Associations Among Sleep, Emotional Eating, and Body Dissatisfaction in Adolescents.

The literature on adolescent sleep has shown a bidirectional relationship between sleep difficulties and altered eating habits, including emotional eating. However, it is unclear if this relationship is related to preexisting body concerns, or if poor sleep is the prime contributor to emotional eating patterns. This study therefore seeks to examine body dissatisfaction as a moderator of the sleep-emotional eating relationship in an at-risk sample. Adolescents (N = 106) presenting for overnight polysomnography self-reported on time-in-bed, insomnia, body dissatisfaction, and emotional eating. Less time-in-bed was correlated with a greater desire for thinness and greater insomnia severity was related to overall emotional eating and eating in response to anxiety, anger, and frustration and in response to depression. Moderation analyses revealed that the relationships between time-in-bed and eating in response to feeling unsettled (b = -.002, 95% CI[- .003, - .001], p < .005) and eating in response to anxiety, anger, and frustration (b = -.01, 95% CI[- .01, - .001], p < .05) were exacerbated by worse body dissatisfaction. Optimizing sleep may attenuate the risk for disordered eating, particularly for adolescents with high body dissatisfaction.

Treatment feasibility of a digital tool for brief self-help behavioural therapy for insomnia (FastAsleep).

Cognitive behavioural therapy for insomnia is efficacious and recommended for insomnia, but availability is scarce. Cognitive behavioural therapy for insomnia self-help interventions could increase availability, especially if unguided. Optimizing cognitive behavioural therapy for insomnia methods and system user-friendliness, we developed a short, digital, self-help programme-FastAsleep-based on the behavioural components of sleep restriction and stimulus control. This study investigated its feasibility and preliminary effects. Thirty media-recruited participants with moderate to severe insomnia were assessed via telephone before using FastAsleep for 4 weeks, and were interviewed afterwards. Self-ratings with web questionnaires were conducted at screening, pre-, mid- and post-treatment, and at 3-month follow-up. Primary outcomes were feasibility (credibility, adherence, system user-friendliness and adverse effects), and secondary outcomes were changes in symptom severity (insomnia, depression and anxiety). Adherence was generally high, participants' feasibility ratings were favourable, and adverse effects matched previously reported levels for cognitive behavioural therapy for insomnia. Symptoms of insomnia decreased after the treatment period (Hedge's g = 1.79, 95% confidence interval = 1.20-2.39), as did symptoms of depression and anxiety. FastAsleep can be considered feasible and promising for alleviating insomnia symptoms among patients fit for self-care. Future controlled trials are needed to establish the efficacy of FastAsleep and its suitability in a stepped care model.

Digital cognitive behaviour therapy for insomnia in individuals with self-reported insomnia and chronic fatigue: A secondary analysis of a large scale randomized controlled trial.

Insomnia is associated with fatigue, but it is unclear whether response to cognitive behaviour therapy for insomnia is altered in individuals with co-occurring symptoms of insomnia and chronic fatigue. This is a secondary analysis using data from 1717 participants with self-reported insomnia in a community-based randomized controlled trial of digital cognitive behaviour therapy for insomnia compared with patient education. We employed baseline ratings of the Chalder Fatigue Questionnaire to identify participants with more or fewer symptoms of self-reported chronic fatigue (chronic fatigue, n = 592; no chronic fatigue, n = 1125). We used linear mixed models with Insomnia Severity Index, Short Form-12 mental health, Short Form-12 physical health, and the Hospital Anxiety and Depression Scale separately as outcome variables. The main covariates were main effects and interactions for time (baseline versus 9-week follow-up), intervention, and chronic fatigue. Participants with chronic fatigue reported significantly greater improvements following digital cognitive behaviour therapy for insomnia compared with patient education on the Insomnia Severity Index (Cohen's d = 1.36, p < 0.001), Short Form-12 mental health (Cohen's d = 0.19, p = 0.029), and Hospital Anxiety and Depression Scale (Cohen's d = 0.18, p = 0.010). There were no significant differences in the effectiveness of digital cognitive behaviour therapy for insomnia between chronic fatigue and no chronic fatigue participants on any outcome. We conclude that in a large community-based sample of adults with insomnia, co-occurring chronic fatigue did not moderate the effectiveness of digital cognitive behaviour therapy for insomnia on any of the tested outcomes. This may further establish digital cognitive behaviour therapy for insomnia as an adjunctive intervention in individuals with physical and mental disorders.

