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Sleep Hygiene Mediates, but Does Not Moderate, Associations Between Temperament and Sleep Quality in University Students
Abstract
Although there are theoretical reasons to expect associations among temperament, sleep hygiene behaviors (SHB), and global sleep quality (GSQ), these relations have not yet been examined despite their potential impact on undergraduate student well-being. The present study was conducted to (1) examine relations between temperament and GSQ in university students broadly recruited, (2) document associations between SHB and temperament in this sample, and (3) to determine whether associations among temperament, SHB, and GSQ were best explained by mediation or moderation models. One hundred fifty-two university students completed questionnaires that inquired about temperament, SHB, and GSQ. Correlations revealed that poorer SHB and GSQ were associated reduced effortful control; poorer SHB was also associated with increased negative affect (SHB and GSQ were unrelated to extraversion and orienting sensitivity). Mediation models assessing relations amongst temperament, SHB, and GSQ indicated that negative affect and effortful control may predispose university students to engage in fewer SHB, negatively impacting GSQ; variability in SHB did not moderate the impact of temperament on GSQ. Additional research is needed to confirm and extend these findings, with the ultimate goal of improving undergraduate GSQ (a) by reducing negative affect and increasing effortful control or (b) by improving SHB that are uniquely associated with these temperament profiles.
... For this reason, research is needed to identify modifiable individual difference variables that may contribute to better sleep in this population. Temperament is one set of individual difference variables that has been associated with sleep in university student samples [1,2]. Given the small number of studies conducted to date, however, as well as the potential implications of improving sleep and daytime functioning in this population, the present research was conducted to (1) examine associations among temperament, sleep hygiene behavior, and insomnia severity in university students as compared to analyses focused on temperament, sleep hygiene behavior, and global sleep quality, to (2) identify the mediating and moderating role of sleep hygiene behavior in explaining the observed relations [1,2], and to (3) replicate previous research documenting correlations between temperament and global sleep quality. ...
... Temperament is one set of individual difference variables that has been associated with sleep in university student samples [1,2]. Given the small number of studies conducted to date, however, as well as the potential implications of improving sleep and daytime functioning in this population, the present research was conducted to (1) examine associations among temperament, sleep hygiene behavior, and insomnia severity in university students as compared to analyses focused on temperament, sleep hygiene behavior, and global sleep quality, to (2) identify the mediating and moderating role of sleep hygiene behavior in explaining the observed relations [1,2], and to (3) replicate previous research documenting correlations between temperament and global sleep quality. Temperament refers to a constellation of biologically-based individual differences in reactivity and regulation that emerge and develop within the broader cultural context [3]. ...
... Temperament is one set of individual difference variables that has been associated with sleep in university student samples [1,2]. Given the small number of studies conducted to date, however, as well as the potential implications of improving sleep and daytime functioning in this population, the present research was conducted to (1) examine associations among temperament, sleep hygiene behavior, and insomnia severity in university students as compared to analyses focused on temperament, sleep hygiene behavior, and global sleep quality, to (2) identify the mediating and moderating role of sleep hygiene behavior in explaining the observed relations [1,2], and to (3) replicate previous research documenting correlations between temperament and global sleep quality. Temperament refers to a constellation of biologically-based individual differences in reactivity and regulation that emerge and develop within the broader cultural context [3]. ...
University students commonly experience sleep problems which have implications for daily functioning and academic achievement. For this reason, research is needed to identify modifiable individual difference variables that may contribute to better sleep in this population. Temperament and sleep hygiene may be two such factors. As part of a larger study, 167 university students (61.7% female) completed online questionnaires that inquired about temperament (the Adult Temperament Questionnaire; ATQ), sleep hygiene behavior (the Sleep Hygiene Index; SHI), global sleep quality (the Pittsburgh Sleep Quality Index; PSQI), and insomnia severity (the Insomnia Severity Index; ISI). Correlations amongst the included measures were in the predicted direction: effortful control was negatively associated with the SHI composite, PSQI global scores, and ISI scores; extraversion was negatively related to PSQI global scores; and negative affect was positively associated with the SHI composite and ISI scores. In addition, the SHI composite mediated the association between effortful control and the PSQI global scores as well as the association between negative affect and PSQI global scores; similar patterns of mediation were found when considering ISI scores, although the direct effects differed. That is, negative affect was directly associated with ISI scores but not PSQI global scores. These findings suggest that interventions designed enhance effortful control, reduce negative affect, and improve sleep hygiene may contribute to better global sleep quality and decrease insomnia in university students.
... Longitudinal studies conducted by other authors have shown that difficult temperament in early childhood is associated with behavior problems throughout childhood (Guerin et al., 1997), predicted delinquency, gang involvement (Wolff et al., 2020), and lack of both empathy and self-control (Javakhishvili & Vazsonyi, 2022) in adolescence, less healthy eating over the lifespan (Lipsanen et al., 2020), developmental trauma and/or post-traumatic stress disorder (Wiseman et al., 2021), non-engagement in education, employment and training , depressive symptoms and lower well-being (Wu, Meehan, et al., 2022), and a nearly five-fold increased risk of psychotic disorder in adulthood (Brannigan et al., 2020). Cross-sectional studies in adult samples have also revealed that difficult temperament has been associated with aggressive behavior (Giancola, 2004;, while individual temperamental characteristics have been shown to predict attention-deficit/hyperactivity disorder symptoms (Kajka et al., 2020) and sleep quality (Lukowski et al., 2019). These original research findings were supported by systematic reviews that confirmed that difficult temperament was associated with intimate partner violence (Curtis et al., 2023) and criminal behavior (Tharshini et al., 2021), and predicted the course of borderline personality disorder (Winsper, 2021). ...
... It should be noted that researchers have used different theoretical approaches to study difficult temperament, and the measurement of the construct also varies. Some authors focus on the pre-known 'universal' constitution of difficult temperament, which is based on the five attributes proposed in the interactionist theory of Chess and Thomas (Brannigan et al., 2020;Javakhishvili & Vazsonyi, 2022;Wiseman et al., 2021), or defined in the context of other temperament theories, such as the behavior genetics-oriented theory of Buss and Plomin (Pesonen et al., 2003) or the developmental model of Rothbart (Lukowski et al., 2019;Wright & Jackson, 2022;Yu & Yan, 2022). This enables researchers to observe how individual attributes or a derived index of difficult temperament relate to outcomes of interest (e.g., psychopathology). ...
