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- Creators: Arizona State University
- Creators: Whisner, Corrie
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
The health benefits of physical activity are widely accepted. Emerging research also indicates that sedentary behaviors can carry negative health consequences regardless of physical activity level. This dissertation explored four projects that examined measurement properties of physical activity and sedentary behavior monitors. Project one identified the oxygen costs of four other care activities in seventeen adults. Pushing a wheelchair and pushing a stroller were identified as moderate-intensity activities. Minutes spent engaged in these activities contribute towards meeting the 2008 Physical Activity Guidelines. Project two identified the oxygen costs of common cleaning activities in sixteen adults. Mopping a floor was identified as moderate-intensity physical activity, while cleaning a kitchen and cleaning a bathtub were identified as light-intensity physical activity. Minutes spent engaged in mopping a floor contributes towards meeting the 2008 Physical Activity Guidelines. Project three evaluated the differences in number of minutes spent in activity levels when utilizing different epoch lengths in accelerometry. A shorter epoch length (1-second, 5-seconds) accumulated significantly more minutes of sedentary behaviors than a longer epoch length (60-seconds). The longer epoch length also identified significantly more time engaged in light-intensity activities than the shorter epoch lengths. Future research needs to account for epoch length selection when conducting physical activity and sedentary behavior assessment. Project four investigated the accuracy of four activity monitors in assessing activities that were either sedentary behaviors or light-intensity physical activities. The ActiGraph GT3X+ assessed the activities least accurately, while the SenseWear Armband and ActivPAL assessed activities equally accurately. The monitor used to assess physical activity and sedentary behaviors may influence the accuracy of the measurement of a construct.
ContributorsMeckes, Nathanael (Author) / Ainsworth, Barbara E (Thesis advisor) / Belyea, Michael (Committee member) / Buman, Matthew (Committee member) / Gaesser, Glenn (Committee member) / Wharton, Christopher (Christopher Mack), 1977- (Committee member) / Arizona State University (Publisher)
Created2012
Description
The purpose of this pilot randomized control trial was to test the initial efficacy of a 10 week social cognitive theory (SCT)-based intervention to reduce workplace sitting time (ST). Participants were currently employed adults with predominantly sedentary occupations (n=24) working in the Greater Phoenix area in 2012-2013. Participants wore an activPAL (AP) inclinometer to assess postural allocation (i.e., sitting vs. standing) and Actigraph accelerometer (AG) to assess sedentary time for one week prior to beginning and immediately following the completion of the 10 week intervention. Self-reported measures of sedentary time were obtained via two validated questionnaires for overall (International Physical Activity Questionnaire [IPAQ]) and domain specific sedentary behaviors (Sedentary Behavior Questionnaire [SBQ]). SCT constructs were also measured pre and post via adapted physical activity questionnaires. Participants were randomly assigned to receive either (a) 10 weekly social cognitive-based e-newsletters focused on reducing workplace ST; or (b) similarly formatted 10 weekly e-newsletters focusing on health education. Baseline adjusted Analysis of Covariance statistical analyses were used to examine differences between groups in time spent sitting (AP) and sedentary (AG) during self-reported work hours from pre- to post- intervention. Both groups decreased ST and AG sedentary time; however, no significant differences were observed. SCT constructs also did not change significantly between pretest and post test in either group. These results indicate that individualized educational approaches to decreasing workplace sitting time may not be sufficient for observing long term change in behaviors. Future research should utilize a larger sample, measure main outcomes more frequently, and incorporate more environmental factors throughout the intervention.
ContributorsGordon, Amanda (Author) / Buman, Matthew (Thesis advisor) / Der Ananian, Cheryl (Committee member) / Swan, Pamela (Committee member) / Arizona State University (Publisher)
Created2013
Description
Osteoporosis is a medical condition that leads to decreased bone mineral density, resulting in increased fracture risk.1 Research regarding the relationship between sleep and bone mass is limited and has primarily been studied in elderly adults. While this population is most affected by osteoporosis, adolescents are the most proactive population in terms of prevention. The purpose of this study was to evaluate the relationship between sleep efficiency and serum osteocalcin in college-aged individuals as a means of osteoporosis prevention. Thirty participants ages 18-25 years (22 females, 8 males) at Arizona State University were involved in this cross-sectional study. Data were collected during one week via self-recorded sleep diaries, quantitative ActiWatch, DEXA imaging, and serum blood draws to measure the bone biomarker osteocalcin. Three participants were excluded from the study as outliers. The median (IQR) for osteocalcin measured by ELISA was 11.6 (9.7, 14.5) ng/mL. The average sleep efficiency measured by actigraphy was 88.3% ± 3.0%. Regression models of sleep efficiency and osteocalcin concentration were not statistically significant. While the addition of covariates helped explain more of the variation in serum osteocalcin concentration, the results remained insignificant. There was a trend between osteocalcin and age, suggesting that as age increases, osteocalcin decreases. This was a limited study, and further investigation regarding the relationship between sleep efficiency and osteocalcin is warranted.
