Bjørn Bjorvatn

University of Bergen | UiB · Department of Global Public Health and Primary Care

Background Oral appliances (OAs) that limit mouth opening during sleep, such as monobloc appliances, have shown superior treatment effects in subgroups of patients with obstructive sleep apnoea. The application of elastic bands on bibloc appliances may resemble these benefits. Objectives The primary objective was to investigate if application of e...

Aims We aim to address the knowledge gap surrounding food insecurity in general practice in Norway, focusing on its prevalence among patients, sociodemographic correlates and its relationship with chronic diseases across different age groups. Methods This study is cross-sectional, collecting data through 69 general practice clinics in 2022 from pa...

Insomnia and obstructive sleep apnea are the two most prevalent sleep disorders and frequently co-exist. People with co-morbid insomnia and sleep apnea (COMISA) experience worse sleep, daytime function, mental health, physical health and quality of life, compared to people with neither disorder, and often compared to people with insomnia alone or s...

Internal circadian phase assessment is increasingly acknowledged as a critical clinical tool for the diagnosis, monitoring, and treatment of circadian rhythm sleep−wake disorders and for investigating circadian timing in other medical disorders. The widespread use of in‐laboratory circadian phase assessments in routine practice has been limited, mo...

We investigated the role of sleep and work hours on wellbeing among day- and shift workers. We tested a mediation-moderation hypothesis proposing that; 1) sleep would mediate the association between the work schedule and the impact of sleep/sleepiness on wellbeing; 2) work hours would moderate the link between work schedule and sleep. We made rando...

Sleep loss due to short time off between shifts has been proposed as a mechanism contributing to impaired functioning in occupational settings. This laboratory crossover trial (ClinicalTrials.gov identifier: NCT05162105, N = 66) compared subjective sleepiness, mood, and cognitive performance on a day shift after an evening shift with only 8 h off b...

Background Global nursing shortages necessitate the identification of mitigatable factors that may reduce nursing absence and turnover. Fatigue has been shown to be associated with these issues. This study aimed to identify factors leading to development of or recovery from excessive fatigue in nurses as these can offer actionable avenues for prote...

Background Poor sleep may negatively affect parents’ health-related quality of life (HRQoL). This longitudinal study aimed to describe and compare sleep, insomnia and HRQoL in mothers and fathers of preterm and full-born infants, and to assess possible associations between sleep, insomnia, and HRQoL from birth up to 12 months in the total sample....

Background Preliminary data suggests that obesity might hasten the decline in mRNA vaccine-induced immunity against SARS-CoV-2. However, whether this renders individuals with obesity more susceptible to long COVID symptoms post-vaccination remains uncertain. Given sleep’s critical role in immunity, exploring the associations between obesity, probab...

This trial presents a laboratory model investigating the effect of quick returns (QRs, <11 h time off between shifts) on sleep and pre-sleep arousal. Using a crossover design, 63 participants worked a simulated QR condition (8 h time off between consecutive evening- and day shifts) and a day-day (DD) condition (16 h time off between consecutive day...

Study objectives: To investigate the effect of a work schedule with abated quick returns (i.e., >11 hours between two shifts) on insomnia, daytime sleepiness, and work-related fatigue compared to a shift schedule maintaining the usual number of quick returns. Methods: A two-armed cluster randomized controlled trial including 66 units was conduct...

Background: Diet can have a major impact on health. In this study, we surveyed the extent to which the subject of diet was raised by patients in general practice and which patients desired such discussions. Material and method: We conducted a questionnaire-based cross-sectional study of patients ≥ 18 years of age at GP practices in Western Norwa...

Objectives To explore whether changes in work schedule, number of night shifts and number of quick returns were related to changes in headache frequencies. Methods A longitudinal study with questionnaire data from 2014 (baseline) and 2017 (follow-up) on work schedule (day only, shift work without nights and shift work with nights), number of night...

