scholarly journals Four-Year Trends in Sleep Duration and Quality: A Longitudinal Study Using Data from a Commercially Available Sleep Tracker

10.2196/14735 ◽  
2020 ◽  
Vol 22 (2) ◽  
pp. e14735 ◽  
Author(s):  
Rebecca Robbins ◽  
Mahmoud Affouf ◽  
Azizi Seixas ◽  
Louis Beaugris ◽  
George Avirappattu ◽  
...  
Keyword(s):  
New York ◽  
Sleep Quality ◽  
Sleep Duration ◽  
Total Sample ◽  
Sleep Time ◽  
Sleep Cycle ◽  
Future Research ◽  
Older Individuals ◽  
Time In Bed ◽  
Reported Data

Background Population estimates of sleep duration and quality are inconsistent because they rely primarily on self-reported data. Passive and ubiquitous digital tracking and wearable devices may provide more accurate estimates of sleep duration and quality. Objective This study aimed to identify trends in sleep duration and quality in New York City based on 2 million nights of data from users of a popular mobile sleep app. Methods We examined sleep duration and quality using 2,161,067 nights of data captured from 2015 to 2018 by Sleep Cycle, a popular sleep-tracking app. In this analysis, we explored differences in sleep parameters based on demographic factors, including age and sex. We used graphical matrix representations of data (heat maps) and geospatial analyses to compare sleep duration (in hours) and sleep quality (based on time in bed, deep sleep time, sleep consistency, and number of times fully awake), considering potential effects of day of the week and seasonality. Results Women represented 46.43% (1,003,421/2,161,067) of the sample, and men represented 53.57% (1,157,646/2,161,067) of individuals in the sample. The average age of the sample was 31.0 years (SD 10.6). The mean sleep duration of the total sample was 7.11 hours (SD 1.4). Women slept longer on average (mean 7.27 hours, SD 1.4) than men (mean 7 hours, SD 1.3; P<.001). Trend analysis indicated longer sleep duration and higher sleep quality among older individuals than among younger (P<.001). On average, sleep duration was longer on the weekend nights (mean 7.19 hours, SD 1.5) than on weeknights (mean 7.09 hours, SD 1.3; P<.001). Conclusions Our study of data from a commercially available sleep tracker showed that women experienced longer sleep duration and higher sleep quality in nearly every age group than men, and a low proportion of young adults obtained the recommended sleep duration. Future research may compare sleep measures obtained via wearable sleep trackers with validated research-grade measures of sleep.

scholarly journals Personality Traits and Insomnia Symptoms in Shift Workers

2021 ◽  
Vol 12 ◽  
Author(s):  
Brigitte Holzinger ◽  
Lucille Mayer ◽  
Gerhard Klösch
Keyword(s):  
Sleep Quality ◽  
Personality Traits ◽  
Sleep Duration ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Work Schedule ◽  
Shift Workers ◽  
Time In Bed ◽  
Shift Schedules ◽  
Insomnia Symptoms

The discrepancy between natural sleep-wake rhythm and actual sleep times in shift workers can cause sleep loss and negative daytime consequences. Irregular shift schedules do not follow a fixed structure and change frequently, which makes them particularly harmful and makes affected individuals more susceptible to insomnia. The present study compares insomnia symptoms of non-shift workers, regular shift workers, and irregular shift workers and takes into account the moderating role of the Big Five personality traits and levels of perfectionism. Employees of an Austrian railway company completed an online survey assessing shift schedules, sleep quality and duration, daytime sleepiness, and personality traits. A total of 305 participants, of whom 111 were non-shift workers, 60 regular shift workers, and 134 irregular shift workers, made up the final sample. Irregular shift workers achieved significantly worse scores than one or both of the other groups in time in bed, total sleep time, sleep efficiency, sleep duration, sleep quality, sleep latency, and the number of awakenings. However, the values of the irregular shifts workers are still in the average range and do not indicate clinical insomnia. Participants working regular shifts reported the best sleep quality and longest sleep duration and showed the least nocturnal awakenings, possibly due to higher conscientiousness- and lower neuroticism scores in this group. Agreeableness increased the effect of work schedule on total sleep time while decreasing its effect on the amount of sleep medication taken. Perfectionism increased the effect of work schedule on time in bed and total sleep time. Generalization of results is limited due to the high percentage of males in the sample and using self-report measures only.

