Maternal Childhood Adversity and Infant Epigenetic Aging: Moderation by Restless Sleep During Pregnancy.

Maternal exposure to childhood adversity is associated with detrimental health outcomes throughout the lifespan and may have implications for offspring. Evidence links maternal adverse childhood experiences (ACEs) to detrimental birth outcomes, yet the impact on the infant's epigenome is unclear. Moreover, maternal sleep habits during pregnancy may influence this association. Here, we explore whether restless sleep during pregnancy moderates the association between exposure to maternal childhood adversity and infant epigenetic age acceleration in 332 mother-infant dyads (56% female; 39% Black; 25% Hispanic). During the 2nd trimester, mothers self-reported childhood adversity and past-week restless sleep; DNA methylation from umbilical vein endothelial cells was used to estimate five epigenetic clocks. Multivariable linear regression was used to test study hypotheses. Despite no evidence of main effects, there was evidence of an interaction between maternal ACEs and restless sleep in predicting infant epigenetic age acceleration using the EPIC Gestational Age clock. Only infants whose mothers reported exposure to both ACEs and restless sleep demonstrated accelerated epigenetic aging. Results provide preliminary evidence that maternal childhood adversity and sleep may influence the infant epigenome.

The role of sleep in prospective associations between parent reported youth screen media activity and behavioral health.

BACKGROUND: Screen media activity (SMA) can negatively affect youth behavioral health. Sleep may mediate this association but has not been previously explored. We examined whether sleep mediated the association between SMA and youth behavioral health among a community sample. METHOD: Parents completed questions about their child (N = 564) ages 3-17 at Wave 1, Wave 2 (4-8 months later), and Wave 3 (12 months later). Path analyses were conducted to examine links between Wave 1 SMA and Wave 3 behavioral health problems (i.e., internalizing, externalizing, attention, peer problems) through Wave 2 sleep disturbance and duration. RESULTS: SMA was significantly associated with greater sleep disturbance, ß = .11, 95% CI [.01, .21] and shorter sleep duration, ß = -.16 [-.25, -.06], and greater sleep disturbance was associated with worse youth behavioral health across internalizing, ß = .14 [.04, .24], externalizing, B = .23 [.12, .33], attention, ß = .24 [.15, .34], and peer problems, ß = .25 [.15, .35]. Longer sleep duration was associated with more externalizing, ß = .13 [.04, .21], and attention problems, ß = .12 [.02, .22], and fewer peer problems, ß = -.09 [-.17, -.01], but not with internalizing problems. Lastly, there was a direct effect of SMA on peer problems, ß = -.15 [-.23, -.06] such that higher SMA that does not impact sleep may have a positive impact on reducing peer problems. CONCLUSIONS: Sleep (i.e., disturbances and shorter duration) may partially account for the small associations observed between SMA and worse behavioral health in youth. To continue expanding our understanding, future research should utilize more diverse representative samples, use objective measures of SMA and sleep, and examine other relevant aspects of SMA, including content, device type, and timing of use.

Predictive ability of the International Classification of Sleep Disorders-3 in identifying risk of obstructive sleep apnea among recently unemployed adults.

BACKGROUND: The International Classification of Sleep Disorders (ICSD)-3 was developed to aid in the identification of these disorders. The core criterion A (ICSD-3A) to identify obstructive sleep apnea (OSA) requires the presentence of specific signs and symptoms. This study explores the predictive ability of the ICSD-3A for OSA as compared with objective measures of respiratory event index (REI). PARTICIPANTS: A total of 291 participants who completed a home sleep apnea test (HSAT) during the screening evaluation of the Assessing Daily Activity Patterns through occupational Transitions (ADAPT) study were included. METHODS: Participants were classified as having mild OSA (REI ≥ 5 and < 15), moderate (≥ 15 to < 30), or severe OSA (> 30). Predictive parameters identifying participants as having OSA by the ICSD-3A criteria were assessed using REI classifications as the reference standard and further compared with a subsample using the STOP-Bang questionnaire. RESULTS: The ICSD-3A had a sensitivity of 19.2% for identifying participants as having moderate to severe OSA and specificity of 84.4%. The ICSD-3A had a receiver operating characteristics (ROC) = 0.53. On the subsample of participants, the STOP-Bang questionnaire's ROC is 0.61. Results were similar when examining the classification of participants with mild compared with no OSA. CONCLUSION: In this population, the ability of the ICSD-3A in detecting moderate to severe OSA as well as mild OSA was low. The ROC for the ICSD-3 did not differ significantly from the STOP-Bang questionnaire's ROC in this research population.

