Publications by authors named "Ståle Pallesen"

329 Publications

Predictors of diagnostically defined insomnia in child and adolescent community samples: a literature review.

Sleep Med 2021 Sep 10;87:241-249. Epub 2021 Sep 10.

Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.

Diagnostically defined insomnia is prevalent, persistent, and associated with a range of negative outcomes in childhood and adolescence. To inform prevention and treatment, we need to identify relevant predictors that can be addressed in such intervention efforts. Therefore, a systematic search for longitudinal studies involving child and adolescent samples (ages 4 to 19) examining predictors of diagnostically defined insomnia adjusted for previous insomnia was conducted. The search identified 6419 studies, resulting in six included papers involving five samples (n = 9949) conducted in five different countries (the US, New Zealand, Norway, China, and Japan). Few longitudinal studies investigated the predictors of diagnostically defined insomnia in children and adolescents, and insomnia is rarely defined according to diagnostic manuals. The results suggested that poor mental health (most notably depression) and female sex may be involved in the etiology of diagnostically defined insomnia. Stress might be the most modifiable factor identified. However, the diversity of the predictors studied in previous reports combined with the lack of replication prevent any firm conclusions from being drawn. This review serves as a summary of the best available evidence.
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http://dx.doi.org/10.1016/j.sleep.2021.09.003DOI Listing
September 2021

Child and family predictors of insomnia from early childhood to adolescence.

Sleep Med 2021 Aug 27;87:220-226. Epub 2021 Aug 27.

Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.

Background: Insomnia is prevalent among children and adolescents and is associated with a wide range of negative outcomes. Knowledge about its determinants is therefore important, but due to the lack of longitudinal studies, such knowledge is limited. The aim of the present inquiry is to identify child and family predictors of future pediatric insomnia within a psycho-bio-behavioral framework.

Methods: A representative community sample (n = 1,037) was followed biennially from 4 to 14 years of age (2007-2017). Insomnia was defined based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria and was diagnosed by a semistructured clinical interview of children (from age eight years of age) and parents (all ages). Predictors included parent ratings of child emotional reactivity, family functioning, and marital conflict; self-reports of personality; and teacher-rated emotion regulation skills.

Results: Random intercept cross-lagged analyses revealed that within-person increases (ie, relative to the child's typical levels across childhood) in emotional reactivity and decreases in emotion regulation skills predicted insomnia diagnosis two years later from ages 4 to 14 after adjusting for previous insomnia and all unmeasured time-invariant factors. Previous insomnia was the strongest predictor of later insomnia, whereas family functioning and marital conflict did not predict insomnia.

Conclusions: Increases in emotional reactivity and decreases in emotion regulation skills predicted insomnia above and beyond all unmeasured time-invariant factors and could be targets for interventions. Previous insomnia predicted later insomnia, thereby underscoring the importance of detecting, preventing, and treating insomnia at an early age.
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http://dx.doi.org/10.1016/j.sleep.2021.08.023DOI Listing
August 2021

Sleep during COVID-19-related school lockdown, a longitudinal study among high school students.

J Sleep Res 2021 Oct 3:e13499. Epub 2021 Oct 3.

Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.

There has been great concern about the impact of coronavirus disease 2019 (COVID-19)-related school lockdown on adolescent health. The aim of the present study was to compare sleep patterns before and during COVID-19-related school lockdown, in a large sample of high school students. The present study is based a prospective, longitudinal survey on adolescent sleep health. Phase 1 was conducted in 2019, whereas phase 2 was conducted in 2020 (response rate 60.2%), during the last 10 days of a 60-day long school lockdown. Main outcomes comprised sleep parameters from the Munich ChronoType Questionnaire (MCTQ). A total of 2,022 students provided valid responses to MCTQ in both survey phases. Results showed later sleep timing on schooldays in 2020 compared to 2019 (36 min later bedtimes, Cohen's d = 0.56; 1:35 hr later rise times, Cohen's d = 1.44). Time spent in bed on schooldays increased from 8:20 to 9:19 hr (Cohen's d = 0.78), and sleep duration increased by 45 min (Cohen's d = 0.49). The proportion of adolescents obtaining the recommended ≥8 hr of sleep on schooldays increased from 13.4% (2019) to 37.5% during the lockdown. Social jetlag was reduced from 2:37 hr (2019) to 1:53 hr (2020, Cohen's d = 0.59). Results points to a potential advantageous effect of school lockdown in terms of increased school day sleep duration and reduced social jetlag. As sleep is important for mental and somatic health, it is conceivable that increased sleep duration offered some protection against harmful aspects of the COVID-19 pandemic and associated social restrictions. Future studies should address possible associations between sleep changes and health during COVID-19-related school lockdown.
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http://dx.doi.org/10.1111/jsr.13499DOI Listing
October 2021

Editorial: Insomnia: A Heterogenic Disorder Often Comorbid With Other Disorders and Diseases.

Front Psychol 2021 14;12:758189. Epub 2021 Sep 14.

Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.

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http://dx.doi.org/10.3389/fpsyg.2021.758189DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8476875PMC
September 2021

The relationship between substance use disorder and gambling disorder: A nationwide longitudinal health registry study.

Scand J Public Health 2021 Sep 30:14034948211042249. Epub 2021 Sep 30.

Department of Psychosocial Science, University of Bergen, Norway.

This study aimed to examine the co-morbidity and temporal relationship between substance abuse disorders (SUDs) and gambling disorder (GD). Cross-tabulated census data were retrieved from the Norwegian Patient Registry. The data included the number of patients by year of first-time incidence of GD and/or SUD diagnoses, age and sex from 2008 to 2017. Approximately 22.5% of GD patients were also diagnosed with SUD, whereas 0.7% of SUD patients were also diagnosed with GD. Among GD patients, males had a greater risk of SUD in the same year compared to females, whereas the risk of SUD a year or more after the onset of GD was greater among females compared to males. Among SUD patients, males had a greater risk of GD in all age categories and across all time periods except among those aged 40-66 years. The risk of GD three to four years after the onset of SUD among those aged 40-66 years was similar between SUD males and females. The overall co-morbidity of SUD and GD was low. However, the risk of the other addictive disorder was contingent upon the nature of the first disorder. The risk of SUD among GDs over time was greater among females compared to males. .
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http://dx.doi.org/10.1177/14034948211042249DOI Listing
September 2021

The Effect of Bright Light Treatment on Rest-Activity Rhythms in People with Dementia: A 24-Week Cluster Randomized Controlled Trial.

Clocks Sleep 2021 Sep 13;3(3):449-464. Epub 2021 Sep 13.

Department of Clinical Psychology, Faculty of Psychology, University of Bergen (UiB), 5009 Bergen, Norway.

