Evolving trends in novel sleep tracking and sleep testing technology publications between 2020-2022.

Study Objectives: To update sleep medicine providers regarding (1) published research on the uses and performance of novel sleep tracking and testing technologies (2) the use of artificial intelligence to acquire and process sleep data and (3) research trends and gaps regarding the development and/or evaluation of these technologies.

Methods: Medline and Embase electronic databases were searched for studies utilizing screening and diagnostic sleep technologies, published between 2020 and 2022 in journals focusing on human sleep. Studies' quality was determined based on the Study Design criteria of The Oxford Centre for Evidence-Based Medicine Levels of Evidence.

Sleep Disturbances in Type 1 Diabetes and Mitigating Cardiovascular Risk.

Cardiovascular disease (CVD) is a major cause of morbidity and mortality in persons with type 1 diabetes (T1D). Despite control of known cardiovascular (CV) risk factors and better glycemic management, persons with T1D still face heightened CVD risk, suggesting additional contributing factors. Sleep has recently been recognized as a CV risk factor; however; the role of sleep in CVD specifically in T1D population has only started to emerge.

Associations of Anxiety, Insomnia, and Physical Activity during the COVID-19 Pandemic.

Purpose: Anxiety, insomnia, and physical activity (PA) are interrelated, but the bi-directional relationships between these three variables are not well understood. Less is known of these relationships in settings of disrupted daily activities and acute stress. This study aimed to characterize and examine relationships between insomnia, anxiety, and PA throughout the first year of the COVID-19 pandemic, when many lifestyle behaviors were disrupted.

Sleepy without stimulation: subjective and objective sleepiness in actigraphy-verified natural short sleepers.

Natural short sleepers (NSS)-individuals who report minimal sleepiness or daytime dysfunction despite habitually sleeping less than the recommended amount (i.e., <7 h)-are a focus of growing interest in sleep research.

Sleep extension and cardiometabolic health: what it is, possible mechanisms and real-world applications.

Short sleep duration is associated with heightened cardiometabolic disease risk and has reached epidemic proportions among children, adolescents and adults. Potential mechanisms underlying this association are complex and multifaceted, including disturbances in circadian timing, food intake and appetitive hormones, brain regions linked to control of hedonic eating, physical activity, an altered microbiome and impaired insulin sensitivity. Sleep extension, or increasing total sleep duration, is an emerging and ecologically relevant intervention with significant potential to advance our understanding of the mechanisms underlying the association between short sleep duration and the risk of cardiometabolic disease.

Predicting the Persistence of Insomnia Symptoms during the COVID-19 Pandemic.

Objective: The goal of this study is to evaluate the factors associated with vulnerability and course of insomnia longitudinally in the COVID-19 pandemic and examine differences between: (a) those who never demonstrated clinical insomnia symptoms, (b) those who demonstrated clinically elevated insomnia symptoms at 1 or 2 time points, and (c) those who demonstrated clinically elevated insomnia symptoms at all 3 time points.

Methods: Participants (≥18 years old) completed measures of insomnia (ISI), depression (PHQ-8), anxiety (GAD-7), and pre-sleep arousal (PSAS) at 3 time points (baseline, 1 month, and 3 months). Data were analyzed using univariable odds ratios and multivariable multicategory logistic regression to determine demographic, psychological, and behavioral predictors of insomnia persistence.

Sleep Technology Intervention to Target Cardiometabolic Health (STITCH): a randomized controlled study of a behavioral sleep extension intervention compared to an education control to improve sleep duration, blood pressure, and cardiometabolic health among adults with elevated blood pressure/hypertension.

Background: Short sleep duration, defined as < 7 h sleep on weeknights, affects 40% of the US adult population, contributing to the increased risk for cardiometabolic diseases, decreased safety, and poorer mental health. Despite the prevalence of short sleep duration, few studies have tested interventions to extend sleep duration. The objective of this study is to test the effects of a behavioral sleep extension intervention on sleep duration, blood pressure, and other measures of cardiometabolic health among adults with elevated blood pressure or hypertension.