Difficult temperament is a set of behavioral characteristics that are associated with mental health and a significant predictor of psychopathology. This study aims to investigate which temperamental characteristics can be considered attributes of difficult temperament in Lithuanian adults. The sample consisted of 429 adults between 18 and 79 years of age. The Adult Temperament Questionnaire was used to assess temperamental characteristics and perceived difficult temperament. Data were analyzed using a mixed-methods approach. The results revealed that the set of attributes perceived as constituting difficult temperament includes characteristics such as negative mood, intensity of emotional reactions, low adaptability, withdrawal, and low regularity. Quantitative data analysis uncovered an unexpected negative relationship between perceived difficult temperament and the rhythmicity characteristic, while a new category of stubbornness emerged in the qualitative data. The findings provide new knowledge about both the cultural specifics of difficult temperament and the content of the temperament construct in general. These results can also aid in the development of further research on difficult temperament, as well as in the planning of mental health interventions and psychological counseling.
... Consistent with other studies, we found that poor sleep hygiene significantly predicted of sleep duration, sleep quality, and insomnia severity (Brown et al., 2002;Suen et al., 2008;Revathi et al., 2016;Ruggiero et al., 2019;Humphries et al., 2021;Shaheen and Alkaid, 2022;Ali et al., 2023). Sleep hygiene may act as a mediator between positive affect and sleep quality, suggesting that failing to engage in good sleep hygiene may exacerbate the bidirectional relationship between poor mental health and poor sleep (Li et al., 2016;Lukowski et al., 2019). Fortunately, sleep hygiene practices can be modified with education. ...
Objectives
This study sought to understand how university student’s academic discipline relates to sleep factors including attitudes, hygiene, quality, and duration.
Methods
Using a cross-sectional approach, a 30-min survey was advertised to students at two Canadian universities in March of 2022. Sleep measures included the Dysfunctional Beliefs and Attitudes Scale, the Sleep Hygiene Index, the Pittsburgh Sleep Quality Index, and the Insomnia Severity Index. Academic discipline was categorized into four groups: Health, Arts, Sciences, and Engineering. Multiple linear regressions were used to investigate (1) the effect of academic discipline on sleep measures, and (2) the effect of academic discipline, dysfunctional sleep attitudes, and sleep hygiene practices on insomnia, sleep quality and duration.
Results
1,566 students completed the survey (69.4% women; 80.3% undergraduates). Compared to Health students, Art students had worse dysfunctional sleep attitudes, hygiene, quality, and insomnia severity (p < 0.001). This relationship disappeared after controlling for differences in mental health (p ≥ 0.05). Art students had longer sleep durations (p < 0.01), whereas Engineering students had shorter sleep durations (p < 0.05). When dysfunctional sleep attitudes and hygiene were included in the model, both academic discipline (p < 0.05) and sleep hygiene (p < 0.001) were associated with sleep duration. Sleep hygiene and attitudes were also associated with sleep quality and insomnia severity (p < 0.001), while academic discipline was not (p ≥ 0.05).
Discussion
These results suggest differences in sleep quality across academic discipline are impacted by dysfunctional sleep attitudes, sleep hygiene, and mental health, whereas differences in sleep duration appear to be independent of these factors. Overall, students in different academic disciplines have unique relationships with sleep and thus may require targeted approaches to improve their sleep. Future interventions should focus on supporting sleep hygiene and attitudes to improve students’ sleep and well-being.
... Objective assessment (e.g., actigraphy) could provide additional information about this relationship. It is noteworthy that PSQI in this sample showed a relatively low internal consistency, which is consistent with previous studies among college students [31][32][33]. Another limitation was that potential confounders might have been missed. ...
Purpose
Healthy sleep is essential for individuals’ physiological and psychological health. Health science students experience a high prevalence of sleep disturbances which may be due to maladaptive behaviors. This study aimed to examine the associations of sleep behaviors including sleep hygiene and bedtime procrastination with the associations of sleep disturbances (e.g., poor sleep quality, insomnia, and short sleep).
Methods
This cross-sectional study included health science students from a medical university in Shanghai, China. Sleep disturbances included poor sleep quality, insomnia, and short sleep. They were measured by the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and one question “How many hours of sleep did you usually get during the past week?”, respectively. Sleep behaviors included sleep hygiene and bedtime procrastination measured by the Sleep Hygiene Index (SHI) and Bedtime Procrastination Scale (BPS), respectively. Logistic regression was performed while controlling for potential confounders.
Results
A total of 464 health science students participated. Poorer overall sleep hygiene and more bedtime procrastination were independently associated with higher odds of poor sleep quality (OR=1.065, 95% CI 1.028–1.103; OR=1.040, 95% CI 1.006–1.075, respectively) and insomnia (OR=1.059, 95% CI 1.018–1.101; OR=1.093, 95% CI 1.049–1.139, respectively). More bedtime procrastination was associated with higher odds of short sleep (OR=1.148, 95% CI 1.093–1.206). Commonly reported specific sleep behaviors, such as “Going to bed later than intended”, “Doing other things than sleep at bedtime”, and “Easily stopping what I am doing at bedtime”, were also related to higher odds of sleep disturbances.
Conclusions
Sleep hygiene and bedtime procrastination were strong predictors of sleep disturbances. Tailored interventions targeting specific sleep behaviors are warranted to clarify their effect on sleep disturbances.
... Similarly, an investigation of 111 Australian adults--college students, employed workers, and homemakers--reported that time structure partially mediated the association between time management behavior and job satisfaction [55]. One possible explanation of the mediating effect of time structure between perceived stress and insomnia is that it helps maintain a healthy lifestyle and increases good sleep hygiene, which decreases the risk of insomnia [98,99]. ...
In recent years, the problem of youth unemployment in China has become a great concern. Unemployed young people often find themselves under tremendous stress and vulnerable to sleep problems. The link between perceived stress and insomnia has been widely documented, but the potential mechanisms underlying this relationship have not been thoroughly revealed. The objective of this study was to examine the underlying mechanisms linking perceived stress to insomnia through testing the mediating effects of emotional dysregulation and time structure. Through a multiple-stage convenience sampling, 511 unemployed young people (38.6% women; mean age = 21.51; SD = 2.22) were measured using the 10-item Perceived Stress Scale (PSS-10), Insomnia Severity Index (ISI), 16-item Difficulties in Emotion Regulation Scale (DERS-16), and Time Structure Questionnaire (TSQ). Based on the statistical description of the sample, chi-squared tests, bivariate correlation analyses, and mediation analyses were performed. The study indicated that 53.0% (95% CI: 48.7–57.4%) of the participants reported probable insomnia, and both insomnia and perceived stress demonstrated strong associations with emotional dysregulation and time structure, which served as partial mediators between perceived stress and insomnia symptoms according to mediation analyses. Path analysis further revealed that, after controlling for age and gender, emotional dysregulation and time structure accounted for 31.8 and 17.6% of the effect of perceived stress on insomnia, respectively. This study provides empirical support for the association among perceived stress, emotional dysregulation, time structure, and insomnia symptoms. To improve the sleep quality and general wellbeing of unemployed young people, emotional dysregulation and time structure must be taken into consideration.
