bluuebunny/crossref_metadata_2025 huggingface dataset:
1196 Machine Learning Derived-Interpretative Algorithm Better Differentiates Sleep and Wake Epochs and Estimates Sleep Parameters from Wrist Actigraphy Data
Authors: Haghayegh S , Khoshnevis S , Smolensky M H , Diller K R , Castriotta R J
Published: May 2020

Introduction

Several different interpretive algorithms (IAs) are available for scoring actigraphy-obtained body movement data for sleep and wake epochs. Although most have high sensitivity in detecting sleep epochs, they identify wake epochs poorly. We derived a machine learning (ML) based IA that improves differentiation of sleep and wake epoch to better estimate sleep parameters.

Methods

Forty-one adults (18 females) 26.6±12.0 years old underwent at-home single-night sleep assessment. Motionlogger® Micro Watch Actigraph recorded in zero crossing mode body movement per 30s epoch, with automated sleep scoring by single-channel electroencephalography (EEG) device (Zmachine® Insight+) as reference. The popular Cole-Kripke IA was applied to score body movement time series data of the following combination of current 1, preceding 4, and following 2 minute long epochs. Data of 21 subjects were utilized to train/derive the ML IA (logistic regression), and data of the other 20 subjects were used to test performance of it and the Cole-Kripke IA.

Results

In reference to the EEG, the Cole-Kripke actigraphy IA showed sensitivity of 0.98±0.02, specificity of 0.48±0.19, and kappa agreement of 0.53±0.16 in detecting sleep epochs, while the ML-derived IA showed corresponding values of 0.90±0.06, 0.71±0.14, and 0.57±0.11. The Cole-Kripke IA, relative to EEG, method significantly (P<0.05) underestimated sleep onset latency (SOL) by 18.0 min and wake after sleep onset (WASO) by 35.1 min, and overestimated total sleep time (TST) by 53.1 min and sleep efficiency (SE) by 9.6%. The ML-derived IA, relative to EEG significantly underestimated SOL by 15.1 min, but comparably (P>0.05) estimated WASO, TST, and SE.

Conclusion

The ML-derived IA, in comparison to Cole-Kripke IA, when applied to sleep-time wrist actigraphy data significantly better differentiates wake from sleep epochs and better estimates sleep parameters.

Support

This work was supported by the Robert and Prudie Leibrock Professorship in Engineering at the University of Texas at Austin.
1198 Efficacy of Direct Thermoelectric Forehead Cooling for Treating Insomnia Symptoms
Authors: Schirm J , Bellamy B , Nofzinger E
Published: May 2020

Introduction

Prior studies have shown beneficial effects of forehead cooling in insomnia patients using a device that circulates cooled fluids through a forehead pad. The current study aimed to determine if a device that cooled via direct thermoelectric contact to the forehead via a Peltier cooler would have similar effects in individuals with insomnia symptoms. Such a technology may allow for form factors that may have advantages for some individuals.

Methods

An intelligent, portable and battery-operated forehead cooling system using thermoelectric coolers (TECs) with a user selectable temperature range between 14C and 18C was used in the study. Individuals with insomnia symptoms (N=30, 25 female) were recruited and studied at 2 geographic locations. Each participant received pre- and post- treatment insomnia severity as well as daily sleep diary assessments over 1 week of baseline and 4 weeks of treatment.

Results

Participants’ insomnia symptoms improved over baseline in insomnia severity index (M + SD = 19.7 + 3.8 pre- vs 9.4 + 5.3 post-treatment, t = -9.3, p<0.00001), in sleep latency (M + SD = 43.0 + 40.8 minutes pre- vs 20.7 + 22.7 minutes post-treatment, t = 6.8, p<0.00001), in minutes awake after sleep onset (M + SD =63.0 + 59.2 minutes pre- vs 24.5 +34.5 minutes post-treatment, t = 8.0, p<0.00001) and in sleep quality (0-10 scale with 10 = best, M + SD = 4.1 + 1.9 pre- vs 6.8 + 2.2 post-treatment, t = -13.4, p<0.00001).

Conclusion

Forehead cooling via direct thermoelectric contact to the forehead via a Peltier cooler had beneficial effects on subjective insomnia symptoms. These promising preliminary data suggest the need for further large scale randomized controlled trials to establish the efficacy of forehead-cooling using direct thermoelectric contact to the forehead via a Peltier cooler on insomnia symptoms.

