bluuebunny/crossref_metadata_2025 huggingface dataset:
0142 Too tired to sleep: A social-ecological exploration of insomnia in Appalachian women
Authors: Moloney Mairead , Badour Christal , Moga Daniela , Schoenberg Nancy
Published: May 2023

Introduction

Appalachian Kentucky contains numerous “hotspots” of insufficient sleep where 25-58% of adults report insufficient sleep 15+/30 nights. Insomnia, a leading cause of insufficient sleep, is present at higher-than-average rates among the NIH-designed health disparity population of Appalachian adults. Given the strong, bi-directional relationship between sleep and health, a better understanding of insomnia in this population is critical. This study focuses on the gender (women) and age group (45+) at highest risk of insomnia and builds on previous qualitative work exploring the intersections of gender and sleep.

Methods

Participants (N=46) were Appalachian females ages 45+ who self-reported difficulty falling/staying asleep ≥3 nights a week for ≥3 months and used prescription or over-the-counter sleep aids ≥3 months. Semi-structured telephone interviews were recorded with permission and professionally transcribed. The social-ecological model of sleep served as an interpretive framework. We used a multi-stage, inductive coding process informed by grounded theory and aided by NVIVO 12.0 software.

Results

Participants most commonly cited social-level issues as insomnia-initiating and perpetuating factors. Caregiving, loss of loved ones, and trauma were prevalent, and often experienced simultaneously. For instance, the death of a child resulted in several participants raising their grandchildren. Caregiving stress, and bed-sharing with, grandchildren perpetuated insomnia. Regional and societal norms (e.g., kinship and gender norms) exacerbated participants’ stressors. Secondarily, women cited a combination of individual-level (e.g., menopause) and/or societal-level (e.g., using technology before bed) insomnia factors.

Conclusion

Our findings illuminate social processes, social structures, and individual-level factors that contribute to the initiation and perpetuation of insomnia among middle-aged Appalachian women. Our data support previous findings that women in this region are more likely than their non-Appalachian peers to raise their grandchildren, while highlighting this kinship arrangement’s insomnia contributions. These insights may aid health care providers and policy makers aiming to address sleep disparities among the health disparity population of rural Appalachian women.

Support (if any)

Building Interdisciplinary Research Careers in Women's Health Program (NIDA K12DA035150); Igniting Research Collaborations Grant (University of Kentucky [UK] College of Pharmacy); UK Center for Clinical and Translational Sciences (UL1TROO1998).
0143 Trait Emotion Reactivity Predicts Change in Negative but Not Positive Affect During Total Sleep Deprivation
Authors: Kurinec Courtney , Proctor Matteya , Stenson Anthony , Whitney Paul , Hinson John , Van Dongen Hans
Published: May 2023

Introduction

During laboratory-based, voluntary exposure to total sleep deprivation (TSD), relatively large decreases in positive mood and relatively small increases in negative mood have been observed, with the magnitudes of change varying across individuals. People differ in their trait emotion reactivity, i.e., their sensitivity to emotion-evoking stimuli or events. As higher reactivity is associated with greater difficulty regulating emotion, we hypothesized this trait could moderate mood changes during TSD.

Methods

N=96 healthy adults (ages 21-38, 47% female) participated in one of three 4-day/3-night in-laboratory TSD studies. In each study, after 10h baseline sleep, participants were exposed to 38h TSD, followed by 10h recovery sleep. Participants completed the Emotion Reactivity Scale (ERS), and their self-reported affect was assessed every 2-4h during wake using the Positive and Negative Affect Schedule (PANAS). The 11 test bouts during TSD shared across studies were included in analyses (day 2: 09:00, 13:00, 21:00, 23:00; day 3: 01:00, 03:00, 05:00, 07:00, 09:00, 13:00, 21:00). Positive and negative affect ratings were analyzed with linear mixed-effects regression with fixed effects of test bout (categorical), ERS score (continuous), and their interaction, covariates for study, sex, and age, and a random intercept over participants.

Results

Participants showed the expected decrease in positive affect as a function of test bout (time awake and time of day, p< 0.001), and a smaller, non-significant increase in negative affect (p=0.17). Higher ERS scores were associated with increased negative affect during TSD (p=0.002), but this effect was small, and negative affect showed a floor effect. Emotion reactivity was not a significant predictor of decreased positive affect during TSD (p=0.97).

Conclusion

As hypothesized, emotion reactivity predicted individual variability in negative affect during TSD, but unexpectedly it did not predict the decrease in positive affect associated with TSD. This suggests that the trait measured by the ERS may be biased toward negative affect, and/or that positive affective changes may be more difficult to predict during the low arousal state induced by TSD. Studies inducing greater variability in negative affect during TSD (e.g., through exposure to a stressor) are needed to confirm our findings.

Support (if any)

NIH CA167691, ONR N00014-13-1-0302, and CDMRP W81XWH-16-1-0319 and W81XWH-20-1-0442.
0145 Associations Among Childhood Stress, Actigraphy-Measured Sleep Efficiency, and Fasting Glucose Concentrations in Young Adults
Authors: Hart Thomas , Schwager Laura , Zucker Anna , Flores Mark , Moon Chooza , Thomas Emily , Jenkins Nathaniel
Published: May 2023

Introduction

Psychosocial stress exposure during the first 18 years of life promotes adverse sleep and cardiometabolic health effects. The purpose of the study was to investigate the relationships between childhood stress (CS), sleep efficiency (SE), and fasting glucose levels (FG) in young adulthood.