The association between nightmare frequency (NMF) and suicidal ideation (SI) is well known, yet the impact of the COVID-19 pandemic on this relation is inconsistent. This study aimed to investigate changes in NMF, SI, and their association during the COVID-19 pandemic. Data were collected in 16 countries using a harmonised questionnaire. The sample...

Accurate measurement of habitual sleep duration (HSD) is crucial for understanding the relationship between sleep and health. This study aimed to assess the bias and agreement limits between two commonly used short HSD self-report methods, considering sleep quality (SQ) and social jetlag (SJL) as potential predictors of bias. Data from 10,268 parti...

A qualitative study on DSWPD

Disturbed sleep and circadian disruption are reported to increase the risk of infections. People with an evening circadian preference and night workers typically report insufficient sleep, and the aims of the present study were to investigate possible associations between various types of infections and circadian preference and shift work status. D...

Background The preset study aimed to explore whether work schedules and sleep disorders predict the onset of headache. Methods A longitudinal study was conducted with questionnaire data from 2014 (baseline) and 2017 (follow-up) on work schedule, number of night shifts, number of quick returns, insomnia, shift work disorder (SWD), restless legs syn...

The ongoing wars in many regions—such as the conflict between Israel and Hamas—as well as the effects of war on communities, social services, and mental health are covered in this special editorial. This article emphasizes the need for international efforts to promote peace, offer humanitarian aid, and address the mental health challenges faced by...

Progress in the field of insomnia since 2017 necessitated this update of the European Insomnia Guideline. Recommendations for the diagnostic procedure for insomnia and its comorbidities are: clinical interview (encompassing sleep and medical history); the use of sleep questionnaires and diaries (and physical examination and additional measures wher...

Background Self-rated health (SRH) is widely recognized as a clinically significant predictor of subsequent mortality risk. Although COVID-19 may impair SRH, this relationship has not been extensively examined. The present study aimed to examine the correlation between habitual sleep duration, changes in sleep duration after infection, and SRH in s...

Objective Sleep is vital for normal cognitive function in daily life, but is commonly disrupted in older adults. Poor sleep can be detrimental to mental and physical health, including cognitive function. This study assessed the association between self‐reported short (<6 h) and long (>9 h) sleep duration and sleep fragmentation (3≥ nightly awakenin...

Sleep disturbances cause great impairment in quality of life. In this cross-sectional study, we analysed questionnaire-collected data from 12,655 persons (30-87 years) who participated in the sixth survey of the Tromsø Study carried out in 2007-2008. First, using this community-based sample representative of the general population of northern Norwa...

Objectives The aims were to explore multidimensional sleep health and the different dimensions of sleep health in the adult Norwegian population in relation to sex, age, education, circadian preference, and chronic insomnia. Methods A representative sample of 1028 Norwegians, aged 18 + years completed a cross-sectional web-based survey. Sleep heal...

Study objectives: Preliminary evidence suggests that the risk of Long COVID is higher among people with pre-existing medical conditions. Based on its proven adjuvant role in immunity, habitual sleep duration may alter the risk for developing Long COVID. The objective of this study was to determine whether the odds of Long COVID are higher amongst...

This paper summarizes the position statement of the World Sleep Society (WSS) International Guidelines Committee regarding the Clinical Practice Guidelines on the Behavioral and Psychological Treatments for Chronic Insomnia Disorder in Adults prepared by a task force of the American Academy of Sleep Medicine (AASM). The practice guidelines were rev...

Background: The COVID-19 pandemic and related restriction measures have affected our daily life, sleep, and circadian rhythms worldwide. Their effects on hypersomnolence and fatigue remain unclear. Methods: The International COVID-19 Sleep Study questionnaire which included items on hypersomnolence such as excessive daytime sleepiness (EDS), and...

