Sleep inequities and associations between poor sleep and mental health for school-aged children: findings from the New Zealand Health Survey

In Aotearoa/New Zealand, ethnic inequities in sleep health exist for young children and adults and are largely explained by inequities in socioeconomic deprivation. Poor sleep is related to poor mental health for these age groups but whether sleep inequities and associations with mental health exist for school-aged children is unclear. We aimed to (1) determine the prevalence of poor sleep health including sleep problems by ethnicity, (2) examine social determinants of health associated with poor sleep, and (3) investigate relationships between poor sleep and mental health for 5-14-year-olds using cross-sectional New Zealand Health Survey data (n = 8895). Analyses included weighted prevalence estimates and multivariable logistic regression. Short sleep was more prevalent for Indigenous Māori (17.6%), Pacific (24.5%), and Asian (18.4%) children, and snoring/noisy breathing during sleep was more prevalent for Māori (29.4%) and Pacific (28.0%) children, compared to European/Other (short sleep 10.2%, snoring/noisy breathing 17.6%). Ethnicity and neighborhood socioeconomic deprivation were independently associated with short sleep and snoring/noisy breathing during sleep. Short sleep was associated with increased odds of anxiety, attention deficit hyperactivity disorder, and activity-limiting emotional and psychological conditions after adjusting for ethnicity, deprivation, age, and gender. In addition, long sleep was independently associated with increased odds of depression. These findings demonstrate that for school-aged children ethnic inequities in sleep exist, socioeconomic deprivation is associated with poor sleep, and poor sleep is associated with poor mental health. Sociopolitical action is imperative to tackle social inequities to support sleep equity and mental health across the lifecourse.fals

Characterizing the sleep location, patterns, and maternally perceived sleep problems of the infants of Māori and non-Māori mothers in Aotearoa New Zealand

Objectives To investigate potential sleep inequities between the infants of Māori and non-Māori mothers in Aotearoa New Zealand, identify socio-ecological factors associated with infant sleep, and determine features of infant sleep that contribute to a mother-perceived infant sleep problem. Design Secondary analysis of longitudinal data from the Moe Kura: Mother and Child, Sleep and Well-being in Aotearoa New Zealand study when infants were approximately 12 weeks old. Participants 383 Māori and 702 non-Māori mother-infant dyads. Methods Chi-square and independent t-tests measured bivariate associations between maternal ethnicity and infant sleep characteristics. Multivariable and ordinal logistic regression models assessed the relative impact of different socio-ecological factors on infant sleep outcome variables. Results Key developmental markers of infant sleep did not differ by maternal ethnicity. There were some ethnicity-based differences in sleep location. Maternal ethnicity, maternal age, parity, maternal depression, maternal relationship status, life stress, breastfeeding, work status, and bedsharing were related to different dimensions of infant sleep, and to maternal perceptions of a sleep problem. Conclusion Sleep at 12 weeks is highly variable between infants and is associated with numerous socio-ecological factors. Findings support a social determinants explanation for sleep health inequities seen later in childhood.fals

Maternal depressive symptoms in and beyond the perinatal period: Associations with infant and preschooler sleep

Study Objectives (1) To describe sleep in infancy and early childhood among children born to mothers with and without clinically significant depressive symptoms, and (2) to explore the relationships between maternal depressive symptoms and sleep patterns and problems during infancy and early childhood. Methods Secondary analysis of longitudinal data from the Moe Kura: Mother and Child, Sleep and Wellbeing in Aotearoa/New Zealand study. Data were collected in pregnancy (T1), 12 weeks postpartum (T2), and 3 years post-birth (T3). Participants were 262 Māori and 594 non-Māori mother–child dyads. Chi-square and independent t-tests measured bivariate associations between maternal mood (T1, T2, and T3) and child sleep characteristics (T2 and T3). Binary logistic regression models examined longitudinal and concurrent associations between maternal depressive symptoms and infant and preschooler sleep. Adjusted models accounted for key socio-demographic variables, as well as infant sleep variables in preschooler models. Results Bivariate associations were found between prior and concurrent depressive symptomology and many of the infant and preschooler sleep outcomes. In adjusted models, prenatal depressive symptoms remained independently associated with shorter-than-recommended sleep durations in preschoolers. In these models, concurrent depression was also associated with night waking, night LSRSP, and perceived sleep problems at 12 weeks postpartum, and CSHQ-determined and perceived sleep problems at 3 years post-birth. Conclusions Longitudinal and cross-sectional associations were found between maternal depressive symptoms and child sleep. Sleep appears to be one pathway by which maternal depression confers risk for suboptimal child health outcomes. Findings support the need for earlier and better maternal mental health services.fals

Are New Zealand children meeting the Ministry of Health guidelines for sleep?

