Michael Grandner

Interests

Teaching

I have been fortunate to have had many excellent teachers and mentors. This has led to my current attitude, which sees teaching and mentoring as a very important part of my work.In the classroom: Courses and lectures to studentsWhile still a graduate student, I had the opportunity to assume the role of an instructor for 2 sections of Statistics for Psychology for two consecutive semesters at San Diego State University. I was responsible for the design of the course, preparing and delivering all lectures, holding office hours, writing and grading all exams and homework assignments, and all other activities. The classes were generally 30-45 students in size. This was an incredibly rewarding experience. I chose to teach statistics because not only do I love the subject, but I know that many Psychology students dread their undergraduate statistics course because it is often taught in a way that is not engaging. I see statistics as a set of useful tools that we can use to make sense of data. I looked forward to seeing if I could translate this to the classroom.My approach seemed to be successful. For all of the sections that I taught, my ratings were very high – what was usually the lowest-rated course in the department was suddenly one of the highest. This work was recognized in an award from the Department of Psychology. More importantly, though, I received a “Professor of the Year” award from a student group.Although I was not able to teach any courses during my postdoctoral fellowship, I look forward to continuing this experience in a faculty position. In addition to teaching Statistics, I would be interested in teaching a number of courses within Psychology. These range from the more general (e.g., Introduction to Psychology, Psychophysiology, Health Psychology, Research Methods, Abnormal Psychology, Clinical Psychology) to more focused (e.g., Sleep and Dreams, Biological Rhythms, Behavioral Assessment, Translational Research). In addition to full courses, I could contribute as a lecture to an existing course, as I have experience in this area (e.g., “Sleep Disorders” for Abnormal Psychology or “Overview of Insomnia” for medical students). In the lab: Mentored research experiencesOver the past several years, I have worked with a number of students in the lab. Having benefitted substantially from outstanding mentors, I strongly believe in the value of mentored research activities. I took the initiative to secure funding for hiring student workers and work-study students in my lab. As word spread regarding what I can offer, I have begun taking on unpaid students who simply want to work with me. Part of the reason why I have developed this reputation is that I offer a very wide range of experiences, which can be tailored to the student’s interests. For example, while all students participate in recruitment, screening, data entry, and other basic activities, they do other things as well. Students interested in medical school learn how to administer oral glucose tolerance tests, process and store plasma samples, and perform assays. Students interested in bioengineering and computer applications are taught statistical programming and they work with specialized equipment and software. Students interested in clinical careers (e.g., Clinical or Counseling Psychology) are encouraged to obtain informed consent, conduct structured clinical interviews, and conduct neuropsychological assessments. In short, the experiences students gain are applicable to their goals. This may be why past students have been very successful in securing admission to graduate schools and/or jobs following graduation.In addition, if students are able to meet their regular goals, I will mentor them through a research project of their own. I talk with them about research studies and how to think like a researcher. We talk about ideas that interest them, and I walk them through the process of developing an idea, turning that idea into a question, finding an existing dataset that can address that question, operationalizing it, forming a data analysis plan, interpreting data, and writing up and presenting the results. In addition, I offer them the opportunity to team up, where one student is primary author and another is secondary author, so they can work together. In the community: Workshops and outreachI believe that an important part of the job of an academician is to engage in outreach to the community. To that end, I have led a number of community-based workshops and focus groups, talking about sleep and behavioral sleep practices for several groups, including new parents, older adults, etc. I look forward to continuing this work.

Research

Insufficient sleep and sleep disorders are implicated in 4 of the 7 leading causes of death (cardiovascular disease, diabetes, stroke and accidents). Over 40 studies across several decades have documented that sleep duration is a significant predictor of mortality. Insufficient sleep and sleep disorders are also associated with weight gain, obesity, hypertension, dyslipidemia, insulin resistance, depression, cognitive deficits, and many other adverse outcomes. Sleep is an important part of overall health.My research interests include the broad application of Behavioral Sleep Medicine, including studies of sleep as a domain of health behavior and the development and implementation of behavioral interventions for insufficient sleep and sleep disorders. Specific areas of focus include: (1) adverse cardiovascular, metabolic, and behavioral health outcomes associated with short sleep and/or insufficient sleep, (2) biopsychosocial determinants of short sleep, insufficient sleep, and poor sleep quality, and (3) behavioral interventions for sleep as a domain of health behavior. In summary, it is my belief that we need to better understand the downstream adverse outcomes of insufficient or poor quality sleep, the upstream determinants of sleep and sleep behaviors, and how knowledge of sleep determinants can inform behavioral interventions for adverse outcomes.1. Adverse cardiovascular, metabolic, and behavioral health outcomes associated with short sleep and/or insufficient sleepExisting epidemiological and laboratory studies have demonstrated associations between short and/or insufficient sleep and a number of adverse health outcomes. Despite provocative findings, several important questions remain, including: (1) How do existing studies (which often rely on unvalidated survey items or assess sleep deprivation in normal sleepers) generalize to the phenomenon of short sleep as it exists in the population? (2) If short sleepers do show impairments, how are these effects modified by individual differences in need for sleep, ability to sleep, and ability to adapt to decreased sleep? (3) How can we tell the difference between someone who is a “true short sleeper” and someone obtaining insufficient sleep? I have several ongoing or recently completed studies in this area. For example, I am currently overseeing a multi-phase study of habitual short sleepers (<6 hours) compared to normal sleepers (7-8 hours). The overall goal of the study is to evaluate (1) Subjective and objective sleep and sleep disorders in self-reported short sleepers, (2) Whether short sleepers are, as a group, impaired relative to normal sleepers, (3) Which cardiometabolic and/or cognitive variables differentiate short and normal sleepers, and (4) Potential subgroups within short sleepers, including “true short sleepers” and “impaired short sleepers.” This will allow for the characterization of the phenotype (and potential endophenotypes) of short sleepers for future genetic and epigenetic studies. This study includes online screening, at-home sleep apnea testing, saliva for DNA, clinical interview, 2-week monitoring with sleep diary and actigraphy, questionnaires assessing sleep, health and psychological factors, ambulatory and in-lab performance tests, neuropsychological testing, overnight in-lab polysomnography, oral glucose tolerance test, assays for metabolic hormones and inflammatory cytokines, and nutritional analysis. Other studies include, for example, secondary analyses of existing national datasets exploring the relative contributions of short sleep vs. insufficient sleep, interactions with insomnia and sleep apnea, etc.2. Biopsychosocial determinants of short sleep, insufficient sleep, and poor sleep qualitySleep is an important domain of health behavior that is largely overlooked in the Health Psychology literature. Unlike diet, smoking, exercise, and alcohol, little is known about the determinants of habitual sleep across the biopsychosocial spectrum. This is important, since successful behavioral interventions will need to account for the behaviors, beliefs, attitudes, and environmental factors that determine sleep-related behaviors. Important questions include: (1) How are determinants of sleep associated with social determinants of health in general? (2) What are the habitual sleep-related practices, attitudes, and beliefs that predict healthy sleep? (3) Can health disparities be partially mitigated by addressing sleep disparities? I have several ongoing or recently completed studies in this area as well. For example, I am working (with collaborators) to develop and publish the first instrument for assessment of sleep-related practices, beliefs and attitudes. This is important because it will give us an understanding of determinants of sleep and help elucidate potential intervention pathways. Developing this measure involved generating pools of items grounded in the Health Belief Model, Theory of Reasoned Action and Transtheoretical Model of Behavior Change, and refining this measure through an iterative process that included input from a panel of experts and members of the community, four focus groups (results in press), and implementation as part of a research study (in preparation). This resulted in a final draft of the questionnaire, which was assessed psychometrically. These results will be published with the initial publication of the questionnaire (manuscript submitted, invited to Social Science and Medicine). These initial data will allow us to evaluate behaviors and beliefs associated with sleep practices. In addition, publication of this questionnaire will allow future studies to expand these findings. In addition to this study, I worked with collaborators on a study of sleep quality in the Philadelphia area, documenting a “sleep disparity” related to poverty and race. Other ongoing or recently completed projects are documenting how sleep duration and sleep symptoms are associated with various sociodemographic factors (e.g., age, sex, race/ethnicity, marital status, immigrant status, geography), socioeconomic factors (e.g., income, education, food insecurity, access to healthcare), health behaviors (e.g., diet, exercise, smoking, alcohol use), and the role of social stressors (e.g., racism).Finally, I was first author on the publication that introduced a social-ecological model of sleep and health (the first social ecological model published for sleep), and I am currently working, along with several collaborators at other institutions, to formally introduce a refined version of this model as a framework for future research in the area of sleep at the interface of biopsychosocial factors and health outcomes.3. Behavioral interventions for sleep as a domain of health behaviorWell-described behavioral interventions exist for a number of sleep disorders. However, no interventions currently exist that address habitual unhealthy sleep habits, except for poorly-applied “sleep hygiene” instructions. Much work is needed in this domain to address these questions: (1) How can knowledge about determinants and outcomes of insufficient sleep translate into successful interventions that target habitual sleep practices? (2) Do behavioral interventions for insufficient sleep produce improvements in behavioral and cardiometabolic domains? (3) How can individual-level interventions be translated into community-level and population-level interventions?Although knowledge from the aforementioned areas will be important in informing future interventions, work has already begun to address how to develop and implement a strategy for increasing sleep time as a healthy behavior. I have completed a pilot study of 8 individuals in an open-label trial of an 8-week behavioral sleep extension protocol for habitual short sleepers. Pre-post assessments included sleep, psychological functioning, blood pressure, glucose tolerance and insulin resistance, inflammatory markers, metabolic hormones, neurobehavioral performance, objective sleep propensity, polysomnographic sleep, actigraphic sleep, and other measures. Analysis is ongoing, in preparation for a future grant application.

Courses

Scholarly Contributions

Books

• Grandner, M. (2019). Sleep and Health. United Kingdom: Elsevier.

Chapters

• Grandner, M., & Mian, R. (2017). Effects of Sleep Deprivation and Sleepiness on Society and Drving. In Sleep Disorders Medicine(pp 41-53). New York, NY: Springer. doi:https://doi.org/10.1007/978-1-4939-6578-6_4
• Grandner, M., & Mian, R. M. (2017). Effects of Sleep Deprivation and Sleepiness on Society and Driving. In Sleep Disorders Medicine, 4th Edition(p. 12). New York: Springer. doi:https://doi.org/10.1007/978-1-4939-6578-6_4
• Grandner, M. (2015). Sleep Deprivation: Societal Impact and Long-Term Consequences. In Sleep Medicine: A Comprehensive Guide to Its Development, Clinical Milestones, and Advances in Treatment(pp 495-510). New York: Springer.
• Grandner, M. (2015). Sleep Disparities in the American Population: Prevalence, Potential Causes, Relationships for Cardiometabolic Health Disparities, and Future Directions for Research and Policy. In Kelly Report 2015: Health Disparities in America.(pp 126-132). Washington, DC: House of Representatives.