ContributorsMarsh, Courtney Nicole (Author) / Whisner, Corrie (Thesis director) / Mahmood, Tara (Committee member) / School of International Letters and Cultures (Contributor) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
Background Osteoporosis is a major health problem that can occur in people of all ages. It can stem from poor bone health during childhood and adolescence. It hinders independent living, impacts social living, reduces participation in physical activity, and increases risk of fractures and physical pain. In addition to age, gender, race, physical activity and diet, sleep is considered to be a risk factor in the development of osteoporosis in both the young and elderly population. Bone-specific alkaline phosphatase, a bone formation biomarker was measured to determine osteoporotic risk while an actigraphy device was used to measure sleep efficiency in college students. Objective The purpose of this study is to evaluate the relationship between sleep efficiency and bone-specific alkaline phosphatase levels. Recognition of any association may help in understanding how sleep is related to bone health. Methods Twenty-seven participants were recruited with the use of flyers distributed on campus and in residential halls, social media, email, and student newsletters. Bone-specific alkaline phosphatase biomarker was measured using human specific enzyme-linked immunosorbent assay (ELISA). Sleep data were collected from participants who wore ActiWatch for 7 days and completed a 7-night sleep diary. Linear and multiple regression analysis were performed to evaluate association between B-ALP (outcome) and sleep efficiency while adjusting for covariates (age, BMI, race, gender). Results and Conclusions Overall, there was no significant association between sleep efficiency and bone-specific alkaline phosphatase. Gender, however, showed a significant influence on the levels of bone-alkaline phosphatase. This is supported by a study that found higher bone turnover marker in males than in females. The result from the study could be due to limitations such as small sample size. More participants may provide a better comparison or association between variables. Genetic factors are believed to influence the outcome of the study as genetics can influence rate of bone loss or formation. Findings may be beneficial for public health and policy initiatives and allow health / nutrition educators to more adequately encourage proper habits such as physical activity, healthy diet and sufficient sleep for good bone health.
ContributorsLadipo, Evelyn Irawola (Author) / Whisner, Corrie (Thesis director) / Mahmood, Tara (Committee member) / School of Life Sciences (Contributor) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
Sleep is imperative for health and wellness with direct impacts on brain function, physiology, emotional well-being, performance and safety when compromised. Adolescents and young adults are increasingly affected by factors affecting the maintenance of regular sleep schedules. College and university students are a potentially vulnerable population to sleep deprivation and sleep insufficiency. Possible factors that could contribute to poor sleep hygiene include, but are not limited to, academic pressures, social activities, and increased screen time. Arguably, students are still experiencing bone mineralization, until the age of 30 or even 40 years old, which makes it more important to understand the effects that altered sleep patterns could have on continued development of bone health. It is our understanding that to date, studies assessing the risk of sleep insufficiency on bone mineral density in college students have not been conducted. We hypothesized that college-aged students, between the ages of 18-25 years, with shorter sleep durations, greater sleep schedule variability, and poorer sleep environments will have significantly lower bone mineral density. ActiGraph monitoring, via a wrist ActiWatch was used to quantitatively measure sleep habits for up to 7 consecutive days. During the week-long study participants also captured their self-reported sleep data through the use of a sleep diary. Participants were measured one time within the study for bone mineral density of the lumbar spine and total hip through a dual energy x-ray absorptiometry. This was a preliminary analysis of a larger cross-sectional analysis looked at 17 participants, of which there were 14 females and 3 males, (n=5, 1 and 11 Hispanic, Black and White, respectively). The mean age of participants was 20.8±1.7 y with an average BMI of 22.9±3.2 kg/m2. ActiWatch measurement data showed a mean daily sleep duration of participants to be 437.5 ± 43.1 (372.5 – 509.4) minutes. Mean sleep efficiency (minutes of sleep divided by minutes of time in bed) and mean number of awakenings were 87.4±4.3 (75.4-93.4) minutes and 32.1±6.4 (22.3-42.7) awakenings, respectively. The median time for wake after sleep onset (WASO) was 34.5±10.5 (18.3-67.4) minutes. The mean bone mineral density (BMD) for the hips was 1.06±0.14 (0.81-1.28) g/cm2 with a mean BMD of the lumbar spine being 1.24±0.12 (0.92-1.43) g/cm2. Age-matched Z-scores of the hips was 0.31±0.96 (-1.6-2.1) and lumbar spine was 0.53 (IQR: 0.13, 0.98; -2.25-1.55). Neither sleep duration nor sleep efficiency was significantly correlated to BMD of either locations. While WASO was positively associated with hip and spine BMD, this value was not statistically significant in this population. Overall, associations between sleep and BMD of the femur and spine were not seen in this cohort. Further work utilizing a larger cohort will allow for control of covariates while looking for potential associations between bone health, sleep duration and efficiency.
ContributorsEsch, Patricia Rose (Author) / Whisner, Corrie (Thesis director) / Petrov, Megan (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05
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