Support

Ebb Therapeutics, Pittsburgh, PA 15222
1212 A Systematic Assessment Of Engagement, Functionality, Aesthetics, Information, And Recommendation Features In Sleep Mobile Applications
Authors: Hollimon L , Moore J , Richards S , Robbins R , Grandner M , Chung A , Chung D , Jean-Louis G , Seixas A
Published: May 2020

Introduction

Initial download and use of sleep tracking is very high, but prolonged use is very low. Poor prolonged use may be attributable to several factors such as engagement, functionality, aesthetics, information, and recommendation. We appraised these five factors in 16 consumer- and research/medical- grade digital sleep devices.

Methods

Three reviewers independently assessed 16 consumer- and medical-grade sleep digital devices using the Mobile Application Rating Scale (MARS) App quality ratings, which measures engagement (engagement, entertainment, interest, customization, interactivity, target group), functionality (functionality, performance, ease of use, navigation, gestural design), aesthetics (layout, graphics, visual appeal), information (Accuracy. Goals, Quality of information, Quantity of information, Visual information, Credibility, and Evidence base) and recommended on a Likert scale, with 1- Inadequate to 5 Excellent. Each subcategory is rated on a 1-5 Likert scale which is summed for each category: engagement (30), functionality (25), aesthetics (15), information (35) and recommended (yes or no).

Results

Devices that had the highest engagement score were Fitbit (27), Apple Watch (27), Garmin (27), and Dreem 2 headband (25.5). Apple Watch (30) had highest score; while Fitbit (13), Apple Watch (13), Garmin (13), Samsung Gear (13) had highest aesthetic score. While for information, ActiGraph (35), SOMNOwatch plus (35), CleveMed SleepView Monitor (35), CleveMed Sapphire PSG (35), SOMNOscreen plus (35), Nox T3 Sleep Monitor (35) and Nox A1 PSG System (35) had the highest ratings. The Dreem 2 headband has the potential induce prolong use among users with and without sleep disorders, based on high scores on engagement (25.5), Functionality (20.5), and Information (26.5).

Conclusion

Consumer- and research-grade digital devices that measure sleep have varying levels of engagement, functionality, aesthetics, information and recommendations to facilitate prolong use. Consumer grade devices had higher engagement, functionality and aesthetics scores, while research grade devices had higher information and recommendation scores. If consumer- and research-grade devices are to have prolonged use, standardization is needed across the five MARS components.

Support

K01HL135452, R01MD007716, R01HL142066, and K07AG052685
1238 Central sleep apnea with Cheyne Stokes breathing in a pediatric patient with heart failure
Authors: Powell Weston T , Chen Maida , MacKintosh Erin
Published: May 2020

Introduction

Central sleep apnea due to Cheyne-Stokes breathing (CSA-CSB) commonly occurs in adult patients with chronic heart failure, but has rarely been described in children. We describe a case of CSA-CSB in a pediatric patient with dilated cardiomyopathy and acute heart failure.

Report of Case

A 12-year-old is admitted to the intensive care unit in the setting of new diagnosis of dilated cardiomyopathy leading to acute systolic and diastolic heart failure requiring inotropic infusions. After admission she is noted to have self-resolving desaturations on continuous pulse oximetry while asleep. Sleep medicine is consulted for further evaluation. She has desaturations during naps and night-time sleep that are not associated with any snoring, congestion, cough, choking, or gagging. She underwent adenotonsillectomy 7 years prior. Her father has dilated cardiomyopathy. Current medications are spironolactone, furosemide, ranitidine, loratadine, enoxaparin, milrinone and epinephrine infusion. Physical exam reveals an obese girl with absent tonsils, clear breath sounds, and tachycardia. Cardiac MRI showed severely dilated left ventricle with global hypokinesia and depressed function (EF 7%). Polysomnography reveals AHI 24.2/hr, with oAHI 0/hr and cAHI 24.2/hr. No snoring, flow limitation, or thoracoabdominal paradox is seen. Cheyne-Stokes respiration is present leading to diagnosis of CSA-CSB.

Supplemental oxygen is provided to blunt desaturations. While waiting for titration PSG she underwent placement of a left ventricular assist device and orthotopic heart transplantation. Following heart transplantation she had resolution of desaturations while asleep without supplemental oxygen; family declined repeat polysomnography.

Conclusion

Central sleep apnea with Cheyne-Stokes breathing is associated with increased mortality in adult patients with heart failure and provides important prognostic information if identified. The prevalence of central sleep apnea and its implications are unknown in pediatric patients and our case highlights the need to consider sleep disordered breathing as a cause of desaturations in patients with acute heart failure.
0127 Relationship Between Sleep Metrics with Free-Living Glucose Concentrations and Glycemic Variability in Non-Diabetic Adults
Authors: Sparks J R , Kishman E E , Wang X
Published: May 2020

Introduction

Insufficient sleep and poor sleep quality have been associated with impaired glucose metabolism at fasting and under experimental conditions. Continuous glucose monitoring (CGM) measures glucose concentrations over an extended, free-living period that can be used to assess glycemic health. Relationships between CGM-assessed glucose concentrations and glycemic variability, an emerging glycemic health marker, with sleep metrics have yet to be elucidated. The purpose of this study was to examine the relationships between sleep metrics with glucose concentrations and glycemic variability in non-diabetic adults.