Journals/Publications

• Addison, C., Grandner, M. A., & Baron, K. G. (2023). Sleep medicine provider perceptions and attitudes regarding consumer sleep technology. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 19(8), 1457-1463.
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  This study assessed perceptions and attitudes of sleep medicine providers regarding consumer sleep technology (CST).
• Bhushan, B., Zee, P. C., Grandner, M. A., Jaser, S. S., Hazkani, I., Maddalozzo, J. P., Xu, S., Ahluwalia, V., Chandra, A., Schroeder, J. W., Sharma, M., Suittens, D. A., & Berg, C. A. (2023). Associations of deep sleep and obstructive sleep apnea with family relationships, life satisfaction and physical stress experience in children: a caregiver perspective. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.
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  Obstructive sleep apnea and poor quality of sleep negatively impacts health-related quality of life (HR-QoL) in adults, but few studies have evaluated the association between sleep disturbance (e.g., obstructive sleep apnea, inadequate sleep) and HR-QoL domains (e.g., family relations, life satisfaction) in children.
• Glick, D. R., Abariga, S. A., Thomas, I., Shipper, A. G., Gunia, B. C., Grandner, M. A., Rosenberg, E., Hines, S. E., Capaldi, V., Collen, J., & Wickwire, E. M. (2023). Economic Impact of Insufficient and Disturbed Sleep in the Workplace. PharmacoEconomics, 41(7), 771-785.
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  Insufficient and disturbed sleep are associated with significant morbidity among working-age adults. Poor sleep results in negative health outcomes and increases economic costs to employers. The current systematic review surveyed the peer-reviewed scientific literature and aggregated scientific evidence of sleep-related economic burdens borne by employers.
• Gorovoy, S. B., Campbell, R. L., Fox, R. S., & Grandner, M. A. (2023). App-Supported Sleep Coaching: Implications for Sleep Duration and Sleep Quality. Frontiers in sleep, 2.
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  The present study evaluated whether completers of a 12-week app-based, personalized text supported sleep coaching program demonstrated improvements in sleep continuity, sleep duration, and reduced use of sleep aids.
• Gorovoy, S. B., Tubbs, A. S., & Grandner, M. A. (2023). Sleep disorders symptoms in children, adolescents, and emerging adults: Reducing mortality and population health burden through improved identification, referral, and treatment. Sleep health.
• Grandner, M. A., Bromberg, Z., Hadley, A., Morrell, Z., Graf, A., Hutchison, S., & Freckleton, D. (2023). Performance of a multisensor smart ring to evaluate sleep: in-lab and home-based evaluation of generalized and personalized algorithms. Sleep, 46(1).
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  Wearable sleep technology has rapidly expanded across the consumer market due to advances in technology and increased interest in personalized sleep assessment to improve health and mental performance. We tested the performance of a novel device, the Happy Ring, alongside other commercial wearables (Actiwatch 2, Fitbit Charge 4, Whoop 3.0, Oura Ring V2), against in-lab polysomnography (PSG) and at-home electroencephalography (EEG)-derived sleep monitoring device, the Dreem 2 Headband.
• Grandner, M. A., Min, J. S., Saad, R., Leary, E. B., Eldemir, L., & Hyman, D. (2023). Health-related impact of illness associated with excessive daytime sleepiness in patients with obstructive sleep apnea. Postgraduate medicine, 135(5), 501-510.
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  This real-world study aimed to characterize the impact of illness of excessive daytime sleepiness (EDS) in patients with obstructive sleep apnea (OSA) who are adherent to continuous positive airway pressure (CPAP).
• Grandner, M., Olivieri, A., Ahuja, A., Büsser, A., Freidank, M., & McCall, W. V. (2023). The burden of untreated insomnia disorder in a sample of 1 million adults: a cohort study. BMC public health, 23(1), 1481.
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  Insomnia disorder is a highly prevalent, significant public health concern associated with substantial and growing health burden. There are limited real-world data assessing the burden of insomnia disorder on daytime functioning and its association with comorbidities. The objective of this study was to leverage large-scale, real-world data to assess the burden of untreated insomnia disorder in terms of daytime impairment and clinical outcomes.
• Kennedy, K. E., & Grandner, M. A. (2023). Sleep, rhythms, and food intake: Mechanistic insights. Sleep medicine reviews, 69, 101791.
• Kennedy, K. E., Wills, C. C., Holt, C., & Grandner, M. A. (2023). A randomized, sham-controlled trial of a novel near-infrared phototherapy device on sleep and daytime function. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 19(9), 1669-1675.
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  Near-infrared light exhibits several therapeutic properties, but little is known about the benefits to sleep and daytime function. The purpose of this study was to investigate the effects of red and near-infrared exposure before bed on sleep and next-day function.
• Rasmussen, E. F., Barnard, S., Athey, A., Gorovoy, S., & Grandner, M. A. (2023). Adverse childhood experiences associated with sleep health in collegiate athletes. Sleep health.
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  The relationship between adverse childhood experiences and sleep disturbances in collegiate athletes was examined.
• Scott, H., Cheung, J. M., Muench, A., Ivers, H., Grandner, M. A., Morin, C. M., & Perlis, M. L. (2023). Baseline sleep characteristics are associated with gains in sleep duration after cognitive behavioral therapy for insomnia. Sleep medicine, 102, 199-204.
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  Cognitive behavioural therapy for insomnia (CBT-I) substantially reduces total wake time (TWT) by the end of treatment. In contrast, total sleep time (TST) does not increase above baseline levels for most patients following 4-8 sessions of treatment. In the 6-12 months following CBT-I, without any further intervention, up to 64% of participants substantially increase their TST (by ≥ 30 min). The current study investigated which baseline characteristics are associated with increases in TST after CBT-I.
• Taylor, D. J., Huskey, A., Kim, K. N., Emert, S. E., Wardle-Pinkston, S., Auerbach, A., Ruiz, J. M., Grandner, M. A., Webb, R., Skog, M., Milord, T., & , P. M. (2023). Internal consistency reliability of mental health questionnaires in college student athletes. British journal of sports medicine, 57(10), 595-601.
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  To examine the internal consistency reliability and measurement invariance of a questionnaire battery designed to identify college student athletes at risk for mental health symptoms and disorders.
• Tubbs, A. S., Taneja, K., Ghani, S. B., Nadorff, M. R., Drapeau, C. W., Karp, J. F., Fernandez, F. X., Perlis, M. L., & Grandner, M. A. (2023). Sleep continuity, timing, quality, and disorder are associated with suicidal ideation and suicide attempts among college students. Journal of American college health : J of ACH, 1-9.
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  To evaluate sleep continuity, timing, quality, and disorder in relation to suicidal ideation and attempts among college students. Eight hundred eighty-five undergraduates aged 18-25 in the southwestern United States. Participants completed questionnaires on sleep, suicide risk, mental health, and substance use. Differences in sleep variables were compared by lifetime and recent suicidal ideation and suicide attempts using covariate-adjusted and stepwise regression models. A total of 363 (40.1%) individuals reported lifetime suicidal ideation, of whom 172 (19.4%) reported suicidal ideation in the last 3 months and 97 (26.7%) had attempted suicide in their lifetime. Sleep disturbances were prevalent among those with lifetime suicidal ideation or a lifetime suicide attempt. Insomnia was identified as the best predictor of recent suicidal ideation, but this relationship did not survive adjustment for covariates. Sleep continuity, quality, and sleep disorders are broadly associated with suicidal thoughts and behaviors among college students.
• Valencia, D. Y., Gorovoy, S., Tubbs, A., Jean-Louis, G., & Grandner, M. A. (2023). Sociocultural context of sleep health: modeling change over time. Sleep, 46(1).
• Vargas, I., Muench, A., Grandner, M. A., Irwin, M. R., & Perlis, M. L. (2023). Insomnia symptoms predict longer COVID-19 symptom duration. Sleep medicine, 101, 365-372.
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  /Background: The goal of the present study was to assess the prevalence and incidence of insomnia in the United States during the COVID-19 pandemic, and whether, among those that contracted COVID-19, insomnia predicted worse outcomes (e.g., symptoms of greater frequency, duration, or severity).
• Wieman, S. T., Arditte Hall, K. A., Park, E. R., Gorman, M. J., Comander, A., Goldstein, M. R., Cunningham, T. J., Mizrach, H. R., Juhel, B., Li, R., Markowitz, A., Grandner, M., Liverant, G. I., & Hall, D. L. (2023). Treatment-related changes in insomnia, anticipatory pleasure, and depression symptoms: A proof-of-concept study with cancer survivors. Sleep medicine, 103, 29-32.
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  Cancer survivors have elevated rates of insomnia and depression. Insomnia increases risk for depression onset, and the Integrated Sleep and Reward (ISR) Model suggests that impairments in reward responding (e.g., ability to anticipate and/or experience pleasure) plays a central role in this relationship. Cognitive behavioral therapy for insomnia (CBT-I) is efficacious for treating chronic insomnia and reducing depression in cancer survivor populations. The effects of CBT-I on anticipatory and consummatory pleasure are theoretically and clinically meaningful, yet remain unexamined.
• Abdelwadoud, M., Collen, J., Edwards, H., Mullins, C. D., Jobe, S. L., Labra, C., Capaldi, V. F., Assefa, S. Z., Williams, S. G., Drake, C. L., Albrecht, J. S., Manber, R., Mahoney, A., Bevan, J., Grandner, M. A., & Wickwire, E. M. (2022). Engaging Stakeholders to Optimize Sleep Disorders' Management in the U.S. Military: A Qualitative Analysis. Military medicine, 187(7-8), e941-e947.
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  Sleep disorders' are highly prevalent among U.S. active duty service members (ADSMs) and present well-documented challenges to military health, safety, and performance. In addition to increased need for sleep medicine services, a major barrier to effective sleep management has been a lack of alignment among patients, health providers, and economic-decision-makers. To address this gap in knowledge, the purpose of the present study was to engage diverse stakeholders vested in improving sleep disorders' management in the military.
• Arora, T., Grey, I., Östlundh, L., Alamoodi, A., Omar, O. M., Hubert Lam, K. B., & Grandner, M. (2022). A systematic review and meta-analysis to assess the relationship between sleep duration/quality, mental toughness and resilience amongst healthy individuals. Sleep medicine reviews, 62, 101593.
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  The majority of sleep research has focused on deleterious health outcomes, with little attention to positive sequels. A systematic review of the literature regarding sleep duration and/or sleep quality in relation to mental toughness and resilience amongst non-clinical, healthy populations was completed. Eight databases and selected sources for grey literature were searched from their inception to April 2021. A total of 1925 unique records (1898 from the database search and 27 from grey sources) were identified and screened against the pre-set inclusion and exclusion criteria. Of these, 68 studies were eligible and 63 were included in the meta-analysis. Pooled results indicated a weak, positive correlation between sleep duration and resilience (r = 0.11, p 
• Boyle, J. T., Rosenfield, B., Di Tomasso, R. A., Moye, J., Bamonti, P. M., Grandner, M., Vargas, I., & Perlis, M. (2022). Sleep Continuity, Sleep Related Daytime Dysfunction, and Problem Endorsement: Do These Vary Concordantly by Age?. Behavioral sleep medicine, 1-12.
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  Sleep continuity (i.e., ability to initiate and/or maintain sleep) worsens with age. It is unclear whether problem endorsement and/or daytime dysfunction show similar age-related trends. Accordingly, a large archival dataset was used to examine age differences in sleep continuity, problem endorsement, and sleep related daytime dysfunction.
• Boyle, J. T., Vargas, I., Rosenfield, B., Grandner, M. A., & Perlis, M. L. (2022). Insomnia Severity and Degree of Dysfunction: What Is to Be Learned When These Domains are Discordant?. Behavioral sleep medicine, 20(2), 164-172.
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  Illness severity and resultant dysfunction are often linearly related and tightly coupled (concordant). Some percentage of individuals, however, exhibit discordant associations (high illness severity and low dysfunction [HL] or low illness severity and high dysfunction [LH]). In the present study, a sample of subjects with insomnia complaints were evaluated to determine what percentage of subjects exhibited discordant associations.
• Burke, S., Grudzien, A., Li, T., Abril, M., Spadola, C., Barnes, C., Hanson, K., Grandner, M., & DeKosky, S. (2022). Correlations between sleep disturbance and brain structures associated with neurodegeneration in the National Alzheimer's Coordinating Center Uniform Data Set. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia, 106, 204-212.
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  This study aimed to 1) determine the association between sleep disturbance and brain structure volumes, 2) the moderation effect of apolipoprotein ε4 genotype on sleep disturbance and brain structures, and 3) the moderation effect of sleep disturbance on cognitive status and regional brain volumes. Using the National Alzheimer's Coordinating Center Uniform Data Set (n = 1,533), multiple linear regressions were used to evaluate the association between sleep disturbance and brain volumes. Sleep disturbance was measured using one question from the NPI-Q. After controlling for intracranial volume, age, sex, years of education, race, ethnicity, and applying the FDR correction, total cerebrospinal fluid volume, left lateral ventricle volume, total lateral ventricle volume, and total third ventricle volume demonstrated significantly higher means for those with sleep disturbance. Total brain volume, total white and gray matter volume, total cerebrum brain volume (including gray but not white matter), left hippocampus volume, total hippocampal volume, the left, right, and total frontal lobe cortical gray matter volume, and the left, right, and total temporal lobe cortical gray matter volume demonstrated significantly lower mean volumes for those with sleep disturbance. Sleep disturbance moderated the association between cognitive status and lateral ventricular volumes. These findings suggest that disrupted sleep is associated with atrophy across multiple brain regions and ventricular hydrocephalus ex vacuo.
• Charest, J., & Grandner, M. A. (2022). Sleep and Athletic Performance: Impacts on Physical Performance, Mental Performance, Injury Risk and Recovery, and Mental Health: An Update. Sleep medicine clinics, 17(2), 263-282.
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  Sleep health is an important consideration for athletic performance. Athletes are at high risk of insufficient sleep duration, poor sleep quality, daytime sleepiness and fatigue, suboptimal sleep schedules, irregular sleep schedules, and sleep and circadian disorders. These issues likely have an impact on athletic performance via several domains. Sleep loss and/or poor sleep quality can impair muscular strength, speed, and other aspects of physical performance. Sleep issues can also increase risk of concussions and other injuries and impair recovery after injury. Cognitive performance is also impacted in several domains, including vigilance, learning and memory, decision making, and creativity.
• Charest, J., Cook, J. D., Bender, A. M., Walch, O., Grandner, M. A., & Samuels, C. H. (2022). Associations between time zone changes, travel distance and performance: A retrospective analysis of 2013-2020 National Hockey League Data. Journal of science and medicine in sport, 25(12), 1008-1016.
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  Many studies have investigated the role that travel plays in athletic performance. However, these studies lacked a holistic representation of travel. For instance, they do not consider travel distance and uniquely focuses on travel direction.
• Collen, J., Capaldi, V. F., Williams, S. G., Labra, C., Assefa, S. Z., Abdelwadoud, M., Mullins, C. D., Manber, R., Mahoney, A., Bevan, J., Drake, C. L., Albrecht, J. S., Edwards, H., Grandner, M. A., & Wickwire, E. M. (2022). Moving Beyond "Leaning In"-It Is Time to Reach Out and Partner to Solve the Military Sleep Problem. Military medicine, 187(5-6), 158.
• Ghani, S. B., Delgadillo, M. E., Granados, K., Okuagu, A. C., Wills, C. C., Alfonso-Miller, P., Buxton, O. M., Patel, S. R., Ruiz, J., Parthasarathy, S., Haynes, P. L., Molina, P., Seixas, A., Jean-Louis, G., & Grandner, M. A. (2022). Patterns of Eating Associated with Sleep Characteristics: A Pilot Study among Individuals of Mexican Descent at the US-Mexico Border. Behavioral sleep medicine, 20(2), 212-223.
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  : Previous studies have linked sleep to risk of diabetes and obesity, at least partially via alterations in food intake. Diabetes and obesity are common among Hispanics/Latinos, and studies are needed to better clarify the role of sleep in health among this group. Utilizing the revised TFEQ-R-18, this study will examine whether eating behaviors such as cognitive restraint, emotional eating and uncontrolled eating are related to self-reported sleep experiences. Specifically, we hypothesized that poor eating habits would be associated with (1) more insomnia symptoms, (2) overall worse sleep quality, (3) increased daytime sleepiness, and (4) shorter sleep duration. Data were collected from N = 100 adults (age 18-60, 47% female) of Mexican descent in the city of Nogales, AZ (34% not born in the US). Surveys were presented in English or Spanish. Eating Patterns were assessed with the Three-Factor Eating Questionnaire (TFEQ), which resulted in a total score and subscales for "cognitive restraint," "uncontrolled eating," and "emotional eating." Insomnia was assessed with the use of the Insomnia Severity Index (ISI), Sleepiness with the use of the Epworth Sleepiness Scale (ESS), Sleep quality with the use of the Pittsburgh Sleep Quality Index (PSQI), and weekday and weekend sleep duration with the use of the Sleep Timing Questionnaire (STQ). Covariates included age, sex, Body Mass Index (BMI), education and immigrant status. Overall TFEQ score (problematic eating) was positively associated with greater insomnia, poorer sleep quality, more sleepiness, and less weekend (but not weekday) sleep. Mean TFEQ score in the sample was 18.7 (range 0-51). In adjusted analyses, every point on the TFEQ was associated with 0.6 ISI points, 0.8 PSQI points, 0.5 ESS points, and 1.1 minutes of less weekend sleep duration. Regarding subscale scores, relationships were generally seenbetween sleep and emotional eating and unrestricted eating, and not cognitive restraint. Greater insomnia, poorer sleep quality, increased daytime sleepiness and decreased weekend sleep duration were associated with eating patterns at the US-Mexico border, particularly in the area of unrestricted eating and emotional eating. This suggests possible mechanisms linking sleep and obesity in Hispanic/Latinos.
• Ghani, S. B., Kapoor, A., Tubbs, A. S., Wills, C. C., Karp, J. F., Perlis, M. L., Killgore, W. D., Fernandez, F. X., & Grandner, M. A. (2022). Associations between Insomnia Symptoms and Anxiety Symptoms in Adults in a Community Sample of Southeastern Pennsylvania, USA. Diseases (Basel, Switzerland), 10(4).
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  Although insomnia is reliably associated with anxiety symptoms, aspects of insomnia may differentially relate to one anxiety symptom versus another. Therefore, treatment for insomnia comorbidity with anxiety might be individually tailored to optimize treatment response. Working from this hypothesis, we analyzed data from a survey of 1007 community-dwelling adults. Insomnia was measured using the Insomnia Severity Index (ISI), categorizing items as nighttime disturbances, daytime dysfunction, or self-perceived dissatisfaction. Anxiety symptoms were measured with the Generalized Anxiety Disorder 7-item questionnaire (GAD-7). Linear and binomial logistic regression were used and adjusted for covariates. Post hoc forward stepwise analyses determined which components of the insomnia contributed to individual anxiety symptoms. Significant associations between nighttime disturbance (β = 0.88 [0.44, 1.3]), daytime dysfunction (β = 1.30 [0.81, 1.80]), dissatisfaction (β = 1.20 [0.60, 1.7]) and total GAD-7 score were maintained after adjusting for covariates. Nighttime disturbance was associated with excess worrying, restlessness, irritability, and fear of catastrophe. Daytime dysfunction was associated with all symptoms except for fear of catastrophe, and self-perceived dissatisfaction was associated with all symptoms except irritability. Stepwise analyses revealed that daytime dysfunction and dissatisfaction were most consistently related to anxiety symptoms.Greater attention should be paid to daytime dysfunction in patients with insomnia and anxiety, as improving daytime functioning may improve anxiety.
• Grandner, M. A. (2022). Sleep, Health, and Society. Sleep medicine clinics, 17(2), 117-139.
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  Insufficient sleep and sleep disorders are highly prevalent in the population and are associated with significant morbidity and mortality. Adverse outcomes of insufficient sleep and/or sleep disorders are weight gain and obesity, cardiovascular disease, diabetes, accidents and injuries, stress, pain, neurocognitive dysfunction, psychiatric symptoms, and mortality. Exposure to sleep difficulties varies by age, sex, race/ethnicity, and socioeconomic status; significant sleep health disparities exist in the population. Societal influences, such as globalization, technology, and public policy, affect sleep at a population level.
• Grandner, M. A., Valencia, D. Y., Seixas, A. A., Oliviér, K., Gallagher, R. A., Killgore, W. D., Hale, L., Branas, C., & Alfonso-Miller, P. (2022). Development and Initial Validation of the Assessment of Sleep Environment (ASE): Describing and Quantifying the Impact of Subjective Environmental Factors on Sleep. International journal of environmental research and public health, 19(20).
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  The purpose of this study was to develop and test the reliability and validity of a 13-item self-report Assessment of Sleep Environment (ASE). This study investigates the relationship between subjective experiences of environmental factors (light, temperature, safety, noise, comfort, humidity, and smell) and sleep-related parameters (insomnia symptoms, sleep quality, daytime sleepiness, and control over sleep). The ASE was developed using an iterative process, including literature searches for item generation, qualitative feedback, and pilot testing. It was psychometrically assessed using data from the Sleep and Healthy Activity Diet Environment and Socialization (SHADES) study (N = 1007 individuals ages 22-60). Reliability was determined with an internal consistency and factor analysis. Validity was evaluated by comparing ASE to questionnaires of insomnia severity, sleep quality, daytime sleepiness, sleep control, perceived stress, and neighborhood disorder. The ASE demonstrated high internal consistency and likely reflects a single factor. ASE score was associated with insomnia symptoms (B = 0.09, < 0.0001), sleep quality (B = 0.07, < 0.0001), and sleep control (B = -0.01, < 0.0001), but not daytime sleepiness. The ASE was also associated with perceived stress (B = 0.20, < 0.0001) and neighborhood disorder (B = -0.01, < 0.0001). Among sleep environment factors, only smell was not associated with sleep quality; warmth and safety were negatively associated with sleepiness; and of the sleep environment factors, only light/dark, noise/quiet, and temperature (warm/cool) were not associated with insomnia symptoms. The ASE is a reliable and valid measure of sleep environment. Physical environment (light, temperature, safety, noise, comfort, humidity, and smell) was associated with insomnia symptoms and sleep quality but not sleepiness.
• Gupta, P., Martin, J. L., Malhotra, A., Bergstrom, J., Grandner, M. A., & Kamdar, B. B. (2022). Circadian rest-activity misalignment in critically ill medical intensive care unit patients. Journal of sleep research, 31(5), e13587.
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  Circadian alignment of rest-activity rhythms is an essential biological process that may be vulnerable to misalignment in critically ill patients. We evaluated circadian rest-activity rhythms in critically ill patients and their association with baseline (e.g. age) and clinical (e.g. mechanical ventilation status) variables, along with intensive care unit light-dark cycles. Using wrist actigraphy, we collected 48-hr activity and light exposure data from critically ill patients in a tertiary care medical intensive care unit. We evaluated circadian rest-activity rhythms using COSINOR and non-parametric circadian rhythm analysis models, and stratified these data across baseline and clinical variables. We used linear regression to evaluate the association of circadian rest-activity and light-dark exposure rhythms. In COSINOR and non-parametric circadian rhythm analysis analyses, the 34 medical intensive care unit patients completing 48-hr actigraphy recordings exhibited mean MESOR (mean activity levels of a fitted curve) and amplitudes of 0.50 ± 0.32 and 0.20 ± 0.19 movements per 30-s epoch, with high interdaily variability. Patients who were older, mechanically ventilated, sedated, restrained and with higher organ failure scores tended to exhibit greater circadian rest-activity misalignment, with three of 34 (9%) patients exhibiting no circadian rhythmicity. Circadian light-dark exposure misalignment was observed as well and was associated with rest-activity misalignment (p = 0.03). Critically ill patients in our MICU experienced profound circadian rest-activity misalignment, with mostly weak or absent rhythms, along with circadian light-dark exposure misalignment. Potentially modifiable factors contributing to rest-activity misalignment (i.e. mechanical ventilation, restraints, low daytime light levels) highlight possible targets for future improvement efforts.
• Hall, D. L., Arditte Hall, K. A., Gorman, M. J., Comander, A., Goldstein, M. R., Cunningham, T. J., Wieman, S., Mizrach, H. R., Juhel, B. C., Li, R., Markowitz, A., Grandner, M., & Park, E. R. (2022). The Survivorship Sleep Program (SSP): A synchronous, virtual cognitive behavioral therapy for insomnia pilot program among cancer survivors. Cancer, 128(7), 1532-1544.
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  For cancer survivors, insomnia is prevalent, distressing, and persists for years if unmanaged. Cognitive behavioral therapy for insomnia (CBT-I) is an effective treatment yet can be difficult to access and may require modification to address survivorship-specific barriers to sleep. In this 2-phase study, the authors adapted and assessed the feasibility, acceptability, and preliminary effects of synchronous, virtual CBT-I adapted for cancer survivors (the Survivorship Sleep Program [SSP]).
• Hughes, A. J., Gunn, H., Siengsukon, C., Stearns, M. A., James, E., Donley, T., Grandner, M. A., Thomas, S. J., Hansen, K., & Williams, N. J. (2022). Eliminating Sleep Health Disparities and Achieving Health Equity: Seven Areas for Action in the Behavioral Sleep Medicine Community. Behavioral sleep medicine, 1-13.
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  Racial and ethnically minoritized and under-resourced populations do not reap the same benefits of sufficient sleep as their white counterparts resulting in insufficient sleep and sleep health disparities. Research exploring these disparities have documented a plethora of factors including social determinants of health, community violence, and structural issues - all of which are associated with adverse sleep. There are robust evidence base behavioral intervention that can be leveraged to improve sleep health among racial and ethnic groups. However, EBIs are not well leveraged. In 2021, with participation from members of the society of behavioral sleep medicine, we conducted this report to bring together the field of behavioral sleep medicine including researchers, clinicians and trainees to discuss gaps and opportunities at the intersection of the COVID-19 pandemic, systemic racism, and sleep health. The goals were anchored around seven recommendations toward reducing disparities in the near-term and longer-term approaches to eliminating disparities. Furthermore, we acknowledge that reducing and eliminating disparities in sleep health requires a multifaceted approach that includes a focus on individual, community, health care and societal levels of influence with participation from diverse partners including federal, state and local.
• Jean-Louis, G., Grandner, M. A., & Seixas, A. A. (2022). Social determinants and health disparities affecting sleep. The Lancet. Neurology, 21(10), 864-865.
• Kennedy, K. E., Bastien, C. H., Ruby, P. M., Killgore, W. D., Wills, C. C., & Grandner, M. A. (2022). Nightmare content during the COVID-19 pandemic: Influence of COVID-related stress and sleep disruption in the United States. Journal of sleep research, 31(1), e13439.
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  Nightmares are often associated with psychiatric disorders and acute stress. This study explores how the COVID-19 pandemic may have influenced the content of nightmares. A sample of N = 419 US adults completed online surveys about sleep and COVID-19 experiences. Participants were asked about the degree to which they agreed with statements linking greater general stress, worse overall sleep and more middle-of-the-night insomnia with the COVID-19 pandemic. They were also asked if, during the pandemic, they experienced nightmares related to various themes. Logistic regression analyses examined each nightmare content as outcome and increased stress, worse sleep and more middle-of-the-night insomnia as predictors, adjusted for age, sex and race/ethnicity. Those who reported greater general COVID-related stress were more likely to have nightmares about confinement, failure, helplessness, anxiety, war, separation, totalitarianism, sickness, death, COVID and an apocalypse. Those who reported worsened sleep were more likely to have nightmares about confinement, oppression, failure, helplessness, disaster, anxiety, evil forces, war, domestic abuse, separation, totalitarianism, sickness, death, COVID and an apocalypse. Those who reported worsened middle-of-the-night insomnia were more likely to have nightmares about confinement, oppression, failure, helplessness, disaster, anxiety, war, domestic abuse, separation, totalitarianism, sickness, death, COVID and an apocalypse. These results suggest that increased pandemic-related stress may induce negatively-toned dreams of specific themes. Future investigation might determine whether (and when) this symptom indicates an emotion regulation mechanism at play, or the failure of such a mechanism.
• Kennedy, K. E., Onyeonwu, C., Nowakowski, S., Hale, L., Branas, C. C., Killgore, W. D., Wills, C. C., & Grandner, M. A. (2022). Menstrual regularity and bleeding is associated with sleep duration, sleep quality and fatigue in a community sample. Journal of sleep research, 31(1), e13434.
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  Female menstrual health and its relationship with sleep is an understudied subject. The aim of this investigation was to determine the association between the two in a community sample. Data were obtained from n = 579 menstruating females who participated in the Sleep and Health Activity, Diet, Environment, and Socialization (SHADES) study, a community-based sample of adults aged 22-60 years. Participants were asked, "How regular is your period?", with response choices of "very regular", "mostly regular", "fairly regular" and "not regular". They were also asked, "How much bleeding do you usually experience during your period?" Response choices were: "very heavy", "heavy", "medium", "light" or "very light". These were evaluated as ordinal outcomes. Sleep-related predictors included sleep duration (in hr; ≤ 6 [short], 7-9 [normal] and ≥ 9 [long]), Insomnia Severity Index score, Pittsburgh Sleep Quality Index score, Epworth Sleepiness Scale score and Fatigue Severity Scale score. Covariates included age, education, income, race/ethnicity and body mass index. Short sleep duration was associated with heavier bleeding (odds ratio = 1.46, p = 0.026) and greater cycle irregularity (odds ratio = 1.44, p = 0.031) as compared with normal sleep. Higher Pittsburgh Sleep Quality Index score was associated with greater cycle irregularity (odds ratio = 1.05, p = 0.022). Higher Fatigue Severity Scale score was associated with heavier bleeding (odds ratio = 1.02, p = 0.003) and greater cycle irregularity (odds ratio = 1.02, p = 0.008). Long sleep, Insomnia Severity Index and Epworth Sleepiness Scale were not associated with either outcome. These results demonstrate an association between short sleep duration, poor sleep quality, fatigue, stress and depression with heavier bleeding and menstrual cycle irregularity, highlighting the need for further studies to improve treatment options.
• Killgore, W. D., Alkozei, A., Vanuk, J. R., Reign, D., Grandner, M. A., & Dailey, N. S. (2022). Blue light exposure increases functional connectivity between dorsolateral prefrontal cortex and multiple cortical regions. Neuroreport, 33(5), 236-241.
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  Blue light is a powerful environmental stimulus that can produce significant phase shifts in the circadian rhythm of melatonin and sleep propensity as well as acute effects on alertness of neurobehavioral performance. Here, we undertook an expansion and reanalysis of our previously published findings to examine the effect of acute blue light exposure on the strength of resting-state functional connectivity (rsFC) between a previously identified region of the left dorsolateral prefrontal cortex (DLPFC) and 106 cortical and subcortical regions.
• Killgore, W. D., Grandner, M. A., Tubbs, A. S., Fernandez, F. X., Doty, T. J., Capaldi Ii, V. F., & Dailey, N. S. (2022). Sleep loss suicidal ideation: the role of trait extraversion. Frontiers in behavioral neuroscience, 16, 886836.
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  It is known that sleep disturbance is associated with increased suicidal thinking. Moreover, completed suicides, when adjusted for the proportion of the populace that is awake at a given time, are more probable during the late night/early morning hours. Despite these concerns, no studies have examined the role of trait-like individual differences in vulnerability to suicidal ideation during sleep deprivation or insomnia. In two separate studies, we examined whether the trait of extraversion is predictive of changes in suicidal thinking following two nights of sleep deprivation and among individuals meeting the criteria for insomnia. Study 1: Twenty-five healthy military personnel (20 males), ages 20-35 completed the NEO-PI-R Extraversion scale and the Suicidal Ideation (SUI) scale of the Personality Assessment Inventory (PAI). Participants completed 77 h of continuous sleep deprivation. After 56 h of sleep deprivation, participants completed the SUI scale a second time. We predicted a change in SUI scores from baseline extraversion. Study 2: 2,061 adults aged 18-79 (900 males) were divided into two groups based on the clinical threshold (≥ 10) on the Insomnia Severity Index (ISI) and completed measures of extraversion and depression, including the suicide item of the Patient Health Questionnaire-9 (PHQ9). Study 1: After controlling for the caffeine group and changes in PAI Depression, Extraversion scores were used to predict changes in SUI scores using stepwise multiple linear regression. Higher Extraversion was significantly associated with increased non-clinical suicidal ideation following sleep loss, β = 0.463, partial = 0.512, = 0.013. Study 2: After controlling for depression, the effect of insomnia on suicidal ideation was moderated by trait extraversion ( < 0.0001). Overall, the presence or absence of insomnia had little effect on individuals low in trait extraversion (i.e., introverts), but insomnia was associated with significantly higher suicidal ideation among high trait extraverted individuals. Higher trait extraversion was associated with increased vulnerability to suicidal ideation between rested baseline and total sleep deprivation and was associated with greater suicidal ideation among those meeting criteria for clinically severe insomnia. These findings point to a potential trait-like vulnerability factor that may further our understanding of sleep disruption in the phenomenology of suicide.
• Killgore, W. D., Vanuk, J. R., Persich, M. R., Cloonan, S. A., Grandner, M. A., & Dailey, N. S. (2022). Sleep quality and duration are associated with greater trait emotional intelligence. Sleep health, 8(2), 230-233.