Bright light treatment is an effective way to influence circadian rhythms in healthy adults, but previous research with dementia patients has yielded mixed results. The present study presents a primary outcome of the DEM.LIGHT trial, a 24-week randomized controlled trial conducted at nursing homes in Bergen, Norway, investigating the effects of a bright light intervention. The intervention consisted of ceiling-mounted LED panels providing varying illuminance and correlated color temperature throughout the day, with a peak of 1000 lx, 6000 K between 10 a.m. and 3 p.m. Activity was recorded using actigraphs at baseline and after 8, 16, and 24 weeks. Non-parametric indicators and extended cosine models were used to investigate rest-activity rhythms, and outcomes were analyzed with multi-level regression models. Sixty-one patients with severe dementia (median MMSE = 4) were included. After 16 weeks, the acrophase was advanced from baseline in the intervention group compared to the control group (B = -1.02, 95%; CI = -2.00, -0.05). There was no significant difference between the groups on any other rest-activity measures. When comparing parametric and non-parametric indicators of rest-activity rhythms, 25 out of 35 comparisons were significantly correlated. The present results indicate that ambient bright light treatment did not improve rest-activity rhythms for people with dementia.
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http://dx.doi.org/10.3390/clockssleep3030032DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8482074PMC
September 2021

Internet-based treatment of gambling problems: A systematic review and meta-analysis of randomized controlled trials.

J Behav Addict 2021 Sep 17. Epub 2021 Sep 17.

1Department of Psychosocial Science, University of Bergen, Bergen, Norway.

Background And Aims: The effect of internet-based psychological treatment for gambling problems has not been previously investigated by meta-analysis. The present study is therefore a quantitative synthesis of studies on the effects of internet-based treatment for gambling problems. Given that effects may vary according to the presence of therapist support and control conditions, it was presumed that subgroup analyses would elucidate such effects.

Methods: A systematic search with no time constraints was conducted in PsycINFO, MEDLINE, Web of Science, and the Cochrane Library. Two authors independently extracted data using a predefined form, including study quality assessment based on the Cochrane risk of bias tool. Effect sizes were calculated using random-effects models. Heterogeneity was indexed by Cochran's Q and the I2 statistics. Publication bias was investigated using trim and fill.

Results: Thirteen studies were included in the analysis. Random effects models at post-treatment showed significant effects for general gambling symptoms (g = 0.73; 95% CI = 0.43-1.03), gambling frequency (g = 0.29; 95% CI = 0.14-0.45), and amount of money lost gambling (g = 0.19; 95% CI = 0.11-0.27). The corresponding findings at follow-up were g = 1.20 (95% CI = 0.79-1.61), g = 0.36 (95% CI = 0.12-0.60), and g = 0.20 (95% CI = 0.12-0.29) respectively. Subgroup analyses showed that for general gambling symptoms, studies with therapist support yield larger effects than studies without, both post-treatment and at follow-up. Additionally, on general gambling symptoms and gambling frequency, there were lower effect sizes for studies with a control group compared to studies without a control group at follow-up. Studies with higher baseline severity of gambling problems were associated with larger effect sizes at both posttreatment and follow-up than studies with more lenient inclusion criteria concerning gambling problems.

Discussion And Conclusions: Internet-based treatment has the potential to reach a large proportion of persons with gambling problems. Results of the meta-analysis suggest that such treatments hold promise as an effective approach. Future studies are encouraged to examine moderators of treatment outcomes, validate treatment effects cross-culturally, and investigate the effects of novel developments such as ecological momentary interventions.
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http://dx.doi.org/10.1556/2006.2021.00062DOI Listing
September 2021

Sleep medication and melatonin use among Norwegian nurses - A cross-sectional study.

Nurs Open 2021 Sep 17. Epub 2021 Sep 17.

Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.

Aim: To estimate the prevalence of sleep medication and melatonin use among nurses and to assess if factors related to work, sleep or mental health, were associated with such use.

Design: A cross-sectional study.

Methods: A questionnaire survey including 2,798 Norwegian nurses. Associations were estimated using a modified Poisson regression model.

Results: In total, 7.5%, 4.6% and 2.0% of the nurses included in the present study reported prescribed sleep medication, over-the-counter sleep medication or melatonin use in the last year, respectively. Short sleep duration, sleep problems and psychological conditions were strongly associated with both prescribed and over-the-counter sleep medication use. Nurses who worked more than 60 night shifts in the last year were at increased risk of sleep medication use.
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http://dx.doi.org/10.1002/nop2.1057DOI Listing
September 2021

Stability and Change of the Personality Traits Languidity and Flexibility in a Sample of Nurses: A 7-8 Years Follow-Up Study.

Front Psychol 2021 29;12:652569. Epub 2021 Jul 29.

Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.

The traits languidity (tendency to become tired/sleepy upon losing sleep) and flexibility (ability to sleep and work at odd times) have been implicated in shift work tolerance. However, there is a dearth of knowledge about their temporal stability. The aim of the present study was to explore these traits during a long follow-up (FU) period and identify factors related to potential changes in trait scores over time. In all, 1,652 nurses completed the Circadian Type Inventory-revised (CTI-r), which measures languidity and flexibility, at both 2008/2009 (baseline, BL) and again in 2016 (FU). The latent scores of these two constructs at BL, in addition to age, sex, childcare responsibility, marital status, night work status, and insomnia status, were regressed on the corresponding latent scores at follow-up using a structural equation modeling (SEM) approach. Stability was found for both languidity (rho = 0.59) and flexibility (rho = 0.58). Both composite scores declined significantly from baseline (20.62 and 12.48) to follow-up (19.96 and 11.77). Languidity at baseline was positively associated with languidity at follow-up ( = 0.89, < 0.009). Undertaking childcare responsibility between baseline and follow-up was inversely related to languidity at follow-up ( = -0.09, < 0.05). Starting night work was positively related to languidity at follow-up ( = 0.06, < 0.05). Developing insomnia between baseline and follow-up ( = 0.15, < 0.05) was positively, whereas remitting from insomnia during the same period was negatively ( = -0.11, < 0.01) associated with languidity at follow-up. Flexibility at baseline was positively associated with flexibility at follow-up ( = 0.64, < 0.05). Having childcare responsibility at baseline, but not at follow-up was inversely related to flexibility at follow-up ( = -0.05 < 0.05). Becoming cohabitant with a partner between baseline and follow-up ( = -0.07, < 0.05) was negatively associated with flexibility at follow-up. Starting night work between baseline and follow-up ( = 0.17, < 0.01) and reporting night work at both baseline and follow-up ( = 0.18, < 0.01) were both positively associated with flexibility at follow-up, whereas stopping working nights was negatively ( = -0.09, < 0.05), associated with flexibility at follow-up. The personality traits languidity and flexibility show fairly high stability, albeit the mean scores were significantly reduced during the 7-8 years follow-up period. The results suggest that these personality traits are partly modifiable.
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http://dx.doi.org/10.3389/fpsyg.2021.652569DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8359923PMC
July 2021

The effects of bright light treatment on affective symptoms in people with dementia: a 24-week cluster randomized controlled trial.

