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- Creators: Arizona State University
Description
Health-related quality of life (HR-QOL) is a significant treatment outcome for persons with end-stage renal disease (ESRD); however, little is known about the HR-QOL of Mexican patients with ESRD. This pilot study describes relationships between demographics, sleep disorders, spirituality, mood, folk practices and dialysis modality on the HR-QOL of patients with ESRD residing in Guanajuato, Mexico. Mexican patients receiving continuous ambulatory peritoneal dialysis (CAPD), automated peritoneal dialysis (APD) and hemodialysis (HD) provided information on demographics, clinical health data including body mass index (BMI), and folk health practices. Measures included the Short Form (SF)-36 HR-QOL survey, Sleep Habits Questionnaire, Latin Spirituality Perspective Scale and Hospital Anxiety and Depression Scale. Data were analyzed using SAS software (V9.1). Signifi¬cance level for this pilot study was set at p<0.10. The Quality-Adjusted Life Year method was utilized to examine cost effectiveness for each dialysis modality. Demographics and clinical data showed participants (N=121) to be 59 (SD=13) years, predominantly men (55.4%), married (66.9%), Catholic (92.6%), and not currently working (78.3%). The majority were diabetic (72%) and slightly overweight (BMI M=26.1; SD=5.1). The CAPD group (n=39) demonstrated significantly lower HR-QOL scores compared to the APD (n=42) and HD (n=40) groups. Patients on HD reported higher rates and greater numbers of sleep disorders, including insomnia symptoms, non-restorative and insufficient sleep, and daytime somnolence compared to patients on CAPD and APD. Patients on CAPD reported more anxiety and depression compared to patients on HD and APD. Overall linear regression for HR-QOL found dialysis type, sleep disorders and income to be significant predictors and the model accounted for 31% of the variance. Cost analysis indicated APD as the preferred treatment because it is less costly and results in the best HR-QOL compared to the other treatment modalities. Findings provide the first SF-36 norms for Mexicans with ESRD. Sleep disorders and dialysis type greatly impinge on the HR-QOL of these patients, particularly their mental health. APD was identified as the preferred treatment based on low cost and improved HR-QOL. Results can inform clinical care and health policy for Mexican patients with ESRD.
ContributorsReynaga-Ornelas, Luxana (Author) / Baldwin, Carol M. (Thesis advisor) / Quan, Stuart F (Committee member) / Arcoleo, Kimberly (Committee member) / Arizona State University (Publisher)
Created2011
Description
How early life is experienced and perceived can greatly affect mental and physical health outcomes. An individual is greatly influenced by their first models of what social relationships look and feel like, and with time also learn how to survive when less favorable social experiences occur. The lessons learned may lead to healthy problem solving and resilience, or it may lead to unhealthy problem-solving habits that hinder well-being. Anxious thoughts and other mental health symptoms may accompany an individual long-term and hinder an essential need for a healthy life. The first main purpose of this thesis is to examine the impact of Adverse Childhood Experiences (ACEs) on mental health (anxiety symptoms), and on sleep quality (an essential need). The second purpose of my thesis is to investigate the impact of genetics on resilience, specifically, the mu-opioid receptor gene. The first hypothesis proposed ACEs that were perceived as more traumatic and occurred more frequently would be associated with more poor sleep quality symptoms. The second hypothesis predicted that anxiety symptoms would mediate the association. The third hypothesis (exploratory) suggested that an individual’s alleles for the mu-opioid receptor gene would moderate the mediation pathway. The study was conducted with 318 participants between the ages of 18 and 35 years old. The study demonstrated a direct effect for ACEs and sleep. Anxiety mediated the association between ACEs (exposure and severity) and sleep (insomnia, quality, sleepiness), suggesting that ACEs possibly increase feelings of anxiety which, in turn, lead to worse sleep outcomes. Finally, the moderated-mediation model with OPRM1 as the moderator, was not significant for the mediation pathway A; however, there was a significant interaction with anxiety and sleep symptoms.