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  Prior work suggests that short sleep and total sleep deprivation are associated with reduced trait Emotional Intelligence (trait EI) but not reduced ability Emotional Intelligence (ability EI). To expand this knowledge base, we investigated the role of habitual sleep quality on trait and ability EI above and beyond the known effects of recent sleep duration.
• Lloyd-Jones, D. M., Allen, N. B., Anderson, C. A., Black, T., Brewer, L. C., Foraker, R. E., Grandner, M. A., Lavretsky, H., Perak, A. M., Sharma, G., Rosamond, W., & , A. H. (2022). Life's Essential 8: Updating and Enhancing the American Heart Association's Construct of Cardiovascular Health: A Presidential Advisory From the American Heart Association. Circulation, 146(5), e18-e43.
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  In 2010, the American Heart Association defined a novel construct of cardiovascular health to promote a paradigm shift from a focus solely on disease treatment to one inclusive of positive health promotion and preservation across the life course in populations and individuals. Extensive subsequent evidence has provided insights into strengths and limitations of the original approach to defining and quantifying cardiovascular health. In response, the American Heart Association convened a writing group to recommend enhancements and updates. The definition and quantification of each of the original metrics (Life's Simple 7) were evaluated for responsiveness to interindividual variation and intraindividual change. New metrics were considered, and the age spectrum was expanded to include the entire life course. The foundational contexts of social determinants of health and psychological health were addressed as crucial factors in optimizing and preserving cardiovascular health. This presidential advisory introduces an enhanced approach to assessing cardiovascular health: Life's Essential 8. The components of Life's Essential 8 include diet (updated), physical activity, nicotine exposure (updated), sleep health (new), body mass index, blood lipids (updated), blood glucose (updated), and blood pressure. Each metric has a new scoring algorithm ranging from 0 to 100 points, allowing generation of a new composite cardiovascular health score (the unweighted average of all components) that also varies from 0 to 100 points. Methods for implementing cardiovascular health assessment and longitudinal monitoring are discussed, as are potential data sources and tools to promote widespread adoption in policy, public health, clinical, institutional, and community settings.
• Lloyd-Jones, D. M., Ning, H., Labarthe, D., Brewer, L., Sharma, G., Rosamond, W., Foraker, R. E., Black, T., Grandner, M. A., Allen, N. B., Anderson, C., Lavretsky, H., & Perak, A. M. (2022). Status of Cardiovascular Health in US Adults and Children Using the American Heart Association's New "Life's Essential 8" Metrics: Prevalence Estimates From the National Health and Nutrition Examination Survey (NHANES), 2013 Through 2018. Circulation, 146(11), 822-835.
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  The American Heart Association recently published an updated algorithm for quantifying cardiovascular health (CVH)-the Life's Essential 8 score. We quantified US levels of CVH using the new score.
• Mansfield, D. R., Wasgewatta, S., Reynolds, A., Grandner, M. A., Tubbs, A. S., King, K., Johnson, M., Mascaro, L., Durukan, M., Paul, E., Drummond, S. P., & Perlis, M. L. (2022). Nocturnal Wakefulness and Suicide Risk in the Australian Population. The Journal of clinical psychiatry, 83(4).
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  Temporal patterns for suicide over a 24-hour period have shown mixed results among prior studies. However, analyses of 24-hour temporal patterns for wakeful actions including suicidal behavior should adjust for expected sleep requirements that inherently skew such activities to conventional wakeful times. This study analyzed the time-of-day for suicide cases from the Australian population for the year 2017, adjusting for expected sleep patterns. Identification of time-of-day trends using this methodology may reveal risk factors for suicide and potentially modifiable contributors. The Australian National Coronial Information System database was accessed, and data for completed suicide were extracted for the most recent completed year (2017). Time of suicide was allocated to one of four 6-hourly time bins across 24 hours, determined from time last seen alive and time found subsequently. Prevalence of suicide for each time bin was adjusted for the likelihood of being awake for each bin according to sleep-wake norms published from a large Australian community survey. Observed prevalence of suicide was compared to expected values predicted from likelihood of being awake across each time bin calculated as a standardized incidence ratio (SIR). For the year 2017, there were 2,808 suicides, of which 1,417 were able to be allocated into one of four 6-hourly time bins. When compared to expected values, suicides were significantly more likely to occur in the overnight bin (2301-0500; SIR = 3.93,  
• Martinez, S. M., Chodur, G. M., Esaryk, E. E., Kaladijian, S., Ritchie, L. D., & Grandner, M. (2022). Campus Food Pantry Use Is Linked to Better Health Among Public University Students. Journal of nutrition education and behavior, 54(6), 491-498.
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  To examine retrospectively whether access to a campus food pantry (CFP) is related to improvements in sleep, mental health, and physical health among college students in a public university system.
• Marupuru, S., Bell, M. L., Grandner, M. A., & Taylor-Piliae, R. E. (2022). The Effect of Physical Activity on Sleep Quality among Older Stroke Survivors: Secondary Analysis from a Randomized Controlled Trial. International journal of environmental research and public health, 19(20).
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  Poor sleep quality constitutes one of the most common difficulties faced by stroke survivors. Physical activity has been shown to improve sleep quality among healthy adults. The study objective was to examine the effect of physical activity on sleep outcomes in community-dwelling stroke survivors previously enrolled in a randomized clinical trial (RCT). Secondary analysis of data collected in the RCT was used to examine the effects of physical activity (PA) on sleep outcomes using the Pittsburgh Sleep Quality Index (PSQI), compared to usual care (controls). Unadjusted and adjusted mixed effects models were used to model changes in sleep quality between groups. At baseline, poor sleep quality (PSQI > 5) was reported by about half of the participants (PA group = 48.5%, n = 47/97; controls = 56.3%, n = 27/48). Results from the unadjusted and adjusted models for sleep quality were similar and showed no statistically significant differences between groups ( > 0.05). In the unadjusted model, the difference between groups (change from baseline to 24 weeks) showed that the PA group had better sleep quality than the controls (difference= -1.02 points, 95% CI -2.12, 0.07, = 0.07). In the model adjusted for age, social support, and marital status, the difference between groups (change from baseline to 24 weeks) showed that the PA group had better sleep quality than the controls (difference= -1.07 points, 95% CI -2.19, 0.05, = 0.06). PA did not significantly improve sleep quality in older community-dwelling stroke survivors. Further research is needed to confirm or refute these findings.
• Mason, B. J., Tubbs, A. S., Fernandez, F. X., & Grandner, M. A. (2022). Spectrophotometric properties of commercially available blue blockers across multiple lighting conditions. Chronobiology international, 39(5), 653-664.
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  Lenses that filter short-wavelength ("blue") light are commercially marketed to improve sleep and circadian health. Despite their widespread use, minimal data are available regarding their comparative efficacy in curtailing blue light exposure while maintaining visibility. Fifty commercial lenses were evaluated using five light sources: a blue LED array, a computer tablet display, an incandescent lamp, a fluorescent overhead luminaire, and sunlight. Absolute irradiance was measured at baseline and for each lens across the visual spectrum (380-780 nm), which allowed calculation of percent transmission. Transmission specificity was also calculated to determine whether light transmission was predominantly circadian-proficient (455-560 nm) or non-proficient (380-454 nm and 561-780 nm). Lenses were grouped by tint and metrics were compared between groups. Red-tinted lenses exhibited the lowest transmission of circadian-proficient light, while reflective blue lenses had the highest transmission. Orange-tinted lenses transmitted similar circadian-proficient light as red-tinted lenses but transmitted more non-circadian-proficient light, resulting in higher transmission specificity. Orange-tinted lenses had the highest transmission specificity while limiting biologically active light exposure in ordinary lighting conditions. Glasses incorporating these lenses currently have the greatest potential to support circadian sleep-wake rhythms.
• Muench, A., Vargas, I., Grandner, M. A., Ellis, J. G., Posner, D., Bastien, C. H., Drummond, S. P., & Perlis, M. L. (2022). We know CBT-I works, now what?. Faculty reviews, 11, 4.
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  Cognitive behavioral therapy for insomnia (CBT-I) has been shown to be efficacious and now is considered the first-line treatment for insomnia for both uncomplicated insomnia and insomnia that occurs comorbidly with other chronic disorders (comorbid insomnia). The purposes of this review are to provide a comprehensive summary of the efficacy data (for example, efficacy overall and by clinical and demographic considerations and by CBT-I formulation) and to discuss the future of CBT-I (for example, what next steps should be taken in terms of research, dissemination, implementation, and practice).
• Robbins, R., Beebe, D. W., Byars, K. C., Grandner, M., Hale, L., Tapia, I. E., Wolfson, A. R., & Owens, J. A. (2022). Adolescent sleep myths: Identifying false beliefs that impact adolescent sleep and well-being. Sleep health, 8(6), 632-639.
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  Commonly held beliefs about sleep unsupported by scientific evidence (ie, myths) among adolescents and their parents/caregivers may adversely influence sleep-related attitudes and behaviors among adolescents. Thus, identifying such myths with the goal of developing effective evidence-based counter-messages has the potential to improve sleep health in adolescents.
• Scott, H., Cheung, J. M., Muench, A., Ivers, H., Grandner, M. A., Lack, L., Morin, C. M., & Perlis, M. (2022). Does total sleep time substantially increase after cognitive behavioral therapy for insomnia?. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 18(7), 1823-1829.
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  In most standardized approaches to cognitive behavioral therapy for insomnia, it is commonly the case that total wake time is reduced substantially during sleep restriction, but self-reported total sleep time (TST) is minimally affected. By follow-up, however, TST increases by almost 1 hour on average. A secondary analysis was undertaken to assess what percentage of participants meet or appreciably exceed baseline TST after cognitive behavioral therapy for insomnia.
• Tubbs, A. S., Fernandez, F. X., Grandner, M. A., & Perlis, M. L. (2022). Emerging evidence for sleep instability as a risk mechanism for nonsuicidal self-injury. Sleep, 45(6).
• Tubbs, A. S., Fernandez, F. X., Grandner, M. A., Perlis, M. L., & Klerman, E. B. (2022). The Mind After Midnight: Nocturnal Wakefulness, Behavioral Dysregulation, and Psychopathology. Frontiers in network physiology, 1.
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  Sufficient sleep with minimal interruption during the circadian/biological night supports daytime cognition and emotional regulation. Conversely, disrupted sleep involving significant nocturnal wakefulness leads to cognitive and behavioral dysregulation. Most studies to-date have examined how fragmented or insufficient sleep affects next-day functioning, but recent work highlights changes in cognition and behavior that occur when someone is awake during the night. This review summarizes the evidence for day-night alterations in maladaptive behaviors, including suicide, violent crime, and substance use, and examines how mood, reward processing, and executive function differ during nocturnal wakefulness. Based on this evidence, we propose the hypothesis in which attentional biases, negative affect, altered reward processing, and prefrontal disinhibition interact to promote behavioral dysregulation and psychiatric disorders.
• Tubbs, A. S., Ghani, S. B., Naps, M., Grandner, M. A., Stein, M. D., & Chakravorty, S. (2022). Past-year use or misuse of an opioid is associated with use of a sedative-hypnotic medication: a US National Survey on Drug Use and Health (NSDUH) study. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 18(3), 809-816.
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  Prescription use and misuse of opioids are linked to greater sleep disturbance. However, there are limited data on the prevalence of sedative-hypnotic medication use among persons who use opioids. Therefore, this study examined whether past-year sedative-hypnotic use among persons who used/misused opioids was higher than among individuals who did not use opioids.
• Tubbs, A. S., Hendershot, S., Ghani, S. B., Nadorff, M. R., Drapeau, C. W., Fernandez, F. X., Perlis, M. L., & Grandner, M. A. (2022). Social Jetlag and Other Aspects of Sleep Are Linked to Non-Suicidal Self-Injury Among College Students. Archives of suicide research : official journal of the International Academy for Suicide Research, 1-18.
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  Disrupted sleep is associated with non-suicidal self-injury (NSSI) in young adults, but many specific features of sleep continuity and timing have yet to be examined. Additionally, the psychological mechanisms linking sleep to NSSI are unclear. The present study evaluated 14 sleep variables as classifiers of lifetime or recent NSSI and examined potential confounding and mediating factors.
• Tubbs, A. S., Killgore, W. D., Karp, J. F., Fernandez, F. X., & Grandner, M. A. (2022). Insomnia and the Interpersonal Theory of suicide among civilians, service members, and veterans. Journal of psychiatric research, 155, 534-541.
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  Insomnia is associated with suicide risk in civilian and military populations. Thwarted belongingness is proposed as a mediator of this relationship under the Interpersonal Theory of Suicide (IPTS). The present study explored how insomnia relates to suicidal ideation in conjunction with thwarted belongingness among civilians, Service members, and Veterans.
• Wickwire, E. M., Abdelwadoud, M., Collen, J., Edwards, H., Labra, C., Capaldi, V. F., Williams, S. G., Manber, R., Assefa, S. Z., Drake, C. L., Albrecht, J. S., Bevan, J., Mahoney, A., Tatum, E. D., Pierre, E., Mantua, J., Grandner, M. A., & Mullins, C. D. (2022). Active Duty Service Members, Primary Managers, and Administrators' Perspectives on a Novel Sleep Telehealth Management Platform in the U.S. Military Healthcare System. Military medicine, 187(9-10), e1201-e1208.
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  Sleep disorders are common in the military, and there is a gross shortage of sleep specialists in the military health system. The purposes of the present study were to (1) understand perceptions and expectations surrounding sleep telehealth approaches and (2) solicit feedback to optimize and refine a proposed novel sleep telehealth management platform. To accomplish these objectives, we investigated the perceptions, expectations, and preferences of active duty service members (ADSMs) with sleep disorders, primary care managers (PCMs), and administrative stakeholders regarding sleep telehealth management.
• Xu, S., Turakhia, S., Miller, M., Johnston, D., Maddalozzo, J., Thompson, D., Trosman, I., Grandner, M., Sheldon, S. H., Ahluwalia, V., & Bhushan, B. (2022). Association of obstructive sleep apnea and total sleep time with health-related quality of life in children undergoing a routine polysomnography: a PROMIS approach. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 18(3), 801-808.
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  Obstructive sleep apnea (OSA) negatively impacts health-related quality of life (HR-QoL) in adults, but few pediatric studies have explored this relationship or the relationships between HR-QoL domains.
• de Zambotti, M., Menghini, L., Grandner, M. A., Redline, S., Zhang, Y., Wallace, M. L., & Buxton, O. M. (2022). Rigorous performance evaluation (previously, "validation") for informed use of new technologies for sleep health measurement. Sleep health, 8(3), 263-269.
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  New sleep technologies have become pervasive in the consumer space, and are becoming highly common in research and clinical sleep settings. The rapid, widespread use of largely unregulated and unstandardized technology has enabled the quantification of many different facets of sleep health, driving scientific discovery. As sleep scientists, it is our responsibility to inform principles and practices for proper evaluation of any new technology used in the clinical and research settings, and by consumers. A current lack of standardized methods for evaluating technology performance challenges the rigor of our scientific methods for accurate representation of the sleep health facets of interest. This special article describes the rationale and priorities of an interdisciplinary effort for rigorous, standardized, and rapid performance evaluation (previously, "validation") of new sleep and sleep disorders related technologies of all kinds (eg, devices or algorithms), including an associated article template for a new initiative for publication in Sleep Health of empirical studies systematically evaluating the performance of new sleep technologies. A structured article type should streamline manuscript development and enable more rapid writing, review, and publication. The goal is to promote rapid and rigorous evaluation and dissemination of new sleep technology, to enhance sleep research integrity, and to standardize terminology used in Rigorous Performance Evaluation papers to prevent misinterpretation while facilitating comparisons across technologies.
• Charest, J., Bastien, C. H., Ellis, J. G., Killgore, W. D., & Grandner, M. A. (2021). The Impact of Perceived Sleep, Mood and Alcohol Use on Verbal, Physical and Sexual Assault Experiences among Student Athletes and Student Non-Athletes. International journal of environmental research and public health, 18(6).
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  Previous research has shown that student athletes are more likely to be involved in a physical altercation or be a victim of verbal, physical and/or sexual abuse than student non-athletes, which can have long-lasting negative effects on mood, behavior and quality of life. In addition, among college students, sleep difficulties are ubiquitous and may deteriorate the unique life experience that university represents. The influences of poor sleep quality, mood and alcohol consumption related to these events are examined here between student athletes and student non-athletes. A series of hierarchical logistic regressions explored the relationship between verbal, physical and sexual assault risk factors. Results suggest that poor sleep, alcohol consumption and mood are all associated with exposure to a physical altercation or episode of abuse, irrespective of athlete status. Results also show that variables targeting self-reported difficulty sleeping and experiences of verbal, physical and sexual assault were positively associated. However, given the cross-sectional nature of the study, it is impossible to establish the direction of these relationships.
• Charest, J., Samuels, C. H., Bastien, C. H., Lawson, D., & Grandner, M. A. (2021). Impacts of travel distance and travel direction on back-to-back games in the National Basketball Association. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 17(11), 2269-2274.
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  Travel fatigue and circadian disruptions are known factors that can hinder performance in professional athletes. The present study focused on travel distance and direction on back-to-back games over the 2013-2020 seasons in the National Basketball Association (NBA).
• Chaudhary, N. S., Taylor, B. V., Grandner, M. A., Troxel, W. M., & Chakravorty, S. (2021). The effects of caffeinated products on sleep and functioning in the military population: A focused review. Pharmacology, biochemistry, and behavior, 206, 173206.
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  Military personnel rely on caffeinated products such as coffee or energy drinks (ED) to maintain a maximal level of vigilance and performance under sleep-deprived and combat situations. While chronic caffeine intake is associated with decreased sleep duration and non-restful sleep in the general population, these relationships are relatively unclear in the military personnel. We conducted a focused review of the effects of caffeinated products on sleep and the functioning of military personnel. We used a pre-specified search algorithm and identified 28 peer-reviewed articles published between January 1967 and July 2019 involving military personnel. We classified the findings from these studies into three categories. These categories included descriptive studies of caffeine use, studies evaluating the association between caffeinated products and sleep or functioning measures, and clinical trials assessing the effects of caffeinated products on functioning in sleep-deprived conditions. Most of the studies showed that military personnel used at least one caffeine-containing product per day during active duty and coffee was their primary source of caffeine. Their mean caffeine consumption varied from 212 to 285 mg/day, depending on the type of personnel and their deployment status. Those who were younger than 30 years of age preferred ED use. Caffeine use in increasing amounts was associated with decreased sleep duration and increased psychiatric symptoms. The consumption of caffeinated products during sleep deprivation improved their cognitive and behavioral outcomes and physical performance. Caffeine and energy drink consumption may maintain some aspects of performance stemming from insufficient sleep in deployed personnel, but excessive use may have adverse consequences.
• Ellis, J. G., Perlis, M. L., Espie, C. A., Grandner, M. A., Bastien, C. H., Barclay, N. L., Altena, E., & Gardani, M. (2021). The natural history of insomnia: predisposing, precipitating, coping, and perpetuating factors over the early developmental course of insomnia. Sleep, 44(9).
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  While there is an extensive literature on predisposing, precipitating, coping, and perpetuating factors in those with chronic insomnia, very little work has been undertaken to evaluate these factors over the early developmental course of insomnia. The present aim was to determine whether several hypothesized factors in each domain (predisposing, precipitating, coping, and perpetuating), assessed during an episode of acute insomnia (AI), are related to its persistence or remission to normal sleep. Participants comprised n = 140 people with AI and n = 737 normal sleepers (NS) recruited from the general public. Participants completed measures assessing predisposing characteristics (personality traits, arousal predisposition, and insomnia vulnerability), precipitating events and outcomes (life events, perceived stress, anxiety, and depression), coping styles (thought control strategies and coping styles), and perpetuating factors (sleep preoccupation, pre-sleep arousal, dysfunctional beliefs, and fatigue). Additionally, insomnia status (from AI at baseline to its persistence or natural remission [NR]) was assessed 1 month later (n = 129). Baseline differences between NS and individuals with AI were observed in each domain with increasing age, lower openness to experience and conscientiousness, higher insomnia severity, levels of anxiety, and affective sleep preoccupation significantly predicting AI status. Further, a previous episode of insomnia, higher depression scores, and affective sleep preoccupation scores significantly predicted its persistence, as opposed to its NR. Results are discussed with reference to the conceptualization of insomnia and how the findings may influence the design of preventative interventions to circumvent the transition from acute to chronic insomnia.
• Ghani, S. B., Begay, T. K., & Grandner, M. A. (2021). Sleep-disordered Breathing and Insomnia as Cardiometabolic Risk Factors among U.S. Hispanics/Latinx(s). American journal of respiratory and critical care medicine, 203(3), 285-286.
• Ghani, S. B., Taneja, K., Wills, C. C., Tubbs, A. S., Delgadillo, M. E., Valencia, D., Halane, M., Killgore, W. D., & Grandner, M. A. (2021). Culturally-consistent diet among individuals of Mexican descent at the US-Mexico border is associated with sleep duration and snoring. BMC nutrition, 7(1), 53.
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  Existing studies show that consuming food consistent with one's culture reduces cardiometabolic risk. However, few studies have assessed whether these dietary choices influence sleep health. Accordingly, this study assessed how Mexican food consumption by individuals of Mexican descent residing at the US-Mexico border, was associated with various measures of sleep, after accounting for acculturation.
• Grandner, M. A., & Fernandez, F. X. (2021). The translational neuroscience of sleep: A contextual framework. Science (New York, N.Y.), 374(6567), 568-573.
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  Sleep is entwined across many physiologic processes in the brain and periphery, thereby exerting tremendous influence on our well-being. Yet sleep exists in a social-environmental context. Contextualizing sleep health with respect to its determinants—from individual- to societal-level factors—would enable neuroscientists to more effectively translate sleep health into clinical practice. Key challenges and opportunities pertain to (i) recognizing and exploring sleep’s functional roles, (ii) clarifying causal mechanisms in relation to key outcomes, (iii) developing richer model systems, (iv) linking models to known contextual factors, and (v) leveraging advances in multisensory technology. Meeting these challenges and opportunities would help transcend disciplinary boundaries such that social-environmental considerations related to sleep would become an ever-greater presence in the clinic.
• Grandner, M. A., Hall, C., Jaszewski, A., Alfonso-Miller, P., Gehrels, J. A., Killgore, W. D., & , A. A. (2021). Mental Health in Student Athletes: Associations With Sleep Duration, Sleep Quality, Insomnia, Fatigue, and Sleep Apnea Symptoms. Athletic training & sports health care, 13(4), e159-e167.
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  To quantify the relationship between sleep difficulties and poor mental health among student athletes using validated measures.
• Grandner, M. A., Lujan, M. R., & Ghani, S. B. (2021). Sleep-tracking technology in scientific research: looking to the future. Sleep, 44(5).
• Hoopes, E. K., Witman, M. A., D'Agata, M. N., Berube, F. R., Brewer, B., Malone, S. K., Grandner, M. A., & Patterson, F. (2021). Rest-activity rhythms in emerging adults: implications for cardiometabolic health. Chronobiology international, 1-14.
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  Emerging adulthood (18-25 years) represents a window of opportunity to modify the trajectory of cardiometabolic disease risk into older adulthood. Not known is the extent to which rest-activity rhythms (RAR) may be related to biomarkers of cardiometabolic health in this population. In this cross-sectional, observational study, 52 healthy emerging adults wore wrist accelerometers (14 consecutive days; 24 h/day) for assessment of nonparametric RAR metrics, including interdaily stability (IS; day-to-day RAR consistency), intradaily variability (IV; within-day RAR fragmentation), and relative amplitude (RA; robustness of RAR), as well as autocorrelation (correlation of rest/activity levels at 24-h lag-times). Cardiometabolic biomarkers, including body mass index (BMI), body fat percentage, blood pressure (BP), fasting lipids, glucose, and C-reactive protein (CRP) were assessed. Additional measures including physical activity, sleep duration, and habitual caffeine and alcohol consumption were also evaluated. A series of multivariable regression models of cardiometabolic biomarkers were used to quantify associations with RAR metrics. On average, participants were 20 ± 1 years of age (21 males, 31 females), non-obese, and non-hypertensive. All were nonsmokers and free of major diseases or conditions. In separate models, which adjusted for sex, BMI, moderate-vigorous physical activity, sleep duration, caffeine, and alcohol consumption, IS was inversely associated with total cholesterol (p ≤ 0.01) and non-HDL cholesterol (
• Jean-Louis, G., Grandner, M. A., & Pandi-Perumal, S. R. (2021). Sleep Health and Longevity-Considerations for Personalizing Existing Recommendations. JAMA network open, 4(9), e2124387.
• Kennedy, K. E., & Grandner, M. A. (2021). Sleep, Dreams, and Nightmares During the COVID-19 Pandemic. American journal of health promotion : AJHP, 35(8), 1168-1173.
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  The COVID-19 pandemic has affected the sleep and dreams of many individuals. Some have experienced improvements, while others have had more complaints. The changes to daily life such as working from home and spending more time indoors in confinement may have disturbed the circadian rhythms of some individuals. There were many reports of a shift towards a later bedtime during the pandemic, with several studies showing that in general, females experienced worse sleep than males, including more nighttime awakenings and nightmares. Increased dream and nightmare frequency during the pandemic has been shown in multiple studies. It has been postulated that because dreams are often guided by the dominant emotional state, that dreams and nightmares related to pandemic themes are a result of specific stressors related to COVID-19. Those experiencing unwanted sleep disturbances and nightmares could stand to benefit from mindfulness and relaxation practices that can ease stress and anxiety before bedtime. Striving to maintain a regular sleep schedule and enhance exposure to daylight-particularly during the first half of the day-may also be helpful.
• Knowlden, A. P., Higginbotham, J. C., Grandner, M. A., & Allegrante, J. P. (2021). Modeling Risk Factors for Sleep- and Adiposity-Related Cardiometabolic Disease: Protocol for the Short Sleep Undermines Cardiometabolic Health (SLUMBRx) Observational Study. JMIR research protocols, 10(3), e27139.
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  Obesity and short sleep duration are significant public health issues. Current evidence suggests that these conditions are associated with cardiovascular disease, metabolic syndrome, inflammation, and premature mortality. Increased interest in the potential link between obesity and short sleep duration, and its health consequences, has been driven by the apparent parallel increase in the prevalence of both conditions in recent decades, their overlapping association with cardiometabolic outcomes, and the potential causal connection between the two health issues. The SLUMBRx (Short Sleep Undermines Cardiometabolic Health) study seeks to contribute to the development of a comprehensive adiposity-sleep model while laying the groundwork for a future research program that will be designed to prevent and treat adiposity- and sleep-related cardiometabolic disease risk factors.
• Krupp, K., Madhivanan, P., Killgore, W. D., Ruiz, J. M., Carvajal, S., Coull, B. M., & Grandner, M. A. (2021). Neurological Manifestations in COVID-19: An Unrecognized Crisis in Our Elderly?. Advances in geriatric medicine and research, 3(3).
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  As of December 2020, there were more than 900,000 COVID-19 hospitalizations in the US with about 414,000 among individuals aged 65 years and older. Recent evidence suggests a growing number of older patients continue to suffer serious neurological comorbidities including polyneuropathy, cerebrovascular disease, central nervous system infection, cognitive deficits, and fatigue following discharge. Studies suggest that complaints manifest late in disease and persist beyond resolution of acute COVID-19 symptoms. Recent research reports that neurocognitive symptoms are correlated with severe disease, older age, male gender, and comorbidities including hypertension, renal failure, and neoplastic disease. The underlying causes are unclear, but current hypotheses include hypoxic-ischemic brain injury, immunopathological mechanisms, and neurotropism of SARS-CoV-2 infection. There is a pressing need for more research into the underlying mechanisms of post-COVID-19 neurological sequela, particularly in the elderly, a population already burdened with neurocognitive disorders.
• Lee, R., Tapia, A., Kaladchibachi, S., Grandner, M. A., & Fernandez, F. X. (2021). Meta-analysis of light and circadian timekeeping in rodents. Neuroscience and biobehavioral reviews, 123, 215-229.
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  We conducted a meta-analysis of papers published over the past half-century (1964-2017) that quantified the phase-shifting effects of timed light exposure on rodent locomotor rhythms. Descriptive statistics were tabulated in order to explore the extent to which these studies were generalizable across species, sex, age, circadian timing, and light sources. Attempts at understanding photic resetting were primarily targeted at younger male animals, with particular emphases placed on characterizing the pacemaker systems of C57BL/6 mice and Syrian hamsters during the parts of their subjective night most sensitive to delivery of white-fluorescent light. With subsequent analyses restricted to these rodent models, we then assessed the relationship between luminous exposure (via broadspectrum emission) and phase-shifting through a series of linear regressions. Monotonically increasing illuminance-response functions were noted at most circadian times surveyed. In the aggregate, our results show that previous research conducted on light's regulation of circadian timekeeping has been skewed in design with respect to several important biological variables. This bias might limit translation of phototherapy-relevant data to women and older individuals.
• Lujan, M. R., Perez-Pozuelo, I., & Grandner, M. A. (2021). Past, Present, and Future of Multisensory Wearable Technology to Monitor Sleep and Circadian Rhythms. Frontiers in digital health, 3, 721919.
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  Movement-based sleep-wake detection devices (i.e., actigraphy devices) were first developed in the early 1970s and have repeatedly been validated against polysomnography, which is considered the "gold-standard" of sleep measurement. Indeed, they have become important tools for objectively inferring sleep in free-living conditions. Standard actigraphy devices are rooted in accelerometry to measure movement and make predictions, scoring algorithms, as to whether the wearer is in a state of wakefulness or sleep. Two important developments have become incorporated in newer devices. First, additional sensors, including measures of heart rate and heart rate variability and higher resolution movement sensing through triaxial accelerometers, have been introduced to improve upon traditional, movement-based scoring algorithms. Second, these devices have transcended scientific utility and are now being manufactured and distributed to the general public. This review will provide an overview of: (1) the history of actigraphic sleep measurement, (2) the physiological underpinnings of heart rate and heart rate variability measurement in wearables, (3) the refinement and validation of both standard actigraphy and newer, multisensory devices for real-world sleep-wake detection, (4) the practical applications of actigraphy, (5) important limitations of actigraphic measurement, and lastly (6) future directions within the field.
• Martinez, S. M., Blanco, E., Tschann, J. M., Butte, N. F., Grandner, M. A., & Pasch, L. A. (2021). Sleep duration, physical activity, and caloric intake are related to weight status in Mexican American children: a longitudinal analysis. The international journal of behavioral nutrition and physical activity, 18(1), 93.
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  Obesity is a serious issue, spanning all ages, and, in the U.S., disproportionately affects Latinos and African Americans. Understanding sleep, physical activity and dietary behaviors that may predict childhood obesity can help identify behavioral intervention targets.
• Patterson, F., Brewer, B., Blair, R., Grandner, M. A., Hoopes, E., Ma, G., Criner, G. J., & Satti, A. (2021). An exploration of clinical, behavioral, and community factors associated with sleep duration and efficiency among middle-aged Black/African American smokers. Sleep health, 7(3), 397-407.
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  We examined the most important correlates to sleep duration and efficiency from a comprehensive array of multilevel factors.
