The Impact of Physical Activity and Sleep Patterns on Bone Turnover Markers in College Students

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Description
College students are a niche of young adults, characterized by abnormal sleeping habits and inactive lifestyles. Many students entering college are as young as 18 years old and graduate by 22 years old, a window of time in which their

College students are a niche of young adults, characterized by abnormal sleeping habits and inactive lifestyles. Many students entering college are as young as 18 years old and graduate by 22 years old, a window of time in which their bones are still accruing mineral. The purpose of this cross-sectional study was to determine whether sleep patterns and physical activity observed in college students (N= 52) 18-25 years old at Arizona State University influenced bone biomarkers, osteocalcin (OC) and N-terminal telopeptide of type 1 collagen (NTX-1) concentrations. Students completed various dietary and health history questionnaires including the International Physical Activity Questionnaire short form. Students wore an actigraphy watch for 7 consecutive nights to record sleep events including total sleep time, sleep onset latency and wake after sleep onset. Total sleep time had a significant, negative correlation with OC (r = -0.298, p-value =0.036) while sleep onset latency had a significant, positive correlation with NTX-1 serum concentration (r = 0.293, p-value = 0.037). Despite correlational findings, only sleep percent was found to be significant (beta coefficient = 0.271 p-value = 0.788) among all the sleep components assessed, after adjusting for gender, race, BMI and calcium intake in multivariate regression models. Physical activity alone was not associated with either bone biomarker. Physical activity*sleep onset latency interactions were significantly correlated with osteocalcin (r = 0.308, p-value =0.006) and NTX-1 (r = 0.286, p-value = 0.042) serum concentrations. Sleep percent*physical activity interactions were significantly correlated with osteocalcin (r = 0.280, p-value = 0.049) but not with NTX-1 serum concentrations. Interaction effects were no longer significant after adjusting for covariates in the regression models. While sleep percent was a significant component in the regression model for NTX-1, it was not clinically significant. Overall, sleep patterns and physical activity did not explain OC and NTX-1 serum concentrations in college students 18-25 years old. Future studies may need to consider objective physical activity devices including accelerometers to measure activity levels. At this time, college students should review sleep and physical activity recommendations to ensure optimal healthy habits are practiced.
Date Created
2019
Agent

Improving the Self-Efficacy of Adolescent Sex Trafficking Survivors Through Physical Activity

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Description
Adolescent survivors of sex trafficking are at risk for poor health outcomes and may be less likely to adopt healthy lifestyle behaviors such as physical activity. Survivors of childhood traumas may be less likely to engage in physical activity due

Adolescent survivors of sex trafficking are at risk for poor health outcomes and may be less likely to adopt healthy lifestyle behaviors such as physical activity. Survivors of childhood traumas may be less likely to engage in physical activity due to lack of self-efficacy. The present study was a case-series of a pre-post, single-arm physical activity intervention to test whether the program could increase self-efficacy among adolescent survivors of sex trafficking. The intervention was 8-weeks of 60-minute aerobic physical activity classes offered three times per week at a residential center for adolescent girls who are survivors of sex trafficking and sexual abuse. The primary outcome was physical activity-related self-efficacy as measured by the Sport Competence subscale of the Physical Self Perception Profile (PSPP) questionnaire. Secondary outcomes included self-reported physical activity, emotional eating, and sleep habits. All outcomes were measured at baseline, 4 weeks, and 8 weeks. Five participants were enrolled in the study. Two participants experienced an increase in the Sport Competence subscale of the PSPP Questionnaire by Week 4 of the study and then a decrease by Week 8 of the study. Another participant experienced no change in the Sport Competence subscale score. Scores for the last two participants could not be determined due to invalid data. These findings suggest that more research is needed on enhancing healthy behaviors among adolescent sex trafficking survivors.
Date Created
2019-05
Agent

Physical activity trajectories among newly-diagnosed obstructive sleep apnea patients

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Description
The purpose of this thesis project was to examine the trajectories of physical activity among newly-diagnosed Obstructive Sleep Apnea (OSA) patients within the UC+WS group of the SleepWell24 study across the first 60 days of CPAP use, alone and based