Racial/Ethnic Disparities in the Relationship Between Traumatic Childhood Experiences and Suboptimal Sleep Dimensions Among Adult Women: Findings from the Sister Study.

BACKGROUND: Traumatic childhood experiences (TCEs) are associated with poor adulthood sleep, but racial/ethnic disparities have not been well-studied. We investigated the TCE-adulthood sleep relationship among non-Hispanic (NH)-White, NH-Black, and Hispanic/Latina women. METHOD: Women enrolled in the Sister Study from 2003 to 2009 reported the following TCEs in a follow-up interview (2008-2012): natural disasters; major accidents; household dysfunction; and sexual, physical, and psychological/emotional abuse. Sleep characteristics included short sleep duration (< 7 h vs. 7-9 h), long sleep onset latency (SOL) (> 30 vs. ≤ 30 min), frequent night awakenings (≥ 3 times/night ≥ 3 times/week [yes vs. no]), and frequent napping (≥ 3 vs. < 3 times/week). Using log-binomial regression to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for sleep characteristics among women with vs. without TCEs, we investigated racial/ethnic-specific associations and race/ethnicity as a moderator. RESULTS: Among 40,082 participants (mean age = 55 ± 8.8 years), 55% reported ≥ 1 TCE (NH-White, 54%; NH-Black, 62%; Hispanic/Latina, 57%). NH-White, NH-Black, and Hispanic/Latina women reporting any TCE had a higher prevalence of short sleep compared with their within-race/ethnicity counterparts without TCEs. Associations were strongest among NH-Whites. Compared to NH-Whites with no TCEs, racial/ethnic minorities who reported any TCEs had a higher prevalence of short sleep (PRBlacks = 2.13 [95% CI 2.02-2.24], PRHispanics/Latinas = 1.47 [1.35-1.60]) and long SOL. When comparing racial/ethnic minorities with TCEs to NH-Whites with TCEs, PRs for short sleep (PRBlacks = 1.98 [1.88-2.08] and PRHispanics/Latinas = 1.36 [1.25-1.48]) and long SOL were weaker. CONCLUSION: TCEs were positively associated with poor sleep characteristics among women, and TCEs appear to contribute to short sleep duration and long SOL disparities.

Maternal Bonding Predicts Actigraphy-Measured Sleep Parameters in Depressed and Nondepressed Adults.

Associations between subjective maternal bonding recalled from the first 16 years of life and current sleep indices were investigated in a clinical sample of 34 adults with major depressive disorder and 36 normal controls (n = 70) using the self-report parental bonding instrument and wrist actigraphy. Results of multiple linear regression analyses indicated that reports of maternal bonding indices were associated with several sleep indices in adulthood independent of depression status. Higher levels of maternal care were associated with greater time in bed and total sleep time. Higher levels of maternal overprotection were associated with fewer awakenings. Findings indicate that reported maternal bonding characteristics in childhood are related to objectively measured sleep characteristics in adulthood, independent of mood state.

E-cigarette use and sleep-related complaints among youth.

