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INTRODUCTION: Previous studies have linked sleep to risk of diabetes and obesity, at least partially via alterations in food intake. Diabetes and obesity are common among Hispanics/Latinos, and studies are needed to better clarify the role of sleep in health among this group. Utilizing the revised TFEQ-R-18, this study will examine whether eating behaviors such as cognitive restraint, emotional eating and uncontrolled eating are related to self-reported sleep experiences. Specifically, we hypothesized that poor eating habits would be associated with (1) more insomnia symptoms, (2) overall worse sleep quality, (3) increased daytime sleepiness, and (4) shorter sleep duration. METHODS: Data were collected from N=100 adults (age 18–60, 47% female) of Mexican descent in the city of Nogales, AZ (34% not born in the US). Surveys were presented in English or Spanish. Eating Patterns were assessed with the Three-Factor Eating Questionnaire (TFEQ), which resulted in a total score and subscales for “cognitive restraint,” “uncontrolled eating, “and “emotional eating.” Insomnia was assessed with the use of the Insomnia Severity Index (ISI), Sleepiness with the use of the Epworth Sleepiness Scale (ESS), Sleep quality with the use of the Pittsburgh Sleep Quality Index (PSQI), and weekday and weekend sleep duration with the use of the Sleep Timing Questionnaire (STQ). Covariates included: age, sex, Body Mass Index (BMI), education and immigrant status. RESULTS: Overall TFEQ score (problematic eating) was positively associated with greater insomnia, poorer sleep quality, more sleepiness, and less weekend (but not weekday) sleep. Mean TFEQ score in the sample was 18.7 (range 0–51). In adjusted analyses, every point on the TFEQ was associated with 0.6 ISI points, 0.8 PSQI points, 0.5 ESS points, and 1.1 minutes of less weekend sleep duration. Regarding subscale scores, relationships were generally seen between sleep and emotional eating and unrestricted eating, and not cognitive restraint. CONCLUSIONS: Greater insomnia, poorer sleep quality, increased daytime sleepiness and decreased weekend sleep duration were associated with eating patterns at the US Mexico border, particularly in the area of unrestricted eating and emotional eating. This suggests possible mechanisms linking sleep and obesity in Hispanic/Latinos.

The purpose of this study was to develop and test the reliability and validity of a 13-item self-report Assessment of Sleep Environment (ASE). This study investigates the relationship between subjective experiences of environmental factors (light, temperature, safety, noise, comfort, humidity, and smell) and sleep-related parameters (insomnia symptoms, sleep quality, daytime sleepiness, and control over sleep). The ASE was developed using an iterative process, including literature searches for item generation, qualitative feedback, and pilot testing. It was psychometrically assessed using data from the Sleep and Healthy Activity Diet Environment and Socialization (SHADES) study (N = 1007 individuals ages 22–60). Reliability was determined with an internal consistency and factor analysis. Validity was evaluated by comparing ASE to questionnaires of insomnia severity, sleep quality, daytime sleepiness, sleep control, perceived stress, and neighborhood disorder. The ASE demonstrated high internal consistency and likely reflects a single factor. ASE score was associated with insomnia symptoms (B = 0.09, p < 0.0001), sleep quality (B = 0.07, p < 0.0001), and sleep control (B = −0.01, p < 0.0001), but not daytime sleepiness. The ASE was also associated with perceived stress (B = 0.20, p < 0.0001) and neighborhood disorder (B = −0.01, p < 0.0001). Among sleep environment factors, only smell was not associated with sleep quality; warmth and safety were negatively associated with sleepiness; and of the sleep environment factors, only light/dark, noise/quiet, and temperature (warm/cool) were not associated with insomnia symptoms. The ASE is a reliable and valid measure of sleep environment. Physical environment (light, temperature, safety, noise, comfort, humidity, and smell) was associated with insomnia symptoms and sleep quality but not sleepiness.

