Jessica R. Dietch

Adolescent sleep disparities: sex and racial/ethnic differences

OBJECTIVESnDuring adolescence, significant changes occur in sleep (eg, decreased sleep duration and increased sleep problems). To date, few studies have examined whether self-reported sleep duration differences exist between races/ethnicities in early adolescence (ages 11-14 years).nnnMETHODSnThis study compared sexes and race/ethnicity groups on self-reported sleep duration in a large (n = 1543; 48.9% boys) racially/ethnically diverse (62.7% White, 23.7% Hispanic/Latino, 10.4% African American, and 3.2% Asian) sample of young adolescents (mean age, 12.31) drawn from local middle schools.nnnRESULTSnA 2-way analysis of variance revealed that there was a trend for a significant sex effect (P = .067, partial χ2 = .002), with boys reporting more sleep than girls and significant race/ethnicity effects (P < .001, partial χ2 = .012), with Hispanic and African American students reporting shorter sleep duration than White and Asian students. The interaction between sex × race/ethnicity was significant (P = .014, partial χ2 = .002), with post hoc tests revealing that Hispanic males demonstrated significantly shorter sleep duration than White and Asian males and African American females demonstrating significantly shorter sleep duration than White females.nnnCONCLUSIONSnGiven the literature showing short sleep duration is related to various negative health outcomes and all-cause mortality, more research is needed to determine the factors involved in these disparities. Adolescent sleep disparities: sex and racial/ethnic differences.

Psychometric Evaluation of the PSQI in U.S. College Students.

STUDY OBJECTIVESnExamine the psychometric properties of the PSQI in two U.S. college samples.nnnMETHODSnStudy I assessed convergent and divergent validity in 866 undergraduates who completed a sleep diary, PSQI, and other sleep and psychosocial measures. Study II assessed PSQI insomnia diagnostic accuracy in a separate sample of 147 healthy undergraduates with and without insomnia.nnnRESULTSnThe PSQI global score had only moderate convergent validity with sleep diary sleep efficiency (prospective global measure of sleep continuity; r = 0.53), the Insomnia Severity Index (r = 0.63), and fatigue (r = 0.44). The PSQI global score demonstrated good divergent validity with measures of excessive daytime sleepiness (r = 0.18), circadian preference (r = -0.08), alcohol (r = 0.08) and marijuana (r = 0.05) abuse scales, and poor divergent validity with depression (r = 0.48), anxiety (r = 0.40), and perceived stress (r = 0.33). Examination of other analogous PSQI and sleep diary components showed low to moderate convergent validity: sleep latency (r = 0.70), wake after sleep onset (r = 0.37), sleep duration (r = 0.51), and sleep efficiency (r = -0.32). Diagnostic accuracy of the PSQI to detect insomnia was very high (area under the curve = 0.999). Sensitivity and specificity were maximized at a cutoff of 6.nnnCONCLUSIONSnThe PSQI demonstrated moderate convergent validity compared to measures of insomnia and fatigue and good divergent validity with measures of daytime sleepiness, circadian phase preference, and alcohol and marijuana use. The PSQI demonstrated considerable overlap with depression, anxiety, and perceived stress. Therefore, caution should be used with interpretation.

Gender and racial/ethnic differences in sleep duration in the North Texas heart study

Objective: Short sleep duration has been linked with a wide array of poor mental and physical health outcomes. Such risks, however, may be moderated by demographic factors such as gender and race/ethnicity. In a diverse community sample, the current study examined the relationship between gender, race/ethnicity and objectively measured sleep duration, controlling for select potential confounds. Methods: Participants were 300 community adults (50% female), aged 21 to 70 years, and included 60% non‐Hispanic Whites, 15% non‐Hispanic Blacks, 19% Hispanic/Latino, and 6% other. As part of a larger study, participants wore an actigraphy device over two nights to assess sleep duration (averaged across both nights). Gender and race/ethnicity were used as grouping variables in a two‐way analysis of covariance (ANCOVA) predicting objectively assessed total sleep time, with age, income, and employment status as covariates. Results: On average, males slept 34 min less than females (P = .002). After controlling for socioeconomic factors, there was a gender by race/ethnicity interaction (P = .030). Within males, Hispanics slept 45 min less than non‐Hispanic Whites (P = .002) and 57 min less than non‐Hispanic others (P = .008). Males also slept significantly less than females within the non‐Hispanic White (difference = −22.9; P = .016) and the Hispanic (difference = −77.1; P < .001) groups. Conclusions: Extending previous research, the current study provides additional evidence for differences in objective sleep duration based on gender and race/ethnicity in daily life. These data suggest that risk associated with sleep duration is patterned in important ways across gender and race/ethnicity; such information can be used to tailor prevention efforts.