The purpose of this thesis project was to examine the trajectories of physical activity among newly-diagnosed Obstructive Sleep Apnea (OSA) patients within the UC+WS group of the SleepWell24 study across the first 60 days of CPAP use, alone and based on Apnea-Hypopnea Index (AHI), Body Mass Index (BMI), sex, and age. The study utilizes objective data from the SleepWell24 randomized controlled trial conducted by a collaborative research team at Arizona State University and Mayo Clinic Arizona and Rochester. Participants use wearable sensors to track activity behaviors, such as sleep, sedentary behavior, light-intensity physical activity (LPA), and moderate-vigorous physical activity (MVPA). The primary aim of the study was to examine the physical activity trajectories among newly-diagnosed OSA patients over the first 8 weeks of CPAP use, utilizing the physical activity data from wearable sensors. The secondary aim was to assess the trajectories of physical activity between categories of AHI, BMI, sex, and age. Multilevel modeling was used to account for clustering within participants considering between and within subject variations, and week was used as a level 1 predictor in the model for LPA, and MVPA, and total activity (sum of LPA and MVPA), while between subject factors of BMI, sex, age, and AHI were also included in the model. It was found that there were no statistically significant trajectories of LPA, MVPA or total activity over the first 8 weeks of CPAP use within the sample of 30 participants. However, a few notable differences in physical activity were seen between categories of age, sex, and BMI. Also, there was a significant interaction found between BMI and each week that influenced the trajectory of physical activity within obese patients, as compared to participants considered overweight or with a lower BMI. Ultimately, this study provides insight into patterns of physical activity seen in a clinical population of OSA patients over the initial period of CPAP use.
Date Created
2019-05
Agent

Stress, Depression, and Sleep Among College Students

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Description
There has been a rise in the prevalence of mental health disorders among western industrialized populations.1 By 2020, depression will be second to heart disease in its contribution to the global burden of disease as measured by disability-adjusted life years.2

There has been a rise in the prevalence of mental health disorders among western industrialized populations.1 By 2020, depression will be second to heart disease in its contribution to the global burden of disease as measured by disability-adjusted life years.2 Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States ages 18 and older, or 18.1% of the U.S population every year.3
Mental disorders are prevalent in young adults and frequently present between 12-24 years of age.4 The top five sources of stress reported by college students were changes in sleeping routines, changes in eating habits, increased amount of work, new responsibilities, and breaks/vacations.5 Overall, a total of 73% of college students report occasional difficulties sleeping, and 48% of students suffer from sleep deprivation, as self-reported.6,7
Lifestyle factors such as diet, exercise and sleep may influence symptoms related to stress and depression.8 Symptoms of depression include but are not limited to, persistent anxious or sad moods, feeling guilty or helpless, loss of interest in hobbies, irritability, and other behaviors that may interrupt daily living.9 Inadequate intake of folic acid from fruits and vegetables, and essential fatty acids in fish, may increase symptoms of depression.10 Unhealthy eating habits may be associated with increases in depression-like symptoms in women, supporting the notion that healthier eating habits may decrease major depression.11 Diet is only one component of how lifestyle may influence depression and stress in adults. Exercise may be another important component in decreasing depression-related symptoms due to the release of endorphins.12 It has been found that participating in regular physical activity may decrease tension levels, increase and stabilize mood, improve self-esteem, and lead to better sleeping patterns.13 It has been concluded that individuals who consume a healthy diet are less likely to experience depression whereas people eating unhealthy and processed diets are more likely to be depressed.14
Poor sleep quality as well as unstable sleeping patterns may lead to poor psychological and physical health.15 Poor sleep includes longer duration of sleep onset latency, which is defined as the amount of time it takes to fall asleep, waking up multiple times throughout the night, and not getting a restful sleep because of tossing and turning.16 In healthy adults, the short-term consequences of sleep disruption consist of somatic pain, emotional destress and mood disorders, reduced quality of life, and increased stress responsivity.17 Irregular sleep-wake patterns, defined as taking numerous naps within a 24 hour span and not having a main nighttime sleep experience, are present at alarming levels (more than a quarter) among college students.18 A study done with 2,000 college students concluded that more than a quarter of the students were at risk of a sleeping disorder.19 Therefore, college students who were classified as poor-quality sleepers, reported experiencing more psychological and physical health problems compared to their healthy counterparts. Perceived stress was also found to be a factor in lower sleep quality of young adults.20
The link between depression-like symptoms and sleep remains poorly understood. It is mentioned that there are risk factors of poor sleep, depression and anxiety among college students but this topic has not yet been heavily studied within this population.
Date Created
2019-05
Agent

