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/Background: The allostatic framework is a theoretical perspective that identifies allostatic load (AL) as a meaningful measure of dysregulation and desynchrony across biological processes due to cumulative stress exposure, thereby increasing disease risk. Research exploring the relationships of AL with sleep quality have yielded inconsistent findings. We examined AL at three visits (2004–2009 [Visit 1], 2009–2013 [Visit 2] and 2013–2017 [Visit 3]) in relation to sleep quality [Visit 3] among urban adults by sex, race and age group. We analyzed data on 1489 Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) participants [59.6% female, baseline age: 48.2 years, 58.5% African Americans] with available data on cardiovascular, metabolic and inflammatory AL markers and Pittsburgh Sleep Quality Index (PSQI) scores. Least squares regression models were constructed to evaluate AL score at Visit 1 (AL v1) and z-transformed probability of higher trajectory in AL score between Visit 1 and Visit 3 (AL traj) as predictors of PSQI score at Visit 3, controlling for demographic, lifestyle and health characteristics at Visit 1. AL traj was generated using group-based trajectory modeling. In fully adjusted models, AL v1 and PSQI score were positively related among men only (β = 0.43, P = 0.001), whereas higher AL traj was associated with PSQI score among women (β = 0.51, P = 0.001), White (β = 0.45, P = 0.011) and African American (β = 0.33, P = 0.014) populations. There were no statistically significant interactions according to age group (<50 vs. ≥ 50). Disparities exist whereby AL trajectory predicted sleep quality among women irrespective of race and baseline AL predicted sleep quality among men. Future studies should examine bi-directional AL-sleep relationships. • 1489 Healthy Aging in Neighborhoods of Diversity across the Life Span participants. • Allostatic load and Pittsburgh Sleep Quality Index scores. • Baseline allostatic load predicted sleep quality among men. • Allostatic load trajectory predicted sleep quality among women irrespective of race. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Over 40-million Americans are undiagnosed, misdiagnosed, or untreated for sleep disorders. Despite the growing need to integrate sleep medicine knowledge into the medical education curriculum, educational leaders have struggled to incorporate contemporary medical topics such as sleep medicine into the already packed curricula. We set out to examine the efficacy of an online, self-paced, sleep medicine learning module as an educational tool for medical students. Methods: We studied 87 Johns Hopkins medical students. Participants were randomly assigned to the sham module (SM, n =40) or learning module (LM, n =47). The efficacy of the tool was assessed based on changes in performance (pre- and post-module completion) on a validated sleep knowledge questionnaire (the Dartmouth Sleep Knowledge and Attitude Survey). Results: Improvement in overall sleep knowledge, as measured by the Dartmouth Sleep Knowledge and Attitude Survey, was significantly higher in the LM group compared to the SM group (F(1,84)=9.71, p <.01, η 2 =0.10). Although the SM group’s improvement was significantly lower than the LM group, within-subject comparisons did show improvement from their pre- to post-assessment scores as well. Conclusion: A self-paced learning module is an effective educational tool for delivering sleep medicine knowledge to medical students. [Copyright &y& Elsevier]

Objective: Our aim was to examine sex- and age-specific relationships of sleep behaviors with all-cause mortality rates.Methods: A retrospective cohort study was conducted among 5288 adults (≥50 years) from the 2005-2008 National Health and Nutrition Examination Surveys who were followed-up for 54.9 ± 1.2 months. Sleep duration was categorized as < 7 h, 7-8 h and >8 h. Two sleep quality indices were generated through factor analyses. 'Help-seeking behavior for sleep problems' and 'diagnosis with sleep disorders' were defined as yes/no questions. Sociodemographic covariates-adjusted Cox regression models were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).Results: A positive relationship was observed between long sleep and all-cause mortality rate in the overall sample (HR = 1.90, 95% CI: 1.38, 2.60), among males (HR = 1.48, 95% CI: 1.05, 2.09), females (HR = 2.32, 95% CI: 1.48, 3.61) and elderly (≥65 years) people (HR = 1.80, 95% CI: 1.30, 2.50). 'Sleepiness/sleep disturbance' (Factor I) and all-cause mortality rate were positively associated among males (HR = 1.22, 95% CI: 1.03, 1.45), whereas 'poor sleep-related daytime dysfunction' (Factor II) and all-cause mortality (HR = 0.75, 95% CI: 0.62, 0.91) were negatively associated among elderly people.Conclusions: Sex- and age-specific relationships were observed between all-cause mortality rate and specific sleep behaviors among older adults. [ABSTRACT FROM AUTHOR]