ORCID Profile
0000-0002-7408-1849
Current Organisations
Harvard Medical School
,
Harvard University
,
Brigham and Women's Hospital
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Publisher: Oxford University Press (OUP)
Date: 08-2012
DOI: 10.5665/SLEEP.2004
Publisher: Oxford University Press (OUP)
Date: 22-06-2021
Abstract: Due to the significant mortality and morbidity consequences of the coronavirus disease 2019 (COVID-19) pandemic among older adults, these in iduals were urged to avoid going out in public and socializing with others, among other major disruptions to daily life. While these significant and often unavoidable disruptions have been shown to bear consequences for mental health, less attention has been devoted to behavioral changes, such as changes to sleeping or eating due to the COVID-19 pandemic, and their implications for emotional well-being. We utilized data from a nationally representative survey of Medicare beneficiaries (aged 65 and older), which was administered between June and October 2020 (n = 3,122). We examine the relationship between self-reported changes to daily behaviors (e.g., sleep, drinking alcohol, and exercise) and emotional impacts of the COVID-19 pandemic (i.e., feelings of depression and anxiety about the COVID-19 pandemic) using stepwise hierarchical multivariable Poisson regression. We found that worse sleep quality, sleeping more or less, watching more television, and walking less were associated with more feelings of depression and anxiety about the COVID-19 pandemic. Previous research has shown a connection between the significant and often unavoidable disruptions to daily life due to the COVID-19 pandemic (e.g., sheltering in place) and adverse mental health symptoms. Less attention has been paid to potentially modifiable behaviors, such as sleep and exercise. Our findings highlight the behavioral changes associated with adverse emotional impacts among older adults during the COVID-19 pandemic. Future research may evaluate whether behavioral interventions may aim to attenuate the impact of pandemics on daily, modifiable behaviors to buffer against adverse emotional impacts.
Publisher: Cold Spring Harbor Laboratory
Date: 24-04-2020
DOI: 10.1101/2020.04.22.20076141
Abstract: Governments worldwide have recommended unprecedented measures to mitigate the coronavirus disease 2019 (COVID-19) pandemic. As pressure mounts to scale back these measures, understanding public compliance with and priorities for COVID-19 mitigation is critical. The main aim of this study was to assess public compliance with and support for government-imposed stay-at-home orders in nations and cities with different COVID-19 infection and death rates. In this cross-sectional study, questionnaires were administered to nationally representative respondents from April 2-8, 2020. Regions with different disease prevalence included two nations [the United States (US—high) and Australia (AU—low)] and two cities [New York (NY—high) and Los Angeles (LA—low)]. For adults 18 years or older residing in specified regions, eligible respondents were empaneled until representative quotas were reached for age, gender, and either race and ethnicity (US, NY, LA) or ancestry (AU), matching the 2010 US or 2016 AU census. Of 8718 eligible potential respondents, 5573 (response rate, 63.9%) completed surveys (US: 3010 NY: 507 LA: 525 AU: 1531). The median age was 47 years (range, 18-89) 3039 (54.5%) were female. The prevalence of COVID-19 in each region (cumulative infections, deaths) as of April 8, 2020: US (458610, 15659), AU (5956, 45), 1 NY (81803, 4571), LA (7530, 198). 2 Public compliance with and attitudes regarding government-imposed stay-at-home orders were evaluated and compared between regions. Of 5573 total respondents, 4560 (81.8%) reported compliance with recommended quarantine or stay-at-home policies (range of s les, 75.5%-88.2%). Despite significant disruptions of social and work life, health, and behavior, 5022 respondents (90.1%) supported government-imposed stay-at-home orders (range of s les, 88.9%-93.1%). Of these, 90.8% believe orders should last at least three more weeks or until public health or government officials recommend, with such support spanning the political spectrum. Public compliance with stringent quarantine and stay-at-home policies was very high, in both highly-affected (US, NY) and minimally-affected regions (AU, LA). Despite extensive disruption of respondents’ lives, the vast majority supported continuation of long-term government-imposed stay-at-home orders. These findings have important implications for policymakers grappling with the decision as to when to lift restrictions.
Publisher: Elsevier BV
Date: 2021
DOI: 10.2139/SSRN.3741244
Publisher: MDPI AG
Date: 11-03-2019
DOI: 10.3390/NU11030587
Abstract: The timing of caloric intake is a risk factor for excess weight and disease. Growing evidence suggests, however, that the impact of caloric consumption on metabolic health depends on its circadian phase, not clock hour. The objective of the current study was to identify how in iduals consume calories and macronutrients relative to circadian phase in real-world settings. Young adults (n = 106 aged 19 ± 1 years 45 females) photographically recorded the timing and content of all calories for seven consecutive days using a smartphone application during a 30-day study. Circadian phase was determined from in-laboratory assessment of dim-light melatonin onset (DLMO). Meals were assigned a circadian phase relative to each participant’s DLMO (0°, ~23:17 h) and binned into 60° bins. Lean (n = 68 15 females) and non-lean (n = 38, 30 females) body composition was determined via bioelectrical impedance. The DLMO time range was ~10 h, allowing separation of clock time and circadian phase. Eating occurred at all circadian phases, with significant circadian rhythmicity (p 0.0001) and highest caloric intake at ~300° (~1900 h). The non-lean group ate 8% more of their daily calories at an evening circadian phase (300°) than the lean group (p = 0.007). Consumption of carbohydrates and proteins followed circadian patterns (p 0.0001) and non-lean participants ate 13% more carbohydrates at 240° (~1500 h) than the lean group (p = 0.004). There were no significant differences when caloric intake was referenced to local clock time or sleep onset time (p 0.05). Interventions targeting the circadian timing of calories and macronutrients for weight management should be tested.
Publisher: Korean Society of Sleep Medicine
Date: 30-06-2023
Abstract: Patients with chronic rhinosinusitis (CRS) report improved sleep quality after dupilumab, an anti IL4/13 therapy. Concurrent CRS and obstructive sleep apnea (OSA) cases are not rare, and CRS seemingly raises nasal resistance. Thus, we hypothesized that improved sleep quality by dupilumab therapy in CRS patients might be due to lowered nasal resistance and subsequent improvement of unrecognized comorbid OSA. Patients with concurrent CRS and OSA were recruited. Nasal resistance was measured invasively with transnasal pressure and flow data collected during normal respiration in the supine position. Results from the first five participants did not support our hypothesis. Subjective and objective measures for CRS and nasal resistance values were improved with dupilumab therapy in CRS patients with nasal polyps. However, apnea severity and sleep-related subjective parameters did not change. In the patients with CRS without nasal polyps, no significant changes in either CRS or OSA-related measures were observed.