BMC Psychiatry 2021 07 28;21(1):377. Epub 2021 Jul 28.

Department of Clinical Psychology, Faculty of Psychology, University of Bergen (UiB), Aarstadveien 17, 5009, Bergen, Norway.

Background: The majority of people with dementia have behavioral and psychological symptoms of dementia (BPSD), including depression, anxiety and agitation. These may be elicited or aggravated by disrupted circadian rhythms. Bright light treatment (BLT) is a promising non-pharmacological approach to the management of BPSD, but previous research has yielded mixed results.

Methods: Eight nursing home dementia units (1 unit = 1 cluster) with 78 patients were invited to participate in a cluster randomized controlled trial from September 2017 to April 2018 investigating the effects of BLT on sleep and circadian rhythms (primary outcome) and BPSD (secondary outcome). Ceiling mounted LED-panels were installed in the intervention group (four units), providing light at 1000 lx and 6000 K (vertically at 1.2 m) between 10 a.m. and 3 p.m., with lower values in the mornings and evenings. Standard indoor light was used in the control group (four units). BPSD were assessed with The Cornell Scale for Depression in Dementia (CSDD) and the Neuropsychiatric Inventory Nursing Home Version (NPI-NH). Data collection took place at baseline and after 8, 16 and 24 weeks. Multilevel regression models with and without false discovery rate correction were used for the analysis, with baseline values and dementia stage entered as covariates.

Results: Sixty-nine patients were included in the study at baseline. Compared to the control group, the intervention group had a larger reduction on the composite scores of both the CSDD (95% CI = - 6.0 - - 0.3) and the NPI-NH (95% CI = - 2.2 - - 0.1), as well as on the NPI-NH Affect sub-syndrome, and the CSDD Mood related signs sub-scale at follow-up after 16 weeks. With FDR correction, the group difference was significant on the CSDD Mood related signs sub-scale (95% CI = - 2.7 - - 0.8) and the NPI-NH Affect sub-syndrome (95% CI = - 1.6 - - 0.2). No differences were found between conditions at weeks 8 or 24.

Conclusion: Compared to the control condition, affective symptoms were reduced after 16 weeks in the group receiving BLT, suggesting BLT may be beneficial for nursing home patients with dementia.

Trial Registration: ClinicalTrials.gov Identifier: NCT03357328 . Retrospectively registered on November 29, 2017.
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http://dx.doi.org/10.1186/s12888-021-03376-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8317398PMC
July 2021

Gaming in the Military: A Longitudinal Study of Changes in Gaming Behavior Among Conscripts During Military Service and Associated Risk Factors.

Front Psychiatry 2021 9;12:591038. Epub 2021 Jul 9.

Betanien hospital, Psychiatric Outpatient Clinic for Child and Adolescense, Skien, Norway.

A central task in military leadership is to take care of one's followers, which presupposes knowledge about relevant risk factors. Very little research has focused on the risks of developing problematic gaming behavior during military service. The present study tries to bridge this gap by assessing prevalence rates and associated risk factors of problem gaming in a sample of Norwegian conscripts across two time-points: at the beginning and end of duty. The sample comprised 2,555 individuals aged 18-24 years. A total of 1,017 (39.8%) completed the questionnaire at Time 1, ~1 month after starting the military service. Respondents who completed the first wave, at enrollment, were invited to participate in wave two, after completing their service. At Time 2, 259 (25.5%) participants responded. The prevalence rates of gaming addiction were 0.5% at Time 1 and 4.6% at Time 2, while problem gaming use was reported by 4.8% of the sample at Time 1 and 8.1% of the sample at Time 2. Paired sample -tests revealed an overall significant increase in the mean scores on the Gaming Addiction Scale from T1 ( = 0.86, = 1.35) to T2 ( = 1.31, = 2.14), = -2.40, < 0.05. According to the reliable change index, 17.1% of the sample showed a reliable negative change, whereas 8.3% exhibited a reliable positive change in gaming addiction scores. However, no psychological variables measured at T1 (loneliness, boredom proneness-Internal, boredom proneness-External, anxiety, depression, game addiction, and time spent gaming) were related to attrition (from T1 to T2), or worsening of game addiction, while a positive relationship was observed between boredom proneness-External and reduced gaming addiction from T1 to T2. In sum, we observed a tendency toward a negative change in gaming behaviors during military service which may complicate the soldiers' reintegration into civilian life after their service. More research is needed to assess potential gaming problems in the Military.
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http://dx.doi.org/10.3389/fpsyt.2021.591038DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8298751PMC
July 2021

Regulatory Measures' Effect on Gambling Participation: Experiences From Norway.

Front Psychiatry 2021 30;12:672471. Epub 2021 Jun 30.

Department of Psychosocial Science, University of Bergen, Bergen, Norway.

The purpose of gambling regulation can be to ensure revenue for the public, to prevent crime and gambling problems. One regulatory measure involves restriction of what games can be offered in a market. In this study, the effects of two regulatory market changes are investigated: First, a restriction of availability when slot machines were banned from the Norwegian market in 2007, and second the introduction of regulated online interactive games to the same market in 2014. Data collected from the general population in the period from 2005 through 2018, comprising 2,000 respondents every year, are used to investigate how participation in gambling changed over time. The respondents were asked if they took part in various games or lotteries. Logistic regression analyses were used to predict the proportion participating in five groups of games and if changes in participation coincided with major market changes. The first change was associated with a reduction in gambling on slot machines as well as a reduction in gambling participation overall. Following the slot machine ban, results show an increase in women participating in games offered in land-based bingo premises. A general increase in gambling on foreign websites was also seen, albeit much smaller than the reduction in slot machine gambling. The increases can partly be explained as substitution of one type of gambling with another. New regulated online interactive games were introduced in 2014. Despite the relatively large growth of such games internationally, Norway included, increased online gambling in general and an increased marketing of foreign gambling websites, the participation on foreign websites seemed stable. However, the overall participation in online interactive games increased. The introduction of the regulated alternative seems to have had a channelizing effect. Overall, the changes in gambling participation coinciding with two major regulatory changes can be explained by transformations of physical and social availability, and in terms of mechanisms outlined by the model of total consumption.
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http://dx.doi.org/10.3389/fpsyt.2021.672471DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8278013PMC
June 2021

Problematic Gaming and Sleep: A Systematic Review and Meta-Analysis.

Front Psychiatry 2021 7;12:675237. Epub 2021 Jun 7.

Department of Psychosocial Science, University of Bergen, Bergen, Norway.

