Association of accelerometer-measured sleep duration and different intensities of physical activity with incident type 2 diabetes in a population-based cohort study

Purpose:The aim of the current study was to investigate the association of accelerometer-measured sleep duration and different intensities of physical activity(PA)with the risk of incident type 2 diabetes in a population-based prospective cohort study.Methods:Altogether,88,000 participants(mean age=62.2±7.9 years,mean±SD)were included from the UK Biobank.Sleep duration(short:<6 h/day;normal:6-8 h/day;long:>8 h/day)and PA of different intensities were measured using a wrist-won accelerometer over a 7-day period between 2013 and 2015.PA was classified according to the median or World Health Organization-recommendation:total volume of PA(high,low),moderate-to-vigorous PA(MVPA)(recommended,not recommended),and light-intensity PA(high,low).Incidence of type 2diabetes was ascertained using hospital records or death registries.Results:During a median follow-up of 7.0 years,1615 incident type 2 diabetes cases were documented.Compared with normal sleep duration,short(hazard ratio(HR)=1.21,95%confidence interval(95%CI):1.03-1.41)but not long sleep duration(HR=1.01,95%CI:0.89-1.15)was associated with excessive type 2 diabetes risk.This increased risk among short sleepers seems to be protected against by PA.Compared with normal sleepers with high or recommended PA,short sleepers with low volume of PA(HR=1.81,95%CI:1.46-2.25),not recommended(below the World Health Organization-recommended level of)MVPA(HR=1.92,95%CI:1.55-2.36),or low light-intensity PA(HR=1.49,95%CI:1.13-1.90)had a higher risk of type 2 diabetes,while short sleepers with a high volume of PA(HR=1.14,95%CI:0.88-1.49),recommended MVPA(HR=1.02,95%CI:0.71-1.48),or high light-intensity PA(HR=1.14,95%CI:0.92-1.41)did not.Conclusion:Accelerometer-measured short but not long sleep duration was associated with a higher risk of incident type 2 diabetes.A higher level of PA,regardless of intensity,potentially ameliorates this excessive risk.

Associations of daily sedentary behavior,physical activity,and sleep with irritable bowel syndrome:A prospective analysis of 362,193 participants

Background:Irritable bowel syndrome(IBS)substantially affects quality of life and requires early prevention.This study aimed to elucidate the relationships between IBS and daily behaviors,including sedentary behavior(SB),physical activity(PA),and sleep.In particular,it seeks to identify healthy behaviors to reduce IBS risk,which previous studies have rarely addressed.Methods:Daily behaviors were retrieved from self-reported data of 362,193 eligible UK Biobank participants.Incident cases were determined by self-report or health care data according to RomeⅣcriteria.Results:A total of 345,388 participants were IBS-free at baseline,during a median follow-up of 8.45 years,19,885 incident IBS cases were recorded.When examined individually,SB and shorter(≤7 h/day)or longer(>7 h/day)sleep duration were each positively associated with increased IBS risk,and PA was associated with lower IBS risk.The isotemporal substitution model suggested that replacing SB with other activities could provide further protective effects against IBS risk.Among people sleeping≤7 h/day,replacing 1 h of SB with equivalent light PA,vigorous PA,or sleep was associated with 8.1%(95%confidence interval(95%CI):0.901-0.937),5.8%(95%CI:0.896-0.991),and 9.2%(95%CI:0.885-0.932)reduced IBS risk,respectively.For people sleeping>7 h/day,light and vigorous PA were associated with a 4.8%(95%CI:0.926-0.978)and a 12.0%(95%CI:0.815-0.949)lower IBS risk,respectively.These benefits were mostly independent of genetic risk for IBS.Conclusion:SB and unhealthy sleep duration are risk factors for IBS.A promising way to mitigate IBS risk for individuals sleeping≤7 h/day and for those sleeping>7 h/day appears to be by replacing SB with adequate sleep or vigorous PA,respectively,regardless of the genetic predisposition of IBS.