Methods

In 24 adults between the ages of 18 and 35 years (83% Female; mean±SD, age = 24±5 y), CS was assessed using a retrospective childhood stress assessment and averaged across reference ages of 5, 10, and 15 years old. FG concentrations were obtained from whole blood samples and SE was assessed using an actigraphy device (ActTrust2) worn on the wrist for 7 days, yielding ≥6 days of sleep data. Zero-order correlations were used to investigate the relationships among CS, SE, and FG. Multiple linear regression analyses were used to examine the effect of CS and SE on FG controlling for sex. To explore preliminary indications of a mechanistic effect of SE on the link between CS and FG, ANCOVA analysis was used. Participants were grouped as either low CS (CS-low) or high CS (CS-high), and analyses were completed with sex as the only covariate and sex and SE as covariates, with FG as the outcome.

Results

CS was associated with FG (r=0.50, p=0.01) and SE (r=-0.41, p=0.47), and SE with FG (r=-0.45, p=0.03). The association of CS with FG (β=0.51, p=0.016) and SE (β=-0.43, p=0.046) remained with adjustment for sex. ANCOVA analyses confirmed the effect of CS on FG, where FG was higher in CS-high than CS-low with adjustment for sex (92.4±4.8 vs. 83.6±5.4 mg/dL; p=0.008). Additional adjustment for SE reduced the difference between CS-high and CS-low, but this difference remained significant (91.6±5.0 vs. 84.5±5.5 mg/dL; p=0.044).

Conclusion

CS is linked with elevated FG and low SE in young adults. Our preliminary data suggest that SE warrants further examination as a potential mechanism by which CS relates to FG, but larger sample sizes will be necessary to draw definitive conclusions.

Support (if any)

Research reported in this publication was supported in part by the NCATS of the NIH (UL1TR002537) and by the Injury Prevention Research Center through the CDC (R49 CE003095).
0149 Emotion Dysregulation and Sleep Disturbances in Trauma-Exposed College Students
Authors: Clark Jayne , Anderson Shayla , Messman Brett , Griffith Elizabeth , Briggs Madasen , Slavish Danica
Published: May 2023

Introduction

Trauma-exposed individuals are at risk of developing symptoms of posttraumatic stress disorder (PTSD), which has been linked to both sleep disturbances and sleep-related daytime impairment. A growing body of literature suggests affective processes, such as negative and positive emotion regulation, may influence associations between PTSD and sleep. Therefore, our study aimed to examine if there was a direct effect of negative and positive emotion dysregulation on sleep disturbances and sleep-related impairment above the influence of PTSD symptoms.

Methods

Participants were 460 trauma-exposed college students (69.8% female; 62.0% White; Mage = 20.13 ± 2.94) recruited from the University of North Texas. Trauma exposure was assessed with the Life Events Checklist for DSM-5. Participants completed demographic questionnaires, the PTSD Checklist for DSM-5 (excluding sleep-related questions), the Difficulties in Emotion Regulation Scale (DERS-16), the Difficulties in Emotion Regulation – Positive (DERS-P), the PROMIS Sleep Disturbance (PROMIS-SD), and Sleep-Related Impairment (PROMIS-SRI) Short Forms. Multiple regression models with robust standard errors were conducted to examine associations between both positive and negative emotion dysregulation on sleep disturbances and sleep-related impairment, covarying for PTSD symptoms, age, gender, race, and ethnicity.

Results

Greater negative emotion dysregulation was associated with greater sleep disturbances (b = 0.06, SE = 0.03, p = .015, ηp2 = 0.01) above the influence of positive emotion dysregulation, PTSD symptoms, age, gender, race, and ethnicity (R2 = 0.28). Greater negative emotion dysregulation was also associated with greater sleep-related impairments (b = 0.20, SE = 0.03, p < .001, ηp2 = 0.08) above the influence of the same covariates (R2 = 0.31). Positive emotion dysregulation was not associated with sleep disturbances or sleep-related impairments.

Conclusion

Results suggest that more difficulty regulating negative emotions is linked to disturbed sleep among trauma-exposed individuals. Additional experimental work is needed to understand if regulating negative emotions via cognitive-behavioral strategies (e.g., mindfulness, cognitive restructuring) can lead to downstream improvements in sleep.

Support (if any)
0151 Modulating Emotion Regulation and the Late Positive Potential ERP Component through Sleep Extension
Authors: Kurdziel Laura , Seitchik Allison
Published: May 2023

Introduction

Sleep deprivation and poor sleep quality reduces functional connectivity between prefrontal cortical networks and the amygdala, thus causing emotional dysregulation. In contrast, sleep extension in the form of napping has been shown to impact emotional memory consolidation and emotional reactivity. To date, however, the role of napping in adult emotion regulation has yet to be determined. We hypothesize that sleep extension in the form of a nap will improve emotion regulation abilities in healthy adults.

Methods

In this within-subjects design, participants completed an emotion regulation task following either a nap or an equivalent bout of wake time (separated by ~1 week, order counterbalanced). In the task, participants were shown negative and neutral IAPS pictures, and were instructed to suppress, maintain, or enhance their emotional experience. During the task, the late positive potential was assessed at Pz, a component that may reflect downstream neurobiological effects of amygdala activation.