scholarly journals 0212 Questionnaire Assessment of Intraindividual Variability in Sleep: Inconsistent Sleep Can Be Worse Than Short Average Sleep

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A82-A83
Author(s):  
C Gao ◽  
T Luster ◽  
V Bermudez ◽  
A Porro ◽  
M K Scullin
Keyword(s):  
Sleep Quality ◽  
Sleep Duration ◽  
Transition Period ◽  
Explanatory Power ◽  
Sleep Time ◽  
Intraindividual Variability ◽  
Future Research ◽  
Underrepresented Minority ◽  
First Semester ◽  
Social Jetlag

Abstract Introduction The consequences of short sleep are well-documented, but recent evidence indicates that night-to-night consistency in sleep may be just as important. For the current work, we developed an intraindividual variability in sleep (IIV) questionnaire to make IIV measurement possible in single-time-point studies. We investigated whether self-reported IIV explained unique variance in sleep quality and health beyond average total sleep time (TST), focusing on a critical transition period (first semester of college) in which high variability was predicted. Methods First-semester college students (N=126, Mage=18.28, 75.40% females) completed an IIV questionnaire in which participants indicated their average sleep duration, then estimated how much their sleep duration deviated from their average duration for each day of a typical week. We quantified IIV as the mean day-to-day change in sleep. Participants also completed standard questionnaires on global sleep quality, social jetlag, daytime sleepiness, depression, and stress. Results Participants reported substantial IIV in their sleep durations (M=1.77 hours, SD=0.86) that was largely distinguishable from measures of social jetlag (r=.25) and average TST (r=-.18). Patterns of IIV differed across race/ethnicities: in white/Asian students, IIV was strongly associated with social jetlag (r=-.44) whereas in underrepresented minority students, IIV and social jetlag were separate constructs (r=-.03), suggesting that fluctuations in the latter group occur across all days of the week. Greater IIV was associated with significantly worse global sleep quality (r=.24, p=.01), stress (r=.20, p=.03), and depression, r=.20, p=.03). These associations were significant after adjusting for average TST, and only marginally reduced when controlling for social jetlag. Conclusion IIV in sleep/wake patterns can be captured using a questionnaire, and such measurement provides unique explanatory power to understanding sleep quality and mental health. Future research is needed to compare IIV questionnaire data to actigraphy data and to understand the underlying mechanisms by which inconsistent sleep detrimentally affects individuals. Support National Science Foundation (NSF 1920730)

scholarly journals Differential Effects of DHA- and EPA-Rich Oils on Sleep in Healthy Young Adults: A Randomized Controlled Trial

Nutrients ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 248
Author(s):  
Michael J. Patan ◽  
David O. Kennedy ◽  
Cathrine Husberg ◽  
Svein Olaf Hustvedt ◽  
Philip C. Calder ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Controlled Trial ◽  
Sleep Time ◽  
Sleep Efficiency ◽  
Omega 3 ◽  
Double Blind ◽  
Differential Effects ◽  
Positive Effects ◽  
Time In Bed ◽  
Oily Fish

Emerging evidence suggests that adequate intake of omega-3 polyunsaturated fatty acids (n-3 PUFAs), which include docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), might be associated with better sleep quality. N-3 PUFAs, which must be acquired from dietary sources, are typically consumed at suboptimal levels in Western diets. Therefore, the current placebo-controlled, double-blind, randomized trial, investigated the effects of an oil rich in either DHA or EPA on sleep quality in healthy adults who habitually consumed low amounts of oily fish. Eighty-four participants aged 25–49 years completed the 26-week intervention trial. Compared to placebo, improvements in actigraphy sleep efficiency (p = 0.030) and latency (p = 0.026) were observed following the DHA-rich oil. However, these participants also reported feeling less energetic compared to the placebo (p = 0.041), and less rested (p = 0.017), and there was a trend towards feeling less ready to perform (p = 0.075) than those given EPA-rich oil. A trend towards improved sleep efficiency was identified in the EPA-rich group compared to placebo (p = 0.087), along with a significant decrease in both total time in bed (p = 0.032) and total sleep time (p = 0.019) compared to the DHA-rich oil. No significant effects of either treatment were identified for urinary excretion of the major melatonin metabolite 6-sulfatoxymelatonin. This study was the first to demonstrate some positive effects of dietary supplementation with n-3 PUFAs in healthy adult normal sleepers, and provides novel evidence showing the differential effects of n-3 PUFA supplements rich in either DHA or EPA. Further investigation into the mechanisms underpinning these observations including the effects of n-3 PUFAs on sleep architecture are required.