Before the COVID-19 pandemic, undergraduate students experienced sleep problems and mental health issues that were negatively associated with academic achievement. Studies comparing undergraduate sleep and health pre- to mid-pandemic have yielded mixed results, necessitating additional research on other cohorts and examination of potential moderators. The present study was conducted to examine whether American undergraduate students tested mid-pandemic experienced poorer sleep, health, and academic achievement relative to students tested pre-pandemic, as well as to examine whether poor sleep during the pandemic was preferentially associated with poorer health in women. The current cross-sectional study included 217 participants tested pre-pandemic (February-December 2019) and a separate sample of 313 participants tested mid-pandemic (November-December 2020). Participants in both samples provided demographic information and completed questionnaires inquiring about participant sleep quality, insomnia, and cumulative grade point average (GPA); participants in the mid-pandemic sample also reported on measures of general, physical, and mental health. Participants tested mid-pandemic reported poorer global sleep quality, greater insomnia severity, greater stress, and higher cumulative GPAs relative to participants tested pre-pandemic. For the mid-pandemic sample only, poorer sleep quality was associated with reduced physical health; interactions indicated that women with poor sleep quality reported poorer mental health relative to both women with good sleep quality and men with poor quality sleep. Perceived stress mediated the association between sleep problems and GPA. These findings indicate that the pandemic negatively impacted the functioning of undergraduate students and highlights the need for future studies examining additional moderators of the reported effects.
Objective:
The present study was conducted to examine the impact of experimentally-manipulated perceptions of sleep on self-reported affective reactivity and recovery from a social stressor in undergraduate students.
Design:
The study design is experimental, as the participants were randomly assigned to either good or poor perceived sleep quality conditions.
Main outcome measures:
The impact of condition on self-reported affective responses to and recovery from the social stressor were assessed as well as whether the observed effects were moderated by stress, rumination, and depression.
Results:
Participants in the good sleep condition reported increased negative affect (NA) after the social stressor and after a six-minute recovery period relative to participants in the poor sleep condition; participants in the former condition also reported heightened NA post-recovery relative to baseline (a comparison that was non-significant for participants in the poor sleep condition). The effect of condition on NA post-stressor and post-recovery was moderated by depression and rumination, with important implications for participants in the good sleep condition in particular.
Conclusions:
These findings may have resulted from participant expectations about the impacts of sleep on their behaviour, although additional research remains to be conducted to identify the mechanism responsible for the obtained pattern of results.
Whereas previous research has indicated that sleep problems tend to co-occur with increased mental health issues in university students, relatively little is known about relations between sleep quality and mental health in university students with generally healthy sleep habits. Understanding relations between sleep and mental health in individuals with generally healthy sleep habits is important because (a) student sleep habits tend to worsen over time and (b) even time-limited experience of sleep problems may have significant implications for the onset of mental health problems. In the present research, 69 university students with generally healthy sleep habits completed questionnaires about sleep quality and mental health. Although participants did not report clinically concerning mental health issues as a group, global sleep quality was associated with mental health. Regression analyses revealed that nighttime sleep duration and the frequency of nighttime sleep disruptions were differentially related to total problems and clinically-relevant symptoms of psychological distress. These results indicate that understanding relations between sleep and mental health in university students with generally healthy sleep habits is important not only due to the large number of undergraduates who experience sleep problems and mental health issues over time but also due to the potential to intervene and improve mental health outcomes before they become clinically concerning.
Inhibitory control training has been hypothesised as a technique that will improve an individual's ability to overrule impulsive reactions in order to regulate behaviour consistent with long-term goals.
A meta-analysis of 19 studies of inhibitory control training and health behaviours was conducted to determine the effect of inhibitory control training on reducing harmful behaviours. Theoretically-driven moderation analyses were also conducted to determine whether extraneous variables account for heterogeneity in the effect; in order to facilitate the development of effective intervention strategies. Moderators included type of training task, behaviour targeted, measurement of behaviour, and training duration.
A small-but homogenous effect of training on behaviour was found (d(+) = 0.378, CI95 = [0.258, 0.498]). Moderation analyses revealed that the training paradigm adopted, and measurement type influenced the size of the effect such that larger effects were found for studies that employed go/no-go training paradigms rather than stop-signal task paradigms, and objective outcome measures that were administered immediately yielded the largest and most consistent effects on behaviour.
Results suggest that go/no-go inhibitory control training paradigms can influence health behaviour, but perhaps only in the short-term. Future research is required to systematically examine the influence of training duration, and the longevity of the training effect. Determining these factors could provide the basis for cost-effective and efficacious health promoting interventions.
Theories of temperament suggest that individual differences in affective reactivity (e.g., negative affectivity) may confer risk for internalizing psychopathology in youth and that self-regulatory aspects of temperament (e.g., effortful control) may protect against the deleterious effects of high negative affective reactivity. However, no study to date has examined how the relationship between temperament and youth internalizing psychopathology may be moderated by stress. The current study used a prospective longitudinal design to test the interaction of temperament (e.g., negative affectivity and effortful control) and stressors as a predictor of youth (ages 7-16; 56 % female; N = 576) depressive and anxious symptoms over a 3-month period. Findings show that at low levels of stress, high levels of effortful control protect against the development of depressive and anxious symptoms among youth with high levels of negative affectivity. However, at high levels of stress, this buffering effect is not observed. Gender and grade did not moderate this relationship. Overall, findings extend current understanding of how the interaction of individual psychosocial vulnerabilities and environmental factors may confer increased or decreased risk for depressive and anxious symptoms.