Psychosocial determinants of sleep difficulties in adolescence: the role of perceived support from family, peers, and school in an Italian HBSC sample.

The present study explores the concurrent contribution to sleep problems of individual-related, family-related, and school-related factors in adolescence. Gathering from the Italian 2018 Health Behavior in School-Aged Children (HBSC) data collection, we used hierarchical logistic regression on a sample of 3397 adolescents (51% females, Mage = 13.99, SD = 1.62) to explore the contribution to sleep problems of the individual (Model 1: alcohol use, smoking, screen time, physical activity), familial (Model 2: parental communication, parental support), and school-related (Model 3: peer support, schoolmates/students support, teacher support and school pressure) variables. 28.3 percent of adolescents reported having sleep difficulties. Overall, Model 3 significantly improved over Model 2 and Model 1. Data showed that increasing smoking (OR = 1.11; 95% CI: 1.03-1.20) and screen time (OR = 1.05; 95% CI: 1.02-1.08) were associated with sleep difficulties but not alcohol use and physical activity. Also, impaired communication with both parents and increasing parental support (OR = 0.84; 95% CI: 0.78-0.90) were associated with decreased odds of sleep problems. Finally, both increases in school pressure (OR = 1.40; 95% CI: 1.26-1.56) and lack of student support (OR = 1.25; 95% CI: 1.10-1.42) were associated with a higher likelihood of sleep problems, while peer support and teacher support were not.   Conclusion: Our findings highlight the importance of an integrated approach to the study of sleep difficulties in adolescence that includes specific psychosocial contributors such as the quality of parental communication and perceived parental support and considers the quality of the day-to-day relationship with schoolmates and the school level of demands. What is Known: • Adolescents' are at-risk of more significant sleep difficulties, and recent literature highlights the importance of an integrated approach to understanding this phenomenon, including biological, psychosocial, and contextual factors. • The literature lacks findings that consider the concurrent contribution of individual and psychosocial factors to sleep difficulties in adolescence. What is New: • The quality of parental communication and perceived parental support, as expressions of adult figures' emotional and behavioural availability in the adolescent's life, are significant determinants of sleep difficulties. • The quality of day-to-day relationships with schoolmates and the school level of demands contribute to adolescent sleep problems.

A nationally representative study of aerobic activity and strength training in older cancer survivors and their psychological distress and sleep difficulties.

OBJECTIVE: To examine the prevalence of different levels of aerobic activity and strength training in older cancer survivors and their associations with psychological distress and sleep difficulties. METHODS: We used cross-sectional data from the 2016-2018 National Health Interview Survey on 3,425 survivors aged ≥ 65 years. Individuals were classified into active, insufficiently active, and inactive categories, and by whether they reported strength training at least twice per week. The outcome variables were self-reported psychological distress, trouble falling asleep, trouble staying asleep, and trouble waking up feeling rested. Multivariate logistic models were used to calculate the odds ratios (ORs) and the 95% confidence intervals (CIs). RESULTS: Only 35.2% of older survivors reached the recommended aerobic activity guidelines, and 12% had strength training at least twice per week. A total of 626 (18.3%) reported at least moderate psychological distress, and 1,137 (33.2%) had trouble staying asleep. For survivors who reported strength training less than two times per week, being insufficiently active or inactive was associated with worse psychological distress (OR 1.52, 95% CI 1.17-1.97; OR 1.30, 95% CI 1.02-1.64) and more sleep difficulties (OR ranging from 1.33 to 2.07). Among active survivors, strength training two or more times per week was associated with more trouble staying asleep (OR 1.67, 95% CI 1.06-2.58). CONCLUSIONS: Most older cancer survivors did not meet the recommended physical activity guidelines and suffered from psychological distress and sleep difficulties. Additional research may be needed to examine the effects of frequent muscle strength training on sleep quality.