Problematic gaming has been linked to poor sleep outcomes; however, these associations have not yet been synthesized quantitatively. This review employed a meta-analysis to investigate the relationship between problematic gaming and sleep-related outcomes. A search of Medline, Embase, Web of Science, PsycINFO, and Google Scholar identified a total of 763 studies, including 34 studies ( = 51,901 participants) eligible for inclusion. Papers were included if available in any European language, addressed problematic gaming, contained original data, and provided sufficient data for calculation of effect sizes. Two researchers independently extracted data using pre-defined fields including quality assessment. Sleep-related outcomes were meta-analyzed for sleep parameters that were reported by 5 or more papers. Significant overall effects were found for sleep duration ( = -0.238, 95% = -0.364, -0.112), poor sleep quality ( = 2.02, 95% = 1.47, 2.78), daytime sleepiness ( = 1.57, 95% = 1.00, 2.46) and sleep problems ( = 2.60, 95% = 1.94, 3.47). Between-study heterogeneity was detected for all meta-analyses. Subgroup analyses showed a higher inverse effect size for adolescent samples compared to adult or non-specific age samples in terms of sleep duration. For daytime sleepiness, a larger effect size was found for studies based on single-item sleep measures compared to multi-item sleep measures. For sleep problems, the subgroup analysis showed the opposite with a higher effect size for studies based on single-item sleep measures than multi-item sleep measures. Across all sleep parameters, problematic gamers consistently reported a more adverse sleep status than non-problematic gamers. https://www.crd.york.ac.uk/PROSPERO/; record ID: CRD42020158955.
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http://dx.doi.org/10.3389/fpsyt.2021.675237DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8216490PMC
June 2021

Sleep patterns among Norwegian nurses between the first and second wave of the COVID-19 pandemic.

BMC Nurs 2021 Jun 21;20(1):105. Epub 2021 Jun 21.

Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Jonas Lies vei 65, 5021, Bergen, Norway.

Background: Nurses are in the frontline and play an important role in the battle against the COrona VIrus Disease-2019 (COVID-19) pandemic. Sleep problems among health care workers are likely to increase due to the pandemic. However, it is conceivable that negative health outcomes related to the pandemic fluctuate with the infection rate waves of the pandemic. The present study aimed to investigate sleep patterns among Norwegian nurses, after the first wave, during a period with very low rates of COVID-19.

Methods: Data stemmed from the cohort study "SUrvey of Shift work, Sleep and Health (SUSSH)" among Norwegian nurses. A total of 1532 nurses responded one time to a questionnaire between June and September in 2020 including items about demographics and work, information about COVID-19 and quarantine, sleep patterns and changes in sleep patterns due to the pandemic. Descriptive statistics for all relevant variables were calculated and McNemar tests were used to compare categorical variables.

Results: The majority of nurses (84.2%) reported no change in sleep duration after the first wave of the COVID-19 pandemic compared to before, 11.9% reported less sleep, and 3.9% reported more sleep. Similarly, 82.4% of the nurses reported no change in their sleep quality, whereas 16.2% of the nurses reported poorer sleep quality after the first wave of the pandemic compared to before. The majority of nurses reported no change in their sleep schedule due to the pandemic, although 9.6% of the nurses reported to go to bed later and 9.0% woke up earlier than before the pandemic.

Conclusions: Most existing literature exploring sleep among health care workers during the COVID-19 pandemic has been carried out during periods with high infection rates. In this study we aimed to investigate sleep patterns among Norwegian nurses following the first wave, during a period of low COVID-19 rates in Norway. Most of the nurses reported no change in neither sleep duration, sleep quality, bedtime, nor wake-up times compared to before the pandemic. Still, nearly 12% reported shorter sleep duration, and about 16% reported poorer sleep quality indicating that some nurses experienced worsening of their sleep following the pandemic.
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http://dx.doi.org/10.1186/s12912-021-00628-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8215314PMC
June 2021

Aggression and Psychological Distress in Male and Female Anabolic-Androgenic Steroid Users: A Multigroup Latent Class Analysis.

Front Psychiatry 2021 4;12:629428. Epub 2021 Jun 4.

Department of Psychosocial Science, University of Bergen, Bergen, Norway.

The relationship between anabolic-androgenic steroid (AAS) use and aggression and psychological distress requires further elucidation. No previous study has examined whether the latent patterns of aggression and psychological distress are the same in male and female AAS users. Multigroup latent class analysis (MLCA) can be used to classify individuals into groups based on their responses on a set of variables, and to investigate measurement invariance across subgroups. We therefore conducted a MLCA to identify discrete subgroups of aggression and psychological distress in AAS users, and used measurement invariance to examine whether the identified subgroups can be applied to both sexes. We also examined the relationship between sex and subgroup belongingness. The sample comprised 206 AAS users (females = 58.30%) aged 14-56 (mean = 26.86, = 7.12) years. They completed questionnaires assessing demographics, AAS use, aggression, and psychological distress. Based on the MLCA, five subgroups were identified: high aggression moderate distress users (HAMoD: 07.63%), moderate aggression distress users (18.64%), moderate direct aggression-mild indirect aggression moderate distress users (22.95%), mild direct aggression-moderate indirect aggression-distress users (11.71%), and low aggression mild distress users (LAMiD: 39.06%). Although a homogenous five-class solution was the best model for both sexes, sex was significantly associated with the probability of subgroup membership. In particular, members of the HAMoD subgroup were more likely to be male whereas members of the LAMiD subgroup were more likely to be female. Our study provides novel empirical evidence of the idiosyncratic patterns of aggression and psychological distress among male and female AAS users.
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http://dx.doi.org/10.3389/fpsyt.2021.629428DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8211877PMC
June 2021

Sex differences in sleep and influence of the menstrual cycle on women's sleep in junior endurance athletes.

PLoS One 2021 17;16(6):e0253376. Epub 2021 Jun 17.

Faculty of Social and Educational Sciences, Department of Education and Lifelong Learning, Norwegian University of Science and Technology, Trondheim, Norway.

