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Article ; Online: Past, Present, and Future of Multisensory Wearable Technology to Monitor Sleep and Circadian Rhythms

Matthew R. Lujan / Ignacio Perez-Pozuelo / Michael A. Grandner

Frontiers in Digital Health, Vol

2021 Volume 3

Abstract: Movement-based sleep-wake detection devices (i.e., actigraphy devices) were first developed in the early 1970s and have repeatedly been validated against polysomnography, which is considered the “gold-standard” of sleep measurement. Indeed, they have ... ...

Abstract	Movement-based sleep-wake detection devices (i.e., actigraphy devices) were first developed in the early 1970s and have repeatedly been validated against polysomnography, which is considered the “gold-standard” of sleep measurement. Indeed, they have become important tools for objectively inferring sleep in free-living conditions. Standard actigraphy devices are rooted in accelerometry to measure movement and make predictions, via scoring algorithms, as to whether the wearer is in a state of wakefulness or sleep. Two important developments have become incorporated in newer devices. First, additional sensors, including measures of heart rate and heart rate variability and higher resolution movement sensing through triaxial accelerometers, have been introduced to improve upon traditional, movement-based scoring algorithms. Second, these devices have transcended scientific utility and are now being manufactured and distributed to the general public. This review will provide an overview of: (1) the history of actigraphic sleep measurement, (2) the physiological underpinnings of heart rate and heart rate variability measurement in wearables, (3) the refinement and validation of both standard actigraphy and newer, multisensory devices for real-world sleep-wake detection, (4) the practical applications of actigraphy, (5) important limitations of actigraphic measurement, and lastly (6) future directions within the field.
Keywords	actigraphy ; heart rate ; photoplethysmography ; wearables ; validation ; Medicine ; R ; Public aspects of medicine ; RA1-1270 ; Electronic computers. Computer science ; QA75.5-76.95
Subject code	290 ; 600
Language	English
Publishing date	2021-08-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Nocturnal leg cramps

Michael A Grandner / John W Winkelman

PLoS ONE, Vol 12, Iss 6, p e

Prevalence and associations with demographics, sleep disturbance symptoms, medical conditions, and cardiometabolic risk factors.

2017 Volume 0178465

Abstract: Nocturnal leg cramps (NLC) are common and poorly understood.To determine the prevalence of NLC and associations with cardiometabolic, sleep, and behavioral risk factors in the US population.Cross-sectional epidemiology.National Health and Nutrition ... ...

Abstract	Nocturnal leg cramps (NLC) are common and poorly understood.To determine the prevalence of NLC and associations with cardiometabolic, sleep, and behavioral risk factors in the US population.Cross-sectional epidemiology.National Health and Nutrition Examination Survey, 2005-2006 and 2007-2008 waves.NLC were assessed with, "In the past month, how often did you have leg cramps while trying to sleep?" Responses were categorized as None, Mild, or Moderate-Severe. Demographics, medical history, sleep disturbances, and cardiometabolic risk factors were evaluated using the 2005-2006 dataset. Variables that demonstrated significant relationships to NLC after adjusting for age, sex, education, and BMI were assessed in the 2007-2008 dataset. Variables that were still significant were entered into a forward stepwise regression model combining both waves, to determine which variables best explained the variance in NLC.Prevalence was 24-25% reporting mild and 6% reporting moderate-severe NLC. NLC increased with age, lower education, unemployment, shorter sleep duration, all assessed sleep symptoms (nocturnal "leg jerks", snoring, snorting/gasping, difficulty falling asleep, difficulty maintaining sleep, non-restorative sleep, sleepiness, use of sleep medications), higher BMI, smoking, medical history (hypertension, heart failure, angina, stroke, arthritis, respiratory disease, and cancer), depression symptoms, and biomarkers (CRP, HbA1c, calcium, cadmium, red blood cells). Stepwise analysis showed that moderate-severe nocturnal leg cramps were associated with (in decreasing order of partial R2): leg jerks, poor overall health, arthritis, difficulty falling asleep, age, nonrestorative sleep, red blood cell count, lower education, angina, and difficulty maintaining sleep.Based on this first large, representative study, NLC occurring >5x per month are reported by 6% of the adult US population. Sleep disturbance symptoms and health conditions are associated with higher frequency of NLC, suggesting that NLC is a marker, and ...
Keywords	Medicine ; R ; Science ; Q
Subject code	610
Language	English
Publishing date	2017-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A Randomized, Double-Blind, Placebo-Controlled Trial of a Polyphenol Botanical Blend on Sleep and Daytime Functioning

Andrew S. Tubbs / Kathryn E. R. Kennedy / Pamela Alfonso-Miller / Chloe C. A. Wills / Michael A. Grandner

International Journal of Environmental Research and Public Health, Vol 18, Iss 3044, p

2021 Volume 3044

Abstract: Despite the high prevalence of subclinical sleep disturbances, existing treatments are either potent prescription medications or over-the-counter supplements with minimal scientific support and numerous side effects. However, preliminary evidence shows ... ...

