bluuebunny/crossref_metadata_2025 huggingface dataset:
0185 Video Game Addiction and Its Relationship with Sleep Quality Among Medical Students
Authors: Wali Siraj , Alghamdi Faisal , Abusulaiman Abdullah , Alghamdi Faisal , Alsulami Abdulaziz , Bamotref Mohammed , Alosaimi Albraa , Bamousa Omar
Published: April 2024

Introduction

Problematic video game playing has grown vastly in the past decade with internet addiction and has caused many public health problems. Among these problems is the poor sleep quality as a result of gaming addiction. Given the significant increase in video game sales, it is important to determine the prevalence of gaming addiction among medical students and whether it is associated with poor sleep quality which may be reflected on the academic performance.

Methods

A cross-sectional survey was conducted between January and June of 2023 on medical students of King Abdulaziz University, Jeddah, Saudi Arabia. An online survey was used and was divided into three sections. The first section included demographic data. The second section included the 7-item Gaming Addiction Scale (GAS), and the third section included the Pittsburgh Sleep Quality Index (PSQI). Using GAS Scale and based on the total score, gamers are classified as addicted, problematic, engaged, or normal. Hence, abnormal gamers include engaged gamers, problematic gamers, and addicted gamers.

Results

There were 357 participants with mean age of 22.5 -/+ 1.8 years and 75.3 % were males. The data showed that 38.8% of the study population were abnormal gamers: 40 (11.2%) engaged gamers, 81 (22.8%) problematic gamers and 17 (4.8%) addicted gamers. Furthermore, abnormal gaming was linked to poor sleep quality when comparing abnormal gamers with normal gamers (92% VS 80.3%, p value of 0.002). Abnormal gamers were found to rely on sleep medication to help them sleep at night and take longer time to fall asleep (p=0.050 & p=0.045 respectively).

Conclusion

Abnormal gaming is common among medical students and it is strongly associated with poor sleep quality.

Support (if any)
0186 Experimental Sleep Restriction Affects Artwork Perceptions
Authors: Godinho Ariadne Dias , Neuhoff Elise , Diaz Jose , Nickel Allison , Scullin Michael
Published: April 2024

Introduction

Sleep deprivation is known to detrimentally affect attention, memory, and other cognitive processes. Less is known about whether and how sleep loss influences perception, such as the aesthetic experience of viewing art, which serves as a conduit for social bonding, creative expression, and life enrichment. In the current work, we tested perceptions of abstract artwork after normal sleep and sleep restricted periods.

Methods

Sixty-four young adults (mean age=19.98, 53.2% female, 54.8% non-Caucasian) were enrolled in a cross-over designed, in-laboratory study. Following an adaptation night, participants were randomly assigned to undergo two nights of sleep restriction (1:30 AM – 7:00AM) or two nights of normal sleep (10:00 PM – 07:00AM), with polysomnography recordings. In the morning, participants viewed 12 abstract paintings, each for 15 seconds coupled with a female artist’s name or male artist’s name (randomized across paintings). After each painting, participants rated the painting's beauty, colorfulness, skillfulness, creativity, and how much they liked it overall. During the next week, participants completed the other sleep condition (order counterbalanced) with a new set of abstract paintings and artist names.

Results

We conducted a series of 2 (sleep condition) x 2 (artist gender) x 2 (participant gender) ANOVAs. Males tended to favor male artwork, and females tended to favor female artwork, but gender effects were not statistically significant (ps>.10). Interestingly, sleep restriction significantly reduced how much participants rated liking the artwork (p=0.009) and tended to reduce perceptions of the beauty of the artwork (p=.051). Perceptions of colorfulness, skillfulness, and creativity were not significantly affected (ps>.10).

Conclusion

Sleep loss can subtly affect perceptions of artwork, generally by dampening the aesthetic experience. Future work should investigate economic and cultural impacts of sleep loss, and how short sleep in artists affects their creative output.

Support (if any)

Support provided by the National Science Foundation (1920730).
0188 Impact of the Menarcheal Transition on Sleep in Biological Females
Authors: Adornetti Julianna , Hagy Hannah , Crowley Stephanie , Kmiecik Matthew , Tham See Wan , Hellman Kevin , Tu Frank , Bohnert Amy
Published: April 2024

Introduction

Puberty encompasses a multitude of physical, hormonal, and psychological changes. Additionally, adolescents also experience a delay in circadian rhythm, increasing their vulnerability to insufficient sleep. Even though puberty and sleep share a strong association, few studies have explored the shift in sleep after the onset of menstruation (i.e., menarche). This longitudinal, multimethod study examines sleep health parameters before and after menarche among a community sample of females.

Methods

Biological females (n = 47; 74% white) from a Midwestern metropolitan area were recruited as part of a larger study on menarche. Participants completed two lab visits: Time 1 (T1: prior to menarche; Mage = 11.3, SDage = 1.0) and Time 2 (T2: 3-9 months post-menarche; Mage = 12.6, SDage = 1.0). An actigraph wristwatch was worn for 7 days following each lab visit to measure dimensions of sleep health including bedtime, wake time, time in bed, and total sleep time. Phillips Actiware Software was used to score actigraphy data; SPSS 27 was used to perform paired sample t-tests to explore changes over time.

Results

Following menarche, there were significant differences in several parameters of sleep health including: 1) a 1.7-hour delay in bedtime (T1M = 21:45, T1SD = 1:02; T2M = 23:29, T2SD = 3:07, t(46) = (3.37), p = (.002), 2) less time in bed (T1M = 542, T1SD = :48; T2M = 518, T2SD = :58), t(46) = (2.67), p (.01), and 3) a 27-minute decrease in total sleep time (T1M = 482, T1SD = :40; T2M = 455, T2SD = :51), t(46) = (3.32), p = (.002). Overall, these results indicate participants are sleeping significantly less in the months following menarche.