ContributorsBailey, Elise (Author) / Mickelson, Kristin (Thesis advisor) / Burleson, Mary (Committee member) / Petrov, Megan (Committee member) / Arizona State University (Publisher)
Created2022
Description
The relationship between sleep and physical activity is an area of growing scientific interest, particularly in the context of older adults. The importance of examining long sleep duration and its influence on physical activity in this demographic becomes increasingly relevant given rising healthcare costs. This dissertation aims to investigate this intricate relationship via secondary analysis by examining the effects of moderate time-in-bed (TIB) restriction (60 minutes per night)) on various intensities of physical activity (sedentary, light, moderate, vigorous, moderate-vigorous physical activity) in older adults classified as long sleepers and average duration sleepers. It was hypothesized that moderate TIB restriction would result in differential changes in physical activity levels across various intensities, with long sleepers exhibiting increased physical activity and average sleepers displaying decreased activity, potentially influenced by alterations in TST (total sleep time) and SE (sleep efficiency). Utilizing a randomized controlled trial design, this study examined the effect of treatment changes in objectively measures activity (waist actigraphy) and subjects physical activity levels as measured by the Godin Leisure-Time Exercise Questionnaire . Eligible participants were long sleepers (sleeping > 9 hours per night) and average sleepers (sleeping 7-9 hours per night). Both types of sleepers were either randomized to TIB restriction or asked to maintain their average sleep patterns. Mean TIB restriction compared with baseline was 39.5 minutes in average sleepers and 52.9 minutes in long sleepers randomized to TIB restriction . Contrary to the original hypothesis, no significant effect of TIB restriction was observed across all physical activity levels in either long sleepers or average sleepers. However, a notable association was found between increased sleep efficiency (+0.09% [SD = ± 4.64%]) and light physical activity (±31 minutes [SD = ± 104.81, R=0.445, P < 0.007]) in long sleepers undergoing TIB restriction. While this study presents several methodological limitations, including its nature as a secondary analysis and the less-than-intended achievement of TIB restriction, it adds a valuable layer to the existing body of research on sleep and physical activity in older adults. The findings suggest that moderate TIB restriction may not be sufficiently impactful to change behavior in physical activity levels, thus highlighting the need for more nuanced, targeted research in this domain.
ContributorsPerry, Christopher (Author) / Youngstedt, Shawn D (Thesis advisor) / Petrov, Megan (Committee member) / Swan, Pamela (Committee member) / Buman, Matthew (Committee member) / Ringenbach, Shannon (Committee member) / Arizona State University (Publisher)
Created2023
Description
This dissertation combines three first-author manuscripts that focused broadly on the study of adolescent sleep within a family context (Sasser et al., 2021; Sasser & Oshri, 2023; Sasser et al., 2023). First, Chapter 1 introduces the theoretical background and empirical research that grounded the research questions and hypotheses explored across the studies. The first study (Chapter 2) examined the influence of family connection on actigraphy-measured sleep among Latinx late adolescents and explored family dynamics and cultural values as potential moderators. The second study (Chapter 3) investigated daily and average concordance between parent and youth actigraphy-measured sleep and how this varied as a function of family context (e.g., parenting, family functioning). The third study (Chapter 4) examined concordance in actigraphy sleep among parent-youth and sibling dyads and explored how relations differed across zygosity type and sleeping arrangements. The dissertation concludes with an immersive discussion (Chapter 5) that summarizes the key differences, similarities, and takeaways across studies and highlights future directions and implications for developmental science, public policy, and clinical interventions. Collectively, this dissertation contributes to the understanding of youth and adolescent sleep within a family context by identifying proximal (e.g., daily interactions with parents/siblings) and broader family-level factors (e.g., dynamics, culture) that may help promote more healthful sleep among both adolescents and their family members.