• Perlis, M. L., Morales, K. H., Vargas, I., Muench, A., Seewald, M., Gooneratne, N., Grandner, M. A., Thase, M. E., Kaptchuk, T. J., & Ader, R. (2021). Durability of treatment response to zolpidem using a partial reinforcement regimen: does this strategy require priming?. Sleep medicine, 87, 56-61.
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  Previous research has shown that after one month of full dose nightly treatment with zolpidem (priming), subjects with chronic insomnia (CI) switched to intermittent dosing with medication and placebos were able to maintain their treatment responses. This approach to maintenance therapy is referred to as partial reinforcement. The present study sought to assess whether priming is required for partial reinforcement or whether intermittent dosing with placebos (50% placebos and 50% active medication) can, by itself, be used for both acute and extended treatment.
• Perlis, M. L., Morales, K. H., Vargas, I., Posner, D. A., Grandner, M. A., Muench, A. L., Seewald, M. W., Gooneratne, N. S., Kloss, J. D., Gencarelli, A. M., Khader, W. S., Thase, M. E., & Ellis, J. G. (2021). The natural history of insomnia: Does sleep extension differentiate between those that do and do not develop chronic insomnia?. Journal of sleep research, 30(5), e13342.
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  According to the "3P model" of insomnia, the variable that mediates the transition from acute insomnia (AI) to chronic insomnia is "sleep extension" (the behavioural tendency to expand sleep opportunity to compensate for sleep loss). In the present analysis, we sought to evaluate how time in bed (TIB) varies relative to the new onset of AI and chronic insomnia. A total of 1,248 subjects were recruited as good sleepers (GS). Subjects were monitored over 1 year with sleep diaries. State transitions were defined, a priori, for AI, recovered from AI (AI-REC), and for chronic insomnia (AI-CI). Two additional groupings were added based on profiles that were unanticipated: subjects that exhibited persistent poor sleep following AI (AI-PPS [those that neither recovered or developed chronic insomnia]) and subjects that recovered from chronic insomnia (CI-REC). All the groups (GS, AI-REC, AI-CI, AI-PPS and CI-REC) were evaluated for TIB differences with longitudinal mixed effects models. Post hoc analyses for the percentage of the groups that were typed as TIB "restrictors, maintainers, and expanders" were conducted using longitudinal mixed effects models and contingency analyses. Significant differences for pre-post AI TIB were not detected for the insomnia groups. Trends were apparent for the AI-CI group, which suggested that minor increases in TIB occurred weeks before the declared onset of AI. Additionally, it was found that a significantly larger percentage of AI-CI subjects engaged in sleep extension (as compared to GS). The present data suggest that transition from AI to chronic insomnia does not appear to be initiated by sleep extension and the transition may occur before the elapse of 3 months of ≥3 nights of sleep continuity disturbance. Given these findings, it may be that the mismatch between sleep ability and sleep opportunity is perpetuated over time given the failure to "naturally" engage in sleep restriction (as opposed to sleep extension).
• Perlis, M. L., Pigeon, W. R., Grandner, M. A., Bishop, T. M., Riemann, D., Ellis, J. G., Teel, J. R., & Posner, D. A. (2021). Why Treat Insomnia?. Journal of primary care & community health, 12, 21501327211014084.
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  "Why treat insomnia?" This question grows out of the perspective that insomnia is a symptom that should only receive targeted treatment when temporary relief is needed or until more comprehensive gains may be achieved with therapy for the parent or precipitating medical or psychiatric disorders. This perspective, however, is untenable given recent data regarding the prevalence, course, consequences, and costs of insomnia. Further, the emerging data that the treatment of insomnia may promote better medical and mental health (alone or in combination with other therapies) strongly suggests that the question is no longer "why treat insomnia," but rather "when isn't insomnia treatment indicated?" This perspective was recently catalyzed with the American College of Physicians' recommendation that chronic insomnia should be treated and that the first line treatment should be cognitive-behavioral therapy for insomnia (CBT-I).
• Rezaei, N., & Grandner, M. A. (2021). Changes in sleep duration, timing, and variability during the COVID-19 pandemic: Large-scale Fitbit data from 6 major US cities. Sleep health, 7(3), 303-313.
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  The COVID-19 pandemic has resulted in societal-level changes to sleep and other behavioral patterns. Objective data would allow for a greater understanding of sleep-related changes at the population level. About 163,524 active Fitbit users from 6 major US cities contributed data, representing areas particularly hard-hit by the pandemic (Chicago, Houston, Los Angeles, New York, San Francisco, and Miami). Sleep variables extracted include nightly and weekly mean sleep duration and bedtime, and variability (standard deviation) of sleep duration and bedtime. Deviation from similar timeframes in 2018 and 2019 were examined, as were changes in these sleep metrics during the pandemic, relationships to changes in resting heart rate, and changes during re-opening in May and June. Overall, compared to 2019, mean sleep duration in 2020 was higher among nearly all groups, mean sleep phase shifted later for nearly all groups, and mean sleep duration and bedtime variability decreased for nearly all groups (owing to decreased weekday-weekend differences). Over the course of January to April 2020, mean sleep duration increased, mean bedtime shifted later, and mean sleep duration variability decreased. Changes in observed resting heart rate correlated positively with changes in sleep and negatively with activity levels. In later months (May and June), many of these changes started to drift back to historical norms.
• Robbins, R., Grandner, M., Knowlden, A., & Severt, K. (2021). Examining key hotel attributes for guest sleep and overall satisfaction. Tourism and hospitality research : the Surrey quarterly review, 21(2), 144-155.
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  Despite the fact that hotels provide a venue for sleeping, there is surprisingly little research that has explored sleep among hotel guests. The aim of this study is to identify the relationship between hotel attributes (e.g., light in the guestroom, bed linens), guest sleep, and overall guest satisfaction.
• Robbins, R., Piazza, A., Martin, R. J., Jean-Louis, G., Knowlden, A. P., & Grandner, M. A. (2021). Examining the relationship between poor sleep health and risky driving behaviors among college students. Traffic injury prevention, 22(8), 599-604.
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  Risky driving behaviors, such as texting while driving, are common among young adults and increase risk of traffic accidents and injuries. We examine the relationship between poor sleep and risky driving behaviors among college students as potential targets for traffic injury prevention. Data for this study were obtained from a cross-sectional survey administered to a college student sample in the United States Midwest (n = 1,305). Sleep was measured using the Pittsburgh Sleep Quality Index (PSQI). Risky driving behaviors were measured, including sending texts/emails; reading texts/emails while driving; talking on the phone while driving; falling asleep while driving; and driving under the influence. Risky driving behavior was defined as a response of "just once," "rarely," "sometimes," "fairly often" or "regularly" (reference = "never"). Logistic regression was used to examine the relationship between sleep and risky driving, after adjusting for confounders. Among participants, 75% reported sending texts/emails while driving, 82% reported reading texts/emails while driving, and 84% reported phone talking while driving; 20% reported falling asleep while driving; 8% reported driving under the influence; and 62% reported 3 or more risky behaviors. Compared to those reporting no sleep disturbance, those with sleep disturbance "once or twice a week" were more likely to report sending a text/email while driving (aOR: 2.9, 95%CI:1.7-4.9), reading a text/email while driving (aOR:3.1,95%CI:1.5-5.5), talking on the phone while driving (aOR:1.9, 95%CI:1.0-3.4), and falling asleep while driving (aOR:3.4,95%CI:1.5-7.4). Compared to those reporting no daytime dysfunction, those reporting issues "once or twice a week" were more likely to report talking on the phone while driving (aOR:1.7, 95%CI:1.1-2.7) and falling asleep while driving (aOR:3.6,95%CI:2.3-5.6). Future research may consider designing behavioral interventions that aim to improve sleep, reduce drowsy driving among young adults.
• Taylor-Piliae, R. E., Morrison, H. W., Hsu, C. P., Whitman, S., & Grandner, M. (2021). The Feasibility of Tai Chi Exercise as a Beneficial Mind-Body Intervention in a Group of Community-Dwelling Stroke Survivors with Symptoms of Depression. Evidence-based complementary and alternative medicine : eCAM, 2021, 8600443.
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  Depression is prevalent among one-third to two-thirds of acute and chronic stroke survivors. Despite the availability of pharmacotherapies and/or psychotherapies, depression persists, even for 5-10 years after stroke, reflecting limited treatment responses and/or adherence to this conventional care. Mind-body interventions are commonly used among adults to ameliorate depressive symptoms. Thus, the feasibility of Tai Chi, alongside conventional care, to manage poststroke depression was investigated using a single-group pre-post intervention design. Recruitment and retention, intervention adherence, safety, acceptability, and fidelity were assessed. Symptoms of depression, anxiety, and stress were assessed using standardized questionnaires, objective sleep was assessed via a research-grade triaxial accelerometer, and blood samples were taken to measure oxidative stress, inflammatory markers, and a neurotrophic growth factor using commercially available kits per manufacturer's protocol. Pre-post intervention changes were assessed using paired -tests. We enrolled stroke survivors ( = 11, mean age = 69.7 ± 9.3) reporting depression symptoms. After the intervention, we observed significant reductions in symptoms of depression (-5.3 ± 5.9, =0.01), anxiety (-2.2 ± 2.4, =0.01), and stress (-4.6 ± 4.8, =0.01), along with better sleep efficiency (+1.8 ± 1.8, =0.01), less wakefulness after sleep onset (-9.3 ± 11.6, =0.04), and less time awake (-9.3 ± 11.6, =0.04). There was a 36% decrease in oxidative stress (=0.02), though no significant changes in the other biomarkers were found (all values >0.05). Tai Chi exercise is a feasible intervention that can be used alongside conventional care to manage poststroke depression, aid in reducing symptoms of anxiety and stress, and improve sleep.
• Tubbs, A. S., Fernandez, F. X., Ghani, S. B., Karp, J. F., Patel, S. I., Parthasarathy, S., & Grandner, M. A. (2021). Prescription medications for insomnia are associated with suicidal thoughts and behaviors in two nationally representative samples. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 17(5), 1025-1030.
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  Z-drugs (eszopiclone, zolpidem, and zaleplon) are commonly used for insomnia but are also associated with suicide risk. However, it is unclear if this association is unique to Z-drugs. Therefore, the present study estimated the associations between multiple prescription insomnia medications and suicidal thoughts and behaviors.
• Tubbs, A. S., Fernandez, F. X., Johnson, D. A., Perlis, M. L., & Grandner, M. A. (2021). Nocturnal and Morning Wakefulness Are Differentially Associated With Suicidal Ideation in a Nationally Representative Sample. The Journal of clinical psychiatry, 82(6).
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  Prior studies indicate nocturnal wakefulness is associated with suicide, while morning wakefulness is linked to reduced suicidal ideation. These relationships, however, may be confounded by sociodemographic factors. Therefore, this study investigated whether timing of wakefulness was associated with suicidal ideation in a nationally representative sample. Data were collected from the US National Health and Nutrition Examination Survey for the years 2015 to 2018, resulting in a final sample of 10,166 participants (51.1% female) with complete data available on suicidal ideation status, time to bed, and time out of bed. Population-weighted logistic regression models estimated the associations between time spent out of bed (ie, being awake) and suicidal ideation. A total of 385 survey participants (47.5% female) reported suicidal ideation in the past 2 weeks for a population-weighted prevalence of 3.37% (95% CI, 2.85%-3.87%). Wakefulness between 11:00 pm and 5:00 am was associated with suicidal ideation (OR = 1.16; 95% CI, 1.08-1.24 per hour), even after adjustment for sociodemographic factors and symptoms of sleep disorders, but not after adjustment for the severity of depression symptoms. Conversely, wakefulness between 5:00 am and 11:00 am was associated with reduced odds of suicidal ideation (OR = 0.77; 95% CI, 0.70-0.85 per hour) in all models. Individuals who spent more time awake at night were more likely to have recent suicidal ideation, while the opposite was true for those with more time spent awake in the morning. Moreover, these associations were independent of sociodemographic factors and thus not confounded by varying rates of suicidal ideation in different populations.
• Tubbs, A. S., Kennedy, K. E., Alfonso-Miller, P., Wills, C. C., & Grandner, M. A. (2021). A Randomized, Double-Blind, Placebo-Controlled Trial of a Polyphenol Botanical Blend on Sleep and Daytime Functioning. International journal of environmental research and public health, 18(6).
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  Despite the high prevalence of subclinical sleep disturbances, existing treatments are either potent prescription medications or over-the-counter supplements with minimal scientific support and numerous side effects. However, preliminary evidence shows that polyphenols such as rosmarinic acid and epigallocatechin gallate can support healthy sleep without significant side effects. Therefore, the present study examined whether a polyphenol botanical blend (PBB) could improve sleep and/or daytime functioning in individuals with subclinical sleep disturbances. A total of 89 individuals completed a double-blind, randomized trial of daily treatment with PBB ( = 43) or placebo ( = 46) 30 min before bed for 30 days. Participants were monitored for changes in sleep (by sleep diary and an activity tracker), mood, and neurocognitive functioning. After 30 days, PBB improved diary sleep quality ( = 0.008) and reduced insomnia severity ( = 0.044) when compared to placebo. No other changes in sleep outcomes were observed. Additionally, PBB did not impair neurocognitive functioning, and some improvement was noted in vigilant attention, working memory, and risk assessment. Among individuals with subclinical sleep disturbances, PBB improved sleep quality, insomnia severity, and neurocognitive functioning over placebo. These findings indicate that polyphenol compounds may be useful for improving certain aspects of sleep without compromising neurocognitive functioning.
• Vargas, I., Perlis, M. L., Grandner, M., Gencarelli, A., Khader, W., Zandberg, L. J., Klingaman, E. A., Goldschmied, J. R., Gehrman, P. R., Brown, G. K., & Thase, M. E. (2021). Insomnia Symptoms and Suicide-Related Ideation in U.S. Army Service Members. Behavioral sleep medicine, 18(6), 820-836.
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  : Insomnia has been identified as a key risk factor for suicide, though most studies have been limited to global measures of these constructs. The aim of the present study was to evaluate the link between insomnia symptoms and five different aspects of suicide-related ideation. : 1,160 active U.S. Army service members (719 male; M = 31.2; SD = 8.62). : As part of an archival analysis, retrospectively assessed insomnia, depression, anxiety symptoms, as well as suicide-related ideation, were evaluated. Suicide-related ideation was assessed in terms of: thoughts of death, thoughts of suicide, suicidal plan, suicidal intent, and suicidal communication. : Subjects with clinically significant insomnia symptoms were 3.5 times more likely to report any suicide-related ideation, and approximately 3 times more likely to report thoughts of death and thoughts of suicide. More frequent nocturnal awakenings (i.e., waking up three or more times during a single night) were associated with a greater likelihood of reporting thoughts of death or suicide, whereas greater middle insomnia (i.e., waking up and having difficulty getting back to sleep) was associated with lower odds of experiencing thoughts of suicide, suicidal plan, and suicidal intent. : A more refined delineation of insomnia and suicide-related ideation may serve to clarify the nature of the association, and potentially offer some clues as to the underlying mechanisms. With regard to potential clinical implications, the results support that careful assessment of insomnia symptoms, suicide-related ideation, and their respective subtypes, is important and may influence how we estimate risk for suicide.
• Wills, C., Ghani, S., Tubbs, A., Fernandez, F. X., Athey, A., Turner, R., Robbins, R., Patterson, F., Warlick, C., Alfonso-Miller, P., Killgore, W. D., & Grandner, M. A. (2021). Chronotype and social support among student athletes: impact on depressive symptoms. Chronobiology international, 38(9), 1319-1329.
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  Previous studies have shown individuals with evening chronotype to have a greater likelihood for depression (self-reported and clinical ratings), especially in young adults. However, the mechanisms for this relationship remain unknown. Low levels of social support may be a plausible mechanism: young adults with evening chronotypes are awake when others are sleeping, which may lead to feelings of isolation or low support. This study examined links between chronotype, depression, and social support in relationship subtypes within a group of university student athletes. Data were obtained from 189 NCAA Division-I student athletes across all sports. Chronotype was assessed with the Circadian Energy Scale and ranged from -2 (definitely morning type) to +2 (definitely evening type). Depressive symptoms were assessed with Center for Epidemiological Studies Depression scale. Social support was assessed with the Multidimensional Scale of Perceived Social Support, which included subscales for Family, Friends, and Significant Other. A subscale for Team was created using the items from the Friends subscale (changing the word "friends" to "teammates"). Regression analyses adjusted for age, sex, and minority status. More evening chronotype was associated with higher reported depressive symptoms ( = .018), lower overall perceived social support ( = .001), and lower perceived social support specifically provided by family (
• Zhu, B., Grandner, M. A., Jackson, N. J., Pien, G. W., Srimoragot, M., Knutson, K. L., & Izci-Balserak, B. (2021). Associations between Diet and Sleep Duration in Different Menopausal Stages. Western journal of nursing research, 43(10), 984-994.
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  This study aimed to determine which dietary factors were associated with habitual sleep duration in pre/peri- and post-menopausal women. Data from the 2007-2008 National Health and Nutrition Examination Survey were used ( = 1,783). Habitual sleep duration was categorized as very short (
• Charest, J., & Grandner, M. A. (2020). Sleep and Athletic Performance: Impacts on Physical Performance, Mental Performance, Injury Risk and Recovery, and Mental Health. Sleep medicine clinics, 15(1), 41-57.
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  Research has characterized the sleep of elite athletes and attempted to identify factors associated with athletic performance, cognition, health, and mental well-being. Sleep is a fundamental component of performance optimization among elite athletes, yet only recently embraced by sport organizations as an important part of training and recovery. Sleep plays a crucial role in physical and cognitive performance and is an important factor in reducing risk of injury. This article aims to highlight the prevalence of poor sleep, describe its impacts, and address the issue of sport culture surrounding healthy sleep.
• Crew, E. C., Baron, K. G., Grandner, M. A., Ievers-Landis, C. E., McCrae, C. S., Nadorff, M. R., Nowakowski, S., Margolies, S. O., & Hansen, K. (2020). The Society of Behavioral Sleep Medicine (SBSM) COVID-19 Task Force: Objectives and Summary Recommendations for Managing Sleep during a Pandemic. BEHAVIORAL SLEEP MEDICINE, 18(4), 570-572.
• Crew, E. C., Baron, K. G., Grandner, M. A., Ievers-Landis, C. E., McCrae, C. S., Nadorff, M. R., Nowakowski, S., Ochsner Margolies, S., & Hansen, K. (2020). The Society of Behavioral Sleep Medicine (SBSM) COVID-19 Task Force: Objectives and Summary Recommendations for Managing Sleep during a Pandemic. Behavioral sleep medicine, 1-3.
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  As a response to clinical observations that the pervasive stress and social/environmental disruptions from the 2020 COVID-19 pandemic have also impacted sleep, the Society of Behavioral Sleep Medicine (SBSM) convened the COVID-19 Task Force with goals to identify and disseminate information that could be useful in addressing sleep concerns during this crisis. Members of the SBSM COVID-19 Task Force. Herein is a summary of the resources developed by the SBSM COVID-19 Task force, which includes links to online materials developed for use by providers and patients, as well as brief descriptions of key recommendations by the Task Force for specific sleep conditions (e.g., acute insomnia, nightmares) and vulnerable populations (e.g., parents, essential/healthcare workers, older adults).
• Fernandez, F. X., Flygare, J., & Grandner, M. A. (2020). Narcolepsy and COVID-19: sleeping on an opportunity?. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 16(8), 1415.
• Gangemi, A. J., Satti, A., Zantah, M., Blair, R., Brewer, B., Ma, G., Grandner, M. A., Davey, A., Criner, G. J., & Patterson, F. (2020). Sleep Duration and Efficiency Associated With Better Functional Exercise Capacity in Black Smokers at Risk for COPD. Chest.
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  Black smokers have earlier development of lung disease as well as poorer sleep health than whites.
• Ghani, S. B., Delgadillo, M. E., Granados, K., Okuagu, A. C., Alfonso-Miller, P., Buxton, O. M., Patel, S. R., Ruiz, J., Parthasarathy, S., Haynes, P. L., Molina, P., Seixas, A., Williams, N., Jean-Louis, G., & Grandner, M. A. (2020). Acculturation Associated with Sleep Duration, Sleep Quality, and Sleep Disorders at the US-Mexico Border. International journal of environmental research and public health, 17(19).
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  Sleep disparities exist among Hispanics/Latinos, although little work has characterized individuals at the United States (US)-Mexico border, particularly as it relates to acculturation. This study examined the association of Anglo and Mexican acculturation to various facets of sleep health among those of Mexican descent at the US-Mexico border. Data were collected from = 100 adults of Mexican descent in the city of Nogales, Arizona (AZ). Surveys were presented in English or Spanish. Acculturation was assessed with the Acculturation Scale for Mexican-Americans (ARSMA-II). Insomnia was assessed with the Insomnia Severity Index (ISI), sleepiness was assessed with the Epworth Sleepiness Scale (ESS), sleep apnea risk was assessed with the Multivariable Apnea Prediction (MAP) index, weekday and weekend sleep duration and efficiency were assessed with the Sleep Timing Questionnaire, sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI), and sleep duration and sleep medication use were assessed with PSQI items. No associations were found between Mexican acculturation and any sleep outcomes in adjusted analyses. Anglo acculturation was associated with less weekend sleep duration and efficiency, worse insomnia severity and sleep quality, and more sleep apnea risk and sleep medication use. These results support the idea that sleep disparities may depend on the degree of acculturation, which should be considered in risk screening and interventions.
• Gooding, H. C., Gidding, S. S., Moran, A. E., Redmond, N., Allen, N. B., Bacha, F., Burns, T. L., Catov, J. M., Grandner, M. A., Harris, K. M., Johnson, H. M., Kiernan, M., Lewis, T. T., Matthews, K. A., Monaghan, M., Robinson, J. G., Tate, D., Bibbins-Domingo, K., & Spring, B. (2020). Challenges and Opportunities for the Prevention and Treatment of Cardiovascular Disease Among Young Adults: Report From a National Heart, Lung, and Blood Institute Working Group. Journal of the American Heart Association, 9(19), e016115.
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  Improvements in cardiovascular disease (CVD) rates among young adults in the past 2 decades have been offset by increasing racial/ethnic and gender disparities, persistence of unhealthy lifestyle habits, overweight and obesity, and other CVD risk factors. To enhance the promotion of cardiovascular health among young adults 18 to 39 years old, the medical and broader public health community must understand the biological, interpersonal, and behavioral features of this life stage. Therefore, the National Heart, Lung, and Blood Institute, with support from the Office of Behavioral and Social Science Research, convened a 2-day workshop in Bethesda, Maryland, in September 2017 to identify research challenges and opportunities related to the cardiovascular health of young adults. The current generation of young adults live in an environment undergoing substantial economic, social, and technological transformations, differentiating them from prior research cohorts of young adults. Although the accumulation of clinical and behavioral risk factors for CVD begins early in life, and research suggests early risk is an important determinant of future events, few trials have studied prevention and treatment of CVD in participants
• Grandner, M. A. (2020). Sleep, Health, and Society. Sleep medicine clinics, 15(2), 319-340.
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  Biological needs for sleep are met by engaging in behaviors that are largely influenced by the environment, social norms and demands, and societal influences and pressures. Insufficient sleep duration and sleep disorders such as insomnia and sleep apnea are highly prevalent in the US population. This article outlines some of these downstream factors, including cardiovascular and metabolic disease risk, neurocognitive dysfunction, and mortality, as well as societal factors such as age, sex, race/ethnicity, and socioeconomics. This review also discusses societal factors related to sleep, such as globalization, health disparities, public policy, public safety, and changing patterns of use of technology.
• Grandner, M. A., Olivier, K., Gallagher, R., Hale, L., Barrett, M., Branas, C., Killgore, W. D., Parthasarathy, S., Gehrels, J. A., & Alfonso-Miller, P. (2020). Quantifying impact of real-world barriers to sleep: The Brief Index of Sleep Control (BRISC). Sleep health.
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  Lack of control over sleep may contribute to population-level sleep disturbances, yet relatively little work has explored the degree to which an individual's sense of control over their sleep may represent an important factor.
• Khader, W. S., Fernandez, F. X., Seixas, A., Knowlden, A., Ellis, J., Williams, N., Hale, L., Branas, C., Perlis, M., Jean-Louis, G., Killgore, W. D., Alfonso-Miller, P., & Grandner, M. A. (2020). What makes people want to make changes to their sleep? Assessment of perceived risks of insufficient sleep as a predictor of intent to improve sleep. Sleep health.
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  The objective of the present study is to identify which underlying beliefs about the impact of sleep on health may motivate change in sleep behavior.
• Khader, W. S., Tubbs, A. S., Haghighi, A., Athey, A. B., Killgore, W. D., Hale, L., Perlis, M. L., Gehrels, J. A., Alfonso-Miller, P., Fernandez, F. X., & Grandner, M. A. (2020). Onset insomnia and insufficient sleep duration are associated with suicide ideation in university students and athletes. Journal of affective disorders, 274, 1161-1164.
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  Previous work has shown that poor sleep is a prospective risk factor for suicide in clinical populations and might contribute to risk in the general population. The present study evaluated whether sleep distress, onset insomnia, and insufficient sleep are associated with suicide ideation in university students and athletes participating in the 2011-2014 National College Health Assessment (NCHA; n = 113,185).
• Khader, W. S., Tubbs, A. S., Haghighi, A., Athey, A. B., Killgore, W., Hale, L., Perlis, M. L., Gehrels, J., Alfonso-Miller, P., Fernandez, F., & Grandner, M. A. (2020). Onset insomnia and insufficient sleep duration are associated with suicide ideation in university students and athletes. JOURNAL OF AFFECTIVE DISORDERS, 274, 1161-1164.
• Killgore, W. D., Cloonan, S. A., Taylor, E. C., Fernandez, F., Grandner, M. A., & Dailey, N. S. (2020). Suicidal ideation during the COVID-19 pandemic: The role of insomnia. Psychiatry research, 290, 113134.
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  There is growing concern over the potential for increased suicide risk in vulnerable populations as the COVID-19 pandemic unfolds. To contextualize this risk during the first weeks of the nationwide lockdown efforts, we had 1,013 U.S. adults complete questionnaires assessing worries over COVID-19, insomnia severity, and suicidal ideation. Anxiety about COVID-19 correlated positively with insomnia severity and suicidal ideation. Analysis revealed that the statistical association between pandemic fears and suicidal thinking was fully accounted for by insomnia severity, suggesting that interventions aimed at improving sleep may be useful in reducing suicide risk during the current pandemic.
• Perlis, M. L., Vargas, I., Ellis, J. G., Grandner, M. A., Morales, K. H., Gencarelli, A., Khader, W., Kloss, J. D., Gooneratne, N. S., & Thase, M. E. (2020). The Natural History of Insomnia: the incidence of acute insomnia and subsequent progression to chronic insomnia or recovery in good sleeper subjects. SLEEP, 43(6).
• Petrov, M. E., Long, D. L., Grandner, M. A., MacDonald, L. A., Cribbet, M. R., Robbins, R., Cundiff, J. M., Molano, J. R., Hoffmann, C. M., Wang, X., Howard, G., & Howard, V. J. (2020). Racial differences in sleep duration intersect with sex, socioeconomic status, and U.S. geographic region: The REGARDS study. Sleep health.
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  Short and long sleep duration are associated with poor health outcomes and are most prevalent among racial/ethnic minorities. Few studies have investigated the intersection of other sociodemographic characteristics with race/ethnicity on sleep duration prevalence.
• PhD, A. N., Rhee, J. U., Haynes, P., Chakravorty, S., Patterson, F., Killgore, W. D., Gallagher, R. A., Hale, L., Branas, C., Carrazco, N., Alfonso-Miller, P., Gehrels, J. A., & Grandner, M. A. (2020). Smoke at night and sleep worse? The associations between cigarette smoking with insomnia severity and sleep duration. Sleep health.
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  Insomnia is a clinically verified nicotine withdrawal symptom. As nicotine is a stimulant, it is plausible that smoking at night could disturb sleep more than smoking at earlier times of the day, but this remains empirically unclear. This study examined smoking status and its associations with insomnia severity and sleep duration while considering the potential role of smoking time.
• Raikes, A. C., Athey, A., Alfonso-Miller, P., Killgore, W., & Grandner, M. A. (2020). Author response: concussion assessment tools - A possible measure of sleepiness?. SLEEP MEDICINE, 66, 260-261.
• Reardon, C. L., Hainline, B., Aron, C. M., Baron, D., Baum, A. L., Bindra, A., Budgett, R., Campriani, N., Castaldelli-Maia, J. M., Currie, A., Derevensky, J. L., Glick, I. D., Gorczynski, P., Gouttebarge, V., Grandner, M. A., Han, D. H., McDuff, D., Mountjoy, M., Polat, A., , Purcell, R., et al. (2020). Infographic. Sleep disorders in athletes. British journal of sports medicine, 54(3), 188-189.
• Reardon, C. L., Hainline, B., Aron, C. M., Baron, D., Baum, A. L., Bindra, A., Budgett, R., Campriani, N., Castaldelli-Maia, J. M., Currie, A., Derevensky, J. L., Glick, I. D., Gorczynski, P., Gouttebarge, V., Grandner, M. A., Han, D. H., McDuff, D., Mountjoy, M., Polat, A., , Purcell, R., et al. (2020). Infographic: Mental health in elite athletes. An IOC consensus statement. British journal of sports medicine, 54(1), 49-50.
• Robbins, R., Weaver, M. D., Quan, S. F., Rosenberg, E., Barger, L. K., Czeisler, C. A., & Grandner, M. A. (2020). Employee Sleep Enhancement and Fatigue Reduction Programs: Analysis of the 2017 CDC Workplace Health in America Poll. American journal of health promotion : AJHP, 890117120969091.
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  Poor sleep health, including sleep deficiency and sleep disturbance, is common among employed adults in the U.S. and is associated with undesirable workplace outcomes. Adoption of workplace health promotion programs (WHPPs) is increasing, yet few programs aim to reduce fatigue or improve sleep among employees.
• Seixas, A. A., Moore, J., Chung, A., Robbins, R., Grandner, M., Rogers, A., Williams, N. J., & Jean-Louis, G. (2020). Benefits of Community-Based Approaches in Assessing and Addressing Sleep Health and Sleep-Related Cardiovascular Disease Risk: a Precision and Personalized Population Health Approach. CURRENT HYPERTENSION REPORTS, 22(8).
• Seixas, A. A., Moore, J., Chung, A., Robbins, R., Grandner, M., Rogers, A., Williams, N. J., & Jean-Louis, G. (2020). Benefits of Community-Based Approaches in Assessing and Addressing Sleep Health and Sleep-Related Cardiovascular Disease Risk: a Precision and Personalized Population Health Approach. Current hypertension reports, 22(8), 52.
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  In this current review, we describe the benefits of community-based and "precision and personalized population health" (P3H) approaches to assessing and addressing sleep health problems and sleep-related cardiovascular diseases (CVD) among vulnerable populations such as racial/ethnic minorities, the elderly, and the socioeconomically disadvantaged.
• Tubbs, A. S., Fernandez, F. X., Perlis, M. L., Hale, L., Branas, C. C., Barrett, M., Chakravorty, S., Khader, W., & Grandner, M. A. (2020). Suicidal ideation is associated with nighttime wakefulness in a community sample. Sleep.
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  Nocturnal wakefulness is a risk factor for suicide and suicidal ideation in clinical populations. However, these results have not been demonstrated in general community samples or compared to sleep duration or sleep quality. The present study explored how the timing of wakefulness was associated with suicidal ideation for weekdays and weekends.
• Tubbs, A. S., Gallagher, R., Perlis, M. L., Hale, L., Branas, C., Barrett, M., Gehrels, J., Alfonso-Miller, P., & Grandner, M. A. (2020). Relationship between insomnia and depression in a community sample depends on habitual sleep duration. SLEEP AND BIOLOGICAL RHYTHMS, 18(2), 143-153.
• Tubbs, A. S., Harrison-Monroe, P., Fernandez, F. X., Perlis, M. L., & Grandner, M. A. (2020). When reason sleeps: attempted suicide during the circadian night. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.
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  Disrupted sleep and nocturnal wakefulness are evidence-based risk factors for suicidal thoughts and behaviors. We present a suicide attempt following a rapid increase in nocturnal wakefulness. This case illustrates how nocturnal wakefulness may drive suicide risk through circadian misalignment.
• Tubbs, A. S., Khader, W., Fernandez, F., & Grandner, M. A. (2020). The common denominators of sleep, obesity, and psychopathology. CURRENT OPINION IN PSYCHOLOGY, 34, 84-88.
• Tubbs, A. S., Perlis, M. L., Basner, M., Chakravorty, S., Khader, W., Fernandez, F., & Grandner, M. A. (2020). Relationship of Nocturnal Wakefulness to Suicide Risk Across Months and Methods of Suicide. The Journal of clinical psychiatry, 81(2).
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  Insomnia is a risk factor for suicide, and the risk of suicide after accounting for population wakefulness is disproportionately highest at night. This study investigated whether this risk varied across months and/or methods of suicide.
• Walsh, N. P., Halson, S. L., Sargent, C., Roach, G. D., Nédélec, M., Gupta, L., Leeder, J., Fullagar, H. H., Coutts, A. J., Edwards, B. J., Pullinger, S. A., Robertson, C. M., Burniston, J. G., Lastella, M., Le Meur, Y., Hausswirth, C., Bender, A. M., Grandner, M. A., & Samuels, C. H. (2020). Sleep and the athlete: narrative review and 2021 expert consensus recommendations. British journal of sports medicine.
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  Elite athletes are particularly susceptible to sleep inadequacies, characterised by habitual short sleep (