Results

Participants were able to use the cognitive reappraisal strategy to alter their emotional valence (F(2,14)= 17.781, p< 0.001, η2=0.718) and arousal (F(2,14),=36.995, p< 0.001, η2=0.841) according to the instructions. While not significant due to small sample size, participants showed greater mean amplitude in the late LPP component (1,900-3,000ms) for negative images compared to neutral images (F(1,5)=3.165, p=0.135, η2=0.367), and in the wake condition compared to the nap condition (F(1,5)=2.894, p=0.150, η2=0.388). Following instructions, there was a non-significant interaction between condition and the maintain and suppress instructions (F(1,5)=2.357, p=0.185, η2=0.320); compared to the nap condition, in the wake condition participants averaged greater mean amplitude of the LPP (300-5,000ms) in the suppress condition.

Conclusion

Data from this study followed predicted directions that sleep extension in the form of a nap may help to improve emotion regulation by increasing top-down control of amygdalar activation.

Support (if any)

This work was supported by the Merrimack College Zampell Family Faculty Fellowship, and the Merrimack College START Program.
0152 Natural disaster experiences and their varying impact on sleep impairment
Authors: Myers Annika , Vieira Alyssa , Kim Jinu , Cifre Anthony , Rech Megan , Gonzalez Rogelio , Alfano Candice
Published: May 2023

Introduction

As rates and severity of natural disasters increase due to climate change, it is crucial to consider their effects on mental health. Among Hurricane Katrina survivors, stressors experienced following the Hurricane, including financial losses, were more robustly predictive of rates of PTSD than traumatic experiences occurring during the Hurricane (Galea et al., 2008). Because sleep disturbance is intimately associated with trauma exposure and has been implicated in the etiology of PTSD, we examined relationships between experiences during and after Hurricane Harvey (a historic storm that hit Texas in 2017) and sleep disturbance in sample of college students impacted by the storm.

Methods

Undergraduate students (N = 191, age: M = 21.25, SD = 3.14) at the University of Houston completed online surveys 6-8 months after Hurricane Harvey. Sleep quality was measured using the Pittsburg Sleep Quality Index (PSQI) and post-traumatic stress (PTS) symptoms were measured using the PTSD Checklist for DSM-5, excluding sleep items. Participants also reported on experiences/events during, immediately after, and in the weeks/months following the Hurricane. Total traumatic experiences during the Hurricane (e.g., thinking oneself or others would get hurt or die) and stressful experiences after the storm (e.g., losing power, damage to car or property) were calculated. Financial stress was examined as a unique predictor. Analyses controlled for total traumatic life events measured with the Life Events Checklist for DSM-5.

Results

In a multiple linear regression model, we tested whether traumatic experiences during, stressors after, and financial stressors due to the Hurricane predicted global PSQI score, controlling for other traumatic life experiences and total PTS symptoms. The overall model was significant (R2 = 0.22, F (5,185) = 10.48, p < .000). Traumatic experiences during the Hurricane (B = 0.37, p = 0.04), but not stressors (B = 0.02, p = 0.87) or financial stress (B = -0.29, p = 0.67) following the Hurricane significantly predicted poor sleep quality at present.

Conclusion

Our findings suggest that among a sample of young adult college students impacted by Hurricane Harvey, traumatic experiences during the storm were the most robust predictor of sleep disturbance several months later even after accounting for PTS symptoms.

Support (if any)
0153 Overcommitment to work impacts the relationship between effort-reward imbalance and insomnia differently for physicians and nurses
Authors: Gustavsson Katarzyna , Smułek Daria , Wichniak Adam
Published: May 2023

Introduction

Occupational stress is a predictor of sleep problems. Recovery from it by detaching yourself from work-related issues outside of work hours is crucial for sleep health. Shift workers, especially in healthcare, are at a higher risk of sleep problems, which may lead to fatigue and errors at work, impacting patient care. The aim of the study was to 1) verify whether overcommitment to work is a moderator of the relationship between occupational stress and insomnia symptoms, and 2) check if this moderation is impacted by an individual’s occupation – whether overcommitment impacts the relationship of occupational stress and insomnia symptoms the same way for the two biggest occupational groups in healthcare in Poland - physicians and nurses.

Methods

Participants provided information on their occupation and filled in the Effort-Reward Imbalance questionnaire (ERI) with the Overcommitment (OC) scale, and the Insomnia Severity Index (ISI). Using the PROCESS macro for SPSS, we conducted a moderated regression analysis to test a multiple moderation (Model 3).

Results

We gathered responses from 281 participants – 178 physicians and 103 nurses. The interaction of ERI and OC was not significant, but a three-way interaction (ERI*OC*occupation) was significant in predicting ISI score. The relationship between ERI and ISI was moderated by OC depending on a respondent’s occupation. For physicians as OC increased the relationship between ERI and ISI increased as well. For nurses as OC increased the relationship between ERI and ISI decreased.

Conclusion

This study showed that stress at work has the strongest relationship with insomnia when physicians ruminate over work problems, are easily overwhelmed with time pressure and are unable to unwind in their free time. However, when nurses obtain high scores on an overcommitment measure, they will experience sleep problems regardless of the level of occupational stress.

Support (if any)

This work was supported by the National Science Center in Poland under Grant 2019/33/N/HS6/02572.
0161 Structural Changes in Mood Domains During Sleep Deprivation and Recovery
Authors: Vattikuti Shashaank , Doty Tracy Jill , Balkin Thomas , Hughes John
Published: May 2023

Introduction

Mood is known to vary as a function of sleep debt. Mood batteries often measure multiple, non-orthogonal domains. In the present study, the latent structure of the Automated Neuropsychological Assessment Metrics Mood (ANAM-mood) battery was assessed during five different states of alertness. We present a novel scheme to evaluate changes in the structure of such batteries across conditions. It was hypothesized that the structure would change, with the greatest changes manifest during sleep deprivation.