ContributorsSasser, Jeri (Author) / Doane, Leah D (Thesis advisor) / Su, Jinni (Committee member) / Grimm, Kevin J (Committee member) / Lemery-Chalfant, Kathryn (Committee member) / Arizona State University (Publisher)
Created2023
Description
The control, function, and evolution of sleep in animals has received little attention compared to many other fitness-relevant animal behaviors. Though natural selection has largely been thought of as the driving evolutionary force shaping sleep biology, sexual and social selection may also have transformative effects on sleep quantity and quality in animals. An overarching hypothesis is that increased levels of investment into inter-sexual choice and intra-sexual competition will reduce sleep. An alternative hypothesis is that sexual ornamentation (e.g. avian plumage coloration and song) may have evolved to communicate sleep health and may therefore be positively related to sleep investment. In this dissertation, I studied how sleep is related to components of sexual and social selection in animals (mostly in birds). I first reviewed the literature for empirical examples of how social and sexual selection drive animal sleep patterns and found support for this relationship in some common types of inter-individual interactions (e.g. mating, intra-sexual competition, parent-offspring interactions, group interactions); I also provided new ideas and hypotheses for future research. I then tested associations between sleep behavior with expression of ornaments (song and plumage coloration), using the house finch (Haemorhous mexicanus) as a model system. For both color and song, I found support for the hypothesis that individuals with exaggerated ornaments slept deeper and longer, suggesting that sleep is a critical resource for ornament elaboration and/or may be communicated by both types of sexual signal. Following this, I tested the phylogenetic association between sleep and social/sexual selection as well as other life-history traits across birds. I found that more territorial bird species sleep less, that polygynous birds sleep more than monogamous and polygynandrous birds, and that birds migrating longer distances sleep less and have less REM sleep. Finally, in the interest of applying basic knowledge about sleep biology to current global problems, I found support for the hypothesis that house finches from city environments have developed resilience to artificial light pollution at night. Altogether, I found that social, sexual, and life-history traits are indeed important and overlooked drivers of sleep behavior from multiple levels of analysis.
ContributorsHutton, Pierce (Author) / McGraw, Kevin J (Thesis advisor) / Rutowski, Ronald L (Committee member) / Deviche, Pierre J (Committee member) / Sweazea, Karen L (Committee member) / Lesku, John A (Committee member) / Arizona State University (Publisher)
Created2021
Description
Chronic pain is common during childhood and has negative immediate and long-term implications for physical and mental health. Prior research points to physical activity and sleep as protective health-promoting behaviors predicting lower chronic pain intensity and disability during adulthood. No study has yet examined the interaction of physical activity and sleep parameters in prediction of chronic pain in a community sample of children. Guided by the biopsychosocial model of pediatric chronic pain, this study explored objectively assessed physical activity and sleep patterns at age 8 as predictors of childhood chronic pain at age 9 in a racially/ethnically and socioeconomically diverse sample of 896 twins participating in the longitudinal Arizona Twin Project. It was hypothesized that parameters of physical activity levels and sleep health would independently predict chronic pain one year later, and that sleep parameters would moderate the association between physical activity and chronic pain. Monthly chronic pain was common, with 57.1% of participants reporting at least one pain location. Headaches, stomachaches, and backaches were the most frequent chronic pain presentations. Participants exceeded physical activity guidelines but did not meet sleep recommendations for their age group. Multilevel modeling analyses revealed that physical activity and sleep parameters at age 8 did not predict chronic pain one year later, and that sleep parameters did not moderate the associations between physical activity and chronic pain. The present study provides evidence that the associations between objectively assessed physical activity and sleep and chronic pain are not yet evident during middle childhood in this community sample compared to patient samples who have existing pain, suggesting that these health behaviors may play distinct roles in pain development versus pain management. They also point to the need to pinpoint the time frame during which these health behaviors become relevant and potentially interact to predict chronic pain development and maintenance. Longitudinal research tracking these health behaviors and pain using both subjective and objective methods as children transition into and through adolescence can help to identify optimal developmental stages at which to target prevention and intervention efforts to promote long term health.
ContributorsBartsch, Eva Marie (Author) / Davis, Mary C (Thesis advisor) / Doane, Leah D (Committee member) / Lemery-Chalfant, Kathryn (Committee member) / Arizona State University (Publisher)
Created2023
Description
Food insecurity affects more than 10 million households in the United States and has been shown to impact what and how a child is fed. Additionally, there is some evidence to suggest that food insecurity may affect how an infant is soothed (either with food or another mechanism), but no study has examined the possible relationship between soothing techniques and the incidence of food insecurity. To evaluate whether food security status and nighttime soothing techniques have a relationship, surveys were administered to a sample of mothers from various racial and socioeconomic backgrounds at 3-weeks, 8-weeks, and 3-months postpartum. Of the 69 participants sampled, 61 had data that could contribute to evaluations of food security status and soothing techniques used at night. A chi-square model was utilized to determine what, if any, relationship existed between the two variables. The chi-square model did not yield statistically significant results (Pearson Chi-Square= .506, p=.477) and descriptive statistics showed that just six of the 61 participants sampled did not use food to soothe at the time their baby was 3-weeks-old. Further examination of descriptive statistics revealed that, between breastfeeding and bottle-feeding as a means to soothe an infant, breastfeeding was used twice as much as bottle-feeding. For participants enrolled in the Special Supplemental Nutrition Program for Women, Infants, Children (WIC), the use of food to soothe increased at each of the three time points. Among participants found to be food-insecure, the use of breastfeeding and bottle-feeding as means to soothe varied from time point to time point. The physical and mental toll of the postpartum period may contribute to the high use of food-to-soothe among mothers seen in this study. Future research efforts in this area should examine whether the observations reported in this study are similar among larger samples, and if more mental health support for mothers has any effect on whether food is used to soothe.