142 Prenatal Sleep Quality and Infant Sleep: A Longitudinal Study

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A58-A59
Author(s):  
Rebecca Burdayron ◽  
Marie-Helene Pennestri ◽  
Elizabeth Keys ◽  
Lianne Tomfohr-Madsen ◽  
Gerald Giesbrecht
Keyword(s):  
Sleep Quality ◽  
Sleep Duration ◽  
Gestational Age ◽  
Sleep Onset ◽  
Depression Scale ◽  
Future Research ◽  
Poor Sleep ◽  
Infant Sleep ◽  
Maternal Sleep ◽  
Sleep Parameters

Abstract Introduction Poor sleep quality is common during pregnancy and can increase the risk of adverse obstetric and fetal outcomes. Existing research on the association between prenatal sleep and infant sleep is scarce and has focused on other aspects of prenatal sleep such as sleep duration, chronotype, and insomnia symptoms. To our knowledge, no studies have examined the association between prenatal sleep quality and infant sleep outcomes. Thus, this study aimed to investigate whether maternal sleep quality during pregnancy was prospectively associated with infant sleep dimensions, independent of relevant covariates. Methods Participants were a subset of 272 mother-infant dyads enrolled in an ongoing cohort study. Maternal prenatal sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI) in early to mid- (M gestational age = 15.12 ± 3.56 weeks) and late- (M gestational age = 32.44 ± 0.99 weeks) pregnancy. Mothers completed the Brief Infant Sleep Questionnaire (BISQ) at 3, 6, and 12 months postpartum. The following infant sleep parameters were assessed: sleep duration (day, night, 24-hour), number of night awakenings, and wake after sleep onset. Prenatal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS) at both pregnancy time points. Other covariates included maternal age at enrollment, infant age, parity, and co-sleeping status. Results Generalized estimating equations (GEE) models revealed that poorer maternal sleep quality during early-to-mid pregnancy did not significantly predict infant sleep parameters after adjustment for covariates (p &gt; .05). However, in late pregnancy, poorer maternal sleep quality significantly predicted shorter 24-hour sleep duration and longer wake after sleep onset, but not daytime sleep duration, nighttime sleep duration, and number of night awakenings (p &lt; .05). Conclusion Study findings advance our understanding of the prospective link between maternal prenatal sleep quality and infant sleep. Results indicate that maternal sleep quality during late gestation may play a role in the development of infant sleep patterns. These findings have important implications for intervention efforts targeting maternal sleep quality during pregnancy. Future research should use objective measures of sleep, such as actigraphy, to better elucidate the effects of prenatal sleep quality on infant sleep outcomes. Support (if any) The Canadian Institutes of Health Research (CIHR)

scholarly journals 1092 Attention-deficit/hyperactivity Disorder Symptoms And Sleep Characteristics Within A Seasonal Affective Disorder Spectrum

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A415-A416
Author(s):  
K N Kim ◽  
D L Wescott ◽  
P L Franzen ◽  
B P Hasler ◽  
K A Roecklein
Keyword(s):  
Sleep Quality ◽  
Sleep Duration ◽  
Adhd Symptom ◽  
Symptom Severity ◽  
Daytime Sleepiness ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Sleep Onset Latency ◽  
Adhd Symptoms ◽  
Depression Severity