Objective: The objective was to assess the association between self-reported infections and sleep duration, sleep debt, chronic insomnia, and insomnia severity. Methods: In total, 1023 participants were recruited from the Norwegian practice-based research network in general practice to a cross-sectional online survey with validated questions abo...

Aim To investigate whether pain, sleep duration, insomnia, sleepiness, work-related factors, anxiety, and depression associate with excessive fatigue in nurses. Background Fatigue among nurses is a problem in the context of ongoing nursing shortages. While myriad factors are associated with fatigue not all relationships are understood. Prior studi...

Objectives There is emerging evidence that sleep problems and short sleep duration increase the risk of infection. We aimed to assess whether chronic insomnia disorder, chronic sleep problems, sleep duration and circadian preference based on self-report were associated with risk of infections and antibiotic use among patients visiting their general...

The present study explored the associations between school start time and sleep habits among older adolescents, and whether these associations depended on circadian preference. The sample comprised 4010 high school students aged 16–17 years who completed a web‐based survey on habitual school start time, sleep, and health. The survey included the Mu...

Short nighttime sleep duration impairs the immune response to virus vaccination, and long nighttime sleep duration is associated with poor health status. Thus, we hypothesized that short (<6 h) and long (>9 h) nighttime sleepers have a higher post-COVID risk than normal nighttime sleepers, despite two doses of mRNA vaccine (which has previously bee...

Sleep patterns and problems vary in relation to internal (e.g., sex, age, circadian preference) and external (e.g., social structures) factors. The main aim of the present study was to describe habitual sleep patterns and chronic sleep problems in a population-based sample of Norwegian adults. During spring 2022, a sample of 1028 adults completed a...

Nightmares are highly prevalent and distressing for the sufferer, which underlines the need for well-documented treatments. A comprehensive literature review and meta-analysis of the effects of different pharmacological placebo-controlled randomized clinical trials, covering the period up to 1 December 2022, was performed. Searches were conducted i...

The present study had two main aims. First, to investigate whether shift/night workers had a higher prevalence and severity of COVID-19 compared with day workers. Second, to investigate whether people regularly working in face-to-face settings during the pandemic exhibited a higher prevalence and severity of COVID-19 compared with those having no n...

Recent investigations show that many people affected by SARS‐CoV2 (COVID‐19) report persistent symptoms 2–3 months from the onset of the infection. Here, we report the Italian findings from the second International COVID‐19 Sleep Study survey, aiming to investigate sleep and dream alterations in participants with post‐acute symptoms, and identify t...

The present study estimated the frequency of using methods or tricks to fall asleep in the general Norwegian population. Further, people with chronic insomnia were compared with people without chronic insomnia. A representative sample of 1028 participants aged 18 years or older completed a web-based survey. The response rate was 33.5%. Insomnia sym...

Objective To assess whether cardiorespiratory fitness (CRF) is associated with first purchase of a prescribed hypnotic drug in the adult population. Methods A total of 34,357 adult participants (53.9% women) with a mean age of 51.5 years (SD 15.6 years) from the third Trøndelag Health Study (HUNT) of 2006 to 2008 were observed until January 1, 201...

Many people report suffering from post‐acute sequelae of COVID‐19 or “long‐COVID”, but there are still open questions on what actually constitutes long‐COVID and how prevalent it is. The current definition of post‐acute sequelae of COVID‐19 is based on voting using the Delphi‐method by the WHO post‐COVID‐19 working group. It emphasizes long‐lasting...

The aim of this randomised controlled assessor-blinded trial was to examine the effect of cognitive behavioural therapy for insomnia on sleep variables and depressive symptomatology in outpatients with comorbid insomnia and moderate to severe depression. Forty-seven participants were randomized to receive one weekly session in 6 weeks of cognitive...

Background Sleep problems are common in the general population, but there are few studies on the prevalence of sleep problems and hypnotic use among patients in general practice. Objectives To estimate the prevalence of insomnia (based on the Diagnostic and Statistical Manual of Mental Disorders [DSM], version 5), self-reported sleep problems and...