“Active Feedback” Fitbit-Based Physical Activity and Sleep Hygiene Intervention for Memory Assessment Service (MAS) Patients with Cognitive Deficits: Feasibility, Acceptability, Sleep Quality, Stress, and Wellbeing Outcomes

Research Background: Compared to the general population, people experiencing age-related cognitive decline are more likely to have low levels of physical activity and sleep problems. Sufficient physical activity and quality sleep are protective factors against cognitive decline and poor health and can improve coping with stressors. The “Active Feedback” intervention comprises a wearable activity and sleep tracker (Fitbit), access to Fitbit software healthy lifestyle software apps;one session with Memory Assessment Service (MAS) staff providing physical activity and sleep hygiene advice and two further engagement, discussion, and feedback sessions. Purpose/Aim: This study investigates the acceptability and feasibility of Active Feedback and the effect on stress, mental wellbeing, and sleep quality, and the links between these factors. Methods: An open-label patient cohort design with no control group was used. Pre-intervention, 4-week and 8-week intervention assessments were performed using participant self-report measures: Perceived Stress Scale (PSS), Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), and Sleep Conditioning Index (SCI). Twenty-five participants completed an eight-week three-session intervention (18 males and 7 females), with the age range of 66 - 84 years old, and average age of 73.8 years (SD = 5.09). Fifteen participants had a diagnosis of MCI, ten participants did not. Results: There were non-significant improvements in SCI scores from 21.0 (SD = 8.84) to 21.6 (SD = 6.20) at 8 weeks, PSS scores from 17.5 (SD = 5.89) to 17.0 (SD = 6.20) at 8 weeks, and WEMWBS scores from 46.9 (SD = 9.23) to 48.8 (SD = 9.69) at 8 weeks. There were negative correlations between WEMWBS and PSS. Conclusion: Active Feedback intervention was found to be feasible and acceptable. Active Feedback could be enhanced to include motivational interviewing and goal setting.

Effects of personalized exercise prescriptions and social media delivered through mobile health on cancer survivors’physical activity and quality of life

Purpose This study aimed to examine the effects of a multi-component mobile health intervention(wearable,apps,and social media)on cancer survivors’(CS')physical activity(PA),quality of life,and PA determinants compared to exercise prescription only,social media only,and attention control conditions.Methods A total of 126 CS(age=60.37±7.41 years,mean±SD)were recruited from the United States.The study duration was 6 months and participants were randomly placed into 4 groups.All participants received a Fitbit tracker and were instructed to install its companion app to monitor their daily PA.They(1)received previously established weekly personalized exercise prescriptions via email,(2)received weekly Facebook health education and interacted with one another,(3)received both Conditions 1 and 2,or(4)were part of the control condition,meaning they adopted usual care.CS PA daily steps,quality of life(i.e.,physical health and mental health),and PA determinants(e.g.,self-efficacy,social support)were measured at baseline,3 months,and 6 months.Results The final sample size included 123 CS.The results revealed only the multi-component condition had greater improvements in PA daily steps than the control condition post-intervention(95%confidence interval(95%CI):368–2951;p<0.05).Similarly,those in the multi-component condition had significantly greater increased physical health than the control condition(95%CI:–0.41 to–0.01;p<0.05)over time.In addition,the social media condition had significantly greater increased perceived social support than the control condition(95%CI:0.01–0.93;p<0.05).No other significant differences on outcomes were identified.Conclusion The study findings suggest that the implementation of a multi-component mobile health intervention had positive effects on CS PA steps and physical health.Also,offering social media intervention has the potential to improve CS perceived social support.

