Study Objectives: Sleep disturbance is common in those who experience trauma. In a sample of nontreatment-seeking refugees, we examined the associations between trauma exposure, postmigration stress, sleep symptoms, and posttraumatic psychological symptoms. Methods: Syrian and Iraqi refugees (n = 86; 51% female; mean age = 45 years) residing in Australia were recruited from the local community. Cross-sectional descriptive design, multinominal regression analyses, and mediation analyses were used. Participants completed measures in Arabic assessing premigration trauma exposure, postmigration stress, sleep symptoms, and mental health. They also completed 7 days of sleep diaries and actigraphy. Results: We identified 34.9% of the participants as normal sleepers, 32.6% as probably having insomnia, and 32.6% as likely having insomnia. Variables associated with greater sleep disturbance (McFadden's R 2 = 0.57) included greater trauma exposure, increased time of resettlement, greater postmigration stress, and greater presleep arousal. The association of premigration trauma exposure to current posttraumatic symptoms was mediated sequentially by postmigration stress and sleep symptoms. Conclusions: Our findings highlight the extent of sleep disturbance in refugees. We found evidence for an indirect pathway between trauma exposure and posttraumatic symptoms through premigration stress and sleep (particularly presleep arousal). In the current global refugee crisis, improving the existing system of care in countries experiencing increased migration is critical. Because sleep disturbance is a modifiable condition associated with mental health, targeting sleep could be an important component of psychological interventions for refugees.
Objectives: Elite athletes are often required to travel across time zones for national and international competitions, causing frequent jet lag. The aim of this study was to examine whether the direction of travel-related jet lag is associated with performance in the National Basketball Association (NBA), and if so, to explore potential mechanisms.Methods: Ten seasons comprising of 11,481 games of NBA data from the 2011/2012 to the 2020/2021 regular season were analyzed using multi-level mixed models with one fixed factor (three levels; jet lag direction: eastward vs westward vs no jet lag) and three random factors (team, opponent, game time). Predicted circadian resynchronization rate was accounted for, and home and away games were analysed separately. Mediation analyses were performed to examine potential mechanisms.Results: Among home teams, eastward (but not westward) jet lag was associated with reduced winning (Δ (i.e., change) = −6.03%, p = 0.051, marginal), points differential (Δ = −1.29 points, p = 0.015), rebound differential (Δ = −1.29 rebounds, p < 0.0001), and effective field goal percentage differential (Δ = −1.2%, p < 0.01). As the magnitude of eastward jet lag increased, home team points differential decreased (2 h Δ = −4.53 points, p < 0.05; 1 h Δ = −0.72 points, p = 0.07). No significant associations were found between jet lag and away team performance.Conclusion: Eastward jet lag was associated with impaired performance for home (but not away) teams. Sleep and circadian disruption associated with advancing phase following eastward travel may have significant adverse consequences on performance in the NBA, particularly when recovery time is limited. Sports organisations could consider chronobiology-informed scheduling and interventions to maximise recovery and performance of their athletes.
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