Previous studies have shown individuals with evening chronotype to have a greater likelihood for depression (self-reported and clinical ratings), especially in young adults. However, the mechanisms for this relationship remain unknown. Low levels of social support may be a plausible mechanism: young adults with evening chronotypes are awake when others are sleeping, which may lead to feelings of isolation or low support. This study examined links between chronotype, depression, and social support in relationship subtypes within a group of university student athletes. Data were obtained from 189 NCAA Division-I student athletes across all sports. Chronotype was assessed with the Circadian Energy Scale and ranged from -2 (definitely morning type) to +2 (definitely evening type). Depressive symptoms were assessed with Center for Epidemiological Studies Depression scale. Social support was assessed with the Multidimensional Scale of Perceived Social Support, which included subscales for Family, Friends, and Significant Other. A subscale for Team was created using the items from the Friends subscale (changing the word "friends" to "teammates"). Regression analyses adjusted for age, sex, and minority status. More evening chronotype was associated with higher reported depressive symptoms (

Sleep disturbances, such as short sleep duration and insomnia, are core features of depression. However, it is unclear if sleep duration and insomnia have an interactive effect on depression severity or individual symptoms. Data were drawn from a community sample (N = 1007) containing responses on the Insomnia Severity Index, Patient Health Questionnaire–9 (PHQ-9), and average sleep duration. Regression analyses determined the prevalence risks (PR) of symptoms of depression based on insomnia severity and sleep duration. Depression severity was related to insomnia severity (PR 1.09, p < 0.001) and short sleep duration (PR 1.52, p < 0.001), but the interaction between the two was negative (PR 0.97, p < 0.001). Insomnia severity increased the prevalence risk of all individual depression symptoms between 8 and 15%, while sleep duration increased the prevalence risk of appetite dysregulation (PR 1.86, p < 0.001), fatigue (PR 1.51, p < 0.001), difficulty concentrating (PR 1.61, p = 0.003), feelings of failure (PR 1.58, p = 0.002), and suicidal behavior (PR 2.54, p = 0.01). The interaction of sleep duration and insomnia was negative and ranged between 3 and 6%. In clinically significant depression (PHQ >=10), only insomnia severity increased the prevalence risk of depression severity (PR 1.02, p = 0.001). Insomnia and short sleep predict prevalent depression, but their interactive effect was negative. Thus, while insomnia had a greater association with depression severity and symptoms, this association was dependent on habitual sleep duration.

Introduction Sleep research that has been previously completed with individuals of Mexican descent generally do not use instruments that have been translated in accordance with the language norms of the target community. In this study, the Assessment of Sleep Environment (ASE) was translated by a bilingual research study team. The ASE was then completed by English and Spanish speaking participants, in their preferred language. Methods Data were collected from a sample of N=100 individuals of Mexican descent in Nogales, Arizona, located at the US-Mexico border. The ASE is a 13-item scale that quantifies the degree to which an individual perceives that their physical environment interferes with their sleep quality. It includes items about heat, cold, noise, quiet, light, dark, smell, humidity, comfort of sleeping surface and bedding, and safety. To translate the measure into Spanish, the following procedure was followed: (1) a bilingual study team member performed an initial translation; (2) a bilingual community member edited the translation; (3) a certified medical translator edited the revision; (4) a focus group of N=5 bilingual community members made contextual edits; (5) a back-translation was performed; (6) an additional bilingual focus group examined the final version for compatibility; and (7) the medical translator certified the accuracy of the final version. T-tests examined differences between those who completed the measure in Spanish vs English. Results Of the N=100 survey respondents, N=42 completed the ASE in Spanish. No significant differences were seen in overall scores between those who completed the measure in English or Spanish (p=0.17). In addition, no differences were seen for individual items assessing light (p=0.19), dark (p=0.21), noise (p=0.73), quiet (p=0.15), heat (p=0.08), cold (p=0.96), pillows (p=0.93), firmness (p=0.98), other sleeping surface issues (p=0.08), or safety (p=0.28), but mean differences were seen for humid (0.04), smell (0.04), and softness (p=0.02), with respondents to the Spanish version reporting a lower degree of disturbance due to these factors. Conclusion There were no significant differences seen in overall scores between those that completed the English and Spanish versions. Future studies can use the Spanish version of the ASE when assessing this population. Support (If Any)

