impaired sleep can have detrimental effects on performance and health, and a stronger focus on preventing insomnia as a mean of sustaining critical societal functions both during and after the pandemic is warranted. Organizations should consider interventions aimed at reducing health concerns among their employees during the COVID-19 pandemic.

The validation of the Norwegian Basic Psychological Need Satisfaction and Frustration Scale: A stratified sampling procedure.

This study aimed to validate the Norwegian version of the Basic Psychological Need Satisfaction and Frustration Scale (BPNSFS) and to examine its relations with indicators of well-being and ill-being. Additionally, despite the vast number of studies employing the BPNSFS, norms related to the BPNSFS are currently lacking. Therefore, we also aimed to provide normative data for this scale. Data were collected among a representative sample of 326 participants (M age = 42.90 years, SD = 14.76; range 18-70) in Norway, of which 49.7% was female. Results yielded evidence for a six-factor structure (i.e., combining satisfaction/frustration with the type of need) and showed the subscales to be highly reliable. Subsequent structural equation modeling showed that both need satisfaction and need frustration related strongly to vitality, life satisfaction, and internalizing symptoms, but in opposite ways. Norm scores were provided, thereby differentiating between women and men and different age groups. These findings support the use of the Norwegian BPNSFS and provide researchers and professionals with normative data on the most widely used tool to assess individuals' satisfaction and frustration of the basic psychological needs for autonomy, competence, and relatedness.

The rhythm of affect, autonomy, competence and relatedness: A pilot diary study.

The aim of this study was to explore the circadian rhythm of affect, autonomy, competence, and relatedness in the at-home sleep environmental setting. Participants completed electronic questionnaires at 06:30 h, 16:00 h and 21:00 h for seven days. Ninety-six respondents participated. Among these, 70 were students (73.7%; of which 65.7% were 18-25 years of age, the remainder being 26 years old or more) and 25 nonstudents (26.3%; all 26 years old or more), with one person neglecting to report such status. A total of 24 (25.0%) respondents had full-time jobs during the data collection, 51 (53.1%) had a part-time job, and 21 (21.9%) did not have a job. There was significant difference between times of day for positive affect, autonomy frustration, and competence frustration. This included an increase in positive affect from morning to afternoon, and reduction in autonomy frustration and competence frustration from afternoon to evening. Chronotype was not related to the daily variations in the studies psychological variables. We conclude that although there are some intra-daily variations in some of the basic needs, these are not as strong as those seen for positive affect, in terms of consistency across several days.

The development, inter-rater agreement and performance of a hierarchical procedure for setting the rest-interval in actigraphy data.

The aim of this study was to develop and empirically test a hierarchical procedure for defining rest intervals in actigraphy data. BACKGROUND: This is a two-part study. The aim of study 1 was to identify common practices for setting rest intervals in actigraphy research and investigate whether standardized guidelines for setting the rest interval exist, as a base to develop a new procedure for defining rest intervals in actigraphy. The aim of study 2 was to empirically test this procedure (The Rest Interval Setting, RISE Procedure). The RISE procedure was applied to a dataset of 537 nights from the sleep study SLEEPIC. PARTICIPANTS: Participants (N = 55) were aged 19-33 (M = 22.7, SD = 3.0). METHODS: Study 1: Structured overview of the methods used to correct actigraphy data. Study 2: Three scorers independently applied the RISE procedure to the dataset. RESULTS: Study 1 demonstrated that methods and reporting practices are inconsistent and that there is a need for a standardized procedure for setting the rest interval. The results in study 2 revealed that using the new procedure for setting rest intervals provided high agreement between scorers for both rest onsets (α= 0.975) and offsets (α= 0.998). Applying the procedure to the dataset resulted in a shortening of the rest interval by 36 min and 19 s on average. There were significant changes (p < 0.001) in all sleep estimate outcomes after applying the RISE procedure. CONCLUSION: Methods for processing and reporting actigraphy data are highly inconsistent across studies. Here we present empirical support for a new standardized procedure for setting the rest interval, which is likely to improve transparency and reproducibility in achigraphy research.

