Person: Phillips, Andrew J. K.
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Publication Irregular sleep/wake patterns are associated with poorer academic performance and delayed circadian and sleep/wake timing
(Nature Publishing Group UK, 2017) Phillips, Andrew J. K.; Clerx, William M.; O’Brien, Conor S.; Sano, Akane; Barger, Laura; Picard, Rosalind W.; Lockley, Steven; Klerman, Elizabeth; Czeisler, CharlesThe association of irregular sleep schedules with circadian timing and academic performance has not been systematically examined. We studied 61 undergraduates for 30 days using sleep diaries, and quantified sleep regularity using a novel metric, the sleep regularity index (SRI). In the most and least regular quintiles, circadian phase and light exposure were assessed using salivary dim-light melatonin onset (DLMO) and wrist-worn photometry, respectively. DLMO occurred later (00:08 ± 1:54 vs. 21:32 ± 1:48; p < 0.003); the daily sleep propensity rhythm peaked later (06:33 ± 0:19 vs. 04:45 ± 0:11; p < 0.005); and light rhythms had lower amplitude (102 ± 19 lux vs. 179 ± 29 lux; p < 0.005) in Irregular compared to Regular sleepers. A mathematical model of the circadian pacemaker and its response to light was used to demonstrate that Irregular vs. Regular group differences in circadian timing were likely primarily due to their different patterns of light exposure. A positive correlation (r = 0.37; p < 0.004) between academic performance and SRI was observed. These findings show that irregular sleep and light exposure patterns in college students are associated with delayed circadian rhythms and lower academic performance. Moreover, the modeling results reveal that light-based interventions may be therapeutically effective in improving sleep regularity in this population.
Publication Behaviorally-determined sleep phenotypes are robustly associated with adaptive functioning in individuals with low functioning autism
(Nature Publishing Group UK, 2017) Cohen, Simonne; Fulcher, Ben D.; Rajaratnam, Shantha M. W.; Conduit, Russell; Sullivan, Jason P.; Hilaire, Melissa A. St; Phillips, Andrew J. K.; Loddenkemper, Tobias; Kothare, Sanjeev V.; McConnell, Kelly; Ahearn, William; Braga-Kenyon, Paula; Shlesinger, Andrew; Potter, Jacqueline; Bird, Frank; Cornish, Kim M.; Lockley, StevenDespite sleep disturbance being a common complaint in individuals with autism, specific sleep phenotypes and their relationship to adaptive functioning have yet to be identified. This study used cluster analysis to find distinct sleep patterns and relate them to independent measures of adaptive functioning in individuals with autism. Approximately 50,000 nights of care-giver sleep/wake logs were collected on school-days for 106 individuals with low functioning autism (87 boys, 14.77 ± 3.11 years) for 0.5–6 years (2.2 ± 1.5 years) from two residential schools. Using hierarchical cluster analysis, performed on summary statistics of each individual across their recording duration, two clusters of individuals with clearly distinguishable sleep phenotypes were found. The groups were summarized as ‘unstable’ sleepers (cluster 1, n = 41) and ‘stable’ sleepers (cluster 2, n = 65), with the former exhibiting reduced sleep duration, earlier sleep offset, and less stability in sleep timing. The sleep clusters displayed significant differences in properties that were not used for clustering, such as intellectual functioning, communication, and socialization, demonstrating that sleep phenotypes are associated with symptom severity in individuals with autism. This study provides foundational evidence for profiling and targeting sleep as a standard part of therapeutic intervention in individuals with autism.