Assessing the benefits of napping and short rest breaks on processing speed in sleep-restricted adolescents

The relationships between wanting to nap, actually napping, and depressed and anxious mood

Study Objectives

These studies disentangle the relationships between wanting to nap (nap desire), actually napping (nap behavior), and depressed and anxious mood. Study 1 partially replicated and extended findings connecting napping and depressed and anxious mood. Study 2 explored the distinction between nap desire and behavior using a new, larger sample and a different technique.

Methods

Study 1 used a longitudinal, multimethod approach to understand napping and mood among undergraduate students in the United States (N = 104). In Study 2, a cross-sectional survey was conducted on adults over 25 in the continental United States (N = 1406), including items from the DASS-21 and questions about nap desire and behavior.

Results

Study 1 found a significant relationship between same-day napping behavior and depressed mood (M nap = 1.61, SE nap = 0.08 vs. M no nap = 1.44, SE no nap = 0.06, p = .018) but not anxious mood (p = .766). Study 2 partially replicated those findings; Analysis of Covariance (ANCOVA) showed that napping desire had a significant effect on anxious (F(1, 1291) = 6.86, p = .009, partial η2 = .005) and depressed mood (F(1, 1291) = 13.46, p < .001, partial η2 = .010), accounting for age, gender, and restedness, but napping behavior did not add to that effect.

Conclusions

Wanting to nap is related to greater depressed and anxious mood, but actual napping did not add to that relationship. These results have implications for clinicians using sleep assessment as a screening tool for mental health and highlight the need for further research on napping motivation.

Self-regulation of effort for a better health-related quality of life: a multidimensional activity pacing model for chronic pain and fatigue management

PURPOSE

To propose a comprehensive multidimensional model of activity pacing that improves health-related quality of life and promotes sustained physical activity engagement among adults with chronic conditions.

MATERIALS AND METHODS

A narrative review was conducted to examine the existing literature on activity pacing, health-related quality of life, pain and fatigue management, and physical activity promotion in chronic conditions.

RESULTS

The literature revealed a lack of a cohesive approach towards a multidimensional model for using activity pacing to improve health-related quality of life. A comprehensive multidimensional model of activity pacing was proposed, emphasizing the importance of considering all aspects of pacing for sustained physical activity engagement and improved health-related quality of life. The model incorporates elements such as rest breaks, self-regulatory skills, environmental factors, and effective coping strategies for depression/anxiety. It takes into account physical, psychological, and environmental factors, all of which contribute significantly to the enhancement of health-related quality of life, physical function, and overall well-being, reflecting a holistic approach.

CONCLUSIONS

The model offers guidance to researchers and clinicians in effectively educating patients on activity pacing acquisition and in developing effective interventions to enhance physical activity engagement and health outcomes among adults with chronic conditions. Additionally, it serves as a tool towards facilitating discussions on sustained physical activity and a healthy lifestyle for patients, which can eventually lead to improved quality of life.

Behavioural sleep problems in children and adults with intellectual disabilities: An integrative literature review

BACKGROUND

People with intellectual disabilities are more likely to experience sleep problems, which can affect quality of life, physical health, mental health and well-being.

METHODS

An integrative literature review was conducted to investigate what is known about behavioural sleep disturbances in people with an intellectual disability. The search used the following databases: Scopus, PsycInfo and Cinahl, to find papers published since 2015.

RESULTS

Within intellectual disability research, sleep appears as a common issue due to its high prevalence, negative relationships with an individual's physical and mental health, their quality of life, and impact of sleep problems on family or carers. The growing evidence base appears to support the use of behavioural, lifestyle and pharmacological interventions to improve sleep in people with an intellectual disability.

CONCLUSION

A wide array of literature provides evidence that people with intellectual disabilities are affected by and need support with their sleep.