Experience and Impact of the “Well-Track” Physical Activity and Sleep Tracker Based Healthy Lifestyle Intervention for Patients in an Early Intervention in Psychosis (EIP) Service

Background: Physical activity and sleep are interconnected with mental health, physical health, wellbeing, quality of life, cognition, and functioning. Compared to the general population, people who experience psychosis are more likely to have low levels of physical activity, high levels of sedentary behaviour, and sleep problems. Intervention: The Well-Track intervention addresses these issues through: provision of a wearable activity and sleep tracker (Fitbit);physical activity and sleep hygiene advice;a brief motivational interview;a goal-setting workbook;and three engagement, feedback and discussion sessions with early intervention in psychosis (EIP) staff. Participants: Thirty participants using an EIP service took part in an eight-week intervention. Thirteen participants (6 males;7 females) with an age range of 18 to 61 years old (M = 28 years) took part in an interview. Methods: A qualitative approach was used to conduct in-depth semi-structured interviews. Thematic and content analyses were employed to analyse the data. Results: Participants set goals, made lifestyle changes to their daily routine and integrated a Fitbit and its functions into their lives that resulted in more physical activity and enabled more effective sleep. This resulted in improved self-management, positive feelings and thoughts, motivation, confidence, social engagement, mood, health, and wellbeing. Participants made progress towards goals they had set. Conclusion: Well-Track has been successfully integrated into an EIP service and it could be delivered through all EIP and other healthcare services where there is a need to promote healthy lifestyle behaviours.

Monitoring of Sleep Indicators, Physical Activity, Pain, and Fatigue in Patients with Systemic Lupus Erythematosus and Relations among These Variables: A Pilot Study

Background: Poor sleep, fatigue, and pain are major health problems in patients with systemic lupus erythematosus (SLE). However, only cross-sectional surveys on these health outcomes have been conducted, and the association between day-to-day fluctuations remains unknown. Objectives: We aimed to characterize daily fluctuations in sleep quality, physical activity, pain, and fatigue in patients with SLE. Method: Exploratory study with a cross-sectional design. Two rheumatology centers (a university hospital and a prefectural hospital) in Japan between September 2017 and May 2019. The sample size was set to 20. Demographic and clinical data were collected. Sleep and physical activity were measured with monitoring devices;pain and fatigue levels were recorded daily during the 4-week period. The Pittsburgh Sleep Quality Index, Short Form Health Survey-12, the Japanese version of the Lupus Patient Outcome, and SLE Disease Activity Index 2000 were collected at the start and end of the study. Descriptive statistics and coefficients of variation (CV) were tabulated to examine daily fluctuations. Pearson correlation coefficients were obtained for monitored variables. Results: The mean age was 43.7 ± 8.5 years, and the mean SLE duration was 16.0 ± 7.2 years. The mean moderate-to-vigorous physical activity (MVPA) duration was 7.8 ± 5.8 min/day, and the mean total sleep duration was 391.8 ± 65.3 min, with a mean sleep efficiency of 88.6% ± 6.1%. Daily fluctuations were high for leaving the bed frequency, MVPA duration, pain, and waking after sleep onset. Seventeen participants showed correlations between some of the variables, such as fatigue or longer MVPA duration and poorer sleep outcomes;longer sleep latency and increased frequency of leaving the bed;and higher physical activity and increased pain and fatigue. Conclusion: The quality of sleep and fatigue fluctuated daily, and correlations existed between these variables, as well as for pain and physical activity. The impact of MVPA duration on pain and fatigue is of concern as increased physical activity may worsen the quality of life patients with SLE. The monitoring of sleep and physical activity using the device seems feasible for SLE symptom management.