Conclusion

Findings confirm that biological females experience changes in sleep behaviors within 9 months of menarche. Chronic sleep loss and daytime sleepiness worsens throughout adolescence, furthering the risk for cognitive and behavioral issues. Data collection is ongoing and future analyses will examine sleep variability across this transitional point in development. This is one of the first studies to examine the sleep-wake experience of females across menarche.

Support (if any)
0189 Menstrual Cycle Phase and Alcohol Use Interact to Influence Daily Sleep Outcomes
Authors: Schuler Maricel , Whitehurst Lauren
Published: April 2024

Introduction

Rates of heavy drinking are increasing in women at an alarming pace. Studies suggest that although alcohol has an initial sedative effect, it can lead to frequent awakenings. Preliminary studies suggest that women may be more sensitive to alcohol-disrupted sleep than men. Women’s sleep changes across the month due to the impact of cycling hormones, yet studies examining links between alcohol-disrupted sleep and menstrual cycling are scarce. Here, we used daily diary methods to track menstrual cycles, sleep, and alcohol use in normal cycling women.

Methods

44, cisgender women, aged 18-45, completed morning and nightly diaries to track sleep/wake behavior, alcohol use, and menstrual cycling for two weeks (N=586observations). Each morning, participants reported bedtime and waketime and the number of minutes it took them to fall asleep, which was used to determine sleep duration and onset latency, respectively. Sleep quality was assessed on a Likert scale of 1=‘very bad’ to 4=‘very good’ and morning ratings of refresh on a Likert scale of 1=‘not at all’ and 7=‘completely’. Prior to sleep, participants indicated if they drank any alcohol, and if so, how many drinks they ingested. We examined the impact of on vs. off menses as well as day in cycle – early-follicular, late-luteal, or periovulatory – on alcohol use and sleep outcomes using linear mixed effects models.

Results

On average, participants went to bed at 12:18AM, woke up at 7:59AM, slept 8hrs and 17mins, and had sleep onset latencies of nearly 16mins. Participants reported good sleep quality (M=3.14) and feeling relatively refreshed (M=5.14) upon awakening. On menses, drinking was associated with longer sleep onset latencies (r=.216). Off menses, drinking was associated with lower sleep quality (r=-.125) and ratings of morning refresh (r=-.214). On days when women drank alcohol, they also had marginally worse sleep quality (p=.056). Periovulatory vs. early-follicular days were associated with less ratings of morning refresh (p=.019), and a marginal interaction between phase and alcohol suggested that drinking alcohol during the periovulatory phase led to significantly lower feelings of refresh the next morning (p=.076).

Conclusion

These data suggest that sleep may be more sensitive to alcohol disruption near ovulation in women.

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0192 Brain Circuits That Regulate Awakenings to Pain Stimulus
Authors: Lynch Nicole , Gangeddula Nishta , Spinieli Richard , Kaur Satvinder
Published: April 2024

Introduction

Many neurons in the external lateral PB express the calcitonin gene-related peptide [CGRP; PBelCGRP], and also receive spinal afferents carrying pain signals that are relayed to forebrain arousal promoting areas. Thus, PBelCGRP neurons form the critical relay node transmitting pain to induce cortical arousals. We tested this with genetic deletion or acute optogenetic inhibition in both inflammatory pain and opto-pain models, and found that blocking this node prevents pain-induced arousals. Our current focus is on understanding which terminal fields of the PBelCGRP neurons contribute to pain-induced wakefulness.

Methods

Using pharmacological antagonists and optogenetics, we blocked PBelCGRP neuron terminal fields located in the basal forebrain (BF), bed nucleus of stria terminalis (BNST), and central nucleus of Amygdala (CeA). For pharmacological blocking, wild type mice implanted with a guide cannula targeting one of the terminal fields received bilateral microinjections of NMDA antagonist (AP-5, 4.0 µg/200nl), or CGRP receptor antagonist (BIBN4096BS at 8 µg/200nl). For optogenetic (opto) blocking, CGRP-CreER mice injected bilaterally in the PB with AAV-Flex-Opn3-mscarlet (inhibitory opsin) and implanted with bilateral optical fibers in the terminal fields received laser light pulses for opto-inhibition. Both groups were implanted and recorded for sleep following acute inflammatory pain (AIP) of a 10 µl foot injection of 5% formalin in combination either with or without terminal field blocking.

Results

The effects on sleep-wake after pharmacological blocking or opto-inhibition were compared to saline and AIP groups. AIP induced a robust 54% decrease in sleep for 3h post-injection (F1, 17= 105; P< 0.001) compared to saline. Preceding NMDA antagonist injections in the BNST and BF reversed AIP-induced sleep-loss by 95% (F4, 28= 17.1; P< 0.001), followed by CeA (83% reversal). While blocking CGRP receptors (F4, 28= 12.2; P< 0.001) followed the order BF> BNST> CeA for recovering AIP-induced sleep loss. A similar order of effect (F4, 23= 31.6; P< 0.001) was produced by opto-inhibition of PBelCGRP neuron terminal fields at BF, BNST and CeA.

Conclusion

Our results show that PBelCGRP neurons likely target BF, BNST, and CeA by acting through both CGRP and NMDA receptors to promote awakenings in response to acute pain.

