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Background: Poor sleep can contribute to poorer health and socioemotional outcomes. Sleep health can be influenced by a range of individual and other socioecological factors. Perceptions of neighborhood physical and social characteristics reflect broader social-level factors that may influence sleep, which have not been well studied in the Australian context. This study examined the association between perceived neighborhood characteristics and sleep in a large sample of Australians., Methods: Data were from 9,792 people aged 16 years or older, from Waves 16 and 17 of the nationally representative Household, Income and Labour Dynamics in Australia Survey. Associations between perceived neighborhood characteristics (neighborly interaction and support, environmental noise, physical condition, and insecurity) and self-reported sleep duration, sleep disturbance, and napping were examined using multiple logistic regression models., Results: "Neighborhood interaction and support" and "neighborhood physical condition" were not significantly associated with any sleep outcomes after adjusting for relevant covariates. However, "environmental noise" and "neighborhood insecurity" remained significantly associated with sleep duration and sleep disturbance. None of the neighborhood characteristics were associated with napping. Furthermore, associations did not significantly vary by gender., Conclusions: This study highlights the potential benefit of public health policies to address noise and safety in neighborhoods to improve sleep., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The onset of monophasic sleep, in which napping ceases and sleep consolidates into a single night period, is a key developmental milestone of childhood. Yet to date, there is little consensus regarding the timing of cessation of napping in children. The aim of the current study is to examine global evidence regarding napping patterns in childhood, and, through meta-analysis, describe patterns of napping cessation and duration observed in children aged 0-12 y. A systematic search of all published, original research articles reporting children's napping patterns, by age, was conducted. The quality of studies was assessed, and meta-analysis of eligible studies undertaken. Risk of bias and heterogeneity of measurement was high. Current evidence indicates that less than 2.5% of children cease napping prior to age 2, while 94% cease napping by age 5. The preschool period (3-5 y; 36-60 mo) represents a particularly dynamic period in napping cessation, with large variation in rates of napping across studies evidencing potential ecological effects. Future studies should focus on understanding of the underlying mechanisms explaining individual variations in napping patterns and the extent to which patterns of napping may represent a marker of child development., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Objective: To independently assess compliance with safe sleeping guidelines for infants <12 months in licensed childcare services., Design: Full-day, in-situ observations of childcare practices (including sleep and non-sleep periods) conducted in 2016-2017., Setting: Australian home-based and centre-based licensed childcare services. All subject to national regulation and legislation to comply with safe sleeping guidelines., Participants: The sample was 18 licensed childcare settings (15 centre-based, 3 home-based) that had infants <12 months (n=49) attending at the time of observation. 31 educators completed self-report surveys., Main Outcomes and Measures: Standard observations of childcare practices, including a 20-item infant Safe Sleeping Guideline checklist. Educator characteristics, including each individual's knowledge, beliefs and attitudes regarding safe sleeping practices., Results: 83% of childcare services were observed to be non-compliant on at least 1 of 20 target guidelines (median 2.5, max=7); 44% were observed placing infants prone/side and 67% used loose bedding, quilts, doonas/duvets, pillows, sheepskins or soft toys in cots. 71% of the childcare settings had a copy of current safe sleeping guidelines displayed either in or at entry to the infant sleep room., Conclusion: Despite 25 years of public health messaging, non-compliance with safe sleeping guidelines was observed to be high in childcare services. Understanding of the reasons underlying non-compliance, particularly in contexts were legislative mandate and access to information regarding safe sleeping is high, is critical to informing ongoing public health messaging and should be the focus of future studies., Trial Registration Number: ANZCTR 12618001056280-pre-results., Competing Interests: Competing interests: SSt reports grants from Queensland Government, during the conduct of the study and has been previously commissioned by the Queensland Department of Education to develop resources and professional development programmes for the childcare sector. SSm and SI report grants from Queensland Government, during the conduct of the study; KT reports grants from Department of Education, Queensland Government, during the conduct of the study; JY reports grants from Department of Child Safety, Youth and Women and fees for professional time to consult to the Queensland Child Death Review Panel outside the submitted work. CP, AP and PB have nothing to disclose., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