INTRODUCTION: E-cigarette use is highly prevalent among adolescents. However, little research has examined the relationship between e-cigarette use and sleep-related complaints in this population. The objective of this study was to assess whether exclusive e-cigarette, exclusive combusted cigarette, and dual-product use are associated with sleep-related complaints among adolescents. METHODS: Participants were 9,588 U.S. adolescents from the Population Assessment of Tobacco and Health Study, a nationally representative cohort, followed from 2013 through 2015. Using logistic regression, we examined the cross-sectional association between past-year e-cigarette, combusted cigarette, or dual-product use and past-year sleep-related complaints (bad dreams, sleeping restlessly, or falling asleep during the day), both measured at Wave 2. We controlled for Wave 1 demographic characteristics, emotional and behavioral health, and prior history of e-cigarette use, combusted cigarette use, and sleep-related complaints. RESULTS: In unadjusted analyses, e-cigarette, combusted cigarette, and dual-product use were significantly associated with greater odds of sleep-related complaints, compared to use of neither product (e-cigarettes: OR = 1.61, 95% CI 1.34-1.94; combusted cigarettes: OR = 1.62, 95% CI 1.26-2.09; dual-product use: OR = 2.00, 95% CI 1.63-2.46). Associations between e-cigarette and dual-product use and sleep-related complaints remained significant in fully adjusted analyses (e-cigarettes: aOR = 1.29, 95% CI 1.05-1.59; dual-product use: aOR = 1.57, 95% CI 1.24-1.99), whereas associations with combusted cigarette use were significant in all models except the fully adjusted model (aOR = 1.30, 95% CI 0.98-1.71). CONCLUSIONS: E-cigarette and dual-product use are significantly associated with greater odds of reporting sleep-related complaints among adolescents. Future research should evaluate whether this association may be causal.

Longitudinal assessment of daily activity patterns on weight change after involuntary job loss: the ADAPT study protocol.

BACKGROUND: The World Health Organization has identified obesity as one of the most visible and neglected public health problems worldwide. Meta-analytic studies suggest that insufficient sleep increases the risk of developing obesity and related serious medical conditions. Unfortunately, the nationwide average sleep duration has steadily declined over the last two decades with 25% of U.S. adults reporting insufficient sleep. Stress is also an important indirect factor in obesity, and chronic stress and laboratory-induced stress negatively impact sleep. Despite what we know from basic sciences about (a) stress and sleep and (b) sleep and obesity, we know very little about how these factors actually manifest in a natural environment. The Assessing Daily Activity Patterns Through Occupational Transitions (ADAPT) study tests whether sleep disruption plays a key role in the development of obesity for individuals exposed to involuntary job loss, a life event that is often stressful and disrupting to an individual's daily routine. METHODS: This is an 18-month closed, cohort research design examining social rhythms, sleep, dietary intake, energy expenditure, waist circumference, and weight gain over 18 months in individuals who have sustained involuntary job loss. Approximately 332 participants who lost their job within the last 3 months are recruited from flyers within the Arizona Department of Economic Security (AZDES) Unemployment Insurance Administration application packets and other related postings. Multivariate growth curve modeling will be used to investigate the temporal precedence of changes in social rhythms, sleep, and weight gain. DISCUSSION: It is hypothesized that: (1) unemployed individuals with less consistent social rhythms and worse sleep will have steeper weight gain trajectories over 18 months than unemployed individuals with stable social rhythms and better sleep; (2) disrupted sleep will mediate the relationship between social rhythm disruption and weight gain; and (3) reemployment will be associated with a reversal in the negative trajectories outlined above. Positive findings will provide support for the development of obesity prevention campaigns targeting sleep and social rhythms in an accessible subgroup of vulnerable individuals.

Association of Time in Bed, Social Jetlag, and Sleep Disturbances With Cognitive Performance in Children With ADHD.

OBJECTIVES: Children with ADHD commonly exhibit sleep disturbances, but there is limited knowledge about how sleep and sleep timing are associated with cognitive dysfunction in children with ADHD. METHODS: Participants were 350 children aged 5 to 12 years diagnosed with ADHD. Three sleep-related constructs-time in bed, social jetlag (i.e., discrepancy in sleep timing pattern between school nights and weekend nights), and sleep disturbances were measured using a caregiver-report questionnaire. Linear regression models assessed the associations between sleep-related constructs and cognitive performance. RESULTS: After adjustment for sociodemographic variables, there were few associations between time in bed or sleep disturbances and cognitive performance, however, greater social jetlag was negatively associated with processing speed (ß = -.20, 95% CI [-0.35, -0.06]), visually-based reasoning (ß = -.13, 95% CI [-0.27, 0.00]), and language-based reasoning (ß = -.22, 95% CI [-0.36, -0.08]); all p < .05). CONCLUSION: Social jetlag, but not time in bed or disturbances, was associated with lower cognitive performance among children with ADHD.