Methods

Twenty-four non-diabetic adults (age=46.0±5.8 years; BMI=32.2±5.7 kg/m2) completed actigraphy, sleep diary, and CGM over 7 consecutive days. Time-in-bed (TIB), total sleep time (TST), wake duration after sleep onset, and sleep efficiency [(TST÷TIB)×100%] were determined using actigraphy assisted with sleep diary input. Nightly variability of each sleep metric was calculated as standard deviation (SD) across all nights. Glucose concentrations at waking in the morning, and 1, 2, and 3 hours prior to waking, and diurnal, nocturnal, and 24-hour means were determined. Intra-day glycemic variability, including mean amplitude of glycemic excursions and continuous overlapping of net glycemic action of 1, 2, and 4 hours, and inter-day glycemic variability, mean of daily differences, were calculated. Pearson product correlations between sleep metrics with glucose concentrations and glycemic variability were performed.

Results

Average TIB and TST were 462.6±61.7 minutes and 403.3±59.7 minutes, respectively. TIB negatively correlated with glucose concentrations at 2 and 3 hours prior to waking (r=-0.42, p=0.04 and r=-0.42, p=0.04, respectively). Nightly variability in sleep efficiency positively correlated with waking, and 1, 2, and 3 hours prior to waking glucose concentrations (0.44≤r≤0.48, p≤0.03 for all). No sleep metrics correlated with glycemic variability measures (p≥0.10 for all).

Conclusion

Findings suggest a longer amount of sleep opportunity and more consistent sleep efficiency relate to better glucose metabolism in non-diabetic adults.

Support

American Heart Association 14BGIA20380706 and University of South Carolina Support to Promote Advancement of Research and Creativity Grant #11530-17-43917.
1268 When scars don’t let you sleep- unusual case of Restless Legs Syndrome secondary to Keloids
Authors: Agarwal Abhishek , Chopra Nikki , Rives-Sanchez Marisela , Bae Charles
Published: May 2020

Introduction

Restless leg syndrome(RLS) is a common disorder which has been estimated to be present in 5 – 15% of the general population with 2.5 % requiring intervention. RLS can be primary or secondary. Secondary RLS usually develops later in life and is associated with another disorder like chronic kidney disease, iron deficiency, spinal cord disease, or varicose veins. Keloids have never been reported to be the cause of RLS.

Report of Case

50 y.o female with hypertension and diabetes presented for evaluation of loud snoring and witnessed apneas. Prior to the visit she underwent a sleep study that showed she had moderate sleep apnea (AHI 15). She also reported having a painful sensation in her legs mainly at night affecting the skin on her calves. The painful sensation gave her an urge to move her legs. Moving or rubbing her legs helped relieve the painful sensation partially. She did not have these symptoms during the day. The symptoms started in the summer of 2018 after she started having keloids on her calves. Keloids followed the course of her varicose veins and the keloids progressed over the last year. Her RLS symptoms were less bothersome when the keloids were smaller. When she has taken tramadol and oxycodone in the past for other pains, she noticed that her painful RLS symptoms were completely eliminated. She was taking gabapentin 600 mg at bedtime for neuropathic pain which hasn’t helped her RLS symptoms. On physical exam, major keloids were seen bilaterally on her calves. Her OSA with treated with CPAP and she was also asked to increase her gabapentin from 600 mg to 1200 mg for her restless legs.

Conclusion

This is one of the first reported cases of RLS secondary to keloids. Whether treatment of keloids would help relieve RLS symptoms is unknown.
0142 TAK-925, an Orexin 2 Receptor-Selective Agonist, Enhanced Cortical Arousal in a Narcolepsy Mouse Model Different from Effects of Modafinil
Authors: Kimura H , Ishikawa T
Published: May 2020

Introduction

Patients with narcolepsy type 1 (NT1) suffer from distressing symptoms such as excessive daytime sleepiness (EDS) and cataplexy. Modafinil is widely used as a therapy for NT1; however, it has limited efficacy for EDS and no efficacy for cataplexy. TAK-925 is an orexin 2 receptor (OX2R)-selective agonist which improves multiple symptoms of narcolepsy such as fragmentation of wakefulness and cataplexy-like episodes, and also reduces weight gain, in orexin/ataxin-3 mice, a narcolepsy mouse model. An early proof of concept study showed TAK-925 increased wakefulness compared to placebo in individuals with NT1; however, a head-to-head comparison between TAK-925 and modafinil in NT1 has not been performed to date. In this study, we carefully compared the wake-promoting effects of TAK-925 and modafinil in orexin/ataxin-3 mice.