Objectives: To examine the associations between sleep parameters and weight status in a large sample of preschool children., Design: Cross-sectional survey data from the Effective Early Educational Experiences for children (E4Kids) study were analyzed., Participants: 1111 children aged 3 to 6 years from Queensland and Victoria, Australia., Measurements: General linear modeling, with adjustment for significant control variables, assessed the impact of night sleep duration, total sleep duration, napping frequency, sleep timing (onset, offset and midpoint), and severity of sleep problems on standardized body mass index (BMI z score). General linear modeling was conducted for the total sample and then separately by sex., Results: For the total sample, there was a significant association between short sleep duration (≤10 hours) and increased BMI z score. No other sleep parameters were associated with BMI z score in this sample. Analyses by sex revealed that, among girls, there were no associations between any sleep parameter and BMI z score. However, among boys, short night sleep duration and napping frequency were both significantly associated with weight status even after adjustment for controls., Conclusion: Night sleep duration is a consistent independent predictor of body mass in young children. These results identify a complex relationship between sleep and body mass that implicates sex. Potential mechanisms that might explain sex differences warrant further investigation., (Copyright © 2018 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.)

Policy provision for naps is typical in child care settings, but there is variability in the practices employed. One practice that might modify children's early sleep patterns is the allocation of a mandatory nap time in which all children are required to lie on their beds without alternate activity permitted. There is currently limited evidence of the effects of such practices on children's napping patterns. This study examined the association between duration of mandatory nap times and group-level napping patterns in child care settings. Observations were undertaken in a community sample of 113 preschool rooms with a scheduled nap time (N = 2,114 children). Results showed that 83.5% of child care settings implemented a mandatory nap time (range = 15-145 min) while 14.2% provided alternate activities for children throughout the nap time period. Overall, 31% of children napped during nap times. Compared to rooms with ≤ 30 min of mandatory nap time, rooms with 31-60 min and > 60 min of mandatory nap time had a two-and-a-half and fourfold increase, respectively, in the proportion of children napping. Nap onset latency did not significantly differ across groups. Among preschool children, exposure to longer mandatory nap times in child care may increase incidence of napping.

Background: Duration and quality of sleep affect child development and health. Encouragement of napping in preschool children has been suggested as a health-promoting strategy., Objectives: The aim of this study is to assess evidence regarding the effects of napping on measures of child development and health., Design: This study is a systematic review of published, original research articles of any design., Subjects: Children aged 0-5 years., Method: Electronic database search was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and assessment of research quality was carried out following a Grading of Recommendations, Assessment, Development and Evaluations (GRADE) protocol., Results: Twenty-six articles met inclusion criteria. These were of heterogeneous quality; all had observational designs (GRADE-low). Development and health outcomes included salivary cortisol, night sleep, cognition, behaviour, obesity and accidents. The findings regarding cognition, behaviour and health impacts were inconsistent, probably because of variation in age and habitual napping status of the samples. The most consistent finding was an association between napping and later onset, shorter duration and poorer quality of night sleep, with evidence strongest beyond the age of 2 years., Limitations: Studies were not randomised. Most did not obtain data on the children's habitual napping status or the context of napping. Many were reliant on parent report rather than direct observation or physiological measurement of sleep behaviour., Conclusions: The evidence indicates that beyond the age of 2 years napping is associated with later night sleep onset and both reduced sleep quality and duration. The evidence regarding behaviour, health and cognition is less certain. There is a need for more systematic studies that use stronger designs. In preschool children presenting with sleep problems clinicians should investigate napping patterns., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