• Young, D. R., Sidell, M. A., Grandner, M. A., Koebnick, C., & Troxel, W. (2020). Dietary behaviors and poor sleep quality among young adult women: watch that sugary caffeine!. Sleep health, 6(2), 214-219.
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  Associations of dietary patterns with sleep quality have not been sufficiently studied, particularly among young adults. Studying factors associated with sleep quality among young adults are especially important given the significant life changes they are experiencing, which can influence not only sleep quality but also dietary behaviors.
• Bailey, O., Combs, D., Sans-Fuentes, M., Havens, C. M., Grandner, M. A., Poongkunran, C., Patel, S., Berryhill, S., Provencio, N., Quan, S. F., & Parthasarathy, S. (2019). Delayed Sleep Time in African Americans and Depression in a Community-Based Population. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 15(6), 857-864.
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  Studies have shown racial differences in circadian rhythm in African Americans when compared to non-Hispanic whites, and an association between circadian dyssynchrony and depression. We hypothesized that the prevalence of delayed sleep time is greater in African Americans when compared to whites and that delayed sleep time is associated with depression.
• Balserak, B. I., Zhu, B., Grandner, M. A., Jackson, N., & Pien, G. W. (2019). Obstructive sleep apnea in pregnancy: performance of a rapid screening tool. Sleep & breathing = Schlaf & Atmung, 23(2), 425-432.
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  The Sleep Apnea Symptom Score (SASS) has been commonly used to assess obstructive sleep apnea (OSA). The aim of this study was to examine the psychometric properties of the SASS and the predictive value of SASS incorporating bedpartner-reported information in identifying OSA in pregnant women.
• Bastien, C. H., Ellis, J. G., Athey, A., Chakravorty, S., Robbins, R., Knowlden, A. P., Charest, J., & Grandner, M. A. (2019). Driving After Drinking Alcohol Associated with Insufficient Sleep and Insomnia among Student Athletes and Non-Athletes. Brain sciences, 9(2).
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  The proportion of university/college students (UCS) consuming alcohol is similar to the number of those reporting poor sleep, at approximately 30%, the proportion being greater in student athletes (SA). What remains to be understood is if poor sleep potentiates risky behaviors.
• Begay, T. K., & Grandner, M. A. (2019). Sleep and cardiometabolic health in indigenous populations: importance of socio-cultural context. Sleep medicine, 59, 88-89.
• Brauer, A. A., Athey, A. B., Ross, M. J., & Grandner, M. A. (2019). Sleep and Health Among Collegiate Student Athletes. Chest, 156(6), 1234-1245.
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  Although the link between sleep, health, and performance has been well documented, research on this link in collegiate student athletes is still in its infancy. A large body of evidence indicates that collegiate student athletes are not obtaining enough sleep, but less is known about their sleep quality, patterns, and the impact on health and performance. Consequently, short sleep negatively affects physical and mental health, as well as several domains of performance (ie, aerobic, anaerobic, sport-specific, cognitive). The majority of studies examining the links between short sleep, health, and performance have been conducted with healthy adults or noncollegiate athlete samples; however, collegiate student athletes have demands unlike those of their nonathlete or noncollegiate athlete counterparts. Poor sleep health and sleep disorders are of increasing concern among the college athlete population and have recently been recognized by national and international sports governing bodies. The purpose of this review is to summarize the available literature on sleep and its impact on health and performance among athletes, specifically addressing gaps where little to no data is available on collegiate student athletes. Consideration is also given to evidence-based sleep interventions that have been utilized with athletes, as well as recommendations for future research and intervention development.
• Grandner, M. A., & Perlis, M. L. (2019). Pharmacotherapy for Insomnia Disorder in Older Adults. JAMA network open, 2(12), e1918214.
• Grandner, M. A., Khader, W. S., Warlick, C. D., & Fernandez, F. (2019). Acculturation and sleep: implications for sleep and health disparities. Sleep, 42(3).
• Ji, X., Bastien, C. H., Ellis, J. G., Hale, L., & Grandner, M. A. (2019). Disassembling insomnia symptoms and their associations with depressive symptoms in a community sample: the differential role of sleep symptoms, daytime symptoms, and perception symptoms of insomnia. Sleep health, 5(4), 376-381.
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  Insomnia and depression are closely related. However, few studies have investigated whether certain insomnia symptoms differentially relate to certain depressive symptoms. The present study aimed to examine relationship between specific types of insomnia symptoms (sleep symptoms, daytime symptoms, and perception symptoms) and specific symptoms of depression.
• Klingman, K. J., Williams, N. J., Perlis, M. L., & Grandner, M. A. (2019). Doctor-patient sleep discussions for US adults: results from the SHADES study. Sleep health, 5(6), 658-665.
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  Determine the current rate of patient-provider sleep discussions and identify factors associated with occurrence of these discussions.
• Kroshus, E., Wagner, J., Wyrick, D., Athey, A., Bell, L., Benjamin, H. J., Grandner, M. A., Kline, C. E., Mohler, J. M., Roxanne Prichard, J., Watson, N. F., & Hainline, B. (2019). Wake up call for collegiate athlete sleep: narrative review and consensus recommendations from the NCAA Interassociation Task Force on Sleep and Wellness. British journal of sports medicine, 53(12), 731-736.
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  Sleep is an important determinant of collegiate athlete health, well-being and performance. However, collegiate athlete social and physical environments are often not conducive to obtaining restorative sleep. Traditionally, sleep has not been a primary focus of collegiate athletic training and is neglected due to competing academic, athletic and social demands. Collegiate athletics departments are well positioned to facilitate better sleep culture for their athletes. Recognising the lack of evidence-based or consensus-based guidelines for sleep management and restorative sleep for collegiate athletes, the National Collegiate Athletic Association hosted a sleep summit in 2017. Members of the Interassociation Task Force on Sleep and Wellness reviewed current data related to collegiate athlete sleep and aimed to develop consensus recommendations on sleep management and restorative sleep using the Delphi method. In this paper, we provide a narrative review of four topics central to collegiate athlete sleep: (1) sleep patterns and disorders among collegiate athletes; (2) sleep and optimal functioning among athletes; (3) screening, tracking and assessment of athlete sleep; and (4) interventions to improve sleep. We also present five consensus recommendations for colleges to improve their athletes' sleep.
• Mai, Q. D., Hill, T. D., Vila-Henninger, L., & Grandner, M. A. (2019). Employment insecurity and sleep disturbance: Evidence from 31 European countries. Journal of sleep research, 28(1), e12763.
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  For nearly half a century, jobs have become increasingly characterized by employment insecurity. We examined the implications for sleep disturbance with cross-sectional data from the European Working Conditions Survey (2010). A group of 24,553 workers between the ages of 25 and 65 years in 31 European countries were asked to indicate whether they suffered from "insomnia or general sleep difficulties" in the past 12 months. We employed logistic regression to model the association between employment insecurity and sleep disturbance for all countries combined and each individual country. For all countries combined, employment insecurity increased the odds of reporting insomnia or general sleep difficulties in the past 12 months. Each unit increase in employment insecurity elevated the odds of sleep disturbance by approximately 47%. This finding was remarkably consistent across 27 of 31 European countries, including Albania, Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, the Netherlands, Norway, Slovakia, Slovenia, Spain, Sweden, Turkey and UK. These results persisted with adjustments for age, gender, immigrant status, household size, partnership status, number of children, child care, elder care, education, earner status, precarious employment status, workplace sector, workplace tenure and workplace size. Employment insecurity was unrelated to sleep disturbance in four European countries: Malta, Poland, Portugal and Romania. Our research continues recent efforts to reveal the human costs associated with working in neoliberal postindustrial labour markets. Our analyses contribute to the external validity of previous research by exploring the impact of employment insecurity across European countries.
• Martinez, S. M., Grandner, M. A., Nazmi, A., Canedo, E. R., & Ritchie, L. D. (2019). Pathways from Food Insecurity to Health Outcomes among California University Students. Nutrients, 11(6).
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  The prevalence of food insecurity (FI) among college students is alarmingly high, yet the impact on student health has not been well investigated. The aim of the current study was to examine the simultaneous relationships between food insecurity and health-related outcomes including body mass index (BMI) and overall health in a college student population. Randomly sampled students in the University of California 10 campus system were invited to participate in an online survey in spring 2015. The analytic sample size was 8705 graduate and undergraduate students. Data were collected on FI in the past year, daily servings of fruits and vegetables (FV), number of days in the past week of enough sleep and moderate- to vigorous-intensity physical activity (MVPA), height and weight, self-rated health, and student characteristics. Using path analysis, mediated pathways between FI, BMI, and poor health were examined through FV intake, number of days of MVPA and enough sleep. Analyses controlled for student characteristics. Mean BMI was 23.6 kg/m (SD, 5.0), and average self-rated health was good. FI was directly and indirectly related to higher BMI and poor health through three pathways. First, FI was related to fewer days of enough sleep, which in turn was related to increased BMI and poor health. Second, FI was related to fewer days of MVPA, which in turn was related to increased BMI and poor health. Third, FI was related to fewer daily servings of FV, which in turn was related to poor health. FI is associated with poor health behaviors among college students, which may contribute to higher weight status and poor health. These findings highlight the importance of food security for a healthy college experience.
• Parthasarathy, S., Grandner, M., Combs, D., & Tubbs, A. S. (2019). Obstructive Sleep Apnea in Jacobsen Syndrome. Sleep and Vigilance.
• Patterson, F., Connick, E., Brewer, B., & Grandner, M. A. (2019). HIV status and sleep disturbance in college students and relationship with smoking. Sleep health, 5(4), 395-400.
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  Adults with HIV have greater sleep difficulties and are more likely to smoke cigarettes. We tested whether current smoking plays a role in sleep difficulties experienced by young adults with HIV.
• Patterson, F., Grandner, M., Malone, S. K., Rizzo, A., Davey, A., & Edwards, D. G. (2019). Sleep as a Target for Optimized Response to Smoking Cessation Treatment. Nicotine and Tobacco Research, 21(2), 139-148. doi:10.1093/ntr/ntx236
• Perlis, M. L., Vargas, I., Ellis, J. G., Grandner, M. A., Morales, K. H., Gencarelli, A., Khader, W., Kloss, J. D., Gooneratne, N. S., & Thase, M. E. (2019). The Natural History of Insomnia: The Incidence of Acute Insomnia and Subsequent Progression to Chronic Insomnia or Recovery in Good Sleeper Subjects. Sleep.
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  The primary aim of the present study was to estimate the incidence per annum of acute insomnia and to what extent those that develop acute insomnia recover good sleep or develop chronic insomnia. Unlike prior studies, a dense-sampling approach was used here (i.e., daily diaries) and this allowed for a more precise detection of acute insomnia and the follow-on states (the transitions to either recovery or chronic insomnia).
• Raikes, A. C., Athey, A., Alfonso-Miller, P., Killgore, W. D., & Grandner, M. A. (2019). Author response: concussion assessment tools - A possible measure of sleepiness?. Sleep medicine.
• Raikes, A. C., Athey, A., Alfonso-Miller, P., Killgore, W. D., & Grandner, M. A. (2019). Insomnia and daytime sleepiness: risk factors for sports-related concussion. Sleep medicine, 58, 66-74.
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  Poor quality and inadequate sleep are associated with impaired cognitive, motor, and behavioral components of sport performance and increased injury risk. While prior work identifies sports-related concussions as predisposing factors for poor sleep, the role of sleep as a sports-related concussion risk factor is unknown. The purpose of this study was to quantify the effect of poor sleep quality and insomnia symptoms on future sports-related concussion risk.
• Reardon, C. L., Hainline, B., Aron, C. M., Baron, D., Baum, A. L., Bindra, A., Budgett, R., Campriani, N., Castaldelli-Maia, J. M., Currie, A., Derevensky, J. L., Glick, I. D., Gorczynski, P., Gouttebarge, V., Grandner, M. A., Han, D. H., McDuff, D., Mountjoy, M., Polat, A., , Purcell, R., et al. (2019). Mental health in elite athletes: International Olympic Committee consensus statement (2019). British journal of sports medicine, 53(11), 667-699.
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  Mental health symptoms and disorders are common among elite athletes, may have sport related manifestations within this population and impair performance. Mental health cannot be separated from physical health, as evidenced by mental health symptoms and disorders increasing the risk of physical injury and delaying subsequent recovery. There are no evidence or consensus based guidelines for diagnosis and management of mental health symptoms and disorders in elite athletes. Diagnosis must differentiate character traits particular to elite athletes from psychosocial maladaptations.Management strategies should address all contributors to mental health symptoms and consider biopsychosocial factors relevant to athletes to maximise benefit and minimise harm. Management must involve both treatment of affected individual athletes and optimising environments in which all elite athletes train and compete. To advance a more standardised, evidence based approach to mental health symptoms and disorders in elite athletes, an International Olympic Committee Consensus Work Group critically evaluated the current state of science and provided recommendations.
• Redeker, N. S., Caruso, C. C., Hashmi, S. D., Mullington, J. M., Grandner, M., & Morgenthaler, T. I. (2019). Workplace Interventions to Promote Sleep Health and an Alert, Healthy Workforce. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 15(4), 649-657.
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  The purpose of this review is to synthesize the published literature that addresses employer-initiated interventions to improve the sleep of workers and in turn improve health, productivity, absenteeism, and other outcomes that have been associated with sleep disorders or sleep deficiency.
• Robbins, R., Grandner, M. A., Buxton, O. M., Hale, L., Buysse, D. J., Knutson, K. L., Patel, S. R., Troxel, W. M., Youngstedt, S. D., Czeisler, C. A., & Jean-Louis, G. (2019). Sleep myths: an expert-led study to identify false beliefs about sleep that impinge upon population sleep health practices. Sleep health, 5(4), 409-417.
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  False beliefs about sleep can persist despite contradicting scientific evidence, potentially impairing population health. Identifying commonly held false beliefs lacking an evidence base ("myths") can inform efforts to promote population sleep health.
• Robbins, R., Jean-Louis, G., Gallagher, R. A., Hale, L., Branas, C. C., Gooneratne, N., Alfonso-Miller, P., Perlis, M., & Grandner, M. A. (2019). Examining social capital in relation to sleep duration, insomnia, and daytime sleepiness. Sleep medicine, 60, 165-172.
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  Sleep, which plays an important role in health and well-being, is socially patterned such that certain demographic groups have worse sleep health than others. One possible mechanism driving sleep disparities is social capital. The current study examines the association between social capital and self-reported sleep variables (eg, duration, insomnia symptoms, and daytime sleepiness) among a sample of 1007 participants from the Sleep Health and Activity, Diet and Environment Study (SHADES).
• Rosenberger, M. E., Fulton, J. E., Buman, M. P., Troiano, R. P., Grandner, M. A., Buchner, D. M., & Haskell, W. L. (2019). The 24-Hour Activity Cycle: A New Paradigm for Physical Activity. Medicine and science in sports and exercise, 51(3), 454-464.
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  The physiologic mechanisms by which the four activities of sleep, sedentary behavior, light-intensity physical activity, and moderate-to-vigorous physical activity (MVPA) affect health are related, but these relationships have not been well explored in adults. Research studies have commonly evaluated how time spent in one activity affects health. Because one can only increase time in one activity by decreasing time in another, such studies cannot determine the extent that a health benefit is due to one activity versus due to reallocating time among the other activities. For example, interventions to improve sleep possibly also increase time spent in MVPA. If so, the overall effect of such interventions on risk of premature mortality is due to both more MVPA and better sleep. Further, the potential for interaction between activities to affect health outcomes is largely unexplored. For example, is there a threshold of MVPA minutes per day, above which adverse health effects of sedentary behavior are eliminated? This article considers the 24-h Activity Cycle (24-HAC) model as a paradigm for exploring inter-relatedness of health effects of the four activities. It discusses how to measure time spent in each of the four activities, as well as the analytical and statistical challenges in analyzing data based on the model, including the inevitable challenge of confounding among activities. The potential usefulness of this model is described by reviewing selected research findings that aided in the creation of the model and discussing future applications of the 24-HAC model.
• Tubbs, A. S., Grandner, M. A., & Combs, D. (2019). Refractory Insomnia in an Adolescent with Total Blindness. The Yale journal of biology and medicine, 92(2), 201-204.
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  We present a totally blind adolescent with refractory insomnia due to a combination of Non-24 hour sleep-wake disorder and restless leg syndrome that was successfully treated with tasimelteon, iron replacement, and gabapentin. To our knowledge, this is the first published report of treatment of N24 with tasimelteon in an adolescent. In addition, this case highlights the importance of recognizing and treating multifactorial causes of insomnia.
• Tubbs, A. S., Khader, W., Fernandez, F., & Grandner, M. A. (2019). The common denominators of sleep, obesity, and psychopathology. Current opinion in psychology, 34, 84-88.
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  Sleep is an important contributor to mental and physical health. Insomnia, nightmares, and other sleep disturbances are closely linked to depression, anxiety, weight gain, diabetes, and progression of cardiometabolic disease. The high comorbidity between sleep problems, obesity, and mental illness suggest that common mechanisms are at work between them. This review discusses the presence of bivariate relations between sleep, obesity, and psychopathology, as well as the limited evidence suggesting interactions among all three. While the review identifies obstructive sleep apnea, food intake, and inflammation as potential linking mechanisms, the dearth of current literature limits strong conclusions. More data is needed to evaluate the potential moderating/mediating influences between sleep, obesity, and mental health.
• Tubbs, A. S., Perlis, M. L., & Grandner, M. A. (2019). Surviving the long night: The potential of sleep health for suicide prevention. Sleep medicine reviews, 44, 83-84.
• Tubbs, A., Grandner, M., & Combs, D. (2019). Refractory insomnia in a visually impaired adolescent. Yale Journal of Biology and Medicine.
• Turner, R. W., Vissa, K., Hall, C., Poling, K., Athey, A., Alfonso-Miller, P., Gehrels, J. A., & Grandner, M. A. (2019). Sleep problems are associated with academic performance in a national sample of collegiate athletes. Journal of American college health : J of ACH, 1-8.
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  Examine associations between a range of sleep problems and academic performance in a national sample of collegiate athletes. Data were obtained from the National College Health Assessment of US college/university students from 2011-2014 ( = 8,312 collegiate athletes). Univariate comparisons for all sleep variables and demographics were stratified across GPA, using one-way ANOVA for continuous variables and chi-square for categorical variables. Multinomial logistic regression models, with GPA as outcome (reference = A) and sleep variable as predictor, were examined and adjusted for age, sex, and survey year. Ordinal regression examined a 1-level change in GPA associated with each sleep variable, adjusted for covariates. Sleep difficulty was associated with increased likelihood of B/C averages. Initial-insomnia was associated with increased likelihood of B/C, and D/F averages. Tiredness was associated with increased likelihood of B/C, and D/F averages. Sleep problems are highly prevalent and associated with poorer academic performance in collegiate athletes.
• Wills, C. C., & Grandner, M. A. (2019). Review of The Science of Sleep: What It Is, How It Works, and Why It Matters. Sleep, 42(8).
• Chakravorty, S., Chaudhary, N. S., Morales, K., Grandner, M. A., & Oslin, D. W. (2018). Is family history of alcohol dependence a risk factor for disturbed sleep in alcohol dependent subjects?. Drug and alcohol dependence, 188, 311-317.
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  Disturbed sleep and a family history of alcohol dependence (AD) are risk factors for developing AD, yet the underlying relationship between them is unclear among individuals with AD. Understanding these inherited associations will help us not only identify risk for development of these comorbid disorders, but also individualize treatment at this interface. We evaluated whether a first-degree family history of AD (FH+) was a risk factor for sleep continuity disturbance in patients with AD. We also evaluated whether alcohol use or mood disturbance moderated the relationship between FH and sleep.
• Chakravorty, S., Smith, R. V., Perlis, M. L., Grandner, M., & Kranzler, H. R. (2018). Circadian Pattern of Deaths Due to Suicide in Intoxidated Alcohol-Dependent Individuals. Journal of Clinical Psychiatry, 79(6). doi:10.4088/JCP.17m11800
• Fox, E. C., Wang, K., Aquino, M., Grandner, M., Xie, D., Branas, C. C., & Gooneratne, N. S. (2018). Sleep Dept at the Community Level: Impact of Age, Sex, Race/Ethnicity and Health. Sleep Health, 4(4), 317-324. doi:10.1016/j.sleh.2018.05.007
• Full, K. M., Kerr, J., Grandner, M. A., Malhotra, A., Moran, K., Godoble, S., Natarajan, L., & Soler, X. (2018). Validation of a Physical Activity Accelerometer Device Worn on the Hip and Wrist against Polysomnography. Sleep Health, 4(2), 209-216. doi:10.1016/j.sleh.2017.12.007
• Garland, S. N., Rowe, H., Repa, L. M., Fowler, K., Zhou, E. S., & Grandner, M. (2018). A Decade's Difference: 10-year Change in Insomnia Symptom Prevalence in Canada Depends on Sociodemographics and Health Status. Sleep Health, 4(2), 160-165. doi:10.1016/j.sleh.2018.01.003
• Garland, S. N., Vargas, I., Grandner, M., & Perlis, M. L. (2018). Treating Insomnia in Patients with Comorbid Psychiatric Disorders: A Focused Review. Canadian Psychology, 59(2), 176-186. doi:10.1037/cap0000141
• Gonzalez, B. D., Grandner, M., Caminiti, C. B., & Hui, S. A. (2018). Cancer Survivors in the Workplace: Sleep Disturbance Mediates the Impact of Cancer on Healthcare Expenditures and Work Absenteeism. Journal of Supportive Care in Cancer, 26(12), 4049-4055. doi:10.1007/s00520-018-4272-4
• Grandner, M. (2018). The Cost of Sleep Lost: Implications for Health, Performance, and the Bottom Line. American Journal of Health Promotion, 32(7), 1480-1485. doi:10.1177/0890117118790621a
• Grandner, M., Mullington, J. M., Hashmi, S. D., Redeker, N. S., Watson, N. F., & Morgenthaler, T. I. (2018). Sleep Duration and Hypertension: Analysis of > 700,000 Adults by Age and Sex. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 14(6), 1031-1039.
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  The objective of this study was to evaluate the cross-sectional relationship between sleep duration and hypertension in a large, nationally-representative dataset that spans 10 years. This analysis may provide detailed information with high resolution about how sleep duration is related to hypertension and how this differs by demographic group.
• Grandner, M., Watson, N. F., Kay, M., Ocano, D., & Kientz, J. A. (2018). Addressing the Need for Validation of a Touchscreen Psychomotor Vigilance Task:Important Considerations for Sleep Health Research. Sleep Health, 4(5), 387-389. doi:10.1016/j.sleh.2018.08.003
• Knowlden, A. P., Robbins, R., & Grandner, M. (2018). Social Cognitive Models of Fruit and Vegetable Consumption, Moderate Physical Activity, and Overweight and Obese Men. American Academy of Health Behavior, 1(2).
• Kools, F. R., Mirali, S., Holst-Bernal, S., Nijhof, S. L., Cavalli, G., & Grandner, M. A. (2018). Publications Are Not the Finish Line: Focusing on Societal Rather Than Publication Impact. Frontiers in medicine, 5, 314.
• Ong, J. C., Arand, D., Schmitz, M., Baron, K., Blackburn, R., Grandner, M. A., Lichstein, K. L., Nowakowski, S., Teixeira, C., Boling, K., C Dawson, S., & Hansen, K. (2018). A Concept Map of Behavioral Sleep Medicine: Defining the Scope of the Field and Strategic Priorities. Behavioral sleep medicine, 16(6), 523-526.
• Patterson, F., Grandner, M., Lozano, A., Satti, A., & Ma, G. (2018). Transitioning from Adequate to Inadequate Sleep Duration Associated with Higher Smoking Rate and Greater Nicotine Dependence in a Populaiton Sample. Addictive Behaviors, 77, 47-50.
• Patterson, F., Grandner, M., Lozano, A., Satti, A., & Ma, G. (2018). Transitioning from adequate to inadequate sleep duration associated with higher smoking rate and greater nicotine dependence in a population sample. Addictive Behaviors, 77, 3. doi:10.1016/j.addbeh.2017.09.011
• Patterson, F., Malone, S. K., Grandner, M., Lozano, A., Perkett, M., & Hanlon, A. (2018). Interactive Effects of Sleep Duration and Morning/ Evening Preference on Cardiovascular Risk Factors. European Journal of Public Health, 28(1), 155-161.
• Petrov, M. E., Howard, G., Grandner, M. A., Kleindorfer, D., Molano, J. R., & Howard, V. J. (2018). Sleep duration and risk of incident stroke by age, sex, and race: The REGARDS study. Neurology, 91(18), e1702-e1709.
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  To investigate the association between reported sleep duration and incident stroke in a US cohort of black and white adults, and evaluate race, age, and sex as potential effect modifiers.
• Petrov, M. E., Howard, G., Grandner, M., Kleindorfer, D., Molano, J. R., & Howard, V. J. (2018). Sleep Duration and Risk of Incident Stroke by Age, Sex, and Race: The REGARDS Study. Neurology, 91(18). doi:https://doi.org/10.1212/WNL.0000000000006424
• Seixas, A. A., Vallon, J., Barnes-Grant, A., Butler, M., Langford, A. T., Grandner, M. A., Schneeberger, A. R., Huthchinson, J., Zizi, F., & Jean-Louis, G. (2018). Mediating effects of body mass index, physical activity, and emotional distress on the relationship between short sleep and cardiovascular disease. Medicine, 97(37), e11939.
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  The current study investigated the mediating effects of body mass index (BMI), physical activity, and emotional distress on the association between short sleep duration (
• Shulman, R., Cohen, D. L., Grandner, M. A., Gislason, T., Pack, A. I., Kuna, S. T., Townsend, R. R., & Cohen, J. B. (2018). Sleep duration and 24-hour ambulatory blood pressure in adults not on antihypertensive medications. Journal of clinical hypertension (Greenwich, Conn.), 20(12), 1712-1720.
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  Short sleep duration has been widely linked to increased cardiovascular morbidity and mortality. We performed a post hoc analysis of 24-hour ambulatory blood pressure monitoring (ABPM) in the Lifestyle Modification in Blood Pressure Lowering Study (LIMBS) and Penn Icelandic Sleep Apnea (PISA) Study. The 24-hour mean systolic blood pressure (BP) was 12.7 mm Hg higher in LIMBS (P 
• Bastien, C. H., Ellis, J. G., & Grandner, M. (2017). CBT-I and the Short Sleep Duration Insomnia Phenotype: A Comment on Bathgate, Edinger and Krystal. Annals of Translational Medicine, 5(16), 335. doi:10.21037/atm.2017.04.27
• Bastien, C. H., Ellis, J. G., & Grandner, M. (2017). CBT-I and the short sleep duration insomnia phenotype: a comment on Bathgate, Edinger and Krystal. Annals of Translational Medicine, 5(16), 1. doi:10.21037/atm.2017.04.27
• Chaudhary, N. S., Grandner, M. A., Jackson, N. J., & Chakravorty, S. (2017). Caffeine consumption, insomnia, and sleep duration: Results from a nationally representative sample. Nutrition (Burbank, Los Angeles County, Calif.), 32(11-12), 1193-9.
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  Insomnia symptoms have been individually associated with both caffeine consumption and sleep duration abnormalities in prior studies. The goal of this study was to determine whether caffeine consumption was associated with insomnia symptoms from a population perspective and whether this relationship depended on habitual sleep duration.
• Ellis, J. G., Seed, J., Bastien, C. H., & Grandner, M. (2017). Is it time to get some SHUT-i?. Annals of Translational Medicine, 5(16), 1. doi:10.21037/atm.2017.04.28
• Ellis, J. G., Seed, J., Bastien, C. H., & Grandner, M. (2017). Is it time to get some SHUT-i?. Annals of Translational Medicine, 5(16), 336. doi:10.21037/atm.2017.04.28
• Grandner, M. (2017). Sleep and obesity risk in adults: possible mechanisms; contextual factors; and implications for research, intervention, and policy. Sleep Health, 3(5), 7. doi:10.1016/j.sleh.2017.07.014
• Grandner, M. (2017). Sleep, Health, and Society. Sleep Medicine Clinics, 12(1), 22. doi:http://dx.doi.org/10.1016/j.jsmc.2016.10.012
• Grandner, M. A. (2017). Sleep and obesity risk in adults: possible mechanisms; contextual factors; and implications for research, intervention, and policy. Sleep health, 3(5), 393-400.
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  Obesity is a major public health problem among US adults. Insufficient sleep and sleep disorders are prevalent and may contribute to the public health problem of obesity. This review addresses several key questions regarding sleep and obesity in adults, including the following: (1) What constitutes adequate sleep in adults? (2) What are the consequences of inadequate sleep in adults? (3) What factors influence sleep in adults? (4) How can adults improve their sleep? (5) How can we implement these in adults? (6) How can these issues be addressed in future research and policy decisions? Although a comprehensive review of all of these is beyond the scope of this article, this review brings these concepts together toward a discussion of the role of sleep in the health of US adults.
• Grandner, M. A., & Winkelman, J. W. (2017). Nocturnal leg cramps: Prevalence and associations with demographics, sleep disturbance symptoms, medical conditions, and cardiometabolic risk factors. PloS one, 12(6), e0178465.
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  Nocturnal leg cramps (NLC) are common and poorly understood.
• Grandner, M., & Chakravorty, S. (2017). Insomnia in Primary Care: Misreported, Mishandled, and Just Plain Missed. Journal of Clinical Sleep Medicine, 13(8), 2. doi:10.5664/jcsm.6688
• Grandner, M., & Chakravorty, S. (2017). Insomnia in Primary Care: Misreported, Mishandled, and Just Plain Missed. Journal of Clinical Sleep Medicine, 13(8), 937-939. doi:10.5664/jcsm.6688
• Grandner, M., & Malhotra, A. (2017). Connecting insomnia, sleep apnea, and depression. Respirology, 22(7), 1249-1250. doi:10.1111/resp.13090
• Grandner, M., & Malhotra, A. (2017). Connecting insomnia, sleep apnoea and depression. Respirology, 22(7), 1. doi:10.1111/resp.13090
• Grandner, M., & Winkelman, J. (2017). Nocturnal leg cramps: Prevalence and associations with demographics, sleep disturbance symptoms, medical conditions, and cardiometabolic risk factors. PLoS ONE, 12(6). doi:10.1371/journal.pone.0178465
• Grandner, M., Segal, A., Perlis, M. L., Nowakowski, S., Tal, J. Z., & Grandner, M. (2017). Sleep Disturbance Partially Mediates the Relationship between Intimate Partner Violence and Physical/Mental Health. Journal of Interpersonal Violence, 32(16), 2471-2495.
• Ji, X., Grandner, M., & Liu, J. (2017). The relationship between micronutrient status and sleep patterns: a systematic review.. Public Health Nutrition, 20(4), 14. doi:10.1017/S1368980016002603
• Lalley-Charecko, L., Segal, A., Perlis, M. L., & Grandner, M. (2017). Sleep Disturbance Partially Mediates the Relationship Between Intimate Partner Violence and Physical/ Mental Health in Women and Men. Journal of Interpersonal Violence, 32(16), 24. doi:10.1177/0886260515592651
• Li, J., Grandner, M., Chang, Y., Jungquist, C., & Porock, D. (2017). Person-Centered Dementia Care and Sleep in Assisted Living Residents With Dementia: A Pilot Study.. Behavioral Sleep Medicine, 15(2), 16. doi:10.1080/15402002.2015.1104686
• Patterson, F., Grandner, M., Malone, S. K., Rizzo, A., Davey, A., & Edwards, D. G. (2017). Sleep as a Target for Optimized Response to Smoking Cessation Treatment. Nicotine and Tobacco Research. doi:10.1093/ntr/ntx236
• Patterson, F., Malone, S. K., Grandner, M., Lozano, A., Perkett, M., & Hanlon, A. (2017). Interactive effects of sleep duration and morning/evening preference on cardiovascular risk factors.. European Journal of Public Health. doi:10.1093/eurpub/ckx029
• Shetty, S., Fernandes, A., Patel, S., Combs, D., Grandner, M., & Parthasarathy, S. (2017). Unanticipated Nocturnal Oxygen Requirement during Positive Pressure Therapy for Sleep Apnea and Medical Comorbidities.. Journal of Clinical Sleep Medicine, 13(1), 6. doi:10.5664/jcsm.6392
• Thomas, A., Grandner, M., Nowakowski, S., Nesom, G., Corbitt, C., & Perlis, M. L. (2017). Where are the Behavioral Sleep Medicine Providers and Where are They Needed? A Geographic Assessment. Behavioral sleep medicine, 14(6), 687-98.
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  Although it is widely acknowledged that there are not enough clinicians trained in either Behavioral Sleep Medicine (BSM) in general or in Cognitive Behavioral Therapy for Insomnia (CBT-I) in specific, what is unclear is whether this problem is more acute in some regions relative to others. Accordingly, a geographic approach was taken to assess this issue. Using national directories as well as e-mail listservs (Behavioral Sleep Medicine group and Behavioral Treatment for Insomnia Roster), the present study evaluated geographic patterning of CBSM and BSM providers by city, state, and country. Overall, 88% of 752 BSM providers worldwide live in the United States (n = 659). Of these, 58% reside in 12 states with ≥ 20 providers (CA, NY, PA, IL, MA, TX, FL, OH, MI, MN, WA, and CO), and 19% reside in just 2 states (NY and CA). There were 4 states with no BSM providers (NH, HI, SD, and WY). Of the 167 U.S. cities with a population of > 150,000, 105 cities have no BSM providers. These results clearly suggest that a targeted effort is needed to train individuals in both the unserved and underserved areas.
• Chaudhary, N., Grandner, M., Jackson, N., & Chakravorty, S. (2016). Caffeine consumption, insomnia, and sleep duration: Results from a nationally representative sample. Nutrition, 32(11), 6. doi:10.1016/j.nut.2016.04.005 0899-9007
• Grandner, M. (2016). Healthy sleep for student-athletes: A guide for athletics departments and coaches.. NCAA Sport Science Institute Newsletter, 4(2).
• Grandner, M. (2016). Mental Health Best Practices: Inter-Association Consensus Document: Best Practices for Understanding and Supporting Student-Athlete Mental Wellness.. National Collegiate Athletics Association.
• Grandner, M. (2016). Sleep, health, and society. Clinics in Sleep Medicine..
• Grandner, M. A., Alfonso-Miller, P., Fernandez-Mendoza, J., Shetty, S., Shenoy, S., & Combs, D. (2016). Sleep: important considerations for the prevention of cardiovascular disease. Current opinion in cardiology, 31(5), 551-65.
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  Sleep plays many roles in maintenance of cardiovascular health. This review summarizes the literature across several areas of sleep and sleep disorders in relation to cardiometabolic disease risk factors.