Previous research shows that female athletes sleep better according to objective parameters but report worse subjective sleep quality than male athletes. However, existing sleep studies did not investigate variations in sleep and sleep stages over longer periods and have, so far, not elucidated the role of the menstrual cycle in female athletes' sleep. To address these methodological shortcomings, we investigated sex differences in sleep and sleep stages over 61 continuous days in 37 men and 19 women and examined the role of the menstrual cycle and its phases in 15 women. Sleep was measured by a non-contact radar, and menstrual bleeding was self-reported. Associations were investigated with multilevel modeling. Overall, women tended to report poorer subjective sleep quality (p = .057), but objective measurements showed that women obtained longer sleep duration (p < .001), more light (p = .013) and rapid eye movement sleep (REM; hours (h): p < .001, %: p = .007), shorter REM latency (p < .001), and higher sleep efficiency (p = .003) than men. R2 values showed that sleep duration, REM and REM latency were especially affected by sex. Among women, we found longer time in bed (p = .027) and deep sleep (h: p = .036), and shorter light sleep (%: p = .021) during menstrual bleeding vs. non-bleeding days; less light sleep (h: p = .040), deep sleep (%: p = .013) and shorter REM latency (p = .011) during the menstrual than pre-menstrual phase; and lower sleep efficiency (p = .042) and more deep sleep (%: p = .026) during the follicular than luteal phase. These findings indicate that the menstrual cycle may impact the need for physiological recovery, as evidenced by the sleep stage variations. Altogether, the observed sex differences in subjective and objective sleep parameters may be related to the female athletes' menstrual cycle. The paper provides unique data of sex differences in sleep stages and novel insights into the role of the menstrual cycle in sleep among female athletes.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0253376PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8211225PMC
June 2021

Sleep, evening light exposure and perceived stress in healthy nulliparous women in the third trimester of pregnancy.

PLoS One 2021 3;16(6):e0252285. Epub 2021 Jun 3.

Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway.

Objective: Sleep disturbances are common in pregnancy, and the prevalence increases during the third trimester. The aim of the present study was to assess sleep patterns, sleep behavior and prevalence of insomnia in pregnant women in the third trimester, by comparing them to a group of non-pregnant women. Further, how perceived stress and evening light exposure were linked to sleep characteristics among the pregnant women were examined.

Methods: A total of 61 healthy nulliparous pregnant women in beginning of the third trimester (recruited from 2017 to 2019), and 69 non-pregnant women (recruited in 2018) were included. Sleep was monitored by actigraphy, sleep diaries and the Bergen Insomnia Scale. The stress scales used were the Relationship Satisfaction Scale, the Perceived Stress Scale and the Pre-Sleep Arousal Scale. Total white light exposure three hours prior to bedtime were also assessed.

Results: The prevalence of insomnia among the pregnant women was 38%, with a mean score on the Bergen Insomnia Scale of 11.2 (SD = 7.5). The corresponding figures in the comparing group was 51% and 12.3 (SD = 7.7). The pregnant women reported lower sleep efficiency (mean difference 3.8; 95% CI = 0.3, 7.3), longer total sleep time derived from actigraphy (mean difference 59.0 minutes; 95% CI = 23.8, 94.2) and higher exposure to evening light (mean difference 0.7; 95% CI = 0.3, 1.2), compared to the non-pregnant group. The evening light exposure was inversely associated with total sleep time derived from actigraphy (B = -8.1; 95% CI = -14.7, -1.5), and an earlier midpoint of sleep (B = -10.3, 95% CI = -14.7, -5.9). Perceived stressors were unrelated to self-reported and actigraphy assessed sleep.

Conclusion: In healthy pregnant participants sleep in the third trimester was preserved quite well. Even so, the data suggest that evening light exposure was related to shorter sleep duration among pregnant women.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0252285PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8174691PMC
June 2021

Relationships Between Exposure to Different Gambling Advertising Types, Advertising Impact and Problem Gambling.

J Gambl Stud 2021 May 31. Epub 2021 May 31.

Department of Psychosocial Science, University of Bergen, P.O. box 7807, 5020, Bergen, Norway.

People with gambling problems report more exposure and impact from gambling advertising, although less is known regarding the role of specific advertising types. Data on gamblers (n = 5830, 48.5% women, mean age = 44.27) was collected from a general population cross-sectional survey in Norway (32.7% response rate). We examined if problem gambling was associated with perceived advertising impact (on gambling involvement, awareness, and knowledge) or exposure (via internet, TV, retail outlet, newspaper, and direct advertising). We also investigated if advertising exposure was associated with advertising impact. ANOVAs revealed that problem gambling was associated with increased perceived advertising impact on gambling involvement (ω = 0.09, p < .001) and awareness of gambling (ω = 0.04, p < .001). Reported exposure to direct advertising increased linearly with problem gambling level (ω = 0.04, p < .001), whereas we found small/no differences in exposure to other types of advertising. Multiple regressions revealed that among advertising types, internet advertising was the strongest predictor of perceived advertising impact on gambling involvement (β = 0.1, p < .001). TV advertising was the strongest predictor of advertising impact on knowledge of gambling forms and operators (β = 0.28, p < .001) and awareness of gambling (β = .05, p < .05). Future studies should elucidate how different subtypes of internet advertising impact gambling involvement. Clinicians should assess clients' experiences with direct advertising and devise interventions for coping. Researchers should be aware that internet and direct advertising allow for more tailored content compared to other advertising types.
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http://dx.doi.org/10.1007/s10899-021-10038-xDOI Listing
May 2021

Daylight Saving Time preferences in Norway: Do individual chronotype and home address' latitude and longitude matter?

Chronobiol Int 2021 10 25;38(10):1449-1459. Epub 2021 May 25.

Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.

Daylight Saving Time is highly debated and associated with several health risks. Health experts recommend terminating adjusting the clock time, and to keep permanent standard (winter) time year around. The aims of the study were to investigate preferences for keeping or terminating this biannual adjustment of clock times and for permanent standard or summer time, in the general Norwegian population. Furthermore, we aimed to investigate whether such preferences depended on individual chronotype and home address' latitude/longitude. The online survey included 47,194 participants. Chronotype was measured with the Composite Scale of Morningness (morning types, intermediate types, evening types). Results showed that 78.2% preferred to terminate adjusting the clock time. Summer time year around was preferred by 61.5% whereas 29.1% preferred standard time year around, and 9.4% did not have any preference. Preferences for terminating adjustment of clock times and summer time year around were found in all chronotypes and regardless of living south (latitude 58-59°N), north (latitude 69-71°N), west (longitude 5-6°E) or east (longitude 19-31°E). However, a relatively larger proportion of evening chronotypes preferred to terminate adjusting the clock time compared to morning chronotypes, and relatively more people living north or east preferred termination than people living south or west, respectively. Permanent standard time was more strongly preferred by extreme morning types in comparison with the other chronotypes. In conclusion, nearly four out of five participants reported to prefer to terminate adjusting the clock time, in line with recommendations. However, in contrast to advice from health experts, permanent summer time was preferred by twice as many as permanent standard time. Both chronotype and home address' latitude and longitude mattered in regard to such preferences, but only to a small degree.
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http://dx.doi.org/10.1080/07420528.2021.1931278DOI Listing
October 2021

Ambient bright light treatment improved proxy-rated sleep but not sleep measured by actigraphy in nursing home patients with dementia: a placebo-controlled randomised trial.

BMC Geriatr 2021 05 17;21(1):312. Epub 2021 May 17.

Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway.