Replications and robustness checks are key elements of the scientific method and a staple in many disciplines. However, leading journals in developmental psychology rarely include explicit replications of prior research conducted by different investigators, and few require authors to establish in their articles or online appendices that their key results are robust across estimation methods, data sets, and demographic subgroups. This article makes the case for prioritizing both explicit replications and, especially, within-study robustness checks in developmental psychology. It provides evidence on variation in effect sizes in developmental studies and documents strikingly different replication and robustness-checking practices in a sample of journals in developmental psychology and a sister behavioral science-applied economics. Our goal is not to show that any one behavioral science has a monopoly on best practices, but rather to show how journals from a related discipline address vital concerns of replication and generalizability shared by all social and behavioral sciences. We provide recommendations for promoting graduate training in replication and robustness-checking methods and for editorial policies that encourage these practices. Although some of our recommendations may shift the form and substance of developmental research articles, we argue that they would generate considerable scientific benefits for the field. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
This study examined sleep hygiene practices and bedtime resistance and tested whether associations differed by child temperament. Parents of Head Start preschoolers (n = 374, 56% non-Hispanic white) completed the Going to Bed subscale of the Children's Sleep-Wake Scale (GTB; higher score reflects less bedtime resistance), Children's Sleep Hygiene Scale (CSHS; higher score reflects better sleep hygiene), and Child Behavior Questionnaire (Anger, Activity, Impulsivity subscales indicated difficult temperament). Monte Carlo simulation adjusted for demographic covariates tested associations of CSHS with GTB in children with more- vs. less-difficult temperaments. Children with more- vs. less-difficult temperaments experienced worse sleep hygiene (p < .0001) and had more bedtime resistance (p < .0001). Among children with more difficult temperaments, better sleep hygiene was linearly associated with less bedtime resistance (β = 1.28, 95% CI 0.77, 1.78). Among children with less difficult temperaments, the association followed a piecewise linear trend: sleep hygiene was not associated with bedtime resistance when CSHS scores were < 4.1 (β = 0.15, 95% CI -4.87, 3.13), but for CSHS scores ≥ 4.1, an increase in CSHS was associated with lower bedtime resistance (β = 1.33, 95% CI 1.00, 1.79). Consistent sleep hygiene is associated with less bedtime resistance and may be helpful in reducing bedtime resistance among children with more difficult temperaments.
Sleep-temperament associations have not yet been examined among university students, despite awareness of the high incidence of sleep problems in this population. The present study was conducted (a) to examine whether sleep quality was associated with temperament among university-attending young adults and (b) to determine whether particular components of sleep quality were differentially associated with temperament. University students completed questionnaires designed to assess sleep quality and temperament. Poor sleep quality was associated with increased negative affect and orienting sensitivity as well as decreased effortful control; regression analyses revealed differential associations between components of nighttime sleep quality and temperament ratings. The presented study reveals conceptual continuity in sleep-temperament relations from infancy to young adulthood and highlights important avenues for future research.
Research findings: In order to assess the relations between sleep problems and temperament in infants, temperament ratings of 63 toddlers who presented with night waking problems were compared to those of 35 non-referred toddlers. An objective method to assess sleep patterns was used to validate the distinct sleep patterns of the two groups prior to the comparison of the temperament scales. Measures included: Toddler Temperament Questionnaire (TTQ) and the child's scales of the Parental Stress Index (PSI). On the TTQ, Night Wakers were rated as having lower sensory thresholds compared to the controls. Night Wakers were also rated as less adaptive than the controls. On the PSI, Night Wakers were rated as more distractible; less reinforcing; less adaptive and more demanding. Practice or policy: The results suggest that sleep disturbances in early childhood are closely associated with negative maternal perceptions of child temperament. It is proposed that early detection and treatment of sleep problems during early childhood may prevent some of the associated negative behavioral consequences.
Hierarchical relations among theoretically generated lower order scales of adult temperament were explored in two studies. In Study One, 258 undergraduates completed the Adult Temperament Questionnaire (ATQ). A five-factor model emerged from exploratory factor analysis, with factors labeled Orienting Sensitivity, Effortful Control, Extraversion, Affiliativeness, and Negative Affect. This model showed considerable convergence with the Big Five. Study Two, with a community sample of 700 participants, yielded a six-factor model, distinguishing aggressive negative affect from non-aggressive negative affect. Relations of the six temperament factors to Cloninger’s TCI, the Five Factor Model, and the Multi-Language Seven were investigated, providing support for the discriminating power of the six-factor temperament model in understanding individual differences in adult temperament and personality.
Nighttime sleep awakenings and infant and family characteristics were measured longitudinally in more than 1,200 infants when the infants were 6, 15, 24, and 36 months old. By 6 months of age, the majority of children slept through the night, awakening their mothers only about once or twice per week. However, not all children followed this predominant developmental pattern. Using growth mixture modeling, we identified 2 distinct developmental patterns. One group, labeled Sleepers, included 66% of the children. These children showed a flat trajectory of sleep awakenings from 6 through 36 months, with mothers reporting their infant awakening from sleep about 1 night per week. The second group, labeled Transitional Sleepers, included 34% of the infants. These children had 7 reported nights of awakenings per week at 6 months, dropping to 2 nights per week at 15 months and to 1 night per week by 24 months. Compared with Sleepers, Transitional Sleepers were more likely to be boys, score higher on the 6-month difficult temperament assessment, be breastfed at 6 and 15 months old, and have more depressed mothers at 6 months old. Using 2-group structural equation modeling, we examined individual differences at different points on the individual infants' sleep trajectories. For infants in both groups, reported sleep awakenings were associated with difficult temperament measured at 6 months, breastfeeding, infant illness, maternal depression, and greater maternal sensitivity. Infant-mother attachment measures were not related to these sleep awakenings. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
To examine whether sleep hygiene-related factors are associated with sleep quality among university students.
Cross-sectional survey.
A university in Hong Kong.
Full-time university students recruited by convenience sampling.
Responses to a sleep questionnaire containing the Pittsburgh Sleep Quality Index and obtaining sleep hygiene knowledge and practice, as well as knowledge on caffeine were used for data collection.
Regression analysis with stepwise selection procedure revealed that sleep hygiene practice was significantly associated with the Pittsburgh Sleep Quality Index score after adjusting for age, gender, year of study, and type of residence (b= -0.08, P<0.001).
Our study's results indicated that sleep hygiene practice was significantly associated with sleep quality. Appropriate measures and sleep hygiene education need to be emphasised among university students in order to increase their awareness on the importance of adopting healthy sleep hygiene practices.
During the first year of life, infants spend most of their time in the sleeping state. Assessment of sleep during infancy presents an opportunity to study the impact of sleep on the maturation of the central nervous system (CNS), overall functioning, and future cognitive, psychomotor, and temperament development. To assess what is currently known regarding sleep during infancy and its effects on cognitive, psychomotor, and temperament development, we assessed the relevant literature published over the last several decades. To provide a foundation for a more in-depth understanding of this literature, we preface this with an overview of brain maturation, sleep development, and various assessment tools of both sleep and development during this unique period. At present, we do not have sufficient data to conclude that a causal relationship exists between infant sleep and cognitive, psychomotor, and temperament development. Caution should be used in predicting outcomes, as the timing and subjectivity of evaluations may obviate accurate assessment. Collectively, studies assess a wide array of sleep measures, and findings from one developmental period cannot be generalized readily to other developmental periods. Future studies should follow patients longitudinally. Additionally, refinements of existing assessment tools would be useful. In view of the relatively high reported pediatric prevalence of cognitive and behavioral deficits that carry significant long-term costs to individuals and society, early screening of sleep-related issues may be a useful tool to guide targeted prevention and early intervention.