Differences in Traditional and Non-Traditional Cardiovascular Disease Risk Factors between Asian and Non-Hispanic White Young Adults

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Description
The objective of the present study was to investigate differences in traditional and non-traditional cardiovascular disease (CVD) risk factors between Asian and non-Hispanic White young adults. The burden of CVD varies by racial/ethnic group. Traditional risk factors that increase the

The objective of the present study was to investigate differences in traditional and non-traditional cardiovascular disease (CVD) risk factors between Asian and non-Hispanic White young adults. The burden of CVD varies by racial/ethnic group. Traditional risk factors that increase the likelihood of developing CVD include smoking, alcohol, physical inactivity, obesity, diabetes, high cholesterol, and high blood pressure. Suboptimal sleep is known to be a non-traditional risk factor for poor overall health, CVD risk factors, and CVD. The present study was an investigation of a cross-sectional, screening survey used for a larger community-based study on sleep and cardiovascular health. The unadjusted results examining differences in traditional CVD risk factors indicated that Asian participants were less likely to report alcohol use compared to non-Hispanic White participants. For non-traditional CVD risk factors, Asians were less likely to report experiencing sleep-related fatigue or malaise, attention impairment, daytime sleepiness, reduced motivation or energy, or concerns about their sleep compared to non-Hispanic White participants. Multivariate-analyses were conducted adjusting for sex and age. The adjusted results indicated that the Asian participants were less likely to report alcohol consumption, regular engagement in exercise, engagement in hard intensity exercise, concerns with sleep quality, and sleep difficulty-related fatigue, attention impairment, daytime sleepiness, reduced motivation, and were more likely to be obese compared to non-Hispanic White participants. The results may help guide cardiovascular prevention education provided to these groups. The data indicate the need for further longitudinal research studies on non-traditional CVD risk factors like sleep by ethnicity/race.
Date Created
2017-12
Agent

Methods of Relaxation for Promoting Sleep in Patients Diagnosed with Cancer

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Description
For this creative project, an instructional video on relaxation techniques was created. The relaxation techniques demonstrated were intended to help patients with comorbid cancer and sleep disturbance fall asleep with greater ease. Based on a literature review, autogenic training and

For this creative project, an instructional video on relaxation techniques was created. The relaxation techniques demonstrated were intended to help patients with comorbid cancer and sleep disturbance fall asleep with greater ease. Based on a literature review, autogenic training and tai chi were chosen as the relaxation techniques to demonstrate in the video project. The literature review informed what components of autogenic training and tai chi should be included in the video. A patient with cancer was asked to participate in the making of the video. The patient was guided through autogenic training and tai chi. The patient provided feedback on her experience after completing each technique. The video also included background information on the two relaxation techniques. The completed video was presented to the director of Natural Medicine and Detox in Phoenix, AZ, a naturopathic physician, and a cancer survivor. These individuals provided feedback on what they liked about the video and what they thought needed improvement. The video was posted on YouTube as a resource for patients with cancer. https://www.youtube.com/watch?v=04kYz1kSCaU
Date Created
2016-12

Comparison of Actigraphic and Subjective Assessment of Sleep Parameters in Healthy Individuals

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Description
Sleep diaries and actigraphy are two common methods used to assess sleep subjectively and objectively, respectively. Compared to the gold standard of sleep assessment, polysomnography, sleep diaries and actigraphic methods are more cost-effective and simpler to use. This study aimed