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No Earlier Than 9:45 A.M. A Qualitative Study of Adolescents' Experiences of Later School Start Times in Aotearoa New Zealand

OBJECTIVES: Many teenagers suffer chronic sleep loss, which could potentially be mitigated by later school start times to accommodate the natural shift in their circadian timekeeping system favoring later bedtimes. This study explored experiences of senior students from a school in Aotearoa New Zealand with later school start times. METHOD: Semi-structured interviews were conducted with 14 students, purposively sampled for equivalent numbers starting later every day (9:45 A.M.), or on just one weekday (10:00 A.M.). Transcripts were analyzed using reflexive thematic analysis. RESULTS: Four themes were identified that addressed the impact of later starts on sleep struggles, daily functioning, student autonomy, and routines and scheduling. Most perceived later starts as positively influencing their sleep quality, concentration, productivity, and personal well-being. The importance of autonomy over their learning, and impact of different start times on students' schedules was also emphasized. Major disadvantages were lack of free classes and potentially later finish times. CONCLUSIONS: The experiences of later school start times for these adolescents were largely positive across a variety of life domains. Findings support the need for sleep health to be considered within school's health education and policy to address the unmet health concerns of chronic sleep loss in teens.fals

Inequities in adolescent sleep health in Aotearoa New Zealand: Cross-sectional survey findings.

OBJECTIVES: To investigate ethnic inequities in, and social determinants of, adolescent sleep health in Aotearoa New Zealand. METHODS: Analysis of self-report data from a cross-sectional survey of secondary school students (12- to 18-year-olds). Analyses included weighted prevalence estimates of good and poor sleep health stratified by ethnicity, and multivariable logistic regression models concurrently adjusted for ethnicity, school year, gender, rurality, neighborhood deprivation, school decile, housing deprivation, sleeping elsewhere due to lack of adequate housing, unsafe environment, and racism. RESULTS: Inequities in social determinants of health were evident for Māori (Indigenous peoples of Aotearoa New Zealand; n = 1528) and minoritized (Pacific n = 1204; Asian n = 1927; Middle Eastern, Latin American, and African [MELAA] n = 210; and 'Other' ethnicity n = 225) adolescents. A greater proportion of Māori, Pacific, Asian, MELAA, and 'Other' adolescents had short sleep, compared to European (n = 3070). Māori, Pacific, Asian, and MELAA adolescents were more likely to report late bedtimes (after midnight), and Māori, Pacific, and 'Other' adolescents were more likely to report early waketimes (5 AM-6 AM or earlier), on school days. Rurality, neighborhood deprivation, school-level deprivation, housing deprivation, sleeping elsewhere due to inadequate housing, unsafe environments, and racism partially, but not fully, explained associations between ethnicity and short sleep, late bedtimes, and early waketimes. CONCLUSIONS: Ethnic inequities exist in adolescent sleep health in Aotearoa New Zealand. Socio-political actions are needed to address racism and colonialism as root causes of ethnic inequities in adolescent sleep, to ensure all young people are afforded the basic human right of good sleep health and associated mental and physical well-being.fals

Associations between maternal stressful life events and child health outcomes in indigenous and non-indigenous groups in New Zealand

Exposure to stressful life events (SLE) around the time of pregnancy is associated with adverse health outcomes for mothers and children. Previous New Zealand research found Indigenous Māori women are more likely to be exposed to SLE than non-Māori, and are exposed to a higher number of SLE. The consequences of this for ethnic inequities in child health outcomes are unknown. This paper examines the relationship between patterns of maternal SLE exposure with child health and development outcomes at age 3 years, for Indigenous and non-Indigenous children. We found most children had a stressful early life environment at least sometimes, but more than a quarter of Māori children had a mother experiencing multiple SLE on all occasions measured. We found a clear association between maternal experiences of SLE and disordered child sleep and development concerns. While not able to fully assess the contribution of maternal SLE to ethnic inequities in child health outcomes, we did clearly demonstrate that more Māori children have mothers exposed to multiple SLE, and that these maternal SLE are associated with poorer child outcomes. The impacts of chronic SLE exposure need to be better understood, especially given the large ethnic disparity in chronic SLE exposure.fals