ContributorsKoelbel, Megan (Author) / Whisner, Corrie (Thesis advisor) / Petrov, Megan (Committee member) / Bruening, Meg (Committee member) / Arizona State University (Publisher)
Created2023
Description
Sleep is an essential human function. Modern day society has made it so that sleep is prioritized less and less. Professionals in critical positions such as doctors, nurses, and emergency medical technicians can often have hectic schedules that are unforgiving toward sleep due to the increase in shift work that dominates these fields. Sleep deficits can have detrimental effects on one’s psyche and mood. Depression and anxiety both have high comorbidity rates with insomnia because of sleeping deficits. Transdermal Electrical Nerve Stimulation (TENS) offers a potential solution to improving sleep quality and mood by modulating the ascending reticular activating system (RAS). This system starts in the anterior portion of the head with trigeminal nerve branches and is stimulated using a 500-550 Hz waveform.
In this experiment Positive Affect and Negative Affect Schedule (PANAS) scores are recorded daily to monitor mood differences between pre and post treatment (TENS vs Sham). PANAS scores were found to be insignificant between groups. Pittsburgh Sleep Quality Index (PSQI), and Fitbit were chosen to study perceived sleep, and objective sleep. Both PSQI, and Fitbit found insignificant differences between TENS and Sham. Finally, the Beck Depression and Beck Anxiety Inventories were administered weekly to determine if there are immediate changes to depressive and anxiety symptom, after a week of treatment (TENS vs Sham). A significant difference was found between the pre and post of the TENS treatment group. The TENS group was not found to be significantly different from Sham, potentially the result of a placebo effect. These results were found with n=10 participants in the TENS treatment group and n=6 in the sham group.
In this experiment Positive Affect and Negative Affect Schedule (PANAS) scores are recorded daily to monitor mood differences between pre and post treatment (TENS vs Sham). PANAS scores were found to be insignificant between groups. Pittsburgh Sleep Quality Index (PSQI), and Fitbit were chosen to study perceived sleep, and objective sleep. Both PSQI, and Fitbit found insignificant differences between TENS and Sham. Finally, the Beck Depression and Beck Anxiety Inventories were administered weekly to determine if there are immediate changes to depressive and anxiety symptom, after a week of treatment (TENS vs Sham). A significant difference was found between the pre and post of the TENS treatment group. The TENS group was not found to be significantly different from Sham, potentially the result of a placebo effect. These results were found with n=10 participants in the TENS treatment group and n=6 in the sham group.