Objectives: To examine the relationship between mandatory naptimes in child care and children's nighttime sleep duration, both concurrently and 12 months later once in school., Methods: A sample of 168 children (50-72 months; 55% males) attending licensed child care centers were observed across their morning and throughout their scheduled naptime. Mandatory naptime was determined as the period in which children were not permitted any alternative activity except lying on their bed. Teachers reported each child's napping in child care. Nighttime and total sleep duration was reported by parents at 2 time points, in child care and in the second semester of their first school year. General linear models were used to examine group differences in sleep duration between children experiencing 0 to 60 minutes and >60 minutes of mandatory naptime, adjusting for key confounders. Path analysis was conducted to test a mediation model in which mandatory naptime is associated with nighttime sleep duration through increased napping in child care., Results: Children who experienced >60 minutes of mandatory naptime in child care had significantly less nighttime sleep than those with 0 to 60 minutes of mandatory naptime. This difference persisted at 12-month follow-up, once children were in school. Napping in child care mediated the relationship between mandatory naptime and duration of nighttime sleep., Conclusions: Exposure to mandatory naptimes of >60 minutes in child care is associated with decreased duration of nighttime sleep that endures beyond child care attendance. Given the large number of children who attend child care, sleep practices within these settings present an important focus for child health.

The purpose of this study was to compare the effects of two commonly utilized sleepiness countermeasures: a nap break and an active rest break. The effects of the countermeasures were evaluated by physiological (EEG), subjective, and driving performance measures. Participants completed 2 h of simulated driving, followed by a 15-min nap break or a 15-min active rest break, then completed the final hour of simulated driving. The nap break reduced EEG and subjective sleepiness. The active rest break did not reduce EEG sleepiness, with sleepiness levels eventually increasing, and resulted in an immediate reduction of subjective sleepiness. No difference was found between the two breaks for the driving performance measure. The immediate reduction of subjective sleepiness after the active rest break could leave drivers with erroneous perceptions of their sleepiness, particularly with increases of physiological sleepiness after the break., (Copyright © 2014 Society for Psychophysiological Research.)

Excess weight and obesity are factors that are strongly associated with risk for Obstructive Sleep Apnoea (OSA). Weight loss has been associated with improvements in clinical indicators of OSA severity; however, patients' beliefs about diet change have not been investigated. This study utilized a validated behaviour change model to estimate the relationship between food liking, food intake and indices of OSA severity. Two-hundred and six OSA patients recruited from a Sleep Disorders Clinic completed standardized questionnaires of: a) fat and fibre food intake, food liking, and food knowledge and; b) attitudes and intentions towards fat reduction. OSA severity and body mass index (BMI) were objectively measured using standard clinical guidelines. The relationship between liking for high fat food and OSA severity was tested with hierarchical regression. Gender and BMI explained a significant 20% of the variance in OSA severity, Fibre Liking accounted for an additional 6% (a negative relationship), and Fat Liking accounted for a further 3.6% of variance. Although the majority of individuals (47%) were currently "active" in reducing fat intake, overall the patients' dietary beliefs and behaviours did not correspond. The independent relationship between OSA severity and liking for high fat foods (and disliking of high fibre foods) may be consistent with a two-way interaction between sleep disruption and food choice. Whilst the majority of OSA patients were intentionally active in changing to a healthy diet, further emphasis on improving healthy eating practices and beliefs in this population is necessary., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Background: Loneliness and low mood are associated with significant negative health outcomes including poor sleep, but the strength of the evidence underlying these associations varies. There is strong evidence that poor sleep quality and low mood are linked, but only emerging evidence that loneliness and poor sleep are associated., Aims: To independently replicate the finding that loneliness and poor subjective sleep quality are associated and to extend past research by investigating lifestyle regularity as a possible mediator of relationships, since lifestyle regularity has been linked to loneliness and poor sleep., Methods: Using a cross-sectional design, 97 adults completed standardized measures of loneliness, lifestyle regularity, subjective sleep quality and mood., Results: Loneliness was a significant predictor of sleep quality. Lifestyle regularity was not a predictor of, nor associated with, mood, sleep quality or loneliness., Conclusions: This study provides an important independent replication of the association between poor sleep and loneliness. However, the mechanism underlying this link remains unclear. A theoretically plausible mechanism for this link, lifestyle regularity, does not explain the relationship between loneliness and poor sleep. The nexus between loneliness and poor sleep is unlikely to be broken by altering the social rhythm of patients who present with poor sleep and loneliness.