Systematic review and meta-analyses on the effects of afternoon napping on cognition

Naps are increasingly considered a means to boost cognitive performance. We quantified the cognitive effects of napping in 60 samples from 54 studies. 52 samples evaluated memory. We first evaluated effect sizes for all tests together, before separately assessing their effects on memory, vigilance, speed of processing and executive function. We next examined whether nap effects were moderated by study features of age, nap length, nap start time, habituality and prior sleep restriction. Naps showed significant benefits for the total aggregate of cognitive tests (Cohen's d = 0.379, CI₉₅ = 0.296-0.462). Significant domain specific effects were present for declarative (Cohen's d = 0.376, CI₉₅ = 0.269-0.482) and procedural memory (Cohen's d = 0.494, CI₉₅ = 0.301-0.686), vigilance (Cohen's d = 0.610, CI₉₅ = 0.291-0.929) and speed of processing (Cohen's d = 0.211, CI₉₅ = 0.052-0.369). There were no significant moderation effects of any of the study features. Nap effects were of comparable magnitude across subgroups of each of the 5 moderators (Q values = 0.009 to 8.572, p values > 0.116). Afternoon naps have a small to medium benefit over multiple cognitive tests. These effects transcend age, nap duration and tentatively, habituality and prior nocturnal sleep.

Staying vigilant during recurrent sleep restriction: dose-response effects of time-in-bed and benefits of daytime napping

Study Objectives

We characterized vigilance deterioration with increasing time-on-task (ToT) during recurrent sleep restriction of different extents on simulated weekdays and recovery sleep on weekends, and tested the effectiveness of afternoon napping in ameliorating ToT-related deficits.

Methods

In the Need for Sleep studies, 194 adolescents (age = 15–19 years) underwent two baseline nights of 9-h time-in-bed (TIB), followed by two cycles of weekday manipulation nights and weekend recovery nights (9-h TIB). They were allocated 9 h, 8 h, 6.5 h, or 5 h of TIB for nocturnal sleep on weekdays. Three additional groups with 5 h or 6.5 h TIB were given an afternoon nap opportunity (5 h + 1 h, 5 h + 1.5 h, and 6.5 h + 1.5 h). ToT effects were quantified by performance change from the first 2 min to the last 2 min in a 10-min Psychomotor Vigilance Task administered daily.

Results

The 9 h and the 8 h groups showed comparable ToT effects that remained at baseline levels throughout the protocol. ToT-related deficits were greater among the 5 h and the 6.5 h groups, increased prominently in the second week of sleep restriction despite partial recuperation during the intervening recovery period and diverged between these two groups from the fifth sleep-restricted night. Daytime napping attenuated ToT effects when nocturnal sleep restriction was severe (i.e. 5-h TIB/night), and held steady at baseline levels for a milder dose of nocturnal sleep restriction when total TIB across 24 h was within the age-specific recommended sleep duration (i.e. 6.5 h + 1.5 h).

Conclusions

Reducing TIB beyond the recommended duration significantly increases ToT-associated vigilance impairment, particularly during recurrent periods of sleep restriction. Daytime napping is effective in ameliorating such decrement.

Clinical Trial Registration

NCT02838095, NCT03333512, and NCT04044885.

A collaborative approach to adopting/adapting guidelines. The Australian 24-hour movement guidelines for children (5-12 years) and young people (13-17 years): An integration of physical activity, sedentary behaviour, and sleep

Abstract

Background

In 2018, the Australian Government updated the Australian Physical Activity and Sedentary Behaviour Guidelines for Children and Young People. A requirement of this update was the incorporation of a 24-hour approach to movement, recognising the importance of adequate sleep. The purpose of this paper was to describe how the updated Australian 24-Hour Movement Guidelines for Children and Young People (5 to 17 years): an integration of physical activity, sedentary behaviour and sleep were developed and the outcomes from this process.

Methods

The GRADE-ADOLOPMENT approach was used to develop the guidelines. A Leadership Group was formed, who identified existing credible guidelines. The Canadian 24-Hour Movement Guidelines for Children and Youth best met the criteria established by the Leadership Group. These guidelines were evaluated based on the evidence in the GRADE tables, summaries of findings tables and recommendations from the Canadian Guidelines. We conducted updates to each of the Canadian systematic reviews. A Guideline Development Group reviewed, separately and in combination, the evidence for each behaviour. A choice was then made to adopt or adapt the Canadian recommendations for each behaviour or create de novo recommendations. We then conducted an online survey (n=237) along with three focus groups (n=11 in total) and 13 key informant interviews. Stakeholders used these to provide feedback on the draft guidelines.

