Sleep regularity is associated with sleep-wake and circadian timing, and mediates daytime function in Delayed Sleep-Wake Phase Disorder

Murray, Jade M.; Phillips, Andrew J. K.; Magee, Michelle; Sletten, Tracey L.; Gordon, Christopher J.; Lovato, Nicole; Bei, Bei; Bartlett, Delwyn J.; Kennaway, David J.; Lack, Leon; Grunstein, Ronald R.; Lockley, Steven W.; Rajaratnam, Shanthakumar M W; Armstrong, E.; Chohan, Karan; Djavadkhani, Y.; Dodds, Kevin J.; Gunaratnam, Shaminka; Hardy, Madeleine F.; Joosten, Simon A.; Lee, J.; Micic, Gorica; Raman, Betty; Roese, E.; Salkeld, Mark D.; Verberne, E.; Wong, Keith; Yee, Brendon J.; Yeo, Aeneas; Yu, Kweon

doi:10.1016/j.sleep.2019.03.009

Cited by 38 publications

(25 citation statements)

References 54 publications

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“…However, the 95% confidence intervals between the two groups overlapped so interpretation of the findings should be considered in this context. This finding was contrary to Murray et al [17], who found no associations between the SRI and depressive/anxiety symptoms and lower sleep regularity. However, our findings do support conclusions from a systematic review by Bei and colleagues [18] that found depressive symptoms as one of the most common correlates associated with intra-individual variability in one or more of the sleep/wake patterns.…”

Section: Discussioncontrasting

confidence: 99%

“…Although significant inter-individual variability exists among humans in sleep and circadian timing, a growing body of evidence suggests that intra-individual variability in sleep timing may exceed inter-individual variability [17]. This intra-individual variability may be further compounded by variability in alcohol consumption and severity of AUD with accompanying psychiatric co-morbidities.…”

Section: Purpose Of Studymentioning

confidence: 99%

“…Additionally, lower SRI scores are associated with increased perceived stress and depression, indicating that sleep irregularity could represent an early target for preventing cardiometabolic disease [16]. Most recently, among patients with delayed sleep-wake disorder, higher SRI scores were associated with earlier sleep and longer total sleep time [17]. According to a recent review, the correlates most commonly associated with intra-individual variability in one or more sleep/wake patterns were younger age, non-white race/ethnicity, living alone, physical health, high BMI, weight gain, depressive symptoms, stress, and evening chronotype [18].…”

Section: Introductionmentioning

confidence: 99%

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Sleep Regularity Index in Patients with Alcohol Dependence: Daytime Napping and Mood Disorders as Correlates of Interest

Brooks

Raju

Barb³

et al. 2020

IJERPH

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Alcohol use disorder (AUD) is often accompanied by comorbid conditions, including sleep disturbances related to sleep regularity and timing. The Sleep Regularity Index (SRI) is a novel measure that assesses the probability that an individual is awake (vs. asleep) at any two time points 24 h apart. We calculated actigraphy-based SRI on 124 participants with alcohol dependence to capture the effects of changes in sleep timing and duration among patients enrolled in an inpatient alcohol treatment program. During the course of the study, the mean SRI increased between weeks 1 and 3 (75.4 to 77.8), thus indicating slightly improved sleep quality and regularity during alcohol treatment. Individuals within the bottom quartile of SRI scores at week 1 improved significantly over time. Average total SRI for individuals with no mood disorders was slightly higher than that for individuals with one or more mood disorders. Increased SRI scores were associated with lower total nap duration from week 1 to week 3. Increased SRI scores were associated with decreased mental/physical exhaustion scores from week 1 to week 3. The SRI could be a target for assessment/intervention in certain sub-groups of individuals undergoing inpatient treatment for AUD.

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Section: Discussioncontrasting

confidence: 99%

Section: Purpose Of Studymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Sleep Regularity Index in Patients with Alcohol Dependence: Daytime Napping and Mood Disorders as Correlates of Interest

Brooks

Raju

Barb³

et al. 2020

IJERPH

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“…Design elements may include long shift durations of >12 h, early shift start times (before 06:00), and backward rotating rosters (night to day shifts) (Akerstedt and Wright, 2009). The roster schedule design may also interfere with sleep regularity in shift workers contributing to intra-individual variability in the timing of sleep onset and wake time when on workdays compared to days off (Murray et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