Hospital physicians´ working hour characteristics and sleep quality: a cross-sectional analysis of realized working hour and survey data.

BACKGROUND: Hospital physicians' work includes on-call duties to provide 24/7 health care. Previous studies using self-reported survey data have associated long working hours and on-call work with sleep difficulties. To reduce recall bias, we complemented survey data with payroll-based objective data to study whether hospital physicians' realized working hours are associated with sleep. METHODS: The study was nested within the Finnish Public Sector study. We used survey data on 728 hospital physicians (mean age 43.4 years, 62% females) from 2015 linked to realized daily working hour data from 3 months preceding the survey. The associations of working hour characteristics with sleep quantity and quality were studied with multinomial logistic regression analysis adjusted for demographics, overall stressfulness of life situation, control over scheduling of shifts, and hospital district. RESULTS: One fourth (26%) of the participants reported short (≤6.5 h) average sleep duration. Frequent night work (> 6 shifts/91 days) was associated with short sleep (OR 1.87 95%CI 1.23-2.83) compared to no night work. Approximately one third (32%) of the physicians reported insufficient sleep. Physicians with long weekly working hours (> 48 hours) had higher odds for insufficient sleep (OR 1.78 95%CI 1.15-2.76) than physicians with short weekly working hours (< 40 hours). Insufficient sleep was also associated with frequent on-call duties (> 12 shifts/3 months OR 2.00 95%CI 1.08-3.72), frequent night work (OR 1.60 95%CI 1.09-2.37), and frequent short shift intervals (≤11 hours; > 12 times/3 months OR 1.65 95%CI 1.01-2.69) compared to not having these working hour characteristics. Nearly half of the physicians (48%) reported at least one sleep difficulty at least two times a week and frequent night work increased odds for difficulties in initiating sleep (OR 2.43 95%CI 1.04-5.69). Otherwise sleep difficulties were not associated with the studied working hour characteristics. CONCLUSION: We used realized working hour data to strengthen the evidence on on-call work and sleep quality and our results advice to limit the frequency of night work, on-call shifts, short shift intervals and long weekly working hours to promote hospital physicians' sufficient sleep.

Sleep difficulties, incident dementia and all-cause mortality among older adults across 8 years: Findings from the National Health and Aging Trends Study.

Sleep difficulties have been implicated in the development and progression of dementia and in all-cause mortality. This study examines the relationship between sleep difficulties, incident dementia and all-cause mortality over 8 years of follow-up among a nationally representative sample of older (≥65 years) adults in the United States. We used data collected from the National Health and Aging Trends Study (NHATS) from 2011 to 2018, a prospective cohort study of Medicare beneficiaries. At baseline, the NHATS sample comprised 6,376 older adults who were representative of 32 million older adults. Respondents reported routine difficulty initiating sleep or difficulty falling back asleep "most nights" or "every night" in each study year. In each year, dementia was determined by either self-reported diagnosis or performance on immediate and delayed recall word and clock drawing tests, whereas all-cause mortality was determined by proxy. We conducted Cox proportional hazards modelling, adjusting for age, sex, marital status and chronic conditions. In models predicting all-cause mortality, we also controlled for dementia. Among respondents at baseline, 19% were 65-75 years of age, 71% identified as non-Hispanic white and 59% were female. Difficulty initiating sleep (hazard ratio [HR], 1.49; 95% confidence interval [CI],1.25-1.77), difficulty falling back asleep (HR, = 1.39; 95% CI,1.14-1.70) and concurrent sleep difficulties (HR, 1.58; 95% CI, 1.25-1.99) were associated with greater risk of dementia. Difficulty initiating sleep (HR, 1.44; 95% CI,1.20-1.72), difficulty falling back asleep (HR, 1.56; 95% CI,1.29-1.89), and concurrent sleep difficulties (HR, 1.80; 95% CI, 1.44-2.24) were associated with greater risk of all-cause mortality. Our findings demonstrate that reported difficulties are prospectively associated with an increased risk of dementia and all-cause mortality among older people.