• Grandner, M. A., Williams, N. J., Knutson, K. L., Roberts, D., & Jean-Louis, G. (2016). Sleep disparity, race/ethnicity, and socioeconomic position. SLEEP MEDICINE, 18, 7-18.
• Grandner, M., Chaudhary, S., Perlis, M. L., Brown, G. K., Basner, M., Chakravorty, S., Morales, K. H., Gehrman, P. R., Thase, M. E., & Dinges, D. F. (2016). Nocturnal wakefulness: A previously unrecognized risk factor for suicide.. Journal of Clinical Psychiatry.
• Grandner, M., Orzech, K. M., Roane, B., & Carskadon, M. (2016). Digital media use in the 2 hours before bedtime is associated with sleep variables in university students.. Computers in Human Behavior.
• Ji, X., Grandner, M. A., & Liu, J. (2016). The relationship between micronutrient status and sleep patterns: a systematic review. Public health nutrition, 1-15.
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  To review articles on the relationship of dietary and circulating micronutrients with sleep patterns, and to identify issues surrounding implications for future research and public health practice.
• Lam, M. T., Grandner, M. A., & Malhotra, A. (2016). Lungs can tell time-a highlight from 2016 ATS session on clock genes, inflammation, immunology, and sleep. Journal of thoracic disease, 8(Suppl 7), S579-81.
• Orzech, K. M., Grandner, M. A., Roane, B. M., & Carskadon, M. A. (2016). Digital media use in the 2 h before bedtime is associated with sleep variables in university students. Computers in human behavior, 55(A), 43-50.
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  Digital media use is widespread in University students, and use of digital media near bedtime has a broadly negative effect on sleep outcomes. Adequate and good quality sleep is important for physical and mental health, but few studies have rigorously measured both sleep and digital media use. In this study, we investigated whether self-reported sleep patterns were associated with digital media use in a first-year University student (N = 254, 48% male) population. Students tracked their sleep through daily online diaries and provided digital media use data in 15-min blocks for 2 h prior to bedtime on nine occasions. A longer duration of digital media use was associated with reduced total sleep time and later bedtime, while greater diversity of digital media use was associated with increased total sleep time and earlier bedtime. Analysis of activities in the last hour before bedtime indicated that activity type plays a role in digital media's effect on sleep, with computer work, surfing the Internet, and listening to music showing the strongest relationship to multiple sleep variables. These findings have implications for physical and mental health of University students and can inform design of devices to minimize negative effects of digital media on sleep.
• Orzech, K. M., Roane, B., Grandner, M., & Carskadon, M. (2016). Digital media use in the 2 h before bedtime is associated with sleep variables in university students. Computers in Human Behavior, 55, 7. doi:10.1016/j.chb.2015.08.049
• Patterson, F., Malone, S. K., Lozano, A., Grandner, M. A., & Hanlon, A. L. (2016). Smoking, Screen-Based Sedentary Behavior, and Diet Associated with Habitual Sleep Duration and Chronotype: Data from the UK Biobank. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 50(5), 715-726.
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  Sleep duration has been implicated in the etiology of obesity but less is known about the association between sleep and other behavioral risk factors for cardiovascular disease.
• Patterson, F., Malone, S. K., Lozano, A., Grandner, M., & Hanlon, A. L. (2016). Smoking, sedentary behavior, and diet associated with habitual sleep duration and chronotype: Data from the UK Biobank. Annals of Behavioral Medicine, 50(5), 11. doi:10.1007/s12160-016-9797-5
• Perlis, M. L., Grandner, M. A., Brown, G. K., Basner, M., Chakravorty, S., Morales, K. H., Gehrman, P. R., Chaudhary, N. S., Thase, M. E., & Dinges, D. F. (2016). Nocturnal Wakefulness as a Previously Unrecognized Risk Factor for Suicide. The Journal of clinical psychiatry, 77(6), e726-33.
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  Suicide is a major public health problem and the 10th leading cause of death in the United States. The identification of modifiable risk factors is essential for reducing the prevalence of suicide. Recently, it has been shown that insomnia and nightmares significantly increase the risk for suicidal ideation, attempted suicide, and death by suicide. While both forms of sleep disturbance may independently confer risk, and potentially be modifiable risk factors, it is also possible that simply being awake at night represents a specific vulnerability for suicide. The present analysis evaluates the frequency of completed suicide per hour while taking into account the percentage of individuals awake at each hour.
• Perlis, M. L., Grandner, M., Chakravorty, S., Bernert, R. A., Brown, G. K., & Thase, M. E. (2016). Suicide and sleep: Is it a bad thing to be awake when reason sleeps?. Sleep Medicine Reviews, 29, 6. doi:10.1016/j.smrv.2015.10.003
• Shetty, S., Fernandes, A., Patel, S., Combs, D., Grandner, M. A., & Parthasarathy, S. (2016). Unanticipated Nocturnal Oxygen Requirement During Positive Pressure Therapy for Sleep Apnea and Medical Comorbidities. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.
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  Home-based management of sleep-disordered breathing (SDB) generally excludes patients with significant medical comorbidities, but such an approach lacks scientific evidence. The current study examined whether significant medical comorbidities are associated with persistent hypoxia that requires unanticipated nocturnal O2 supplementation to positive airway pressure (PAP) therapy. Conceivably, in such patients, home-based management of SDB may not detect or therefore adequately treat persistent hypoxia.
• St-Onge, M. P., Coons, M., Bhatt, D. L., Brown, D., Conroy, M. B., Grandner, M., & Jean-Louis, G. (2016). Sleep duration and quality: Impact on lifestyle behaviors and cardiometabolic health: An advisory from the American Heart Association. Circulation, 134(18), 20. doi:10.1161/CIR.0000000000000444
• St-Onge, M. P., Grandner, M. A., Brown, D., Conroy, M. B., Jean-Louis, G., Coons, M., Bhatt, D. L., & , A. H. (2016). Sleep Duration and Quality: Impact on Lifestyle Behaviors and Cardiometabolic Health: A Scientific Statement From the American Heart Association. Circulation, 134(18), e367-e386.
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  Sleep is increasingly recognized as an important lifestyle contributor to health. However, this has not always been the case, and an increasing number of Americans choose to curtail sleep in favor of other social, leisure, or work-related activities. This has resulted in a decline in average sleep duration over time. Sleep duration, mostly short sleep, and sleep disorders have emerged as being related to adverse cardiometabolic risk, including obesity, hypertension, type 2 diabetes mellitus, and cardiovascular disease. Here, we review the evidence relating sleep duration and sleep disorders to cardiometabolic risk and call for health organizations to include evidence-based sleep recommendations in their guidelines for optimal health.
• St-Onge, M., Grandner, M. A., Brown, D., Conroy, M. B., Jean-Louis, G., Coons, M., & Bhatt, D. L. (2016). Sleep duration and quality: Impact on lifestyle behaviors and cardiometabolic health: An advisory from the American Heart Association.. Circulation.
• Thomas, A., Grandner, M., Nesom, G., Corbitt, C., & Perlis, M. L. (2016). Where are the behavioral sleep medicine providers and where are they needed? A geographic assessment. Behavioral Sleep Medicine, 14(6), 11. doi:10.1080/15402002.2016.1173551
• Truong, K. K., Lam, M., Grandner, M., Sassoon, C. S., & Malhotra, A. (2016). Timing Matters: Circadian Rhythm in Sepsis, Obstructive Lung Disease, Obstructive Sleep Apnea, and Cancer.. Annals of the American Thoracic Society, 13(7), 1144-1154.
• , C. C., Watson, N. F., Badr, M. S., Belenky, G., Bliwise, D. L., Buxton, O. M., Buysse, D., Dinges, D. F., Gangwisch, J., Grandner, M. A., Kushida, C., Malhotra, R. K., Martin, J. L., Patel, S. R., Quan, S. F., & Tasali, E. (2015). Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 11(8), 931-52.
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  The American Academy of Sleep Medicine and Sleep Research Society recently released a Consensus Statement regarding the recommended amount of sleep to promote optimal health in adults. This paper describes the methodology, background literature, voting process, and voting results for the consensus statement. In addition, we address important assumptions and challenges encountered during the consensus process. Finally, we outline future directions that will advance our understanding of sleep need and place sleep duration in the broader context of sleep health.
• , C. C., Watson, N. F., Badr, M. S., Belenky, G., Bliwise, D. L., Buxton, O. M., Buysse, D., Dinges, D. F., Gangwisch, J., Grandner, M. A., Kushida, C., Malhotra, R. K., Martin, J. L., Patel, S. R., Quan, S. F., & Tasali, E. (2015). Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion. Sleep, 38(8), 1161-83.
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  The American Academy of Sleep Medicine and Sleep Research Society recently released a Consensus Statement regarding the recommended amount of sleep to promote optimal health in adults. This paper describes the methodology, background literature, voting process, and voting results for the consensus statement. In addition, we address important assumptions and challenges encountered during the consensus process. Finally, we outline future directions that will advance our understanding of sleep need and place sleep duration in the broader context of sleep health.
• , C. C., Watson, N. F., Badr, M. S., Belenky, G., Bliwise, D. L., Buxton, O. M., Buysse, D., Dinges, D. F., Gangwisch, J., Grandner, M. A., Kushida, C., Malhotra, R. K., Martin, J. L., Patel, S. R., Quan, S. F., Tasali, E., , N. O., Twery, M., Croft, J. B., , Maher, E., et al. (2015). Recommended Amount of Sleep for a Healthy Adult: A Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 11(6), 591-2.
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  Sleep is essential for optimal health. The American Academy of Sleep Medicine (AASM) and Sleep Research Society (SRS) developed a consensus recommendation for the amount of sleep needed to promote optimal health in adults, using a modified RAND Appropriateness Method process. The recommendation is summarized here. A manuscript detailing the conference proceedings and evidence supporting the final recommendation statement will be published in SLEEP and the Journal of Clinical Sleep Medicine.
• Arble, D. M., Bass, J., Behn, C. D., Butler, M. P., Challet, E., Czeisler, C., Depner, C. M., Elmquist, J., Franken, P., Grandner, M. A., Hanlon, E. C., Keene, A. C., Joyner, M. J., Karatsoreos, I., Kern, P. A., Klein, S., Morris, C. J., Pack, A. I., Panda, S., , Ptacek, L. J., et al. (2015). Impact of Sleep and Circadian Disruption on Energy Balance and Diabetes: A Summary of Workshop Discussions. Sleep, 38(12), 1849-60.
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  A workshop was held at the National Institute for Diabetes and Digestive and Kidney Diseases with a focus on the impact of sleep and circadian disruption on energy balance and diabetes. The workshop identified a number of key principles for research in this area and a number of specific opportunities. Studies in this area would be facilitated by active collaboration between investigators in sleep/circadian research and investigators in metabolism/diabetes. There is a need to translate the elegant findings from basic research into improving the metabolic health of the American public. There is also a need for investigators studying the impact of sleep/circadian disruption in humans to move beyond measurements of insulin and glucose and conduct more in-depth phenotyping. There is also a need for the assessments of sleep and circadian rhythms as well as assessments for sleep-disordered breathing to be incorporated into all ongoing cohort studies related to diabetes risk. Studies in humans need to complement the elegant short-term laboratory-based human studies of simulated short sleep and shift work etc. with studies in subjects in the general population with these disorders. It is conceivable that chronic adaptations occur, and if so, the mechanisms by which they occur needs to be identified and understood. Particular areas of opportunity that are ready for translation are studies to address whether CPAP treatment of patients with pre-diabetes and obstructive sleep apnea (OSA) prevents or delays the onset of diabetes and whether temporal restricted feeding has the same impact on obesity rates in humans as it does in mice.
• Chakravorty, S., Siu, H. Y., Lalley-Chareczko, L., Brown, G. K., Findley, J. C., Perlis, M. L., & Grandner, M. A. (2015). Sleep Duration and Insomnia Symptoms as Risk Factors for Suicidal Ideation in a Nationally Representative Sample. The primary care companion for CNS disorders, 17(6).
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  Suicidal behavior (suicidal ideation, suicide attempts, and suicide completion) has been increasingly linked with difficulty initiating sleep, maintaining sleep, and early morning awakenings. However, the relationship between suicidal behavior and sleep duration abnormalities is unclear, especially at the population level. The present study used a nationally representative sample to examine the association of suicidal ideation with extreme sleep durations and insomnia symptoms.
• Chaudhary, N. S., Kampman, K. M., Kranzler, H. R., Grandner, M. A., Debbarma, S., & Chakravorty, S. (2015). Insomnia in alcohol dependent subjects is associated with greater psychosocial problem severity. Addictive behaviors, 50, 165-72.
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  Although psychosocial problems are commonly associated with both alcohol misuse and insomnia, very little is known about the combined effects of insomnia and current alcohol dependence on the severity of psychosocial problems. The present study evaluates whether the co-occurrence of insomnia and alcohol dependence is associated with greater psychosocial problem severity.
• Grandner, M. A., & Malhotra, A. (2015). Sleep as a vital sign: why medical practitioners need to routinely ask their patients about sleep. Sleep health, 1(1), 11-12.
• Grandner, M. A., & Perlis, M. L. (2015). Treating Insomnia Disorder in the Context of Medical and Psychiatric Comorbidities. JAMA internal medicine, 175(9), 1472-3.
• Grandner, M. A., Jackson, N. J., Izci-Balserak, B., Gallagher, R. A., Murray-Bachmann, R., Williams, N. J., Patel, N. P., & Jean-Louis, G. (2015). Social and Behavioral Determinants of Perceived Insufficient Sleep. Frontiers in neurology, 6, 112.
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  Insufficient sleep is associated with cardiometabolic disease and poor health. However, few studies have assessed its determinants in a nationally representative sample. Data from the 2009 behavioral risk factor surveillance system were used (N = 323,047 adults). Insufficient sleep was assessed as insufficient rest/sleep over 30 days. This was evaluated relative to sociodemographics (age, sex, race/ethnicity, marital status, region), socioeconomics (education, income, employment, insurance), health behaviors (diet, exercise, smoking, alcohol), and health/functioning (emotional support, BMI, mental/physical health). Overall, insufficient sleep was associated with being female, White or Black/African-American, unemployed, without health insurance, and not married; decreased age, income, education, physical activity; worse diet and overall health; and increased household size, alcohol, and smoking. These factors should be considered as risk factors for insufficient sleep.
• Grandner, M. A., Nowakowski, S., Kloss, J. D., & Perlis, M. L. (2015). Insomnia symptoms predict physical and mental impairments among postmenopausal women. Sleep medicine, 16(3), 317-8.
• Grandner, M. A., Schopfer, E. A., Sands-Lincoln, M., Jackson, N., & Malhotra, A. (2015). Relationship between sleep duration and body mass index depends on age. Obesity (Silver Spring, Md.), 23(12), 2491-8.
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  Sleep duration is associated with obesity and cardiometabolic disease. It is unclear, though, how these relationship differs across age groups.
• Grandner, M. A., Smith, T. E., Jackson, N., Jackson, T., Burgard, S., & Branas, C. (2015). Geographic distribution of insufficient sleep across the United States: a county-level hotspot analysis. Sleep health, 1(3), 158-165.
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  Insufficient sleep is associated with cardiometabolic risk and neurocognitive impairment. Determinants of insufficient sleep include many social and environmental factors. Assessment of geographic hot/coldspots may uncover novel risk groups and/or targets for public health intervention. The aim of this study was to discern geographic patterns in the first data set to include county-level sleep data.
• Grandner, M., & Malhotra, A. (2015). Sleep as a vital sign: Why medical practitioners need to routinely ask their patients about sleep. Sleep Health, 1, 11-12.
• Grandner, M., Chakravorty, S., Siu, H. Y., Oliver, L., Brown, G. K., Findley, J., & Findley, M. L. (2015). Insomnia symptoms and sleep duration as risk factors for suicidal ideation. Primary Care Companion for CNS Disorders.
• Grandner, M., Jean-Louis, G., Youngstedt, S. D., Williams, N. J., Sarpong, D., Zizi, F., & Ogedegbe, G. (2015). Unequal burden of sleep-related obesity among black and white Americans.. Sleep Health.
• Grandner, M., Smith, T. E., Jackson, T., Jackson, N., Burgard, S., & Branas, C. (2015). Geographic distribution of insufficient sleep across the US: A county-level hotspot analysis. Sleep Health.
• Hui, S. A., & Grandner, M. A. (2015). Associations between Poor Sleep Quality and Stages of Change of Multiple Health Behaviors among Participants of Employee Wellness Program. Preventive medicine reports, 2, 292-299.
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  Using the Transtheoretical Model of behavioral change, this study evaluates the relationship between sleep quality and the motivation and maintenance processes of healthy behavior change.
• Hui, S. A., & Grandner, M. A. (2015). Trouble Sleeping Associated With Lower Work Performance and Greater Health Care Costs: Longitudinal Data From Kansas State Employee Wellness Program. Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine, 57(10), 1031-8.
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  To examine the relationships between employees' trouble sleeping and absenteeism, work performance, and health care expenditures over a 2-year period.
• Jean-Louis, G., & Grandner, M. (2015). Importance of recognizing sleep health disparities and implementing innovative interventions to reduce these disparities. Sleep medicine.
• Jean-Louis, G., Grandner, M. A., Youngstedt, S. D., Williams, N. J., Zizi, F., Sarpong, D. F., & Ogedegbe, G. G. (2015). Differential increase in prevalence estimates of inadequate sleep among black and white Americans. BMC public health, 15(1), 1185.
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  The National Health Interview Survey (NHIS) was used to ascertain whether increases in inadequate sleep differentially affected black and white Americans. We tested the hypothesis that prevalence estimates of inadequate sleep were consistently greater among blacks, and that temporal changes have affected these two strata differentially.
• Jean-Pierre, P., Grandner, M. A., Garland, S. N., Henry, E., Jean-Louis, G., & Burish, T. G. (2015). Self-reported memory problems in adult-onset cancer survivors: effects of cardiovascular disease and insomnia. Sleep medicine, 16(7), 845-9.
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  Cancer and its treatments can deleteriously affect memory. Cardiac function and insomnia can exacerbate memory problems.
• Jen, R., Grandner, M. A., & Malhotra, A. (2015). Future of Sleep-Disordered Breathing Therapy Using a Mechanistic Approach. The Canadian journal of cardiology, 31(7), 880-8.
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  Sleep disordered breathing (SDB) is highly prevalent among patients with cardiovascular disease (CVD), and the relationship between SDB and CVD may be bidirectional. However, SDB remains underdiagnosed and undertreated. One of the major barriers identified by cardiologists is lack of satisfaction with SDB therapy. This situation could be the result of the discordance between treatment and the pathophysiological characteristics of SDB. This condition is caused by multiple pathophysiological mechanisms, which could be classified into upper airway anatomic compromise, pharyngeal dilator muscle dysfunction, and ventilatory control instability. However, the effective treatment of SDB remains limited, and positive airway pressure therapy is still the mainstay of the treatment. Therefore, we review the pathophysiological characteristics of SDB in this article, and we propose to provide individualized treatment of SDB based on the underlying mechanism. This approach requires further study but could potentially improve adherence and success of therapy.
• Lalley-Chareczko, L., Segal, A., Perlis, M. L., Nowakowski, S., Tal, J. Z., & Grandner, M. A. (2015). Sleep Disturbance Partially Mediates the Relationship Between Intimate Partner Violence and Physical/Mental Health in Women and Men. Journal of interpersonal violence.
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  Intimate partner violence (IPV) is a worldwide health concern and an important risk factor for poor mental/physical health in both women and men. Little is known about whether IPV leads to sleep disturbance. However, sleep problems may be common in the context of IPV and may mediate relationships with mental/physical health. Data from the 2006 Behavioral Risk Factor Surveillance System (BRFSS) were used (N = 34,975). IPV was assessed in female and male participants for any history of being threatened by, physically hurt by, or forced to have sex with an intimate partner (THREAT, HURT, and SEX, respectively), and, further, as being forced to have sex with or physically injured by an intimate partner within the past year (SEXyr and HURTyr, respectively). These survey items were coded yes/no. Sleep disturbance was assessed as difficulty falling asleep, staying asleep, or sleeping too much at least 6 of the last 14 days. Logistic regression analyses, adjusted for age, sex, race, income, education, and physical/mental health, assessed whether IPV predicted sleep disturbance. Sobel-Goodman tests assessed whether relationships between IPV and physical/mental health were partially mediated by sleep disturbance. All IPV variables were associated with sleep disturbance, even after adjusting for the effects of age, sex, race/ethnicity, income, education, employment, marital status, physical health and mental health. THREAT was associated with sleep disturbance (odds ratio [OR] = 2.798, p < .0001), as was HURT (OR = 2.683, p < .0001), SEX (OR = 3.237, p < .0001), SEXyr (OR = 7.741, p < .0001), and HURTyr (OR = 7.497, p < .0001). In mediation analyses, all IPV variables were associated with mental health (p < .0001), and all were associated with physical health (p < .007) except SEXyr. Sleep disturbance partially mediated all relationships (Sobel p < .0005 for all tests). Mediation was around 30%, ranging from 18% (HURTyr and mental health) to 41% (HURT and physical health). IPV was strongly associated with current sleep disturbance above the effect of demographics and overall mental/physical health, even if the IPV happened in the past. Furthermore, sleep disturbance partially mediates the relationship between IPV and mental/physical health. Sleep interventions may potentially mitigate negative effects of IPV.
• Li, J., A Grandner, M., Chang, Y., Jungquist, C., & Porock, D. (2015). Person-Centered Dementia Care and Sleep in Assisted Living Residents with Dementia: A Pilot Study. Behavioral sleep medicine, 1-17.
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  The sleep of people with dementia living in long-term care is known to be disturbed. This pre-post controlled pilot study examined the effects of a person-centered dementia care intervention on sleep in assisted living residents with dementia. The three-month intervention included in-class staff training plus supervision and support in practice. The sleep-wake patterns were measured using actigraphy for three consecutive days at baseline and postintervention. Sixteen residents from the intervention and six from the control groups completed the study. The intervention group had significantly more nighttime sleep at posttest. After adjusting for baseline, the intervention group exhibited significantly less daytime sleep and more nighttime sleep. Person-centered dementia care may be effective for improving sleep of residents with dementia.
• Pak, V. M., Keenan, B. T., Jackson, N., Grandner, M. A., Maislin, G., Teff, K., Schwab, R. J., Arnardottir, E. S., Júlíusson, S., Benediktsdottir, B., Gislason, T., & Pack, A. I. (2015). Adhesion molecule increases in sleep apnea: beneficial effect of positive airway pressure and moderation by obesity. International journal of obesity (2005), 39(3), 472-9.
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  Elevated levels of intercellular adhesion molecule 1 (ICAM-1) and vascular cell adhesion molecule 1 (VCAM-1) may contribute to cardiovascular disease and are associated with obstructive sleep apnea (OSA) and obesity. The relationship between OSA and obesity in determining ICAM-1 and VCAM-1 levels, and the effect of treatment, is unclear.
• Perlis, M., Grandner, M., Zee, J., Bremer, E., Whinnery, J., Barilla, H., Andalia, P., Gehrman, P., Morales, K., Thase, M., Bootzin, R., & Ader, R. (2015). Durability of treatment response to zolpidem with three different maintenance regimens: a preliminary study. Sleep medicine, 16(9), 1160-8.
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  At present, there is no consensus regarding how to medically manage chronic insomnia in the long term. The unstated standard of practice is for patients to use hypnotics intermittently. The present study aimed to compare a partial reinforcement strategy with nightly and intermittent dosing strategies for its potential as a maintenance therapy.
• Watson, N. F., Badr, M. S., Belenky, G., Bliwise, D. L., Buxton, O. M., Buysse, D., Dinges, D. F., Gangwisch, J., Grandner, M. A., Kushida, C., Malhotra, R. K., Martin, J. L., Patel, S. R., Quan, S. F., & Tasali, E. (2015). Recommended Amount of Sleep for a Healthy Adult: A Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society. Sleep, 38(6), 843-4.
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  Sleep is essential for optimal health. The American Academy of Sleep Medicine (AASM) and Sleep Research Society (SRS) developed a consensus recommendation for the amount of sleep needed to promote optimal health in adults, using a modified RAND Appropriateness Method process. The recommendation is summarized here. A manuscript detailing the conference proceedings and evidence supporting the final recommendation statement will be published in SLEEP and the Journal of Clinical Sleep Medicine.
• Williams, N. J., Grandne, M. A., Snipes, A., Rogers, A., Williams, O., Airhihenbuwa, C., & Jean-Louis, G. (2015). Racial/ethnic disparities in sleep health and health care: importance of the sociocultural context. Sleep health, 1(1), 28-35.
• Williams, N. J., Grandner, M. A., Wallace, D. M., Cuffee, Y., Airhihenbuwa, C., Okuyemi, K., Ogedegbe, G., & Jean-Louis, G. (2015). Social and behavioral predictors of insufficient sleep among African Americans and Caucasians. Sleep medicine.
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  Few studies have examined the social and behavioral predictors of insufficient sleep.
• Chakravorty, S., Jackson, N., Chaudhary, N., Kozak, P. J., Perlis, M. L., Shue, H. R., & Grandner, M. A. (2014). Daytime sleepiness: associations with alcohol use and sleep duration in americans. Sleep disorders, 2014, 959152.
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  The aim of the current analysis was to investigate the relationship of daytime sleepiness with alcohol consumption and sleep duration using a population sample of adult Americans. Data was analyzed from adult respondents of the National Health and Nutritional Examination Survey (NHANES) 2007-2008 (N = 2919) using self-reported variables for sleepiness, sleep duration, and alcohol consumption (quantity and frequency of alcohol use). A heavy drinking episode was defined as the consumption of ≥5 standard alcoholic beverages in a day. Logistic regression models adjusted for sociodemographic variables and insomnia covariates were used to evaluate the relationship between daytime sleepiness and an interaction of alcohol consumption variables with sleep duration. The results showed that daytime sleepiness was reported by 15.07% of the subjects. In univariate analyses adjusted for covariates, an increased probability of daytime sleepiness was predicted by decreased log drinks per day [OR = 0.74 (95% CI, 0.58-0.95)], a decreased log drinking frequency [0.90 (95% CI, 0.83-0.98)], and lower sleep duration [OR = 0.75 (95% CI, 0.67-0.84)]. An interaction between decreased sleep duration and an increased log heavy drinking frequency predicted increased daytime sleepiness (P = 0.004). Thus, the effect of sleep duration should be considered when evaluating the relationship between daytime sleepiness and heavy drinking.
• Grandner, M. A. (2014). Addressing sleep disturbances: an opportunity to prevent cardiometabolic disease?. International review of psychiatry (Abingdon, England), 26(2), 155-76.
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  There is increasing awareness of the role of sleep disturbance as an important factor in health and disease. Although sub-clinical sleep disturbances (insufficient sleep duration or inadequate sleep quality) may be difficult to assess with conceptual and/or methodological clarity, this review attempts to summarize and synthesize these findings. First, the concept of sleep disturbance in a public health context is introduced, to provide context and rationale. Second, operational definitions of 'cardiometabolic disease' and 'sleep disturbance' are offered, to address many unclear operationalizations. Third, the extant literature is summarized regarding short or long sleep duration and/or insufficient sleep, insomnia and insomnia symptoms, general (non-specific sleep disturbances), circadian rhythm abnormalities that result in sleep disturbances, and, briefly, sleep-disordered breathing. Fourth, the review highlights the social/behavioural context of sleep, including discussions of sleep and race/ethnicity, socio-economic position, and other social/environmental factors, in order to place these findings in a social-environmental context relevant to public health. Fifth, the review highlights the issue of sleep as a domain of health behaviour and addresses issues regarding development of healthy sleep interventions. Finally, a research agenda of future directions is proposed.
• Grandner, M. A., Knutson, K. L., Troxel, W., Hale, L., Jean-Louis, G., & Miller, K. E. (2014). Implications of sleep and energy drink use for health disparities. Nutrition reviews, 72 Suppl 1, 14-22.
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  The popularity of energy drinks has increased rapidly in the past decade. One of the main reasons people use energy drinks is to counteract effects of insufficient sleep or sleepiness. Risks associated with energy drink use, including those related to sleep loss, may be disproportionately borne by racial minorities and those of lower socioeconomic status. In this review, a brief introduction to the issue of health disparities is provided, population-level disparities and inequalities in sleep are described, and the social-ecological model of sleep and health is presented. Social and demographic patterns of energy drink use are then presented, followed by discussion of the potential ways in which energy drink use may contribute to health disparities, including the following: 1) effects of excessive caffeine in energy drinks, 2) effects of energy drinks as sugar-sweetened beverages, 3) association between energy drinks and risk-taking behaviors when mixed with alcohol, 4) association between energy drink use and short sleep duration, and 5) role of energy drinks in cardiometabolic disease. The review concludes with a research agenda of critical unanswered questions.
• Petrov, M. E., Howard, V. J., Kleindorfer, D., Grandner, M. A., Molano, J. R., & Howard, G. (2014). Over-the-counter and prescription sleep medication and incident stroke: the REasons for Geographic and Racial Differences in Stroke study. Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 23(8), 2110-6.
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  Preliminary evidence suggests sleep medications are associated with risk of vascular events; however, the long-term vascular consequences are understudied. This study investigated the relation between sleep medication use and incident stroke.
• Whinnery, J., Jackson, N., Rattanaumpawan, P., & Grandner, M. A. (2014). Short and long sleep duration associated with race/ethnicity, sociodemographics, and socioeconomic position. Sleep, 37(3), 601-11.
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  Short and/or long sleep duration are associated with cardiometabolic disease risk and may be differentially experienced among minorities and the socioeconomically disadvantaged. The present study examined nationally representative data along multiple dimensions of race/ ethnicity and socioeconomic status.
• Grandner, M. A., & Perlis, M. L. (2013). Insomnia as a cardiometabolic risk factor. Sleep, 36(1), 11-2.
• Grandner, M. A., Buxton, O. M., Jackson, N., Sands-Lincoln, M., Pandey, A., & Jean-Louis, G. (2013). Extreme sleep durations and increased C-reactive protein: effects of sex and ethnoracial group. Sleep, 36(5), 769-779E.
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  We hypothesize that extremes of sleep duration are associated with elevated C-reactive protein (CRP), a pro-inflammatory marker for cardiovascular disease risk.
• Grandner, M. A., Gallagher, R. A., & Gooneratne, N. S. (2013). The use of technology at night: impact on sleep and health. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 9(12), 1301-2.
• Grandner, M. A., Petrov, M. E., Rattanaumpawan, P., Jackson, N., Platt, A., & Patel, N. P. (2013). Sleep symptoms, race/ethnicity, and socioeconomic position. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 9(9), 897-905; 905A-905D.
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  Growing evidence indicates sleep is a major public health issue. Race/ethnicity and socioeconomics may contribute to sleep problems. This study assessed whether sleep symptoms were more prevalent among minorities and/or the socioeconomically disadvantaged.
• Grandner, M. A., Sands-Lincoln, M. R., Pak, V. M., & Garland, S. N. (2013). Sleep duration, cardiovascular disease, and proinflammatory biomarkers. Nature and science of sleep, 5, 93-107.
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  Habitual sleep duration has been associated with cardiometabolic disease, via several mechanistic pathways, but few have been thoroughly explored. One hypothesis is that short and/or long sleep duration is associated with a proinflammatory state, which could increase risk for cardiovascular and metabolic diseases. This hypothesis has been largely explored in the context of experimental sleep deprivation studies which have attempted to demonstrate changes in proinflammatory markers following acute sleep loss in the laboratory. Despite the controlled environment available in these studies, samples tend to lack generalization to the population at large and acute sleep deprivation may not be a perfect analog for short sleep. To address these limitations, population based studies have explored associations between proinflammatory markers and habitual sleep duration. This review summarizes what is known from experimental and cross-sectional studies about the association between sleep duration, cardiovascular disease, and proinflammatory biomarkers. First, the association between sleep duration with both morbidity and mortality, with a focus on cardiovascular disease, is reviewed. Then, a brief review of the potential role of proinflammatory markers in cardiovascular disease is presented. The majority of this review details specific findings related to specific molecules, including tumor necrosis factor-α, interleukins-1, -6, and -17, C-reactive protein, coagulation molecules, cellular adhesion molecules, and visfatin. Finally, a discussion of the limitations of current studies and future directions is provided.
• Grandner, M. A., Jackson, N. J., Pigeon, W. R., Gooneratne, N. S., & Patel, N. P. (2012). State and regional prevalence of sleep disturbance and daytime fatigue. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 8(1), 77-86.
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  Social and demographic influences are important for sleep attainment. Geographic location has not been previously explored.
• Grandner, M. A., Martin, J. L., Patel, N. P., Jackson, N. J., Gehrman, P. R., Pien, G., Perlis, M. L., Xie, D., Sha, D., Weaver, T., & Gooneratne, N. S. (2012). Age and sleep disturbances among American men and women: data from the U.S. Behavioral Risk Factor Surveillance System. Sleep, 35(3), 395-406.
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  Explore the prevalence of sleep-related complaints across age groups, examining effects of sex, general health, and depressed mood.