The Sleep of Shift Workers in a Remote Mining Operation: Methodology for a Randomized Control Trial to Determine Evidence-Based Interventions

et al. 2021

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Shiftwork may adversely impact an individual’s sleep-wake patterns and result in sleep loss (<6 h. following night shift), due to the circadian misalignment and the design of rosters and shifts. Within a mining operation, this sleep loss may have significant consequences due to fatigue, including an increased risk of accidents and chronic health conditions. This study aims to (i) determine the efficacy of an intervention that comprises a sleep education program and biofeedback through a smartphone app on sleep quality, quantity, and alertness (ii) determine the prevalence of risk for a potential sleep disorder, and (iii) quantify and describe the sleep habits and behaviors of shift workers in a remote mining operation. This study consists of a randomized controlled trial whereby eighty-eight shift workers within a remote mining operation are randomized to a control group or one of three different treatment groups that are: (i) a sleep education program, (ii) biofeedback on sleep through a smartphone app, or (iii) a sleep education program and biofeedback on sleep through a smartphone app. This study utilizes wrist-activity monitors, biomathematical modeling, and a survey instrument to obtain data on sleep quantity, quality, and alertness. A variety of statistical methods will determine the prevalence of risk for a potential sleep disorder and associations with body mass index, alcohol, and caffeine consumption. A generalized linear mixed model will examine the dependent sleep variables assessed at baseline and post-intervention for the control group and intervention groups, as well as within and between groups to determine changes. The findings from this study will contribute to the current understanding of sleep and alertness behaviors, and sleep problems and disorders amongst shift workers. Importantly, the results may inform fatigue policy and practice on interventions to manage fatigue risk within the mining industry. This study protocol may have a broader application in other shiftwork industries, including oil and gas, aviation, rail, and healthcare.

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“…Indeed, variability in sleep timing and duration is greater in DSWPD patients than in healthy controls, 11 and more variability is associated with later circadian phase. 21 Moreover, increased activity during the night due to more time awake, and decreased activity during the day due to daytime sleepiness may also decrease the amplitude of the rest-activity cycle on work days compared to free days. Increased variability of the rest-activity cycle and blunted amplitude have been associated with adverse health outcomes.…”

Section: Introductionmentioning

confidence: 99%

<p>Impact of Mandatory Wake Time on Sleep Timing, Sleep Quality and Rest-Activity Cycle in College and University Students Complaining of a Delayed Sleep Schedule: An Actigraphy Study</p>

Moderie¹,

Maren²,

Paquet

et al. 2020

NSS

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Background: Individuals complaining of a delayed sleep schedule are expected to have shorter sleep duration and lower sleep quality when they must comply with morning obligations. The changes in the sleep schedule imposed by morning obligations may in turn decrease the stability and amplitude of their rest-activity cycle. These expectations were only partially supported in previous studies, possibly due to poor differentiation between days with mandatory or free wake times. Participants: Fourteen college/university students (8 women) with a complaint of a late sleep schedule and a bedtime after midnight were compared to fourteen controls with an earlier sleep schedule and no complaint. Methods: During a week of 24-h activity recording, participants specified in their sleep diary whether their wake time was free or determined by an obligation. Results: The number of nights with mandatory wake times was similar in the two groups. Groups were also similar for sleep duration and sleep quality over the 7 days of recording. Actigraphic sleep efficiency was the same in the two groups for both free and mandatory wake times, but subjective sleep quality decreased on the nights with mandatory wake time in both groups. On the nights with mandatory wake time, delayed participants had shorter sleep episodes and less total sleep time than controls. Rest-activity cycle amplitude was lower in the delayed group whether wake time was free or mandatory. Conclusion: Sleep duration and total sleep time differed between the two groups only when wake time was mandatory. Prior to mandatory wake times, delayed participants kept the same bedtime and shortened their sleep; sleep latency and sleep efficiency were preserved but subjective sleep quality and alertness on awakening decreased compared to nights with free wake time. Lower amplitude of the rest-activity cycle in delayed subjects may reflect lifestyle differences compared to control participants.

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Sleep regularity is associated with sleep-wake and circadian timing, and mediates daytime function in Delayed Sleep-Wake Phase Disorder

Cited by 38 publications

References 54 publications

Sleep Regularity Index in Patients with Alcohol Dependence: Daytime Napping and Mood Disorders as Correlates of Interest

Sleep Regularity Index in Patients with Alcohol Dependence: Daytime Napping and Mood Disorders as Correlates of Interest

The Sleep of Shift Workers in a Remote Mining Operation: Methodology for a Randomized Control Trial to Determine Evidence-Based Interventions

<p>Impact of Mandatory Wake Time on Sleep Timing, Sleep Quality and Rest-Activity Cycle in College and University Students Complaining of a Delayed Sleep Schedule: An Actigraphy Study</p>

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