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Item Enhancing maternal sleep health in Aotearoa New Zealand: insights from the Wāhi Kōrero platform(Taylor and Francis Group on behalf of the Royal Society of New Zealand, 2025-07-03) Walsh Z; Muller D; Signal TL; Breheny M; Severinsen C; Ware F; Reweti AMaternal sleep health is crucial for maternal wellbeing, particularly maternal mental health which has implications for the wellbeing of children, families and whānau. In Aotearoa New Zealand, the Well Child Tamariki Ora (WCTO) service provides a unique opportunity to support mothers, their families, and whānau by providing education on sleep health for both mothers and children. However, there is a need for a deeper understanding of mothers' experiences with WCTO and the sleep information they receive to enhance these services. This primary research used data gathered from the Wāhi Kōrero online story-sharing platform, with 181 stories focusing specifically on sleep. Using thematic analysis, three key themes were identified: maternal instinct as a guide in navigating child sleep practices, promoting strength-based rather than deficit-focused approaches, and the necessity to move beyond rigid, monocultural service models. Findings underscore the importance of tailoring maternal and child health services to better meet the needs and perspectives of mothers, their families, and whānau, particularly in the areas of sleep and maternal mental health. Implications of findings for future policy and practice are discussed, including developing strength-based, culturally responsive approaches within services like WCTO, and adapting policy to support more flexible, whānau-centred models of care.Item Adolescents’ next-day perceptions of their sleep quality, quantity, sleepiness and sleepiness-related symptoms relative to actigraphy metrics(Elsevier B V, 2025-09-01) Tang C; Meredith-Jones K; Haszard JJ; Signal TL; Wickham S-R; Muller D; Taylor R; Galland BCBackground: Next-day perceptions of sleep and related symptoms are frequently collected in research and clinical practice, but how they correlate with objective sleep measures in adolescents has received little attention. Methods: Participants were aged 16–17 years and without a sleep disorder, anxiety or depression diagnosis. Seven-day wrist actigraphy was collected alongside daily survey ratings of sleep quality, sufficiency, morning and daytime sleepiness, and sleepiness-related mood and concentration. Within-person associations between daily actigraphic sleep metrics (6 variables representing quantity, quality and timing) and subjective ratings were estimated using mixed effects regression models with participant included as a random effect. Results: The sample comprised 71 adolescents (49 % female, 51 % male). No actigraphy metrics linked to sleep sufficiency ratings. Sleep onset was the strongest correlate of sleep quality and morning sleepiness in the expected direction e.g. every 10 min later onset led to a −1.4 point (95 % CI: −2.1, −0.7) drop in the sleep quality score (5-point scale, higher worse), but significant relationships were only in females. While actigraphic sleep quantity metrics were linked to several ratings, all effect sizes were marginal. Sleep quality metrics in the overall sample were not correlated to any ratings. Unexpectedly, timing and quantity metrics linked to sleepiness-related mood ratings, but in the opposite direction hypothesized. Conclusions: The lack of correlation between objective and subjective sleep quality add to the complexity of defining sleep quality accurately. Sleep onset timing, rarely explored in these types of studies emerged as an important correlate of sleep quality perception and other subjective ratings.Item Inequities in adolescent sleep health in Aotearoa New Zealand: Cross-sectional survey findings.(Published by Elsevier Inc. on behalf of National Sleep Foundation, 2024-06-22) Muller D; Signal TL; Shanthakumar M; Fleming T; Clark TC; Crengle S; Donkin L; Paine S-JOBJECTIVES: To investigate ethnic inequities in, and social determinants of, adolescent sleep health in Aotearoa New Zealand. METHODS: Analysis of self-report data from a cross-sectional survey of secondary school students (12- to 18-year-olds). Analyses included weighted prevalence estimates of good and poor sleep health stratified by ethnicity, and multivariable logistic regression models concurrently adjusted for ethnicity, school year, gender, rurality, neighborhood deprivation, school decile, housing deprivation, sleeping elsewhere due to lack of adequate housing, unsafe environment, and racism. RESULTS: Inequities in social determinants of health were evident for Māori (Indigenous peoples of Aotearoa New Zealand; n = 1528) and minoritized (Pacific n = 1204; Asian n = 1927; Middle Eastern, Latin American, and African [MELAA] n = 210; and 'Other' ethnicity n = 225) adolescents. A greater proportion of Māori, Pacific, Asian, MELAA, and 'Other' adolescents had short sleep, compared to European (n = 3070). Māori, Pacific, Asian, and MELAA adolescents were more likely to report late bedtimes (after midnight), and Māori, Pacific, and 'Other' adolescents were more likely to report early waketimes (5 AM-6 AM or earlier), on school days. Rurality, neighborhood deprivation, school-level deprivation, housing deprivation, sleeping elsewhere due to inadequate housing, unsafe environments, and racism partially, but not fully, explained associations between ethnicity and short sleep, late bedtimes, and early waketimes. CONCLUSIONS: Ethnic inequities exist in adolescent sleep health in Aotearoa New Zealand. Socio-political actions are needed to address racism and colonialism as root causes of ethnic inequities in adolescent sleep, to ensure all young people are afforded the basic human right of good sleep health and associated mental and physical well-being.Item Sleep inequities and associations between poor sleep and mental health for school-aged children: findings from the New Zealand Health Survey(Oxford University Press on behalf of Sleep Research Society, 2023-11-18) Muller D; Signal TL; Shanthakumar M; Paine S-JIn Aotearoa/New Zealand, ethnic inequities in sleep health exist for young children and adults and are largely explained by inequities in socioeconomic deprivation. Poor sleep is related to poor mental health for these age groups but whether sleep inequities and associations with mental health exist for school-aged children is unclear. We aimed to (1) determine the prevalence of poor sleep health including sleep problems by ethnicity, (2) examine social determinants of health associated with poor sleep, and (3) investigate relationships between poor sleep and mental health for 5-14-year-olds using cross-sectional New Zealand Health Survey data (n = 8895). Analyses included weighted prevalence estimates and multivariable logistic regression. Short sleep was more prevalent for Indigenous Māori (17.6%), Pacific (24.5%), and Asian (18.4%) children, and snoring/noisy breathing during sleep was more prevalent for Māori (29.4%) and Pacific (28.0%) children, compared to European/Other (short sleep 10.2%, snoring/noisy breathing 17.6%). Ethnicity and neighborhood socioeconomic deprivation were independently associated with short sleep and snoring/noisy breathing during sleep. Short sleep was associated with increased odds of anxiety, attention deficit hyperactivity disorder, and activity-limiting emotional and psychological conditions after adjusting for ethnicity, deprivation, age, and gender. In addition, long sleep was independently associated with increased odds of depression. These findings demonstrate that for school-aged children ethnic inequities in sleep exist, socioeconomic deprivation is associated with poor sleep, and poor sleep is associated with poor mental health. Sociopolitical action is imperative to tackle social inequities to support sleep equity and mental health across the lifecourse.Item Are New Zealand children meeting the Ministry of Health guidelines for sleep?(2020-08-01) Muller D; Signal TL; Santos-Fernandez E; McCarthy J; Carr H