Does sleep link child maltreatment to depressive symptoms among incoming first-year college students?

Study Objectives: We examined whether sleep (i.e. quality, regularity, and duration) mediated associations between child maltreatment (CM) and depressive symptoms among emerging adults undergoing the major life transition of starting college. Methods: Students (N = 1400; 44% male; 48% non-Hispanic white, 20% non-Hispanic Asian, 15% Hispanic all races, 7% non-Hispanic black, and 10% non-Hispanic other races) completed daily sleep diaries for 9 weeks, followed by the Childhood Trauma Questionnaire-Short Form, Pittsburgh Sleep Quality Index, and the Center for Epidemiologic Studies Depression Scale (CES-D). DSD data were used to compute participants' Sleep Regularity Index and average 24-hour total sleep time. We used a nonparametric structural equation modeling bootstrap approach and full information maximum likelihood to account for missing data. In model 1, we controlled for sex and race and ethnicity. In model 2, we further adjusted for baseline CES-D scores. Results: The prevalence of self-reported moderate-to-severe CM was 22%. Small but significant indirect effects of CM on greater depressive symptoms through worse sleep quality (ß = 0.06, 95% CI = 0.04, 0.09) and lower sleep regularity (ß = 0.02, 95% CI = 0.005, 0.03) were observed in model 1. In model 2, only the indirect effect of sleep quality remained significant (ß = 0.03, 95% CI = 0.01, 0.06). Conclusions: Poorer sleep quality may partially account for associations between CM and depressive symptoms during the first semester of college. Including sleep as a target in student health interventions on college campuses may not only help buffer against poor mental health outcomes for students with CM, but also poor academic and socioeconomic outcomes long-term.

Effects of sleep on breakfast behaviors in recently unemployed adults.

OBJECTIVES: Skipping meals is linked to negative cardiometabolic health outcomes. Few studies have examined the effects of breakfast skipping after disruptive life events, like job loss. The present analyses examine whether sleep timing, duration, and continuity are associated with breakfast eating among 186 adults who recently (past 90 days) experienced involuntary unemployment from the Assessing Daily Activity Patterns Through Occupational Transitions (ADAPT) study. METHODS: We conducted both cross-sectional and 18-month longitudinal analyses to assess the relationship between actigraphic sleep after job loss and breakfast eating. RESULTS: Later sleep timing was associated with a lower percentage of days breakfast was eaten at baseline (B = -0.09, SE = 0.02, P < .001) and longitudinally over 18 months (estimate = -0.04; SE = 0.02; P < .05). No other sleep indices were associated with breakfast consumption cross-sectionally or prospectively. CONCLUSIONS: Unemployed adults with a delay in sleep timing are more likely to skip breakfast than adults with an advancement in sleep timing. Future studies are necessary to test chronobiological mechanisms by which sleep timing might impact breakfast eating. With the understanding that sleep timing is linked to breakfast eating, the advancement of sleep timing may provide a pathway for the promotion of breakfast eating, ultimately preventing cardiometabolic disease.

Use of Sleep Aids in Insomnia: The Role of Time Monitoring Behavior.

Objective: Over-the-counter (OTC) and prescription sleep medications are frequently used as treatments for chronic insomnia, despite risks and limited long-term efficacy. Investigating mechanisms underlying this predilection for pharmacotherapy may uncover strategies to decrease reliance on sleep aids. The objective of this study was to determine how time monitoring behavior (TMB; clock-watching) and associated frustration may interact with insomnia symptoms to drive the use of sleep aids.Methods: Patients (N = 4,886) presenting for care at a community-based, private sleep medical center between May 2003 and October 2013 completed the Insomnia Severity Index (ISI) and Time Monitoring Behavior-10 (TMB-10) and reported their frequency of sleep medication use (OTC and prescription, separately). Mediation analyses examined how clock-watching and related frustration could be associated with insomnia symptoms and medication use.Results: The relationship between TMB and sleep medication use was significantly explained by ISI (P < .05), in that TMB (especially related frustration) appears to aggravate insomnia, which in turn leads to sleep aid use. Similarly, but to a lesser extent, the relationship between ISI and sleep medication use was explained by TMB, in that ISI may lead to increased TMB, which may in turn lead to sleep aid use.Conclusions: TMB and the associated frustration it engenders may perpetuate a negative cycle of insomnia and sleep aid use. Future longitudinal and interventional research is necessary to examine the developmental course of these clinical symptoms and behaviors and to test whether decreasing frustration by limiting TMB reduces the proclivity for pharmacotherapy.