Introduction The Sleep Disorders Symptom Checklist (SDSCL-25) is a brief assessment of patient-reported symptoms that suggest risk for a wide range of sleep disorders. To ensure the validity of study subject responses, the SDSCL-25 was translated into Spanish by a bilingual research study team. It was then administered to study subjects in their preferred language. Methods Data were collected from a sample of N=100 individuals of Mexican Descent in Nogales, Arizona, US-Mexico border. The SDSCL-25 is a screening tool that assesses the presence of a wide range of symptoms for sleep disorders. To translate the measure into Spanish, the following procedure was followed: (1) a bilingual study team member performed an initial translation; (2) a bilingual community member edited the translation; (3) a certified medical translator edited the revision; (4) a focus group of N=5 bilingual community members made contextual edits; (5) a back-translation was performed; (6) an additional bilingual focus group examined the final version for compatibility; and (7) the medical translator certified the accuracy of the final version. T-tests examined differences between those who completed the measure in Spanish vs English. Results Of the N=100 survey respondents, N=42 completed the SDSCL-25 in Spanish. Those who took the measure in Spanish showed no differences in frequency of reports of delayed sleep phase (p=0.28), snoring (p=0.85), morning dry mouth (p=0.87), choking/gasping (p=0.09), uncomfortable sensations in legs (p=0.25), urge to move legs (p=0.09), cataplexy (p=0.09), sleep paralysis (p=0.12), sleepwalking (p=0.08), or bruxism (p=0.13). Respondents in Spanish reported lower frequency of insufficient sleep (p=0.01), variability in bedtime (p=0.02), difficulty falling asleep (p=0.002), difficulty staying asleep (p=0.01), early morning awakenings (p=0.02), daytime tiredness/fatigue (p=0.006), phase advance (p=0.0003), daytime sleepiness (p=0.03), loud snoring (0.002), breathing pauses (p=0.049), frequent awakenings (p=0.0007), hypnogogic/pompic hallucinations (p=0.003), nightmares (p=0.047), panic awakenings (p=0.01), and overall sleep disturbance (p=0.043). Conclusion The present study describes a Spanish translation of the SDSCL-25. For those that took the Spanish version, there were lower reported frequencies of insufficient sleep, variability in bedtime, insomnia symptoms, daytime sleepiness and tiredness/fatigue, phase advance, sleep apnea symptoms, frequent awakenings, hypnogogic/pompic hallucinations, nightmares, panic awakenings, and overall sleep disturbance. Support (If Any)

Introduction Circadian health is increasingly recognized for the contributions it makes to general health. Few instruments assessing circadian rhythms have been translated into Spanish, however. The present study describes a Spanish translation of the Circadian Energy Scale (CIRENS). The instrument was designed according to the language norms of those living along the US-Mexico border by a bilingual research team. The CIRENS was completed by both English and Spanish speaking border residents, in their preferred language. Methods Data were collected from a sample of N=100 individuals of Mexican descent living in Nogales, Arizona. CIRENS is a 2-item scale that assesses chronotype by examining overall energy level in the morning and evening. Translation of the instrument into Spanish was done according to the following process: (1) a bilingual study team member attempted an initial translation; (2) a bilingual community member edited the translation; (3) a certified medical translator edited the revision; (4) a focus group of N=5 bilingual community members made further contextual edits; (5) a back-translation was performed; (6) an additional bilingual focus group examined the final version for compatibility; and (7) the medical translator certified the accuracy of the final version. T-tests examined differences between those who completed the measure in Spanish vs English. Results Of the N=100 survey respondents, N=42 completed the CIRENS in Spanish. No significant differences were observed in overall chronotype determination between those who took the Spanish versus English version (p=0.22) of the instrument. As a continuous score, the respondents in Spanish demonstrated slightly more morningness (p=0.01). Per the individual items, no differences were seen for evening energy levels (p=0.22), but Spanish respondents reported slightly higher morning energy scores (2.76 vs 2.17, p=0.008). Conclusion The individuals that completed the CIRENS in Spanish reported higher morning energy scores but no significant differences in chronotype. Future studies can use the Spanish CIRENS to evaluate circadian factors across cultural/linguistic groups. Support (If Any)

