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Special Issue "Sleep and Wellbeing"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (15 September 2019) | Viewed by 37286

Special Issue Editor

Prof. Dr. Chin Moi Chow
E-Mail Website
Guest Editor
Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney 2006, Australia
Interests: lifestyle factors and sleep health; circadian rhythms; sleep apnea; insomnia; depression; sleeping environment; electroencephalography; actigraphy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are organizing a Special Issue on Sleep and Wellbeing in the International Journal of Environmental Research and Public Health. The venue is a peer-reviewed scientific journal that publishes articles and communications in the interdisciplinary area of environmental health sciences and public health. For detailed information on the journal, we refer you to https://www.mdpi.com/journal/ijerph.

Sleep is medicine, as exercise is medicine. Sleep, a behavioural performance enhancer, surpasses the ergogenic effects of caffeine and other enhancing agents. However, sleep can be delicate and easily disrupted by the same factors that promote it, including psychological, physical, medical, and lifestyle (diets, exercise, environment, relationships, stressors, and sleep hygiene) factors. Sleep deprivation can have negative implications for mental, metabolic, physical, and immune functions.

This Special Issue is open to any subject area related to sleep health and wellbeing. The listed keywords suggest just a few of the many possibilities.

Assoc. Prof. Chin Moi Chow
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Lifestyle factors
  • Stress
  • Dietary factors
  • Sleeping environment
  • Thermal comfort
  • Exercise/Physical activity
  • Neuroendocrine
  • Sleep loss
  • Sleep homeostasis
  • Circadian
  • Light sensitivity

Published Papers (15 papers)

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Editorial

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Editorial
Sleep and Wellbeing, Now and in the Future
Int. J. Environ. Res. Public Health 2020, 17(8), 2883; https://doi.org/10.3390/ijerph17082883 - 22 Apr 2020
Cited by 11 | Viewed by 2464
Abstract
The processes of sleeping, eating and moving, in concert with cognition and learning, support health and life [...] Full article
(This article belongs to the Special Issue Sleep and Wellbeing)

Research

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Article
Does the Proximity of Meals to Bedtime Influence the Sleep of Young Adults? A Cross-Sectional Survey of University Students
Int. J. Environ. Res. Public Health 2020, 17(8), 2677; https://doi.org/10.3390/ijerph17082677 - 14 Apr 2020
Cited by 9 | Viewed by 3087
Abstract
Avoiding food before bedtime is a widely accepted sleep hygiene practice, yet few studies have assessed meal timing as a risk factor for disrupted sleep. This study examined the relationship between evening meal timing and sleep quality in young adults. A total of [...] Read more.
Avoiding food before bedtime is a widely accepted sleep hygiene practice, yet few studies have assessed meal timing as a risk factor for disrupted sleep. This study examined the relationship between evening meal timing and sleep quality in young adults. A total of N = 793 participants (26% male) aged between 18 and 29 years responded to an online survey, which captured sociodemographic information, lifestyle variables, and sleep characteristics. Meal timing was defined as meals more than 3 h before or within 3 h of bedtime. The outcomes were as follows: one or more nocturnal awakenings, sleep onset latency of >30 min, and sleep duration of ≤6 h. Logistic regression analyses showed that eating within 3 h of bedtime was positively associated with nocturnal awakening (OR = 1.61, 95% CI = 1.15–2.27) but not long sleep onset latency (1.24; 0.89–1.73) or short sleep duration (0.79; 0.49–1.26). The relationship remained significant after adjusting for potential confounders of ethnicity and body mass index (OR = 1.43, 95% CI = 1.00–2.04). Meal timing appears to be a modifiable risk factor for nocturnal awakenings and disrupted sleep. However, this is a preliminary cross-sectional study and highlights the need for additional research on the influence of the timing of food intake on sleep. Full article
(This article belongs to the Special Issue Sleep and Wellbeing)
Article
Sleep Regularity Index in Patients with Alcohol Dependence: Daytime Napping and Mood Disorders as Correlates of Interest
Int. J. Environ. Res. Public Health 2020, 17(1), 331; https://doi.org/10.3390/ijerph17010331 - 03 Jan 2020
Cited by 9 | Viewed by 2319
Abstract
Alcohol use disorder (AUD) is often accompanied by comorbid conditions, including sleep disturbances related to sleep regularity and timing. The Sleep Regularity Index (SRI) is a novel measure that assesses the probability that an individual is awake (vs. asleep) at any two time [...] Read more.