2024 Adult Compendium of Physical Activities:A third update of the energy costs of human activities

Background:The Compendium of Physical Activities was published in 1993 to improve the comparability of energy expenditure values assigned to self-reported physical activity(PA)across studies.The original version was updated in 2000,and again in 2011,and has been widely used to support PA research,practice,and public health guidelines.Methods:This 2024 update was tailored for adults 19-59 years of age by removing data from those≥60 years.Using a systematic review and supplementary searches,we identified new activities and their associated measured metabolic equivalent(MET)values(using indirect calorimetry)published since 2011.We replaced estimated METs with measured values when possible.Results:We screened 32,173 abstracts and 1507 full-text papers and extracted 2356 PA energy expenditure values from 701 papers.We added303 new PAs and adjusted 176 existing MET values and descriptions to reflect the addition of new data and removal of METs for older adults.We added a Major Heading(Video Games).The 2024 Adult Compendium includes 1114 PAs(912 with measured and 202 with estimated values)across 22 Major Headings.Conclusion:This comprehensive update and refinement led to the creation of The 2024 Adult Compendium,which has utility across research,public health,education,and healthcare domains,as well as in the development of consumer health technologies.The new website with the complete lists of PAs and supporting resources is available at https://pacompendium.com.

Physical activity and exercise in children with chronic health conditions

In the last two or three decades,physical activity(PA) has gained increasing recognition as being essential for maintaining good health and improving quality of life for all ages.Children have traditionally been active in both free play and organized sports.However,there has been a recent decline in the PA levels among children for various reasons.This lifestyle change has resulted in increased obesity accompanied by a rise in diabetes and cardiovascular risk among otherwise healthy children.These lifestyle changes have been shown to be even more a problem when the child is already affected by a chronic disease.Due to medical limitations and contraindications,much care must be taken to make certain that these children are involved in the appropriate volume and intensity of exercise.The type of activity must also be given careful consideration to avoid undue risk for the child who may have problems such as poor balance,limited strength,poor vision,or cognitive disability.Further complications are either caused or exacerbated by lack of sufficient PA.The priority beyond concern for safety should be focused on ensuring the highest quality of life possible.The purpose of this review is to examine how PA can benefit children with selected chronic health conditions.

The role of physical activity and exercise in obesity and weight management: Time for critical appraisal

The prevalence of overweight and obesity has increased dramatically during last 3 decades with devastating consequences to public health. Recommended strategies to reduce obesity have focused on healthier diet and physical activity （PA）. Clearly, these approaches have not been successful, but whether this is due to failure to restrict energy intake or to maintain high levels of energy expenditure has been the subject of great controversy. Consequently, there has been a great deal of confusion about the role of PA and exercise in obesity and weight management. In this article, the theoretical basis for considering reduced PA and energy expenditure as the cause of obesity is appraised. Further, the role of PA in food intake and weight control is examined. The idea that obesity is caused by consistent deeline in daily energy expenditure is not supported either by objective measures of energy expenditure or physiological theory of weight gain alone. However, since voluntary exercise is the most important discretionary component of total daily energy expenditure, it can affect energy balance. Therefore, PA and exercise hold potential as part of the solution for the ongoing obesity epidemic.

Scoping review: obese elderly women with breast cancer and physical activity/exercise

Objective:Obesity and breast cancer(BC)are diseases of concern,especially within the context of an aging population.This scoping review is aimed at mapping out the literature on the subject of elderly women(EW)with breast cancer,obesity and physical activity/exercise(PAE)to identify gaps in the present extant literature,and to suggest directions for future research.Data sources:A total of four articles were finalized from an initial 2905 articles found via searches on the Annals of Internal Medicine by American College of Physicians(ACP)^(TM),BioMed Central(BMC)^(TM),BMJ Journals^(TM),Journal of the American Medical Association(JAMA)^(TM),PubMed^(TM),SAGE^(TM),ScienceDirect^(TM),SpringerLink(e-journals)^(TM),Taylor and Francis Online^(TM),and Wiley Online Library^(TM) databases.Methods:Recognized structural frameworks for scoping reviews were utilized to guide the methodology and technical aspects of this paper.Data extraction was conducted via a charting table.Results:Research gaps identified include a paucity in research on the subject of obesity and breast cancer among elderly women;there is a limitation of the types of methodologies used in the research on this subject indicating vast opportunities for future studies using different methodologies;lack of use of the alternative types of physical activity and exercise such as Tai Chi,Qigong and Yoga;lack of focus on the older elderly population;and areas of social support from family and friends for obese elderly with breast cancer to engage in physical activity and exercise.Conclusion:Future research would address the urgent need within academia to address the research gap of PAE and EWBC.Such research should use a diverse range of both quantitative and qualitative research methodologies,while including eastern exercise regimens such as Tai Chi,Qigong and Yoga as a means of studying PAE among EWBC.Additionally,future research may focus on the“old elderly”as a demographic group of study as well as how social support may encourage PAE among EWBC.

