0810 Impact of Schooling on the Measurement of Multidimensional Sleep Health in Adolescence

Abstract Introduction Multidimensional Sleep Health (MSH) is an emerging concept in sleep and circadian science that aims to capture the 24-hour experience of sleep and identify individuals in the population with good sleep health. While schooling is one of the most important contextual variables impacting adolescent sleep, little is known about how it impacts the measurement of MSH. In the present study, we examined differences in adolescent MSH while they were either in-school or on-break. Methods We studied 377 adolescents (16.4±2.3 yr; 46.4% female; 21.5% racial/ethnic minority) from the Penn State Child Cohort, a randomly-selected population-based sample, with 63% of the sample (n=236) in-school when sleep data were collected. We used the MSH RU-SATED framework – regularity, satisfaction, alertness, timing, efficiency, and duration – to derive a composite score of sleep health using actigraphy and self-reports. Results Adolescents in-school had a marginally (p=0.07) higher MSH score (3.12±1.2) than those on-break (2.87±1.4). Adolescents on-break were more likely to have optimal alertness (37.8% vs 31.8%, p 0.05) and duration (37.2% vs 61.5%, p 0.05), but less likely to have optimal timing (30.8% vs 61.8%, p 0.001) and efficiency (34.6% vs 50.9%, p 0.001) compared to those assessed while in-school. The differences observed in the timing and duration domains were driven by on-break adolescents mean sleep midpoint being more than an hour later than those in-school (4:42 am vs 3:36 am, p 0.001) and having a mean sleep efficiency slightly below the cut-off of 85% (84.3% vs 85.9%, p 0.05). Conclusion Accounting for contextual factors in adolescents, specifically whether they are attending school or not, is important for the measurement of MSH. Future work should derive cut-offs for optimal sleep health specific to adolescents as well as potentially include other timing dimensions beyond average sleep midpoint, such as social jetlag. Support (if any) NIH Awards Number R01HL136587, UL1TR000127