ContributorsUdave, Ceasar (Author) / Tyler, William J (Thesis advisor) / Buneo, Christopher (Committee member) / Wyckoff, Sarah (Committee member) / Arizona State University (Publisher)
Created2018
Description
Reproduction is energetically costly and seasonal breeding has evolved to capitalize on predictable increases in food availability. The synchronization of breeding with periods of peak food availability is especially important for small birds, most of which do not store an extensive amount of energy. The annual change in photoperiod is the primary environmental cue regulating reproductive development, but must be integrated with supplementary cues relating to local energetic conditions. Photoperiodic regulation of the reproductive neuroendocrine system is well described in seasonally breeding birds, but the mechanisms that these animals use to integrate supplementary cues remain unclear. I hypothesized that (a) environmental cues that negatively affect energy balance inhibit reproductive development by acting at multiple levels along the reproductive endocrine axis including the hypothalamus (b) that the availability of metabolic fuels conveys alterations in energy balance to the reproductive system. I investigated these hypotheses in male house finches, Haemorhous mexicanus, caught in the wild and brought into captivity. I first experimentally reduced body condition through food restriction and found that gonadal development and function are inhibited and these changes are associated with changes in hypothalamic gonadotropin-releasing hormone (GnRH). I then investigated this neuroendocrine integration and found that finches maintain reproductive flexibility through modifying the release of accumulated GnRH stores in response to energetic conditions. Lastly, I investigated the role of metabolic fuels in coordinating reproductive responses under two different models of negative energy balance, decreased energy intake (food restriction) and increased energy expenditure (high temperatures). Exposure to high temperatures lowered body condition and reduced food intake. Reproductive development was inhibited under both energy challenges, and occurred with decreased gonadal gene expression of enzymes involved in steroid synthesis. Minor changes in fuel utilization occurred under food restriction but not high temperatures. My results support the hypothesis that negative energy balance inhibits reproductive development through multilevel effects on the hypothalamus and gonads. These studies are among the first to demonstrate a negative effect of high temperatures on reproductive development in a wild bird. Overall, the above findings provide important foundations for investigations into adaptive responses of breeding in energetically variable environments.
ContributorsValle, Shelley (Author) / Deviche, Pierre (Thesis advisor) / McGraw, Kevin (Committee member) / Orchinik, Miles (Committee member) / Propper, Catherine (Committee member) / Sweazea, Karen (Committee member) / Arizona State University (Publisher)
Created2018
Description
No studies have evaluated the impact of tracking resting energy expenditure (REE) and modifiable health behaviors on gestational weight gain (GWG). In this controlled trial, pregnant women aged >18 years (X=29.8±4.9 years) with a gestational age (GA) <17 weeks were randomized to Breezing™ (N=16) or control (N=12) for 13 weeks. The Breezing™ group used a real-time metabolism tracker to obtain REE. Anthropometrics, diet, and sleep data were collected every 2 weeks. Rate of GWG was calculated as weight gain divided by total duration. Early (GA weeks 14-21), late (GA weeks 21-28), and overall (GA week 14-28) changes in macronutrients, sleep, and GWG were calculated. Mediation models were constructed using SPSS PROCESS macro using a bootstrap estimation approach with 10,000 samples. The majority of women were non-Hispanic Caucasian (78.6%). A total of 35.7% (n=10), 35.7% (n=10), and 28.6% (n=8) were normal weight, overweight, and obese, respectively, with 83.3% (n=10) and 87.5% (n=14) of the Control and Breezing™ groups gaining above IOM GWG recommendations. At baseline, macronutrient consumption did not differ. Overall (Breezing™ vs. Control; M diff=-349.08±150.77, 95% CI: -660.26 to -37.90, p=0.029) and late (M diff=-379.90±143.89, 95% CI:-676.87 to -82.93, p=0.014) changes in energy consumption significantly differed between the groups. Overall (M diff=-22.45±11.03, 95% CI: -45.20 to 0.31, p=0.053), late (M diff=-23.16±11.23, 95% CI: -46.33 to 0.01, p=0.05), and early (M diff=20.3±10.19, 95% CI: -0.74 to 41.34, p=0.058) changes in protein differed by group. Nocturnal total sleep time differed by study group (Breezing vs. Control; M diff=-32.75, 95% CI: -68.34 to 2.84, p=0.069). There was a 11.5% increase in total REE throughout the study. Early changes in REE (72±211 kcals) were relatively small while late changes (128±294 kcals) nearly doubled. Interestingly, early changes in REE demonstrated a moderate, positive correlation with rates of GWG later in pregnancy (r=0.528, p=0.052), suggesting that REE assessment early in pregnancy may help predict changes in GWG. Changes in macronutrients did not mediate the relationship between the intervention and GWG, nor did sleep mediate relationships between dietary intake and GWG. Future research evaluating REE and dietary composition throughout pregnancy may provide insight for appropriate GWG recommendations.
ContributorsVander Wyst, Kiley Bernhard (Author) / Whisner, Corrie M (Thesis advisor) / Reifsnider, Elizabeth G. (Committee member) / Petrov, Megan E (Committee member) / Buman, Matthew (Committee member) / Shaibi, Gabriel Q (Committee member) / Arizona State University (Publisher)
Created2019