Physical activity and exercise training in young people with cystic fibrosis:Current recommendations and evidence

Despite the acceptance of physical activity （PA） being integral to a young person＇s health, children with disability often exhibit low levels of PA. In young people with cystic fibrosis （CF） the importance of exercise and daily PA is acknowledged by clinicians and their support teams, however, there is a lack of knowledge related to its prescription. CF is a recessive genetic disorder affecting the lung, pancreas and sweat glands. CF is the most common life shortening genetic disease in the Caucasian population for which there is no cure. In the UK, CF affects over 9000 people, with 4000 under 16 years of age. Only about half of the CF population can expect to live beyond 40 years of age. Besides drug therapies, rehabilitative exercise programmes form an important component of treatment and long term exercise programmes are considered positive treatment strategies, but all lack any detailed prescriptive information. Several reviews and editorials have highlighted the lack of evidence based research in PA and exercise training in young people with CF; but advocate a greater need for understanding the role of exercise in therapeutic interventions. The purpose of this review is to update the reader on the current recommendations and evidence in PA and exercise training for young people with CE These developments have extended our understanding of PA and exercise training in children and adolescents with CF, and its implementation in the management of this chronic disease.

Prospective associations between joint categories of physical activity and insomnia symptoms with onset of poor mental health in a population-based cohort

Background:Physical inactivity and insomnia symptoms are independently associated with increased risk of depression and anxiety;however,few studies jointly examine these risk factors.This study aimed to prospectively examine the joint association of physical activity(PA)and insomnia symptoms with onset of poor mental health in adults.Methods:Participants from the 2013 to 2018 annnual waves of the Household Income and Labour Dynamics in Australia panel study who had good mental health(Mental Health Inventory-5>54)in 2013,and who completed at least 1 follow-up survey(2014-2018),were included(n=10,977).Poor mental health(Mental Health Inventory-5≤54)was assessed annually.Baseline(2013)PA was classified as high/moderate/low,and insomnia symptoms(i.e.,trouble sleeping)were classified as no insomnia symptoms/insomnia symptoms,with 6 mutually exclusive PAinsomnia symptom groups derived.Associations of PA-insomnia symptom groups with onset of poor mental health were examined using discrete-time proportional-hazards logit-hazard models.Results:There were 2322 new cases of poor mental health(21.2%).Relative to the high PA/no insomnia symptoms group,there were higher odds(odds ratio and 95%confidence interval(95%CI))of poor mental health among the high PA/insomnia symptoms(OR=1.87,95%CI:1.57-2.23),moderate PA/insomnia symptoms(OR=1.93,95%CI:1.61-2.31),low PA/insomnia symptoms(OR=2.33,95%CI:1.96-2.78),and low PA/no insomnia symptoms(OR=1.14,95%CI:1.01-1.29)groups.Any level of PA combined with insomnia symptoms was associated with increased odds of poor mental health,with the odds increasing as PA decreased.Conclusion:The se findings highlight the potential benefit of interventions targeting both PA and insomnia symptoms for promoting mental health.