Methods

The present analyses were conducted on data from a prior sleep deprivation study (n = 25 healthy young adults). We used the identity property of MANOVA. Given correlation matrices Σi and Σj, structural invariance was defined as Σi Σj-1 ≈ I (Identity). MANOVA statistic m was the largest eigenvalue of Σi Σj-1. Resampling was used to generate m-distributions within and between the five different alertness conditions - Rested, Sleep Deprived (SD) days 1 and 2, and Recovery days 1 and 2. In addition, the relative number of mood dimensions was estimated by the odds (via resampling) of two dimensions explaining 80% of the variance of Σi compared to Σj.

Results

The pairwise MANOVA-statistic revealed significant structural variations across conditions (p< 0.001 for all comparisons). Significant differences included Rested vs SD1 and SD2. Recovery 1 showed the most pronounced differences to all conditions. Recovery 2 was like Recovery 1, but more like Rested than the prior day. The odds ratio of two-dimensions for Recovery 1 was much higher compared to all other conditions (OR: 2.4-245, p< 0.001).

Conclusion

Individuals respond differently to a mood survey across specific alertness conditions resulting in structural changes to the data. Wakefulness during recovery from severe sleep loss differs most significantly from all states, contrary to our hypothesis. This is important to consider when interpreting mood changes as measured by such batteries (including related Spielberger's State Anxiety Inventory and Beck Depression Inventory-II) during sleep studies. Follow up studies are needed to fully assess such effects and devise methods to account for them.

Support (if any)

This effort was fully supported by the Department of Defense Military Operational Medicine Research Program (MOMRP).
0163 Impact of cold-water hand immersion on cognitive performance and sleepiness during sleep inertia
Authors: Adkins Matthew , Cox Rebecca , Axelsson John , Wright Kenneth
Published: May 2023

Introduction

Sleep inertia is a state of impaired cognitive performance upon awakening that dissipates with time awake. Manipulation of the distal-to-proximal skin temperature gradient using cold water has been hypothesized as a potential countermeasure to sleep inertia, but not previously explored (Krauchi et al., 2004). This study examined the effects of cold-water hand immersion on subsequent cognitive performance and sleepiness during sleep inertia.

Methods

Ten healthy adults (mean±standard deviation [SD] age 23.2±4.96 years; 6M, 4F) have thus far completed an ongoing 8-day protocol. Prior to an overnight in-laboratory visit, participants maintained habitual 8h sleep schedules for 1 week at home. In-laboratory sleep opportunities were timed to coincide with habitual sleep time. Following at least 5-min of electroencephalogram (EEG) verified continuous slow wave sleep (SWS), participants were awakened twice during the night to submerge their non-dominant hand in warm (34 C) or ice-cold water (0 C) for 3 min in a randomized, crossover design. Sleep inertia was assessed with a Mathematical Addition Test (ADD) and the Karolinska Sleepiness Scale (KSS) at ~ 5, 15, and 25 min after each awakening. Outcomes included number of correct responses and median reaction time for correct responses on the ADD and KSS scores. Data were analyzed with mixed-model ANOVA with condition, condition order and time since awakening as fixed factors and subject as a random factor.

Results

The average (Mean±SD) amount of SWS prior awakening was similar before the cold 7.0±2.3 min and warm 6.6±1.0min conditions (p>0.10). Following cold water immersion, subjective sleepiness was reduced and the median reaction time for correct responses was faster compared with warm water immersion (main effects of condition, p’s< 0.05). The number of correct responses was not significantly different between conditions, nor were there any significant interaction effects among the fixed factors.

Conclusion

These preliminary findings indicate that cold-water hand immersion may reduce sleepiness and increase the speed of arithmetic calculations during sleep inertia, which could have important implications for military and first responders performing after awakenings from sleep.

Support (if any)

Office of Naval Research MURI N00014-15-1-2809; NIH RHL165343A and CTSA Grant UL1 TR002535; Undergraduate Research Opportunities Grant, University of Colorado Boulder.
0168 The Role of Alertness (vs. Fatigue) in the Performance of Professional Criminal Investigators
Authors: Krizan Zlatan , Miller Anthony , Meissner Christian
Published: May 2023

Introduction

Investigative interviews and interrogations are a critical component of official inquiries. However, how levels of alertness (vs. fatigue) of the interviewer impact performance during investigative interviews or their outcomes is unclear. To this end, the current effort aimed to estimate the impact of objectively estimated alertness on (1) deception detection across true and false alibi statements and (2) outcomes of real-life investigative interviews conducted by officers in the field.

Methods

To achieve the first goal, sets of 8 video-recorded alibi statements (each from a different individual, with half being true) were presented to 26 law-enforcement professionals (average age of 42, two-thirds male). Prior to judging the alibi statements on truthfulness, they completed the 5-min Psychomotor Vigilance Test and rated their sleepiness. To achieve the second goal, another study tracked daily fluctuations in alertness among investigators to predict their experiences with actual field interviews. Fifty law-enforcement investigators (mean age 42, 75% male) wore a sleep-activity tracker (Readiband) for two weeks while keeping a daily-diary of interviews conducted in the field. For each interview, the investigators indicated (a) how well they established rapport with the subject, (b) how much resistance they encountered, (c) how well they maintained their own focus and composure, and (d) the overall utility of evidence obtained. Readiband-generated estimates of daily fatigue were used to predict daily interview outcomes.