Excessive daytime sleepiness (EDS) in children has been associated with a number of problems. In contrast to adults who experience EDS and who may fall asleep or doze when in a monotonous or boring situation, children with EDS may present as hyperactive or poorly behaved. This community-based study aims to identify the prevalence of EDS in children from three perspectives: parent report, self-report, and teacher report. The study also explores the association between EDS and academic outcomes in children. The participants were 365 students (161 males) aged 4-12 years, their parents, and their teachers at a regional school. Academic outcomes were based on each student's school grades at the conclusion of the semester in which the community-based survey was administered. Using a cutoff score of 15 or greater on the PDSS, 113 (31%) students were identified by at least one respondent as displaying or experiencing EDS. EDS as observed by teachers using the PDSS was found to be associated with the student's academic outcomes, higher sleepiness scores being associated with poorer academic outcomes. Our findings suggest that the prevalence of EDS in a community setting may be higher than previously identified.

Objective: Adherence to continuous positive airway pressure (CPAP) therapy for obstructive sleep apnoea (OSA) is poor. We assessed the effectiveness of a motivational interviewing intervention (motivational interview nurse therapy [MINT]) in addition to best practice standard care to improve acceptance and adherence to CPAP therapy in people with a new diagnosis of OSA. Method: One hundred six Australian adults (69% male) with a new diagnosis of OSA and a clinical recommendation for CPAP treatment were recruited from a tertiary sleep disorders center. Participants were randomly assigned to receive either 3 sessions of a motivational interviewing intervention (MINT; n = 53; mean age = 55.4 years) or no intervention (control; n = 53; mean age = 57.74 years). The primary outcome was the difference between the groups in objective CPAP adherence at 1-month, 2-month, 3-month, and 12-month follow-ups. Results: Fifty (94%) participants in the MINT group and 50 (94%) participants in the control group met all inclusion and exclusion criteria and were included in the primary analysis. The number of hours of CPAP use per night in the MINT group at 3 months was 4.63 hr and was 3.16 hr in the control group (p = 0.005). This represents almost 50% better adherence in the MINT group relative to the control group. Patients in the MINT group were substantially more likely to accept CPAP treatment. Conclusions: MINT is a brief, manualized, effective intervention that improves CPAP acceptance and objective adherence rates compared to standard care alone. (Contains 4 tables and 2 figures.)

Light affects human health and behaviour. Research has demonstrated that children are more susceptible to the effects of light than adults, however this population remains underrepresented in the literature. This systematic review reports evidence of objectively measured light exposure on health and development outcomes in children (0–12 years old). Study (n = 59) outcomes were categorised into five thematic domains. Heterogeneity of light measurement and summarisation techniques were identified. Light's effects on melatonin and activity patterns were relatively robust, while research on sleep was sparse. Mixed findings suggest a protective effect of light on myopia, and vision improvements under cooler, brighter lighting. Increased light during the daytime was broadly associated with beneficial effects on social-emotional, cognitive, and physical health outcomes. Timing, colour, and intensity of light exposures were important in understanding health and developmental effects of light. Heterogeneity in light measurement methods limits comparability across studies and should be carefully considered. Greater understanding about the effects of light on children could inform novel approaches to support children's health, sleep, and development. • Reviews a rapidly emerging field of research into the effects of light for children's health and developmental outcomes. • Lighting exposure was linked to melatonin suppression and daily activity patterns, but sleep research remains sparse. • Increased daytime light was broadly associated with ophthalmological, psychological, and physical health outcomes. • Light measurement and summarisation methods are currently heterogenous across existing literature and research fields. [ABSTRACT FROM AUTHOR]