An irregular bedtime schedule is a prevalent problem in young adults, and could be a factor detrimentally affecting sleep quality. The goal of the present study was to explore the association between an irregular bedtime schedule and sleep quality, daytime sleepiness, and fatigue among undergraduate students in Taiwan.
A total of 160 students underwent a semi-structured interview and completed a survey comprising 4 parts: Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), and a rating of irregular bedtime frequency. Participants were grouped into 3 groups in terms of irregular bedtime frequency: low, intermediate, or high according to their 2-week sleep log. To screen for psychological disorders or distress that may have affected responses on the sleep assessment measures, the Chinese health questionnaire-12 (CHQ-12) was also administered.
We found an increase in bedtime schedule irregularity to be significantly associated with a decrease in average sleep time per day (Spearman r = -0.22, p = 0.05). Multivariate regression analysis revealed that irregular bedtime frequency and average sleep time per day were correlated with PSQI scores, but not with ESS or FSS scores. A significant positive correlation between irregular bedtime frequency and PSQI scores was evident in the intermediate (partial r = 0.18, p = 0.02) and high (partial r = 0.15, p = 0.05) frequency groups as compared to low frequency group.
The results of our study suggest a high prevalence of both an irregular bedtime schedule and insufficient sleep among university students in Taiwan. Students with an irregular bedtime schedule may experience poor sleep quality. We suggest further research that explores the mechanisms involved in an irregular bedtime schedule and the effectiveness of interventions for improving this condition.
1) To characterize PSQI and ESS scores, and their relationship to each other, in an adult community sample; 2) To determine whether PSQI and ESS scores, in combination with each other, were associated with distinct demographic, clinical, and sleep characteristics.
The PSQI, ESS, clinical rating scales, sleep diaries, actigraphy, and home polysomnography were collected from 187 community-dwelling adults (mean age 59.5 years, 47.1% women, 41.2% African Americans) as part of a study investigating novel cardiovascular risk factors. Correlations, cluster analysis, principal components analysis, MANOVA, ANOVA, and regressions were used to characterize the relationships between the PSQI, ESS, and other study variables
Mean PSQI score was 6.3 (3.4), and mean ESS score was 8.2 (3.9). PSQI and ESS correlated weakly with each other (r = 0.16, p = 0.03), but segregated from each other on principal components analysis. Groups of participants categorized by either cluster analysis of PSQI and ESS scores, or by scores above or below traditional cut-off values, differed from each other on psychological/stress symptoms and quantitative and qualitative sleep diary measures, but not on actigraphic or polysomnographic measures. Specifically, higher PSQI scores were associated with female sex, greater psychological distress, and greater sleep disturbance on sleep diaries.
The PSQI and ESS measure orthogonal dimensions of sleep-wake symptoms, but neither is related to objective sleep measures. The PSQI is more closely related to psychological symptom ratings and sleep diary measures than the ESS. These instruments are not likely to be useful as screening measures for polysomnographic sleep abnormalities.
Recent efforts to integrate psychometric and neurobiological data about personality have stimulated diverse interdisciplinary applications. The dissociation of major brain systems linked to procedural and propositional memory and learning has clarified the clinical distinction between two components of personality: temperament and character. Temperament can be defined in terms of individual differences in percept-based habits and skills (i.e. related to procedural memory and learning), which are regulated by the amygdala, hypothalamus, striatum, and other parts of the limbic system. In contrast, character can be defined in terms of individual differences in concept-based goals and values (i.e. related to propositional memory and learning), which are encoded by the hippocampal formation and cerebral neocortex. Recent descriptive, developmental, genetic, and neurobehavioral studies indicate that at least four dimensions of temperament and three dimensions of character can be uniquely described and functionally dissociated.
The negative effects of sleep difficulties have been well documented. However, the prevalence of such problems among US college students has not been well studied. Design difficulties are common in the limited number of existing investigations, making it difficult to estimates the prevalence and types of disturbance studied. The authors describe the use of a quantitative-based assessment instrument to provide an initial indication of students' sleep problems and to serve as a means of addressing some of the deficiencies in the literature. In their sample of 191 undergraduates at a rural southern university, they found that most of the students exhibited some form of sleep disturbance and that women, in general, reported more sleep disturbances than men did. They suggest how colleges and university officials can alter procedures to minimize students' sleep disturbances and reduce the deleterious effects of sleep problems on academic performance.
College students are known for their variable sleep schedules. Such schedules, along with other common student practices (e.g., alcohol and caffeine consumption), are associated with poor sleep hygiene. Researchers have demonstrated in clinical populations that improving sleep hygiene knowledge and practices is an effective treatment for insomnia. However, researchers who have examined relationships between sleep hygiene and practices in nonclinical samples and overall sleep quality have produced inconsistent findings, perhaps because of questionable measures. In this study, the authors used psychometrically sound instruments to examine these variables and to counter the shortcomings in previous investigations. Their findings suggest that knowledge of sleep hygiene is related to sleep practices, which, in turn, is related to overall sleep quality. The data from their regression modeling indicated that variable sleep schedules, going to bed thirsty, environmental noise, and worrying while falling asleep contribute to poor sleep quality.
The Sleep Hygiene Index was developed to assess the practice of sleep hygiene behaviors. The Sleep Hygiene Index was delivered to 632 subjects and a subset of the subjects participated in a readministration of the instrument. Test-retest reliability analyses suggested that sleep hygiene behaviors are relatively stable over time for a nonclinical population. Results confirmed that sleep hygiene is strongly related to sleep quality and modestly related to perceptions of daytime sleepiness. As predicted, support of the sleep hygiene construct was also provided by strong correlations with the associated features of a diagnosis of inadequate sleep hygiene. The Sleep Hygiene Index, a much shorter sleep hygiene instrument than previously published, demonstrated comparable psychometric properties with additional evidence of validity and a clear item selection rationale.
Dominant models of individual health behavior omit biological variables entirely and are composed almost exclusively of social-cognitive and conative variables. Research from the neurosciences suggests a role for brain function in explaining behaviors that require active self-regulation for consistent performance. However, the association between brain function and health behavior is underexplored.
To examine the predictive power of executive function for 2 health risk behaviors and 2 health protective behaviors in healthy adults.
A cross-sectional community sample (N = 216) of adults 20-100 years of age were administered a battery of neuropsychological tests and completed self-report questionnaires regarding their health practices. It was hypothesized that poor performance on neuropsychological tests tapping executive function would be associated with poor health behavior tendencies.
