Delayed sleep phase disorder in a Swedish cohort of adolescents and young adults: Prevalence and associated factors

A delayed sleep–wake and circadian rhythm often occurs during puberty. While some individuals only develop a delayed sleep phase (DSP), others will fulfill the criteria for the diagnosis of delayed sleep phase disorder (DSPD). All previous studies have however not separated DSP from DSPD, and, as a result, the prevalence and associated factors are largely unknown for the two conditions individually. We estimated the prevalence of DSP and DSPD in a Swedish cohort of adolescents and young adults. We also investigated associated factors in the two conditions relative to each other and individuals with no DSP. A questionnaire regarding sleep patterns, demographics, substance use/abuse and symptoms of depression, anxiety, worry and rumination was sent to 1000 randomly selected participants (16–26 years of age) in Uppsala, Sweden (response rate = 68%). DSP was defined as a late sleep onset and a preferred late wake-up time. The DSPD diagnosis was further operationalized according to the Diagnostic and Statistical Manual of Mental Disorders, Edition 5 (DSM-5) criteria including insomnia or excessive sleepiness, distress or dysfunction caused by the DSP and that the sleep problem had been evident for 3 months. DSP occurred at a frequency of 4.6% and DSPD at a frequency of 4% in the investigated cohort. DSP was more common in males and was associated with not attending educational activity or work, having shift work, nicotine and alcohol use and less rumination. DSPD was equally common in males and females and was associated with not attending educational activity or work and with elevated levels of anxiety. Both DSP and DSPD appear to be common in adolescents and young adults in this Swedish cohort. No educational activity or work was associated with both DSP and DSPD. However, there were also apparent differences between the two groups in shift work, substance use and mental health, relative to persons with no DSP. Thus, it seems reasonable to assess DSP and DSPD as distinct entities in future studies.     

‘I Have Māori in Me’: Shades of Commitment and Negotiation of Subjectivity in an Aotearoa/New Zealand School

ABSTRACT

Based on ethnographic fieldwork (1997–1998) at a secondary school with a Māori?English bilingual unit in Aotearoa/New Zealand, this article examines two different ways students with Māori ancestry identified themselves contextually: those in the bilingual unit identified themselves mostly as being Māori, while those in mainstream classes identified themselves mostly as Pākehā (white New Zealander) but occasionally as being Pākehā but having Māori in them. Existing analytical frameworks, such as symbolic ethnicity (Gans 1999) or citizenship (Ong 2003), fail to capture the contextual and dialogic display of these different shades of identification practices. Applying the notion of commitment and its disavowal proposed by Doerr for this special issue (2013), this article analyses these two identification practices as a proactive commitment and a hedging commitment linked to institutional belonging to the bilingual unit and mainstream classes, respectively, and to the wider cultural politics of the official yet tokenistic biculturalism of Aotearoa/New Zealand.     

Decolonizing conviviality and ‘becoming ordinary’: cross-cultural face-to-face encounters in Aotearoa New Zealand

This paper explores convivial culture in a settler society. The paper draws on interview data from ethnographic research exploring how Māori and Pākehā worked together on a building project in a rural community. Both Māori and Pākehā participants reported their pleasure in engagements with each other that centred on Māori tikanga (protocols). In these encounters, Māori ‘difference’ was the catalyst for the development of new, convivial relationships. The paper argues that such everyday conviviality contributes to the process of decolonizing Māori–Pākehā relations at the level of everyday life. Through decolonizing conviviality Pakehā ‘become ordinary’ in Māori cultural contexts, and are offered the opportunity to come to understand themselves as embedded in colonial relationalities. Crucial to the development of such conviviality is the opportunity for face-to-face, embodied encounters with Māori in contexts where Māori cultural difference matters.     