Support (if any)

NS112175
0196 One Less Pathway to Explain the Chronic Insufficient Sleep and Metabolism Relationship: Thyroid Regulation
Authors: Petrov Megan , Zuraikat Faris , Cheng Bin , St-Onge Marie-Pierre
Published: April 2024

Introduction

Chronic insufficient sleep contributes to the development of obesity and type 2 diabetes (T2D). However, the physiologic underpinnings of these effects are incompletely understood. There is some evidence that sleep restriction (SR) adversely affects thyroid hormones and growth factors involved in energy metabolism, but findings are mixed. Furthermore, no study has evaluated changes in thyrotropic axis hormones in response to a model of chronic, mildly insufficient sleep resembling real-world short sleep. Therefore, we investigated whether 6wk of 1.5 h/night SR vs. maintenance of adequate sleep (AS) impacted free thyroxine (T4), thyroid stimulating hormone (TSH), and fibroblast growth factor-21 (FGF21) in healthy adults.

Methods

Men and women with actigraphy-assessed habitual total sleep time (TST) of 7-9h/night and no cardiometabolic diseases participated in a randomized, crossover study with two 6-week phases: AS and SR. Sleep was monitored daily with actigraphy, and compliance was assessed every 1-2wk. Blood was collected following a ≥12h fast at baseline, wk 3, wk 4, and endpoint of each phase. For this investigation, circulating levels of T4, TSH, and FGF21, within an all-female subsample (n=18), were quantified from plasma. Linear mixed models tested the effect of SR on the post-baseline values of the outcomes, with models adjusted for corresponding baseline outcome values, week, and phase.

Results

Data were available from 30 participants (20 women, 39.0±14.0y, BMI: 26.7±3.6; 10 men, 29.4±5.2y, BMI: 26.6±2.2). T4, TSH, and FGF21 concentrations at the baselines of each phase ranged from 0.27-2.55 ng/dL (M±SD: 0.87±0.47), 0.86-1.66 μIU/ml (M±SD: 1.24±0.19) and 17.5-383.3 pg/mL (M±SD: 140.2±97.6), respectively. In the full sample free T4 (β=-0.02, p=0.64) and TSH (β=0.02, p=0.67), and in the subsample, FGF21 (β=-1.57, p=0.83) were not significantly different between study arms. In analyses of T4 and TSH stratified by sex, there were no differences between study arm.

Conclusion

In a sample of healthy adults, prolonged mild sleep restriction did not cause alterations in thyroid hormones and FGF21. These findings suggest that adverse endocrine and metabolic consequences commonly observed with chronic short sleep are not owed to disruptions in the thyroid axis endocrine pathway.

Support (if any)

American Heart Association 16SFRN27950012 and NIH/NHLBI R01HL128226 and R35HL155670 and in part by UL1TR001873
0214 Pre- and Post-Pandemic Adolescent Physical Activity and Potential Impacts on Sleep
Authors: Anderson Abrianna , Shoval Noa , Sheppard Kennedy , Shah Saira , Price Garrett , Garrison Michelle
Published: April 2024

Introduction

Research suggests that up to 70% of U.S. adolescents get less than 8 hours of sleep per night regularly and less than 25% of children ages 6-17 years old meet the CDC recommendation of 60 minutes of daily physical activity. We hypothesize that decreased physical activity was associated with worse sleep among adolescents across 2017 to 2021, and that the magnitude of the association may have changed during and after the COVID-19 pandemic.

Methods

We utilized the Youth Risk Behavior Surveillance System (YRBS) for our analyses. All participants of the 2017, 2019, and 2021 national YRBS surveys were eligible for inclusion. The main outcome of interest was school-night sleep duration (ordinal variable: <= 5 hours, 6-7 hours, 8+ hours), and the primary predictor was days per week of 60+ minutes of moderate to vigorous physical activity. We conducted survey weighted ordinal logistic regressions to explore the association between physical activity and sleep.

Results

The analytic sample included 38,531 adolescents; ages 12 to 18 years old. Across all three years of the data, each additional day of physical activity was associated with a similar increase in the odds of receiving more sleep: in 2021 OR = 1.11 95%CI 1.08 – 1.15, in 2019: 1.09, 95%CI 1.07 – 1.12, and in 2017: 1.08 95%CI 1.05 – 1.11.

Conclusion

As hypothesized, increased physical activity was significantly associated with increased sleep. Although the effect size increased somewhat across the three years sequentially, this change was not statistically significant. 2023 YRBSS data will be available in January 2024. We plan to run additional analyses to expand on initial findings at that time, in addition to identifying potential effect modifiers of the relationship.

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0224 Sleep Deprivation and Recovery Sleep Impact Serum Biomarkers of Alzheimer's Disease in Retired Adults
Authors: Lehrer Matthew , Zeng Xuemei , Krafty Robert , Wilkens Kristine , Buysse Daniel , Karikari Thomas
Published: April 2024

Introduction

Short sleep increases Alzheimer’s disease (AD) risk, and sleep facilitates clearance of AD-related metabolites. Blood-based AD biomarkers (e.g., beta amyloid [Aβ] 42/40 ratio, phosphorylated tau181 [p-Tau181], neurofilament light chain [NfL], glial fibrillary acidic protein [GFAP]) are validated and increasingly used clinically. However, the impact of sleep deprivation and recovery sleep on these markers is unclear. This study determined the effects of sleep deprivation and recovery sleep on serum AD biomarkers in retired adults and explored: 1) whether changes in EEG slow-wave activity (SWA) from baseline to recovery sleep were associated with serum AD biomarker changes, and 2) whether findings differed between retired night shift and day workers.