Expanding on Threat and Deprivation: Empirical Examination of Adversity Dimensions and Psychiatric Outcomes Among Emerging Adults.

Dimensional models of adversity, whereby experiences lie along dimensions of threat and deprivation, are increasingly popular; however, their empirical validation is limited. In a sample of emerging adults (N=1,662; M age =20.72; 53% female; 72% Black), we conducted exploratory factor analyses using adversities derived from items probing family relationships and a validated assessment of traumatic events. Resulting factors were used to test associations with odds of lifetime diagnosis of a substance use disorder, other mental health disorders, and suicide attempt. Results supported a four-factor solution: threat (non-betrayal), emotional deprivation, sexual assault, and threat (betrayal). Threat (betrayal) summary scores were most strongly associated with increased odds of substance use and other disorders, whereas sexual assault was most strongly associated increased odds of lifetime suicide attempt. Findings provide some empirical support for categorizing adversity along dimensions of threat and deprivation. However, it also suggests the possibility of further divisions within these dimensions.

Adverse childhood experiences and sleep links in a predominantly Black sample of overweight adults.

Adverse childhood experiences (ACEs) have been associated with worse sleep, but existing literature is limited by use of predominantly White samples, lack of objective sleep measurement, and use of non-standardized questionnaires. We investigated associations between retrospectively reported ACEs and sleep in adulthood in a sample of 43 adults 20-53 years of age, free from chronic conditions, with a Body mass index (BMI) ≥ 25 (Mean age = 33.14 [SD = 10.05], 74% female, 54% Black). Sleep efficiency (SE), total sleep time (TST), wake after sleep onset (WASO), and sleep onset latency (SOL), were measured by actigraphy and daily diary. Global sleep quality and insomnia severity were measured by questionnaires. Sleepiness, fatigue, and sleep quality were also measured by daily diary. Adjusting for demographic characteristics and BMI, ACEs were significantly associated with poorer global sleep quality and diary measures of greater daytime sleepiness, fatigue, and poorer sleep quality. There were no significant associations between ACEs and SE, TST, WASO, or SOL measured by diary or actigraphy. Findings suggest that ACEs are associated with worse sleep perception and daytime functioning in adulthood. Larger prospective studies are needed to replicate these findings, examine racial/ethnic differences, and determine temporal associations between ACEs, sleep, and health (e.g., BMI).

Nocturnal Delta Power is Associated With Lower Next-Day Pain But Not Pain Catastrophizing: Results From a Cohort of Female Participants With Temporomandibular Joint Pain.

Existing data demonstrate reduced delta power during sleep in patients with depression and chronic pain. However, there has been little examination of the relationship between delta power and pain-reports, or pain-catastrophizing. We recruited female participants (n = 111) with insomnia and temporomandibular disorder, and measured nocturnal and daytime measures of pain and pain catastrophizing, and calculated relative nocturnal delta (0.5-4 Hz) power during sleep. We fit linear regression models, and further examined the moderating effect of depressive symptom severity. Lower relative delta power across the whole night was significantly associated with greater nocturnal pain (B = -20.276, P = .025, R2 = 0.214). Lower relative delta power during the first-third of the night, was associated with greater nocturnal pain (B = -17.807, p = 0.019, R2 = 0.217), next-day pain (B = 13.876, P = .039, R2 = 0.195), and next-morning pain (B = -15.751, P = .022, R2 = 0.198). Lower relative delta power during the final-third of the night was significantly associated with greater nocturnal (B = -17.602, P = .029, R2 = 0.207) and next-morning pain (3rd: B = -14.943, P = .042, R2 = 0.187). Depressive symptom severity did not moderate these relationships. Delta power was not significantly associated with nocturnal or daytime pain catastrophizing. These findings demonstrate that greater relative delta power during sleep is associated with lower nocturnal and next-day pain in patients with temporomandibular disorder. This data may guide the use of sleep interventions in clinical pain populations, with the aim of improving pain outcomes. PERSPECTIVE: This article presents data demonstrating an association between increased nocturnal delta power and reduced next-day pain. These findings may help promote interventions which aim to increase nocturnal delta power in clinical pain populations, with the goal of improving pain outcomes.