Results

First, when judging alibis’ credibility, officer’s alertness was a strong predictor of lie-detection performance. Specifically, officers who were better at detecting deception across alibi statements were more objectively alert, indicated by faster reaction times (r = .52) and fewer attentional lapses (r = -.67). This better detection performance was largely accounted by stronger skepticism of actual lies. Second, Investigators from the field-interviewing study consistently reported more difficulties maintaining their focus and composure during interviews on days with lower alertness, as well as indicated more subject resistance and less rapport.

Conclusion

The findings suggest fatigue among criminal investigators (and underlying sleep disruption) is an important factor for how actual law-enforcement field interviews unfold. The findings implicate adequate sleep as a modifiable fitness factor for criminal investigators.

Support (if any)

Federal Bureau of Investigation Contract #15F06718C000253
0172 Canadian varsity athletes’ sleep and mental health: preliminary analyses
Authors: Duval Félix Gabriel , Imbeault Pascal , Bourgon Vincent , Forest Geneviève
Published: May 2023

Introduction

Because of their double reality of university student and athlete, varsity athletes are particularly at risk of having sleep difficulties, but also depression and anxiety symptoms. To this day, there is almost no data available characterizing the sleep of Canadian varsity student-athletes, while these athletes must often combine their studies and sports practice with a job to support themselves. As part of a larger study, the aim of the present study was to investigate the relationship between sleep and well-being in young Canadian varsity athletes at the beginning of their sports season.

Methods

A team of 16 Canadian varsity basketball players that will undergo a sleep management program completed a modified version of the Pittsburgh Sleep Index Quality (PSQI), the insomnia severity index (ISI), the Epworth Sleepiness Scale (ESS), the Generalized Anxiety Disorder-7 (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), and the Athlete Burnout Questionnaire (ABQ) before the intervention at the start of the season. The relationships between scores on each well-being questionnaire and scores on the sleep questionnaires were investigated using Pearson product moment correlations.

Results

Total GAD-7 scores were significantly associated with PSQI scores (r=.666, p=.005) and ISI scores (r=.755, p<.001). Total PHQ-9 scores were significantly associated with PSQI scores (r=.844, p<.001) and ISI scores (r=.855, p<.001). Total ABQ scores were significantly associated with PSQI scores (r=.592, p=.016). There was no other significant correlation found.

Conclusion

These preliminary results suggest that sleep disturbances, such as insomnia symptoms and poor sleep quality are closely associated with anxiety, depression, and athlete burnout symptoms in varsity athletes. Future analyses of this study will allow us to verify whether participation in a program aimed at improving sleep can have an impact on their mental health, as well as on other aspects related to the practice of their sport.

Support (if any)
0174 Patterns of sleep habits and their impact on nighttime sleep quality in college students
Authors: Zhong Jie , Katigbak Carina , Gregas Matthew , Ye Lichuan
Published: May 2023

Introduction

Poor sleep quality is common in college student. Unhealthy sleep habits (e.g., delayed bedtime, inconsistent sleep routine between schooldays and weekends) could lead to poor sleep quality, which is associated with poor academic performance, mental and physical health. However, little is known about the patterns of sleep habits in terms of timing and consistency and their impact on nighttime sleep quality in college students.

Methods

This was a cross-sectional anonymous web-based survey to examine sleep in college students. The Classification and Regression Tree (C&RT) was used to identify distinct patterns based on sleep habits including bedtime and wake-up time (usual, schooldays, and weekends), and consistency of bedtime, wake-up time, and duration between schooldays and weekends. The response variable was nighttime sleep quality measured by the Pittsburgh Sleep Quality Index (PSQI) global score. The imputed PSQI global score was used to minimize missing data.

Results

A total of 439 students participated in this survey, with a response rate at 22%. Four distinct clusters were identified. Both Cluster 1 (37.8%) and Cluster 2 (10.9%) included participants who reported a difference in sleep duration between schooldays and weekends < 1.75 hours, with Cluster 1 reporting a usual bedtime before 1:45AM while Cluster 2 after 1:45AM. Both Cluster 3 (3.4%) and Cluster 4 (47.8%) included participants who reported a difference in sleep duration between schooldays and weekends ≥ 1.75 hours, with Cluster 3 reporting school-day wake-up time before 7AM while Cluster 4 after 7AM. Among the four clusters, participants in Cluster 3 (late riser with inconsistent schooldays-weekends duration) had the worst sleep quality (8.95±3.43), followed by Cluster 2 (late sleeper with consistent schooldays-weekends duration, 6.98±2.79) and Cluster 4 (late riser with inconsistent schooldays-weekends duration, 6.83±2.87). Cluster 1 (“early” sleepers with consistent schooldays-weekends duration) had the best sleep quality among all (5.61±2.54).

Conclusion

Distinct patterns of sleep timing and consistency can have significant impact on sleep quality, with some habits such as extremely late bedtime and inconsistent sleep duration between schooldays and weekends had the most negative impact. Tailoring interventions targeting these unhealthy sleep habits are needed in promoting sleep in this population.

Support (if any)

None
0176 Predictors of sleep duration among university students in Japan: Cross-cultural insights for developing sleep health interventions
Authors: Eakman Aaron , Kawakatsu Yuki , Takahata Miki , Muraoka Shuhei , Kudo Daisuke , Satake Shinji , Sato Toshiaki
Published: May 2023

Introduction

Inadequate sleep among university students, especially in Japan, contributes to low academic performance and mental health challenges. Sleep health, including adequate sleep duration and quality, may serve a protective role in promoting performance and full participation in daily life. We sought to identify factors explaining sleep duration in Japanese college students as potential targets for culturally sensitive sleep health promoting intervention.