Methods

Participants were 58 cognitively normal retired shift workers (n = 28) and retired day workers (n = 30). All completed a 60-hour laboratory study including a baseline night of EEG sleep recording, one night of total sleep deprivation, and one night of recovery sleep. EEG SWA (0.5-1Hz) was assessed during baseline and recovery sleep. Blood was collected the morning after each night. Serum samples were analyzed for Aβ40, Aβ42, p-Tau181, NfL, and GFAP using ultra-sensitive immunoassay. Linear mixed models determined the effects of sleep deprivation and recovery sleep on biomarker levels adjusted for age, sex, race/ethnicity, and education.

Results

Mean participant age was 67.8 +/- 5.5 years, 52% were female, 86% were White, and mean education was 16.0 +/- 1.9 years. Serum Aβ42/40 ratio, NfL, and GFAP decreased following one night of sleep deprivation. Following recovery sleep, the Aβ42/40 ratio remained below baseline, while NfL and GFAP increased to baseline levels. Serum pTau-181 did not change following sleep deprivation or recovery sleep. Greater SWA increase from baseline to recovery sleep was associated with smaller Aβ42/40 ratio decrease. Findings did not differ between shift and day work groups.

Conclusion

In retired adults, acute sleep deprivation and recovery sleep impacted serum AD biomarker levels. Sleep characteristics may therefore affect the diagnostic accuracy of these tests. Former night shift work exposure did not influence serum biomarker responses, suggesting no effect of long-term shift work exposure over time. SWA may aid Aβ clearance during sleep.

Support (if any)

K01AG075171, R01AG047139, R01GM140476, R01GM113243
0227 Association Between Sleep Quality and Sleep Duration and Physical Frailty Among Older Adults in India
Authors: Thalil Muhammad , Lee Soomi , Pai Manacy
Published: April 2024

Introduction

Considering the significant growth in India's aging population, it is imperative to identify risk factors associated with frailty among older Indians. However, there is limited studies that assessed the linkage between sleep and frailty in this population and it is focused on sleep disorder. The purpose of this study was to examine the association between sleep quality, sleep duration, and physical frailty among older Indian adults.

Methods

Data come from the World Health Organization’s Study on global AGEing and adult health (WHO-SAGE), India wave-2 (2013-14). The sample size comprised 6,512 older adults aged 50 years and above. Pre-frailty and frailty were assessed using the modified version of the frailty phenotype proposed by Fried and colleagues. Sleep was assessed by self-reported quality and duration. Multinomial logistic regression analysis was employed to examine the associations of sleep quality and duration with pre-frailty and frailty.

Results

A total of 66.7%, and 25.3% of older adults in our sample were pre-frail and frail, respectively. A higher prevalence of frailty was found among those with poor sleep quality (44.8%) and with short sleep duration (< 7 hours/night; 32.2%). Relative to peers with good sleep quality, the odds of frailty were significantly higher among older adults with poor sleep quality [AOR: 2.79; CI: 1.37–5.66]. And, notably, compared to those who enjoyed the recommended age-appropriate amount of sleep (7-8 hours), older adults with long sleep duration (≥ 9 hours) reported a significantly lower likelihood of both, pre-frailty [AOR: 0.73; CI: 0.57-0.93] and frailty [AOR: 0.68; CI: 0.51-0.91].

Conclusion

Our study found both sleep quality and quantity to be associated with pre-frailty and frailty among older Indians. Poor sleep quality may increase risk for frailty, yet long sleep duration may be a protective factor independent of the quality of sleep.

Support (if any)
0238 Disparities in Sleep, Asthma, and the Sleep Context in Urban Children
Authors: Koinis-Mitchell Daphne , Kopel Sheryl J , Dunsiger Shira , Guzman Luis , Mattice Carly , Kirchhof Sidney , Gredvig-Ardito Caroline , Carskadon Mary
Published: April 2024

Introduction

Children who have asthma and live in urban settings experience challenges that can complicate asthma management and compromise sleep outcomes. The goals of this presentation are to 1) describe environmental factors in children’s homes impacting asthma and sleep, 2) examine associations between asthma and sleep outcomes in urban children, and 3) examine the moderating role of environmental and behavioral factors in the association between asthma and sleep outcomes.

Methods

140 children 7-9 years old with persistent asthma and their primary caregivers completed a 16-day observational protocol. Asthma and sleep outcomes were evaluated via self/caregiver report (Asthma Control, Sleep Hygiene) and objective (portable handheld spirometer, actigraphy) methods. Home sleep and asthma environment was assessed with a structured interview.

Results

The most prevalent environmental risk factors for asthma and sleep were tobacco smoke (25% of sample), pets (42%), and pests (e.g., rodents, roaches, etc.; 34%). Sleep hygiene/environmental factors reported by families as challenging included child routinely falling asleep (48% of sample) or sleeping all night (48%) in a room not intended as their sleep space. Shared sleep space (40%) and lack of protective allergy bedding (40%) were also common challenges. Numerous factors causing objectively measured nighttime awakenings and sleep disruption were also reported. On average, children with well-controlled asthma reported more optimal sleep hygiene behaviors (rho = .91, p<.05) relative to those with poorly controlled asthma. Better day-to-day lung function (via spirometry) was related to fewer nighttime awakenings, measured with actigraphy (rho = .20; p’s <.05). Children with poorly controlled asthma tended to have more night awakenings and lower levels of sleep efficiency than those with well controlled asthma. Analyses testing a moderating role of environmental/behavioral processes are underway.