Publisher: Springer Science and Business Media LLC
Date: 29-03-2019
DOI: 10.1038/S41598-019-41712-1
Abstract: The PERIOD2 ( PER2 ) gene is a core molecular component of the circadian clock and plays an important role in the generation and maintenance of daily rhythms. Rs35333999, a missense variant of PER2 common in European populations, has been shown to associate with later chronotype. Chronotype relates to the timing of biological and behavioral activities, including when we sleep, eat, and exercise, and later chronotype is associated with longer intrinsic circadian period (cycle length), a fundamental property of the circadian system. Thus, we tested whether this PER2 variant was associated with circadian period and found significant associations with longer intrinsic circadian period as measured under forced desynchrony protocols, the ‘gold standard’ for intrinsic circadian period assessment. Minor allele (T) carriers exhibited significantly longer circadian periods when determinations were based on either core body temperature or plasma melatonin measurements, as compared to non-carriers (by 12 and 11 min, respectively accounting for ~7% of inter-in idual variance). These findings provide a possible underlying biological mechanism for inter-in idual differences in chronotype, and support the central role of PER2 in the human circadian timing system.
Publisher: Informa UK Limited
Date: 18-04-2016
Publisher: SAGE Publications
Date: 15-09-2011
Abstract: Early attempts to characterize free-running human circadian rhythms generated three notable results: 1) observed circadian periods of 25 hours (considerably longer than the now established 24.1- to 24.2-hour average intrinsic circadian period) with sleep delayed to later circadian phases than during entrainment 2) spontaneous internal desynchrony of circadian rhythms and sleep/wake cycles—the former with an approximately 24.9-hour period, and the latter with a longer (28-68 hour) or shorter (12-20 hour) period and 3) bicircadian (48-50 hour) sleep/wake cycles. All three results are reproduced by Kronauer et al.’s (1982) coupled oscillator model, but the physiological basis for that phenomenological model is unclear. We use a physiologically based model of hypothalamic and brain stem nuclei to investigate alternative physiological mechanisms that could underlie internal desynchrony. We demonstrate that experimental observations can be reproduced by changes in two pathways: promotion of orexinergic (Orx) wake signals, and attenuation of the circadian signal reaching hypothalamic nuclei. We reason that delayed sleep is indicative of an additional wake-promoting drive, which may be of behavioral origin, associated with removal of daily schedules and instructions given to participants. We model this by increasing Orx tone during wake, which reproduces the observed period lengthening and delayed sleep. Weakening circadian input to the ventrolateral preoptic nucleus (possibly mediated by the dorsomedial hypothalamus) causes desynchrony, with observed sleep/wake cycle period determined by degree of Orx up-regulation. During desynchrony, sleep/wake cycles are driven by sleep homeostasis, yet sleep bout length maintains circadian phase dependence. The model predicts sleep episodes are shortest when started near the temperature minimum, consistent with experimental findings. The model also correctly predicts that it is possible to transition to bicircadian rhythms from either a synchronized or desynchronized state. Our findings suggest that feedback from behavioral choices to physiology could play an important role in spontaneous internal desynchrony.
Publisher: BMJ
Date: 09-2018
DOI: 10.1136/BMJOPEN-2018-022041
Abstract: To examine sleep-promoting and wake-promoting drug use in police officers and associations between their use and health (excessive sleepiness, stress and burnout), performance (fatigue-related errors) and safety (near-crashes) outcomes, both alone and in combination with night-shift work. Cross-sectional survey. Police officers from North America completed the survey either online or via paper encil at a police station. 4957 police participated, 3693 online (91.9%, participation rate) and 1264 onsite (cooperation rate 63.1%). Sleep-promoting and wake-promoting drug use, excessive sleepiness, near-crash motor vehicle crashes, dozing while driving, fatigue errors, stress and burnout. Over the past month, 20% of police officers reported using sleep-promoting drugs and drugs causing sleepiness, while wake-promoting agents were used by 28% of police (5% used wake-promoting drugs, 23% used high levels of caffeine and 4% smoked to stay awake). Use of sleep-promoting drugs was associated with increased near-crashes (OR=1.61 95% CI 1.21 to 2.13), fatigue-related errors (OR=1.75 95% CI 1.32 to 2.79), higher stress (OR=1.41 95% CI 1.10 to 1.82), and higher burnout (OR=1.83 95% CI 1.40 to 2.38). Wake-promoting drug use, high caffeine and smoking to stay awake were associated with increased odds of a fatigue-related error, stress and burnout (ORs ranging from 1.68 to 2.56). Caffeine consumption was common, and while smoking was not, of those participants who did smoke, one-in-three did so to remain awake. Night-shift work was associated with independent increases in excessive sleepiness, near-crashes and fatigue-related errors. Interactions between night-shift work and wake-promoting drug use were also found for excessive sleepiness. Police who use sleep-promoting and wake-promoting drugs, especially when working night shifts, are most vulnerable to adverse health, performance and safety outcomes. Future research should examine temporal relationships between shift work, drug use and adverse outcomes, in order to develop optimal alertness management strategies.
Publisher: Cold Spring Harbor Laboratory
Date: 08-07-2023
DOI: 10.1101/2023.07.06.23292337
Abstract: This study assesses whether chronotype is related to COVID-19 infection and whether there is an interaction with shift work. Cross-sectional survey of 19,821 U.S. adults COVID-19 infection occurred in 40% of participants, 32.6% morning and 17.2% evening chronotypes. After adjusting for demographic and socioeconomic factors, shift work, sleep duration and comorbidities, morning chronotype was associated with a higher (aOR: 1.15, 95% CI 1.10-1.21) and evening chronotype with a lower (aOR: 0.82, 95% CI: 0.78-0.87) prevalence of COVID-19 infection in comparison to an intermediate chronotype. Working exclusively night shifts was not associated with higher prevalence of COVID-19. Morning chronotype and working some evening shifts was associated with the highest prevalence of previous COVID-19 infection (aOR: 1.87, 95% CI: 1.28-2.74). Morning chronotype and working a mixture of shifts increase risk of COVID-19 infection. Describe the association between chronotype and prevalence of COVID-19 infection Summarize the combined effect of chronotype and shift work on the prevalence of COVID-19 infection
Publisher: Wiley
Date: 26-05-2019
DOI: 10.1111/JSR.12869
Publisher: IEEE
Date: 06-2015
Publisher: MDPI AG
Date: 09-2022
Abstract: Objectives: This study assessed the associations between parent intent to have their child receive the COVID-19 vaccination, and demographic factors and various child activities, including attendance at in-person education or childcare. Methods: Persons undergoing COVID-19 testing residing in Minnesota and Los Angeles County, California with children aged years completed anonymous internet-based surveys between 10 May and 6 September 2021 to assess factors associated with intention to vaccinate their child. Factors influencing the parents’ decision to have their child attend in-person school or childcare were examined. Estimated adjusted odds rations (AORs, 95% CI) were computed between parents’ intentions regarding children’s COVID-19 vaccination and participation in school and extra-curricular activities using multinomial logistic regression. Results: Compared to parents intending to vaccinate their children (n = 4686 [77.2%]), those undecided (n = 874 [14.4%]) or without intention to vaccinate (n = 508 [8.4%]) tended to be younger, non-White, less educated, and themselves not vaccinated against COVID-19. Their children more commonly participated in sports (aOR:1.51 1.17–1.95) and in-person faith or community activities (aOR:4.71 3.62–6.11). A greater proportion of parents without intention to vaccinate (52.5%) indicated that they required no more information to make their decision in comparison to undecided parents (13.2%). They further indicated that additional information regarding vaccine safety and effectiveness would influence their decision. COVID-19 mitigation measures were the most common factors influencing parents’ decision to have their child attend in-person class or childcare. Conclusions: Several demographic and socioeconomic factors are associated with parents’ decision whether to vaccinate their -year-old children for COVID-19. Child participation in in-person activities was associated with parents’ intentions not to vaccinate. Tailored communications may be useful to inform parents’ decisions regarding the safety and effectiveness of vaccination.