The Effectiveness of Physical Exercise on Psychological Status, and Sleep Quality among Jordanian Patients Undergoing Hemodialysis: Literature Review

Background: Patients receiving hemodialysis are suffered from several psychological complications, and they required to receive safe, feasible, and applicable interventions to improve their psychological health. Practicing physical exercises were used in the literature as a possible intervention to improve patient’s outcomes. Purpose: The current literature review aimed to evaluate the effectiveness of physical exercises on psychological status, and sleep quality among patients undergoing hemodialysis, and to detect the gab in the Jordanian literature about the effectiveness of practicing physical exercises on psychological status, and sleep quality among patients undergoing hemodialysis. Methods: The design of the current article was literature review of fifty studies. Results: The current review revealed that most of the research studies were conducted to describe the levels and prevalence’s of psychological and mental complication of hemodialysis process, and to evaluate the impact of different types and methods of physical exercises on physical, psychological, and functional outcomes among patients undergoing hemodialysis. However, there are no agreement about the type, time, and intensity of physical exercises, and its impact on patients’ psychological outcomes. In Jordanian context, there are no experimental studies were conducted about the effectiveness of physical exercises on psychological status and sleep quality among patients undergoing hemodialysis. Conclusion: It is imperative for researchers to fill the gap that existed in the body of knowledge regarding the effectiveness of physical exercises on psychological outcomes among patients undergoing hemodialysis in order to improve psychological well-being and improve both quality of life for patients, and quality of nursing care.

Adolescents' personal beliefs about sufficient physical activity are more closely related to sleep and psychological functioning than self-reported physical activity: A prospective study

Background: Preliminary evidence among adults suggests that the ways in which individuals think about their physical activity(PA) behavior is more closely associated with their well-being than self-reported PA. This study therefore aimed to examine whether and how self-reported PA and personal beliefs about suffbcient PA are associated with sleep and psychological functioning in a sample of Swiss adolescents, using both cross-sectional and prospective data.Methods: An overall sample of 864 vocational students(368 girls, 17.98± 1.36 years, mean ± SD) was followed prospectively over a 10-month period. At each measurement occasion, participants filled in a series of self-report questiocnaires to assess their PA levels, their personal beliefs about whether or not they engage in sufficient PA, sleep(insomnia symptoms, sleep quality, sleep-onset latency, and number of awakenings),and psychological functioning(depressive symptoms, quality of life, perceived stress, and mental toughness).Results: Adolescents who believe that they are sufficiently physically active to maintain good health reported more restoring sleep. No differen?ces in sleep were found between adolescents who meet PA recommendationsvs. those who do not. Additionally, adolescents who believe that they were sufficiently physically active also reported better psychological functioning. This close relationship between adolescents5 beliefs about their PA involvement and their sleep and psychological functioning was corroborated in the prospective analyses.Conclusion: Cognitive factors should be studied more intensively when elucidating the relationship among PA, sleep, and psychological functioning in young people, particularly when aiming to develop new exercise interventions targeting psychological outcomes.

Physical exercise,Sedentary Behaviour,Sleep and Depression Symptoms in Chinese Young Adults During the COVID-19 Pandemic:A Compositional Isotemporal Analysis

Numerous studies links movement activity(e.g.,physical activity,sedentary behavior[SB],and sleep)with mental health or illness indicators during the COVID-19 pandemic;however,research has typically examined time-use behaviors independently,rather than considering daily activity as a 24-hour time-use composition.This cross-sec-tional study aimed to use compositional isotemporal analysis to estimate the association between reallocation of time-use behaviors and depression symptoms in young adults in China.Participants(n=1475;68.0%of female;20.7[1.60]years)reported their time spent in moderate to vigorous physical activity(MVPA),light physical activ-ity(LPA),SB,and sleep.Replacing SB with sleep,LPA,and MVPA at 5,10,or 15 min was significantly associated with lower estimated depression symptoms scores.For example,adding MVPA from SB at 15 min was associated with lower depression symptoms scores(estimated difference:-0.13[-0.17,-0.09]).The associations between reallocation of time use behaviors with depression symptoms scores were slightly differentiated.Our results emphasize the importance of increased MVPA and decreased SB as well as their mutual replacements for lowering the risks of depression symptoms in young adults during the COVID-19 pandemic.Our results can inform policy to develop effective plans and strategies for mental health promotion.