Conclusion

Urban children's sleep environment contains asthma and sleep-related factors that make it challenging to fall and stay asleep. These disruptors affect both asthma activity and sleep and are areas to target in future multi-component asthma and sleep interventions.

Support (if any)

NHLBI R01HL142058 (Koinis Mitchell and Carskadon); NIGMS 5P20GM139743 (Carskadon)
0240 Associations Between Parental Education Level and Subjective Sleep Parameters in Chilean School-aged Children
Authors: Ramírez-Contreras Catalina , San Martín Carla Ortiz , Romero Javiera Vásquez , Venegas María Fernanda Vejar
Published: April 2024

Introduction

Healthy sleep is crucial for children's development. The literature suggests that higher parental education is associated with longer child sleep duration. However, little is known about how family education level affects children’s sleep patterns in Chile. We aimed to investigate the relationship between parental education level and sleep patterns and sleep duration during the week and on weekends.

Methods

Two hundred and fifty-eight participants (6-13 years; 50% girls) were included in this cross-sectional study. Data collected were parent-reported and included: educational level of the household head, categorized as no schooling or primary school, secondary school, technical or higher (graduate) college degree, bedtime, midpoint of sleep and sleep duration on weekdays and weekends. General linear models were tested to calculate adjusted differences between parental education level categories, adjusted for age and gender, followed by a Tukey post hoc test.

Results

We found that higher parental education level was significantly associated with advancing children’s bedtime on weekends (P = 0.007). Participants whose parents had a secondary school degree postponed their weekend bedtime by 0.36 hours (95% CI: 0.11, 0.61) compared to those whose parents had a technical or higher college degree. We also found that higher parental education level was significantly associated with advancing children’s weekend midpoint of sleep (P = 0.044). Specifically, the weekend midpoint of sleep was earlier (−0.29 h; 95% CI: −0.06, −0.53) for participants whose parents had a technical or higher college degree than for parents with a secondary school degree. Surprisingly, we found that lower parental education was associated with children sleeping longer on weekends (P = 0.026). In detail, participants whose parents had no schooling or primary education had 0.45 h longer weekend sleep duration (95% CI: 0.04, 0.87) compared to those whose parents had secondary school level.

Conclusion

Higher parental education level was associated with earlier weekend sleep patterns in children. However, lower parental education levels were associated with children sleeping longer on weekends. These results could be useful for the development of parenting programs targeting different levels of education to promote optimal sleep duration and time, as well as the well-being of Chilean children.

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0241 Racial/Ethnic and Socioeconomic Disparities in Circadian Misalignment in Adolescents
Authors: Morales-Ghinaglia Natasha , Calhoun Susan , Liao Jason , Vgontzas Alexandros , Liao Duanping , Bixler Edward , Fernandez-Mendoza Julio
Published: April 2024

Introduction

Prior research has shown sleep health disparities as a function of race/ethnicity and socioeconomic status (SES). However, most studies focused on habitual sleep duration and its night-to-night variability. Few studies have examined the association of these social determinants with circadian misalignment metrics, such as sleep midpoint (SM), sleep irregularity (SI), and social jetlag (SJL). We hypothesize that adolescents who identify as a racial/ethnic minority or from low SES households have greater circadian misalignment as compared to non-Hispanic whites or those from high SES households.

Methods

We analyzed 377 adolescents from the Penn State Child Cohort (median 16y; 46% female; 22% racial/ethnic minority, of which 58% were Black/African American and 28% Hispanic) who had at least 3 nights of actigraphy. SM was defined as the intra-individual midpoint of the sleep period, SI as the intra-individual standard deviation of the SM across nights, and SJL as the absolute difference between SM on weekdays vs. weekends. SES variables included parent’s professional status, student working status and zip-code level median household income and 5-year average percentage of high school/college graduates. Multivariate general linear models adjusted for sex, age, sleep duration, and sleep variability as well as a composite score of SES variables.

Results

Adolescents identifying as a racial/ethnic minority, working part-time, belonging to a household of lower professional status, lower median income or with less high-school or college graduates had a significantly delayed SM (p=0.011, p=0.005, p=0.049, p=0.047, p=0.009 and p=0.004, respectively). Adolescents identifying as a racial/ethnic minority and belonging to a household of lower professional status had significantly increased SI (p=0.009 and p=0.028, respectively). Race/ethnicity or SES were not associated with SJL (p≥0.203). The association of race/ethnicity with a delayed SM and increased SI remained significant after adjusting for all covariates, including SES (p=0.009 and p=0.029, respectively).

Conclusion

Racial/ethnic disparities in the circadian timing of sleep are not fully explained by socioeconomic factors in adolescents. Beyond insufficient sleep, circadian misalignment and its upstream social determinants should also be a target of strategies to prevent sleep health inequalities in historically minoritized racial/ethnic groups.

Support (if any)

AHA (23PRE1011962), NIH (R01HL136587,R01MH118308,UL1TR000127)
0246 Testing for Obstructive Sleep Apnea by Area Socioeconomic Deprivation in Six Million Adults
Authors: Greider Montana , Fernandez Chris , Rusk Sam , Nygate Yoav , Richardson Dana , Hutchinson Brian , Bartholow Tim , Watson Nathaniel , Wickwire Emerson
Published: April 2024

Introduction

Area socioeconomic deprivation, as measured by the Area Deprivation Index (ADI), is associated with numerous adverse health and economic outcomes (cardiovascular, readmissions, Alzheimer’s). This composite score is based on 17 health disparities indicators (income, education, employment, housing) used to rank relative disadvantage across communities, and is a widely utilized key social determinant of health and a validated marker of health risk. The purpose of this study was to determine the association between the ADI and OSA testing and diagnosis.