Who meets national early childhood sleep guidelines in Aotearoa New Zealand? A cross-sectional and longitudinal analysis

Study Objectives: To investigate the proportion of children in Aotearoa New Zealand (NZ) who do or do not meet sleep duration and sleep quality guidelines at 24 and 45 months of age and associated sociodemographic factors. Methods: Participants were children (n = 6490) from the Growing Up in New Zealand longitudinal study of child development with sleep data available at 24 and/or 45 months of age (48.2% girls, 51.8% boys; 22.4% Māori [the Indigenous people of NZ], 12.9% Pacific, 13.4% Asian, 45.2% European/Other). Relationships between sociodemographic factors and maternally reported child sleep duration (across 24 hours) and night wakings were investigated cross-sectionally and longitudinally. Estimates of children in NZ meeting sleep guidelines were calculated using a range of analytical techniques including Bayesian linear regression, negative binomial multiple regression, and growth curve models. Results: In NZ, 29.8% and 19.5% of children were estimated to have a high probability of not meeting sleep duration guidelines and 15.4% and 8.3% were estimated to have a high probability of not meeting night waking guidelines at 24 and 45 months respectively, after controlling for multiple sociodemographic variables. Factors associated cross-sectionally with children’s sleep included ethnicity, socioeconomic deprivation, material standard of living, rurality, and heavy traffic, and longitudinal sleep trajectories differed by gender, ethnicity, and socioeconomic deprivation. Conclusions: A considerable proportion of young children in NZ have a high probability of not meeting sleep guidelines but this declines across the ages of 24 and 45 months. Sleep health inequities exist as early as 24 months of age in NZ.fals

A scoping review of non-pharmacological perinatal interventions impacting maternal sleep and maternal mental health

© The Author(s) 2022BACKGROUND: A woman's vulnerability to sleep disruption and mood disturbance is heightened during the perinatal period and there is a strong bidirectional relationship between them. Both sleep disruption and mood disturbance can result in significant adverse outcomes for women and their infant. Thus, supporting and improving sleep in the perinatal period is not only an important outcome in and of itself, but also a pathway through which future mental health outcomes may be altered. METHODS: Using scoping review methodology, we investigated the nature, extent and characteristics of intervention studies conducted during the perinatal period (pregnancy to one-year post-birth) that reported on both maternal sleep and maternal mental health. Numerical and descriptive results are presented on the types of studies, settings, sample characteristics, intervention design (including timeframes, facilitation and delivery), sleep and mood measures and findings. RESULTS: Thirty-seven perinatal interventions were identified and further described according to their primary focus (psychological (n = 9), educational (n = 15), lifestyle (n = 10), chronotherapeutic (n = 3)). Most studies were conducted in developed Western countries and published in the last 9 years. The majority of study samples were women with existing sleep or mental health problems, and participants were predominantly well-educated, not socio-economically disadvantaged, in stable relationships, primiparous and of White race/ethnicity. Interventions were generally delivered across a relatively short period of time, in either the second trimester of pregnancy or the early postnatal period and used the Pittsburgh Sleep Quality Index (PSQI) to measure sleep and the Edinburgh Postnatal Depression Scale (EPDS) to measure mood. Retention rates were high (mean 89%) and where reported, interventions were well accepted by women. Cognitive Behavioural Therapies (CBT) and educational interventions were largely delivered by trained personnel in person, whereas other interventions were often self-delivered after initial explanation. CONCLUSIONS: Future perinatal interventions should consider spanning the perinatal period and using a stepped-care model. Women may be better supported by providing access to a range of information, services and treatment specific to their needs and maternal stage. The development of these interventions must involve and consider the needs of women experiencing disadvantage who are predominantly affected by poor sleep health and poor mental health.Published onlin

Performance of the CMS Cathode Strip Chambers with Cosmic Rays

The Cathode Strip Chambers (CSCs) constitute the primary muon tracking device in the CMS endcaps. Their performance has been evaluated using data taken during a cosmic ray run in fall 2008. Measured noise levels are low, with the number of noisy channels well below 1%. Coordinate resolution was measured for all types of chambers, and fall in the range 47 microns to 243 microns. The efficiencies for local charged track triggers, for hit and for segments reconstruction were measured, and are above 99%. The timing resolution per layer is approximately 5 ns