Sleep quality and outcome of exposure therapy in adults with social anxiety disorder.

INTRODUCTION: Poor sleep is prevalent among individuals with social anxiety disorder (SAD) and may negatively affect exposure therapy outcomes. Poor sleep may impair memory and learning, and thus compromise fear extinction learning thought to take place in exposure therapy. We examined poor sleep as a predictor of exposure therapy outcomes for SAD and the moderating role of d-cycloserine (DCS) on this relationship. METHODS: Participants were 152 individuals with a primary diagnosis of SAD. As part of a randomized clinical trial evaluating the efficacy of DCS for enhancing the effects of exposure therapy, they completed self-report baseline measure of sleep quality, and self-report sleep diaries assessing sleep duration (total sleep time [TST]) and sleep quality the nights before and after treatment sessions. RESULTS: Poorer baseline sleep quality was significantly associated with slower improvement over time and worse symptom outcomes at the end of treatment and follow-up after controlling for baseline symptoms of depression and social anxiety. Greater TST the night before treatment predicted lower SAD symptoms at the next session, after controlling for symptoms at the previous session. There was no relation between prior or subsequent night sleep quality on symptoms at the next session. No associations were moderated by DCS. CONCLUSIONS: We replicated and extended findings indicating that poor sleep quality is associated with poorer exposure therapy outcomes for SAD. Assessing for sleep difficulties before treatment initiation and incorporating sleep interventions into treatment may enhance exposure therapy outcomes for SAD.

Sleep-related difficulties in healthy children and adolescents.

BACKGROUND: As sleep-related difficulties are a growing public health concern, it is important to gain an overview of the specific difficulty areas of the most vulnerable individuals: children. The current descriptive study presents the prevalence of sleep-related difficulties in two large samples of healthy children and adolescents and outlines the effects of age, gender, and socioeconomic status (SES) on various sleep-related difficulties. METHODS: Participants were 855 4-9 year-old children (child sample) and 1,047 10-17 year-old adolescents (adolescent sample) participating 2011-2015 in the LIFE Child study, a population-based cohort study in Germany. Parents of the child participants completed the Children's Sleep Habits Questionnaire (CSHQ), whereas adolescents self-administered the Sleep Self Report (SSR). Familial SES was determined by a composite score considering parental education, occupational status, and income. Multiple regression analyses were carried out to address the research question. RESULTS: Among 4-9 year-old children, the mean bedtime was reported to be 8 p.m., the mean wake-up time 7 a.m., and sleep duration decreased by 14 min/year of age. 22.6 % of the children and 20.0 % of the adolescents showed problematic amounts of sleep-related difficulties. In the child sample, bedtime resistance, sleep onset delay, sleep-related anxiety, night waking, and parasomnia were more frequent in younger than older children. In the adolescent sample, difficulties at bedtime were more frequent among the younger adolescents, whereas daytime sleepiness was more prominent in the older than the younger adolescents. Considering gender differences, sleep-related difficulties were more frequent among boys in the child sample and among girls in the adolescent sample. Lower SES was associated with increased sleep-related difficulties in the adolescent, but not the child sample. CONCLUSIONS: The present results report sleep-related difficulties throughout both childhood and adolescence. Gender differences can already be observed in early childhood, while effects of SES emerge only later in adolescence. The awareness for this circumstance is of great importance for pediatric clinicians who ought to early identify sleep-related difficulties in particularly vulnerable individuals.