Background: Up to 70% of nursing home patients with dementia suffer from sleep problems. Light is the main zeitgeber to the circadian system and thus has a fundamental impact on sleep-wake behaviour. Low indoor light levels in nursing homes have been reported, and in combination with age-related reductions in light sensitivity, insufficient light exposure is likely to contribute to sleep problems in this population. Increasing daytime light exposure using bright light treatment (BLT) may represent a feasible non-pharmacological treatment for sleep problems in nursing home patients with dementia.

Methods: The present study reports on sleep outcomes, which are the primary outcomes of the DEM.LIGHT trial (Therapy Light Rooms for Nursing Home Patients with Dementia- Designing Diurnal Conditions for Improved Sleep, Mood and Behavioural Problems), a 24-week cluster-randomised placebo-controlled trial including 8 nursing home units and 69 resident patients. The intervention comprised ambient light of 1000 lx and 6000 K from 10:00 to 15:00, with gradually increasing and decreasing light levels prior to and following this interval, using ceiling mounted light-fixtures and light emitting diode technology. The placebo condition had continuous standard light levels (150-300 lx, ~ 3000 K). Sleep was assessed at baseline and follow-up at week 8, 16, and 24, using the proxy-rated Sleep Disorder Inventory (SDI) and actigraphy (Actiwatch II, Philips Respironics). Mixed linear models were used to evaluate intervention effects, adjusting for relevant covariates such as age, gender, number of drugs, severity of dementia, eye disease, and estimated light exposure.

Results: Sleep as measured by the SDI was significantly improved in the intervention group compared to the control group from baseline to week 16 (B = - 0.06, 95% CI -0.11 - -0.01, p < .05) and from baseline to week 24 (B = - 0.05, 95% CI -0.10 - -0.01, p < .05). There was no effect according to the SDI at week 8 and no significant effects in terms of actigraphically measured sleep.

Conclusions: Proxy-rated sleep improved among nursing home patients with dementia following 16 and 24 weeks of BLT. These improvements were not corroborated by actigraphy recordings.

Trial Registration: ClinicalTrials.gov Identifier: NCT03357328 . Registered 29 November 2017 - Retrospectively registered.
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http://dx.doi.org/10.1186/s12877-021-02236-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8127192PMC
May 2021

Circadian typology and implications for adolescent sleep health. Results from a large, cross-sectional, school-based study.

Sleep Med 2021 07 22;83:63-70. Epub 2021 Apr 22.

Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Norway; Centre for Sleep Medicine, Haukeland University Hospital, Norway; Department of Global Public Health and Primary Care, University of Bergen, Norway.

Study Objectives: To investigate circadian typology in a large, representative sample of Norwegian adolescents, and its implications for sleep health.

Methods: The sample included 3920 1 year high school students aged 16-17 years. Respondents completed a web-based survey, including the short version of the Horne-Ostberg Morningness-Eveningness Questionnaire (rMEQ), the Munich Chronotype Questionnaire (MCTQ) and items on sleep-related behaviors (eg electronic media usage in bed, consumption of caffeinated beverages), sleep beliefs and daytime sleepiness. Data were analyzed using one-way ANOVAs and Chi-squared tests.

Results: In all, 7.8% were categorized as morning, 52.3% as intermediate and 39.9% as evening types, respectively. Evening types had later sleep timing, longer sleep latency, more social jetlag and shorter school day sleep duration than morning types, with intermediate types displaying a sleep pattern between these two extremes. None of the circadian types met the minimum recommended amount of sleep on school nights (ie 8+ hours), and only morning types had a mean sleep duration of 7+ hours (7:19 h, nearly 1 h more than evening types who slept 6:20 h, p < 0.001). Evening types reported more use of electronic media in bed, more consumption of caffeinated beverages and more daytime sleepiness than the other circadian types. They were also less satisfied with their school day sleep duration and perceived it more difficult to change their sleep pattern.

Conclusions: Results from this study suggest that eveningness represents a sleep health challenge for older adolescents.
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http://dx.doi.org/10.1016/j.sleep.2021.04.020DOI Listing
July 2021

Changes Over Time and Predictors of Online Gambling in Three Norwegian Population Studies 2013-2019.

Front Psychiatry 2021 15;12:597615. Epub 2021 Apr 15.

Department of Psychosocial Science, University of Bergen, Bergen, Norway.

To investigate changes over time and identify predictors of online gambling among gamblers by using three Norwegian representative samples covering a 6-year (2013-2019) period. We also aimed to identify different characteristics (including video game participation and video gaming problems) of online compared to offline gamblers. Data from gamblers ( = 15,096) participating in three cross-sectional surveys (2013, 2015, and 2019) based on random sampling from the Norwegian Population Registry were analyzed. Participants were asked how frequently they engaged in online gambling on different platforms (e.g., mobile phone). Data on sociodemographics, games gambled, gambling problems, gaming, and problem gaming were collected and analyzed by logistic regression analyses. Overall, an increase in online gambling from 2013 to 2015 was found (a larger percentage of gamblers reported having gambled online at least once during the last year), and an increase in online gambling from 2015 to 2019 was found (more gamblers reported having gambled online at least once last year and at least once per week). The increase was largest for gambling on mobile phone. Consistent predictors of online gambling (at least once last year and at least once per week) were male gender, high income, being unemployed, being on disability pension, having work assessment allowance, being a homemaker or retiree, number of games gambled, and gambling problems. Online gambling, especially on mobile phones, has increased significantly during the last 6 years in Norway. Hence, gambling availability seems to have grown, which may pose a risk for development of gambling problems. Compared to offline gamblers, online gamblers were more likely to be men, young, not working or studying, gambling on several games, and having gambling problems. Responsible gambling efforts aiming at preventing or minimizing harm related to online gambling should thus target these groups.
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http://dx.doi.org/10.3389/fpsyt.2021.597615DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8082097PMC
April 2021

Prevalence of Shift Work Disorder: A Systematic Review and Meta-Analysis.

Front Psychol 2021 23;12:638252. Epub 2021 Mar 23.

Department of Psychosocial Science, University of Bergen, Bergen, Norway.