Short-term effect of physical activity on sleep health:A population-based study using accelerometry

Background:Regular physical activity(PA) is an important behavior in improving sleep health.However,the short-term effects of PA on sleep are still controversial.This study aimed to verify the effect of different intensities of PA practiced in different periods of the day on the subsequent sleep night in a population-based cohort of young adults.Methods::Prospective analyses were conducted for PA performed during the day and its effect on the following sleep night using data from the22-year follow-up of the 1993 Pelotas Birth Cohort in Brazil(mean age of participants-22.6 years).Wrist-worn accelerometry was usedto measure both PA and sleep parameters.Regarding intensity,we analyzed the sleep effect of light PA(LPA),moderate PA,and vigorous PA,stratified by sex.Sleep variables were sleep time window(STW;the difference between sleep onset and sleep end),total sleep time(TST;the sum of minutes classified as sleep in STW),and sleep percent(SP;SP=(TST/STW);expressed in percentage).We performed generalized estimating equations using Stata software.Results::The means of STW,TST,and SP were 443.6 min/day,371.1 min/day,and 84%,respectively.Time spent in moderate PA and vigorous PA in the morning and afternoon was not associated with sleep variables.Among men,10 min/day of morning LPA increased TST by2.56 min/day.Among women,10 min/day of morning LPA increased SP by 0.15 percentage points.Afternoon LPA also increased SP by 0.09 percentage points for women.Night PA seems to have an inverse effect on sleep variables for any intensity and both sexes.Conclusion::The effect of PA on sleep health is intrinsically related to the period of the day in which it is performed.The effect magnitude is different between sexes.For better sleep health,it is preferable that PA be performed during the day.

A Qualitative Study of Early Intervention Psychosis (EIP) Service Patient’s Experience of Sleep, Exercise, Sleep Hygiene Advice and Fitbit Wearable Activity and Sleep Tracker

Background: In psychosis physical activity, sleep, mental health, physical health, wellbeing, quality of life, cognition and functioning are interconnected. People who experience psychosis are more likely than the general population to have low levels of physical activity, high levels of sedentary behaviour and sleep problems. This project was innovative in seeking to address these issues through provision of a wearable activity and sleep tracker (a Fitbit) and sleep hygiene advice. Participants: Participants using an early intervention psychosis (EIP) service took part in an eight-week intervention, which incorporated the provision of a Fitbit, sleep hygiene advice as well as three engagement, feedback and discussion points with a clinician. Methods: A qualitative approach was used to conduct in-depth semi-structured interviews with 12 of the 25 intervention participants (5 male;7 female). Thematic and content analyses were employed to analyse the data. Results: Participants provided valuable insights into their experience of sleep, exercise, Fitbit use and sleep hygiene advice use. It was found that participants placed a high value on effective night time sleep, recognized improvements in physical activity and noted a positive effect on mood and wellbeing as a result of Fitbit use. The negative impact of having ineffective night time sleep and insufficient physical activity was described. Participants demonstrated a good level of understanding of the connection between sleep, exercise, wellbeing, and health. Conclusion: Participants reported the Fitbit and sleep hygiene advice received through an EIP service to be beneficial for improved levels of physical activity and exercise, and more effective sleep. This is a simple and low cost intervention which could be made widely available through EIP and other mental health services.