Methods

Cross-sectional descriptive study of university students in Japan in 2021; N = 362 completed validated Japanese versions of the Pittsburg Sleep Quality Index (PSQI), Morningness and Eveningness Questionnaire, Sleep Hygiene Practice Scale, and Dysfunctional Beliefs and Attitudes about Sleep. Indicators of sleep and PSQI subscales (except sleep duration), personality, depression, anxiety, time use, and participation quality were included in multivariate logistic regression modeling to explain less healthy (6 hours or less) versus healthier (more than 6 hours) sleep duration.

Results

Students were 20.0 (SD = 1.3) years, 86.4% female with a mean sleep duration of 400 (SD = 67) minutes. The mean PSQI score was 4.8 (SD = 2.5) indicating good sleep quality, though 41.4% of the sample reported sleeping 6 hours or less and these persons had lower sleep quality (PSQI; d = 1.20) compared to longer sleepers. Logistic regression explained category assignment (Chi-square = 68.978, df = 8, p <.001; Nagelkerke R-squared = .234). Longer sleepers were more likely to report greater sleep efficiency, less frequent sleep disturbances, lesser daytime dysfunction, shorter commuting times, a morning-like chronotype, greater participation quality, and a less agreeable personality type. Interestingly, longer sleepers reported less effective sleep hygiene practices.

Conclusion

Short sleep was common and associated with poor sleep quality. Longer sleepers were more likely to report optimal sleep health indicators and greater participation quality (i.e. engagement in meaningful activities). Counter-intuitive sleep hygiene findings indicate potential cultural variation in sleep timing, pre-sleep arousal, and environment regulation as targets for intervention. Sleep health promotion intervention should consider personality, chronotype preference and time use (e.g. meaningful activities, commuting) as factors promoting or inhibiting sufficient sleep duration and quality in university students.

Support (if any)

Fulbright U.S. Scholar Award to Japan
0185 Circadian Rhythm of Rock Climbing Specific Finger Strength
Authors: Yao Zhixing , Smith Andrew , Vaughn Bradley
Published: May 2023

Introduction

Circadian rhythm influences various aspects of athletic performance; however, the sport specific effects in rock climbing are not well studied. This study aimed to evaluate circadian changes in finger strength in rock climbers. This may have important implications for timing of training and challenging climbing goals.

Methods

Participants completed two rounds of finger strength testing on the same day (morning 7-9 am and evening 5-7 pm) consisting of maximal pulls on a polyurethane training block (18 mm flat edge) anchored to a dynamometer (TindeqTM). Participants were cued to keep 4 fingers on without using the thumb and given two attempts on each hand with the highest load recorded each session. Demographic data, climbing experience level, sleep quality (Promis Sleep short form.), and chronotype (Morningness-Eveningness questionnaire) were recorded for secondary outcome analysis. Standard descriptive statistics and paired t-tests were performed to compare the morning and afternoon findings.

Results

10 participants completed finger strength testing. There was a significant increase in mean maximum finger strength from morning (M = 35.2 kg, SD = 14.8) to afternoon (M = 40.1 kg, SD = 16.1), t(9) = 4.1, p = .003, with a large effect size (Cohen’s d = 1.3). The mean increase was 5.0 kg with 95% confidence interval of 2.2 kg to 7.7 kg. The morning to afternoon increase in maximal strength remained significant when subdivided by sex (males n = 6, p = .04, 95% CI [0.4kg, 10.0] kg, and females n = 4, p = 0.48, 95% CI [0.1, 9.1] kg). This study lacked sufficient power to detect differences related to other secondary measures.

Conclusion

Maximum finger strength in rock climbers was greater in the afternoon compared to morning suggesting a circadian rhythm influence. Rock climbers needing peak finger strength may benefit from timing hard climbs in the afternoon rather than early morning. Further study is needed to determine if this finding is seen in larger groups or impacted by sleep quality and chronotype.

Support (if any)

Training space was supported by Triangle Rock Club, Durham NC.
0187 Hypnograms for 365 Nights Predicts Subjective Sleep Quality in Healthy Adults: Results from the Ultra Long-Term Sleep (ULTS) Study
Authors: Ahrens Esben , Hemmsen Martin C , Duun-Henriksen Jonas , Taptiklis Nick , Cormack Francesca , Djurhuus Bjarki , Homøe Preben , Kjær Troels W , Jennum Poul
Published: May 2023

Introduction

Sleep quality is fundamental to our somatic and mental health. However, the relationship between subjective sleep quality and sleep architecture remains poorly understood. New wearable or minimally invasive technologies facilitate the recording of electroencephalography (EEG) with lower spatial resolution than standard EEG but much greater longitudinal dispersion. This enables investigation of day-to-day variation in sleep measured directly with EEG. This study will compare EEG-derived sleep parameters with covariates such as sustained attention and subjective sleep quality.

Methods

Twenty-five healthy adults were implanted with a two-channel subcutaneous EEG (sqEEG) lead. Twenty subjects completed the 1-year protocol (average 32±13 years of age). Their sqEEG signals were recorded each night for 1 year alongside a morning 3-minute Psychomotor Vigilance Task (PVT) and self-reported sleep quality, which included Karolinska Sleepiness Scale (KSS). A deep learning model, U-Sleep, was fine-tuned on sqEEG with synchronized gold standard polysomnography used as ground truth. Hypnograms and sleep parameters were thus automatically calculated.