Positive airway pressure adherence among patients with obstructive sleep apnea and cognitive impairment: A narrative review.

Adults with Mild Cognitive Impairment (MCI) and Alzheimer's disease (AD) have increased rates of Obstructive Sleep Apnea (OSA). Positive Airway Pressure (PAP) is the first-line treatment for OSA and may have potential benefits for slowing cognitive decline in these individuals. However, adherence is low in PAP users overall and those with cognitive impairment may have unique challenges.

Association between sleep variability and time in range of glucose levels in patients with type 1 diabetes: Cross-sectional study.

Objective: Sleep and circadian disturbances emerge as novel factors influencing glycemic control in type 1 diabetes (T1D). We aimed to explore the associations among sleep, behavioral circadian parameters, self-care, and glycemic parameters in T1D.

Methods: Seventy-six non-shift-working adult T1D patients participated.

The thief of (bed)time: Examination of the daily associations between bedtime procrastination and multidimensional sleep health.

Objectives: Sleep insufficiency is associated with increased risk of morbidity and mortality. Bedtime procrastination, or the needless and voluntary delay in sleep, is a sleep-related behavior which may interfere with sleep health. The objective of this study is to comprehensively examine the daily associations among bedtime procrastination and measures of sleep regularity, satisfaction, timing, efficiency, and duration.

What a difference a year makes: Objective rest/activity patterns, circadian phase markers, and sleep quality before and during the COVID-19 pandemic.

Objectives: The COVID-19 pandemic led to numerous changes in sleep duration, quality, and timing. The goal of this study was to examine objective and self-reported changes in sleep and circadian timing before and during the pandemic.

Methods: Data were utilized from an ongoing longitudinal study of sleep and circadian timing with assessments at baseline and 1-year follow-up.

A daily examination of executive functioning and chronotype in bedtime procrastination.

Study Objectives: Bedtime procrastination, or delays in bedtime not attributable to external obligations, is a behavioral tendency that undermines sleep and is conceptualized as a consequence of poor self-regulation. Prior studies investigating the mechanistic role of self-regulation in bedtime procrastination relied on cross-sectional methods and self-reported self-regulation. The present study examined the association between bedtime procrastination and both objective and self-reported executive functioning (EF) as indices of self-regulation, as well as the moderating role of chronotype, using methods that examined these associations at the daily level.

A feasibility study to understand the components of behavioral sleep extension.

Objectives: The goal of this study was to examine the contribution of sleep extension intervention components (wearable sleep tracker and coaching) on sleep extension outcomes.

Patient Involvement: This study collected open ended qualitative responses of treatment preference, acceptability, and feasibility as a key outcome.

Methods: Adults aged 25 to 65 years with sleep duration <7 h and BMI ≥ 25 were randomized into one of four groups: Self-Management (control), Fitbit, Telephone Coaching, or Fitbit + Coaching.

Sleep medicine provider perceptions and attitudes regarding consumer sleep technology.

Study Objectives: This study assessed perceptions and attitudes of sleep medicine providers regarding consumer sleep technology (CST).

Methods: A convenience sample of n = 176 practicing sleep medicine and behavioral sleep medicine experts was obtained using social media and the American Academy of Sleep Medicine directory. Providers completed a questionnaire that assessed perceptions and attitudes about patient use of CST in the clinical setting.

Short sleep duration and interest in sleep improvement in a multi-ethnic cohort of diverse women participating in a community-based wellness intervention: an unmet need for improvement.

Background: Disparities in sleep duration are a modifiable contributor to increased risk for cardiometabolic disorders in communities of color. We examined the prevalence of short sleep duration and interest in improving sleep among a multi-ethnic sample of women participating in a culturally tailored wellness coaching program and discussed steps to engage communities in sleep health interventions.