Abstract	Despite the high prevalence of subclinical sleep disturbances, existing treatments are either potent prescription medications or over-the-counter supplements with minimal scientific support and numerous side effects. However, preliminary evidence shows that polyphenols such as rosmarinic acid and epigallocatechin gallate can support healthy sleep without significant side effects. Therefore, the present study examined whether a polyphenol botanical blend (PBB) could improve sleep and/or daytime functioning in individuals with subclinical sleep disturbances. A total of 89 individuals completed a double-blind, randomized trial of daily treatment with PBB ( n = 43) or placebo ( n = 46) 30 min before bed for 30 days. Participants were monitored for changes in sleep (by sleep diary and an activity tracker), mood, and neurocognitive functioning. After 30 days, PBB improved diary sleep quality ( p = 0.008) and reduced insomnia severity ( p = 0.044) when compared to placebo. No other changes in sleep outcomes were observed. Additionally, PBB did not impair neurocognitive functioning, and some improvement was noted in vigilant attention, working memory, and risk assessment. Among individuals with subclinical sleep disturbances, PBB improved sleep quality, insomnia severity, and neurocognitive functioning over placebo. These findings indicate that polyphenol compounds may be useful for improving certain aspects of sleep without compromising neurocognitive functioning.
Keywords	nutrition ; sleep quality ; polyphenol ; cognition ; dietary supplement ; Medicine ; R
Subject code	610
Language	English
Publishing date	2021-03-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Associations between poor sleep quality and stages of change of multiple health behaviors among participants of employee wellness program

Siu-kuen Azor Hui / Michael A. Grandner

Preventive Medicine Reports, Vol 2, Iss C, Pp 292-

2015 Volume 299

Abstract: Objective: Using the Transtheoretical Model of behavioral change, this study evaluates the relationship between sleep quality and the motivation and maintenance processes of healthy behavior change. Methods: The current study is an analysis of data ... ...

Abstract	Objective: Using the Transtheoretical Model of behavioral change, this study evaluates the relationship between sleep quality and the motivation and maintenance processes of healthy behavior change. Methods: The current study is an analysis of data collected in 2008 from an online health risk assessment (HRA) survey completed by participants of the Kansas State employee wellness program (N = 13,322). Using multinomial logistic regression, associations between self-reported sleep quality and stages of change (i.e. precontemplation, contemplation, preparation, action, maintenance) in five health behaviors (stress management, weight management, physical activities, alcohol use, and smoking) were analyzed. Results: Adjusted for covariates, poor sleep quality was associated with an increased likelihood of contemplation, preparation, and in some cases action stage when engaging in the health behavior change process, but generally a lower likelihood of maintenance of the healthy behavior. Conclusions: The present study demonstrated that poor sleep quality was associated with an elevated likelihood of contemplating or initiating behavior change, but a decreased likelihood of maintaining healthy behavior change. It is important to include sleep improvement as one of the lifestyle management interventions offered in EWP to comprehensively reduce health risks and promote the health of a large employee population.
Keywords	Multiple health behaviors change ; Transtheoretical model ; Sleep quality ; Employee wellness programs ; Medicine ; R
Subject code	796
Language	English
Publishing date	2015-01-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Culturally-consistent diet among individuals of Mexican descent at the US-Mexico border is associated with sleep duration and snoring

Sadia B. Ghani / Krishna Taneja / Chloe C. A. Wills / Andrew S. Tubbs / Marcos E. Delgadillo / Dora Valencia / Mohamed Halane / William D. S. Killgore / Michael A. Grandner

BMC Nutrition, Vol 7, Iss 1, Pp 1-

2021 Volume 9

Abstract: Abstract Background Existing studies show that consuming food consistent with one’s culture reduces cardiometabolic risk. However, few studies have assessed whether these dietary choices influence sleep health. Accordingly, this study assessed how ... ...

