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1. From Alert Child to Sleepy Adolescent: Age Trends in Chronotype, Social Jetlag, and Sleep Problems in Youth with Autism

Author

Briana J. Taylor, Kahsi A. Pedersen, Carla A. Mazefsky, Martine A. Lamy, Charles F. Reynolds, William R. Strathmann, and Matthew Siegel

Abstract

Purpose: Developmental changes in sleep in youth with autism spectrum disorder (ASD) are understudied. In non-ASD youth, adolescents exhibit a "night owl chronotype" (i.e., later sleep/wake timing) and social jetlag (i.e., shifts in sleep timing across school nights and weekends), with corresponding sleep problems. The purpose of this study is to evaluate age trends in chronotype, social jetlag, and sleep problems in high-risk youth with ASD. Methods: Youth with ASD (N = 171), ages 5-21 years old, were enrolled at the time of admission to specialized psychiatric units. Caregivers reported children's demographic information, habitual sleep timing, and sleep problems. Multivariate analyses evaluated the effect of age on chronotype, social jetlag, and sleep problems and the effects of chronotype and social jetlag on sleep problems. Covariates and moderators included sex, race, verbal ability, autism symptom severity, supplemental melatonin, and pubertal status. Results: Older age was associated with later chronotype, more social jetlag, fewer sleep anxiety/co-sleeping problems, fewer night waking and parasomnia problems, and more daytime alertness problems. The effect of age on chronotype was stronger for youth with greater social affective symptom severity. Mediation analyses showed that later chronotype statistically mediated the association between age and daytime alertness problems. Conclusions: Youth with ASD may exhibit night owl chronotype behavior and social jetlag as they enter adolescence. Shifts toward a later chronotype may be exacerbated by autism severity and may contribute to alertness problems and sleepiness during the day. Chronotype is modifiable and may be leveraged to improve daytime functioning in youth with ASD.

Published
2024
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2. Rest-activity rhythm and sleep characteristics associated with depression symptom severity in strained dementia caregivers

Author

Lynn M. Martire, Stephen F. Smagula, Briana J. Taylor, Martica H. Hall, Richard Schulz, and Robert T. Krafty

Subjects
Male, Sleep Wake Disorders, medicine.medical_specialty, Cognitive Neuroscience, Rest, Population, Polysomnography, Article, 03 medical and health sciences, Behavioral Neuroscience, 0302 clinical medicine, Internal medicine, medicine, Dementia, Humans, Longitudinal Studies, Wakefulness, education, Depression (differential diagnoses), Aged, education.field_of_study, Sleep disorder, Depressive Disorder, Major, 030214 geriatrics, medicine.diagnostic_test, business.industry, Depression, Actigraphy, General Medicine, medicine.disease, Cross-Sectional Studies, Caregivers, Physical therapy, Major depressive disorder, Female, Sleep onset, business, Sleep, 030217 neurology & neurosurgery
Abstract

Summary Depression is associated with disturbances to sleep and the 24-h sleep–wake pattern (known as the rest–activity rhythm: RAR). However, there remains a need to identify the specific sleep/RAR correlates of depression symptom severity in population subgroups, such as strained dementia caregivers, who are at elevated risk for major depressive disorder. We assessed the cross-sectional associations of sleep/RARs with non-sleep depression symptom severity among 57 (mean age: 74 years, standard deviation: 7.4) strained dementia caregivers who were currently without clinical depression. We derived sleep measures from polysomnography and actigraphy, modelled RARs using a sigmoidally transformed cosine curve and measured non-sleep depression symptom severity using the Hamilton Depression Rating Scale (HRDS) with sleep items removed. The following sleep–wake measures were associated with greater depression symptom severity (absolute Spearman's correlations ranged from 0.23 to 0.32): more time awake after sleep onset (WASO), higher RAR middle level (mesor), relatively shorter active periods (alpha), earlier evening settling time (down-mesor) and less steep RARs (beta). In multivariable analysis, high WASO and low RAR beta were associated independently with depression symptom severity. Predicted non-sleep HDRS means (95% confidence intervals) in caregivers with and without these characteristics were: normal WASO/beta = 3.7 (2.3–5.0), high WASO/normal beta = 5.5 (3.5–7.6), normal WASO/low beta = 6.3 (3.6–8.9) and high WASO/low beta = 8.1 (5.3–10.9). Thus, in our sample of strained caregivers, greater sleep fragmentation (WASO) and less sustained/sharply segregated resting and active periods (low RAR beta) correlate uniquely with depression symptom severity. Longitudinal studies are needed to establish whether these independent sleep–wake correlates of depression symptoms explain heightened depression risk in dementia caregivers.

Published
2017

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