Errors on the Stroop task were positively associated with health risk behavior and negatively associated with health protective behavior after controlling for demographics, education, and IQ.
Executive function is associated with health behavior tendencies. If the association is causal, explanatory models of individual health behavior should be revised to account for individual differences in biologically imbued self-regulatory abilities.
The study aimed at assessing possible relationship between behavior features during sleep and temperament covered period from 2001 to 2002 and comprised 115 randomly selected, apparently healthy infants from the community setting, aged two months who were singletons born at term with normal weight (>2500 g). Early Infancy Temperament Questionnaire was used to describe different aspects of infant temperament: activity, rhythmicity, approach, adaptability, intensity, mood, persistence, distractibility and threshold. Infant behavioral features during sleep were estimated using modified Children's Sleep Habits Questionnaire. The infants with more negative mood more often required rocking or rhythmic movements to fall asleep, resisted sleeping alone, slept too little, were restless and moved a lot during sleep, woke up during night screaming, sweating and being inconsolable; less often could return to sleep after waking without parental interference. Infants with higher intensity less often fell asleep alone. More active infants less often slept about the same amount each day. Less distractible babies were less often ready to go to bed at bedtime, more frequently resisted going to bed at bedtime, were reluctant to sleep alone, slept too little and less often slept about the same amount each day. More rhythmic infants were more often ready to go to bed at bedtime and less often resisted going to bed at bedtime; less often they slept too little, were restless and moved a lot during sleep, woke up very early in the morning.
Sleep patterns and temperament in the first year of life are closely related. However, research utilizing objective, rather than subjective measurements of sleep and temperament is scarce and results are inconsistent. In addition, a relative lack of longitudinal data prevents inference of causality between the two constructs. In this study, infant sleep was objectively assessed among 95 infants at 3, 6, and 12 months-of-age with an actigraph in the home setting. Reactivity to sound, light, and touch, a specific aspect of temperament, was behaviorally assessed at 3 and 6 months, both during sleep (at home) and during waking (at the laboratory). Expected maturational trends were recorded in sleep, with a temporal increase in sleep efficiency and percent of motionless sleep. Quadratic (i.e., inverse U shape) relations were found, especially among girls, when predicting change in sleep by reactivity thresholds, suggesting that both hyposensitive and hypersensitive infants are at risk for poor sleep quality. These are the first research findings suggesting that low reactivity in infancy might be associated with compromised sleep quality. The observed nonlinear effects may account for null or inconsistent results in previous studies that explored only linear associations between temperament and sleep. Future studies should address both extremes of the temperament continuum when exploring relations with sleep patterns.
© 2015 The Society for Research in Child Development, Inc.
Parents' responses to the Carey Infant Temperament Questionnaire and results of a standard interview regarding sleep duration were obtained for 23 Chinese-American and 60 non-Chinese infants. Chinese-American infants were rated as significantly more withdrawing, less adaptable, and more negative in mood than the other infants. Total sleep duration for the Chinese-American infants was 13.2 hours, compared to 14.2 hours for the other infants (p < .05). Night sleep duration had a significant negative correlation with mood ratings in the Chinese-American babies. These findings suggest that there are ethnic differences in infant temperament and that the relationship between negative mood and brief sleep is present among different ethnic groups.
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Both sleep deprivation and poor sleep quality are prominent in American society, especially in college student populations. Sleep problems are often a primary disorder rather than secondary to depression. The purpose of the present study was to determine if sleep deprivation and/or poor sleep quality in a sample of nondepressed university students was associated with lower academic performance. A significant negative correlation between Global Sleep Quality score (GSQ) on the Pittsburgh Sleep Quality Index and grade point average supports the hypothesis that poor sleep quality is associated with lower academic performance for nondepressed students. Implications for both the remedial (assessment and treatment) and preventive (outreach) work of college and university counseling centers is discussed.
Fifty-two children without significant sleep disturbance seen at a primary care clinic for well-child care were compared on measures of temperament, parenting style, daytime behavior, and overall sleep disturbance to three diagnostic subgroups identified in a pediatric sleep clinic: children with obstructive sleep apnea (n=33), parasomnias (night terrors, sleepwalking, etc.) (n=16), and behavioral sleep disorders (limitsetting disorder, etc.) (n=31). The mean age of the entire sample was 5.7 years. Temperamental emotionality in the behavioral sleep disorders group was associated with a higher level of sleep disturbance (p<.001); parenting laxness was associated with sleep disturbance in the general pediatric population (p<.01); and intense and negative temperament characteristics seemed to be associated with clinically significant behavioral sleep disturbances. Ineffective parenting styles and daytime disruptive behaviors were more likely to be associated with the milder sleep disturbances found in children in a primary care setting. J Dev Behav Pediatr 18:314-321, 1997.
(C) Lippincott-Raven Publishers.
The objective of this study was to investigate the reliability and validity of the Pittsburgh Sleep Quality Index (PSQI) in a non-clinical sample consisting of younger and older adults. There has been little research validating the PSQI with respect to multinight recording as with actigraphy, and more validation is needed in samples not specifically selected for clinical disturbance. Also, the degree to which the PSQI scores may reflect depressive symptoms versus actual sleep disturbance remains unclear. One-hundred and twelve volunteers (53 younger and 59 older) were screened for their ability to perform treadmill exercises; inclusion was not based on sleep disturbance or depression. Internal homogeneity was evaluated by correlating PSQI component scores with the global score. Global and component scores were correlated with a sleep diary, actigraphy, and centers for epidemiological studies - depression scale scores to investigate criterion validity. Results showed high internal homogeneity. PSQI global score correlated appreciably with sleep diary variables and the depression scale, but not with any actigraphic sleep variables. These results suggest that the PSQI has good internal homogeneity, but may be less reflective of actual sleep parameters than a negative cognitive viewpoint or pessimistic thinking. The sleep complaints measured may often be more indicative of general dissatisfaction than of any specifically sleep-related disturbance.
This study investigated the sleep hygiene behaviour of university students within the framework of the Theory of Planned Behaviour (TPB [Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179-211.]), and examined the predictive validity of additional variables including perceived autonomy support, past behaviour and response inhibition. A total of 257 undergraduate students from an Australian university were administered two online questionnaires at two time points. At time 1, participants completed the TPB questionnaire and the Go/NoGo task as a measure of response inhibition. A week later at time 2, participants completed a questionnaire measuring the performance of sleep hygiene behaviours. Multiple and hierarchical regression analyses showed that the TPB model significantly predicted intention and behaviour. Although intention and perceived behavioural control were statistically significant in predicting behaviour, past behaviour and response inhibition accounted for more variance when added to the TPB model. Subjective norm was found to be the strongest predictor of intention implying the importance of normative influences in sleep hygiene behaviours. Response inhibition was the strongest predictor of behaviour, reinforcing the argument that the performance of health protective behaviours requires self-regulatory ability. Therefore, interventions should be targeted at enhancing self-regulatory capacity.