OBJECTIVE: Examine associations between a range of sleep problems and academic performance in a national sample of collegiate athletes. PARTICIPANTS: Data were obtained from the National College Health Assessment of US college/university students from 2011-2014 (N=8,312 collegiate athletes). METHODS: Univariate comparisons for all sleep variables and demographics were stratified across GPA, using one-way ANOVA for continuous variables and chi-square for categorical variables. Multinomial logistic regression models, with GPA as outcome (reference = A) and sleep variable as predictor, were examined and adjusted for age, sex, and survey year. Ordinal regression examined a 1-level change in GPA associated with each sleep variable, adjusted for covariates. RESULTS: Sleep-difficulty was associated with increased likelihood of B/C averages. Initial-insomnia was associated with increased likelihood of B/C, and D/F averages. tiredness was associated with increased likelihood of B/C, and D/F averages. CONCLUSIONS: Sleep problems are highly prevalent and associated with poorer academic performance in collegiate athletes.

OBJECTIVE: Sleep, which plays an important role in health and well-being, is socially patterned such that certain demographic groups have worse sleep health than others. One possible mechanism driving sleep disparities is social capital. The current study examines the association between social capital and self-reported sleep variables (e.g., duration, insomnia symptoms, and daytime sleepiness) among a sample of 1,007 participants from the Sleep Health and Activity, Diet and Environment Study (SHADES). METHODS: Logistic regressions were used to estimate whether the sleep variables were associated with social capital measures. All models control for age, sex, race/ethnicity (Non-Hispanic White, Black/African-American, Hispanic/Latino, Asian, and multicultural/other), income, and education (less than high school, high school graduate, some college, and college graduate). RESULTS: Lower likelihood of membership in groups was seen for long sleepers (>9hrs, p-value

Despite the high prevalence of subclinical sleep disturbances, existing treatments are either potent prescription medications or over-the-counter supplements with minimal scientific support and numerous side effects. However, preliminary evidence shows that polyphenols such as rosmarinic acid and epigallocatechin gallate can support healthy sleep without significant side effects. Therefore, the present study examined whether a polyphenol botanical blend (PBB) could improve sleep and/or daytime functioning in individuals with subclinical sleep disturbances. A total of 89 individuals completed a double-blind, randomized trial of daily treatment with PBB (n = 43) or placebo (n = 46) 30 min before bed for 30 days. Participants were monitored for changes in sleep (by sleep diary and an activity tracker), mood, and neurocognitive functioning. After 30 days, PBB improved diary sleep quality (p = 0.008) and reduced insomnia severity (p = 0.044) when compared to placebo. No other changes in sleep outcomes were observed. Additionally, PBB did not impair neurocognitive functioning, and some improvement was noted in vigilant attention, working memory, and risk assessment. Among individuals with subclinical sleep disturbances, PBB improved sleep quality, insomnia severity, and neurocognitive functioning over placebo. These findings indicate that polyphenol compounds may be useful for improving certain aspects of sleep without compromising neurocognitive functioning.

Introduction Data were collected for the Insomnia Severity Index (ISI). To ensure the validity of study subject responses, the ISI was translated into Mexican Spanish by a bilingual research study team, based on a previous Spanish translation. It was then administered to study subjects in their preferred language. Methods Data were collected from a sample of N=100 individuals of Mexican Descent in Nogales, Arizona, at the US-Mexico border. The Insomnia Severity Index (ISI) is a 7-item scale that quantifies the degree to which an individual experiences insomnia symptoms. A Spanish translation already exists, but this had not been previously localized to Mexican Spanish. To localize the measure, the following procedure was followed: (1) a bilingual community member edited the translation; (2) a certified medical translator edited the revised items; (3) a focus group of N=5 bilingual community members made contextual edits to the new measure; (4) a back-translation was performed; (5) an additional bilingual focus group examined the final version for compatibility; and (6) the medical translator certified the accuracy of the final version. As a result of this process, text edits to items 4 and 6 were made to accomplish the localization (the other items remained unchanged). T-tests examined differences between those who completed the measure in Mexican Spanish vs English. Results Of the N=100 survey respondents, N=42 completed the ISI in Spanish. Those who completed the ISI in Spanish reported significantly lower overall scores (8.2 vs 9.8, p=0.048). No significant differences were seen for individual items regarding early morning awakenings (p=0.13), satisfaction (p=0.71), interference with daily functioning (p=0.29), whether sleep problems are noticeable (p=0.06), and worry/distress about sleep (p=0.14). However, those completing the measure in Spanish reported lower scores on items regarding difficulty falling asleep (p=0.03) and staying asleep (p=0.001). Conclusion When adapting the ISI to a Spanish-speaking population at the US-Mexico border, modifications were made to the existing Spanish translation to improve linguistic and cultural appropriateness. Support (If Any)