Alcohol use disorder (AUD) is often accompanied by comorbid conditions, including sleep disturbances related to sleep regularity and timing. The Sleep Regularity Index (SRI) is a novel measure that assesses the probability that an individual is awake (vs. asleep) at any two time points 24 h apart. We calculated actigraphy-based SRI on 124 participants with alcohol dependence to capture the effects of changes in sleep timing and duration among patients enrolled in an inpatient alcohol treatment program. During the course of the study, the mean SRI increased between weeks 1 and 3 (75.4 to 77.8), thus indicating slightly improved sleep quality and regularity during alcohol treatment. Individuals within the bottom quartile of SRI scores at week 1 improved significantly over time. Average total SRI for individuals with no mood disorders was slightly higher than that for individuals with one or more mood disorders. Increased SRI scores were associated with lower total nap duration from week 1 to week 3. Increased SRI scores were associated with decreased mental/physical exhaustion scores from week 1 to week 3. The SRI could be a target for assessment/intervention in certain sub-groups of individuals undergoing inpatient treatment for AUD. Full article
(This article belongs to the Special Issue Sleep and Wellbeing)
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Article
A Survey of Koreans on Sleep Habits and Sleeping Symptoms Relating to Pillow Comfort and Support
Int. J. Environ. Res. Public Health 2020, 17(1), 302; https://doi.org/10.3390/ijerph17010302 - 01 Jan 2020
Cited by 5 | Viewed by 2968
Abstract
The number of people who complain of sleep disturbances is steadily increasing. An understanding of sleep-related factors is required to address sleep problems. This survey study investigated the sleep habits and sleeping symptoms relating to the comfort and support characteristics of pillows and [...] Read more.
The number of people who complain of sleep disturbances is steadily increasing. An understanding of sleep-related factors is required to address sleep problems. This survey study investigated the sleep habits and sleeping symptoms relating to the comfort and support characteristics of pillows and the relationship between sleep quality and pillow design factors. The study utilized data from 332 participating Korean adults aged 20–76 years (mean age ± SD: males, 40.4 ± 15.2; females, 42.9 ± 15.4). We developed a questionnaire that evaluated sleep habits (sleep duration, bedtime, wake-up time and sleeping position); sleeping symptoms (snoring or coughing, breathing and sleepiness during waking hours) based on the Korean version of the Pittsburgh Sleep Quality Index (PSQI-K) questionnaire; and pillow-related factors (support, comfort, fatigue, height and shape) from existing pillow studies. The average sleep duration was 6.8 h, with more than half (52%) of participants sleeping in the supine position. The overall score for sleep quality was considered poor (4.84 points on a seven-point Likert scale), with some degree of sleepiness during waking hours (4.4 points on a seven-point Likert scale). Females went to bed earlier than males and were more likely to sleep in the lateral position compared to males. The number of toss and turn or waking events during sleep increased with age, and older individuals went to sleep earlier and woke up earlier. Among the symptoms of fatigue, pain, discomfort with changing position, snoring, coughing and breathing discomfort, participants reported their highest levels of discomfort due to sleepiness after waking, and they experienced the least head pain. Participants who used a regular-type pillow had poorer satisfaction on multiple comfort and support factors (support, comfort, height suitability, shape suitability) compared with those who used a functional-type pillow. Less head fatigue, less neck fatigue and less shoulder pain had significant effects on sleep quality. To reduce neck fatigue and shoulder pain, designers should consider the height for neck support in the lateral position. To reduce neck fatigue, it is desirable to use materials like latex or memory foam that provide neck support, which can improve sleep quality. The findings of this study contribute to a better understanding of sleep habits and characteristics of pillow comfort and provide practical guidelines for better pillow designs. Full article
(This article belongs to the Special Issue Sleep and Wellbeing)
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Article
Sleep Difficulties in Preschoolers with Psychiatric Diagnoses
Int. J. Environ. Res. Public Health 2019, 16(22), 4485; https://doi.org/10.3390/ijerph16224485 - 14 Nov 2019
Cited by 2 | Viewed by 1160
Abstract
Background: Sleep problems among preschoolers are highly prevalent. Given the impact of poor sleep quality on development, this relationship is particularly relevant in vulnerable populations but is less documented. This study aims to document parental perception of sleep problems in preschoolers assessed in [...] Read more.