No systematic review or meta-analysis concerning the prevalence of shift work disorder (SWD) has been conducted so far. The aim was thus to review prevalence studies of SWD, to calculate an overall prevalence by a random effects meta-analysis approach and investigate correlates of SWD prevalence using a random-effects meta-regression. Systematic searches were conducted in ISI Web of Science, PsycNET, PubMed, and Google Scholar using the search terms "shift work disorder" and "shift work sleep disorder." No restrictions in terms of time frame were used. Included studies had to present original data on the prevalence of SWD in an occupational sample published in English. A total of 349 unique hits were made. In all, 29 studies were finally included from which two authors independently extracted data using predefined data fields. The meta-regression included four predictors (diagnostic criteria, study country, type of workers, and sample size). The overall prevalence of SWD was 26.5% (95% confidence interval = 21.0-32.8). Cochran was 1,845.4 ( = 28, < 0.001), and the was 98.5%, indicating very high heterogeneity across the observed prevalence estimates. Diagnostic criteria (International Classification of Sleep Disorders-2 = 0, International Classification of Sleep Disorders-3 = 1) and sample size were inversely related to SWD prevalence. The prevalence of SWD was high across the included studies. The between-study disparity was large and was partly explained by diagnostic criteria and sample size. In order to facilitate comparative research on SWD, there is a need for validation and standardization of assessment methodology as well as agreement in terms of sample restrictions.
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http://dx.doi.org/10.3389/fpsyg.2021.638252DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8021760PMC
March 2021

Anabolic-androgenic steroid administration increases self-reported aggression in healthy males: a systematic review and meta-analysis of experimental studies.

Psychopharmacology (Berl) 2021 Jul 20;238(7):1911-1922. Epub 2021 Mar 20.

Department of Psychosocial Science, University of Bergen, Christiesgate 12, 5015, Bergen, Norway.

Rationale: Aggression and irritability are notable psychiatric side effects of anabolic-androgenic steroid (AAS) use. However, no previous study has systematically reviewed and quantitatively synthesized effects reported by experimental studies on this topic.

Objective: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating the effect of AAS administration on self-reported and observer-reported aggression.

Methods: Twelve RCTs comprising a total of 562 healthy males were identified through systematic searches of MEDLINE, PsycInfo, ISI Web of Science, ProQuest, Google Scholar, and the Cochrane Library.

Results: After excluding one outlier, AAS administration was associated with an increase in self-reported aggression under a random-effects model, albeit small (Hedges' g = 0.171, 95% CI: 0.029-0.312, k = 11, p = .018), and when restricting the analysis to the effect of acute AAS administration on self-reported aggression under a fixed-effect model (g = 0.291, 95% CI: 0.014-0.524, p = .014). However, the above effects were neither replicated in the analysis of observer-reported aggression nor after restricting the analysis to the effects of the administration of higher (over 500 mg) and long-term (3 days to 14 weeks) doses.

Conclusions: The present meta-analysis provides evidence of an increase, although small, in self-reported aggression in healthy males following AAS administration in RCTs. Ecologically rational RCTs are warranted to better explore the effect of AAS administration on aggression in humans.
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http://dx.doi.org/10.1007/s00213-021-05818-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8233285PMC
July 2021

Changes in work schedule affect the prevalence of shift work disorder among Norwegian nurses - a two year follow-up study.

Chronobiol Int 2021 06 18;38(6):924-932. Epub 2021 Mar 18.

Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.

This study aimed to explore how changes in the work schedule would affect the prevalence of Shift Work Disorder (SWD) over time. Two-year follow-up data from 1076 nurses participating in the longitudinal SUrvey of Shift work, Sleep and Health among Norwegian nurses (SUSSH) were included in the study. The questionnaires included measures of work-related factors, i.e., work schedule and numbers of night shifts and quick returns (QRs) worked the last year, as well as questions related to SWD according to the ICSD-3 diagnostic criteria at both baseline and at 2-year follow-up. Data were analyzed with paired samples t-tests, chi-square tests, and logistic regression analyses adjusting for sex and age. Terminating night work was the strongest predictor for recovering from SWD from baseline to follow-up (OR 10.91, 95% CI 6.11-19.46). Additionally, changing the work schedule from day work to night work from baseline to follow-up was the strongest predictor for developing SWD in the same period (OR 4.75, 95% CI 2.39-9.47). Reductions in number of nights (more than 10) and QRs (more than 10) worked the last year were associated with recovering from SWD between baseline and follow-up. Nurses who recovered from SWD had significantly reduced the mean number of night shifts worked the last year from 32.3 at baseline to 20.4 at follow-up ( = .001). Furthermore, an increase of more than 10 nights or more than 10 QRs worked the last year between baseline and follow-up predicted developing SWD. Nurses developing SWD between baseline and follow-up had significantly increased the mean number of nights worked the last year from 25.8 at baseline to 31.0 at follow-up ( =-.043). Changes in night work exposure were the strongest predictors for both recovering from or developing SWD from baseline to follow-up. Reducing exposure to night work and QRs were associated with recovering from SWD and increasing exposure to night work and QRs were associated with developing SWD. The results imply that unfavorable work schedules play a role in the development of sleep problems among nurses. These results may be useful when designing healthy working schedules.
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http://dx.doi.org/10.1080/07420528.2021.1896535DOI Listing
June 2021

Weekday time in bed and obesity risk in adolescence.

Obes Sci Pract 2021 Feb 21;7(1):45-52. Epub 2020 Sep 21.

Department of Psychosocial Science University of Bergen Bergen Norway.

Introduction: Sleep curtailment is associated with obesity in children, but few studies have investigated this relationship in a longitudinal sample of adolescents. The aim of the present study was to examine the longitudinal association between weekday time in bed (TIB) at age 10-13 and overweight at age 16-19.

Methods: Adolescents and their parents ( = 3025 families), participating in a longitudinal population-based study, completed questionnaires assessing habitual bedtime and wake time on weekdays, weight and height, socioeconomic status (SES), internalizing mental health problems and disturbed eating. Two surveys were administered with a 6-year interval (T1 and T2). A one-way analysis of covariance (ANCOVA) was performed examining the association between TIB and weight category 6 years later, with SES, internalizing problems and disturbed eating at baseline entered as covariates. Hierarchical and logistic regression analyses were used to assess TIB at age 10-13 years to as a predictor of body mass index (BMI) standardized deviation scores (SDS) and overweight status at age 16-19 adjusting for the same confounders and baseline BMI.

Results: A linear inverse relationship between TIB at age 10-13 and BMI category at age 16-19 was demonstrated by the ANCOVA,  < 0.001. Shorter TIB was related to higher weight, but the effect size was small (partial eta squared = 0.01). When adjusting for the included baseline confounders in the hierarchical regression model TIB significantly predicted later BMI SDS ( = -0.039,  = 0.02). The adjusted logistic regression model showed that for each hour reduction of TIB at T1 the odds of being overweight/obese at T2 increased with a factor of 1.6.

Conclusion: Shorter TIB was found to be a significant, yet modest, independent predictor of later weight gain in adolescence. The findings implicate that establishing healthy sleep habits should be addressed in prevention and treatment strategies for adolescent obesity.
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http://dx.doi.org/10.1002/osp4.455DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7909586PMC
February 2021

Insomnia - A Heterogenic Disorder Often Comorbid With Psychological and Somatic Disorders and Diseases: A Narrative Review With Focus on Diagnostic and Treatment Challenges.

Front Psychol 2021 11;12:639198. Epub 2021 Feb 11.

Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.

Patients with insomnia complain of problems with sleep onset or sleep maintenance or early morning awakenings, or a combination of these, despite adequate opportunity and circumstances for sleep. In addition, to fulfill the diagnostic criteria for insomnia the complaints need to be associated with negative daytime consequences. For chronic insomnia, the symptoms are required to be present at least 3 days per week for a duration of at least 3 months. Lastly, for insomnia to be defined as a disorder, the sleep complaints and daytime symptoms should not be better explained by another sleep disorder. This criterion represents a diagnostic challenge, since patients suffering from other sleep disorders often complain of insomnia symptoms. For instance, insomnia symptoms are common in e.g., obstructive sleep apnea and circadian rhythm sleep-wake disorders. It may sometimes be difficult to disentangle whether the patient suffers from insomnia disorder or whether the insomnia symptoms are purely due to another sleep disorder. Furthermore, insomnia disorder may be comorbid with other sleep disorders in some patients, e.g., comorbid insomnia and sleep apnea (COMISA). In addition, insomnia disorder is often comorbid with psychological or somatic disorders and diseases. Thus, a thorough assessment is necessary for correct diagnostics. For chronic insomnia disorder, treatment-of-choice is cognitive behavioral therapy, and such treatment is also effective when the insomnia disorder appears comorbid with other diagnoses. Furthermore, studies suggest that insomnia is a heterogenic disorder with many different phenotypes or subtypes. Different insomnia subtypes may respond differently to treatment, but more research on this issue is warranted. Also, the role of comorbidity on treatment outcome is understudied. This review is part of a Research Topic on insomnia launched by Frontiers and focuses on diagnostic and treatment challenges of the disorder. The review aims to stimulate to more research into the bidirectional associations and interactions between insomnia disorder and other sleep, psychological, and somatic disorders/diseases.
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http://dx.doi.org/10.3389/fpsyg.2021.639198DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7904898PMC
February 2021

Persistent Short Sleep from Childhood to Adolescence: Child, Parent and Peer Predictors.

Nat Sci Sleep 2021 15;13:163-175. Epub 2021 Feb 15.

Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.

Purpose: Many children have periods when they sleep too little, with widely recognized detrimental effects. Less is known about persistent short sleep during childhood. Therefore, the present study aimed to investigate the prevalence of persistent short sleep in school-aged children and identify a set of child, parent, and peer predictors thereof.

Participants And Methods: Objectively measured sleep duration (hip-held accelerometer) was biennially assessed in a community sample followed from 6 to 14 years (n=801). A latent profile analysis was applied to assess whether a subgroup of children slept consistently short across time and predictors of persistent short sleep were determined through regression analysis.

Results: A subgroup of children (n=160; 20.2%) was identified as having persistent short sleep across time. Temperamental negative affectivity (β=0.08; 95% CI=0.01, 0.15; p=0.03) and low observer-assessed parental emotional availability (β=-.09; 95% CI=-.18, -.01; p=0.04) predicted membership to that group. Teacher ratings of victimization from bullying were not associated with persistent short sleep (β=0.01; 95% CI: -.10, 11; p=0.88).

Conclusion: High child temperamental negative affectivity and low parental emotional availability may be involved in the development of persistent short sleep through childhood.
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http://dx.doi.org/10.2147/NSS.S290586DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7894796PMC
February 2021

Alcohol Consumption during a Pandemic Lockdown Period and Change in Alcohol Consumption Related to Worries and Pandemic Measures.

Int J Environ Res Public Health 2021 01 29;18(3). Epub 2021 Jan 29.

Department of Addiction Medicine, Haukeland University Hospital, 5021 Bergen, Norway.

Whether lockdown related to the COVID-19 pandemic influences alcohol consumption is not well known. This study assesses alcohol consumption and hazardous drinking behavior during the initial phase of pandemic measures in Norway and identifies potential risk factors. A cross-sectional study ( = 25,708) was conducted in Bergen, Norway, following the first six weeks of strict infection control measures. In a model of self-assessed increased alcohol consumption, logistic regression analysis was conducted with independent variables for COVID-19-related worries, joblessness, quarantine, self-reported drinking behavior, age, gender, and occupational situation. These are reported with odds ratios (ORs) with 95% confidence intervals. Fifty-one percent of respondents reported economic or health-related worries due to COVID-19, 16% had been in quarantine, 49% worked/studied from home, 54% reported hazardous drinking behavior, and 13% reported increased alcohol consumption. People aged 30-39 years had elevated odds of increased alcohol consumption during lockdown (OR 3.1, 2.4-3.8) compared to the oldest adults. Increased drinking was more frequent among people reporting economic worries (OR 1.6, 1.4-1.8), those quarantined (OR 1.2, 1.1-1.4), and those studying or working at home (OR 1.4, 1.3-1.6). More than half of respondents reported hazardous drinking behavior. Increased alcohol consumption during lockdown was common among people with economic worries, people in quarantine, and people studying or working at home. These data could be important when adjusting pandemic measures.
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http://dx.doi.org/10.3390/ijerph18031220DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7908087PMC
January 2021

The Effects of Responsible Gambling Pop-Up Messages on Gambling Behaviors and Cognitions: A Systematic Review and Meta-Analysis.

Front Psychiatry 2020 25;11:601800. Epub 2021 Jan 25.

Department of Psychosocial Science, University of Bergen, Bergen, Norway.

Pop-up messages utilized by gambling operators are normally presented to gamblers during gambling sessions in order to prevent excessive gambling and/or to help in the appraisal of maladaptive gambling cognitions. However, the effect of such messages on gambling behavior and gambling cognitions has not previously been synthesized quantitatively. Consequently, a meta-analysis estimating the efficacy of pop-up messages on gambling behavior and cognitions was conducted. A systematic literature search with no time constraints was performed on Web of Science, PsychInfo, Medline, PsychNET, and the Cochrane Library. Search terms included "gambling," "pop-up," "reminder," "warning message," and "dynamic message." Studies based on randomized controlled trials, quasi-experimental designs and pre-post studies reporting both pre- and post-pop-up data were included. Two authors independently extracted data using pre-defined fields including quality assessment. A total of 18 studies were included and data were synthesized using a random effects model estimating Hedges' . The effects of pop-ups were = 0.413 for cognitive measures (95% CI = 0.115-0.707) and = 0.505 for behavioral measures (95% CI = 0.256-0.746). For both outcomes there was significant between-study heterogeneity which could not be explained by setting (laboratory vs. naturalistic) or sample (gambler vs. non-gamblers). It is concluded that pop-up messages provide moderate effects on gambling behavior and cognitions in the short-term and that such messages play an important role in the gambling operators' portfolio of responsible gambling tools.
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http://dx.doi.org/10.3389/fpsyt.2020.601800DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7868407PMC
January 2021
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