Association of Physical Activity, Screen Time and Sleep with Depressive Symptoms in Adolescents

Little is known on the association between movement behaviors including physical activity(PA),screen time(ST)and sleep(SLP)with depression in adolescents.This study aimed to explore the associations of PA,ST and SLP with depressive symptoms in adolescents.A total of 1,331 middle school students participated in this survey and provided valid data pertaining to the study variables.Self-reported questionnaires were used to collect information on participants’sociodemographic parameters.The Health Behavior in School-aged Children Questionnaire was used to assess the PA(days for moderate to vigorous PA),ST(daily hours of ST)and SLP(daily hours of SLP).Study participants’depressive symptoms were assessed using the Children’s Depression Inventory.Generalized linear models were used to estimate the associations of PA,ST and SLP with depressive symptoms.Of all the 1331 study participants,boys accounted for 51.31%and percentage of 7th,8th and 9th graders were 52.44%,23.22%and 24.34%,respectively.After controlling for sex,body mass index,grade,ethnicity,residence,siblings,perceived family affluence,father and mother educational level,only ST was positively associated with depressive symptoms(beta=0.17,p=0.005).This study suggests that excessive ST would be detrimental to depressive symptoms in adolescents.It may be effective to reduce ST for depression intervention or prevention.Future studies are encouraged to use an improved study design to confirm or negate this study’s researchfindings.

Wearable Physical Activity and Sleep Tracker Based Healthy Lifestyle Intervention in Early Intervention Psychosis (EIP) Service: Patient Experiences

Background: Physical activity, sleep, mental health, physical health, wellbeing, quality of life, cognition, and functioning in people who experience psychosis are interconnected factors. People experiencing psychosis are more likely to have low levels of physical activity, high levels of sedation, and sleep problems. Intervention: An eight-week intervention;including the provision of a Fitbit and its software apps, sleep hygiene and physical activity guidance information, as well as three discussion and feedback sessions with a clinician. Participants: Out of a sample of 31 using an early intervention psychosis (EIP) service who took part in the intervention, fifteen participants consented to be interviewed—9 (60%) males and 6 (40%) females, age range: 19 - 51 years, average age: 29 years. Method: In-depth interviews investigating patient experience of the intervention and its impact on sleep, exercise, and wellbeing were undertaken. Thematic analysis was applied to analyse the qualitative data and content analysis was used to analyse questions with a yes/no response. Results: Most of the participants actively used the Fitbit and its software apps to gain information, feedback, and set goals to make changes to their lifestyle and daily routines to improve quality of sleep, level of physical activity, and exercise. Conclusion: The intervention was reported to be beneficial, and it is relatively easy and low cost to implement and therefore could be offered by all EIP services. Furthermore, there is potential value for application in services for other psychiatric disorders, where there is often a need to promote healthy lifestyle, physical activity, and effective sleep.

Effectiveness of a Fitbit Based Sleep and Physical Activity Intervention in an Early Intervention Psychosis (EIP) Service

Purpose: Compared to levels in the general population, people with experiences of psychosis have poorer physical fitness, more sedentary behaviour, lower physical activity, more sleep problems, and a higher incidence of insomnia. The aim of the current study was to examine the feasibility and impact of an intervention with the goal of addressing these issues. Method: Design: intervention with outcome measure data collection, with no control group. Forty-nine early intervention psychosis (EIP) service patients took part in an intervention: provision of a Fitbit, Fitbit software apps, sleep hygiene, and physical activity guidance, and three discussion sessions with clinicians. The sample consisted of 29 males and 20 females, with age range of 17 - 54 years, and average age of 29.5 years. Measures used were Fitbit activity and sleep data, and self-rated Warwick–Edinburgh Mental Wellbeing Scale (WEMWBS) and Positive and Negative Affect Schedule (PANAS). Results: WEMWBS scores significantly improved, with a medium effect size. PANAS negative affect (NA) dropped significantly. Analysis of Fitbit activity and sleep data yielded non-significant results. Conclusion: The intervention was acceptable to EIP patients and is feasible. Improvements in mental wellbeing and negative affect indicate the positive impact of the intervention on mental health. EIP services should consider assessing sleep quality and physical activity/exercise levels, and using this study’s intervention to promote wellbeing and mental health within recovery focused practice. Further research could be undertaken through a sufficiently powered randomised control trial (RCT) comparing this intervention and treatment as usual (TAU).