Position statement: start middle and high schools at 8:30 am or later to promote student health and learning

The Society of Behavioral Medicine recommends school officials start middle and high school classes at 8:30 am or later. Such a schedule promotes students sleep health, resulting in improvements in physical health, psychological well-being, attention and concentration, academic performance, and driving safety. In this position statement, we propose a four-tiered approach to promote later school start times for middle and high schools.

The role of sleep dysfunction in the relationship between trauma, neglect and depression in methamphetamine using men

BackgroundnChildhood abuse and neglect, or childhood trauma (CT), has been associated with methamphetamine use, HIV, and depression. This study explored the potential for sleep dysfunction to influence the relationship between CT and depression in methamphetamine using men.nnnMethodsnA total of N = 347 men were enrolled: 1) HIV-uninfected, non-methamphetamine (MA) using heterosexual and homosexual men (HIV- MA-; n = 148), 2) MA-using MSM living with HIV (HIV + MA +; n = 147) and 3) HIV-uninfected, MA using MSM (HIV- MA +; n = 52). Participants completed measures of demographic characteristics, sleep dysfunction, childhood trauma, and depression.nnnResultsnParticipants were on average 37 years old (SD = 9.65). Half of participants were Hispanic, and 48.1% had a monthly personal income of less than USD

Computer-Guided Problem-solving Treatment for Depression, PTSD, and Insomnia Symptoms in Student Veterans: A Pilot Randomized Controlled Trial

500. Controlling for sleep dysfunction and control variables, the impact of CT on depression decreased significantly, b = 0.203, p < 0.001, and the indirect effect of CT on depression was significant according to a 95% bCI, b = 0.091, bCI (95% CI 0.057, 0.130). That is, sleep dysfunction partially explained the relationship between CT on depression.nnnLimitationsnImportant limitations included the cross-sectional design of the study, and the self-reported measure of sleep.nnnConclusionsnResults highlight the use of sleep interventions to prevent and treat depression, and the utility of assessing sleep disturbances in clinical care.

0144 Subjective, But Not Objective, Measures of Sleep Continuity Are Associated with Perceived Stress in a Community Sample

Depression is a highly prevalent psychological disorder experienced disproportionately by college student military veterans with many deleterious effects including risk for suicide. Treatment can help, but the debilitating nature of depression often makes seeking in-person treatment difficult and many are deterred by stigma, inconvenience, concerns about privacy, or a preference to manage problems themselves. The current study examines the efficacy of a computer-guided Problem-Solving Treatment (ePST®) for reducing symptoms of depression, posttraumatic stress disorder (PTSD), and insomnia in student military veterans. Twenty-four student veterans (Meanage = 32.7) with symptoms of depression were randomly assigned either to a treatment group receiving six weekly sessions of ePST or to a minimal contact control group (MCC). Participants completed the Patient Health Questionnaire-9 (PHQ-9) depression scale at baseline and then weekly through post-ePST or post-MCC. PTSD and insomnia questionnaires were also completed at baseline and posttreatment. A linear mixed model regression showed a statistically significant Group (ePST vs. MCC) × Time (pretreatment through posttreatment) interaction for depression, with the ePST showing substantial improvements in depressive symptoms over the 6-week period. Significant improvements were also seen in PTSD and insomnia symptoms. Results suggest that ePST can effectively treat depression, PTSD, and insomnia symptoms in student military veterans and may be a viable alternative for those who are not able to access live therapy. Future work should examine the durability of treatment effects and utility for more severe depression and suicide prevention.