Results

Subjective sleep quality measured by KSS revealed a moderate negative correlation with rapid-eye-movement (REM) duration (r=-0.31, 95% CI=(-0.31, -0.31)), and total sleep time (TST) (r=-0.31, 95% CI=(-0.31, -0.31)). There was a moderate correlation between KSS and mean PVT reaction time (r=0.21, 95% CI=(0.21, 0.22)). There was a low negative correlation between PVT and TST (r=-0.1). Preliminary results indicate a moderate correlation between sleep parameters and subjective sleep quality. The correlations with PVT were lower, which suggests that 3-minute PVT is not sensitive to TST in normal sleep. However, the correlation between PVT and KSS suggests that PVT does predict subjective sleep quality, but to a smaller degree than standard sleep parameters.

Conclusion

Measuring day-to-day variation in high-quality EEG-based sleep recordings has the potential of creating a new branch in sleep medicine. Patients can be evaluated not only by findings in a single recording but the stability and variation of all findings can be analyzed. Preliminary results suggest that subjective sleep quality can be predicted directly from sqEEG and potentially be explained by behavioral factors in a subsequent cause-effect analysis.

Support (if any)

The project is supported by Innovation Fund Denmark, UNEEG medical, and T&W Engineering.
0188 OBJECTIVE AND SUBJECTIVE FEATURES OF SLEEP AND BEHAVIOR IN ADULT SURVIVORS OF PEDIATRIC HODGKIN LYMPHOMA
Authors: Navarrete Miguel , Mulrooney Daniel , Flerlage Jamie , Hudson Melissa , Mandrell Belinda , Krull Kevin
Published: May 2023

Introduction

Adult survivors of pediatric Hodgkin Lymphoma (HL) report poor sleep quality and excessive fatigue, often associated with obstructive sleep apnea (OSA). However, little is known about sleep dynamics in HL survivors without sleep disorders. In this exploratory study we evaluated quantitative and qualitative sleep of HL survivors without OSA and examined associations with cancer treatment and functional outcomes.

Methods

Adult participants completed two consecutive nights of in-home polysomnography (PSG) with at least 4 hours of recorded sleep. For those participants with a sleep efficiency >85% and without OSA (HL survivors N=39, mean[SD] age=35[7.8] years; community controls N=33, age=29[7.4] years) PSG’s were scored following AASM guidelines. Standardized surveys assessed subjective sleep quality (PSQI), fatigue (FACIT-F) and quality-of-life (SF-36). Group differences were evaluated using ANCOVA adjusting for age. Multivariable linear regression was used to evaluate associations between sleep and SF36 measures. Kendall correlations were computed for objective and subjective sleep and chest radiation dosimetry.

Results

No significative differences between groups were found for standard objective PSG variables (sleep stages, latency, efficiency, etc.). Compared to controls, survivors had higher mean heart rate (HR) during sleep (p< 0.003), higher fatigue (p< 0.004), and lower sleep quality (p=0.005). Among HL survivors, poor PSQI ratings were associated with higher HR (τ = 0.36, p=0.001), lower sleep time (τ = -0.26, p=0.019) and increased fatigue (τ = -0.47, p< 0.001). Higher radiation dosimetry was associated with lower PSG sleep efficiency (τ = -0.23, p=0.042). Among survivors and community controls, mean HR during sleep (p=0.049) and lower sleep efficiency by PSG (p=0.032) were associated with poorer SF36 physical health (p< 0.001).

Conclusion

HL Survivors demonstrate elevated mean HR during sleep, which is associated with patient reported functional limitations. Interventions to lower mean HR during sleep may have the potential to improve sleep quality, physical function, and overall quality of life.

Support (if any)

NCI - NCI NIH: 1R01CA215405, T32CA225590
0189 Particulate Matter 2.5: Examining How Its Exposure Affects Perceived Sleep Quality and Electroencephalography Based Sleep Metrics
Authors: Byun Kunjoon , Tang Mengjia , Liu Qingyang , Mazurek Kevin , Pantelic Jovan
Published: May 2023

Introduction

Individuals are exposed to various air pollutants every day, both when they are inside and when they are outside. Poor air quality can negatively impact an individual’s sleep quality, especially when the individual has been exposed to Particulate Matter 2.5 (PM2.5) which can adversely affect human health due to its ability to penetrate into a human body easily.

Methods

We examined how PM2.5 exposure impacts perceived sleep quality and sleep metrics. 11 individuals (7 Female, 4 Male) with an average age 34.18±10.24 years participated where each participant lived in a simulated one-bedroom apartment unit located in Rochester, MN for 20 nights in total over 4 weeks. Participants wore an EEG-based sleep headband (Dreem) to measure sleep metrics and completed surveys to assess perceived sleep quality and fatigue level each weekday after they woke up. Air quality including PM2.5 was monitored in the units from sensors and from the participants outside the units using a portable research grade air quality monitor paired with GPS. Total PM2.5 exposure was calculated each day by multiplying the PM2.5 concentration by 6 liter/min of inhalation rate and duration (min). We excluded nights with less than 5 hours of sleep duration. One participant who reported poor sleep quality over 70% of the time was also excluded.