Abstract Introduction Seasonal affective disorder (SAD) increases risk for attention-deficit/hyperactivity disorder (ADHD), although the mechanism linking SAD and ADHD is unknown. Prior research has identified insomnia and delayed sleep phase in both ADHD and SAD. We hypothesized that sleep duration and timing in SAD would be associated with the severity of ADHD symptoms. Methods Adults with SAD (n = 45) and subsyndromal SAD (S-SAD; n = 18) aged 19-66 years from Pittsburgh, PA., were assessed for ADHD symptoms, self-report sleep quality, depression severity, and daytime sleepiness in the Winter. Participants wore an Actiwatch for 4-14 days, from which we calculated sleep-onset latency, total sleep time, sleep midpoint, and sleep efficiency. We conducted a hierarchical multivariate linear regression to determine if sleep characteristics predict ADHD symptom severity in our sample while controlling for depressive symptoms. Age and gender were added in Step 1, seasonal depression severity in Step 2, actigraphy-based total sleep time, sleep onset latency, midpoint, and efficiency in Step 3, and self-reported sleep quality and daytime sleepiness in Step 4. Results Participants mostly scored in the “likely” or “highly likely” ADHD range (87.30%, n=55), higher than the national prevalence rate (4.4%). When controlling for age, gender, and depression severity, only shorter actigraphy-based total sleep time was associated with higher ADHD symptom severity (β=-0.30, p&lt;0.05). However, when self-reported sleep quality and daytime sleepiness were added as predictors, total sleep time was no longer a statistically-significant predictor of ADHD symptom severity and only daytime sleepiness predicted ADHD symptom severity (β=0.31, p&lt;0.05). Conclusion Our results suggest that individuals with SAD who experience daytime sleepiness and/or possibly shorter actigraphy-based sleep duration experience higher ADHD symptom severity. Treatments like Trans-C or CBT-I to improve daytime sleepiness and sleep duration may be indicated for SAD patients who present with comorbid ADHD symptoms. Support NIMH K.A.R. MH103303

scholarly journals 0409 The Efficacy of Afternoon-Evening Sleep Following Night Shifts on Sleep and Alertness in Nurses with Rotating Shift Work Schedule: Real World Data

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A156-A157
Author(s):  
J Kim ◽  
S Han ◽  
S Kim ◽  
J Duffy
Keyword(s):  
Sleep Duration ◽  
Shift Work ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Hospital Nurses ◽  
Sleep Timing ◽  
Time In Bed ◽  
Shift Schedules ◽  
Sleep Schedule ◽  
Night Shifts

Abstract Introduction The aim of this study was to investigate the efficacy of changing sleep timing to afternoon-evening following nightshifts in hospital nurses with three rapid rotating shift schedules. Methods Hospital nurses with three rotating shift schedules were enrolled for a 1-month pre-intervention and a 1-month intervention study. During the Intervention, sleep timing following nightshifts was directed to afternoon-evening sleep for 8h time-in-bed (TIB) after 1 PM, and ad-lib sleep schedule for other shifts. Baseline and follow-up evaluation included sleep schedule, sleep duration, Epworth sleepiness scale (ESS), insomnia severity index (ISI) for each shift, Beck depression inventory (BDI), and Beck anxiety inventory (BAI). Sleep was assessed by sleep diary and actigraphy. Alertness during the night shift was evaluated using the Karolinska sleepiness scale (KSS) in the beginning and at the end of the shift by texts sent to their cell phones. The participants were asked to give feedback and a willingness to continue this intervention. Results A total of 26 subjects (30.7±8.5years, 25 female) finished the study among 29 nurses who participated in the study. The shift work was 6.5±8.0years. The mean morningness-eveningness scale was 42.1±8.0(31-62). TIB following nightshifts were 379.9±91.2 and 478.4±48.7 min for preintervention and intervention, respectively (p=0.001). Total sleep time (TST) was 328.0±91.0 vs. 361.0±70.4min, respectively following nightshifts (p=0.187, Cohen’s drm = 0.467). BDI, BAI, ESS, and ISI were significantly improved after the intervention. 60.7% and 49% of the participants reported improved alertness, and work efficiency during the nightshift. 17.9% and 42.9% of the participants reported increased sleep duration, and improved sleep quality after nightshift, respectively. Only eight participants were willing to continue the afternoon-evening sleep schedule following night shifts. KSS was not different between pre-intervention and intervention. Conclusion The afternoon-evening sleep schedule modestly increased total sleep time following nightshift. The overall mood, sleepiness and insomnia scale improved after the intervention although the alertness assessed by KSS failed to show the difference. The individual difference should be considered for applying afternoon-evening sleep for rapid rotating shift schedules. Support 2018 Research award grants from the Korean sleep research society and NRF-2019R1A2C1090643 funded by the Korean national research foundation

scholarly journals 0845 The Difference in Sleep Characteristics of Chronic Insomnia Disorder According to Gender and Age