Introduction The Brief Index of Sleep Control (BRISC) is a 4-item assessment of the degree to which an individual perceives that they are in control of their sleep. Previous work shows that this measure may be useful for sleep health promotion efforts. The present study describes an attempt to develop a version of this measure in Spanish, particularly for individuals of Mexican descent. Methods Data were collected from a sample of N=100 individuals of Mexican Descent in Nogales, Arizona, located at the US-Mexico border. The BRISC is a 4-item scale that quantifies the degree to which an individual perceives that their sleep is under their control, assessing perceived control over time to bed, time out of bed, total sleep time, and sleep quality. To translate the measure into Spanish, the following procedure was followed: (1) a bilingual study team member performed an initial translation; (2) a bilingual community member edited the translation; (3) a certified medical translator edited the revision; (4) a focus group of N=5 bilingual community members made contextual edits; (5) a back-translation was performed; (6) an additional bilingual focus group examined the final version for compatibility; and (7) the medical translator certified the accuracy of the final version. T-tests examined differences between those who completed the measure in Mexican Spanish vs English. Results Of the N=100 survey respondents, N=42 completed the BRISC in Spanish. No significant differences were seen in overall scores between those who completed the measure in English or Spanish (p=0.69). In addition, no differences were seen for individual items regarding time to bed (p=0.30), wake time (p=0.77), total sleep time (p=0.58), or sleep quality (p=0.98). Conclusion Data collection instruments be linguistically and culturally appropriate to the study population. This version of the BRISC was adapted to Mexican Spanish for use in future studies. Support (If Any)

PURPOSE: To quantify the relationship between sleep difficulties and poor mental health among student athletes using validated measures. METHODS: Data were collected from 190 National Collegiate Athletic Association Division I student athletes. Sleep assessments included measures of sleep duration, sleep quality, insomnia, fatigue, and sleep apnea symptoms. Mental well-being was assessed as depression, anxiety, mental health days, stress, and social support from family, friends, significant other, and teammates. RESULTS: Shorter sleep duration, poor sleep quality, insomnia, and fatigue were consistently and independently associated with stress, depression, anxiety, mental health days, and social support. Sleep apnea symptoms were associated with stress, depression, and social support. CONCLUSIONS: Short sleep duration, poor sleep quality, and daytime fatigue in student athletes are all associated with depression, anxiety, stress, poor mental health days, and decreased social support. These associations are not accounted for solely by stress.

Objective Insomnia is a clinically verified nicotine withdrawal symptom. As nicotine is a stimulant, it is plausible that smoking at night could disturb sleep more than smoking at earlier times of the day, but this remains empirically unclear. This study examined smoking status and its associations with insomnia severity and sleep duration while considering the potential role of smoking time. Methods Data were derived from the Sleep and Healthy Activity Diet Environment and Socialization study, a community-based study of 1007 adults (nnonsmokers = 818; nsmokers = 189) aged 22-60 from the Philadelphia area. Smoking status and time of smoking were self-reported. Insomnia was assessed with the Insomnia Severity Index and categorized as none, mild, and moderate-to-severe. Sleep duration was assessed with one item from the National Health and Nutrition Examination Survey and categorized as very short, short, normal, and long. Ordinal and multinomial logistic regressions were used to determine the association of smoking status including smoking time with insomnia severity and sleep duration controlling for sociodemographic covariates. Results Compared to nonsmoking, smoking was associated with experiencing increased insomnia (odds ratio = 2.5, 95% confidence interval [CI] 1.9, 3.4, P Conclusions Findings provide evidence that smoking is associated with increased insomnia severity and shorter sleep duration, particularly nightly smoking. Sleep health should be considered in smoking cessation efforts.