Results

Participants had an average of 58.2μg±63.8 PM2.5 exposure during a day until they went to bed and 0.8μg±2.6 PM2.5 exposure during sleep. Because there was minimal night PM2.5 exposure, only the day exposure was correlated to sleep measures. There was no significant effect of PM2.5 exposure on sleep efficiency, sleep onset latency, wake after sleep onset, and total sleep time as measured from the Dreem headband. There was a modest but significant effect of PM2.5 on perceived sleep quality, as participants rated poorer sleep quality (r(141)=.17, p=.042) and higher fatigue levels (r(141)=.26, p=.002) the next morning.

Conclusion

These findings suggest acute PM2.5 exposure levels were not high enough to affect sleep metrics but did affect one’s perceived sleep. Future studies should examine longer period to assess whether there is a chronic effect of PM2.5 exposure on sleep.

Support (if any)
0194 Sleep Tracker: How Accurate Does It Need To Be?
Authors: Reifman Jaques , Vital-Lopez Francisco , Priezjev Nikolai
Published: May 2023

Introduction

Commercial sleep tracker devices offer the ability to measure an individual’s sleep patterns, providing a portable and low-cost option to collect sleep-wake data to enhance fatigue management and minimize alertness impairment. While multiple studies have reported that sleep parameters estimated with these devices differ from gold-standard polysomnography (PSG), the extent to which these differences are acceptable is not known. Here, we provide a method to quantitatively assess whether sleep-duration errors generated by sleep trackers hinder our ability to assess alertness impairment.

Methods

To obtain representative statistics of sleep-duration errors, we performed a literature review and identified 14 studies that compared estimations of sleep parameters between 18 unique commercial sleep trackers and PSG. Then, we used the well-validated Unified Model of Performance (UMP), a mathematical model that predicts alertness impairment as a function of sleep history, to quantitatively assess the effect of sleep-duration errors on alertness predictions. For this purpose, we performed 20,000 simulations in which an individual slept 8 hour per night for 30 consecutive days. Each day, we randomly sampled sleep-duration errors using the obtained representative statistics and computed daily alertness-prediction errors. We repeated these simulations for 5 and 9 hours of sleep per night. We assumed that sleep-duration errors that lead to alertness-prediction errors of ≤30 ms (i.e., the within-subject variability under well-rested conditions) are not a concern.

Results

Based on the 14 studies, sleep trackers yielded sleep-duration errors with a mean of 22 minutes and a standard deviation of 44 minutes. Using these statistics to sample daily errors, we found that, at the end of the 30 days of UMP simulations, these sleep-duration errors led to a mean alertness-prediction error of ~20 ms, with ~75% of the errors ≤30 ms. We also found that, for each additional minute of sleep-duration error, the prediction error increased by ~1 ms. These results were consistent when the hours of sleep per night varied from 5 to 9 hours.

Conclusion

On average, sleep trackers lead to alertness-prediction errors that are consistently smaller than the within-subject variability of alertness impairment, suggesting that they are an alternative approach for measuring sleep duration.

Support (if any)
0198 Effects of a 1-hour nightly weeklong sleep extension pilot study in undergraduates on health
Authors: Mathew Gina , Nahmod Nicole , Master Lindsay , Reichenberger David , Rosinger Asher , Chang Anne-Marie
Published: May 2023

Introduction

Sleep restriction impairs health, but less is known about the potential health benefits of extending sleep in undergraduate students with habitual short sleep. This study examined the effects of a 1-week, 1-hour per night sleep extension on cardiometabolic health, hydration status, sedentary behavior, and physical activity in undergraduate students.

Methods

Twelve healthy undergraduate students (83% female; mean±SD age 20.2±1.5; range 18-23 years) obtaining fewer than 7 hours of average nightly sleep completed a two-week study. The first week consisted of sleeping typically ("Habitual"), followed by a peer-delivered intervention to extend time in bed by ≥1 hour/night during the second week ("Extension"). Sleep and physical activity actigraphy were collected throughout. Following each week, participants completed in-person cardiometabolic assessments, including a standardized meal response procedure and blood pressure measurement. Blood samples for measurement of glucose and insulin were collected before, during, and following a standardized breakfast. Urine samples yielded markers of hydration (specific gravity and osmolality). Mixed-effects regression models with random intercepts for individuals compared outcomes after the Extension week to Habitual outcomes.

Results

Compared to Habitual sleep, average sleep duration across the Extension week increased (b±SEM, +42.6±.3 minutes; p=.005). After the breakfast meal, glucose area under the curve (AUC; −26.5±10.2 mg/dL*h; p=.025) and time to return to baseline levels (−83.0±46.4 minutes; p=.031) decreased following Extension. There was no change in insulin AUC. Systolic blood pressure decreased (−6.6±2.8 mmHg; p=.037) after Extension. Average time spent in sedentary behavior (−44.3±15.7 minutes; p=.018) and percentage of wake spent in moderate-to-vigorous physical activity (−1%±.4%; p=.030) decreased across the Extension week. Participants who increased average sleep duration ≥15 minutes (n=9) were better hydrated according to urine osmolality (−187.0±68.4 mOsm/kg; p=.026) and specific gravity (−.01±.002 g/mL; p=.012) and had lowered odds of dehydration according to urine osmolality (≥800 mOsm/kg; −67%; OR=.03; p=.035).

Conclusion

This pilot study provided evidence that sleep extension may improve cardiometabolic health and hydration and reduce both sedentary behavior and moderate-to-vigorous physical activity. Future research in randomized controlled trials should examine if such findings extrapolate to larger samples and older populations.

Support (if any)

CRC/CTSI: UL1-TR002014; pilot grant to AMC from the Department of Biobehavioral Health, Pennsylvania State University