Sleep diaries and actigraphy are two common methods used to assess sleep subjectively and objectively, respectively. Compared to the gold standard of sleep assessment, polysomnography, sleep diaries and actigraphic methods are more cost-effective and simpler to use. This study aimed to compare the sleep parameters derived from actigraphy and sleep diaries (total sleep time, sleep onset latency, number of awakenings, wake after sleep onset, percentage of time awake, and sleep efficiency). Based on results from previous similar studies, it was hypothesized that the sleep diaries would overestimate the total sleep time parameter and underestimate wake parameters. Twenty healthy young adults without sleep problems volunteered to participate. The participants wore an Actiwatch 2 on their wrist and filled out a sleep diary every morning for the duration of six days. A high intraclass correlation coefficient value between subjective and objective sleep was found for the parameter total sleep time, even though total sleep time was found to be slightly overestimated by the sleep diaries. Sleep onset latency, wake after sleep onset, number of awakenings, percentage of time awake, and sleep efficiency were underestimated by the sleep diaries and did not have high correlation values. Based off of the ICC results, there does not seem to be a strong correlation between the Actiwatch 2 and the sleep diaries, but looking at the Bland Altman plots, there seems to be agreement between the methods.
Date Created
2016-12
Agent

Effects of Decreased Opportunity to Sleep on Cognitive Performance and Mood by Sex in Older Adults

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Description
Objectives: The goal of this study was to compare older adults (ages 60 to 80) with a fixed sleep schedule compared to a restricted sleep schedule. The purpose was to determine if reducing one's sleep by an hour each night

Objectives: The goal of this study was to compare older adults (ages 60 to 80) with a fixed sleep schedule compared to a restricted sleep schedule. The purpose was to determine if reducing one's sleep by an hour each night for 12 weeks, led to worse cognition and mood over time. Study Design: The study contained two groups: older adults with their sleep restricted and older adults with their sleep un-restricted. Participants were recruited by researchers at Arizona State University and The University of Arizona by advertising in newspapers, on flyers in senior centers, and on radio stations. After rigorous screening for health conditions, current sleep patterns and depression, individuals entered the study. Participants completed the Geriatric Depression Scale after two weeks of baseline, and again after treatment week 14 of the study. Likewise, males and females performed three cognitive tests after two weeks of baseline, and again after treatment week 14 of the study. These cognitive tests included Stroop Color and Word Test, Trail making and PVT. Results: The depression scale and three cognitive tests showed that there was no significant difference with cognition and mood over 14 weeks between individuals with a fixed sleep schedule compared to a restricted sleep schedule. Conclusions: Reducing older adult's sleep duration by an hour each night for 14 weeks does not produce negative effects, and does not provoke signs of depression or weakened cognition.
Date Created
2017-05

The Effects of Sleep on Bone Mineral Density in College-Aged Males and Females

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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

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.

Date Created
2017-05
Agent

Accelerated Aging in Adults With Knee Osteoarthritis Pain: Consideration for Frequency, Intensity, Time, and Total Pain Sites

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Description

Introduction: Individuals with osteoarthritis (OA) show increased morbidity and mortality. Telomere length, a measure of cellular aging, predicts increased morbidity and mortality. Telomeres shorten with persisting biological and psychosocial stress. Living with chronic OA pain is stressful. Previous research exploring

Introduction: Individuals with osteoarthritis (OA) show increased morbidity and mortality. Telomere length, a measure of cellular aging, predicts increased morbidity and mortality. Telomeres shorten with persisting biological and psychosocial stress. Living with chronic OA pain is stressful. Previous research exploring telomere length in people with OA has produced inconsistent results. Considering pain severity may clarify the relationship between OA and telomeres.

Objectives: We hypothesized that individuals with high OA chronic pain severity would have shorter telomeres than those with no or low chronic pain severity.

Methods: One hundred thirty-six adults, ages 45 to 85 years old, with and without symptomatic knee OA were included in the analysis. Peripheral blood leukocyte telomere length was measured, and demographic, clinical, and functional data were collected. Participants were categorized into 5 pain severity groups based on an additive index of frequency, intensity, time or duration, and total number of pain sites (FITT). Covariates included age, sex, race or ethnicity, study site, and knee pain status.

Results: The no or low chronic pain severity group had significantly longer telomeres compared with the high pain severity group, P50.025. A significant chronic pain severity dose response emerged for telomere length, P50.034. The FITT chronic pain severity index was highly correlated with the clinical and functional OA pain measures. However, individual clinical and functional measures were not associated with telomere length.

Conclusion: Results demonstrate accelerated cellular aging with high knee OA chronic pain severity and provide evidence for the potential utility of the FITT chronic pain severity index in capturing the biological burden of chronic pain.

Date Created
2017-04
Agent