Background: Sleep problems among preschoolers are highly prevalent. Given the impact of poor sleep quality on development, this relationship is particularly relevant in vulnerable populations but is less documented. This study aims to document parental perception of sleep problems in preschoolers assessed in a psychiatric clinic, as a function of diagnosis type. Methods: Children (14–71 months, n = 228) were evaluated by a psychiatrist, and diagnoses were pooled into four categories: behavioral disorders, relational disorders/psychosocial problems, developmental coordination disorder (DCD), and communication disorders. Sleep problems were measured using the Child Behavior Checklist (CBCL). Results: In this clinical sample of preschoolers, 21.6% of children were identified as having a sleep problem by their parents. Behavioral disorders and communication disorders were associated with increased parental report of sleep problems (respectively, trouble falling asleep and nighttime awakenings), while DCD was associated with lower parental report of sleep problems (fewer nighttime awakenings and less difficulty falling asleep) (p < 0.05). Relational disorders were not associated with parental reports of sleep difficulties (p > 0.05). Moreover, some psychiatric categories were associated with specific sleep symptoms (such as difficulty falling asleep and night awakenings). Conclusion: Parents of preschoolers with behavioral disorders and communication disorders are more likely to report sleep problems in their children than parents of preschoolers with DCD and relational disorders. Since different categories of psychiatric disorders are associated with specific types of sleep complaints, screening, and treatment should be adapted accordingly. Full article
(This article belongs to the Special Issue Sleep and Wellbeing)
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Article
Cardiac Vagal Control, Regulatory Processes and Depressive Symptoms: Re-Investigating the Moderating Role of Sleep Quality
Int. J. Environ. Res. Public Health 2019, 16(21), 4067; https://doi.org/10.3390/ijerph16214067 - 23 Oct 2019
Cited by 1 | Viewed by 1087
Abstract
Lower cardiac vagal control (CVC), which is often understood as an indicator for impaired regulatory processes, is assumed to predict the development of depressive symptoms. As this link has not been consistently demonstrated, sleep quality has been proposed as a moderating factor. However, [...] Read more.
Lower cardiac vagal control (CVC), which is often understood as an indicator for impaired regulatory processes, is assumed to predict the development of depressive symptoms. As this link has not been consistently demonstrated, sleep quality has been proposed as a moderating factor. However, previous studies were limited by non-representative samples, cross-sectional data, and focused on CVC as a physiological indicator for impaired regulatory processes, but neglected corresponding subjective measures. Therefore, we investigated whether sleep quality moderates the effects of CVC (quantified by high-frequency heart rate variability) and self-reported regulatory processes (self- and emotion-regulation) on concurrent depressive symptoms and on depressive symptoms after three months in a representative sample (N = 125). Significant interactions between CVC and sleep quality (in women only), as well as self-/emotion-regulation and sleep quality emerged, whereby higher sleep quality attenuated the relation between all risk factors and current depressive symptoms (cross-sectional data). However, there were no significant interactions between those variables in predicting depressive symptoms three months later (longitudinal data). Our cross-sectional findings extend previous findings on sleep quality as a protective factor against depressive symptoms in the presence of lower CVC and subjective indices of impaired regulatory processes. In contrast, our conflicting longitudinal results stress the need for further investigations. Full article
(This article belongs to the Special Issue Sleep and Wellbeing)
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Article
The City Doesn’t Sleep: Community Perceptions of Sleep Deficits and Disparities
Int. J. Environ. Res. Public Health 2019, 16(20), 3976; https://doi.org/10.3390/ijerph16203976 - 18 Oct 2019
Cited by 3 | Viewed by 1218
Abstract
While sleep research has focused primarily on aspects of the immediate physical environment and behavioral factors, a growing body of evidence suggests that broader social determinants may play an important role in sleep insufficiency. Yet public health education efforts for sleep largely address [...] Read more.