This systematic review explored the outcomes of current interventions to increase sleep duration in healthy young people (14–25 years). Nine databases were systematically searched, and 26 studies were included in this review. Quality assessment of the included studies was evaluated using two tools: the Newcastle-Ottawa scale, and Cochrane Risk of Bias. The interventions incorporated a range of strategies including behavioral (46.2%), educational (26.9%), a combination of behavioral and educational (15.4%), and other strategies such as physical therapy (11.5%). The findings indicate that behavioral and combination interventions were consistently effective in increasing sleep duration in healthy young people. Educational interventions alone were less effective at increasing young people's sleep duration. Of all the included studies, only one randomized control trial but none of the non-randomized trials were rated as good quality. Our findings suggest a combination of strategies with an emphasis on personalization of intervention could possibly maximize the chances of success at improving sleep duration in healthy young people. More high-quality studies with long-term assessments (≥ 6 months) should be conducted to test the efficacy and durability of interventions to increase sleep duration in young people, as well as the clinical implications to mental and physical health. [ABSTRACT FROM AUTHOR]

Young drivers (18–24 years) are over-represented in sleep-related crashes (comprising one in five fatal crashes in developed countries) primarily due to decreased sleep opportunity, lower tolerance for sleep loss, and ongoing maturation of brain areas associated with driving-related decision making. Impaired driving performance is the proximal reason for most car crashes. There is still a limited body of evidence examining the effects of sleep loss on young drivers’ performance, with discrepancies in the methodologies used, and in the definition of outcomes. This study aimed to identify the direction and magnitude of the effects of sleep loss on young drivers’ performance, and to appraise the quality of current evidence via a systematic review. Based on the Preferred Reporting Items for Systematic Reviews and Meta- Analyses (PRISMA) approach, 16 eligible studies were selected for review, and their findings summarised. Next, critical elements of these studies were identified, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines augmented to rate those elements. Using those criteria, the quality of individual papers was calculated and the overall body of evidence for each driving outcome were assigned a quality ranking (from ‘very low’ to ‘high-quality’). Two metrics, the standard deviation of lateral position and number of line crossings, were commonly reported outcomes (although in an overall ‘low-quality’ body of evidence), with significant impairments after sleep loss identified in 50% of studies. While speed-related outcomes and crash events (also with very low- quality evidence) both increased under chronic sleep loss, discrepant findings were reported under conditions of acute total sleep deprivation. It is crucial to obtain more reliable data about the effects of sleep loss on young drivers’ performance by using higher quality experimental designs, adopting common protocols, and the use of consistent metrics and reporting of findings based on GRADE criteria and the PRISMA statement. Key words: Young drivers, sleep loss, driving performance, PRISMA, the GRADE, systematic review. [ABSTRACT FROM AUTHOR]

The primary objective was to determine if poor sleep predicts postconcussion symptoms in the subacute period after mild traumatic brain injury (TBI). The impact of poor sleep pre- and post-injury was examined. The research design was cross-sectional. After screening to detect response invalidity, 61 individuals with a self-reported history of mild TBI 1-to-6 months prior answered an online fixed order battery of standardized questionnaires assessing their sleep (current and preinjury) and persistent postconcussion symptoms (Neurobehavioral Symptom Inventory, minus sleep, and fatigue items). The sleep measures were the Insomnia Severity Index, Epworth Sleepiness Scale, a single Likert-scale pre-injury sleep quality rating, and two PROMIS™ measures (sleep-related impairment and sleep disturbance). After controlling for the effects of preinjury sleep quality and demographics, the combination of the sleep measures made a significant contribution to the outcome (F[8,58] = 4.013, p = .001, [Formula: see text]). Only current sleep-related impairment (ß = .60, p < .05) made a significant and unique contribution to neurobehavioral symptoms. Preinjury sleep was not a predictor (ß = -.19, p > .05), although it contributed 3% of the variance in NSI scores after controlling for demographics. Sleep-related impairment is a modifiable factor. As a significant contributor to neurobehavioral symptoms, treatment for post-injury sleep-related impairment warrants further attention. [ABSTRACT FROM AUTHOR]