Publisher: American Academy of Sleep Medicine (AASM)
Date: 15-09-2013
DOI: 10.5664/JCSM.2992
Publisher: SAGE Publications
Date: 12-2007
Abstract: In rodents, increased activity due to running-wheel access is associated with a change in observed circadian period. In humans, exposure to exercise has failed to demonstrate similar effects on period. Methodological issues with prior studies such as light exposure during exercise, length of study, and method of measuring period confounded those evaluations of the effect of exercise on period in humans. In the present experiment, the authors examined the effect of exercise on period in 8 subjects using a 44-day within-subjects inpatient study. They used a 20-h forced desynchrony protocol, in which subjects were exposed to exercise across circadian phases under dim light conditions. Exercise consisted of three 45-min sessions per wake period on an ergometer. Target exercise intensity was ~65% of maximal heart rate. Intrinsic circadian period was measured using both core body temperature and hourly plasma melatonin s les. Consistent with previous reports, the authors find no effect of exercise on endogenous circadian period as measured by either core body temperature or melatonin. Exercise distributed across biological day and night does not appear to affect circadian period.
Publisher: Proceedings of the National Academy of Sciences
Date: 22-12-2015
Abstract: Drowsy driving is a major public health issue, particularly impacting the 9.5 million shift workers in America. Previous reports have assessed the impact of night work on driving in driving simulators. This real-vehicle driving study demonstrated increased objective and subjective drowsiness and degraded daytime driving performance in 16 night-shift workers while driving after a night of work, deteriorating with drive duration. No near-crashes occurred during driving after a night of sleep 11 occurred during driving after night-work all near-crashes occurred after at least 45 min of driving. Policy makers and night-workers should consider avoiding/minimizing driving or deploying effective countermeasures when driving after night-shift work to reduce drowsy driving and preventable crashes and injuries in this high-risk population.
Publisher: Wiley
Date: 03-06-2021
DOI: 10.1111/RESP.14094
Publisher: Oxford University Press (OUP)
Date: 28-04-2017
Publisher: American Diabetes Association
Date: 16-02-2016
DOI: 10.2337/DB15-0999
Abstract: The risk of type 2 diabetes (T2D) is increased by abnormalities in sleep quantity and quality, circadian alignment, and melatonin regulation. A common genetic variant in a receptor for the circadian-regulated hormone melatonin (MTNR1B) is associated with increased fasting blood glucose and risk of T2D, but whether sleep or circadian disruption mediates this risk is unknown. We aimed to test if MTNR1B diabetes risk variant rs10830963 associates with measures of sleep or circadian physiology in intensive in-laboratory protocols (n = 58–96) or cross-sectional studies with sleep quantity and quality and timing measures from self-report (n = 4,307–10,332), actigraphy (n = 1,513), or polysomnography (n = 3,021). In the in-laboratory studies, we found a significant association with a substantially longer duration of elevated melatonin levels (41 min) and delayed circadian phase of dim-light melatonin offset (1.37 h), partially mediated through delayed offset of melatonin synthesis. Furthermore, increased T2D risk in MTNR1B risk allele carriers was more pronounced in early risers versus late risers as determined by 7 days of actigraphy. Our results provide the surprising insight that the MTNR1B risk allele influences dynamics of melatonin secretion, generating a novel hypothesis that the MTNR1B risk allele may extend the duration of endogenous melatonin production later into the morning and that early waking may magnify the diabetes risk conferred by the risk allele.
Publisher: Cold Spring Harbor Laboratory
Date: 02-2021
DOI: 10.1101/2021.01.28.21250694
Abstract: Markedly elevated adverse mental health symptoms were widely observed early in the coronavirus disease 2019 (COVID-19) pandemic. Unlike the U.S., where cross-sectional data indicate anxiety and depression symptoms have remained elevated, such symptoms reportedly declined in the U.K., according to analysis of repeated measures from a largescale longitudinal study. However, nearly 40% of U.K. respondents (those who did not complete multiple follow-up surveys) were excluded from analysis, suggesting that survivorship bias might partially explain this discrepancy. We therefore sought to assess survivorship bias among participants in our longitudinal survey study as part of The COVID-19 Outbreak Public Evaluation (COPE) Initiative. Survivorship bias was assessed 4,039 U.S. respondents who completed surveys including the assessment of mental health as part of The COPE Initiative in April 2020 and were invited to complete follow-up surveys. Participants completed validated screening instruments for symptoms of anxiety, depression, and insomnia. Survivorship bias was assessed for (1) demographic differences in follow-up survey participation, (2) differences in initial adverse mental health symptom prevalences adjusted for demographic factors, and (3) differences in follow-up survey participation based on mental health experiences adjusted for demographic factors. Adjusting for demographics, in iduals who completed only one or two out of four surveys had higher prevalences of anxiety and depression symptoms in April 2020 (e.g., one-survey versus four-survey, anxiety symptoms, adjusted prevalence ratio [aPR]: 1.30, 95% confidence interval [CI]: 1.08-1.55, P =0.0045 depression symptoms, aPR: 1.43, 95% CI: 1.17-1.75, P =0.00052). Moreover, in iduals who experienced incident anxiety or depression symptoms had higher odds of not completing follow-up surveys (adjusted odds ratio [aOR]: 1.68, 95% CI: 1.22-2.31, P =0.0015, aOR: 1.56, 95% CI: 1.15-2.12, P =0.0046, respectively). Our findings revealed significant survivorship bias among longitudinal survey respondents, indicating that restricting analytic s les to only respondents who provide repeated assessments in longitudinal survey studies could lead to overly optimistic interpretations of mental health trends over time. Cross-sectional or planned missing data designs may provide more accurate estimates of population-level adverse mental health symptom prevalences than longitudinal surveys.
Publisher: Cold Spring Harbor Laboratory
Date: 05-02-2021
DOI: 10.1101/2021.02.02.21251042
Abstract: To estimate the prevalence of unpaid caregiving during the coronavirus disease 2019 (COVID-19) pandemic, and to identify factors associated with adverse mental health symptoms, substance use, and suicidal ideation in this population, which provides critical support in health care systems by providing care to older adults and those with chronic conditions. In June 2020, Internet-based surveys with questions about demographics, caregiving responsibilities, and mental health were administered to US adults aged ≥18 years. Demographic quota s ling and survey weighting to improve cross-sectional s le representativeness of age, gender, and race/ethnicity. Prevalence ratios for adverse mental health symptoms were estimated using multivariable Poisson regressions. Of 9,896 eligible invited adults, 5,412 (54.7%) completed surveys 5,011 (92.6%) respondents met screening criteria and were analysed, including 1,362 (27.2%) caregivers. Caregivers had higher prevalences of adverse mental health symptoms than non-caregivers, including anxiety or depressive disorder symptoms (57.6% vs 21.5%, respectively, p .0001) having recently seriously considered suicide (33.4% vs 3.7%, p .0001). Symptoms were more common among caregivers who were young vs older adults (e.g., aged 18–24 vs ≥65 years, aPR 2.75, 95% CI 1.95–3.88, p .0001), Hispanic or Latino vs non-Hispanic White (1.14, 1.04–1.25, p=0.0044), living with vs without disabilities (1.18, 1.10–1.26, p .0001), and with moderate and high vs low Caregiver Intensity Index scores (2.31, 1.65–3.23 2.81, 2.00–3.94 both p .0001). Suicidal ideation was more prevalent among non-Hispanic Black vs non-Hispanic White caregivers (1.48, 1.15–1.90, p=0.0022). Caregivers, who accounted for one in four US adult respondents in this nationally representative s le, more commonly reported adverse mental health symptoms than non-caregivers. Increased visibility of and access to mental health care resources are urgently needed to address mental health challenges of caregiving.