Biotechnology: the language of multiple views in Māori communities

In Aotearoa (New Zealand), the government funded studies on communicating biotechnology to different sectors in the community from 2003 to 2006. Subsequently, a researcher covering the Māori sector performed a content analysis of data gathered in the community. Qualitative analysis methods included examining text from participant interviews, focus groups, government documents, newspapers, Internet sites, and current literature. Content was coded by identifying common themes in the English and the Māori language. Words like genetic modification (GM), genetic engineering (GE), and biotechnology were explained to provide a basic understanding between the communities and researcher. The terminology applied in the research was essential to achieve communication between the researcher and the community. The resultant themes represented seven views to interpret the communities association with biotechnology: purist Māori, religious Māori, anti Māori, pro Māori, no Māori, uncertain Māori, and middle Māori views. The themes are taken from the analysis of data compiled after 3 years of completing different stages of a research project. The views indicate that a common understanding can be achieved in the diverse range of Māori tribal communities providing those communicating biotechnology can identify the view and interpretations communities associate with biotechnology. This knowledge is essential for government agencies, researchers, community practitioners, scientist, and businesses that desire to dialogue with Māori communities in the language of biotechnology.     

Incidence,trends, and survival of oropharyngeal squamous cell cancer in Aotearoa New Zealand, 2006–2020

BackgroundAn increasing trend of oropharyngeal cancer (OPC) has been reported in several countries with different demographic characteristics, and often attributed to increases in human papillomavirus (HPV) infection. The survival of patients with OPC has steadily improved, especially for those with positive HPV status. This study assessed the incidence, trends, and survival of OPC in Aotearoa New Zealand (NZ) by age at diagnosis, sex and ethnicity.MethodsThe study included all 2109 patients resident in NZ with a primary diagnosis of oropharyngeal squamous cell carcinoma from 2006 to 2020, identified from the National Cancer Registry. We assessed age-standardised incidence rate (ASR), annual percent change (APC) and overall and relative survival rates.ResultsThe average annual incidence of OPC was 2.2 per 100,000 population. There was a steady increase of 4.9% per year over 15 years. Although the incidence rates were higher in males over the study period, the overall rate of increase was similar in males (4.9%) and in females (4.3%). The incidence was highest in the 50–69-year group (8.8/100,000 population). This age group had an incidence that increased by 7.5% per year to 2018, and then declined. The main increase in rates was seen between the birth cohort of 1946–50 and that of 1956–60. The increase in incidence was seen in Māori and Pākehā/European populations, but no increase was seen in Pacific or Asian populations. The 5-year overall relative survival rate improved from 69% in 2006‐13 to 78% in 2014–20. Survival rates were lower in older patients, females, and Māori patients.ConclusionThis study confirmed a substantial increase in OPC incidence in NZ, with some evidence to suggest a recent slowing in this increase. Māori and Pākehā/European had the highest incidence, while Pacific and Asian populations showed the lowest rates and no increase over the study period. Survival rates have improved over time, but remained lower in some demographic groups.     

Māori Research Collaborations,Mātauranga Māori Science and the Appropriation of Water in New Zealand

This article is an exploratory piece which introduces an argument that a new Māori-science discourse for freshwater has emerged in New Zealand. At the heart of the discourse is the Māori word mātauranga. Drawing on my attendance at a recent Māori water symposium, this work will track the shifting power relationships and fluid boundaries of groups of people with interests in science and claims to freshwater resources. With a focus on the words and language used by Ngai Tahu tribal leaders and natural scientists attending the symposium, this work asks what role the politics of language and discourse plays in transforming identities, power relations and sociopolitical hierarchies. A major focus of this article is the shifting relationships between identity, knowledge and power. Its thesis is that subtle shifts in discourse reflect wider social and symbolic struggles.     

Ethnic differences in sleep duration and morning–evening type in a population sample

This cross-sectional population study examined associations of sleep duration and morning–evening type with sociodemographic and cardiometabolic disease in adults participating in the UK Biobank study (N = 439 933). Multivariable Poisson regression models of sleep duration and morning–evening type with a robust error variance were generated to estimate adjusted prevalence ratios and their 95% confidence intervals. All models were adjusted for sex, race, college attendance, employment status and age. Twenty five percent of the sample reported short sleep; 27% were morning, 64% intermediate and 9% evening type. Black ethnicity emerged as most strongly associated with sleep behavior. Short sleep was twice as prevalent, and morning versus intermediate type was 1.4 times more prevalent in Black than White participants. The greater prevalence of short sleep and morning type among Blacks suggests that sleep-based approaches to improving cardiometabolic outcomes may require a more multidimensional approach that encompasses adequate sleep and circadian alignment in this population.     