The aim of this study was to determine the association between temperament and sleep in adolescents. Participants included 516 adolescents and their mothers drawn from the community. Findings indicated that as with younger children, sleep and dimensions of temperament (sociability, impulsivity and negative affect) are related in adolescents.
To characterize sleep patterns and predictors of poor sleep quality in a large population of college students. This study extends the 2006 National Sleep Foundation examination of sleep in early adolescence by examining sleep in older adolescents.
One thousand one hundred twenty-five students aged 17 to 24 years from an urban Midwestern university completed a cross-sectional online survey about sleep habits that included the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale, the Horne-Ostberg Morningness-Eveningness Scale, the Profile of Mood States, the Subjective Units of Distress Scale, and questions about academic performance, physical health, and psychoactive drug use.
Students reported disturbed sleep; over 60% were categorized as poor-quality sleepers by the PSQI, bedtimes and risetimes were delayed during weekends, and students reported frequently taking prescription, over the counter, and recreational psychoactive drugs to alter sleep/wakefulness. Students classified as poor-quality sleepers reported significantly more problems with physical and psychological health than did good-quality sleepers. Students overwhelmingly stated that emotional and academic stress negatively impacted sleep. Multiple regression analyses revealed that tension and stress accounted for 24% of the variance in the PSQI score, whereas exercise, alcohol and caffeine consumption, and consistency of sleep schedule were not significant predictors of sleep quality.
These results demonstrate that insufficient sleep and irregular sleep-wake patterns, which have been extensively documented in younger adolescents, are also present at alarming levels in the college student population. Given the close relationships between sleep quality and physical and mental health, intervention programs for sleep disturbance in this population should be considered.
Despite the prevalence of sleep complaints among psychiatric patients, few questionnaires have been specifically designed to measure sleep quality in clinical populations. The Pittsburgh Sleep Quality Index (PSQI) is a self-rated questionnaire which assesses sleep quality and disturbances over a 1-month time interval. Nineteen individual items generate seven "component" scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. The sum of scores for these seven components yields one global score. Clinical and clinimetric properties of the PSQI were assessed over an 18-month period with "good" sleepers (healthy subjects, n = 52) and "poor" sleepers (depressed patients, n = 54; sleep-disorder patients, n = 62). Acceptable measures of internal homogeneity, consistency (test-retest reliability), and validity were obtained. A global PSQI score greater than 5 yielded a diagnostic sensitivity of 89.6% and specificity of 86.5% (kappa = 0.75, p less than 0.001) in distinguishing good and poor sleepers. The clinimetric and clinical properties of the PSQI suggest its utility both in psychiatric clinical practice and research activities.
The major behavioral treatments of insomnia--progressive relaxation, biofeedback, cognitive approaches, stimulus control instructions, chronotherapy, and sleep restriction therapy--are described. The basis of these interventions are conceptualized as issuing from the interdependence of sleep and wakefulness, the temporal organization of sleep-wake processes, cognitive effects on arousal, the role of perpetuating factors in chronic insomnia, and conditioning. A pilot study of the conditioning of rapid sleep onset with the aid of a hypnotic provides a preliminary demonstration of the application of conditioning to the pharmacotherapy of sleep. It is predicted that the commonly accepted view of sleep latency as solely reflecting physiological sleep tendency, will require modification to include the effects of conditioning. The current pattern of hypnotic usage, an issue of widespread concern, is subjected to a behavioral analysis based on a new model of conditioned tolerance. The intermittent administration of placebo within a hypnotic regimen is predicted to be especially beneficial in sustaining hypnotic efficacy.
In a randomly selected series of 60 infants in a single private practice, 15 (25 per cent) had the sleep disturbance of night waking between 6 and 12 months of age. There was a significant correlation (p<0.02) between night woking and the temperamental characteristic of low sensory threshold as determined by a questionnaire technique. Though this problem is usually attributed to illness in the child or faulty management by the parents, the evidence presented here for a temperamental predisposition illustrates the need for a broader perspective in its diagnosis and management.
Parental reports of sleep patterns, ratings on the Behavioral Style Questionnaire, and Conners' Abbreviated Parents' Questionnaire were obtained for 60 three-year-old children. Children who were more adaptable, mild, and positive in mood, or children with an easy temperament, had longer total sleep durations and lower Conners' ratings than children with opposite traits. Adaptability was the temperament characteristic most highly correlated with total sleep duration and the only characteristic which correlated with the number of night wakings. In addition, children with low activity ratings had long total sleep durations, low Conners' ratings, and were described as having a quiet sleep pattern. Long sleep durations and low Conners' ratings appear to be features of children with an easy temperament or low motor activity when awake and asleep.
Infant temperament ratings and parental reports of sleep patterns and sleep durations were obtained on 105 normal infants. Boys with more difficult temperaments and active sleep patterns had brief attention spans compared to the other children (p = 0.005). Among all infants, active sleep pattern was associated with maleness and increased activity ratings when awake (both p less than 0.05). Infants with easy temperaments slept longer than those with difficult temperaments (14.9 +/- 0.2 versus 12.8 +/- 0.5 hours, p less than 0.001). Gender, maternal prenatal smoking, method of feeding, and infant sleep position did not affect attention span ratings or sleep durations.
Parents' responses to the Carey Infant Temperament Questionnaire and results of a standard interview regarding sleep duration were obtained for 23 Chinese-American and 60 non-Chinese infants. Chinese-American infants were rated as significantly more withdrawing, less adaptable, and more negative in mood than the other infants. Total sleep duration for the Chinese-American infants was 13.2 hours, compared to 14.2 hours for the other infants (p less than .05). Night sleep duration had a significant negative correlation with mood ratings in the Chinese-American babies. These findings suggest that there are ethnic differences in infant temperament and that the relationship between negative mood and brief sleep is present among different ethnic groups.