Publisher: Health Affairs (Project Hope)
Date: 09-2015
Publisher: Wiley
Date: 20-06-2021
DOI: 10.1111/JPI.12745
Abstract: The time of dim light melatonin onset (DLMO) is the gold standard for circadian phase assessment in humans, but collection of s les for DLMO is time and resource‐intensive. Numerous studies have attempted to estimate circadian phase from actigraphy data, but most of these studies have involved in iduals on controlled and stable sleep‐wake schedules, with mean errors reported between 0.5 and 1 hour. We found that such algorithms are less successful in estimating DLMO in a population of college students with more irregular schedules: Mean errors in estimating the time of DLMO are approximately 1.5‐1.6 hours. We reframed the problem as a classification problem and estimated whether an in idual's current phase was before or after DLMO. Using a neural network, we found high classification accuracy of about 90%, which decreased the mean error in DLMO estimation—identifying the time at which the switch in classification occurs—to approximately 1.3 hours. To test whether this classification approach was valid when activity and circadian rhythms are decoupled, we applied the same neural network to data from inpatient forced desynchrony studies in which participants are scheduled to sleep and wake at all circadian phases (rather than their habitual schedules). In participants on forced desynchrony protocols, overall classification accuracy dropped to 55%‐65% with a range of 20%‐80% for a given day this accuracy was highly dependent upon the phase angle (ie, time) between DLMO and sleep onset, with the highest accuracy at phase angles associated with nighttime sleep. Circadian patterns in activity, therefore, should be included when developing and testing actigraphy‐based approaches to circadian phase estimation. Our novel algorithm may be a promising approach for estimating the onset of melatonin in some conditions and could be generalized to other hormones.
Publisher: American College of Physicians
Date: 2023
DOI: 10.7326/M22-2226
Publisher: JMIR Publications Inc.
Date: 21-05-2020
Abstract: mid the COVID-19 pandemic, public health policies to curb the spread of SARS-CoV-2 and its associated disease, COVID-19, have resulted in significant alterations to daily routines (eg, work-from-home policies) that may have enabled longer sleep duration among the general population. e aimed to examine changes in estimated sleep duration in 5 major metropolitan areas before and after the start of the COVID-19 pandemic. e conducted a prospective observational study using estimated sleep duration data obtained from a smartphone app. The data were obtained from regular users of the smartphone app before and after the World Health Organization declared COVID-19 a pandemic in March 2020. We compared within-subject estimated sleep duration before and during the COVID-19 pandemic using generalized linear mixed models. mong the 2,871,037 observations, 957,022 (33.3%) were from users in London 549,151 (19.1%) were from users in Los Angeles 846,527 (29.5%) were from users in New York City 251,113 (8.7%) were from users in Seoul and 267,224 (9.3%) were from users in Stockholm. The average age of the users in the s le was 35 years (SE 11 years). Prior to the COVID-19 pandemic, people residing in Seoul had the shortest estimated sleep duration (mean 6 hours 28 minutes, SE 11.6 minutes) and those residing in Stockholm had the longest estimated sleep duration (mean 7 hours 34 minutes, SE 9.9 minutes). The onset of the COVID-19 pandemic was associated with a 13.7 minute increase in estimated sleep duration when comparing March 2019 and March 2020 (95% CI 13.1-14.3, i P /i & .001) and an increase of 22.3 minutes when comparing April 2019 and April 2020 (95% CI 21.5-23.1, i P /i & .001). he average estimated sleep duration increased sharply in the months after the onset of the COVID-19 pandemic. This finding suggests that the implementation of COVID-19 mitigation strategies has provided people worldwide with increased opportunities to sleep, which may enhance the response of the immune system to viral pathogens.
Publisher: Springer Science and Business Media LLC
Date: 15-03-2021
DOI: 10.1186/S12889-021-10410-X
Abstract: Governments worldwide recommended unprecedented measures to contain the coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As pressure mounted to scale back measures, understanding public priorities was critical. We assessed initial public adherence with and support for stay-at-home orders in nations and cities with different SARS-CoV-2 infection and COVID-19 death rates. Cross-sectional surveys were administered to representative s les of adults aged ≥18 years from regions with different SARS-CoV-2 prevalences from April 2–8, 2020. Regions included two nations [the United States (US—high prevalence) and Australia (AU—low prevalence)] and two US cities [New York City (NY—high prevalence) and Los Angeles (LA—low prevalence)]. Regional SARS-CoV-2 and COVID-19 prevalence (cumulative SARS-CoV-2 infections, COVID-19 deaths) as of April 8, 2020: US (363,321, 10,845), AU (5956, 45), NY (81,803, 4571), LA (7530, 198). Of 8718 eligible potential respondents, 5573 (response rate, 63.9%) completed surveys. Median age was 47 years (range, 18–89) 3039 (54.5%) were female. Of 5573 total respondents, 4560 (81.8%) reported adherence with recommended quarantine or stay-at-home policies (range of s les, 75.5–88.2%). Additionally, 29.1% of respondents screened positive for anxiety or depression symptoms (range of s les, 28.6–32.0%), with higher prevalences among those of younger age, female gender, and those in quarantine or staying at home most of the time versus those who did not report these behaviours. Despite elevated prevalences of adverse mental health symptoms and significant life disruptions, 5022 respondents (90.1%) supported government-imposed stay-at-home orders (range of s les, 88.9–93.1%). Of these, 90.8% believed orders should last at least three more weeks or until public health or government officials recommended, with support spanning the political spectrum. Public adherence with COVID-19 mitigation policies was highly prevalent, in both highly-affected (US, NY) and minimally-affected regions (AU, LA). Despite disruption of respondents’ lives, the vast majority supported continuation of extended stay-at-home orders. Despite common support, these two countries erged in stringent mitigation implementation, which may have contributed to subsequent outcomes. These results reveal the importance of surveillance of public support for and adherence with such policies during the COVID-19 pandemic and for future infectious disease outbreaks.