Factors Affecting Work Ability in Day and Shift‐Working Nurses

Satisfactory work ability is sustained and promoted by good physical and mental health and by favorable working conditions. This study examined whether favorable and rewarding work‐related factors increased the work ability among European nurses. The study sample was drawn from the Nurses' Early Exit Study and consisted of 7,516 nursing staff from seven European countries working in state‐owned and private hospitals. In all, 10.8% were day, 4.2% were permanent night, 20.9% were shift without night shift, and 64.1% were shift workers with night shifts. Participants were administered a composite questionnaire at baseline (Time 0) and 1 yr later (Time 1). The Work Ability Index (WAI) at Time 1 was used as the outcome measure, while work schedule, sleep, rewards (esteem and career), satisfaction with pay, work involvement and motivation, and satisfaction with working hours at Time 0 were included as potential determinants of work ability. Univariate and multivariate analyses were conducted after adjusting for a number of confounders (i.e., country, age, sex, type of employment, family status, and other job opportunities in the same area). Work schedule was not related to Time 1 changes in WAI. Higher sleep quality and quantity and more favorable psychosocial factors significantly increased work ability levels. Higher sleep quality and quantity did not mediate the effect of work schedule on work ability. No relevant interaction effects on work ability were observed between work schedule and the other factors considered at Time 0. As a whole, sleep and satisfaction with working time were gradually reduced from day work to permanent night work. However, scores on work involvement, motivation, and satisfaction with pay and rewards were the highest in permanent night workers and the lowest in rotating shift workers that included night shifts.     

Human Perceptions of Megafaunal Extinction Events Revealed by Linguistic Analysis of Indigenous Oral Traditions

Human settlement into new regions is typically accompanied by waves of animal extinctions, yet we have limited understanding of how human communities perceived and responded to such ecological crises. The first megafaunal extinctions in New Zealand began just 700 years ago, in contrast to the deep time of continental extinctions. Consequently, indigenous Māori oral tradition includes ancestral sayings that explicitly refer to extinct species. Our linguistic analysis of these sayings shows a strong bias towards critical food species such as moa, and emphasizes that Māori closely observed the fauna and environment. Temporal changes in form and content demonstrate that Māori recognized the loss of important animal resources, and that this loss reverberated culturally centuries later. The data provide evidence that extinction of keystone fauna was important for shaping ecological and social thought in Māori society, and suggest a similar role in other early societies that lived through megafaunal extinction events.     

Reliability and external validity of the six scales of 72-item Sleep-Wake Pattern Assessment Questionnaire (SWPAQ)

The 72-item Sleep-Wake Pattern Assessment Questionnaire (SWPAQ) provides possibility to self-assess individual variation along as many as 6 factorial dimensions. We examined reliability and external validity of each of its 12-item scales, E, M, W, V, F, and S (evening and morning lateness, anytime and daytime wakeability, anytime and night-time sleepability, respectively). Questionnaire data were collected from residents of Novosibirsk and two smaller Russian cities (N = 755 and 720, respectively). Analysis of these two data-sets suggested good and acceptable internal consistency of each of the scales, respectively. Evidence for external validity of each of the 6 scales was obtained by applying stepwise linear regression analysis to data collected from 160 participants of sleep deprivation experiments who were asked to self-report 6 characteristics of their sleep for a week prior to the experiment. As expected, predictors of scales? scores were a later self-reported time for going to bed (E, W), an earlier/later time for final awakening (W/M), a shorter/longer sleep latency (F, S/E), a shorter/longer total sleep time (W + V/F), a lower/higher sleep satisfaction score (M/W + V), a lower/higher nap frequency (V/F), and a lower self-scored sleepiness after deprivation from sleep for a night (W, V).     