Development of circadian rest-activity rhythms during the first year of life in a racially diverse cohort.

STUDY OBJECTIVES: To describe the development of circadian rest-activity rhythms (CRARs) during infancy in a racially diverse cohort. METHODS: We studied 414 infants from the Nurture birth cohort (51.2% female, 65.2% Black) who wore actigraphs on their left ankles for 4 days and nights at 3, 6, 9, and 12 months. We quantified CRARs using cosinor and non-parametric circadian rhythm analysis, and investigated change in CRARs over time, comparing 6, 9, and 12 months to CRARs at 3 months. We adjusted for baseline and time-varying covariates and used function-on-scalar regression (FOSR) to identify the specific times of day at which activity changes occurred. RESULTS: Across the first year, daily mean and peak activity levels and day-to-day activity level regularity increased, and activity level fragmentation and nighttime activity decreased. Only at 9 months, compared to at 3 months, did timing of peak activity levels and the most active periods shift later, while timing of least active periods shifted earlier. FOSR analyses showed that mean activity levels decreased during nighttime hours and increased during daytime hours, with the most pronounced changes at 9 months. CONCLUSIONS: Among racially diverse infants, CRARs became more robust, stable, and less fragmented over time. Findings suggest the greatest change from 3-month CRARs occurs at 9 months, which may be a key period of CRAR development. This and future research will contribute to our understanding of normative infant CRAR development in diverse populations and enable us to identify infants who may benefit from intervention.

Sex Hormones, Sleep, and Memory: Interrelationships Across the Adult Female Lifespan.

As the population of older adults grows, so will the prevalence of aging-related conditions, including memory impairments and sleep disturbances, both of which are more common among women. Compared to older men, older women are up to twice as likely to experience sleep disturbances and are at a higher risk of cognitive decline and Alzheimer's disease and related dementias (ADRD). These sex differences may be attributed in part to fluctuations in levels of female sex hormones (i.e., estrogen and progesterone) that occur across the adult female lifespan. Though women tend to experience the most significant sleep and memory problems during the peri-menopausal period, changes in memory and sleep have also been observed across the menstrual cycle and during pregnancy. Here, we review current knowledge on the interrelationships among female sex hormones, sleep, and memory across the female lifespan, propose possible mediating and moderating mechanisms linking these variables and describe implications for ADRD risk in later life.

The association between traumatic life events and insomnia symptoms among men and women: Results from the Baltimore Epidemiologic Catchment Area follow-up study.

STUDY OBJECTIVES: Trauma exposure likely contributes to poor sleep, but relatively few studies have empirically tested this, instead focusing on posttraumatic stress disorder. Moreover, little is known about sex differences in sleep after trauma. The current study used a cross-sectional and retrospective design to test hypotheses that trauma exposure would be associated with subsequent insomnia symptoms, particularly among women, even after accounting for important covariates. METHOD: Data from Wave 3 (1993-1996) of the Baltimore Epidemiologic Catchment Area Study (N = 1920) were used to examine associations between remote (prior to past year) and recent (past year) trauma and current sleep disturbance (insomnia, hypersomnia symptoms) in the total sample (Mage= 55, 63.2% women, 57.7% white), and separately in men and women. Sensitivity analyses were conducted among individuals with no pretrauma sleep disturbance to examine incident sleep disturbance. RESULTS: Among all participants, both remote (odds ratio [OR] = 1.95, 95% confidence interval [CI] [1.34, 2.85]) and recent (OR = 1.94, 95% CI [1.31, 2.87]) trauma exposure were associated with increased odds of insomnia (OR = 2.41, 95% CI [1.54, 3.76]) but not hypersomnia. Associations between trauma and insomnia were particularly strong among women, but null among men. The relationship between trauma exposure and insomnia symptoms persisted among individuals with no pretrauma history of insomnia. CONCLUSION: Results suggest women may be vulnerable to insomnia symptoms as sequelae of trauma. Future research should examine prospective associations between trauma and sleep in larger samples and how assessment and treatment of insomnia among women trauma survivors reduces the public health impact of trauma and poor sleep.