Publisher: Oxford University Press (OUP)
Date: 22-12-2017
DOI: 10.1093/SLEEP/ZSX195
Abstract: Extended duration (≥24 hours) work shifts (EDWSs) are associated with increased risk of motor vehicle crashes, and awareness of any impairment has important implications on legal accountability for any adverse driving outcome. The extent to which adverse driving events were preceded by predrive self-reported sleepiness was evaluated in medical residents after an EDWS. Sixteen resident physicians (10 females 29.2 ± 2.0 years) working EDWS were monitored when driving on their commute to and from the hospital (438 drives). Sleep and work hours were obtained from daily logs, and adverse driving outcomes were captured from a driving log completed at the end of each drive. Self-reported sleepiness (Karolinska Sleepiness Scale KSS) and objective drowsiness were captured using a time-st ed, hand-held device and infra-red reflectance oculography. Self-reported sleepiness and objective indices of drowsiness were positively correlated, and both were elevated following EDWSs. Compared with the commute to work, EDWSs were associated with more than double the self-reported adverse outcomes when driving home, significantly higher than drives to or from the day shift at comparable times of day. EDWSs more than tripled the odds of reporting sleep-related, inattentive, hazardous, or violation-driving events. The number and type of adverse event was predicted by the predrive KSS level and in a dose-dependent manner. Driving after an EDWS puts resident physicians/drivers and other road users at avoidable and unnecessary risk. Demonstrating self-reported sleepiness at the beginning of the drive is associated with adverse outcomes has serious implications on the legal accountability for driving when drowsy.
Publisher: The Endocrine Society
Date: 04-05-2020
Abstract: The purpose of this work is to determine whether an uncoupling of bone turnover markers (BTMs) occurs in women exposed to the combination of sleep restriction with circadian disruption (SRCD), as previously reported in men. Four bone biomarkers (N-terminal propeptide of type I procollagen [P1NP] and osteocalcin = bone formation C-telopeptide [CTX] = bone resorption sclerostin = bone formation inhibitor) were measured in bihourly s les over 24 hours at baseline and after approximately 3 weeks of sleep restriction (~5.6 hours of sleep/24 hours) with concurrent circadian disruption (SRCD, recurring 28-hour “day” in dim light). Maximum likelihood estimation in a repeated-measures model was used to assess the effects of SRCD and age on bone biomarkers. Five women were young (22 ± 2.8 years) and four were older (58 ± 1.8 years). Baseline bone biomarker levels did not differ by age (all P ≥ .07). Bone formation markers were lower after SRCD (estimate ± SEE, ΔP1NP = –9.5 ± 2.8 μg/L, P = .01 Δosteocalcin = –2.3 ± 0.9 ng/mL, P = .04). The P1NP decline was greater in young women (ΔP1NP = –12.9 ± 3.7 μg/L, P = .01). After SRCD, CTX was significantly higher in young women (0.182 ± 0.069 ng/mL, P = .04) but did not change in older women. These pilot data are similar to previous findings in men and suggest that SRCD negatively altered bone metabolism in women by decreasing markers of bone formation and, in young women, increasing a marker of bone resorption. If sustained, this pattern of BTM uncoupling may lead to bone loss and lower bone mineral density.
Publisher: Cold Spring Harbor Laboratory
Date: 17-05-2021
DOI: 10.1101/2021.05.16.21257290
Abstract: SARS-CoV-2 containment is estimated to require attainment of high ( %) post-infection and post-vaccination population immunity. To assess COVID-19 vaccine intentions among US adults and their children, and reasons for vaccine hesitancy among potential refusers. Internet-based surveys were administered cross-sectionally to US adults during December 2020 and February to March 2021 (March-2021). Surveys were administered through Qualtrics using demographic quota s ling. A large, demographically erse s le of 10,444 US adults (response rate, 63.9%). COVID-19 vaccine uptake, intentions, and reasons for potential refusal. Adults living with or caring for children aged 2 to 18 years were asked about their intent to have their children vaccinated. Multivariable weighted logistic regression models were used to estimate adjusted odds ratios for vaccine refusal. Of 5256 March-2021 respondents, 3467 (66.0%) reported they would definitely or most likely obtain a COVID-19 vaccine as soon as possible (ASAP Obtainers), and an additional 478 (9.1%) reported they were waiting for more safety and efficacy data before obtaining the vaccine. Intentions for children and willingness to receive a booster shot largely matched personal COVID-19 vaccination intentions. Vaccine refusal (ie, neither ASAP Obtainers nor waiting for more safety and efficacy data) was most strongly associated with not having obtained an influenza vaccine in 2020 (adjusted odds ratio, 4.11 [95% CI, 3.05-5.54]), less frequent mask usage (eg, rarely or never versus always or often, 3.92 [2.52-6.10]) or social gathering avoidance (eg, rarely or never versus always or often, 2.65 [1.95-3.60]), younger age (eg, aged 18-24 versus over 65 years, 3.88 [2.02-7.46]), and more conservative political ideology (eg, very conservative versus very liberal, 3.58 [2.16-5.94]) all P .001. Three-quarters of March-2021 respondents in our large, demographically erse s le of US adults reported they would likely obtain a COVID-19 vaccine, and 60% of adults living with or caring for children plan to have them vaccinated as soon as possible. With an estimated 27% of the US population having been infected with SARS-CoV-2, once vaccines are available to children and they have been vaccinated, combined post-infection and post-vaccination immunity will approach 80% of the US population in 2021, even without further infections. What are COVID-19 vaccines intentions, for adults and for children under their care? Two-thirds of 5256 US adults surveyed in early 2021 indicated they would obtain a COVID-19 vaccine as soon as possible. Intentions for children and booster vaccines largely matched personal vaccine intentions. Refusal was more common among adults who were younger, female, Black, very politically conservative, less educated, less adherent with COVID-19 prevention behaviors (eg, wearing masks), had more medical mistrust, or had not received influenza vaccines in 2020. Tailored vaccine promotion efforts and vaccine programs may improve vaccine uptake and contribute to US immunity against COVID-19.
Publisher: Health Affairs (Project Hope)
Date: 06-2015
Publisher: Centers for Disease Control MMWR Office
Date: 19-06-2020
Publisher: Centers for Disease Control MMWR Office
Date: 16-10-2020
Publisher: Springer Science and Business Media LLC
Date: 26-07-2017
Publisher: SAGE Publications
Date: 02-2017
Abstract: The measurement of circulating levels of brain-derived neurotrophic factor (BDNF) has been proposed to be a marker of disease and an indicator of recovery. Thus, knowing the temporal pattern and influence of potential circadian rhythms is important. Although several studies have measured BDNF at different times of day, no studies have done so while controlling for potential masking influences such as sleep and activity. Further, no previous study has examined circadian rhythms within in iduals. We examined circadian rhythms in plasma BDNF while minimizing masking from behavioral and environmental factors using a 30-h constant routine (CR) protocol. In a s le of 39 healthy adults, we found significant circadian rhythms in 75% of women and 52% of men. The timing of the acrophase of the BDNF rhythm, however, was unrelated to clock time in women, while it was related to clock time in men. These results indicate that the use of single-s le measures of plasma BDNF as a marker of disease will be unreliable, especially in women. Repeated plasma BDNF s les over a 24-h period within in iduals would be needed to reveal abnormalities related to disease states.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-10-2017
Abstract: It is unknown whether short sleep duration, obstructive sleep apnea, and overnight shift work are associated with the risk of recurrent cardiovascular events in patients after an acute coronary syndrome. SOLID ‐ TIMI 52 (The Stabilization of PLaques UsIng Darapladib‐Thrombolysis in Myocardial Infarction 52 Trial) was a multinational, double‐blind, placebo‐controlled trial that enrolled 13 026 patients ≤30 days of acute coronary syndrome. At baseline, all patients were to complete the Berlin questionnaire to assess risk of obstructive sleep apnea and a sleep and shift work survey. Median follow‐up was 2.5 years. The primary outcome was major coronary events ( MCE coronary heart disease death, myocardial infarction, or urgent revascularization). Cox models were adjusted for clinical predictors. Patients who reported hours sleep per night had a 29% higher risk of MCE (adjusted hazard ratio, 1.29 95% confidence interval, 1.12–1.49 P .001) compared with those with longer sleep. Patients who screened positive for obstructive sleep apnea had a 12% higher risk of MCE (1.12 1.00–1.24 P =0.04) than those who did not screen positive. Overnight shift work (≥3 night shifts/week for ≥1 year) was associated with a 15% higher risk of MCE (1.15 1.03–1.29 P =0.01). A step‐wise increase in cardiovascular risk was observed for in iduals with more than 1 sleep‐related risk factor. In iduals with all 3 sleep‐related risk factors had a 2‐fold higher risk of MCE (2.01 1.49–2.71 P .0001). Short sleep duration, obstructive sleep apnea, and overnight shift work are under‐recognized as predictors of adverse outcomes after acute coronary syndrome. Increased efforts should be made to identify, treat, and educate patients about the importance of sleep for the potential prevention of cardiovascular events. URL: www.clinicaltrials.gov . Unique identifier: NCT01000727.