Methods

Our data source was the All-Payer Claims Database (APCD) for the Wisconsin Health Information Organization from 2017-2022 and linked to the publicly available ADI. Sociodemographic variables were extracted from APCD including race, gender, and age. Inclusion criteria included continuous enrollment coverage for a minimum of 12-months prior to the date of OSA diagnosis (defined by ICD code G47.33) and a diagnostic sleep test (defined by CPT codes for PSGs and HSATs). ADI was measured at state and national levels. Rates of OSA testing and diagnosis were compared between individuals with OSA across the entire range of ADI scores using ordinary least squares (OLS) regression analysis.

Results

Of N=6,026,463 participants, n=1,310,286 were linked and included in the final sample: 53% women, Mean age=46.75[SD=22.2], National ADI=52.4[SD=20.2], ethnoracial demographic group affiliation: 22 self-identified categories), n=154,821 underwent OSA diagnostic testing, and n=43,601 were subsequently diagnosed with OSA (45% women, age=56.24[SD=16.2], National ADI=55.95[SD=20.88]). Diagnostic testing for OSA was significantly, positively associated with socioeconomic deprivation based on National ADI (slope: 0.0002, p< 0.005) and State ADI (slope: 0.0003, p< 0.005). The highest rates of OSA testing were observed in areas of socioeconomic disadvantage (>4.5%: ADI-decile 90-10). Conversely, the lowest OSA testing rates were observed in areas of socioeconomic advantage (< 2%: ADI-decile 0-10). Relative to individuals in socioeconomically advantaged areas (low-ADI), individuals in disadvantaged areas (high-ADI) were approximately 3% more likely to be tested for OSA.

Conclusion

Area socioeconomic deprivation measured by ADI is associated with a small but significant increase in OSA testing. Future research should seek to increase access to OSA care in areas of socioeconomic disadvantage to improve sleep health equity and reduce global health disparities.

Support (if any)
0257 Maladaptive Coping Mediates Associations Between Everyday Racial/Ethnic Discrimination and Insomnia Symptoms
Authors: Singh Rupsha , Gaston Symielle , Sandler Dale , Jackson Chandra
Published: April 2024

Introduction

Structural and interpersonal racism contribute to sleep disparities, likely due in part to heightened arousal/vigilance associated with the chronic stress caused by racial/ethnic discrimination. While working to address structural inequities is essential, it is important to identify how individuals cope – whether healthy/adaptive or maladaptive – with exposure to racial/ethnic discrimination to inform intervention targets since myriad coping strategies may either drive or buffer the effects of racial/ethnic discrimination on insomnia symptoms. Our study is the first to investigate whether associations between everyday racial/ethnic discrimination (e.g., treated as less intelligent/worthy/honest than others) and insomnia symptoms are mediated by coping strategies.

Methods

We used data collected over two follow-up periods from 29,137 women (n=903 Latina, n=1,702 non-Hispanic (NH)-Black, and n=26,532 NH-White) enrolled from 2003-2009 (mean±SD age=54.9±8.5 years) in the Sister Study cohort. In 2008-2012, participants self-reported everyday racial/ethnic discrimination experiences (ever vs. never) and healthy/adaptive (e.g., using emotional support) and maladaptive (e.g., behavioral disengagement) coping strategies (‘not at all=1’ to ‘a lot=4’). Self-reported insomnia symptoms (yes vs. no to either difficulty falling or staying asleep) were obtained between 2017-2019. Mediation analysis was performed using PROCESS macro adjusting for sociodemographic/health (e.g., age, sleep medication use) characteristics to provide bias-corrected bootstrapped standard errors and confidence intervals for total, direct, and indirect effects.

Results

Overall, 9% of women reported everyday racial/ethnic discrimination, and prevalence varied by racial/ethnic group (79% among NH-Black, 31% Latina, and 4% NH-White). All racial/ethnic groups reported similar healthy/adaptive (mean±SD overall score=16.2±2.4) and maladaptive (mean±SD overall score=7.1±1.6) coping styles. The prevalence of insomnia symptoms was also similar across racial/ethnic groups (39%-44%). Maladaptive coping fully mediated/explained the relationship between everyday racial/ethnic discrimination and insomnia symptoms for NH-Black (βdirect effect=0.02, 95% CI [-0.229, 0.271]; βindirect effect=0.03, 95% CI [0.006, 0.062]) and partially mediated/explained for NH-White (βdirect effect=0.24, 95% CI [0.107, 0.367]; βindirect effect=0.04, 95% CI [0.025, 0.048]) women, but healthy/adaptive coping did not mediate/explain this relationship across racial/ethnic groups.

Conclusion

Maladaptive coping strategies explain relationships between racial/ethnic discrimination and insomnia symptoms among NH-Black and NH-White women, underscoring the need for interventions that address maladaptive coping strategies to mitigate the impact of racial/ethnic discrimination on sleep disturbances.

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0260 Skin Tone - A Marker for Bias Known as Colorism - In Relation to Sleep Health Among African American Women
Authors: Ogbenna Bethany , Gaston Symielle , Harmon Quaker , Baird Donna , Jackson Chandra
Published: April 2024

Introduction

Colorism – or skin tone bias – likely impacts sleep health through activation of stress pathways in psychological response to trauma from colorist experiences and/or through differential access to health-promoting resources due to fewer educational/economic opportunities granted to darker- compared to lighter-skinned individuals. However, investigations of skin tone in relation to sleep are sparse.