Sleep and academic performance in undergraduates: a multi-measure, multi-predictor approach

The present study examined the associations of sleep patterns with multiple measures of academic achievement of undergraduate university students and tested whether sleep variables emerged as significant predictors of subsequent academic performance when other potential predictors, such as class attendance, time devoted to study, and substance use are considered. A sample of 1654 (55% female) full-time undergraduates 17 to 25 yrs of age responded to a self-response questionnaire on sleep, academics, lifestyle, and well-being that was administered at the middle of the semester. In addition to self-reported measures of academic performance, a final grade for each student was collected at the end of the semester. Univariate analyses found that sleep phase, morningness/eveningness preference, sleep deprivation, sleep quality, and sleep irregularity were significantly associated with at least two academic performance measures. Among 15 potential predictors, stepwise multiple regression analysis identified 5 significant predictors of end-of-semester marks: previous academic achievement, class attendance, sufficient sleep, night outings, and sleep quality (R(2)=0.14 and adjusted R(2)=0.14, F(5, 1234)= 40.99, p < .0001). Associations between academic achievement and the remaining sleep variables as well as the academic, well-being, and lifestyle variables lost significance in stepwise regression. Together with class attendance, night outings, and previous academic achievement, self-reported sleep quality and self-reported frequency of sufficient sleep were among the main predictors of academic performance, adding an independent and significant contribution, regardless of academic variables and lifestyles of the students.     

Disturbance of sports performance after partial sleep deprivation

The changes in cardiac and ventilatory responses were measured in 7 endurance athletes during physical exercise on a bicycle ergometer, taking place after a control night and after a night with partial sleep deprivation in the middle of the night. The results show that, despite the maximal work load was not modified with control, heart rate, ventilation and VE/VO2 ratio (ERO2) were greater at the submaximal (75% of the VO2 max) and maximal work load and oxygen consumption decreased at maximal work, after the night of partial sleep deprivation as compared to the control. These findings suggest that acute sleep loss may contribute to alter the endurance performance by impairment of aerobic pathways.     

Light exposure among adolescents with delayed sleep phase disorder: a prospective cohort study

The objective of this study was to compare light exposure and sleep parameters between adolescents with delayed sleep phase disorder (DSPD; n=16, 15.3±1.8 yrs) and unaffected controls (n=22, 13.7±2.4 yrs) using a prospective cohort design. Participants wore wrist actigraphs with photosensors for 14 days. Mean hourly lux levels from 20:00 to 05:00 h and 05:00 to 14:00 h were examined, in addition to the 9-h intervals prior to sleep onset and after sleep offset. Sleep parameters were compared separately, and were also included as covariates within models that analyzed associations with specified light intervals. Additional covariates included group and school night status. Adolescent delayed sleep phase subjects received more evening (p< .02, 22:00-02:00 h) and less morning (p .05, 08:00-09:00 h and 10:00-12:00 h) light than controls, but had less pre-sleep exposure with adjustments for the time of sleep onset (p< .03, 5-7 h prior to onset hour). No differences were identified with respect to the sleep offset interval. Increased total sleep time and later sleep offset times were associated with decreased evening (p< .001 and p= .02, respectively) and morning (p= .01 and p< .001, respectively) light exposure, and later sleep onset times were associated with increased evening exposure (p< .001). Increased total sleep time also correlated with increased exposure during the 9 h before sleep onset (p= .01), and a later sleep onset time corresponded with decreased light exposure during the same interval (p< .001). Outcomes persisted regardless of school night status. In conclusion, light exposure interpretation requires adjustments for sleep timing among adolescents with DSPD. Pre- and post-sleep light exposures do not appear to contribute directly to phase delays. Sensitivity to morning light may be reduced among adolescents with DSPD.     

Reconstructing spatial vulnerability to forest loss by fire in pre‐historic New Zealand

Aim Despite small and transient populations, early Māori transformed large areas of New Zealand's forest landscapes. We sought to isolate the biophysical predictors that explain forest loss in the pre‐historic (i.e. pre‐European) period in New Zealand. Location New Zealand. Methods We used resampled boosted regression trees to isolate the key predictors of forest loss from a suite of 19 topographic, climatic, soil‐related and archaeological predictors at a 1‐km spatial resolution across New Zealand. Results The key predictors of fire‐driven forest loss during New Zealand's pre‐history relate to moisture and elevation gradients, with sites characterized by low moisture levels and gentle slopes being most vulnerable. Proxies for human activity were important in the North Island, where Māori population densities were higher, but not the South Island. The predicted pattern of forest loss and its relationship with biophysical variables suggest that early Māori neither deliberately protected fire‐prone regions nor systematically burnt less fire‐prone ones. Main conclusions Before Māori settlement of New Zealand fire was naturally rare, despite biophysical conditions being conducive to fire spread. The introduction of an ignition source by humans made widespread forest loss inevitable, even in the absence of sustained and deliberate use of fire. Rapid forest loss at the time of human settlement is recurrent across eastern Polynesia, so understanding this dynamic in New Zealand has implications for the region as a whole.     