Associations between Sleep and Work-Related Cognitive and Emotional Functioning in Police Employees.

AIM: We aimed to examine the cross-sectional and longitudinal associations between sleep and work-related impaired cognitive and emotional functioning in police employees. METHODS: This study included 410 participants (52% men) employed in a police district in Norway at baseline, of which 50% also participated in the study at 6 months later follow-up. The questionnaires included items measuring work schedule, sleep length, insomnia, as well as impaired cognitive and emotional functioning at work. RESULTS: The results showed that insomnia was related to impaired work-related emotional functioning measured at baseline, and to impaired cognitive functioning measured at both baseline and follow-up. Sleep length and rotating shift work were not associated with future decline in cognitive or emotional functioning. CONCLUSION: Our study indicates that the relationship between insomnia and emotional functioning at work may be transient, whereas insomnia can be related to both immediate and future impaired cognitive functioning. Replication of the findings in larger samples is advised. The findings call for an emphasis on the prevention and treatment of sleep problems among police employees as a mean of maintaining and improving cognitive and emotional functioning at work, and thereby reducing the risk for impaired performance and negative health and safety outcomes.

Anxiety as a risk factor for cardiovascular disease independent of depression: A narrative review of current status and conflicting findings.

The aim of this paper is to summarise and evaluate the empirical support for the association between anxiety and cardiovascular disease (CVD) and to address challenges related to method and study design. We review results from meta-analyses and more recent findings on the association of anxiety and the risk of CVD. Depression and anxiety are often listed as psychosocial risk markers of CVD, but the role of anxiety as a risk factor for CVD has not received the same evidential support as the effects of depression. Through a narrative review we identified six meta-analyses as well as 15 recent large studies of anxiety and CVD that we summarise. Some of the conflicting findings may be artefacts of study design or population the sample is drawn from. Researchers should take care to be population specific, measurement specific and outcome specific, and to control for comorbid depression.

Anxiety as a risk factor for cardiovascular disease independent of depression: a prospective examination of community-dwelling men (the MrOS study).

OBJECTIVE: Anxiety and depression have been linked to increased risk of cardiovascular disease (CVD). Whether anxiety is a risk factor independent from depression, and if associations are limited to specific CVD outcomes remains unclear. Design: Participants (N = 3135) of the prospective Osteoporotic Fracturs in Men Sleep ancillary study were community-dwelling men (age ≥ 65) living in the US. Main outcome measures: The Goldberg Anxiety and Depression Scales, coronary heart disease (CHD) and cerebrovascular disease (CER). We used Cox proportional hazards models to calculate adjusted hazard ratios and 95% confidence intervals. Results: During 12 years of follow-up, we accrued 612 cases of CHD and 291 cases of CER (incident or repeat-event). Overall, we observed no association between anxiety or depression and CER. Anxiety was significantly associated with CHD, but this effect was attenuated after controlling for depression and covariates. Depression was significantly associated with CHD after similar adjustments. For men without prior history of CVD, neither anxiety nor depression were associated with incident CHD. Conclusions: Anxiety was not a significant independent predictor of CHD or CER, suggesting that previous findings of anxiety as a risk factor of CVD might be attributed to failure to control for the effect of depression.

Mild to moderate partial sleep deprivation is associated with increased impulsivity and decreased positive affect in young adults.