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A322-A322
Author(s):  
J Hong ◽  
H Lee ◽  
I Yoon
Keyword(s):  
Sleep Quality ◽  
The Elderly ◽  
Sleep Time ◽  
Chronic Insomnia ◽  
Middle Aged ◽  
Subjective Sleep ◽  
Time In Bed ◽  
Insomnia Disorder ◽  
Gender And Age ◽  
Sleep Parameters

Abstract Introduction Impacts of age and gender on sleep have been reported in normal population, but rarely in chronic insomnia disorder (CID). This study aimed to investigate difference in sleep characteristics of CID according to gender and age. Methods The participants with drug-naïve CID and aged between 40 and 79 years were recruited. We compared subjective and objective sleep parameters between the middle-aged (40-64 years, N=86) and the elderly (65-79 years, N=50), and between men (N=45) and women (N=91). The subjective sleep quality and habitual sleep time were measured by Pittsburgh Sleep Quality Index (PSQI). The participants were asked to wear an actigraph for 4 days to obtain objective sleep parameters. Results In the PSQI, the elderly reported earlier bedtime and wake-up time (p=0.018; p=0.026), reduced total sleep time (TST) and sleep efficiency (p=0.003; p=0.011), and low sleep quality (p=0.034) compared to the middle-aged. However, according to the actigraphy, differences were observed only in the bedtime (p=0.016) and the wake-up time (p=0.002) between the two age groups. Between genders, the actigraphy showed that the male patients woke up earlier than the female group (p=0.015); except for this finding, there was no significant gender effect. Meanwhile, regarding gender and age interactions, the elderly women with CID showed longer time in bed (TIB) with increase in both TST and wake after sleep onset (WASO) compared to the middle-aged women. The elderly men showed decreased TIB and TST, and slightly decreased WASO than the middle-aged men. Conclusion The elderly with CID show more subjective sleep complaints than the middle-aged CID despite little difference in objective sleep characteristics, which suggests that the elderly CID may seek medical help more than the middle aged. As women with CID get older, they increase time spent in bed to maintain sleep time, but with resultant increase in wake. Support None

Presleep α-Lactalbumin Consumption Does Not Improve Sleep Quality or Time-Trial Performance in Cyclists

2020 ◽  
Vol 30 (3) ◽  
pp. 197-202
Author(s):  
Martin J. MacInnis ◽  
Christine E. Dziedzic ◽  
Emily Wood ◽  
Sara Y. Oikawa ◽  
Stuart M. Phillips
Keyword(s):  
Sleep Quality ◽  
Time Trial ◽  
Sleep Time ◽  
Cycle Ergometer ◽  
Crossover Designs ◽  
Double Blind ◽  
Female Age ◽  
Collagen Peptide ◽  
Time In Bed ◽  
Improve Sleep Quality

We tested the hypothesis that presleep consumption of α-lactalbumin (LA), a fraction of whey with a high abundance of tryptophan, would improve indices of sleep quality and time-trial (TT) performance in cyclists relative to an isonitrogenous collagen peptide (CP) supplement lacking tryptophan. Using randomized, double-blind, crossover designs, cyclists consumed either 40 g of LA or CP 2 hr prior to sleep. In Study 1, six elite male endurance track cyclists (age 23 ± 6 years, 70.2 ± 4.4 ml·kg−1·min−1) consumed a supplement for three consecutive evenings before each 4-km TT on a velodrome track, whereas in Study 2, six well-trained cyclists (one female; age 24 ± 5 years, 66.9 ± 8.3 ml·kg−1·min−1) consumed a supplement the evening before each 4-km TT on a stationary cycle ergometer. Indices of sleep quality were assessed with wrist-based actigraphy. There were no differences between the CP and LA supplements in terms of total time in bed, total sleep time, or sleep efficiency in Study 1 (LA: 568 ± 71 min, 503 ± 67 min, 88.3% ± 3.4%; CP: 546 ± 30 min, 479 ± 35 min, 87.8% ± 3.1%; p = .41, p = .32, p = .74, respectively) or Study 2 (LA: 519 ± 90 min, 450 ± 78 min, 87.2% ± 7.6%; CP: 536 ± 62 min, 467 ± 57 min, 87.3% ± 6.4%; p = .43, p = .44, p = .97, respectively). Similarly, time to complete the 4-km TT was unaffected by supplementation in Study 1 (LA: 274.9 ± 7.6 s; CP: 275.5 ± 7.2 s; p = .62) and Study 2 (LA: 344.3 ± 22.3 s; CP: 343.3 ± 23.0 s; p = .50). Thus, relative to CP, consuming LA 2 hr prior to sleep over 1–3 days did not improve actigraphy-based indices of sleep quality or 4-km TT performance in cyclists.