Sleep Deprivation Reveals Altered Brain Perfusion Patterns in Somnambulism

Background

Despite its high prevalence, relatively little is known about the pathophysiology of somnambulism. Increasing evidence indicates that somnambulism is associated with functional abnormalities during wakefulness and that sleep deprivation constitutes an important drive that facilitates sleepwalking in predisposed patients. Here, we studied the neural mechanisms associated with somnambulism using Single Photon Emission Computed Tomography (SPECT) with ^99mTc-Ethylene Cysteinate Dimer (ECD), during wakefulness and after sleep deprivation.

Methods

Ten adult sleepwalkers and twelve controls with normal sleep were scanned using ^99mTc-ECD SPECT in morning wakefulness after a full night of sleep. Eight of the sleepwalkers and nine of the controls were also scanned during wakefulness after a night of total sleep deprivation. Between-group comparisons of regional cerebral blood flow (rCBF) were performed to characterize brain activity patterns during wakefulness in sleepwalkers.

Results

During wakefulness following a night of total sleep deprivation, rCBF was decreased bilaterally in the inferior temporal gyrus in sleepwalkers compared to controls.

Conclusions

Functional neural abnormalities can be observed during wakefulness in somnambulism, particularly after sleep deprivation and in the inferior temporal cortex. Sleep deprivation thus not only facilitates the occurrence of sleepwalking episodes, but also uncovers patterns of neural dysfunction that characterize sleepwalkers during wakefulness.     

Applying spatial analysis to the agroecology-led management of an indigenous farm in New Zealand

In Aotearoa New Zealand Māori land is often owned by communities and managed by trusts. Under communal ownership, trust managers are expected to provide for their communities in culturally responsive ways, using alternative land-related paradigms. In the context of Māori trust rural land management, geographic information systems (GIS) are seen as a beneficial resource to plan and support important decisions that have community-wide implications. For example, it is much easier to demonstrate visually the putative outcomes of spatial change to large numbers of people with the help of a GIS than it is to verbalise the effects of change. This paper reports on one aspect of such an application to a Māori trust-owned South Island farm, where a GIS-based multi-criteria analysis of terrain and proximity was conducted using also local botanical knowledge input to indicate optimal areas of growth for traditional medicinal plants. The analysis yielded very useful results, with positive feedback received from the local community. As well as the need to verify the approach empirically, there are plans underway to apply GIS in this way to other similarly-managed farms in Aotearoa New Zealand. However, in order to build a more comprehensive decision support resource for farm management, further plant species need to be modelled, and informed by a wider data set that includes detailed soil data.     

Sleep and Academic Performance in Undergraduates: A Multi-measure,Multi-predictor Approach

The present study examined the associations of sleep patterns with multiple measures of academic achievement of undergraduate university students and tested whether sleep variables emerged as significant predictors of subsequent academic performance when other potential predictors, such as class attendance, time devoted to study, and substance use are considered. A sample of 1654 (55% female) full-time undergraduates 17 to 25 yrs of age responded to a self-response questionnaire on sleep, academics, lifestyle, and well-being that was administered at the middle of the semester. In addition to self-reported measures of academic performance, a final grade for each student was collected at the end of the semester. Univariate analyses found that sleep phase, morningness/eveningness preference, sleep deprivation, sleep quality, and sleep irregularity were significantly associated with at least two academic performance measures. Among 15 potential predictors, stepwise multiple regression analysis identified 5 significant predictors of end-of-semester marks: previous academic achievement, class attendance, sufficient sleep, night outings, and sleep quality (R²?=?0.14 and adjusted R²?=?0.14, F(5, 1234)?=?40.99, p?<?.0001). Associations between academic achievement and the remaining sleep variables as well as the academic, well-being, and lifestyle variables lost significance in stepwise regression. Together with class attendance, night outings, and previous academic achievement, self-reported sleep quality and self-reported frequency of sufficient sleep were among the main predictors of academic performance, adding an independent and significant contribution, regardless of academic variables and lifestyles of the students. (Author correspondence: ana.allen@ua.pt)     

