Yours, mine, or ours? Dyadic sleep hygiene and associations with sleep quality, emotional distress, and conflict frequency in mixed-gender, bed-sharing couples

Although prior research demonstrates the interdependence of sleep quality within couples (i.e., the sleep of one partner affects the sleep of the other), little is known about the degree to which couples' sleep hygiene behaviours are concordant or discordant, and if one's own sleep hygiene or their report of their partners' sleep hygiene is related to worse relational, psychological, and sleep outcomes. In a sample of 143 mixed-gender, bed-sharing couples, each partner completed an online questionnaire consisting of the Sleep Hygiene Index (for themselves and their partner), PROMIS sleep disturbance scale, conflict frequency, PHQ-4 for anxiety and depressive symptoms, and the Perceived Stress Scale. Paired samples t-tests between partners were conducted using total and individual-item Sleep Hygiene Index scores to examine similarities and differences. Intraclass correlation coefficient (ICC) scores of dyadic reports were conducted to examine the level of agreement between each partner's sleep hygiene. Finally, we examined associations between one's own sleep hygiene and their report of their partner's sleep hygiene with both partner's sleep quality, emotional distress, and conflict frequency in a dyadic structural equation model with important covariates and alternative model tests. The results revealed a significant difference between men's (M = 14.45, SD = 7.41) and women's total score self-report sleep hygiene ([M = 17.67, SD = 8.27]; t(142) = -5.06, p < 0.001) and partners only had similar sleep hygiene for 5 out of the 13 items. Examining dyadic reports of sleep hygiene revealed that partners had moderate agreement on their partners' sleep hygiene (0.69-0.856). The results from the dyadic structural equation model revealed that poorer sleep hygiene was associated with one's own poor sleep quality, higher emotional distress, and more frequent relational conflict. For both men and women a poorer report of a partner's sleep hygiene was associated with one's own report of higher relationship conflict. Finally, men's poorer report of a partner's sleep hygiene was related better to their own sleep quality but was related to poorer sleep quality for their partners. These results have implications for sleep promotion and intervention efforts as well as for couple relationship functioning.

High Schools Struggle to Adopt Evidence Based Practices for the Management of Exertional Heat Stroke

CONTEXT

Exertional heat stroke (EHS) deaths can be prevented by adhering to best practices.

OBJECTIVE

We investigated the adoption of policies and procedures for the recognition and treatment of EHS and the factors influencing the adoption of a comprehensive policy.

DESIGN

Cross Sectional.

SETTING

Online questionnaire.

PATIENTS OR OTHER PARTICIPANTS

Athletic trainers (ATs) practicing in the high school (HS) setting.

MAIN OUTCOME MEASURE(S)

Using the NATA Position Statement: Exertional Heat Illness, an online questionnaire was developed and distributed to ATs to ascertain their schools' current written policies for the use of rectal temperature and cold-water immersion (CWI). The Precaution Adoption Process Model (PAPM), allowed for responses to be presented across the various health behavior stages ("Unaware if have the policy", "Unaware for the need for the policy", "Unengaged", "Undecided", "Decided Not to Act", "Decided to Act", "Acting", and "Maintaining"). Additional questions included perceptions of facilitators and barriers. Data are presented as proportions.

RESULTS

A total of 531 ATs completed this questionnaire. Overall, 16.9% (n=62) report adoption of all components for proper recognition and treatment of EHS. The policy component with the highest adoption was "cool first transport second" with 74.1% (n=110) of ATs reporting "Acting" or "Maintaining." The most variability in the PAPM responses was for a rectal temperature policy, with 28.7% (n=103) of ATs reporting "Decided not to Act" and 20.1% (n=72) reporting "Maintaining." The most commonly reported facilitator and barrier for rectal temperature included state mandate from state HS athletics association (n=274,51.5%) and resistance or apprehension from parents or legal guardians (n=311,58.5%), respectively.

CONCLUSIONS

ATs in the HS setting appear to be struggling to adopt a comprehensive EHS strategy, with rectal temperature continuing to appear as the biggest undertaking. Tailored strategies based on health behavior, facilitators and barriers may aid in changing this paradigm.

Comparative weight loss in obese patients restarting a supplemented very-low-calorie diet

Successive weight losses were compared for 21 patients restarting a very-low-calorie diet (VLCD) after weight regain. Patients broke VLCD2 sooner (3.8 vs 9.8 wk) and lost less (9.4 vs 19.1 kg), but weight-loss rates did not differ significantly (0.83 vs 0.71 kg/wk). Net loss post-VLCD2 was 12.0 kg. Restart patients had difficulty adhering to the repeat VLCD, which resulted in lower losses. However, similar weight-loss rates and significant net weight loss suggest repeat VLCDs can be effective.

Species-restriction of rat lymphoid cell migration inhibitory factor

Migration inhibitory factor (MIF) was produced by lymphoid cells of Lewis rats in response to infection with Bacille Calmette Guérin (BCG), mixed lymphocyte reaction or concanavalin A stimulation. It was found that rat lymphokine-containing supernatants demonstrate a definite species specificity, in that MIF activity is observed only when rat indicator cells and not when guinea-pig indicator cells are used. A comparative study of MIF activities, using rat peritoneal exudate cells, revealed that all three methods stimulated MIF production by either spleen or lymph node cells. Only infection with BCG induced peripheral blood leukocytes to elaborate MIF. In all cases, rat MIF inhibited rat peritoneal exudate cells but not guinea-pig peritoneal exudate cells. Possible explanations for the species specificity of rat MIF including a role for receptor carbohydrate moieties and fibronectin are discussed.