The timing, intensity, and duration of exposure to both artificial and natural light have acute metabolic and physiological effects in mammals. Recent research in human adults suggests exposure to moderate intensity light later in the day is concurrently associated with increased body mass; however, no studies have investigated the effect of light exposure on body mass in young children. We examined objectively measured light exposure and body mass of 48 preschool-aged children at baseline, and measured their body mass again 12 months later. At baseline, moderate intensity light exposure earlier in the day was associated with increased body mass index (BMI). Increased duration of light exposure at baseline predicted increased BMI 12-months later, even after controlling for baseline sleep duration, sleep timing, BMI, and activity. The findings identify that light exposure may be a contributor to the obesogenic environment during early childhood. [ABSTRACT FROM AUTHOR]

Objective: Driver sleepiness contributes substantially to road crash incidents. Simulator and on-road studies clearly reveal an impairing effect from sleepiness on driving ability. However, the degree to which drivers appreciate the dangerousness of driving while sleepy is somewhat unclear. This study sought to determine drivers' on-road experiences of sleepiness, their prior sleep habits, and personal awareness of the signs of sleepiness.Methods: Participants were a random selection of 92 drivers traveling on a major highway in the state of Queensland, Australia, who were stopped by police as part of routine drink driving operations. Participants completed a brief questionnaire that included demographic information, sleepy driving experiences (signs of sleepiness and on-road experiences of sleepiness), and prior sleep habits. A modified version of the Karolinska Sleepiness Scale (KSS) was used to assess subjective sleepiness in the 15 min prior to being stopped by police.Results: Participants' ratings of subjective sleepiness were quite low, with 90% reporting being alert to extremely alert on the KSS. Participants were reasonably aware of the signs of sleepiness, with many signs of sleepiness associated with on-road experiences of sleepiness. Additionally, the number of hours spent driving was positively correlated with the drivers' level of sleep debt.Conclusions: The results suggest that participants had moderate experiences of driving while sleepy and many were aware of the signs of sleepiness. The relationship between driving long distances and increased sleep debt is a concern for road safety. Increased education regarding the dangers of sleepy driving seems warranted. [ABSTRACT FROM AUTHOR]

This paper reports on a prospective study investigating the prevalence of maternal postpartum fatigue and sleepiness and highlights the potential increased crash risk faced by mothers when driving in the postpartum period. Twenty-four mothers from across Australia completed a sleep and driving diary for seven consecutive days at three time points; when their baby was 6, 12 and 18 weeks old. The results showed that the mothers’ sleep varied within the sample; however, on average sleep disruption and lack of sleep consolidation was experienced. A high proportion of the mothers reported fatigue and sleepiness impacting their functioning early in the postpartum period, with sleepiness being more enduring throughout the period. Of concern, a high proportion of driving journeys undertaken by the mothers were during high levels of sleepiness, particularly early in the postpartum period and during late night and early hours of the day. These findings have highlighted the need to educate mothers about the potential increased safety risk of driving during the postpartum period and identified key information that should be conveyed. [ABSTRACT FROM PUBLISHER]