Results

Based on the evidence from the Canadian systematic reviews and the updated systematic reviews in Australia, the Guideline Development Group agreed to adopt the Canadian recommendations and, apart from some minor changes to the wording of good practice statements, maintain the wording of the guidelines, preamble, and title of the Canadian Guidelines. The Australian Guidelines provide evidence-informed recommendations for a healthy day (24-hours), integrating physical activity, sedentary behaviour (including limits to screen time), and sleep for children (5-12 years) and young people (13-17 years).

Conclusions

To our knowledge, this is only the second time the GRADE-ADOLOPMENT approach has been used to develop movement behaviour guidelines. The judgments of the Australian Guideline Development Group did not differ sufficiently to change the directions and strength of the recommendations and as such, the Canadian Guidelines were adopted with only very minor alterations. This allowed the Australian Guidelines to be developed in a shorter time frame and at a lower cost. We recommend the GRADE-ADOLOPMENT approach, especially if a credible set of guidelines that was developed using the GRADE approach is available with all supporting materials. Other countries may consider this approach when developing and/or revising national movement guidelines.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-021-01236-2.

The impact of nutrition on sleep in people with an intellectual disability: An integrative literature review

BACKGROUND

People with intellectual disabilities are more likely to experience sleep problems. Sleep can impact on health and well-being; therefore, evidence-based interventions are required to improve sleep in this population.

METHOD

An integrative literature review was conducted on the impact of nutrition on sleep in people with intellectual disabilities. Following screening of papers (n = 289), 14 papers met the inclusion criteria.

RESULTS

Themes related to nutrition and improved overall well-being, use of nutritional supplements, specific foods, links to health comorbidities and food fussiness.

CONCLUSION

This is the first comprehensive review completed on nutritional interventions to improve sleep in people with intellectual disabilities. Dietary patterns may be an important factor to improving the quality and quantity of sleep. However, the current literature regarding the benefit of improved nutrition on sleep in people with an intellectual disability needs to be interpreted with caution.

Sleeping Duration, Napping and Snoring in Association with Diabetes Control among Patients with Diabetes in Qatar

BACKGROUND

Poor glycemic control is associated with chronic life-threatening complications. Several studies have revealed that sleep status is associated with glycemic control.

AIM

to examine the association between sleep duration, quality and glycemic control among adults with diabetes.

METHODS

Data on 2500 participants aged 18-60 years were collected from the Qatar Biobank (QBB). Sleep duration and quality were assessed by a self-completed health and lifestyle questionnaire, and glycemic control was assessed using HbA1c. Logistic regression was used to assess the association between sleep duration, napping, snoring and poor glycemic control.

RESULTS

After adjusting for age and gender, sleep duration was not associated with poor glycemic control. Lack of association persisted after controlling for smoking, physical activity, education, BMI, fruit and vegetable intake, insulin and medication use. However, sleeping for long hours at night (≥8 h) had a trend in increasing the risk of poor glycemic control (OR = 1.28; 95% CI: 0.94-1.74). Napping was positively associated with poor glycemic control. After adjusting for age and gender, patients who reported "sometimes, frequently, or always" napping had more than 30% increased risk of poor control as compared to patients who reported "never/rarely" napping. Snoring was not associated with poor glycemic control among the study sample when adjusted for age and gender (p = 0.61). Other factors were found to be associated with a better glycemic control such as female, high educational and high physical activity level.

CONCLUSIONS

our results suggest that napping may be an independent risk factor for a poor glycemic control in diabetes; further investigations are required.

Understanding sleep facilitators, barriers, and cultural dimensions in Native American urban youth

OBJECTIVES

American Indian/Alaska Native (AI/AN) youth are a high-risk group for sleep problems and associated chronic conditions. Urban AI/AN youth may face certain challenges, including specific psychosocial stressors (e.g., discrimination) and environmental factors (e.g., noise, light) that render them particularly vulnerable to poor sleep health. However, few studies have explored AI/AN adolescent sleep. To our knowledge, this is the first study to use systematic qualitative methods with AI/AN youth to explore their sleep environment and sleep behaviors.

DESIGN

In-depth interviews with 26 youth.

SETTING

Two urban areas in Central and Southern California.

PARTICIPANTS

Urban-dwelling AI/AN youth, age 12-16 years.

INTERVENTION

N/A.

MEASUREMENT

N/A.