While sleep research has focused primarily on aspects of the immediate physical environment and behavioral factors, a growing body of evidence suggests that broader social determinants may play an important role in sleep insufficiency. Yet public health education efforts for sleep largely address “sleep hygiene”, with an emphasis on information for getting a good night’s rest. The Flint Sleep Project employed community-based-participatory research methods to try to understand more about the sleep experiences of residents of an urban community reporting sleep insufficiency. The academic and community partner developed recruitment materials with community residents. The focus group protocol also utilized community input. Seven focus groups, with a total of 70 participants, were conducted. When asked about their view of causes for poor sleep, participants identified a range of stressors reflective of social determinants. Economic, safety, and future insecurity were the dominant themes emerging across all seven discussions. Participants also expressed feeling a lack of control over important aspects of their lives. Interventions to improve sleep are more likely to be effective if they include the perspectives of the community. A community-based approach offers opportunities for community empowerment and engagement that can improve efforts at sleep health promotion. Full article
(This article belongs to the Special Issue Sleep and Wellbeing)
Article
How Do Nurses Cope with Shift Work? A Qualitative Analysis of Open-Ended Responses from a Survey of Nurses
Int. J. Environ. Res. Public Health 2019, 16(20), 3821; https://doi.org/10.3390/ijerph16203821 - 10 Oct 2019
Cited by 17 | Viewed by 3668
Abstract
Nurses are frequently required to engage in shift work given the 24/7 nature of modern healthcare provision. Despite the health and wellbeing costs associated with shift work, little is known about the types of coping strategies employed by nurses. It may be important [...] Read more.
Nurses are frequently required to engage in shift work given the 24/7 nature of modern healthcare provision. Despite the health and wellbeing costs associated with shift work, little is known about the types of coping strategies employed by nurses. It may be important for nurses to adopt strategies to cope with shift work in order to prevent burnout, maintain wellbeing, and ensure high quality care to patients. This paper explores common strategies employed by nurses to cope with shift work. A workforce survey was completed by 449 shift working nurses that were recruited from a major metropolitan health service in Melbourne, Australia. Responses to open-ended questions about coping strategies were analysed using the framework approach to thematic analysis. Four interconnected main themes emerged from the data: (i) health practices, (ii) social and leisure, (iii) cognitive coping strategies, and (iv) work-related coping strategies. Although a range of coping strategies were identified, sleep difficulties often hindered the effective use of coping strategies, potentially exacerbating poor health outcomes. Findings suggest that in addition to improving nurses’ abilities to employ effective coping strategies on an individual level, workplaces also play an important role in facilitating nurses’ wellbeing. Full article
(This article belongs to the Special Issue Sleep and Wellbeing)
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Article
Feasibility and Preliminary Efficacy of an m-Health Intervention Targeting Physical Activity, Diet, and Sleep Quality in Shift-Workers
Int. J. Environ. Res. Public Health 2019, 16(20), 3810; https://doi.org/10.3390/ijerph16203810 - 10 Oct 2019
Cited by 7 | Viewed by 2180
Abstract
Poor health behaviors are prevalent in shift-workers, but few multiple health-behavior interventions consider their unique needs. This study aimed to (1) evaluate the feasibility and acceptability of an existing app-based intervention to improve physical activity, diet, and sleep quality in a shift-worker population, [...] Read more.
Poor health behaviors are prevalent in shift-workers, but few multiple health-behavior interventions consider their unique needs. This study aimed to (1) evaluate the feasibility and acceptability of an existing app-based intervention to improve physical activity, diet, and sleep quality in a shift-worker population, (2) estimate intervention effect in a four-week pilot randomized controlled trial (RCT) (ACTRN12618001785291). Shift-workers (18–65 years old) were randomized to intervention (n = 20) or wait-list (n = 20) groups. Outcomes included recruitment, engagement, attrition, usefulness ratings, System Usability Scale (SUS), qualitative interviews, and estimation of treatment effect (minutes of physical activity, diet quality, and sleep quality) using mixed model analysis. Recruitment took one week. App-use at week four was 55% (11/20), 85% (34/40) completed the four-week follow-up questionnaire, and 20% (4/20) of the intervention group completed the qualitative interview. The intervention was rated as slightly to moderately useful by 76.9% (10/13) of participants on a five-point scale. The SUS score was 62.7 (12.7) out of 100. Diet quality improved for the intervention (4.5 points; 95% confidence interval (CI) = 0.1, 8.9; p = 0.047) vs. the wait-list group, but not physical activity or sleep quality. Qualitative interviews found that a more tailored intervention, more accessible information, and interactive features were desired. The intervention was feasible in terms of recruitment, but modifications to increase engagement are needed. Full article
(This article belongs to the Special Issue Sleep and Wellbeing)
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Article
Association of Depression and Excessive Daytime Sleepiness among Sleep-Deprived College Freshmen in Northern Taiwan
Int. J. Environ. Res. Public Health 2019, 16(17), 3148; https://doi.org/10.3390/ijerph16173148 - 29 Aug 2019
Cited by 5 | Viewed by 1953
Abstract
Background. The aim of this study was to investigate depression and other determinants (sleep-deprived behaviors such as hours spent sleeping, watching television, and on the computer) and their association with excessive daytime sleepiness (EDS) among college freshmen. Methods. Self-administered questionnaires were collected from [...] Read more.
