Open Access Publications

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Open access publications by faculty, staff, postdocs, and graduate students in the Epidemiology Program.

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Browsing Open Access Publications by Author "Brewer, Benjamin"

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    Concordance in caregiver and child sleep health metrics among families experiencing socioeconomic disadvantage: A pilot study
    (Journal of Applied Research on Children, 2022-08-25) Covington, Lauren; Satti, Aditi; Brewer, Benjamin; Blair, Rachel; Duffy, Ilona; Laurenceau, Jean-Phillipe; Mayberry, Shannon; Cordova, Angeni; Hoopes, Elissa; Patterson, Freda
    Purpose: Child and caregiver sleep occurs in a family system, with socioeconomically disadvantaged families experiencing disproportionately worse sleep health than more advantaged families. The extent to which objectively measured sleep health metrics (i.e., sleep duration, midpoint, regularity, efficiency) are concordant within disadvantaged family systems, including caregiver-child dyads, is not clear. To address this gap, this study aimed to: (1) characterize sleep health metrics and (2) identify levels of sleep health concordance among caregiver-child dyads living in families experiencing socioeconomic disadvantage. Design and methods: We enrolled 20 caregivers and 26 children in this micro-longitudinal study. Eligible primary caregivers slept in the same house as the child ≥4 nights/week and had no sleep disorders. Eligible children were aged 6-14 years and reported no medical problems. Dyads wore an actigraphy device continuously for 14 consecutive days. Sleep duration, bedtime, midpoint, and efficiency were estimated, and concordance evaluated using linear mixed modeling (R v.3.5.2). Results: Most caregivers were female (85%), Non-Hispanic Black (80%), and aged 40.45 years (SD=11.82). On average, caregivers were not meeting national recommendations for sleep duration and efficiency. Similarly, sleep duration recommendations were not met by child participants. Bivariate results showed that bedtime 𝑟=0.19, p<.001), sleep efficiency (𝑟=0.24, p<.001), and sleep midpoint (𝑟=0.39, p<.001), were concordant between child and caregiver. Multivariable models showed that caregiver bedtime was predictive of child sleep midpoint (b=0.16, p<.05), and caregiver sleep midpoint was predictive of child bedtime (b=0.29, p<.01) and child sleep midpoint (b=0.31, p<.001). Conclusion: Objectively estimated caregiver sleep may be connected to the sleep timing of their children. Improving child sleep may require addressing caregiver sleep habits too. Practice Implications: Results highlight the importance of providers considering caregiver sleep health when assessing child sleep health during well child visits. KEY TAKE AWAY POINTS: In this sample of caregiver-child dyads living in families experiencing socioeconomic disadvantage, on average, caregivers were not meeting national recommendations for sleep duration (7-9 hours per night) and sleep efficiency (>85%), and children were not obtaining 9-11 hours of sleep per night. Bedtime, sleep efficiency, and sleep midpoint were significantly concordant in caregivers and children, with the strongest association observed with sleep midpoint. In multivariable models, caregiver bedtime predicted child sleep midpoint, and caregiver midpoint predicted child bedtime and midpoint; highlighting the necessity of addressing poor sleep health at the family versus individual level among families experiencing socioeconomic disadvantage.
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    Temporal associations between nightly sleep with daytime eating and activity levels in free-living young adults
    (SLEEP, 2023-04-21) Hoopes, Elissa K.; Brewer, Benjamin; Robson, Shannon M.; Witman, Melissa A.; D’Agata, Michele N.; Malone, Susan K.; Edwards, David G.; Patterson, Freda
    Study Objectives This study aimed to quantify the temporal associations between nightly sleep quantity and timing with daytime eating behavior and activity levels in free-living (i.e. non-experimental) settings. Methods Generally healthy young adults (N = 63; 28.9 ± 7.1 years) completed concurrent sleep (wrist actigraphy), eating (photo-assisted diet records), and activity (waist actigraphy) assessments over 14 days. Multilevel models quantified the associations between nightly sleep (total sleep time, timing of sleep and wake onset) with next-day eating behavior (diet quality, caloric intake, timing of eating onset/offset, eating window duration) and activity levels (total physical activity, sedentary time). Associations in the reverse direction (i.e. eating and activity predicting sleep) were explored. Models adjusted for demographic and behavioral confounders and accounted for multiple testing. Results At within- and between-subject levels, nights with greater-than-average total sleep time predicted a shorter eating window the next day (all p ≤ 0.002). Later-than-average sleep and wake timing predicted within- and between-subject delays in next-day eating onset and offset, and between-subject reductions in diet quality and caloric intake (all p ≤ 0.008). At within- and between-subject levels, total sleep time was bidirectionally, inversely associated with sedentary time (all p < 0.001), while later-than-average sleep and wake timing predicted lower next-day physical activity (all p ≤ 0.008). Conclusions These data underscore the complex interrelatedness between sleep, eating behavior, and activity levels in free-living settings. Findings also suggest that sleep exerts a greater influence on next-day behavior, rather than vice versa. While testing in more diverse samples is needed, these data have potential to enhance health behavior interventions and maximize health outcomes. Graphical Abstract: Available at https://doi.org/10.1093/sleep/zsad123
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