The Impact of Anxiety on Behavioral Sleep Difficulties and Treatment in Young Children: A Review of the Literature.

Sleep difficulties are a common pediatric complaint, and the majority of these sleep difficulties are behavioral in nature (e.g., difficulties initiating or maintaining sleep). Although research supports behavioral interventions to improve sleep in young children with behavioral sleep difficulties, anxiety and child distress are common in this age range and these factors can impact treatment outcomes directly (e.g., increased distress and resistance at bedtime) and indirectly (e.g., poor parental compliance with behavioral strategies). Anxiety is an important aspect of treatment in adolescents and adults with behavioral sleep difficulties, but this factor is rarely considered in the literature for younger children. Thus, this manuscript reviews the literature on anxiety as it relates to behavioral sleep difficulties in young children (i.e., the preschool and surrounding age range), provides an overview of empirically supported behavioral intervention and research incorporating anxiety into behavioral sleep treatments, and provides recommendations and future directions for continuing to advance the literature and treatment in this area.

Effects of an intervention combining self-care and self-hypnosis on fatigue and associated symptoms in post-treatment cancer patients: A randomized-controlled trial.

OBJECTIVE: Cancer has a lot of consequences such as fatigue, sleep disturbances, emotional distress, cognitive impairment and reduced physical activity. Some hypnosis-based psychological interventions showed positive effects on fatigue, sleep and emotional distress, but generally focused on breast cancer patients. Our study aimed at assessing the effects of a group intervention combining self-care and self-hypnosis on quality of life of cancer patients. METHODS: Our longitudinal randomized-controlled trial assessed the benefits of the intervention first on fatigue and secondly on associated symptoms (sleep, emotional distress, cognitive impairment and reduced physical activity) of post-treatment cancer patients, and investigated predictors of the evolution of fatigue. All variables were measured with questionnaires and an actigraph (for sleep and physical activity). RESULTS: Ninety five women with different cancers were included in our study. Group-by-time effects were showed for fatigue, sleep, emotional distress and cognitive functioning: symptoms have improved in the intervention group compared to wait-list control group. Three predictors of the evolution of fatigue were revealed: depression, anxiety and worry. CONCLUSIONS: Our group intervention had benefits for post-treatment cancer patients' quality of life. Impacting emotional distress could be important in order to decrease fatigue. Further studies are needed to replicate our results. This intervention could be easily implemented to improve quality of life of cancer patients. Registration: ClinicalTrials.gov (NCT03144154). Retrospectively registered on the 1st of May, 2017.

The role of sleep difficulties in the vasomotor menopausal symptoms and depressed mood relationships: an international pooled analysis of eight studies in the InterLACE consortium.

BACKGROUND: Many women experience both vasomotor menopausal symptoms (VMS) and depressed mood at midlife, but little is known regarding the prospective bi-directional relationships between VMS and depressed mood and the role of sleep difficulties in both directions. METHODS: A pooled analysis was conducted using data from 21 312 women (median: 50 years, interquartile range 49-51) in eight studies from the InterLACE consortium. The degree of VMS, sleep difficulties, and depressed mood was self-reported and categorised as never, rarely, sometimes, and often (if reporting frequency) or never, mild, moderate, and severe (if reporting severity). Multivariable logistic regression models were used to examine the bi-directional associations adjusted for within-study correlation. RESULTS: At baseline, the prevalence of VMS (40%, range 13-62%) and depressed mood (26%, 8-41%) varied substantially across studies, and a strong dose-dependent association between VMS and likelihood of depressed mood was found. Over 3 years of follow-up, women with often/severe VMS at baseline were more likely to have subsequent depressed mood compared with those without VMS (odds ratios (OR) 1.56, 1.27-1.92). Women with often/severe depressed mood at baseline were also more likely to have subsequent VMS than those without depressed mood (OR 1.89, 1.47-2.44). With further adjustment for the degree of sleep difficulties at baseline, the OR of having a subsequent depressed mood associated with often/severe VMS was attenuated and no longer significant (OR 1.13, 0.90-1.40). Conversely, often/severe depressed mood remained significantly associated with subsequent VMS (OR 1.80, 1.38-2.34). CONCLUSIONS: Difficulty in sleeping largely explained the relationship between VMS and subsequent depressed mood, but it had little impact on the relationship between depressed mood and subsequent VMS.