Proceedings Publications

• Bailey, O., Sans-Fuente, M., Havens, C., Combs, D., Grandner, M., Poongkunran, C., Patel, S., Berryhill, N., Provencio, N., Quan, S. F., & Parthasarathy, S. (2018, April). Delayed Sleep Time In African Americans And Depression In A Community-Based Population. In SLEEP, 41, A242-A242.
• Bajaj, S., Raikes, A., Vanuk, J., Satterfield, B. C., Alkozei, A., Weber, M., Rosso, I. M., Rauch, S. L., Grandner, M., & Killgore, W. D. (2018, April). Impact Of Blue Light Therapy On Cortical Structure, Sleep, And Anxiety Symptoms Following Mild Traumatic Brain Injury. In SLEEP, 41, A381.
• Bernard, S., Athey, A., Killgore, W. D., Alfonso-Miller, P., & Grandner, M. (2018, April). Adverse Childhood Experiences Among Student Athletes are Associated with Sleep Disturbances: Evaluating the Mediating Roles of Depression and Anxiety. In SLEEP, 41, A357.
• Bliznak, V., Athey, A., Killgore, W., Gehrels, J., Alfonso-Miller, P., & Grandner, M. (2018, April). History of Concussion in Student Athletes: A Risk Factor for Short Sleep Duration and Insomnia. In SLEEP, 41, A382.
• Bremer, E., Morales, K., Vargas, I., Grandner, M., Ellis, J., & Perlis, M. (2018, April). Does Time in Bed Vary with the Use of Hypotics?. In SLEEP, 41, A 157-158.
• Challener, S. A., Yung, A., Ozcan, M., Alkozel, A., Raikes, A. C., Grandner, M., & Killgore, W. (2018, April). Functional Impairment due to Excessive Daytime Sleepiness is Associated with Greater Activation in the Default Mode Network when Anticipating Negative Stimuli in Individuals with PTSD. In SLEEP, 41, A349.
• Ellis, J., Bastien, C. H., Gallagher, R., Alfonso-Miller, P., Hale, L., Perlis, M., & Grandner, M. (2018, April). The Impact of Abuse during Childhood on Adult Sleep and the Moderating Influence of Bedroom Safety. In SLEEP, 41, A144.
• Gencarelli, A. M., Khader, W., Morales, K., Grandner, M., Ellis, J., Kloss, J. D., & Perlis, M. (2018, April). A One Year Study Of 1,069 Good Sleepers: The Incidence Of Acute And Chronic Insomnia. In SLEEP, 41, A137-138.
• Gencarelli, A. M., Vargas, I., Khader, W., Muench, A., Boyle, J. T., Morales, K., Grandner, M., Ellis, J., Kloss, J. D., & Perlis, M. L. (2018, April). Evaluating the Association Between Life Events, Perceived Stress, and Insomnia Status: Data from a National Cohort of Good Sleepers (The NITES Study). In SLEEP, 41, A159.
• Gilles, A., & Grandner, M. (2018, April). Sleep Duration and Cardiometabolic Disease Risk in Native Hawaiians. In SLEEP, 41, A324.
• Grandner, M. (2018, April). Basics of Sleep and Relevance to Athletics. In Department of Athletics, University of Arizona.
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  Invited lecture, seminar
• Grandner, M. (2018, April). Introduction to Statistics for Medical Residents Part 1: Descriptive Statistics and Correlation. In Department of Psychiatry, University of Arizona.
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  Invited lecture, seminar
• Grandner, M. (2018, April). Sleep Basics: What you need to know to get the most out of your sleep. In Football, Department of Athletics, University of Arizona.
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  Invited lecture, seminar
• Grandner, M. (2018, April). Sleep and Mental Health/ Performance. In Department of Athletics, University of Arizona.
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  Invited lecture, seminar
• Grandner, M. (2018, April). Sleep and Mental Health: Links with Memory, Thinking, Emotions, and Stress. In Football, Department of Athletics, University of Arizona.
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  Invited lecture, seminar
• Grandner, M. (2018, April). Sleep and Performance: Physical and Mental Performance, and Injury and Pain Management. In Football, Department of Athletics, University of Arizona.
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  Invited lecture, seminar
• Grandner, M. (2018, February). Sleep and Cardiometabloic Disease Risk. In PSY 478: Sleep and Sleep Disorders, Department of Psychology, University of Arizona.
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  Invited lecture, seminar
• Grandner, M. (2018, February). Sleep as Medicine. In Arizona State University.
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  Invited lecture, symposia
• Grandner, M. (2018, January). Optimize Your Sleep for Health and Well-Being. In The Fountains.
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  Invited lecture, Colloquia
• Grandner, M. (2018, January). Sleep and Health Research. In Neuroscience Graduate Interdisciplinary Program, University of Arizona.
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  Invited lecture, symposia
• Grandner, M. (2018, January). Sleep and Health: Upstream Social/Behavioral Determinants and Downstream Cardiometabolic/Neurocognitive Consequences. In University of Iowa, Department of Health and Human Physiology.
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  Invited lecture, symposia
• Grandner, M. (2018, June). Building and Academic Career in Sleep Health: Shining a Light on Unanswered Questions When the Field is the Dark. In Seminar Series High School/ Undergraduate Program, University of Arizona.
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  Invited lecture, seminar
• Grandner, M. (2018, June). Causes and Consequences of Sleep Disparities: Key Areas and Research Directions. In National Institute of Minority Health and Health Disparities.
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  Invited lecture, symposia
• Grandner, M. (2018, June). Contextual Determinants of Sleep Disparities. In National Institute of Minority Health and Health Disparities.
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  Invited lecture, symposia
• Grandner, M. (2018, June). Domestic Violence as a Risk Factor for Insomnia ans Short Sleep Duration, and the Role of Depressed Mood and Anxiety Symptoms. In Associated Professional Sleep Societies.
• Grandner, M. (2018, June). Health Disparities and Sleep. In Sleep Research Society.
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  Invited lecture, symposia
• Grandner, M. (2018, June). Sleep and Health at the US- Mexico Border and Beyond. In Arizona-Mexico Border Commission, Health Services Committee.
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  Invited lecture, symposia
• Grandner, M. (2018, June). Sleep, Health, and Performance: Implications for Athletes. In Drug Free Sport.
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  Invited lecture, symposia
• Grandner, M. (2018, March). Sleep and Developmental Psychopathology. In PSY 583a: Developmental Psychopathology, Department of Psychology Graduate Program, University of Arizona.
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  Invited lecture, seminar
• Grandner, M. (2018, March). Sleep, Health, and Nutrition. In ExpoWest Natural Products Expo.
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  Invited lecture, symposia
• Grandner, M. (2018, May). Sleep Strategies: How to Fall Asleep, How to Wake Up, and Other Tips. In Football, Department of Athletics, University of Arizona.
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  Invited lecture, seminar
• Grandner, M. (2018, May). Sleep and Diverse Populations. In American Thoracic.
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  seminar
• Grandner, M. (2018, May). Sleep, Health and Society: Cardiometabolic / Neurocognitive Outcomes and Social / Behavioral Determinants. In Duke- NUS.
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  Invited lecture, symposia
• Grandner, M., Olivier, K., Killgore, W., Gehrels, J., & Alfonso-Miller, P. (2018, April). Domestic Violence as a Risk Factor for Insomnia and Short Sleep Duration, and the Role of Depressed Mood and Anxiety Symptoms. In SLEEP, 41, A354.
• Grandner, M., Perlis, M., Parthasarathy, S., & Pack, A. (2018, April). Systematic Sleep Time Extension: A Novel Approach to Extending Sleep in Habitual Short Sleepers. In SLEEP, 41, A326-A326.
• Haghighi, H., Athey, A., Killgore, W., Gehrels, J., Alfonso-Miller, P., & Grandner, M. (2018, April). Insufficient Sleep Duration and Insomnia Symptoms Independently Predict Suicide Ideation in Student Athletes and Non-Athletes. In SLEEP, 41, A363.
• Havens, C. M., Parthasarathy, S., Grandner, M., Malone, S. K., Patterson, F., & Klimentidis, Y. C. (2018, April). Sleep Traits Accentuate the Association of Genetic Markers with Obesity: Results from the UK Biobank. In SLEEP, 41, A7.
• Ji, X. W., Grandner, M., & Petrov, M. (2018, April). The Role of Age, Sex, Race/ethnicity, Education, and Marital Status in the Relationship of Chronic Health Conditions and Habitual Sleep Duration. In SLEEP, 41, A332.
• Khader, W., Morales, K., Grandner, M., Ellis, J., Zandberg, L., Kloss, J., & Perlis, M. (2018, April). Does Time in Bed Differentiate Between Good Sleepers and Subjects that Develop Acute Insomnia, Recover from Acute Insomnia, and/or Develop Chronic Insomnia?. In SLEEP, 41, A138-A139.
• Killgore, W. D., Alkozei, A., Knight, S., Grandner, M., & Weber, M. (2018, April). Daily Morning Blue Light Exposure Enhances Executive Functioning in Individuals with Mild Traumatic Brain Injury. In SLEEP, 41, A381.
• Knowlden, A., Petrov, M., Nowakowski, S., & Grandner, M. (2018, April). Gender Differences in the Relationship between Short Sleep and Obesity Depend on Age. In SLEEP, 41.
• Liang, O., Seixas, A., Killgore, W., Gehrels, J., Alfonso-Miller, P., & Grandner, M. (2018, April). Sleep Duration And Diabetes In The Us For 2007–2015: Moderation By Age, Sex, Race/ethnicity, And Body Mass Index. In SLEEP, 41, A330.
• Liu, S., Athey, A., Killgore, W., Gehrels, J., Alfonso-Miller, P., & Grandner, M. (2018, April). Sleep Paralysis and Hypnogogic/Hypnopompic Hallucinations: Prevalence in Student Athletes and Relationship to Depressive Symptoms. In SLEEP, 41, A358.
• Madhavaram, A., Seixas, A., Williams, N., Kalinowskisi, J., Rogers, A., Williams, S., Grandner, M., & Jean-Louis, G. (2018, April). Associations Between Self-Reported Sleep Duration and the new AHA/ACC High Blood Pressure Guidelines: Results from the National Health and Nutrition Examination Survey. In SLEEP, 41, A327.
• Meridew, C., Athey, A., Gehrels, J., Alfonso-Miller, P., & Grandner, M. (2018, April). Academic Performance Associated with Sleep Duration among Student Athletes: Impact of Insomnia, Fatigue, and Depression. In SLEEP, 41, A74-A75.
• Muench, A. L., Boyle, J. T., Morales, K., Vargas, I., Grandner, M., Ellis, J., Kloss, J. D., & Perlis, M. L. (2018, April). Depressive Symptoms in Good Sleepers and Subjects That Develop Acute Insomnia, Recover From Acute Insomnia, and/or Develop Chronic Insomnia. In SLEEP, 41, A354-A355.
• Okuagu, A., Athey, A., Prichard, R., Williams, N., Jean-Louis, G., Killgore, W., Gehrels, J., Alfonso-Miller, P., & Grandner, M. (2018, April). Racial/Ethnic Sleep Disparities Among College Students Are Different in Majority-White vs Majority-Minority Institutions. In SLEEP, 41, A393-A394.
• Sanchez, C., Killgore, W., Gehrels, J., Alfonso-Miller, P., & Grandner, M. (2018, April). Nighttime snacking: Prevalence and Associations with Poor Sleep, Health Obesity, and Diabetes. In SLEEP, 41, A49-A50.
• Sanchez, C., Killgore, W., Gehrels, J., Alfonso-Miller, P., & Grandner, M. (2018, April). Relationships between Dietary Supplement Intake and Sleep Duration, Insomnia and Fatigue. In SLEEP, 41, A72-A73.
• Sandino, M., Killgore, W., Gehrels, J., Alfonso-Miller, P., & Grandner, M. (2018, April). Sleep Duration and Perceived Cognitive Decline. In SLEEP, 41, A34.
• Tang, R., Athey, A., Killgore, W., Gehrels, J., Alfonso-Miller, P., & Grandner, M. (2018, April). Drowsy Driving In Student Athletes: Impact of Insomnia, Sleepiness, and Mood. In SLEEP, 41, A73.
• Tubbs, A., Perlis, M., Basner, M., Killgore, W., Gehrels, J., Alfonso-Miller, P., & Grandner, M. (2018, April). Does Increased Risk of Suicide at Night Favor One Method of Suicide Over Another?. In SLEEP, 41, A363.
• Tubbs, A., Perlis, M., Chakravorty, S., Basner, M., Killgore, W., Gehrels, J., Alfonso-Miller, P., & Grandner, M. (2018, April). Seasonal Changes in Nocturnal Suicide Risk. In SLEEP, 41, A366.
• Warlick, C., Jean-Louis, G., Killgore, W., Gehrels, J., Alfonso-Miller, P., & Grandner, M. (2018, April). Experiences of Discrimination among College Students and Impact on Sleep Quality, Depression, Anxiety, and Suicide Ideation: Does Sleep Account for Relationships with Depressive Symptoms?. In SLEEP, 41, A353-354.
• Yang, R., Hale, L., Branas, C., Perlis, M., Gallagher, R., Killgore, W., Gehrels, J., Alfonso-Miller, P., & Grandner, M. (2018, April). Work Productivity Loss Associated with Sleep Duration, Insomnia Severity, Sleepiness, and Snoring. In SLEEP, 41, A74.
• Alfonso-Miller, A., Athey, A., & Grandner, M. (2017, April). Evaluation of a sleep health intervention in student athletes: Insights for intervention development. In Sleep, 40, 1.
• Alkozei, A., Smith, R., Fridman, A., Dormer, A., Challener, S., & Grandner, M. (2017, April). Daily morning blue light exposure leads to changes in functional brain responses during emotional anticipation in individuals with PTSD. In Sleep, 40, 2.
• Athey, A., & Grandner, M. (2017, April). Studnet athletes" access to healthy sleep information in campus: How does it relate to other types of health information and to sleep difficulties?. In Sleep, 40, 1.
• Forbush, S., Fisseha, E., Gallagher, R., Hale, L., Malone, S., Patterson, F., Branas, C., Barrett, M., Killgore, W. D., Gehrels, J., Alfonso-Miller, P., & Grandner, M. (2017, April). Sociodemographics, poor overall health, cardiovascular disease, depression, fatigue, and daytime sleepiness associated with social jetlag independent of sleep duration and insomnia. In Sleep, 40, 2.
• Gottschlich, M., Hyman, S., Pisner, D., Singh, A., Millan, M., Knight, S., Grandner, M., & Killgore, W. D. (2017, April). Post-concussion severity is associated with sleep problems and neuropsychological status. In Sleep, 40, 1.
• Granados, K., Okuagu, A., Buxton, O., Patel, S., Ruiz, J., Parthasarathy, S., Haynes, P., Alfonso-Miller, P., Molina, P., Seixas, A., Williams, N., Jean-Louis, G., Gehrels, J., & Grandner, M. (2017, April). Acculturation associated with sleep duration, insomnia, and sleep quality at the US-Mexico border. In Sleep, 40, 1.
• Grandner, M. (2017, April). Sleep and Developmental Psychopathology. In Department of Psychology, Graduate Program.
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  invited guest, colloquia
• Grandner, M. (2017, April). Sleep for Peak Performance and Your Heart. In 30th Anniversary Community Lecture Series.
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  Invited lecture, Colloquia
• Grandner, M. (2017, April). Sleep, Cardiometabolic Disease Risk and Social- Environmental Determinants. In Human Biology Association Annual Meeting.
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  Invited lecture, symposia
• Grandner, M. (2017, April). Sleep: A New Dimension in Heart Health and Peak Performance. In Sarver Heart Center, Board of Directors.
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  Invited lecture, symposia
• Grandner, M. (2017, August). Careers in Sleep Medicine. In Department of Population Health, New York University.
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  Invited lecture, symposia
• Grandner, M. (2017, August). Physician Numeracy. In Child and Adolescent Psychiatry, Department of Psychiatry, University of Arizona.
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  Invited lecture, colloquia
• Grandner, M. (2017, August). Sleep and Cardiometabolic Disease Risk: New Insights. In Neuroscience Data Blitz.
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  Invited lecture, colloquia
• Grandner, M. (2017, August). Sleep, Health and Functioning. In Science Cafe, Phoenix Public Library.
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  Invited lecture, Colloquia
• Grandner, M. (2017, August). Social Determinants of Sleep. In Department of Population Health, New York University.
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  Invited lecture, symposia
• Grandner, M. (2017, December). Sleep, Health and Nutrition. In Natrol, Inc.
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  Invited lecture, colloquia
• Grandner, M. (2017, December). Sleep: Athletic Performance and Emerging Technologies. In Major League Baseball Winter Meetings.
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  Invited lecture, Colloquia
• Grandner, M. (2017, February). Sleep and Cardiometabolic Disease Risk. In University of Arizona.
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  Invited lecture, colloquia
• Grandner, M. (2017, February). Sleep and Health in Athletes. In Big Sky Sport Psychology Conference.
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  Invited lecture, symposia
• Grandner, M. (2017, January). Insufficient Sleep and Risk for Cardiometabolic Disease and Neurocognitive Deficits. In Department of Neuroscience, University of Arizona.
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  Invited lecture, symposia
• Grandner, M. (2017, January). Neurocognitive and Cardiometabolic Risk Factors Associated with Insufficient Sleep. In Cognitive Sciences, University of Arizona.
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  Invited lecture, symposia
• Grandner, M. (2017, January). Project REST: Recovery Enhancement ans Sleep Training. In National Collegiate Athletics Association.
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  Invited lecture, conference
• Grandner, M. (2017, January). Sleep and Cardiometabolic Disease Risk in Women. In Sarver Heart Center.
• Grandner, M. (2017, January). Sleep and Health: Upstream Social/Behavioral Determinants and Downstream Cardiometabolic/Neurocognitive Consequences. In University of Iowa, Department of Health and Human Physiology.
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  Invited lecture, symposia
• Grandner, M. (2017, July). Sleep, Health, and Performance: Basic Principles and Applications to Baseball. In Major League Baseball.
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  Invited Lecture, Colloquia
• Grandner, M. (2017, June). How to get a K Award (and how not to get a K award). In Sleep Research Society, Trainee Symposia Series.
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  Invited lecture, colloquia
• Grandner, M. (2017, June). Sleep, Health, and Performance for Football. In Department of Athletics, Texas Tech University.
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  Invited lecture, Colloquia
• Grandner, M. (2017, June). Sleep: Basic Principles and Applications for Athletic Development. In Professional Association of Athletics Development Specialists.
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  Invited lecture, Colloquia
• Grandner, M. (2017, June). Writing and Submitting K Awards. In Sleep Research Society Trainee Symposia Series.
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  Seminar
• Grandner, M. (2017, March). Marijuana Use: Impacts on Sleep, Anxiety and Performance. In Milwaulkee Brewers Spring Training.
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  Invited lecture, colloquia
• Grandner, M. (2017, March). Polysomnography and Sleep Disorders. In Psychiatry Residency Program.
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  Invited lecture, Colloquia
• Grandner, M. (2017, March). Sleep and Health: Epidemiology, Physiologic Implications, and Health Disparities. In Department of Physiology.
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  invited lecture, colloquia
• Grandner, M. (2017, March). Sleep, Health, and Performance for Baseball. In Oakland Athletics Spring Training.
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  invited lecture, colloquia
• Grandner, M. (2017, March). Sleep. In Moderated poster session, Joint Scientific Sessions, American Heart Association.
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  Seminar
• Grandner, M. (2017, May). Insomnia in the Context of Sleep Apnea: When and How Should You Treat?. In American Thoracic Society Sunrise Workshop.
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  Invited lecture, symposia
• Grandner, M. (2017, May). Sleep and Cardiometabolic Disease Risk: A Public Health Issue. In American Thoracic Sociaety.
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  Invited lecture, symposia
• Grandner, M. (2017, May). Sleep and Health: Basic Principles and Applications to Athletics. In National Collegiate Athletics Association.
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  Invited lecture, symposia
• Grandner, M. (2017, May). Sleep: A Public Health Call to Action. In Annual Meeting of the American Thoracic Society.
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  Symposium
• Grandner, M. (2017, May). Sleep: Basic Principles and Applications for Sport Psychologists. In PAC-12 Medical Conference.
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  Invited lecture, symposia
• Grandner, M. (2017, November). Sleep Quantity and Quality. In American Heart Association.
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  Invited lecture, symposia
• Grandner, M. (2017, October). Delivering Insomnia Care: Challenges and Opportunities for Sleep Clinics, Primary Care and Healthcare Networks. In Arizona Sleep Society.
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  Invited lecture, symposia
• Grandner, M. (2017, October). Sleep and Cardiometabolic Disease Risk in the Population. In World Sleep Society.
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  Invited lecture, symposia
• Grandner, M. (2017, October). Sleep and Energy Balance in Humans. In World Sleep Society.
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  Invited lecture, symposia
• Grandner, M. (2017, October). Sleep and Metabolism: A Transnational Perspective. In World Sleep Society.
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  Seminar
• Grandner, M. (2017, October). Social Determinants of Sleep. In Department of Medicine, University of Arizona.
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  Invited lecture, symposia
• Grandner, M. (2017, September). Insomnia Diagnosis, Case Conceptualization and Conceptual Models. In Whole Health Clinic, Department of Psychiatry, University of Arizona.
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  Invited lecture, Colloquia
• Grandner, M. (2017, September). Insomnia: Treatment Approaches. In Whole Health Clinic, Department of Psychiatry, University of Arizona.
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  Invited lecture, seminar
• Grandner, M. (2017, September). Patient-Centered Outcomes Research in Insomnia: Ideas and Assessment. In Sleep Research Network.
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  Invited lecture, symposia
• Grandner, M. (2017, September). Sleep Health and Cardiovascular Risk in Young Adults. In National Heart, Lung, and Blood Institute.
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  Invited lecture, symposia
• Grandner, M. (2017, September). Sleep and Health: Spirit of the Senses. In Salon Series.
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  Invited lecture, Colloquia
• Grandner, M., Gallagher, R., Keenan, B., Hale, L., Alfonso-Miller, P., Branas, C., & Barrett, M. (2017, April). Sleep and Healthy activity, diet, environment, and socialization: The SHADES Study. In Sleep, 40, 1.
• Grandner, M., Ruiz, J., Patel, S., Buxton, O., Ingram, M., Haynes, P. L., & Parthasarathy, S. (2017, April). Acculturation Associated with Sleep Duration, Insomnia, and Sleep Quality at the US-Mexico Border. In Sleep, 40, 1.
• Grandner, M., Ruiz, J., Patel, S., Buxton, O., Ingram, M., Haynes, P. L., & Parthasarathy, S. (2017, June). Acculturation Associated with Sleep Duration, Insomnia, and Sleep Quality at the US-Mexico Border. In Sleep, 40, A310.
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  Submitted version authors: Granados, K., Okuagu, A., Buxton, O., Patel, S., Ruiz, J., Parthasarathy, S., Haynes, P., Alfonso-Miller, P.., Molina, P., Seixas, A., Williams, N., Jean-Louis, G., Gehrels, J., Grandner, M. A.
• Hall, C., Poling, K., Athey, A., Alfonso-Miller, P., Gehrels, J., & Grandner, M. (2017, April). Sleep difficulties associated with academic performance in student athletes. In Sleep, 40, 1.
• Havens, C. M., Grandner, M., Youngstedt, S. D., Pandy, A., & Parthasarathy, S. (2017, April). International variability in the prevalence of insomnia and use of sleep-promoting medications, supplements, and other substances. In Sleep, 40, 2.
• Jaszewski, A., Athey, A., Killgore, W. D., Alfonso-Miller, P., Gehrels, J., & Grandner, M. (2017, April). Sleep Duration and Quality Associated with Mental Well-Being in Student Athletes. In SLEEP, 40, 1.
• Ocano, D., Watson, N., Kay, M., Kientz, J., & Grandner, M. (2017, April). Validation of a touchscreen psychomotor vigilance task for Android devices. In Sleep, 40, 1.
• Okuagu, A., Granados, K., Alfonso-Miller, P., Buxton, O., Patel, S., Ruiz, J., Parthasarathy, S., Haynes, P. L., Molina, P., Seixas, A., Williams, N., Girardin, J. L., Gehrels, J., & Grandner, M. (2017, June). Born in the USA or Born in Mexico? Implications for Sleep Duration, Sleep Quality, Sleep Disorders Symptoms at the US-Mexico Border. In Sleep, 40, A309.
• Olivier, K., Gallagher, R., Hale, L., Barrett, M., Branas, C., Killgore, W. D., Parthasarathy, S., Alfonso-Miller, P., Gehrels, J., & Grandner, M. (2017, April). Development and initial validation of a brief measure of control over sleep. In Sleep, 40, 1.
• Petrov, M. E., Long, L., Grandner, M., MacDonald, L., Cribbet, M. R., Robbins, R., Cundiff, J., Molano, J. R., Hoffmann, N., Howard, G., & Howard, V. J. (2017, April). Sleep duration by sociodemographic, socioeconomic, and geographical status. In Sleep, 40, 1.
• Poling, K., Gallagher, R., Hale, L., Branas, C., Seixas, A., Jean-Louis, G., Killgore, W., Alfonso-Miller, P., Parthasarthy, S., Gehrels, J., & Grandner, M. (2017, April). Sleep partially mediates the association between food insecurity and obesity: Roles of short sleep duration, insomnia, and socioeconomic factors. In Sleep, 40, 1.
• Richards, S., Seixas, A., Chung, D., Nunes, J., Grandner, M., Zizi, F., Tan, N., & Jean-Louis, G. (2017, April). Sleep impacts quality of life and neurocognitive characteristics of black and Hispanic stroke survivors. In Sleep, 40, 1.
• Robbins, R., Jean-Louis, G., Sundarajan, A., Hale, L., Gallagher, R. A., Barrett, M., Gooneratne, N., Branas, C., Alfonso-Miller, P., Perlis, M., & Grandner, M. (2017, April). Social capital and social connectness related to sleep duration, insomnia symptoms, and daytime sleepiness. In Sleep, 40, 1.
• Seixas, A., Li, Y., Pagan, J., Mcfarlane, S., Grandner, M., Youngstedt, S., Zizi, F., & Jean-Louis, G. (2017, April). The role of sleep and physical activity in reducing the prevalence of diabetes in the United States: An Agent-based simulation model approach. In Sleep, 40, 2.
• Till, K., Athey, A., Chakravorty, S., Killgore, W. D., Alfonso-Miller, P., Gehrels, J., & Grandner, M. (2017, April). Insomnia and daytime tiredness in student athletes associated with risky behaviors and porr deicision making when under the influence of alcohol. In Sleep, 40, 2.
• Vanuk, J. R., Shane, B. R., Bajaj, S., Millan, M., Grandner, M., & Killgore, W. D. (2017, April). Short-wavelength light therapy as a way of improving sleep, cognition, and functional connectivity following a mild traumatic brain injury. In Sleep, 40, 1.
• Warlick, C., Hall, C., Athey, A., Chakravorty, S., Killgore, W. D., Alfonso-Miller, P., Gehrels, J., & Grandner, M. (2017, April). Difficulty sleeping associated with substance use among student athletes. In Sleep, 40, 1.
• Yang, R., Gallagher, R., Hale, L., Perlis, M., Barrett, M., Branas, C., Killgore, W. D., Parthasarathy, S., Alfonso-Miller, P., Gehrels, J., & Grandner, M. (2017, April). Would you call yourself a short or long sleeper? Perceptions of sleep category associated with reported sleep duration, insomnia, and health. In Sleep, 40, 1.
• Alkozei, A., Grandner, M., & Killgore, W. (2016, June). Exposure to blue wavelength light is associated with increased dorsolateral prefrontal cortex responses, and increases in response times during a working memory task.. In SLEEP.
• Alkozei, A., Grandner, M., & Killgore, W. (2016, June). Exposure to blue wavelength light reduces activation within the anterior cingulate cortex during anticipation of certain reward stimuli.. In SLEEP.
• Bajaj, S., Alkozei, A., Grandner, M., & Killgore, W. D. (2016, April). Effect of bright light therapy on brain and behavioral abnormalities following a mild traumatic brain injury. In Sleep, 40, 1.
• Brownlow, J., Grandner, M., Gehrman, P. R., Ross, R. J., & Mellman, T. A. (2016, June). Rapid eye movement sleep mediates the relationship between sleep duration and verbal learning.. In Sleep.
• Chakravorty, S., Grandner, M., Kranzler, H., Brown, N., & Perlis, M. L. (2016, June). The Circadian Pattern of Suicides in Intoxicated Individuals with Alcohol Dependence.. In SLEEP.
• Corbitt, C., Ellis, J. A., Morales, K., Nesom, G., Khader, W., Grandner, M., & Perlis, M. L. (2016, June). The Natural History of Insomnia: The Incidence of Acute Insomnia and Subsequent Progression to Chronic Insomnia or Recovery. In SLEEP.
• Davis, B., Yang, R., Killgore, W., Gallagher, R. A., Carrazco, N., Alfonso-Miller, P., Gehrels, J., & Grandner, M. (2016, June). Nightmares in a community sample: Prevalence and associations with daytime function independent of poor sleep quality and depression. In SLEEP.
• Fisseha, E., Gallagher, R., Hale, L., Branas, C., Barrett, M., Killgore, W. D., Alfonso-Miller, P., Jean-Louis, G., Seixas, A., Williams, N., Gehrels, J., & Grandner, M. (2016, April). Habitual weekday sleep duration associated with multiple dimensions of socioeconomic status. In Sleep, 40, 1.
• Fisseha, E., Havens, C., Killgore, W., Gallagher, R. A., Carrazco, N., Alfonso-Miller, P., Gehrels, J., & Grandner, M. (2016, June). Sleep duration’s important role in the relationship among difficulty concentrating, fatigue, stress, and depressed mood: Data from the SHADES study. In SLEEP.
• Forbush, S., Hui, S. A., Carrazco, N., Alfonso-Miller, P., Gehrels, J., & Grandner, M. (2016, June). Longitudinal co-occurrence of headaches and trouble sleeping: Data from the Kansas state employee wellness program. In SLEEP.
• Garland, S. N., Fowler, K., Zhou, E., & Grandner, M. (2016, June). A decade of sleep in Canada. In SLEEP.
• Graham, P. M., Goldstein, M., David, B. M., Perlis, M. L., Perfect, M. M., Frye, S., Killgore, W., Carrazco, N., Alfonso-Miller, P., Gehrels, J., & Grandner, M. (2016, June). Longitudinal analysis of sleep duration using actigraphy and sleep diary: Stability and agreement over 8-11 months. In SLEEP.
• Granados, K., Rojo-Wissar, D. M., Chakravorty, S., Prather, A., Perfect, M. M., Frye, S., Killgore, W., Gallagher, R. A., Carrazco, N., Alfonso-Miller, P., Gehrels, J., & Grandner, M. (2016, June). Adverse childhood exposures associated with adult insomnia symptoms. In SLEEP.
• Grandner, M., & Killgore, W. (2016, June). Positive and negative mood ratings across 24 hours. In SLEEP.
• Grandner, M., & Winkelman, J. W. (2016, June). Nocturnal leg cramps: Prevalence and associations with demographics, sleep disturbance symptoms, medical comorbidity, and cardiometabolic risk factors.. In SLEEP.
• Haynes, P. L., Medici, K., Grandner, M., & Burgess, J. L. (2016, June). Ambient Light Exposure is Positively Associated with Calmness in Mental Health Care Providers. In Sleep, 39, A53.
• Haynes, P. L., Medici, K., Grandner, M., & Burgess, J. L. (2016, June). Ambient light exposure is positively associated with calmness in mental health care providers. In SLEEP.
• Jackson, N., Patterson, F., Seixas, A., Jean-Louis, G., Killgore, W., & Grandner, M. (2016, June). Using big data to determine social, behavioral, and environmental determinants of sleep duration in the US population: Application of a machine-learning approach to data from approximately 700,000 Americans. In SLEEP.
• Jaszewski, A., Meridew, C., Perlis, M. L., Kelly, M., Carrazco, N., Alfonso-Miller, P., Gehrels, J., & Grandner, M. (2016, June). Sleep duration and insomnia associated with specific symptoms of depression. In SLEEP.
• Killgore, W., Tkachenko, O., Grandner, M., & Rauch, S. L. (2016, June). Default mode activation predicts vulnerability to sleep deprivation in the domains of mood, sleepiness, and vigilance. In SLEEP.
• Killgore, W., Weber, M., Grandner, M., & Penetar, D. M. (2016, June). Blue wavelength light therapy improves balance following mild traumatic brain injury. In SLEEP.
• Klingman, K., Grandner, M., Parthasarathy, S., Jungquist, C. R., & Perlis, M. L. (2016, June). Determinants of sleep health discussions between patients and providers. In SLEEP.
• Kotzin, M. D., Alkozei, A., Grandner, M., & Killgore, W. (2016, June). The effects of trait gratitude on quality of sleep, intrusiveness of pre-sleep cognitions, and daytime energy in healthy individuals. In SLEEP.
• Markowski, S. M., Alkozei, A., McIntosh, M. B., Grandner, M., & Killgore, W. (2016, June). Chronotype and risk-taking propensity. In SLEEP.
• McIntosh, M. B., Markowski, S. M., Grandner, M., & Killgore, W. (2016, June). Short-term sleep duration is negatively associated with impulsivity in women. In SLEEP.
• Meridew, C. M., Jaszewski, A., Newman-Smith, K., Killgore, W., Gallagher, R., Carrazco, N., Alfonso-Miller, P., Gehrels, J., & Grandner, M. (2016, June). Sleep practices, beliefs, and attitudes associated with overall health. In SLEEP.
• Nowakowski, S., Kloss, J. D., Perlis, M. L., Borahay, M., Meers, J. M., Culnan, E. J., & Grandner, M. (2016, June). Insomnia associated with age at hysterectomy and partially mediates relationship with depression. In SLEEP.
• Nowakowski, S., Kloss, J. D., Perlis, M. L., Culnan, E. J., Meers, J. M., & Grandner, M. (2016, June). Insomnia associated with increased risk for pregnancies that do not result in live births in reproductive age women. In SLEEP.
• Ocano, D., Jean-Louis, G., Killgore, W., Gallagher, R. A., Carrazco, N., Alfonso-Miller, P., Gehrels, J., & Grandner, M. (2016, June). Sleep duration and decreased social support from family, friends, and significant other: Influence of insomnia and perceived stress level. In SLEEP.
• Okuagu, A., Perlis, M. L., Ellis, J. A., Prather, A. A., Killgore, W., Gallagher, R. A., Carrazco, N., Alfonso-Miller, P., Gehrels, J., & Grandner, M. (2016, June). Does thinking keep people awake? Or does it matter what they are thinking about? Self-directed cognitions associated with insomnia and insufficient sleep. In SLEEP.
• Olivier, K., Gallagher, R. A., Killgore, W., Carrazco, N., Alfonso-Miller, P., Gehrels, J., & Grandner, M. (2016, June). Development and initial validation of the assessment of sleep environment: A novel inventory for describing and quantifying the impact of environmental factors on sleep. In SLEEP.
• Paine, K. N., Forbush, S., Ellis, J. A., Nowakowski, S., Newman-Smith, K., Killgore, W., Gallagher, R. A., Carrazco, N., Alfonso-Miller, P., Gehrels, J., & Grandner, M. (2016, June). Sleep duration and satisfaction with life, health, finances, and relationship. In SLEEP.
• Perlis, M. L., Ellis, J. A., Morales, K., Grandner, M., Corbitt, C., Nesom, G., & Khader, W. (2016, June). The Natural History of Insomnia: Does The 3rd P of The 3p Model Differentiate Between Recovery and the Transition from Acute Insomnia to Chronic Insomnia?. In SLEEP.
• Rhee, J. U., Haynes, P. L., Chakravorty, S., Patterson, F., Killgore, W., Gallagher, R. A., Carrazco, N., Alfonso-Miller, P., Gehrels, J., & Grandner, M. (2016, June). Susceptibility to smoking during the day and its relationship with insomnia and sleep duration. In SLEEP.
• Roberts, S. E., Singh, P., Grandner, M., & Killgore, W. (2016, June). Later wake up time and impulsivity. In SLEEP.
• Roopchand-Martin, S., Seixas, A., Jean-Louis, G., Zizi, F., Carrazco, N., Alfonso-Miller, P., & Grandner, M. (2016, June). Sex differences in sleep-related practices, beliefs, and attitudes of university students in Jamaica. In SLEEP.
• Roopchand-Martin, S., Seixas, A., Jean-Louis, G., Zizi, F., Carrazco, N., Alfonso-Miller, P., & Grandner, M. (2016, June). Sleep-related oractices, beliefs, and attitudes associated with sleep duration among university students in Jamaica. In SLEEP.
• Saccone, J., Davis, B., Chakravorty, S., Killgore, W., Gallagher, R. A., Carrazco, N., Alfonso-Miller, P., Gehrels, J., & Grandner, M. (2016, June). Habitual caffeine use and motivation to consume caffeine: Associations with sleep duration, sleepiness, fatigue, and insomnia severity. In SLEEP.
• Seixas, A., Hencelwood, D., Newsome, V., Robbins, R., Grandner, M., Butler, M., Zizi, F., & Jean-Louis, G. (2016, June). The impact of sleep and body mass index on stroke disparities between blacks and whites: A comparative analysis of structural equation modeling and Bayesian belief network machine learning analysis. In SLEEP.
• Singh, A., Fridman, A., Silveri, M. M., Grandner, M., & Killgore, W. (2016, June). Medial prefrontal GABA predicts hunger ratings during sleep deprivation for men but not women. In SLEEP.
• Sturgis, E., Perlis, M. L., Arnedt, J. T., Kranzler, H., Grandner, M., & Chakravorty, S. (2016, June). The effects of an 8‐week CBT‐I treatment on psychiatric symptoms, alcohol craving, and relapse to drinking in patients with co‐occurring insomnia and alcohol dependence. In SLEEP.
• Unbin Rhee, J., Haynes, P. L., Chakravorty, S., Patterson, F., Killgore, W. D., Gallagher, R. A., Carrazco, N., Alfonso-Miller, P., Gehrels, J., & Grandner, M. (2016, June). Susceptibility to smoking during the day and its relationship with insomnia and sleep duration. In Sleep, 39, A189.
• Vanuk, J. R., Alkozei, A., Grandner, M., & Killgore, W. (2016, June). The effects of light exposure on heart rate variability predict sleepiness and vigilance. In SLEEP.
• Vanuk, J. R., Alkozei, A., Smith, R., Grandner, M., & Killgore, W. (2016, June). Changes in heart rate variability due to light exposure predict frontoparietal connectivity. In SLEEP.
• Warlick, C., Chakravorty, S., Killgore, W., Gallagher, R. A., Carrazco, N., Alfonso-Miller, P., Gehrels, J., & Grandner, M. (2016, June). Timing of alcohol intake associated with insomnia symptoms. In SLEEP.
• Waugaman, D. L., Markowski, S. M., Alkozei, A., Grandner, M., & Killgore, W. (2016, June). Chronotype and emotional intelligence. In SLEEP.
• Weber, M., Grandner, M., & Killgore, W. (2016, June). Blue wavelength light therapy reduces daytime sleepiness following mild traumatic brain injury. In SLEEP.
• Weber, M., Grandner, M., & Killgore, W. (2016, June). Grey matter correlates of daytime sleepiness.. In SLEEP.
• Yang, R., Ocano, D., Chakravorty, S., Killgore, W., Gallagher, R. A., Carrazco, N., Alfonso-Miller, P., Gehrels, J., & Grandner, M. (2016, June). Relationship between insomnia and depression moderated by caffeine.. In SLEEP.
• Grandner, M. (2017, June). Sleep Duration and Hypertension: Analysis of >700,000 Adults by Age and Sex. In Associated Professional Sleep Societies.
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  Invited lecture, symposia
• Grandner, M. (2018, April). Introduction to Statistics for Medical Residents Part 2: Hypothesis Testing and Group Differences. In Department of Psychiatry, University of Arizona.
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  invited lecture, seminar
• Unbin Rhee, J., Haynes, P. L., Chakravorty, S., Patterson, F., Killgore, W. D., Gallagher, R. A., Carrazco, N., Alfonso-Miller, P., Gehrels, J., & Grandner, M. (2015, Winter). Susceptibility to smoking during the day and its relationship with insomnia and sleep duration. In Sleep.