Night-waking is typical across infancy and early childhood, inevitably disrupting family sleep. For some children, sleep problems develop and endure throughout childhood. This systematic review focused on fathers, and synthesised the evidence pertaining to the effects of children's sleep (from birth to 12 years) on fathers' health and wellbeing. A total of 29 studies were included. Key outcomes reported for fathers were: sleep and fatigue; mental and general health; and family functioning. An association between child sleep and father's sleep was observed when child's sleep was measured via actigraphy or paternal report, but not when measured via maternal report, suggesting that mothers may not always be aware of disruptions that awaken fathers. Findings showed poorer child sleep was associated with poorer general health and wellbeing among fathers, however, associations of poor child sleep with depression were fewer, and less frequent than those reported for mothers in the same households. Poor child sleep was negatively associated with the quality of family relationships, both within the couple and between parent and child. Future studies seeking to understand the interplay of child sleep and family wellbeing should apply objective measurement of sleep and integrate formal measures of family dynamics into the study design. [ABSTRACT FROM AUTHOR]

The sleep-wake cycle is a major determinant of locomotor activity in humans, and the neural and physiological processes necessary for optimum postural control may be impaired by an extension of the wake period into habitual sleep time. There is growing evidence for such a contribution from sleep-related factors, but great inconsistency in the methods used to assess this contribution, particularly in control for circadian phase position. Postural control was assessed at hourly intervals across 14 h of extended wake in nine young adult participants. Force plate parameters of medio-lateral and anterior-posterior sway, centre of pressure (CoP) trace length, area, and velocity were assessed with eyes open and eyes closed over 3-min periods. A standard measure of psychomotor vigilance was assessed concurrently under constant routine conditions. After controlling for individual differences in circadian phase position, a significant effect of extended wake was found for anterior-posterior sway and for psychomotor vigilance. These data suggest that extended wake may increase the risk of a fall or other consequences of impaired postural control. [ABSTRACT FROM AUTHOR]

The sensitivity and specificity of four self-report measures of disordered sleep – the Sleep Impairment Index (SII), the Sleep Disorders Questionnaire (SDQ), the Dysfunctional Beliefs and Attitudes About Sleep Scale (DBAS) and the Sleep–Wake Activity Inventory (SWAI) – were compared in subjects with insomnia and normal sleep. Nineteen young adult subjects met DSM-IV criteria for primary insomnia and another 19 were normal control subjects. Discriminatory characteristics of each measure were assessed using receiver operator characteristic curve analyses. Discriminatory power was maximised for each measure to produce cut-scores applicable for identification of individuals with insomnia. The DBAS, SII and SDQ psychiatric DIMS subscale were found to correlate, and discriminated well between the two groups. The SWAI nocturnal sleep subscale was not found to be an accurate discriminator. The results suggest differences in the measures in their ability to detect insomnia, and offer guidelines as to the optimal use of test scores to identify young adults suspected of insomnia. [ABSTRACT FROM AUTHOR]

Objective: To examine geographical variations in the association between bullying victimization and sleep loss over worry among adolescents.Methods: We used data from the Global School-based Student Health Survey conducted between 2003 and 2017 in 91 countries across the globe. Sleep loss was categorised as: none/minimum (reported never or rarely sleep loss), moderate (reported sometimes), and severe (reported most of the time or always). We obtained country-specific estimates from multiple multinomial logistic regression analyses and pooled estimates from meta-analyses.Results: Of 282,036 adolescents 13-17 years of age, 28.1% (male: 25.4%, female: 31.0%) and 8.4% (male: 7.3%, female: 9.5%) of adolescents reported moderate and severe sleep loss respectively. Adolescents who frequently experienced bullying (≥3 per 30 days) reported higher prevalence of severe sleep loss. Meta-analyses showed that increased frequency of bullying victimization is associated with increased odds of sleep loss, with adolescents who experienced bullying for ≥3 days in the past 30 days were 1.65 and 2.65 times more likely than adolescents without being bullied to experience respectively moderate (OR 1.65, 95% CI: 1.59-1.72) and severe (OR 2.65, 95% CI: 2.52-2.79) sleep loss. Irrespective of sex, the association between bullying victimization and sleep loss was significant in all regions, income groups, and in all but a few countries.Conclusions: Increased frequency of bullying victimization is positively associated with increased sleep loss among adolescents. Appropriate policies and programmes to stop bullying at school could help downgrade the risk of sleep loss among adolescents. [ABSTRACT FROM AUTHOR]