scholarly journals The Deleterious Effects of NCAA Division I Programs: A Comparison of the Current Activities of Student-Athletes of Two Different Division Schools Through the Prism of the Wellness Paradigm

2018 ◽  
Vol 3 (2) ◽  
pp. 76
Author(s):  
Andreas Stamatis ◽  
Zacharias Papadakis
Keyword(s):  
New York ◽  
Student Athletes ◽  
National Collegiate Athletic Association ◽  
Statistical Significance ◽  
Division I ◽  
Future Research ◽  
Division Iii ◽  
Collegiate Sports ◽  
Reported Data ◽  
Athletic Scholarship

The majority of American student-athletes participate in National Collegiate Athletic Association (NCAA) programs. Those programs are categorized into three different Divisions, which demonstrate differences in athletic scholarship support, level of competition, and philosophy. Among them, Division III (DIII) institutions account for the highest percentage of schools who play collegiate sports, followed by Division I (DI). Recent events and evidence on depression and suicide, anxiety, disordered eating and eating disorders, and substance use and abuse have raised awareness on mental health difficulties in this specific population of young adults. The purpose of this study is to add to the current state of knowledge by investigating whether there are differences in the promotion of a wellness lifestyle between a DI and a DIII university. Using an online interview created by Côté, Ericcson, and Law (2005) all student athletes from both Rice University (DI) and State University of New York (SUNY) at Plattsburgh (DIII) were recruited via email. Sixty-three participated from Rice and 90 from SUNY Plattsburgh. The response rate was 17% and 29%, respectively. Descriptive statistics and parametric tests were used in data analysis. By comparing these two case studies, differences with statistical significance were found in the current activities of sleeping, socializing, school/career, and studying. These differences infer that a DIII school may be promoting a wellness lifestyle more than a DI school. Possible limitations are the use of unequal samples and self-reported data. Future research on comparing more cases of different Division schools is recommended.

Assessing the impact of durable flooring structures on refugee sleep quality and duration

2018 ◽  
Vol 6 (1) ◽  
Author(s):  
Thomas James Greene ◽  
Christina Ann Chao
Keyword(s):  
Sleep Quality ◽  
Sleep Duration ◽  
Well Being ◽  
Baseline Survey ◽  
Future Research ◽  
Number Of Factors ◽  
Final Sample ◽  
The Impact

Conflict and persecution continue to displace people from their homes adding to an already overwhelming refugee crisis worldwide. Overall, refugee health is difficult to measure objectively and is influenced by a number of factors including transient, and often inadequate, housing conditions. Emergency Floor (EF) is a quickly deployable, lightweight, insulated flooring system intended to protect temporary structures from extreme temperatures and outdoor conditions. A pilot study was conducted in two informal tented settlements in Hermel-Baalbek, Lebanon to assess how installing Emergency Floors in tented shelters impacted sleep duration and quality, indicators of overall wellness, among refugees. A baseline survey was administered, and Emergency Floors were installed in all households in both settlements in October 2016. A follow-up survey was conducted to record outcomes in April 2017. Thirty-four households consisting of 150 individuals participated in the baseline survey. Seven households were were not available for follow-up survey due to moving away from the area. The final sample yielded a total of 27 households and 120 individuals. Results indicated that sleep duration significantly increased, and sleep quality significantly improved after EF installation. Furthermore, respondents reported feeling more comfortable, warmer, safer, and cleaner when sleeping in a shelter with EF installed. These encouraging results suggest an overall increase in perceived well-being. Future research should continue monitoring floors to assess long term wear and explore additional uses for EF in other temporary structures.

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