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      Lingering impacts on sleep following the Daylight Savings Time transition in the Project Baseline Health Study

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      Sleep Science and Practice

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          Abstract

          Background

          The “spring forward” change to Daylight Savings Time (DST) has been epidemiologically linked with numerous health and safety risks in the days following the transition, but direct measures of sleep are infrequently collected in free-living individuals.

          Methods

          The Project Baseline Health Study (PBHS), a prospective, multicenter, longitudinal representative U.S. cohort study that began in 2017 launched a Sleep Mission in March 2021 to characterize sleep using patient-reported and wearable device measures, in free-living circumstances during the DST switch. Estimated sleep period duration, subjective restedness, and sleep quality were compared before and after the DST transition during specified timeframes.

          Results

          Of the total PBHS population of 2502 participants, 912 participants received an invitation and 607 responded by March 6th. Among those, 420 participants opted into the Sleep Mission (69.2%). The transition to DST resulted in both acute and lingering impacts on sleep. Acute effects included a 29.6 min reduction in sleep period ( p = 0.03), increases in the proportion of patients who reported ‘sleeping poorly’ (from 1.7 to 13.6% [ p < 0.01]), and with scores falling into the ‘unrested’ category (from 1.7 to 8.5% [ p = 0.046]). There was also a downward trend in the proportion of participants reporting being rested in the morning following the DST transition (from 62.7% on March 7 to 49.2% on March 14 [ p = 0.10]). Lingering effects included a 18.7% relative decrease in the daily likelihood of participants reporting restedness (from 49.2% in the week prior to the DST transition to 40.0% in the week after [ p < 0.01]).

          Conclusion

          The DST transition is associated with an acute reduction in sleep period, as well as an increased proportion of individuals reporting poor sleep and unrestedness. The DST transition also resulted in lingering impacts on self-reported restedness, lasting into the week following the transition. This work adds to a growing understanding of the persistence of impacts on sleep health metrics due to the DST transition.

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          Most cited references29

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          Chronotype and Social Jetlag: A (Self-) Critical Review

          The Munich ChronoType Questionnaire (MCTQ) has now been available for more than 15 years and its original publication has been cited 1240 times (Google Scholar, May 2019). Additionally, its online version, which was available until July 2017, produced almost 300,000 entries from all over the world (MCTQ database). The MCTQ has gone through several versions, has been translated into 13 languages, and has been validated against other more objective measures of daily timing in several independent studies. Besides being used as a method to correlate circadian features of human biology with other factors—ranging from health issues to geographical factors—the MCTQ gave rise to the quantification of old wisdoms, like “teenagers are late”, and has produced new concepts, like social jetlag. Some like the MCTQ’s simplicity and some view it critically. Therefore, it is time to present a self-critical view on the MCTQ, to address some misunderstandings, and give some definitions of the MCTQ-derived chronotype and the concept of social jetlag.
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            Validation of Self-Reported Sleep Against Actigraphy

            Background Self-report remains the most practical and cost-effective method for epidemiologic sleep studies involving large population-based samples. Several validated questionnaires have been developed to assess sleep, but these tools are lengthy to administer and may be impractical for epidemiologic studies. We examined whether a 3-item sleep questionnaire, similar to those typically used in epidemiologic studies, closely corresponded with objective measures of sleep as assessed using actigraphy monitoring. Methods Eligible participants were Western Australian women aged 18 to 80 years. Participants completed a sleep questionnaire, wore a wrist actigraph for 7 nights, and completed a brief daily sleep log. Objective actigraphy measurements for 56 participants were summarized by mean and mode and compared with the subjective reports, using weighted kappa and delta. Results Data collected from the questionnaire showed poor agreement with objectively measured sleep, with kappas ranging from −0.19 to 0.14. Conclusions Our results indicate that sleep questions typically used in epidemiologic studies do not closely correspond with objective measures of sleep as assessed using actigraphy. The findings have implications for studies that have used such sleep questions. A means of appropriately measuring sleep as a risk factor in epidemiologic studies remains to be determined.
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              Reliability of Actigraphy and Subjective Sleep Measurements in Adults: The Design of Sleep Assessments

              Study Objectives: The aim of the study was to investigate how many nights of measurement are needed for a reliable measure of sleep in a working population including adult women and men. Methods: In all, 54 individuals participated in the study. Sleep was assessed for 7 consecutive nights using actigraphy as an objective measure, and the Karolinska sleep diary for a subjective measure of quality. Using intra-class correlation and the Spearman-Brown formula, calculations of how many nights of measurements were required for a reliable measure were performed. Differences in reliability according to whether or not weekend measurements were included were investigated. Further, the correlation between objectively (actigraphy) measured sleep and subjectively measured sleep quality was studied over the different days of the week. Results/Conclusions: The results concerning actigraphy sleep measures suggest that data from at least 2 nights are to be recommended when assessing sleep percent and at least 5 nights when assessing sleep efficiency. For actigraphy-measured total sleep time, more than 7 nights are needed. At least 6 nights of measurements are required for a reliable measure of self-reported sleep. Fewer nights (days) are required if measurements include only week nights. Overall, there was a low correlation between the investigated actigraphy sleep parameters and subjective sleep quality, suggesting that the two methods of measurement capture different dimensions of sleep. Citation: Aili K, Åström-Paulsson S, Stoetzer U, Svartengren M, Hillert L. Reliability of actigraphy and subjective sleep measurements in adults: the design of sleep assessments. J Clin Sleep Med. 2017;13(1):39–47.
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                Author and article information

                Journal
                Sleep Science and Practice
                Sleep Science Practice
                2398-2683
                December 2022
                December 26 2022
                : 6
                : 1
                Article
                10.1186/s41606-022-00082-w
                a53b88f8-fa3d-40d0-ac0f-424e8b6f9c1d
                © 2022

                https://creativecommons.org/licenses/by/4.0

                https://creativecommons.org/licenses/by/4.0

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