Purpose The COVID-19 pandemic affects mental health and sleep, resulting in frequent nightmares. Therefore, identifying factors associated with nightmare frequency is important, as it can indicate mental health issues. The study aimed to investigate increases in nightmare frequency comparing the pre-pandemic and pandemic period, and identify its ri...

Background: This study aimed to investigate whether different types of changes in the work schedule of nurses working rotating shifts during the COVID-19 pandemic were associated with sleep duration, sleep quality, and turnover intention. Methods: Cross-sectional questionnaire data from 694 nurses participating in the SUrvey of Shift work, Sleep...

Background Shift work, i.e., non-standard work hours, has been associated with both short- and long-term sickness absence. However, findings are inconsistent and inconclusive. Thus far, no comprehensive meta-analytic synthesis on the relationship between shift work and sickness absence has been published. The aims of the planned systematic review a...

Background The early birth and hospitalization of a preterm infant in neonatal intensive care unit can produce several emotional and behavioural responses including sleep problems for parents. Few studies have explored sleep and its associations with health and HRQoL over time in this vulnerable parent population. This purpose of this study was to...

This chapter focuses on the strong association between insomnia and somatic disorders and diseases. The pathophysiological mechanisms behind this association are unclear, but low‐grade inflammation may play a role. Insomnia seems to be a risk factor for many somatic conditions and poor sleep may also impact the severity and outcome of somatic condi...

This chapter focuses on insomnia within the setting of general practice. As insomnia is often co‐morbid with other psychological and somatic disorders, the prevalence of insomnia among patients visiting their GPs is very high. As most patients attend the GP office on a regular basis, GPs are ideally placed within the health care system to manage pa...

Objectives: To explore whether a change in work schedule was associated with a change in the probability of prescribed sleep medication use. Methods: A longitudinal study with annual questionnaire data (2008/2009-2021, except 2019) on work schedule (day work only, shift work without nights and shift work with nights) and prescribed sleep medicat...

Introduction: Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder that is associated with increased risk of cardiovascular disease. The main interest of this clinical review is to discuss the cardiovascular consequences of OSA with a special focus on left ventricular (LV) function and structure, arterial stiffness and atrial...

Background Shift work disorder (SWD) is highly prevalent among shift-working nurses and has multiple negative health-related effects. There is a dearth of insight into career-related decisions made by nurses suffering from SWD, for instance in terms of their intention to quit work (turnover intention). In this study, we aimed to investigate the ass...

Introduction Obstructive sleep apnea (OSA) is highly prevalent with serious health consequences. Demand for diagnostic studies is high, in many countries exceeding capacity. Purpose The objective of this cross-sectional study was to identify predictors of severe OSA among patients on waiting lists for sleep studies, to better prioritize time to ex...

Purpose: Clinical research in primary care is relatively scarce. Practice-based research networks (PBRNs) are research infrastructures to overcome hurdles associated with conducting studies in primary care. In Norway, almost all 5.4 million inhabitants have access to a general practitioner (GP) through a patient-list system. This gives opportunity...

Abstract Purpose: Obstructive sleep apnea (OSA) may increase the risk of severe COVID-19; however, the level of potential modulation has not yet been established. The objective of the study was to determine the association between high risk of OSA, comorbidities, and increased risk for COVID-19, hospitalization, and intensive care unit (ICU) treatm...

There has been increasing concern about the long‐term impact of coronavirus disease 2019 (COVID‐19) as evidenced by anecdotal case reports of acute‐onset parkinsonism and the polysomnographic feature of increased rapid eye movement sleep electromyographic activity. This study aimed to determine the prevalence and correlates of dream‐enactment behav...

The study examined sleep and sleepiness among shift working Helicopter Emergency Medical Service pilots from Norway (Norwegian Air Ambulance; NAA) and Austria (Christophorus Flugrettungverein; CFV). Both pilot groups (N = 47) worked seven consecutive 24 h shifts. Sleep was assessed by diaries and actigraphy while sleepiness was assessed by the Karo...