Background: Previous work has shown that poor sleep is a prospective risk factor for suicide in clinical populations and might contribute to risk in the general population. The present study evaluated whether sleep distress, onset insomnia, and insufficient sleep are associated with suicide ideation in university students and athletes participating in the 2011-2014 National College Health Assessment (NCHA; n = 113,185). Methods: In the NCHA survey, students self-reported the presence or absence of suicide ideation within the past 12 months. SLEEP DISTRESS was assessed with an item indicating that “sleep difficulties” were “particularly traumatic or difficult to handle.” ONSET INSOMNIA was assessed as at least 3 nights per week where survey participants reported an “extremely hard time falling asleep.” INSUFFICIENT SLEEP was operationalized as the number of days per week where the participants felt they did not get “enough sleep to feel rested.” All variables were yes/no except INSUFFICIENT SLEEP, which was categorized as 0-1 (reference), 2-3, 4-5, or 6-7 nights. Binary logistic regression analyses examined suicide ideation as the outcome and sleep variable as a predictor, adjusted for age, sex, year in school, recent depressed mood, and survey year. Associations within student-athletes were likewise assessed. Results: 7.4% of students reported suicide ideation within the past 12 months. In adjusted models, this was significantly associated with SLEEP DISTRESS (OR = 3.01, 95% CI [2.86, 3.16], p < 0.0001), ONSET INSOMNIA (OR = 1.95, 95% CI [1.86, 2.04], p < 0.0001), as well as INSUFFICIENT SLEEP (4-5 nights, OR = 1.41, 95% CI [1.28, 1.56], p < 0.0001; 6-7 nights, OR = 1.92, 95% CI [1.74, 2.13], p < 0.0001). Although suicide ideation was less common among athletes, ORs were similar for athletes for all sleep variables of interest. Conclusion: Sleep distress, onset insomnia, and insufficient sleep were all strongly related to suicide ideation among university students. These relationships were the same among collegiate athletes, even though this group reported less overall suicide ideation. Our findings suggest that university students may benefit from educational materials linking sleep disruption to maladaptive thinking and suicide ideation.

Introduction Previous studies have linked sleep to risk of diabetes and obesity, at least partially via alterations in food intake. Diabetes and obesity are common among Hispanics/Latinos, and studies are needed to better clarify the role of sleep for health among this group. Methods Data were collected from N=100 adults (age 18-60, 47% female) of Mexican descent in the city of Nogales, AZ (34% not born in the US). Surveys were presented in English or Spanish. Eating Patterns were assessed with the Three-Factor Eating Questionnaire (TFEQ), which resulted in a total score and subscales for “cognitive restraint,” “uncontrolled eating, “and “emotional eating.” Insomnia was assessed with the use of the Insomnia Severity Index (ISI), Sleepiness with the use of the Epworth Sleepiness Scale (ESS), Sleep quality with the use of the Pittsburgh Sleep Quality Index (PSQI), and weekday and weekend sleep duration with the use of the Sleep Timing Questionnaire (STQ). Covariates included: age, sex, Body Mass Index (BMI), education and immigrant status. Results When adjusted for age, sex and immigrant status (model-1), eating patterns were associated with greater insomnia (95%CI:[0.066,1.095];p=0.027), poorer sleep quality (95%CI:[0.170,1.456];p=0.014), sleepiness (95%CI[0.032,1.026];p=0.037), and weekend (but not weekday) sleep duration (95%CI:[-0.031,0.003];p=0.015). Further adjustment for education (model-2) revealed similar significant associations. Additional adjustment for BMI (model-3) revealed a change in daytime sleepiness, where no association was seen (95%CI:[-0.202,0.805];p=0.238). Regarding subscale scores, relationships were generally seen between sleep and both emotional eating and uncontrolled eating, but not cognitive restraint. However, after adjustment for BMI, there was a significant association between cognitive restraint and weekend sleep duration (95%CI:[-0.015,-0.001];p=0.030). Conclusion Greater insomnia, poorer sleep quality, increased daytime sleepiness and decreased weekend sleep duration were associated with eating patterns at the US Mexico border, particularly in terms of uncontrolled eating and emotional eating. This suggests possible mechanisms linking sleep and obesity in Hispanic/Latinos. Support (if any) Supported by T32HL007249, R01MD011600, R01DA051321