Publisher: SAGE Publications
Date: 08-2010
Abstract: Studies of sex differences in the timing of human circadian rhythms have reported conflicting results. This may be because the studies conducted to date have not controlled for the masking effects of the rest activity cycle on the circadian rhythms being assessed. In the present analysis of data collected under controlled conditions, we examined sex differences in the timing of circadian rhythms while minimizing masking from behavioral and environmental factors using a constant routine (CR) protocol. All participants (28 women and 28 men paired by habitual wake time age range, 18 30 years) maintained a regular self selected sleep wake schedule at home prior to the study. After 3 baseline days in the laboratory, participants began a CR. Women were found to have a signifi cantly higher melatonin litude and lower temperature litude than men. While sleep timing was the same between the 2 groups, the timing of the circa dian rhythms of core body temperature and pineal melatonin secretion was ear lier relative to sleep time in women as compared to men. Sleep therefore occurred at a later biological time for women than men, despite being at the same clock time. Given that sleep propensity and structure vary with circadian phase and are impacted by circulating melatonin, these findings may have important impli cations for understanding sex differences in sleep timing and duration, diurnal preference, and the prevalence of sleep disorders such as insomnia.
Publisher: Cold Spring Harbor Laboratory
Date: 22-07-2022
DOI: 10.1101/2022.07.22.22277899
Abstract: Given a downward age shift in COVID-19-involved deaths observed during the COVID-19 pandemic, we sought to estimate years of life lost (YLL) associated with leading causes of US death during the first 20 months of the pandemic. Despite 4796 fewer COVID-19 deaths in Jan-Oct 2021 than in Mar-Dec 2020, the number of YLL due to COVID-19 increased by 1,159,761, from 4,474,186 to 5,633,947 (a 25.9% increase). YLL per COVID-19 death increased from 12.8 in 2020 to 16.3 in 2021, a 27.7% increase. YLL per death did not change by more than 2.3% for any other cause. Increased YLL per COVID-19 death in 2021 result from younger-age COVID-19 mortality, contributing to a marked increase in YLL from this preventable cause of death at a later stage of the pandemic despite advancements in vaccines in treatments.
Publisher: JMIR Publications Inc.
Date: 02-02-2021
DOI: 10.2196/20546
Abstract: Amid the COVID-19 pandemic, public health policies to curb the spread of SARS-CoV-2 and its associated disease, COVID-19, have resulted in significant alterations to daily routines (eg, work-from-home policies) that may have enabled longer sleep duration among the general population. We aimed to examine changes in estimated sleep duration in 5 major metropolitan areas before and after the start of the COVID-19 pandemic. We conducted a prospective observational study using estimated sleep duration data obtained from a smartphone app. The data were obtained from regular users of the smartphone app before and after the World Health Organization declared COVID-19 a pandemic in March 2020. We compared within-subject estimated sleep duration before and during the COVID-19 pandemic using generalized linear mixed models. Among the 2,871,037 observations, 957,022 (33.3%) were from users in London 549,151 (19.1%) were from users in Los Angeles 846,527 (29.5%) were from users in New York City 251,113 (8.7%) were from users in Seoul and 267,224 (9.3%) were from users in Stockholm. The average age of the users in the s le was 35 years (SE 11 years). Prior to the COVID-19 pandemic, people residing in Seoul had the shortest estimated sleep duration (mean 6 hours 28 minutes, SE 11.6 minutes) and those residing in Stockholm had the longest estimated sleep duration (mean 7 hours 34 minutes, SE 9.9 minutes). The onset of the COVID-19 pandemic was associated with a 13.7 minute increase in estimated sleep duration when comparing March 2019 and March 2020 (95% CI 13.1-14.3, P .001) and an increase of 22.3 minutes when comparing April 2019 and April 2020 (95% CI 21.5-23.1, P .001). The average estimated sleep duration increased sharply in the months after the onset of the COVID-19 pandemic. This finding suggests that the implementation of COVID-19 mitigation strategies has provided people worldwide with increased opportunities to sleep, which may enhance the response of the immune system to viral pathogens.
Publisher: American Academy of Sleep Medicine (AASM)
Date: 15-04-2013
DOI: 10.5664/JCSM.2588
Publisher: Cold Spring Harbor Laboratory
Date: 04-11-2021
DOI: 10.1101/2021.11.04.21264353
Abstract: We conducted a retrospective observational study using remote wearable and mobile application data to identify US public holidays associated with significant changes in sleep behaviors, including sleep duration, bedtime and waketime, and the consistency of sleep timing, as well as changes in the point prevalence of alcohol use. These metrics were collected and analyzed from objective, high resolution sleep-wake data and survey responses of 24,250 US subscribers to the wrist-worn biometric device platform, WHOOP (Boston, Massachusetts, USA), who were active users during May 1, 2020 through May 1, 2021. Compared to baseline, statistically significant differences in sleep and alcohol measures were found on the US public holidays and their eves. For ex le, New Year’s Eve corresponded with a sleep consistency decrease of 13.8% (± 0.3), a sleep onset of 88.9 minutes (± 3.2) later, a sleep offset of 78.1 minutes (± 3.1), and more than twice as many participants reported alcohol consumption (138.0% ± 6.7) compared to baseline. The majority of US public holidays and holiday eves were associated with s le-level increases in sleep duration, decreases in sleep consistency, later sleep onset and offset, and increases in the prevalence of alcohol consumption. US public holidays were associated with increased sleep duration, decreased sleep consistency, and later sleep timing among US adult users of an objective, validated commercial fitness tracker. Holidays were also associated with an increased prevalence of participants having reported alcohol use. Given the adverse health impacts of sleep timing variability on both weekends and during the transition to daylight savings time, and of increased alcohol use on weekends and public holidays, further investigation of the health impacts of these behavioral changes is warranted.
