Does sleep education change sleep parameters? Comparing sleep education trials for middle school students in Australia and New Zealand

Background: Adolescents suffer daytime consequences from sleep loss. Sleep education programs have been developed in an attempt to increase sleep knowledge and/or duration. This paper presents data from three trials of the Aus-tralian Centre for Education in Sleep (ACES) program for adolescents.

Methods: The ACES program was delivered to 69 Australian adolescents in a pre-post cross-sectional design (mean age 15.2) and 29 New Zealand adolescents in a randomised control trial (mean age 14.8 years). Assessments in sleep parame-ters were undertaken at baseline and post intervention.

Results: Where sleep knowledge was evaluated (Australian trials), significant improvements were shown in all trials (All p <0.05). Where sleep duration was assessed (New Zealand trial) significant improvements were found in week and weekend sleep duration [F(1, 27)=4.26, p=0.04). Both, students and teachers found the program feasible, interesting, and educational.

Conclusions: ACES sleep education programmes can improve both sleep knowledge and sleep duration in adolescents. Improving the programme so sleep knowledge attained equates to actual sleep behaviour change are areas for future direc-tion. Collectively these findings provide encouraging signs that adolescents can improve their sleep knowledge and behav-iour with sleep education which bodes well for sleep-related health and psycho-social issues.

Increasing BMI was associated with increasing risk for overall cancer incidence and mortality in middle-aged women

Question: In middle-aged women, what is the association between body mass index (BMI) and cancer incidence and mortality?METHODSDesign: Prospective cohort study with mean follow-up of 5.4 years for cancer incidence and 7.0 years for cancer mortality.Setting: Population-based study in England and Scotland, United Kingdom.Patients: 1 222 630 women 55 to 64 years of age (mean 56 y) who had no history of cancer at baseline.Risk factors: BMI at baseline, divided into 5 categories (< 22.5, 22.5 to 24.9, 25.0 to 27.4, 27.5 to 29.9, and ≥ 30 kg/m2).Outcomes: Cancer incidence and mortality, overall and for 17 specific types of cancer, identified through linkage with the National Health Service central registers.Main results: Increasing BMI was associated with increasing risks for all cancers, endometrial cancer, esophageal adenocarcinoma, kidney cancer, leukemia, postmenopausal breast cancer, multiple myeloma, pancreatic cancer, non-Hodgkin lymphoma, and ovarian cancer; and with decreasing risks for esophageal squamous cell carcinoma, lung cancer, and premenopausal breast cancer (Table). Risks for stomach, colorectal, cervical, bladder, and brain cancer and malignant melanoma did not vary by BMI. Patterns for cancer mortality were similar to those for cancer incidence: Relative risk for death from any type of cancer was 1.06 (95% CI 1.02 to 1.10) per 10-unit increase in BMI. In postmenopausal women, the estimated proportion of cancer attributable to being overweight or obese (BMI ≥ 25 kg/m2) was 5% for all cancers and about 50% for endometrial cancer and esophageal adenocarcinoma.Conclusions: In middle-aged women, increasing body mass index was associated with increasing risk for cancer incidence and mortality overall. High body mass index increased risk for some types of cancer but reduced risk for other types.