Poster Presentations

• Bedrossian, R. A., Fisher, J. M., Weltzer, R., Briggs, R., Ressel, A. C., Khachatryan, M., Matthews, J. C., Thai, B. Q., Tung, J., Grandner, M., Patterson, F., & Connick, E. (2022, February). Poor Sleep is Linked to CVD Risk in PLWH in a Southwestern US Clinic. Conference on Retroviruses and Opportunistic Infections 2022. Virtual.
• Grandner, M., Hsu, C., Morrison, H. W., Taylor-Piliae, R. E., Grandner, M., Hsu, C., Morrison, H. W., & Taylor-Piliae, R. E. (2021, Summer). Changes in Symptoms, Sleep, Oxidative Stress, and Inflammatory Markers Among Community-Dwelling Stroke Survivors After a Tai Chi Exercise Intervention.. European Society of Cardiology, EuroHeartCare 2021 Congress. online presentation due to COVID-19.
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  (Abstract selected for Press Release). Taylor-Piliae, R.E., Morrison, H., Hsu, C.H., Grandner, M. (2021). Changes in Symptoms, Sleep, Oxidative Stress, and Inflammatory Markers Among Community-Dwelling Stroke Survivors After a Tai Chi Exercise Intervention. European Journal of Cardiovascular Nursing, Volume 20, Issue Supplement_1, July 2021, zvab060.075, https://doi.org/10.1093/eurjcn/zvab060.075
• Grandner, M., Alfonso-Miller, P., Warlick, C., Killgore, W., Taylor-Piliae, R. E., & Jajoo, A. (2019, Spring). Types of Habitual Physical Activity Associated with Habitual Sleep Duration, Sleep Quality, and Daytime Sleepiness.. Sleep 2019: 33rd Annual Meeting of the Associated Professional Sleep Societies.. San Antonio, TX..
• Taylor-Piliae, R. E., Grandner, M., Bell, M. L., & Marupuru, S. (2019, Spring). The effect of physical activity on sleep quality among older stroke survivors: Secondary analysis from a randomized controlled trial.. International Society for Pharmacoeconomics and Outcomes Research. New Orleans, LA.

Reviews

• Grandner, M. A., Seixas, A., Shetty, S., & Shenoy, S. (2016. Sleep Duration and Diabetes Risk: Population Trends and Potential Mechanisms(p. 106).
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  Sleep is important for regulating many physiologic functions that relate to metabolism. Because of this, there is substantial evidence to suggest that sleep habits and sleep disorders are related to diabetes risk. In specific, insufficient sleep duration and/or sleep restriction in the laboratory, poor sleep quality, and sleep disorders such as insomnia and sleep apnea have all been associated with diabetes risk. This research spans epidemiologic and laboratory studies. Both physiologic mechanisms such as insulin resistance, decreased leptin, and increased ghrelin and inflammation and behavioral mechanisms such as increased food intake, impaired decision-making, and increased likelihood of other behavioral risk factors such as smoking, sedentary behavior, and alcohol use predispose to both diabetes and obesity, which itself is an important diabetes risk factor. This review describes the evidence linking sleep and diabetes risk at the population and laboratory levels.
• Grandner, M. A., Williams, N. J., Knutson, K. L., Roberts, D., & Jean-Louis, G. (2015. Sleep disparity, race/ethnicity, and socioeconomic position.
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  Sleep represents a set of biological functions necessary for the maintenance of life. Performing these functions, though, requires that an individual engage in behaviors, which are affected by social and environmental factors. Race/ethnicity and socioeconomic position represent categories of factors that likely play a role in the experience of sleep in the community. Previous studies have suggested that racial/ethnic minorities and the socioeconomically disadvantaged may be more likely to experience sleep patterns that are associated with adverse health outcomes. It is possible that disparities in sleep represent a pathway by which larger disparities in health emerge. This review (1) contextualizes the concept of race/ethnicity in biomedical research, (2) summarizes previous studies that describe patterns of sleep attainment across race/ethnicity groups, (3) discusses several pathways by which race/ethnicity may be associated with sleep, (4) introduces the potential role of socioeconomic position in the patterning of sleep, and (5) proposes future research directions to address this issue.
• Perlis, M. L., Grandner, M. A., Chakravorty, S., Bernert, R. A., Brown, G. K., & Thase, M. E. (2015. Suicide and sleep: Is it a bad thing to be awake when reason sleeps?(pp 101-107).
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  Suicide is the second leading cause of death, worldwide, for those between the ages of 24 and 44 y old. In 2013, more than 41,000 suicides occurred in the United States. These statistics underscore the need to 1) understand why people die by suicide and 2) identify risk factors that are potentially modifiable. While it has been posited that sleep disturbance may represent one such factor, systematic research in this arena did not begin until the 2000s. Since that time, sleep disturbance has been reliably identified as a risk factor for suicidal ideation, suicide attempts, and suicide. While insomnia, nightmares, and other sleep disorders have each been found to contribute to the risk for suicidal ideation and behavior, it is also possible that these factors share some common variance. One possibility is that sleep disturbance results in being awake at night, and being awake at night also confers risk. The hypothesis proffered here is that being awake when one is not biologically prepared to be so results in "hypofrontality" and diminished executive function, and that this represents a common pathway to suicidal ideation and behavior. Such a proposition is highly testable under a variety of possible protocols. The current review summarizes the extant literature on suicide rates by time-of-day, and discusses circadian, psychosocial, and neurocognitive explanations of risk. Such a focus promises to enhance our understanding of how sleep disturbance may confer risk, allows for the identification of future lines of research, and further justifies the need for interventions that promote good sleep continuity among at-risk individuals.

Creative Productions

• Grandner, M., Sharkey, K., & Baron, K. (2020. Pandemic sleep advice straight from experts. Elemental.

Others

• Grandner, M. (2018, June). Sleep to your Heart's Content. Sarver Heart Center Newsletter.
• Grandner, M. (2015, January). Sleep and Health Research Program. http://www.sleephealthresearch.com
• Grandner, M., & Hui, S. (2015, Spring). Poor sleep quality associated with lower work performance and greater healthcare costs: Longitudinal data from Kansas state employee wellness programs. SLEEP.
• Grandner, M., & Hui, S. (2015, Spring). The role of poor sleep quality in motivating and maintaining healthy behavior: Data from the Kansas state employee wellness program. SLEEP.
• Grandner, M., Chakravorty, S., Chaudhary, N. S., Khawaja, I. S., & Oslin, D. W. (2015, Spring). The association of a family history of alcoholism with sleep disturbance and alcohol consumption in alcoholic subjects. SLEEP.
• Grandner, M., Chheda, J., Barilla, H., & Gallagher, R. (2015, Spring). Physical activity and habitual sleep duration: Does the specific type of activity matter?. SLEEP.
• Grandner, M., Corbitt, C., Gehrman, P., Perlis, M., & Nesom, G. (2015, Spring). What factors predict sleep continuity complaints?. SLEEP.
• Grandner, M., Gallagher, R., Chakravorty, S., Gurubhagavatula, I., Barrett, M., Schuschu, J., Khader, W., Perlis, M., & Findley, J. (2015, Spring). Short sleep duration, insomnia, and snoring associated with drowsy driving.. SLEEP.
• Grandner, M., Gallagher, R., Chakravorty, S., Hale, L., Barrett, M., Schuschu, J., Khader, W., & Perlis, M. (2015, Spring). Comparing different methods of assessing habitual sleep duration for epidemiologic research. SLEEP.
• Grandner, M., Gallagher, R., Perlis, M., Chakravorty, S., Hale, L., Barrett, M., Schuschu, J., & Khader, W. (2015, Spring). Use of mobile electronic devices in bed associated with sleep duration, insomnia, and daytime sleepiness. SLEEP.
• Grandner, M., Khader, W., Brownlow, J., Chakravorty, S., Gehrman, P., & Rana, S. (2015, Spring). Daytime cognitive function associated with habitual sleep duration. SLEEP.
• Grandner, M., Nesom, G., Corbitt, C., Andalia, P., Findley, J., Perlis, M., & Gehrman, P. (2015, Spring). Case series review of CBT-I outcomes: The relevance of medication use and morbidity. SLEEP.
• Grandner, M., Perlis, M., Petrov, M., & Jean-Louis, G. (2015, Spring). Relationships among habitual sleep duration, race/ethnicity, and cardiometabolic disease outcomes: Data from > 450,000 us adults from the 2013 Behavioral Risk Factor Surveillance System. SLEEP.
• Grandner, M., Rana, S., & Chakravorty, S. (2015, Spring). Binge drinking and habitual sleep duration, and the roles of depression and smoking: Data from the 2013 Behavioral Risk Factor Surveillance System. SLEEP.
• Grandner, M., Schuschu, J., & Pigeon, W. (2015, Spring). The relationship between sleep duration and obesity depends on state of residence: Data from 50 states and the District of Columbia. SLEEP.
• Grandner, M., Schuschu, J., Pigeon, W., & Jean-Louis, G. (2015, Spring). Where are the sleep duration disparities? The relationship between sleep duration and race/ethnicity depends on state of residence: Data from 50 states and the District of Columbia. SLEEP.
• Grandner, M., Wang, J., Perlis, M., Chakravorty, S., Gallagher, R., Hale, l., Barrett, M., Schuschu, J., Khader, W., & Rana, S. (2015, Spring). Anxiety symptoms predict short sleep duration, but only in individuals who are not “natural” short sleepers. SLEEP.
• Grandner, M., Williams, N. J., Youngstedt, S., Sarpong, D., Zizi, F., Ogedegbe, G., & Jean-Louis, G. (2015, Spring). Unequal burden of sleep-related obesity among black and white Americans.. SLEEP.