KIR diversity in Māori and Polynesians: populations in which HLA-B is not a significant KIR ligand

HLA class I molecules and killer cell immunoglobulin-like receptors (KIR) form a diverse system of ligands and receptors that individualize human immune systems in ways that improve the survival of individuals and populations. Human settlement of Oceania by island-hopping East and Southeast Asian migrants started ~3,500 years ago. Subsequently, New Zealand was reached ~750 years ago by ancestral Māori. To examine how this history impacted KIR and HLA diversity, and their functional interaction, we defined at high resolution the allelic and haplotype diversity of the 13 expressed KIR genes in 49 Māori and 34 Polynesians. Eighty KIR variants, including four ‘new’ alleles, were defined, as were 35 centromeric and 22 telomeric KIR region haplotypes, which combine to give >50 full-length KIR haplotypes. Two new and divergent variant KIR form part of a telomeric KIR haplotype, which appears derived from Papua New Guinea and was probably obtained by the Asian migrants en route to Polynesia. Māori and Polynesian KIR are very similar, but differ significantly from African, European, Japanese, and Amerindian KIR. Māori and Polynesians have high KIR haplotype diversity with corresponding allotype diversity being maintained throughout the KIR locus. Within the population, each individual has a unique combination of HLA class I and KIR. Characterizing Māori and Polynesians is a paucity of HLA-B allotypes recognized by KIR. Compensating for this deficiency are high frequencies (>50 %) of HLA-A allotypes recognized by KIR. These HLA-A allotypes are ones that modern humans likely acquired from archaic humans at a much earlier time.     

Sleep Disturbances Among Female Nurses: Comparing Shift to Day Work

Recently, attention has focused in Israel on the possible legal and health consequences of shift work. We decided to study sleep disorders among female nursing personnel working a shift schedule, in comparison with day nurses, in a large metropolitan general hospital. The study population was composed of 131 female certified nurses working shifts and 44 working days only. Inclusion criteria for the survey was at least 1 year of shift work alternating between day, evening, and night shifts, or at least 1 year of day work. All participants completed a self-report sleep questionnaire encompassing (a) demographic data, (b) sleep survey, and (c) employment details. Statistical analysis was performed using the Pearson correlation test and analysis of variance multiple range test (according to Scheffe's procedure). No significant correlation was found between sleep disorders and age of subjects. No sleep disorders were reported by 19.8% of shift workers versus 76.5% of day workers. Statistically significant findings were that the number of shifts per week >4.1 (p = 0.001) and duration of shift work >13.6 years (p = 0.007) correlated with the presence of sleep disorders. An additional significant finding (p = 0.014) was the impact of evening shifts on sleep disorders. The present small study confined to women supports the growing body of data on sleep complaints among shift workers.     

The Effect of One Night's Sleep Deprivation on Temperature,Mood, and Physical Performance in Subjects with Different Amounts of Habitual Physical Activity

Eleven healthy males were studied twice. On one occasion (control, C), they slept (night 1) and then underwent a battery of tests at 4h intervals from 06: 00 day 1 to 02: 00 day 2; then, after a normal sleep (night 2), they were tested from 10: 00 to 22: 00 on day 2. On the second occasion (sleep deprivation, SD), the subjects remained awake during night 1. Each battery of tests consisted of measurements of tympanic membrane temperature, profile of mood states (POMS), muscle strength, self-chosen work rate (SCWR), perceived exertion, and heart rate (HR) while exercising on a stationary cycle ergometer. Subjects also kept a diary of their activities during the two days and answered a questionnaire about their habitual physical activity. Results showed a significant negative effect of sleep deprivation on most mood states on day 1, but no effect on the other variables. By day 2, mood had tended to recover, though muscle strength tended to be worse in both control and sleep-deprivation experiments. There was also a more general tendency for negative effects to be present at the end of day 1 (02: 00) or at the beginning of day 2 (10: 00). There was limited support for the view that subjects who were habitually more active showed less negative effects after sleep deprivation and responded less adversely to the poor sleep achieved on the university premises (night 2). These results stress the considerable interindividual variation in the responses to sleep loss and, therefore, the difficulty associated with giving general advice to individuals about work or training capability after sleep loss.