Publisher: Springer Science and Business Media LLC
Date: 12-06-2017
DOI: 10.1038/S41598-017-03171-4
Abstract: The association of irregular sleep schedules with circadian timing and academic performance has not been systematically examined. We studied 61 undergraduates for 30 days using sleep diaries, and quantified sleep regularity using a novel metric, the sleep regularity index (SRI). In the most and least regular quintiles, circadian phase and light exposure were assessed using salivary dim-light melatonin onset (DLMO) and wrist-worn photometry, respectively. DLMO occurred later (00:08 ± 1:54 vs. 21:32 ± 1:48 p 0.003) the daily sleep propensity rhythm peaked later (06:33 ± 0:19 vs. 04:45 ± 0:11 p 0.005) and light rhythms had lower litude (102 ± 19 lux vs. 179 ± 29 lux p 0.005) in Irregular compared to Regular sleepers. A mathematical model of the circadian pacemaker and its response to light was used to demonstrate that Irregular vs. Regular group differences in circadian timing were likely primarily due to their different patterns of light exposure. A positive correlation (r = 0.37 p 0.004) between academic performance and SRI was observed. These findings show that irregular sleep and light exposure patterns in college students are associated with delayed circadian rhythms and lower academic performance. Moreover, the modeling results reveal that light-based interventions may be therapeutically effective in improving sleep regularity in this population.
Publisher: JMIR Publications Inc.
Date: 22-02-2021
DOI: 10.2196/28057
Publisher: Public Library of Science (PLoS)
Date: 28-03-2016
Publisher: Springer Science and Business Media LLC
Date: 24-08-2019
Publisher: The Endocrine Society
Date: 15-08-2019
Abstract: Studies suggest that female reproductive hormones are under circadian regulation, although methodological differences have led to inconsistent findings. To determine whether circulating levels of reproductive hormones exhibit circadian rhythms. Blood s les were collected across ∼90 consecutive hours, including 2 baseline days under a standard sleep-wake schedule and ∼50 hours of extended wake under constant routine (CR) conditions. Intensive Physiological Monitoring Unit, Brigham and Women’s Hospital. Seventeen healthy premenopausal women (22.8 ± 2.6 years nine follicular eight luteal). Fifty-hour CR. Plasma estradiol (E2), progesterone (P4), LH, FSH, SHBG, melatonin, and core body temperature. All hormones exhibited significant 24-hour rhythms under both standard sleep-wake and CR conditions during the follicular phase (P 0.05). In contrast, only FSH and SHBG were significantly rhythmic during the luteal phase. Rhythm acrophases and litudes were similar between standard sleep-wake and CR conditions. The acrophase occurred in the morning for P4 in the afternoon for FSH, LH, and SHBG and during the night for E2. Our results confirm previous reports of ∼24-hour rhythms in many female reproductive hormones in humans under ambulatory conditions but demonstrate that these hormones are under endogenous circadian regulation, defined as persisting in the absence of external time cues. These results may have important implications for the effects of circadian disruption on reproductive function.
Publisher: Oxford University Press (OUP)
Date: 22-05-2018
DOI: 10.1093/SLEEP/ZSY098
Publisher: Cold Spring Harbor Laboratory
Date: 22-06-2021
DOI: 10.1101/2021.06.15.21258983
Abstract: Rigorous nonpharmaceutical interventions (e.g., stay-at-home orders, remote-work directives) were implemented in early 2020 for coronavirus disease 2019 (COVID-19) pandemic containment in the U.S. During this time, increased sleep duration and delayed sleep timing were reported through surveys (Leone et al., 2021) and wearable data (Rezaei and Grandner, 2021), as were elevated adverse mental health symptom (Czeisler et al., 2020). Inter-relationships between sleep and mental health have not been examined using longitudinal objective sleep-wake data, during these abruptly imposed lifestyle changes. We examined objective sleep-wake data and surveyed mental health data collected among 4,912 U.S. adult users of a validated sleep wearable (WHOOP, Boston, Massachusetts) before and during the COVID-19 pandemic. Comparing the pre-pandemic (January 1 to March 12, 2020) and acute pandemic-onset intervals (March 13 to April 12, 2020), participants exhibited increased mean sleep duration (0.25h [95% CI = 0.237-0.270]), later sleep onset (18m [17.378-20.045]) and offset (36m [35.111-38.106]), and increased consistency of sleep timing (3.51 [3.295-3.728] out of 100) all P 0.0001. Generally, participants with persistent sleep deficiency and low sleep consistency had higher odds of symptoms of anxiety or depression, burnout, and new or increased substance use during the pandemic. Decreases in sleep duration (adjusted odds ratio [aOR] = 1.30, 95% CI = 1.03-1.65, P = 0.025) and sleep consistency (2.05 [1.17-3.67], P = 0.009) were associated with increased anxiety and depression symptoms during the pandemic. We suggest that sleep duration and consistency may be important predictors of risk of adverse mental health outcomes during a pandemic. M.J. Leone, M. Sigman, D.A. Golombek. Effects of lockdown on human sleep and chronotype during the COVID-19 pandemic. Curr Biol 30 (16), R930–R931 (2020). N. Rezaei N, M.A. Grandner. Changes in sleep duration, timing, and variability during the COVID-19 pandemic: Large-scale Fitbit data from 6 major US cities. Sleep Health 10.1016/j.sleh.2021.02.008. (2021). M.É. Czeisler, R.I. Lane, E. Petrosky, et al., Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic - United States, June 24-30, 2020. MMWR Morb Mortal Wkly Rep 69 (32), 1049–1057 (2020). The coronavirus disease 2019 (COVID-19) pandemic has had profound effects on health, including increased sleep duration and worsened mental health. We examined associations between (1) objective sleep-wake data before and during the COVID-19 pandemic and (2) adverse mental health symptoms and substance use among users of a validated sleep wearable. We found that, in general, participants with persistent sleep deficiency and low sleep consistency had higher odds of symptoms of anxiety or depression, new or increased substance use, and burnout. Our findings suggest that sleep of sufficient duration and consistent timing are associated with mental health resilience, exemplified in this case by the impact of the pandemic and related abrupt lifestyle changes on adverse mental health symptoms.
Publisher: Oxford University Press (OUP)
Date: 14-12-2019
DOI: 10.1093/SLEEP/ZSZ300
Abstract: Sleep regularity, in addition to duration and timing, is predictive of daily variations in well-being. One possible contributor to changes in these sleep dimensions are early morning scheduled events. We applied a composite metric—the Composite Phase Deviation (CPD)—to assess mistiming and irregularity of both sleep and event schedules to examine their relationship with self-reported well-being in US college students. Daily well-being, actigraphy, and timing of sleep and first scheduled events (academic/exercise/other) were collected for approximately 30 days from 223 US college students (37% females) between 2013 and 2016. Participants rated well-being daily upon awakening on five scales: Sleepy–Alert, Sad–Happy, Sluggish–Energetic, Sick–Healthy, and Stressed–Calm. A longitudinal growth model with time-varying covariates was used to assess relationships between sleep variables (i.e. CPDSleep, sleep duration, and midsleep time) and daily and average well-being. Cluster analysis was used to examine relationships between CPD for sleep vs. event schedules. CPD for sleep was a significant predictor of average well-being (e.g. Stressed–Calm: b = −6.3, p & 0.01), whereas sleep duration was a significant predictor of daily well-being (Stressed–Calm, b = 1.0, p & 0.001). Although cluster analysis revealed no systematic relationship between CPD for sleep vs. event schedules (i.e. more mistimed/irregular events were not associated with more mistimed/irregular sleep), they interacted upon well-being: the poorest well-being was reported by students for whom both sleep and event schedules were mistimed and irregular. Sleep regularity and duration may be risk factors for lower well-being in college students. Stabilizing sleep and/or event schedules may help improve well-being. NCT02846077.