Cortical microstructure is influenced by circadian rhythm and sleep deprivation, yet the precise underpinnings of these effects remain unclear. The ratio between T1-weighted and T2-weighted magnetic resonance images (T1w/T2w ratio) has been linked to myelin levels and dendrite density and may offer novel insight into the intracortical microstructur...

Introduction In shift work, quick returns refer to transitions between two shifts with less than 11 hours available rest time. Twenty-three per cent of employees in European countries reported having quick returns. Quick returns are related to short sleep duration, fatigue, sleepiness, work-related accidents and sickness absence. The present study...

Objective The aim of this study was to investigate possible associations between obstructive sleep apnea and fatigue. This naturally led to considering the association between OSA and excessive sleepiness, depression, and anxiety. Background OSA is a highly prevalent sleep disorder, associated with a risk of hypertension, cardiovascular events, da...

Night work leads to sleepiness and reduced vigilant attention during work hours, and bright light interventions may reduce such effects. It is also known that total sleep deprivation impairs cognitive flexibility as measured by reversal learning tasks. Whether night work impairs reversal learning task performance or if bright light can mitigate rev...

The current Russian war against Ukraine is of global concern. It builds on the annexation of Crimea in 2014 and subsequently the war in the Donbas region of Ukraine, and has become a large-scale Russian invasion of Ukraine from three directions, Crimea in the south, Russia in the east, and Belarus in the north. Despite the geopolitical background t...

The impact of obstructive sleep apnea (OSA) on arterial stiffness is less studied. We aimed to investigate the prevalence and covariates of increased pulse pressure (PP), a surrogate marker of arterial stiffness, in the entire study population as well as in separate analyses in normotensive and hypertensive patients. Further, we also explored the i...

Introduction A growing number of studies have demonstrated that the coronavirus disease-19 (COVID-19) pandemic has severely affected sleep and dream activity in healthy people. To date, no investigation has examined dream activity specifically in COVID-19 patients. Methods As part of the International COVID-19 Sleep Study (ICOSS), we compared 544...

This protocol paper describes the second survey produced by the International Covid Sleep Study (ICOSS) group with the aim to examine the associations between SARS-CoV-2 infection and sleep, sleepiness, and circadian problems as potential predisposing factors for more severe COVID-19 disease profile and for development of Long-COVID in the general...

Objectives Sleep is important for human health and well-being. No previous study has assessed whether the COVID-19 pandemic impacts sleep and daytime function across the globe. Methods This large-scale international survey used a harmonised questionnaire. Fourteen countries participated during the period of May–August 2020. Sleep and daytime probl...

Background: The prevalence of restless legs syndrome (RLS) among adults in the general population is around 5-10 %. Few studies have been conducted on the prevalence among patients who consult their general practitioner. There are also few studies on associations between RLS and other common complaints such as irritable bowel syndrome (IBS), chron...

Short sleep and obstructive apneas/hypopneas have been shown to be associated with childhood obesity. Still, few studies have compared sleep in children with obesity, without suspected sleep disordered breathing and normal weight peers by objective sleep measures and compared results with subjective parent assessment of sleep. Children with obesity...

Purpose Lifestyle and work habits have been drastically altered by restrictions due to the COVID-19 pandemic. Whether the associated changes in sleep timing modulate the risk of suffering from symptoms of insomnia, the most prevalent sleep disorder, is however incompletely understood. Here, we evaluate the association between the early pandemic-ass...

There has been great concern about the impact of coronavirus disease 2019 (COVID‐19)‐related school lockdown on adolescent health. The aim of the present study was to compare sleep patterns before and during COVID‐19‐related school lockdown, in a large sample of high school students. The present study is based a prospective, longitudinal survey on...