The impact of social rhythm and sleep disruptions on waist circumference after job loss: A prospective 18-month study.

OBJECTIVE: This study prospectively examined change in waist circumference (WC) as a function of daily social rhythms and sleep in the aftermath of involuntary job loss. It was hypothesized that disrupted social rhythms and fragmented/short sleep after job loss would independently predict gains in WC over 18 months and that resiliency to WC gain would be conferred by the converse. METHODS: Eligible participants (n = 191) completed six visits that included standardized measurements of WC. At the baseline visit, participants completed the social rhythm metric and daily sleep diary and wore an actigraph on their nondominant wrist each day for a period of 2 weeks. RESULTS: When controlling for obesity and other covariates, WC trajectories decreased for individuals with more consistent social rhythms, more activities in their sdiocial rhythms, and higher sleep quality after job loss. WC trajectories did not change for individuals with lower scores on these indicators. CONCLUSIONS: The frequency and consistency of social rhythms after job loss play a key role in WC loss. These findings support the implementation of social rhythm interventions after job loss, a potentially sensitive time for the establishment of new daily routines that have an impact on metabolic health.

Associations of cumulative violence and structural vulnerability with restless sleep among female sex workers in Baltimore, Maryland.

OBJECTIVE: To investigate correlates of restless sleep among street-based female sex workers (FSW) in the United States, an understudied population experiencing high rates of structural vulnerabilities (e.g., homelessness, food insecurity) and trauma. METHODS: Using data from a cohort of street-based cisgender FSW (n = 236; median age = 35 years, 68% non-Hispanic White), we examined cross-sectional associations of individual, interpersonal, and structural factors with frequent restless sleep over the past week (5-7 vs. <5 days). RESULTS: Participants reported a high prevalence of homelessness (62%), food insecurity (61%), daily heroin injection (53%), lifetime sexual or physical violence (81%), and frequent restless sleep (53%). Older age, food insecurity, poor self-rated health, and cumulative violence exposure were independently associated with frequent restless sleep. CONCLUSION: Frequent restless sleep was prevalent among FSW with higher odds among those experiencing intersecting vulnerabilities and multiple exposures to violence. Further research on sleep health in this population is needed to understand its role in health risks.

Associations of adverse childhood experiences with adolescent total sleep time, social jetlag, and insomnia symptoms.

STUDY OBJECTIVE: Adverse childhood experiences (ACEs) are associated with sleep problems in adulthood, but less research has focused on ACEs and sleep during adolescence. The goal of the present study was to explore associations between ACEs reported at ages 5 and 9 years, and sleep (ie, total sleep time (TST), social jetlag, and insomnia symptoms) at age 15. METHODS: Participants comprised 817 families from the Fragile Families and Child Wellbeing Study, a nationally representative sample of children born to unwed parents. Number of ACEs was constructed from primary-caregiver reports at ages 5 and 9, and sleep measures (ie, TST, social jetlag, and insomnia symptoms) were derived from adolescent-reported sleep behaviors at age 15. RESULTS: Adjusting for sex and race/ethnicity, ACEs at age 9 were associated with longer weekend TST (B = 0.16, 95% CI = 0.04, 0.28), more social jetlag (B = 0.17, 95% CI = 0.07, 0.27), and higher odds of trouble falling asleep ≥3 times per week (Odds Ratio = 1.24, 95% CI = 1.01, 1.53). In females only, ACEs were associated with greater school night TST (B = 0.12, 95% CI = 0.01, 0.23). Results were similar after further adjustment for symptoms of anxiety and depression. Associations among ACEs, social jetlag, and insomnia symptoms appeared strongest among Non-Hispanic Black adolescents. CONCLUSION: ACEs appear to be related to multiple aspects of sleep in adolescence. Additional research is needed to confirm these associations and examine the extent to which sleep disturbances associated with ACEs account for later health outcomes.