Methods

We assessed associations between skin tone and sleep dimensions cross-sectionally (2010-2012) and longitudinally (until 2014-2018) among a cohort of 1,674 Black women aged 23-35 years residing in Detroit, MI at enrollment (2010 – 2012). Skin tone was measured objectively using a digital skin reflectance instrument and categorized as light [29.3–57.6] (25%), medium [57.7-72.4] (50%), and dark [72.5-106.1] (25%) brown. Self-reported sleep dimensions were dichotomized (yes vs no) as: short sleep duration (< 7 hours), non-restorative sleep (waking up feeling well-rested < 4 days/week), insomnia symptoms (difficulty falling or staying asleep 10+ days/month), and diagnosis of sleep apnea. Adjusting for age, we used Poisson regression with robust variance to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) and applied generalized estimating equations to determine risk ratios (RRs) and 95% CIs between skin tone and each sleep dimension, separately.

Results

At baseline, mean age was 28.7±3.4 years. Women with darker skin had the highest prevalence of short sleep (61.6% vs. 59.5% [medium] and 55.7% [light]) and comparable prevalence of non-restorative sleep (37.9% vs. 37.8% [medium]) and 37.2% [light] and sleep apnea (6% vs. 5.3% [medium] and 4.5% [light]). Women with light skin had the highest prevalence of insomnia symptoms (21.1% vs. 17.7% [medium] and 15.6% [dark]). Women with dark vs. light skin had a marginally higher prevalence and risk of short sleep (PR=1.04 [95% CI:1.00-1.08] and RR=1.07 [95% CI:0.99-1.16]) and a lower prevalence of insomnia symptoms (PR=0.95 [95% CI:0.91-0.99]). Skin tone was not associated with the remaining sleep dimensions.

Conclusion

Sleep disturbances were prevalent, and dark- compared to light-brown skinned participants had a higher prevalence of short sleep duration but a lower prevalence of insomnia symptoms. Associations between dark skin tone and short sleep duration persisted over time. Future studies should identify structural and psychosocial contributors to inform interventions.

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0261 The Social Determinants of Sleep in Emerging Adulthood
Authors: Joshi Crishnaa , Ebenezer Abisha , Taylor Ronald D
Published: April 2024

Introduction

Emerging adults, especially Black college students, are at risk for poor sleep outcomes. Race and family support are crucial factors linked to sleep, yet lifestyle and health factors are frequently investigated in this population. We examined sleep quality as a mediator of the association between race-related stress and depression at varying levels of housing security and kinship support.

Methods

Black students attending a large predominantly White institute (n = 93, 86.02% female, Mage = 21.7 years, 41.9% low SES) reported on sleep quality, race-related experiences, family factors, and depression. A moderated mediation model was tested using methods established by Baron and Kenny (1986). Participants’ sleep was assessed using the Pittsburgh Sleep Quality Index (Buysse et al., 1989). 86% of participants reported poor sleep based on the recommended cutoff (5 points) established by Buysse (1989), with a higher score indicating poorer sleep quality.

Results

Sleep partially mediated the association between race-related stress and depression. A significant association between race-related stress and depression was found in a simple mediation analysis (b=0.25, p< 0.001), however, the relationship between race-related stress and depression was non-significant (b=0.114, p=0.07) after introducing sleep as a mediator. Sleep was a significant predictor of depression (b=1.69, p< 0.001), and its inclusion significantly improved the model, explaining an additional 25 percent of the variance in depression (R^2=0.25, p< 0.001). Associations between race-related stress and sleep quality varied by the level of kinship support and housing security. The association of race-related stress with depression through sleep is significant for participants with low kinship support (b = .220, p < 0.001), but not for those with high kinship support (b=.056, p= .364). Similarly, the association of race-related stress with depression through sleep was significant for participants experiencing housing insecurity (b=.175, p < .001), but not for those experiencing housing security (b=.07, p = .211).

Conclusion

The conditional effects of kinship support and housing security emphasize the crucial role of social support in mitigating the adverse effects of racial stress on sleep. Our findings demonstrate the interplay of race, sleep, and adjustment, suggesting the importance of tailored interventions for promoting the well-being of Black college students.

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0273 Photovoice for Leveraging Integrative Medicine Amongst Black Adults to Improve Sleep Health
Authors: Moise Rhoda , Chery Maurice , Wyrick MyKayla , Moise Imelda , Seixas Azizi , Jean-Louis Girardin
Published: April 2024

Introduction

Average adults are recommended to have 7-8 hours of sleep. However insufficient sleep (IS; < 7 hours/nightly) is associated with increased risk of chronic diseases such as cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM). Integrative medicine, a burgeoning area of research and practice, leverages both modern and traditional approaches to improve health. Despite integrative medicine’s recognition as a tool to improve sleep and related outcomes, there is a gap in literature in addressing its impact among blacks, who experience a disproportionate burden of IS and chronic disease. This qualitative study aimed to examine current integrative medicine practices to overcome IS and overall health in black communities.

Methods

Using photovoice methodology, a qualitative tool which applies community-engaged principles to produce culturally informed results through interviews and digital media, consented participants were recruited from Miami, Florida and 1) instructed to capture images over one week that communicated their integrative practices to improve sleep and overall health on their mobile device; 2) interviewed using individual, semi-structured procedures to add “voice” to the “photos” they captured for ~20 minutes; and 3) invited to participate in follow-up focus groups for refined discussion and data triangulation for ~1.5 hours. Both individual and focus group interviews were conducted over Zoom with recordings transcribed for formal content analysis using Nvivo software.