Background: Young drivers are over-involved in sleepiness-related crashes. The alerting effects of bright light offer a potential countermeasure for driver sleepiness, either replacing or in conjunction with current countermeasures such as the use of caffeine.Methods: Thirty young (18-25) chronically sleep-restricted drivers drove in a simulator under randomized conditions of continuous bright light ('Light,' 500 nm, 230μw/cm2), caffeine ('Caffeine,' 100 mg caffeinated gum), or light and caffeine together ('Light + Caffeine'), after driving under a placebo condition ('Placebo,' decaffeinated gum, 555 nm light, 0.3 μW/cm2) on three consecutive days. Using mixed-effects linear models, the associations between these conditions and physiological outcomes (EEG alpha and theta power, heart rate, and beat-to-beat intervals), driving performance (lateral lane and steering-related outcomes and lateral acceleration), and subjective sleepiness was assessed.Results: Relative to Placebo, all conditions improved driving performance outcomes (P < 0.0001), with effects of Light + Caffeine equal to Light but greater than Caffeine. Light + Caffeine reduced EEG alpha power more than Light or Caffeine (P < 0.0006), but ECG outcomes were generally worse under all conditions relative to Placebo. Subjective sleepiness improved under the Light + Caffeine condition only (P < 0.0001).Conclusions: Combining bright light and caffeine enhances their alerting effects on lateral lane variability and subjective sleepiness. A bright light could be a practical alternative to caffeine for sleepy drivers who avoid caffeine. The alerting effects of bright light could alleviate chronic community-level mild sleep restriction and provide on-road benefits to reduce severe injuries and fatal sleepiness-related crashes. [ABSTRACT FROM AUTHOR]

Abstract: To assist road safety professionals in developing effective strategies to combat the risk associated with driving while fatigued, a survey was administered to 1000 Australian drivers. Participants reported their past behaviours in regards to driving while sleepy and their perceptions of risk associated with driving fatigued as compared to speeding and driving under the influence of alcohol. Although participants appeared to be aware of the substantial risk associated with driving while sleepy, many drivers reported that they frequently drive when sleepy. Age and gender comparisons, revealed that risk taking behaviour in regards to driving while sleepy is occurring across all age groups and in both male and female drivers. Overall young to middle age drivers and male drivers reported the highest frequency of driving while sleepy and reported the lowest perceived personal risk in regards to driving while sleepy. [Copyright &y& Elsevier]

Sleep disturbance after mild traumatic brain injury (mTBI) is commonly reported as debilitating and persistent. However, the nature of this disturbance is poorly understood. This study sought to characterize sleep after mTBI compared with a control group. A cross-sectional matched case control design was used. Thirty-three persons with recent mTBI (1-6 months ago) and 33 age, sex, and ethnicity matched controls completed established questionnaires of sleep quality, quantity, timing, and sleep-related daytime impairment. The mTBI participants were compared with an independent sample of close-matched controls (CMCs; n=33) to allow partial internal replication. Compared with controls, persons with mTBI reported significantly greater sleep disturbance, more severe insomnia symptoms, a longer duration of wake after sleep onset, and greater sleep-related impairment (all medium to large effects, Cohen's d>0.5). No differences were found in sleep quantity, timing, sleep onset latency, sleep efficiency, or daytime sleepiness. All findings except a measure of sleep timing (i.e., sleep midpoint) were replicated for CMCs. These results indicate a difference in the magnitude and nature of perceived sleep disturbance after mTBI compared with controls, where persons with mTBI report poorer sleep quality and greater sleep-related impairment. Sleep quantity and timing did not differ between the groups. These preliminary findings should guide the provision of clearer advice to patients about the aspects of their sleep that may change after mTBI and could inform treatment selection. [ABSTRACT FROM AUTHOR]