The effects of maternal risk factors during pregnancy on the onset of sleep difficulties in infants at 3 months old.

Sleep problems in young children are among the most common concerns reported to paediatricians. Sleep is thought to have important regulatory functions, and sleep difficulties in early childhood are linked to several psychosocial and physiological problems. Moreover, several prenatal factors have been found to influence infants' sleep. Among them, most of the studies have been focused on maternal prenatal depression and/or anxiety as potential risk factors for sleep problems in childhood, whereas other relevant psychological factors during pregnancy have not received as much attention. Therefore, we aimed to examine the effect of several psychiatric maternal risk factors during pregnancy (i.e. symptoms of anxiety, depression, insomnia, alcohol use, seasonality, attention deficit and hyperactivity disorder and/or stressful life events) on the onset of some sleep problems related to sleep quality and sleep practices in 3-month-old infants. We examined 1,221 cases from a population-based birth cohort, with subjective measures during pregnancy in mothers, and at 3 months after birth in the infants. The findings showed that all the maternal risk factors during pregnancy, except for symptoms of alcoholism and sleepiness, were related to sleep difficulties in infants. Interestingly, attention deficit and hyperactivity disorder symptomatology in mothers during pregnancy was the only variable that predicted more than two sleeping difficulties (i.e. long sleep-onset latency, co-sleeping with parents and irregular sleeping routines) at 3 months old. Our results highlight the relevance of maternal risk factors during pregnancy, and not only prenatal depression and/or anxiety, as variables to be considered when examining sleep difficulties in infants.

Prevalence and correlates of sleep problems among elderly Singaporeans.

BACKGROUND: The current study examined the prevalence and correlates of sleep problems among elderly Singaporeans. METHODS: Data were taken from the Well-being of Singapore Elderly study, a cross-sectional, epidemiological survey conducted among Singapore residents aged 60 years and above (n = 2565). Respondents were screened for sleep problems through a series of questions in the Geriatric Mental State examination. Details on sociodemographic characteristics, physical activity, cognition, disability, chronic physical conditions, and depression were also collected. Logistic regression analysis was used to explore significant associations between sleep problems, sociodemographic characteristics, physical activity, cognition, disability, chronic physical conditions, and depression. RESULTS: Overall, 13.7% (n = 341) of older adults reported at least one sleep problem. Of those who reported sleep problems, 69.4% experienced sleep interruption at night, 48.9% reported having difficulty falling asleep, 22.3% reported early morning awakening, and 11.4% had all three problems. Elderly with sleep problems were significantly more likely to have a range of chronic physical conditions and depression and were also significantly less likely to be physically active. Older adults with at least one sleep problem reported significantly greater disability compared to those with no sleep problems. CONCLUSION: The high probability of comorbid chronic conditions as well as higher disability among those with sleep problems makes this an important area of research.

Intelligence in youth and mental health at age 50.