Lack of control over sleep may contribute to population-level sleep disturbances, yet relatively little work has explored the degree to which an individual's sense of control over their sleep may represent an important factor.Data from the Sleep and Healthy Activity Diet Environment and Socialization (SHADES) study, conducted in the Philadelphia area on a population comprising 1,007 individuals aged 22-60 years, was used. The BRief Index of Sleep Control (BRISC) was developed to quantify the degree to which an individual has control over their sleep. Reliability of the BRISC was assessed using Cronbach's alpha. Convergent validity was assessed by examining age-adjusted items and total score relationships to insomnia (ISI), sleepiness (ESS), sleep quality (PSQI), and total sleep time (NHANES).After adjustment for covariates, greater control over sleep was associated with a lower PSQI score (B = -2.2, 95% CI [-2.4,-2.0], P.0001), lower ISI score (B = -3.1, 95% CI [-3.5,-2.7], P.0001), lower ESS score (B=-1.4, 95% CI [-1.7,-1.1], P.0001), and more hours of sleep duration (B = 0.5, 95% CI [0.4,0.6], P .0001). Each BRISC item was separately associated with each sleep outcome (P.0001), although the items were not collinear with each other (all R0.7). Thus, the BRISC instrument demonstrated high reliability and good validity.Control over sleep may represent an important factor in sleep health. Control over time to bed, time awake, sleep duration, and sleep quality are all related to sleep outcomes and assessment of these constructs may be useful for future sleep interventions.

Objective/Background Poor quality and inadequate sleep are associated with impaired cognitive, motor, and behavioral components of sport performance and increased injury risk. While prior work identifies sports-related concussions as predisposing factors for poor sleep, the role of sleep as a sports-related concussion risk factor is unknown. The purpose of this study was to quantify the effect of poor sleep quality and insomnia symptoms on future sports-related concussion risk. Patients/Methods In this study, 190 NCAA Division-1 athletes completed a survey battery, including the Insomnia Severity Index (ISI) and National Health and Nutrition Examination Survey (NHANES) Sleep module. Univariate risk ratios for future sports-related concussions were computed with ISI and NHANES sleepiness scores as independent predictors. An additional multiple logistic regression model including sport, sports-related concussion history, and significant univariate predictors jointly assessed the odds of sustaining a concussion. Results Clinically moderate-to-severe insomnia severity (RR = 3.13, 95% CI: 1.320–7.424, p = 0.015) and excessive daytime sleepiness two or more times per month (RR = 2.856, 95% CI: 0.681–11.977, p = 0.037) increased concussion risk. These variables remained significant and comparable in magnitude in a multivariate model adjusted for sport participation. Conclusion Insomnia and daytime sleepiness are independently associated with increased sports-related concussion risk. More completely identifying bidirectional relationships between concussions and sleep requires further research. Clinicians and athletes should be cognizant of this relationship and take proactive measures – including assessing and treating sleep-disordered breathing, limiting insomnia risk factors, improving sleep hygiene, and developing daytime sleepiness management strategies – to reduce sports-related concussion risk and support overall athletic performance.

Introduction: Previous studies have linked sleep to risk of diabetes and obesity, at least partially via alterations in food intake. Diabetes and obesity are common among Hispanics/Latinos, and studies are needed to better clarify the role of sleep in health among this group. Methods: Data were collected from N=100 adults (age 18-60, 53% female) of Mexican descent in the city of Nogales, AZ (66% not born in the US, 33% 1 st -generation). Surveys were presented in English or Spanish. Eating Patterns were assessed with the 3-Factor Eating Questionnaire (3FEQ), which resulted in a total score and subscales for “cognitive restraint,” “uncontrolled eating, “and “emotional eating.” Insomnia was assessed with the Insomnia Severity Index (ISI), Sleepiness with the Epworth Sleepiness Scale (ESS), Sleep quality with the Pittsburgh Sleep Quality Index (PSQI), and weekday and weekend sleep duration with the Sleep Timing Questionnaire (STQ). Covariates included age, sex, and immigrant status. Results: See Table. Eating patterns associated with insomnia, sleep quality, sleepiness, and weekend (but not weekday) sleep duration. Regarding subscale scores, relationships were generally seen between sleep and emotional eating and unrestricted eating, and not cognitive restraint. Conclusions: Several different aspects of sleep quality were associated with eating patterns at the US-Mexico border, particularly in the area of unrestricted eating and emotional eating. This suggests possible mechanisms linking sleep and obesity in Hispanics/Latinos.