The effects of mild-moderate partial sleep deprivation on affective and cognitive functioning were evaluated in a naturalistic home environment, mimicking short sleep typically caused by demands from work or society. A total of 52 healthy individuals aged 18-35 was included in an 11-day study protocol. Participants slept at home, and sleep patterns were observed using actigraphs and sleep diaries. After maintaining habitual sleep for 7 days, the participants were asked to sleep 2 hours less than their average sleep duration for the last three nights of the study protocol. A not-X continuous performance test was administered at 9 am (± 90 minutes) on days 1, 4, 8 (habitual sleep), 9 and 11 (sleep deprivation). Performance-based measures included response accuracy and speed. Participant-reported measures included how well the participants felt they performed and how exhausted they were from taking the test, as well as positive and negative affect. There was a significant change in reaction time, number of commission errors, subjective performance, subjective exertion, and positive affect across the visits. Specifically, there was a linear decrease in reaction time, performance, and positive affect throughout the study, and a significant quadratic trend for commissions and exertion (first decreasing, then increasing after sleep deprivation). The univariate tests for omissions and negative affect were not significant. We conclude that sleeping 1.5-2 hours less than usual leads to faster response speed, but more commission errors and decreased positive affect. This indicates that individuals become more impulsive and experience less positive affect after a period of short sleep.

Gender differences in factors associated with symptoms of depression among high school students: an examination of the direct and indirect effects of insomnia symptoms and physical activity.

OBJECTIVE: Scant research exists on the gender-specific association between physical activity, insomnia symptoms and depressive symptoms among adolescents. The present study investigates the direct and indirect association of insomnia and physical activity with symptoms of depression. DESIGN: In a community-based sample (N = 1485) we investigated factors associated with symptoms of depression focusing on insomnia. The study also included measures of physical activity and controlled for parental work- and sexual minority status. Body mass Index (BMI) was calculated for a sub-sample (n = 617) reporting weight and height. RESULTS: The results showed that self-reported insomnia was highly prevalent, and the association between insomnia and depression was strong. The association between insomnia and depression was significantly stronger for girls than for boys. The effect of physical activity was substantially weaker compared to insomnia. Insomnia mediated the relationship between physical activity and depression for both boys and girls. Despite expectation based on the existing literature, BMI showed no association with symptoms of depression or physical activity. CONCLUSION: The results address the importance of a gender-specific approach when investigating mental health among adolescents. Given the high prevalence, interventions aimed at reducing insomnia is important in the prevention of mental illness, especially among girls.

Insomnia as a Partial Mediator of the Relationship Between Personality and Future Symptoms of Anxiety and Depression Among Nurses.

Background: This study investigates insomnia as a partial mediator in the relationship between personality and symptoms of anxiety and depression. Methods: The study is based on partly longitudinal data from the ongoing cohort study "Survey of Shift work, Sleep, and Health" (SUSSH) among Norwegian nurses, a survey examining the work situation and health status of Norwegian nurses measured with annual questionnaires. The present study uses data collected in 2012 (Wave 4), 2013 (Wave 5), and 2014 (Wave 6). The final sample at Wave 6 consisted of 2002 participants, of which 91% were females. The questionnaires included items measuring, among others, demographic variables, work time schedule, insomnia (Bergen Insomnia Scale), personality (Mini-IPIP) and anxiety and depression (Hospital Anxiety and Depression Scale). Results: Extraversion and conscientiousness had no significant direct or indirect association with insomnia, anxiety or depression. Neuroticism and insomnia had direct associations to future symptoms of anxiety and depression. Insomnia was also a significant partial mediator of the relationship between both neuroticism and anxiety, and neuroticism and depression, meaning that neuroticism had an indirect relation to symptoms of anxiety and depression through insomnia. When adjusting for previous symptoms of anxiety and depression at Wave 5, insomnia was no longer a significant mediator between neuroticism and anxiety, and only marginally mediated the relationship between neuroticism and depression. Conclusion: The results showed that insomnia may act as a mediator between neuroticism and symptoms of anxiety and depression, but the indirect relationship between neuroticism and anxiety and depression through insomnia is considerably weaker than the direct association. Hence, the mediating effect of insomnia should be interpreted with caution. The sample mainly consisted of female nurses, and the generalizability of the findings to male dominated occupations is limited. Findings from the present study highlight the importance of an integrated approach and strengthen the understanding of how personality and psychopathology are connected.