BACKGROUND: Few cognitive epidemiology studies on mental health have focused on the links between pre-morbid intelligence and self-reports of common mental disorders, such as depression, sleep difficulties, and mental health status. The current study examines these associations in 50-year-old adults. METHODS: The study uses data from the 5793 participants in the National Longitudinal Survey of Youth 1979 cohort (NLSY-79) who responded to questions on mental health at age 50 and had IQ measured with the Armed Forces Qualification Test (AFQT) when they were aged between 15 and 23 years in 1980. Mental health outcomes were: life-time diagnosis of depression; the mental component score of the 12-item short-form Health Survey (SF-12); the 7-item Center for Epidemiological Studies Depression Scale (CES-D); and a summary measure of sleep difficulty. RESULTS & CONCLUSION: Higher intelligence in youth is associated with a reduced risk of self-reported mental health problems at age 50, with age-at-first-interview and sex adjusted Bs as follows: CES-depression (B = - 0.16, C.I. - 0.19 to - 0.12, p < 0.001), sleep difficulties (B = - 0.11, C.I. - 0.13 to - 0.08, p < 0.001), and SF-12 mental health status (OR = 0.78, C.I. 0.72 to 0.85, p < 0.001; r = - 0.03 p = 0.075). Conversely, intelligence in youth is linked with an increased risk of receiving a diagnosis of depression by the age of 50 (OR 1.11, C.I. 1.01 to 1.22, p = 0.024; r = 0.03, p = 0.109). No sex differences were observed in the associations. Adjusting for adult SES accounted for most of the association between IQ and the mental health outcomes, except for having reported a diagnosis of depression, in which case adjusting for adult SES led to an increase in the size of the positive association (OR = 1.32, C.I. 1.16 to 1.51, p < 0.001).

Prospective relationship between poor sleep and substance-related problems in a national sample of adolescents.

BACKGROUND: Previous studies showed that poor sleep prospectively predicted alcohol-related problems and illicit drug use in adolescents and young adults (Wong and Brower, 2012; Wong et al., 2010). However, more work needs to be done to elucidate the nature of these problems. The purpose of this study was to examine whether sleep difficulties and hours of sleep prospectively predicted several serious substance-related problems, for example, binge drinking, driving under the influence of alcohol, and risky sexual behavior. METHODS: Study participants were 6,504 adolescents from the National Longitudinal Study of Adolescent Health. Data were collected from interviews and questionnaires. This study analyzed data from the first 3 waves of data (T1: 1994 to 1995; T2: 1996; T3: 2001 to 2002). In all analyses, we used sleep difficulties at a previous wave to predict substance-related problems at a subsequent wave, while controlling for substance-related problems at a previous wave. RESULTS: Holding T1 alcohol-related problems constant, sleep difficulties at T1 significantly predicted alcohol-related interpersonal problems, binge drinking, gotten drunk or very high on alcohol, driving under the influence of alcohol, getting into a sexual situation one later regretted due to drinking, ever using any illicit drugs, and drug-related problems at T2. T1 hours of sleep negatively predicted T2 alcohol-related interpersonal problems and binge drinking. The relationship between T2 sleep variables and T3 substance-related problems was consistent with previous waves, although the effect was weaker. CONCLUSIONS: Sleep difficulties and hours of sleep are a significant predictor of a number of substance-related problems. It may be useful to educate adolescents about the importance of sleep, sleep hygiene, and the potential consequences of poor sleep on drinking and related behaviors.

An Initial Investigation of the Relationship Between Insomnia and Hoarding.

OBJECTIVE: Insomnia has been shown to have profound negative consequences on multiple aspects of daily functioning. Despite increased interest in the association between insomnia and psychopathology, no research has examined the relationships between insomnia and hoarding. The aim of the current investigation was to examine the associations between insomnia and hoarding severity. METHODS: Participants consisted of patients with hoarding disorder (n = 24). RESULTS: Results revealed that insomnia was a significant predictor of increased hoarding severity. In addition, when examining the relationships among insomnia and specific hoarding symptoms, sleep difficulties were associated with increased acquiring and difficulty discarding behaviors. CONCLUSIONS: These findings add to a growing body of literature on insomnia and various forms of psychopathology, as well as research on symptoms related to hoarding. Reducing insomnia symptoms among hoarders may help to reduce hoarding-related behaviors and increase treatment efficacy.

Increases in Sleep Difficulties and Psychological Symptoms are Associated With the Increase of Chronic Back Pain in Adolescents: The HBSC Study 2002 to 2018.