Background. The aim of this study was to investigate depression and other determinants (sleep-deprived behaviors such as hours spent sleeping, watching television, and on the computer) and their association with excessive daytime sleepiness (EDS) among college freshmen. Methods. Self-administered questionnaires were collected from two colleges in northern Taiwan from July to September 2014. A total of 2643 students (38.7% male; ages ranged 18–23 years; mean age of 18.8 ± 1.2 years) completed an anonymous questionnaire on lifestyle behaviors (including personal habits, sleep duration and quality, and hours spent watching television and on the computer); perception of one’s health, a validated depression scale (Brief Symptom Rating Scale, BSRS-5); insomnia symptoms (the Chinese version of the Athens Insomnia Scale, CAIS); and EDS rated with the Chinese Epworth sleepiness scale (CESS). The data were analyzed using the chi-squared test, t-test, multivariate logistic regression, and multiple linear regression. Results. The prevalence of EDS among college students was approximately 27.1% (717/2643). The risk of EDS was elevated with increasing severity of depression: odds ratio (OR) = 2.8/3.71/5.01 for female, and OR = 3.29/5.07/5.07 for mild/moderate/severe depression for male, respectively (p < 0.05; marginally higher in male severe depression, p = 0.08). If depression score increased by 1 point, CESS score increased by 0.35 point; if time spent on the computer during non-holidays increased by 1 h, CESS score increased by 0.1 point; and for those whose sleep duration increased by 1 h during non-holidays, CESS score decreased by 0.1 point. Conclusions. EDS significantly predicted depression among college freshmen. Using a computer for a long time and less sleep duration during non-holidays contributed to EDS of college freshmen. Youths who experience EDS are recommended to seek assessment for depression symptoms and sleep-deprived behaviors, thus allowing physicians to offer appropriate screening and treatment. Full article
(This article belongs to the Special Issue Sleep and Wellbeing)
Article
Effectiveness of an Online CBT-I Intervention and a Face-to-Face Treatment for Shift Work Sleep Disorder: A Comparison of Sleep Diary Data
Int. J. Environ. Res. Public Health 2019, 16(17), 3081; https://doi.org/10.3390/ijerph16173081 - 24 Aug 2019
Cited by 22 | Viewed by 5095
Abstract
In western societies, about one in six employees works in shifts. Shiftwork is associated with a number of poor somatic and psychological health outcomes, especially sleep issues. Higher rates of absenteeism and accidents in the workplace are possible consequences. Still, prevention programs and [...] Read more.
In western societies, about one in six employees works in shifts. Shiftwork is associated with a number of poor somatic and psychological health outcomes, especially sleep issues. Higher rates of absenteeism and accidents in the workplace are possible consequences. Still, prevention programs and treatment options that are specifically tailored to shift-workers’ needs are rare. We devised a 4-week online cognitive behavioral therapy for insomnia (CBT-I) intervention (n = 21) and compared sleep outcomes to a face-to-face outpatient treatment for shift-workers (n = 12) using a sleep diary and the Epworth Sleepiness Scale (ESS). In the online sample, measures also included the World Health Organization wellbeing questionnaire (WHO-5) and the Insomnia Severity Index (ISI). In the outpatient sample, the Beck Depression Inventory (BDI-II), the Montgomery–Åsberg Depression Rating Scale (MADRS), and the Pittsburgh Sleep Quality Index (PSQI) were administered. Results showed significant improvements in sleep efficiency by 7.2% in the online sample and 7.7% in the outpatient sample. However, no significant difference was found in the rate of improvement in sleep efficiency across four weeks of treatment between the samples. In the online sample, the wellbeing (WHO-5) and insomnia symptoms (ISI) scores were significantly improved following the CBT-I intervention (p < 0.004 and p < 0.002 respectively). In the outpatient sample, symptoms of depression (BDI-II and MADRS scores) and insomnia symptoms (PSQI scores) improved significantly following the CBT-I intervention. In summary, CBT-I significantly improved sleep efficiency in both the online and outpatient samples, in addition to wellbeing, symptoms of insomnia, and depression. The findings of this study demonstrate online CBT-I as a feasible approach for treating insomnia in shift-workers. Future randomized controlled trials are needed. Full article
(This article belongs to the Special Issue Sleep and Wellbeing)
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Article
An Exploratory Study on the Effects of Forest Therapy on Sleep Quality in Patients with Gastrointestinal Tract Cancers
Int. J. Environ. Res. Public Health 2019, 16(14), 2449; https://doi.org/10.3390/ijerph16142449 - 10 Jul 2019
Cited by 20 | Viewed by 2131
Abstract
The improvement of sleep quality in patients with cancer has a positive therapeutic effect on them. However, there are no specific treatment guidelines for treating sleep disturbance in cancer patients. We investigated the effect of forest therapy on the quality of sleep in [...] Read more.