Sleep disparities exist among Hispanics/Latinos, although little work has characterized individuals at the United States (US)&ndash, Mexico border, particularly as it relates to acculturation. This study examined the association of Anglo and Mexican acculturation to various facets of sleep health among those of Mexican descent at the US&ndash, Mexico border. Data were collected from N = 100 adults of Mexican descent in the city of Nogales, Arizona (AZ). Surveys were presented in English or Spanish. Acculturation was assessed with the Acculturation Scale for Mexican-Americans (ARSMA-II). Insomnia was assessed with the Insomnia Severity Index (ISI), sleepiness was assessed with the Epworth Sleepiness Scale (ESS), sleep apnea risk was assessed with the Multivariable Apnea Prediction (MAP) index, weekday and weekend sleep duration and efficiency were assessed with the Sleep Timing Questionnaire, sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI), and sleep duration and sleep medication use were assessed with PSQI items. No associations were found between Mexican acculturation and any sleep outcomes in adjusted analyses. Anglo acculturation was associated with less weekend sleep duration and efficiency, worse insomnia severity and sleep quality, and more sleep apnea risk and sleep medication use. These results support the idea that sleep disparities may depend on the degree of acculturation, which should be considered in risk screening and interventions.

Purpose of review Sleep plays many roles in maintenance of cardiovascular health. This review summarizes the literature across several areas of sleep and sleep disorders in relation to cardiometabolic disease risk factors. Recent findings Insufficient sleep duration is prevalent in the population and is associated with weight gain and obesity, inflammation, cardiovascular disease, diabetes, and mortality. Insomnia is also highly present and represents an important risk factor for cardiovascular disease, especially when accompanied by short sleep duration. Sleep apnea is a well-characterized risk factor for cardiometabolic disease and cardiovascular mortality. Other issues are relevant as well. For example, sleep disorders in pediatric populations may convey cardiovascular risks. Also, sleep may play an important role in cardiovascular health disparities. Summary Sleep and sleep disorders are implicated in cardiometabolic disease risk. This review addresses these and other issues, concluding with recommendations for research and clinical practice.

Introduction: Habitual sleep duration is associated with cardiometabolic disease risk and poor mental health. Exercise has been shown to improve cardiometabolic disease risk and mental health. Further, insufficient/excessive sleep is associated with sedentary behavior. It is plausible that benefits of exercise may mitigate some negative effects of insufficient or excessive sleep. Methods: Data from the 2013 Behavioral Risk Factor Surveillance System, a phone-based survey conducted by the CDC, was used. All participants were asked to report habitual 24-hour sleep, which was recorded as whole numbers and categorized as Very Short (≤4h), Short (5-6h), Normal (7-8h, reference), and Long (≥9h). Participants reported their primary source of physical activity. For this analysis, the following groups were included: None (N=125314), Walking (N=179,996), Running (N=23,153), Gardening (N=26,637), and Yoga/Pilates (N=3370). Outcomes of interest were obesity, depressed mood, and history of hypertension and diabetes. Population-weighted binary logistic regression models evaluated relationships between sleep duration and these outcomes, stratified by activity group. Covariates included age, sex, race/ethnicity, and education. Results: See Table 1. Relationships between sleep duration and health outcomes differed by activity group. Associations with very short sleep were generally maintained across groups. However, relationships with short sleep were somewhat mitigated in running and yoga, and relationships with long sleep were seen less in running and gardening. Conclusions: The relationship between sleep duration and health may be modified by activity. It is possible that activities such as running and yoga may mitigate some of the negative health effects of insufficient or excessive sleep, as long as sleep duration is not extremely short. Also the obesity relationship was particularly unaffected by exercise.