Cross-national research using data from the Health Behavior in School-aged Children (HBSC) survey showed an increase in the prevalence of chronic back pain from 2002 to 2014. However, it is unknown if this trend has persisted beyond 2014. The aims of this study were to 1) determine if the prevalence of chronic back pain in girls and boys aged 11, 13, and 15 continued to increase from 2014 to 2018 and if this was the case, 2) examine whether this increase in the prevalence of chronic back pain between 2002 and 2018 was explained indirectly by increases in sleep difficulties and psychological symptoms. Data from 7,89,596 adolescents retrieved from 5 waves of the HBSC survey conducted in 2002, 2006, 2010, 2014, and 2018 in 32 countries/regions were used. Logistic regressions and path analyses were conducted. Results showed an overall increase of .5% in the prevalence of chronic back pain between 2014 and 2018, ranging from .4% for 15-year-old girls to 1.3% for 11-year-old boys, indicating a continued overall increase in chronic back pain in adolescents beyond 2014. For 13-year-old girls and for 15-year-old girls and boys, the increase in the prevalence of chronic back pain between 2002 and 2018 was partially mediated by increases in sleep difficulties, which in turn were associated with increases in psychological symptoms. The findings provide important information that may aid stakeholders in enhancing public health initiatives to prevent or reduce the increasing trend in the prevalence of chronic back pain in adolescents. PERSPECTIVE: This study shows that chronic back pain prevalence continues to increase among adolescents, with sleep difficulties and psychological symptoms contributing significantly to this trend. The findings provide insights that may inform strategies to prevent or reduce the increasing trend of chronic back pain in adolescents.

Exploring sleep difficulties, alcohol, illicit drugs, and suicidal ideation among adolescents with a history of depression.

Sleep difficulties and misuse of drugs/alcohol have been associated with suicidal ideation in young people. Using cross-sectional representative surveys of adolescents in the United States, we conducted adjusted logistic regression modeling to assess the relationships between sleep difficulties, substance use, and suicidal ideation among adolescents with a history of depression (n = 38,418) between 2015 and 2020. Sleep difficulties were associated with thinking about (aOR=1.6,95%CI:1.3-1.9), planning (aOR=1.8,95%CI:1.2-2.6), or attempting (aOR=1.7,95%CI:1.2-2.5) suicide. In those reporting alcohol abuse/dependence, sleep difficulties were associated with attempting suicide (aOR=3.1,95%CI:1.2-8.5). In those reporting illicit drug abuse/dependence, sleep difficulties were associated with thinking about (aOR=2.1,95%CI:1.1-4.1) and attempting (aOR=2.2,95%CI:1.2-4.1) suicide.

The associations among sleep-related difficulties, anxiety, and error-related brain activity in youth.

Given the high prevalence of anxiety disorders and their associated impairment, elucidating neural mechanisms related to these disorders has been increasingly prioritized. The error-related negativity (ERN) has been identified as a neural marker that indexes risk for anxiety across development. The ERN seems to confer risk for developing anxiety, especially in the context of stressful life events. The present study sought to examine sleep-related difficulties as another stressful factor that might impact the ERN. In a sample of 221 girls, aged 8 to 15 years old, we first examined the relationship between longer-term (i.e., over the past month) and shorter-term (i.e., over the past week) sleep difficulties and the ERN. We then investigated whether specific sleep difficulties uniquely predict the ERN. In exploratory analyses, we assessed whether sleep difficulties moderate the relationship between the ERN and anxiety. Results indicated that youth who report longer-term lower sleep duration, longer-term worse sleep, and shorter-term lower sleep duration on school days over the past week have a larger (i.e., more negative) ERN. Additionally, only shorter-term sleep duration on school days over the past week uniquely predicted the ERN. Finally, an elevated ERN predicted greater clinical anxiety in the context of longer-term sleep difficulties. Future studies should clarify the direction of these associations via longitudinal designs.