Abstract	Abstract Background Existing studies show that consuming food consistent with one’s culture reduces cardiometabolic risk. However, few studies have assessed whether these dietary choices influence sleep health. Accordingly, this study assessed how Mexican food consumption by individuals of Mexican descent residing at the US-Mexico border, was associated with various measures of sleep, after accounting for acculturation. Methods Data were provided by 100 adults between the ages of 18–60, in the city of Nogales, AZ. Questionnaires were provided in either Spanish or English. Acculturation was assessed with the Acculturation Scale for Mexican-Americans (ARSMA-II), with an additional question, asking how often “my family cooks Mexican foods.” Frequency of cooking Mexican food was coded as either “yes” or “no.” Sleep was assessed, using validated measures that include the Insomnia Severity Index (ISI), the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index (PSQI), and sleep duration with the item “how many hours of actual sleep did you get at night?” Regression models estimated the associations between sleep health variables as outcomes and consumption of Mexican food as the independent variable. Covariates included age, sex, and acculturation scores. Parental education level was also included, as an indicator of childhood socioeconomic status and since food culture likely involves parents. Result We found that among individuals who identified as Mexican-Americans who consumed culturally-consistent foods, was associated with, on average, 1.41 more hours of sleep (95% CI 0.19, 2.62; p = 0.024) and were less likely to report snoring (OR: 0.25; 95% CI 0.07, 0.93; p = 0.039). Consuming Mexican food was not associated with sleep quality, insomnia severity or sleepiness. Conclusion Individuals of Mexican descent residing at the US-Mexico border who regularly consumed Mexican food, reported more sleep and less snoring. Mexican acculturation has been shown previously to improve sleep health. This is likely due ...
Keywords	Sleep duration ; Cultural food ; Sleep health ; Snoring ; Border health disparities ; Nutrition. Foods and food supply ; TX341-641 ; Food processing and manufacture ; TP368-456 ; Medicine (General) ; R5-920
Subject code	360
Language	English
Publishing date	2021-08-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Why Treat Insomnia?

Michael L. Perlis / Wilfred R. Pigeon / Michael A. Grandner / Todd M. Bishop / Dieter Riemann / Jason G. Ellis / Joseph R. Teel / Donn A. Posner

Journal of Primary Care & Community Health, Vol

2021 Volume 12

Abstract: Why treat insomnia?” This question grows out of the perspective that insomnia is a symptom that should only receive targeted treatment when temporary relief is needed or until more comprehensive gains may be achieved with therapy for the parent or ... ...

Abstract	“Why treat insomnia?” This question grows out of the perspective that insomnia is a symptom that should only receive targeted treatment when temporary relief is needed or until more comprehensive gains may be achieved with therapy for the parent or precipitating medical or psychiatric disorders. This perspective, however, is untenable given recent data regarding the prevalence, course, consequences, and costs of insomnia. Further, the emerging data that the treatment of insomnia may promote better medical and mental health (alone or in combination with other therapies) strongly suggests that the question is no longer “why treat insomnia,” but rather “when isn’t insomnia treatment indicated?” This perspective was recently catalyzed with the American College of Physicians’ recommendation that chronic insomnia should be treated and that the first line treatment should be cognitive-behavioral therapy for insomnia (CBT-I).
Keywords	Computer applications to medicine. Medical informatics ; R858-859.7 ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2021-05-01T00:00:00Z
Publisher	SAGE Publishing
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Patient Engagement and Provider Effectiveness of a Novel Sleep Telehealth Platform and Remote Monitoring Assessment in the US Military

Emerson M Wickwire / Jacob Collen / Vincent F Capaldi / Scott G Williams / Samson Z Assefa / Julianna P Adornetti / Kathleen Huang / Janet M Venezia / Rachell L Jones / Christine W Johnston / Connie Thomas / Mary Ann Thomas / Charles Mounts / Christopher L Drake / Michael S Businelle / Michael A Grandner / Rachel Manber / Jennifer S Albrecht

JMIR Formative Research, Vol 7, p e

Pilot Study Providing Evidence-Based Sleep Treatment Recommendations

2023 Volume 47356

Abstract: BackgroundSleep problems are common and costly in the US military. Yet, within the military health system, there is a gross shortage of trained specialist providers to address sleep problems. As a result, demand for sleep medicine care far exceeds the ... ...