The improvement of sleep quality in patients with cancer has a positive therapeutic effect on them. However, there are no specific treatment guidelines for treating sleep disturbance in cancer patients. We investigated the effect of forest therapy on the quality of sleep in patients with cancer. This study was conducted on nine patients (one male, eight female; mean age, 53.6 ± 5.8 years) with gastrointestinal tract cancer. All patients participated in forest therapy for six days. They underwent polysomnography (PSG) and answered questionnaires on sleep apnea (STOP BANG), subjective sleep quality (Pittsburgh Sleep Quality Index, PSQI), sleepiness (Stanford and Epworth Sleepiness Scales), and anxiety and depression (Hospital Anxiety and Depression Scale) to evaluate the quality of sleep before and after forest therapy. Sleep efficiency from the PSG results was shown to have increased from 79.6 ± 6.8% before forest therapy to 88.8 ± 4.9% after forest therapy (p = 0.027) in those patients, and total sleep time was also increased, from 367.2 ± 33.4 min to 398 ± 33.8 min (p = 0.020). There was no significant difference in the STOP BANG score, PSQI scores, daytime sleepiness based on the results of the Stanford and Epworth Sleepiness Scales, and depression and anxiety scores. Based on the results of this study, we suggest that forest therapy may be helpful in improving sleep quality in patients with gastrointestinal cancers. Full article
(This article belongs to the Special Issue Sleep and Wellbeing)
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Article
Patterns of Diet, Physical Activity, Sitting and Sleep Are Associated with Socio-Demographic, Behavioural, and Health-Risk Indicators in Adults
Int. J. Environ. Res. Public Health 2019, 16(13), 2375; https://doi.org/10.3390/ijerph16132375 - 04 Jul 2019
Cited by 19 | Viewed by 2186
Abstract
Our understanding of how multiple health-behaviours co-occur is in its infancy. This study aimed to: (1) identify patterns of physical activity, diet, sitting, and sleep; and (2) examine the association between sociodemographic and health-risk indicators. Pooled data from annual cross-sectional telephone surveys of [...] Read more.
Our understanding of how multiple health-behaviours co-occur is in its infancy. This study aimed to: (1) identify patterns of physical activity, diet, sitting, and sleep; and (2) examine the association between sociodemographic and health-risk indicators. Pooled data from annual cross-sectional telephone surveys of Australian adults (2015–2017, n = 3374, 51.4% women) were used. Participants self-reported physical activity, diet, sitting-time, sleep/rest insufficiency, sociodemographic characteristics, smoking, alcohol use, height and weight to calculate body mass index (BMI), and mental distress frequency. Latent class analysis identified health-behaviour classes. Latent class regression determined the associations between health-behaviour patterns, sociodemographic, and health-risk indicators. Three latent classes were identified. Relative to a ‘moderate lifestyle’ pattern (men: 43.2%, women: 38.1%), a ‘poor lifestyle’ pattern (men: 19.9%, women: 30.5%) was associated with increased odds of a younger age, smoking, BMI ≥ 30.0 kg/m2, frequent mental distress (men and women), non-partnered status (men only), a lower Socioeconomic Index for Areas centile, primary/secondary education only, and BMI = 25.0–29.9 kg/m2 (women only). An ‘active poor sleeper’ pattern (men: 37.0%, women: 31.4%) was associated with increased odds of a younger age (men and women), working and frequent mental distress (women only), relative to a ‘moderate lifestyle’ pattern. Better understanding of how health-behaviour patterns influence future health status is needed. Targeted interventions jointly addressing these behaviours are a public health priority. Full article
(This article belongs to the Special Issue Sleep and Wellbeing)
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Article
Short Sleep Duration and Insomnia Symptoms were Associated with Lower Happiness Levels in Chinese Adults in Hong Kong
Int. J. Environ. Res. Public Health 2019, 16(12), 2079; https://doi.org/10.3390/ijerph16122079 - 12 Jun 2019
Cited by 11 | Viewed by 3146
Abstract
Study objective: To examine the association of sleep duration and insomnia symptoms with happiness. Methods: A random sample of 1691 Chinese adult (mean age 54 ± 20.1, male 51%) were interviewed in a population-based telephone survey. Happiness was measured by the [...] Read more.