RESULTS

We identified five main themes, each with subthemes: sleep patterns and desired sleep, sleep barriers inside the home, environmental factors, sleep facilitators, and cultural dimensions. Key concerns discussed were poor sleep hygiene, excessive use of electronics prior to bedtime, issues with temperature regulation, and noise both within and outside the home. Parents can be an important vehicle for messaging around sleep health and for behavior management. Participating adolescents also indicated differing levels of attachment to Native identity, suggesting that culturally-targeted sleep interventions should build in openness and flexibility to a range of identity starting points. Further, we identified cultural practices, such as sweat lodges and dreamcatchers, that could be incorporated in future sleep interventions for this population.

CONCLUSION

Findings increase our understanding of urban AI/AN youth's sleep environments and behaviors, thus potentially informing program development around sleep health for this vulnerable population.

The Effects of Workplace Rest Breaks on Health Problems Related to Long Working Hours and Shift Work among Male Apartment Janitors in Korea

Background

Rest breaks at work are reported to reduce fatigue and job stress. Apartment janitors in Korea who perform night shift work and work long hours can be exposed to various health problems (HPs). However, few studies have evaluated relationships between their rest breaks and HPs. This study was conducted to examine the relationships between long working hours, shift work, and insufficient rest breaks and HPs among Korean apartment janitors.

Methods

Data on 1,212 selected male apartment janitors were obtained from the 3rd and 4th Korean Working Conditions Surveys. Demographic and occupational characteristics were collected using self-reported questionnaires. Rest breaks at work were classified as "sufficient" or "insufficient." Long working hours were considered as working more than 60 hours per week. Zero-inflated negative binomial (ZINB) regression was performed to investigate the effects of shift work and long working hours on HPs and the effects of rest breaks on relationships between HPs and long working hours and shift work.

Results

Among those with insufficient rest breaks at work, significant associations were found between long working hours and the risk of HPs [odds ratio (OR) = 1.489; 95% confidence interval (CI) = 1.038-2.136] and work-related HPs (WRHPs) [OR 1.621; 95% CI = 1.156-2.272], and between shift work and HPs [OR = 1.603; 95% CI = 1.084-2.372]. These relationships became nonsignificant when sufficient rest breaks were provided.

Conclusion

It is important to provide breaks at work to reduce HPs because of long working hours and shift work among aged workers such as apartment janitors.

Pace yourself: Neural activation and connectivity changes over time vary by task type and pacing

Performance deterioration over time, or time-on-task (TOT) effects, can be observed across a variety of tasks, but little attention has been paid to how TOT-related brain activity may differ based on task pacing and cognitive demands. Here, we employ a set of three closely related tasks to investigate the effect of these variables on fMRI activation and connectivity. When participants dictated the pace of their own responses, activation and network connectivity within the dorsal attention network (DAN) increased over short time scales (~2-3 min), a phenomenon that was not observed when participants had no control over their pace of work. Reaction time slowing was also the most pronounced in this self-paced task. In contrast, TOT-related changes in default-mode network (DMN) activity and connectivity, DAN-DMN anti-correlations, and pupil diameter did not differ based on pacing or task instructions. Over a longer (~10 min) time scale, task-positive activation and connectivity decreased in all paradigms, in agreement with older findings. These results highlight dynamic patterns of resource allocation that have not previously been observed in fMRI experiments, and speak to the idea that the brain may strategically allocate resources depending on the task at hand and the time scale of work.

Beneficial effects of a daytime nap on verbal memory in adolescents

This study aimed to examine the sleep-dependent memory consolidation of verbal declarative memory in Chinese adolescents in a naturalistic experimental setting. Thirty-nine healthy boarding school students (ages 15-18, 70% female) were randomized to either a one-hour afternoon nap or wake group between the baseline and the retest sessions of three verbal declarative memory tasks: a Prose Stories Recall task, a Word Pair Associates task, and Rey Auditory Verbal Learning Test. Results showed that the nap group performed better than the no-nap group on both the Prose Stories Recall task and the Word Pair Associates task, but not on list learning. Our findings suggest that napping is beneficial to verbal declarative memory in adolescents, providing ecologically-valid empirical support for the sleep-dependent memory consolidation hypothesis using a napping paradigm in participants' naturalistic habitat. Our results demonstrate the potential importance of napping as a practical mnemonic intervention/compensatory strategy for student populations.