Sleep problems are a common concern of parents with toddlers. Various reasons have been put forward as to the possible causes and maintenance of sleep disruption. These have included neurophysical differences in the child, perinatal differences such as a long labour and depression and anxiety in the parents themselves resulting in adverse effects on the child's sleep patterns. However, recent research has indicated that a child's temperamental style may be a possible causal factor as to whether the child will present its parents with a sleep problem. This study, therefore, sets out to investigate the importance of temperament as a predictor of whether children may or may not have sleep problems. Environmental factors are controlled as far as possible by selecting toddlers with and without sleep problems from very similar environments. Case studies are also introduced to further illuminate other possible associated factors such as parental handling. The results from this study found significant differences in the temperament profiles of children with and without sleep problems. Children with reported sleep problems were more likely to obtain a 'intermediate high to difficult' profile. Various findings from a group of toddlers with and without sleep problems are discussed in this paper together with implications of the findings and recommendations for further research.
Several problems in understanding executive functions and their relationships to the frontal lobes are discussed. Data are then presented from several of our studies to support the following statements: (1) the examination of patients with focal frontal lobe lesions is a necessary first step in defining the relation of executive functions to the frontal lobes; (2) there is no unitary executive function. Rather, distinct processes related to the frontal lobes can be differentiated which converge on a general concept of control functions; (3) a simple control-automatic distinction is inadequate to explain the complexity of control-automatic processes; (4) the distinction between complex and simple tasks cannot explain the differences in functions between the frontal lobes and other brain regions; and (5) the most important role of the frontal lobes may be for affective responsiveness, social and personality development, and self-awareness and unconsciousness.
The authors analyzed the effect of several health behaviors and health-related variables on grade point averages of a random sample of 200 students living in on-campus residence halls at a large private university. The set of variables included exercise, eating, and sleep habits; mood states; perceived stress; time management; social support; spiritual or religious habits; number of hours worked per week; gender; and age. Of all the variables considered, sleep habits, particularly wake-up times, accounted for the largest amount of variance in grade point averages. Later wake-up times were associated with lower average grades. Variables associated with the 1st-year students' higher grade point averages were strength training and study of spiritually oriented material. The number of paid or volunteer hours worked per week was associated with lower average grades.
Experimental data indicate a role for the prefrontal cortex in mediating normal sleep physiology, dreaming and sleep-deprivation phenomena. During nonrandom-eye-movement (NREM) sleep, frontal cortical activity is characterized by the highest voltage and the slowest brain waves compared to other cortical regions. The differences between the self-awareness experienced in waking and its diminution in dreaming can be explained by deactivation of the dorsolateral prefrontal cortex during REM sleep. Here, we propose that this deactivation results from a direct inhibition of the dorsolateral prefrontal cortical neurons by acetylcholine, the release of which is enhanced during REM sleep. Sleep deprivation influences frontal executive functions in particular, which further emphasizes the sensitivity of the prefrontal cortex to sleep.
Recent experimental studies involving total sleep loss, sleep reduction and clinically related sleep fragmentation report impaired performance on tasks of frontal lobe or executive function, including measures of verbal fluency, creativity and planning skills. Severity of sleep disturbance in obstructive sleep apnoea syndrome (OSAS) is correlated with level of executive impairment, with some residual impairment despite treatment (continuous positive airway pressure - CPAP). Executive impairment appears to be more closely related to hypoxaemic events rather than daytime sleepiness. Studies of electroencephalographic (EEG) changes throughout the course of sleep and following sleep deprivation as well as functional neuroimaging and psychophysiological changes (event-related potentials - ERPs) following sleep deprivation provide further indication of the relative importance of the frontal regions of the brain to sleep. However, neurocognitive studies present many inconsistencies, task classification is often ambiguous and, in the absence of any unifying explanation at the level of cognitive mechanisms, the overall picture is one of a disparate range of impairment following sleep loss and sleep fragmentation. Poorly defined concepts of frontal lobe function, executive function, memory and attention, using tasks largely developed with more severe deficit levels in mind, create further difficulties in interpreting current findings.
Sleep hygiene (SH) refers to a list of behaviors, environmental conditions, and other sleep-related factors that can be adjusted as a stand-alone treatment or component of multimodal treatment for patients with insomnia. This paper presents a review of SH, how this concept has been applied and often modified over the past 24 years, and how it relates to the modern sleep disorder nosology, particularly Inadequate Sleep Hygiene. Although a recognized and commonly utilized treatment option, there is no absolute consensus about which steps must be included to constitute SH treatment, and there is much overlap between SH and other cognitive-behavioral treatments for insomnia such as Stimulus Control Procedures and Sleep Restriction Therapy. The literature on the effects of manipulations of individual components of SH under experimental conditions (e.g. effects of presleep alcohol or caffeine intake) in normal sleepers show mixed results. Empirical data demonstrating the role of poor SH as a contributor to insomnia, or showing that good SH improves sleep in patients with insomnia, is not available. Instead of evaluating the impact of a comprehensive list of SH recommendations, a focus on guidelines for use of individual rules is needed.
We examined the role of children's emotional intensity and vagal functioning in predicting sleep problems in healthy elementary school-aged children. Children's dispositional emotionality was examined via parent report, and their vagal regulation was assessed via respiratory sinus arrhythmia (RSA) during a baseline and a reaction time (RT) task. Sleep problems were examined through both child reports, and home monitoring with wrist actigraphs for four consecutive nights. Increased emotional intensity was predictive of a reduced amount of sleep and increased night activity. Less apt vagal regulation, characterized by lower levels of RSA suppression to the RT task, was predictive of increased sleep problems as assessed through both subjective and actigraphy-based measures of sleep. Results indicate that children's emotionality and regulation predict unique variance in the amount and quality of children's sleep, and suggest that they may underlie, at least in part, sleep disturbances in healthy children.
This study sought to assess the relationship between the development of infant sleep/wake patterns, temperament and overall mental, motor and behavioural development over the first year of life. We hypothesised that infants with more regular sleep/wake patterns and longer sleep durations would have an easier temperament and higher developmental scores.
Sleep/wake characteristics were recorded with the use of both parental sleep diary and actigraphy (Actiwatch AW64, Mini Mitter Company Inc, Sunriver, OR, USA) in 20 healthy term infants at monthly intervals over the first year of life. Temperament was assessed using the Early Infant Temperament Questionnaire (EITQ) at 3 months and the Revised Infant Temperament Questionnaire (RITQ) at 6 and 11 months and mental, motor and behavioural development at 12 months using the Bayley Scales of Infant Development II (BSID-II).
At all 3 ages studied increased nocturnal sleep was correlated with increased approachability. In addition, at 11 months increased diurnal sleep duration was also correlated with increased rhythmicity and adaptability. At 12 months of age decreased daytime sleep duration was correlated with emotional regulation.
Our findings highlight the importance of considering maturational and regulatory aspects of sleep when evaluating infant daytime behaviour. We suggest that concerns regarding sleep characteristics should become a significant aspect of clinical assessment and diagnosis of developmental delay or behaviour problems, particularly in the first year of life.
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