Results

The sample included N=25 diverse US blacks (M=37, SD=13, range 21-57). Approximately a quarter of the sample were unemployed (N=7) and majority were women (N=21). Results highlighted five themes of integrative medicine practice including: (1) natural wellness (sleep supplements, comfort beverages, aromatherapy, herbalism, outdoors); (2) self-care (self- maintenance, physical activity, spatial comfort); (3) leisure (pet support, play); (4) mental stimulation (mindfulness, reading); and (5) spiritual wellness (faith-based practices). Study results elucidate the heterogeneity of diverse US blacks regarding sociocultural knowledge, beliefs, and behaviors.

Conclusion

Addressing IS in black communities requires a comprehensive strategy that integrates cultural sensitivity, family and community dynamics, education, mental health support, and informed policymaking. Future studies should consider how sleep health literacy, stress appraisal, and coping strategies may vary by race/ethnicity for tailored intervention.

Support (if any)

National Institutes of Health (NIH) R25HL-10-5444 and R01HL142066-06.
0281 Mortality and Cardiovascular Changes in a Murine Model of OSA: Aging and 22 Months of Intermittent Hypoxia
Authors: Badran Mohammad , Puech Clementine , Khalyfa Abdelnaby , Gozal David
Published: April 2024

Introduction

Obstructive sleep apnea (OSA) is a prevalent condition marked by intermittent hypoxia (IH), which significantly elevates the risk of cardiovascular disease (CVD) and overall mortality. Furthermore, aging is a widely acknowledged risk factor for the onset and progression of CVD. In this pioneering study, we aim to elucidate the interplay between 22 months of IH exposures and age-related factors by delineating their combined influence on a spectrum of cardiovascular parameters.

Methods

Male C57Bl/6J mice (n=19-23) were exposed to IH (cycles of FiO2 21% 90 s-6% 90s or room air (RA; 21%) for 12 hours/day during the light period) for 22 months. Mean arterial blood pressure (MBP) was assessed using tail-cuff method, while aortic peak velocity (indicator of systolic function), E/A ratio (indicator of diastolic function), coronary flow velocity reserve (CFVR), and pulse wave velocity (PWV) were assessed using Doppler Flow Velocity System. Then, left anterior descending coronary arteries were excised, mounted on wire myographs, and used to obtain vascular relaxation dose-response curves to acetylcholine (ACh).

Results

The mortality rate in IH-exposed mice was 26% versus 0% in RA-exposed mice. Compared to young (8 weeks old) RA mice, MBP was elevated in old RA mice (p < 0.05) and further elevated in surviving IH mice (p < 0.0001). Similarly, diastolic function was impaired in old RA mice (p < 0.001) and further compromised in old IH mice (p < 0.0001). Moreover, systolic function was preserved in old RA mice but impaired in old IH mice vs. old and young RA (p < 0.0001). Similarly, CFVR was only impaired in old IH mice (p < 0.0001). Interestingly, PWV was higher in old RA vs. young RA (p < 0.001), but significantly lower in old IH mice vs. young and old RA (p < 0.001). Coronary maximal ACh-induced vasodilation was significantly impaired in both old RA (52 ± 9%) and IH-exposed mice (47 ± 9%) when compared to young RA mice (86 ± 4%, p < 0.0001).

Conclusion

Prolonged exposure to IH simulating OSA results in elevated mortality rates and imposes substantial cardiovascular disturbances in surviving mice when contrasted with normal aging.

Support (if any)

NIH grant R01-HL166617
0284 Disrupted NREM Sleep Physiology Linked to 22q11.2 Deletion Syndrome
Authors: O'Hora Kathleen , Schleifer Charles , Xu Jennifer , Fung Hoki , Kushan-Wells Leila , Saletin Jared , Bearden Carrie
Published: April 2024

Introduction

A 22q11.2 deletion (22qDel), is a recurrent copy number variant with profound impacts on neurodevelopment. Disruptions in non-rapid eye movement (NREM) sleep neurophysiology have been observed across idiopathic psychiatric disorders. However, it is unknown whether NREM disruptions exist in 22qDel carriers, who have elevated risk of developing psychiatric disorders. Here, we test the hypothesis that 22qDel carriers will exhibit disrupted NREM sleep neurophysiology across the power spectrum.

Methods

22qDel carriers (n=12, Mage=20.42, 13-28 years, 58.3% males) and TD controls (n=11; Mage=19.18, 13-23 years, 27.3% males) completed multiple nights (89 nights total; 1-6 nights per subject; median=3 nights) of sleep EEG recordings with a wearable headband (Dreem 3). 30-second epochs were excluded for visual artifact or high 20-40Hz power. Relative power in the F7-O2 channel during NREM sleep was calculated using multitaper spectral estimation. Differences in relative power between 22qDel carriers and TD controls were tested across 0.5-20Hz using linear mixed-effects models controlling for age and sex. False Discovery Rate (FDR) was used to correct for multiple comparisons.

Results

There was increased NREM power in slow delta frequencies (0.76-0.85 Hz; q< 0.05) and theta/alpha frequencies (5.95-9.73 Hz; q< 0.05) in 22qDel carriers, relative to TD controls. There were increases in the alpha/sigma range (9.73-12.63 Hz) in 22qDel carriers, but these results did not survive FDR correction (q< 0.10).

Conclusion

These findings suggest that neural mechanisms of NREM sleep regulation, particularly homeostatic sleep regulation, may be dysregulated in 22qDel carriers. Next steps will involve examining group differences in specific features of NREM sleep physiology (e.g., slow waves).

Support (if any)

R01MH085953; UCLA Center for Autism Research Pilot Grant; Autism Speaks Predoctoral Fellowship #13530