Methods: Secondary analysis of data from a randomized trial were used.

Circadian Timing, Information processing and Metabolism (TIME) study: protocol of a longitudinal study of sleep duration, circadian alignment and cardiometabolic health among overweight adults.

Background: Both short sleep duration and circadian rhythm misalignment are risk factors for metabolic dysfunction, but the underlying mechanisms are unknown. The goal of this study is to examine how sleep duration and circadian alignment predict changes in cardiometabolic risk factors over a 12-month period, and test cognitive function and hedonic eating tendencies as potential mechanisms.

Methods: We will recruit a sample of 120 working aged adults with BMI 25-35 kg/m (overweight to class I obesity).

Sleep-Opt-In: A Randomized Controlled Pilot Study to Improve Sleep and Glycemic Variability in Adults With Type 1 Diabetes.

Purpose: The purpose of this study was to evaluate the feasibility and acceptability of a technology-assisted behavioral sleep intervention (Sleep-Opt-In) and to examine the effects of Sleep-Opt-In on sleep duration and regularity, glucose indices, and patient-reported outcomes. Short sleep duration and irregular sleep schedules are associated with reduced glycemic control and greater glycemic variability.

Methods: A randomized controlled parallel-arm pilot study was employed.

Photoplethysmography-new applications for an old technology: a sleep technology review.

Unlabelled: Education is integral to the American Academy of Sleep Medicine (AASM) mission. The AASM Emerging Technology Committee identified an important and evolving piece of technology that is present in many of the consumer and clinical technologies that we review on the AASM #SleepTechnology (https://aasm.org/consumer-clinical-sleep-technology/) resource-photoplethysmography.

Sleep optimization to improve glycemic control in adults with type 1 diabetes: study protocol for a randomized controlled parallel intervention trial.

Background: Despite improvements in treatment regimens and technology, less than 20% of adults with type 1 diabetes (T1D) achieve glycemic targets. Sleep is increasingly recognized as a potentially modifiable target for improving glycemic control. Diabetes distress, poor self-management behaviors, and reduced quality of life have also been linked to sleep variability and insufficient sleep duration.

Rationale and study protocol for We-PAP: a randomized pilot/feasibility trial of a couples-based intervention to promote PAP adherence and sleep health compared to an educational control.

Background: Obstructive sleep apnea (OSA) is a serious health condition that affects approximately 30-50% of older adults and contributes to risk for cardiometabolic disorders and dementia. Despite the well-documented role of partners in treatment seeking and adherence to positive airway pressure (PAP), treatments for OSA have nearly exclusively focused on the patient and current treatments for OSA do not address co-existing sleep problems such as insomnia that are prevalent in both patients with OSA and their partners. Therefore, the goal of this study is to develop and test a novel couples-based sleep health intervention to promote adherence to PAP and improve sleep health of the couple.

Couples-based interventions to promote PAP adherence among older adults: a qualitative study of patients, partners, and providers.

Study Objectives: Bed partners play a critical role in the treatment of obstructive sleep apnea and are affected by the treatment (or lack thereof) of their partner's obstructive sleep apnea, but few studies have included partners formally in treatment. In this qualitative study, we examine key stakeholder perspectives (patient, bedpartner, and sleep medicine provider) to inform the development of a novel, couples-based intervention to promote adherence to positive airway pressure (PAP) and sleep health among older adult couples.

Methods: We conducted 3 focus group discussions with patients with obstructive sleep apnea/using PAP and their partners and 3 focus group discussions with sleep medicine providers.

Effects of Sleep-Extend on glucose metabolism in women with a history of gestational diabetes: a pilot randomized trial.

Objectives: Women with a history of gestational diabetes (GDM) are at 7-fold increase in the risk of developing diabetes. Insufficient sleep has also been shown to increase diabetes risk. This study aimed to explore the feasibility of a sleep extension in women with a history of GDM and short sleep, and effects on glucose metabolism.