Study objective: To examine the association of sleep duration and insomnia symptoms with happiness. Methods: A random sample of 1691 Chinese adult (mean age 54 ± 20.1, male 51%) were interviewed in a population-based telephone survey. Happiness was measured by the subjective happiness scale (SHS) and the one-item global happiness index (GHI). Information on sleep included mean past seven-day sleep duration (<6 h, ≥6 to <8 h and ≥8 h) and insomnia symptoms: Difficulty in initiating sleep (DIS), difficulty in maintaining sleep (DMS), and early morning awakening (EMA). Adjusted beta-coefficient (β) of SHS and adjusted odds ratio (aOR) of GHI in relation to sleep problems were calculated. Interaction effects by age (18–65 vs. ≥65) and by sex were assessed. Results: Compared to ≥8 h of sleep, having <6 h of sleep had lower SHS (adjusted β −0.32, 95% CI −0.46 to −0.17) and GHI (aOR 0.54, 95% CI 0.38 to 0.78). The associations were stronger in younger adults and in women (p < 0.05). DIS, DMS, and EMA were associated with lower SHS (adjusted β ranged from −0.20 to −0.06) and GHI (aOR ranged from 0.57 to 0.89). Dose-response association between the number of insomnia symptoms and lower SHS was observed (p < 0.001). These associations were generally stronger in older adults and among women. Conclusions: Lower levels of happiness were observed, particularly in younger adults and females with short sleep duration and older adults and females with insomnia symptoms. Prospective studies are needed to confirm the findings and understand the mechanisms between sleep and happiness. Full article
(This article belongs to the Special Issue Sleep and Wellbeing)

Review

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Review
The Association Between Body Mass Index (BMI) and Sleep Duration: Where Are We after nearly Two Decades of Epidemiological Research?
Int. J. Environ. Res. Public Health 2019, 16(22), 4327; https://doi.org/10.3390/ijerph16224327 - 06 Nov 2019
Cited by 15 | Viewed by 1967
Abstract
Over the past twenty years we have seen a vast number of epidemiological studies emerge on the topic of obesity and sleep duration, with a focus on body mass index, as it is easy and cheap to measure and analyse. Such studies largely [...] Read more.
Over the past twenty years we have seen a vast number of epidemiological studies emerge on the topic of obesity and sleep duration, with a focus on body mass index, as it is easy and cheap to measure and analyse. Such studies largely observe that cross-sectionally a higher BMI is associated with shorter sleep and that in longitudinal studies shorter sleep duration is associated with increases in BMI over time, but some research has found no relationship between the two. This narrative review is not exhaustive, but appraises the literature on sleep duration and BMI from perspectives that have previously been unexplored in a single paper. As such, I discuss research in these important areas: bidirectionality, objective vs. subjective sleep duration, how meaningful the effect sizes are and how we have begun to address causality in this area. From the evidence appraised in this review, it is clear that: (i) there is some modest evidence of a bidirectional relationship between BMI and sleep duration in both children and adults; (ii) objective measurements of sleep should be used where possible; (iii) it remains difficult to confirm whether the effect sizes are conclusively meaningful in a clinical setting, but at least in adults this so far seems unlikely; (iv) to date, there is no solid evidence that this relationship (in either direction) is in fact causal. In the near future, I would like to see triangulation of these findings and perhaps a move towards focusing on distinct aspects of the relationship between obesity and sleep that have not previously been addressed in detail, for various reasons. Full article
(This article belongs to the Special Issue Sleep and Wellbeing)
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