Publisher: Elsevier BV
Date: 02-2018
Publisher: Centers for Disease Control MMWR Office
Date: 14-08-2020
Publisher: Wiley
Date: 08-2018
DOI: 10.1111/JSR.12722
Publisher: BMJ
Date: 11-2019
DOI: 10.1136/BMJOPEN-2019-030302
Abstract: To examine associations between shift work characteristics and schedules on burnout in police and whether sleep duration and sleepiness were associated with burnout. Police officers (n=3140) completed the Maslach Burnout Inventory (emotional exhaustion, depersonalisation, personal accomplishment) and self-reported shift schedules (irregular, rotating, fixed), shift characteristics (night, duration, frequency, work hours), sleep duration and sleepiness. Irregular schedules, long shifts (≥11 hours), mandatory overtime, short sleep and sleepiness were associated with increased risk of overall burnout in police. Police working a greater frequency of long shifts were more likely to have emotional exhaustion (adjusted OR 1.91, 95% CI 1.35 to 2.72) than those not working long shifts. Night shifts were associated with depersonalisation (1.32, 1.05 to 1.66) compared with not working nights. Police working mandatory overtime had increased risk of emotional exhaustion (1.37, 1.14 to 1.65) than those who did not. Compared with fixed schedules, irregular schedules were associated with emotional exhaustion and depersonalisation (1.91, 1.44 to 2.54 and 1.39, 1.02 to 1.89, respectively). Police sleeping hours were more likely to have emotional exhaustion (1.60, 1.33 to 1.93) than those sleeping longer, and excessive sleepiness was associated with emotional exhaustion (1.81, 1.50 to 2.18). Irregular schedules and increased night shifts, sleep disturbances and work hours were related to higher burnout risk in police. Future research should evaluate work schedules in law enforcement that optimise shift duration and frequency, and increase consistency in scheduling and control over work hours to limit burnout in police.
Publisher: Cold Spring Harbor Laboratory
Date: 26-12-2022
DOI: 10.1101/2022.12.23.22283899
Abstract: US public health guidance has increasingly shifted responsibility for actions to minimize ongoing impacts of COVID-19 onto in iduals. During September to October 2022, the World Health Organization continued to characterize COVID-19 as a pandemic. Yet, public perceptions of the pandemic status of COVID-19 and its associations with COVID-19-related behaviors were unknown. To assess US public opinion on the characterization of COVID-19 as a pandemic. The COVID-19 Outbreak Public Evaluation (COPE) Initiative internet-based surveys, administered to 4985 US adults during September to October 2022. Demographic quota s ling and survey weighting were employed to improve s le representativeness of the US population by age, sex, and combined race and ethnicity. The COVID-19 pandemic. Response to the statement, “The pandemic is over.”‘ Response options included Strongly agree, Somewhat agree, Neutral, Somewhat disagree, and Strongly disagree. Overall, 5015 US adults completed The COPE Initiative surveys (response rate, 56.2%), and 4985 (99.4%) provided complete information for all analyzed variables and were included in this analysis. Only 1657 (33.2%) respondents agreed with the statement “the pandemic is over,” while 2141 (43.0%) disagreed and the remaining 1187 (23.8%) were neutral about the statement. Agreement that the pandemic was over was most strongly associated with having received fewer COVID-19 vaccines, lesser concern about SARS-CoV-2 variant viruses, and less frequent engagement in COVID- 19 preventive behaviors, such as mask usage in public spaces, as well as increasingly conservative political ideology, roles as unpaid caregivers of both children and adults, younger age, male sex, and significant disabilities. As of September to October 2022, US public opinion was mixed on the characterization of COVID-19 as a pandemic. Belief the pandemic was over was associated with less frequent engagement in COVID-19 preventive\\behaviors, highlighting the important role of public health communication. Demographic groups to prioritize tailored public health messaging about the pandemic status were identified. Continued assessment of public perceptions about the state of the pandemic is warranted entering Year 4 of the COVID-19 pandemic. As of September to October 2022, what was US public opinion as to whether COVID-19 remained a pandemic? In this demographically representative survey study of 4985 US adults, only 1 in 3 respondents agreed with the statement “the pandemic is over ” 43% of adults disagreed. Agreement that the pandemic was over was associated with less engagement in COVID-19 preventive behaviors and more political conservatism. As of September to October 2022, US public opinion was ided regarding the status of COVID-19 as a pandemic and is associated with COVID-19-related behaviors, underscoring important public health and policy implications of this designation.
Publisher: Elsevier BV
Date: 05-2019
DOI: 10.1016/J.AAP.2017.11.004
Abstract: The morning commute home is an especially vulnerable time for workers engaged in night shift work due to the heightened risk of experiencing drowsy driving. One strategy to manage this risk is to monitor the driver's state in real time using an in vehicle monitoring system and to alert drivers when they are becoming sleepy. The primary objective of this study is to build and evaluate predictive models for drowsiness events occurring in morning drives using a variety of physiological and performance data gathered under a real driving scenario. We used data collected from 16 night shift workers who drove an instrumented vehicle for approximately two hours on a test track on two occasions: after a night shift and after a night of rest. Drowsiness was defined by two outcome events: performance degradation (Lane-Crossing models) and electroencephalogram (EEG) characterized sleep episodes (Microsleep Models). For each outcome, we assessed the accuracy of sets of predictors, including or not including a driver factor, eyelid measures, and driving performance measures. We also compared the predictions using different time intervals relative to the events (e.g., 1-min prior to the event through 10-min prior). By examining the Area Under the receiver operating characteristic Curve (AUC), accuracy, sensitivity, and specificity of the predictive models, the results showed that the inclusion of an in idual driver factor improved AUC and prediction accuracy for both outcomes. Eyelid measures improved the prediction for the Lane-Crossing models, but not for Microsleep models. Prediction performance was not changed by adding driving performance predictors or by increasing the time to the event for either outcome. The best models for both measures of drowsiness were those considering driver in idual differences and eyelid measures, suggesting that these indicators should be strongly considered when predicting drowsiness events. The results of this paper can benefit the development of real-time drowsiness detection and help to manage drowsiness to avoid related motor-vehicle crashes and loss.
Publisher: Centers for Disease Control MMWR Office
Date: 11-09-2020
Publisher: JMIR Publications Inc.
Date: 18-02-2021
Abstract: EMOVE
Location: United States of America
Location: United States of America
No related grants have been discovered for Charles Andrew Czeisler.