Abstract	BackgroundSleep problems are common and costly in the US military. Yet, within the military health system, there is a gross shortage of trained specialist providers to address sleep problems. As a result, demand for sleep medicine care far exceeds the available supply. Telehealth including telemedicine, mobile health, and wearables represents promising approaches to increase access to high-quality and cost-effective care. ObjectiveThe purpose of this study was to evaluate patient engagement and provider perceived effectiveness of a novel sleep telehealth platform and remote monitoring assessment in the US military. The platform includes a desktop web portal, native mobile app, and integrated wearable sensors (ie, a commercial off-the-shelf sleep tracker [Fitbit]). The goal of the remote monitoring assessment was to provide evidence-based sleep treatment recommendations to patients and providers. MethodsPatients with sleep problems were recruited from the Internal Medicine clinic at Walter Reed National Military Medical Center. Patients completed intensive remote monitoring assessments over 10 days (including a baseline intake questionnaire, daily sleep diaries, and 2 daily symptom surveys), and wore a Fitbit sleep tracker. Following the remote monitoring period, patients received assessment results and personalized sleep education in the mobile app. In parallel, providers received a provisional patient assessment report in an editable electronic document format. Patient engagement was assessed via behavioral adherence metrics that were determined a priori. Patients also completed a brief survey regarding ease of completion. Provider effectiveness was assessed via an anonymous survey. ResultsIn total, 35 patients with sleep problems participated in the study. There were no dropouts. Results indicated a high level of engagement with the sleep telehealth platform, with all participants having completed the baseline remote assessment, reviewed their personalized sleep assessment report, and completed the ...
Keywords	Medicine ; R
Subject code	629
Language	English
Publishing date	2023-11-01T00:00:00Z
Publisher	JMIR Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Publications Are Not the Finish Line

Farah R. W. Kools / Sara Mirali / Stephanie Holst-Bernal / Sanne L. Nijhof / Giulio Cavalli / Michael A. Grandner

Frontiers in Medicine, Vol

Focusing on Societal Rather Than Publication Impact

2018 Volume 5

Keywords	publication ; society ; impact ; accountability ; evaluation ; translational medicine ; Medicine (General) ; R5-920
Language	English
Publishing date	2018-11-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Acculturation Associated with Sleep Duration, Sleep Quality, and Sleep Disorders at the US–Mexico Border

Sadia B. Ghani / Marcos E. Delgadillo / Karla Granados / Ashley C. Okuagu / Pamela Alfonso-Miller / Orfeu M. Buxton / Sanjay R. Patel / John Ruiz / Sairam Parthasarathy / Patricia L. Haynes / Patricia Molina / Azizi Seixas / Natasha Williams / Girardin Jean-Louis / Michael A. Grandner

International Journal of Environmental Research and Public Health, Vol 17, Iss 7138, p

2020 Volume 7138

Abstract: Sleep disparities exist among Hispanics/Latinos, although little work has characterized individuals at the United States (US)–Mexico border, particularly as it relates to acculturation. This study examined the association of Anglo and Mexican ... ...

Abstract	Sleep disparities exist among Hispanics/Latinos, although little work has characterized individuals at the United States (US)–Mexico border, particularly as it relates to acculturation. This study examined the association of Anglo and Mexican acculturation to various facets of sleep health among those of Mexican descent at the US–Mexico border. Data were collected from N = 100 adults of Mexican descent in the city of Nogales, Arizona (AZ). Surveys were presented in English or Spanish. Acculturation was assessed with the Acculturation Scale for Mexican-Americans (ARSMA-II). Insomnia was assessed with the Insomnia Severity Index (ISI), sleepiness was assessed with the Epworth Sleepiness Scale (ESS), sleep apnea risk was assessed with the Multivariable Apnea Prediction (MAP) index, weekday and weekend sleep duration and efficiency were assessed with the Sleep Timing Questionnaire, sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI), and sleep duration and sleep medication use were assessed with PSQI items. No associations were found between Mexican acculturation and any sleep outcomes in adjusted analyses. Anglo acculturation was associated with less weekend sleep duration and efficiency, worse insomnia severity and sleep quality, and more sleep apnea risk and sleep medication use. These results support the idea that sleep disparities may depend on the degree of acculturation, which should be considered in risk screening and interventions.
Keywords	acculturation ; sleep ; sleep disparities ; Hispanic/Latino ; health disparities ; sleep duration ; Medicine ; R
Subject code	610
Language	English
Publishing date	2020-09-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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