Methods

TAK-925 or modafinil was administered to orexin/ataxin-3 mice at zeitgeber time 12, and the sleep/wakefulness states were evaluated based on electroencephalogram (EEG) and electromyogram measurements. EEG spectral analysis was performed by fast Fourier transform during wakefulness. EEG frequency band was divided into five frequency bands: delta, theta, alpha, beta, and gamma.

Results

Both TAK-925 and modafinil significantly increased wakefulness time, and ameliorated fragmentation of wakefulness, in orexin/ataxin-3 mice during active phase. In contrast, TAK-925, but not modafinil, significantly decreased delta power, and increased alpha and gamma power during wakefulness in orexin/ataxin-3 mice, suggesting a shift in EEG power density toward higher frequencies.

Conclusion

TAK-925, but not modafinil, enhanced cortical arousal and suppressed signs of somnolence and drowsiness. In a phase 1 study in individuals with NT1, TAK-925 was found to have pronounced effects on the maintenance of wakefulness test, reaching a total duration of 40 minutes wake time at some doses tested. Spectral analysis will be evaluated in future studies in NT1 patients.

Support

This work was conducted by Takeda Pharmaceutical Company Limited.
0145 Pre-Sleep Cognitive Arousal Decreases Following a 4-Week Introductory Mindfulness Course
Authors: Hassirim Z , Lim E C , Lo J C , Lim J
Published: May 2020

Introduction

Mindfulness-based training has shown potential in reducing anxious and ruminative thoughts before sleep, and improving sleep quality. However, traditional 8-week programs have limited acceptability and uptake. In this study, we aimed to test the effects of a short introductory mindfulness training course on pre-sleep arousal and sleep quality.

Methods

Enrollees in a 4-week Mindfulness Foundation Course were invited to participate in the study and were allocated to one of two groups: intervention (N = 57) and waitlist control (N = 39). 101 participants enrolled in the experiment and 96 completed the protocol (mean(sd) age = 49.5(1.5), 56 female). Participants completed the Pittsburgh Sleep Quality Inventory (PSQI) and the pre-sleep arousal scale (PSAS), and were monitored by actigraphy for a week at baseline and post-intervention. To test the effect of the intervention, outcome variables were subjected to repeated-measures ANCOVA with group as a between-subject variable, and age, gender, and years of education as covariates using intent-to-treat analysis.

Results

PSQI scores improved across both groups (treatment: t56=4.25, p<.001, mean(sd) = 6.93(3.25)); waitlist: t38=3.27, p=.002, mean(sd) = 7.15(3.55)); however, there was no significant interaction between group and time. There was a significant group by time interaction in the cognitive arousal subscale of the PSAS (F1,90=4.71, p=.03), Post-hoc tests revealed a significant decrease in the treatment but not the waitlist group (treatment: t50=3.17, p=.001; waitlist: t30=0.20, p=.84). The decrease in cognitive arousal correlated with the decrease in PSQI scores in the treatment group only (r =.3, p=.007). Finally, a statistically significant interaction favoring the treatment group was also observed in actigraphically measured WASO (F1,82=6.18, p=0.015).

Conclusion

The study suggests that a 4-week introductory mindfulness course has moderate effects on reducing cognitive arousal prior to sleep, and that these effects are correlated with improvements in subjective sleep quality.

Support

This study was funded from a STaR investigator grant (NMRC/STaR/0015/2013) and the National Research Foundation (Singapore) Science of Learning Grant (NRF2016-SOL002-001).
0155 SUVN-G3031, A Potent and Selective Histamine H3 Receptor Inverse Agonist - Differentiating Features Over Current Treatments of Narcolepsy
Authors: Shinde A , Subramanian R , Palacharla R , Pandey S , Benade V , Jayarajan P , Bojja K , Nirogi R
Published: May 2020

Introduction

Majority of pharmacological agents used in the treatment of narcolepsy have several limitations. Both nonclinical and clinical evidences suggest usefulness of the histamine H3 receptor (H3R) inverse agonists for the treatment of narcolepsy and addressing several of the current limitations.

Methods

Extensive nonclinical studies were carried out for SUVN-G3031 and other pharmacological agents that are currently being used for the treatment of narcolepsy. Nonclinical parameters like inter-species binding affinity, selectivity profile, in vivo and in vitro ADME features, nonclinical efficacy, neurochemistry and safety were compared.

Results

SUVN-G3031 has no inter-species variation in binding affinity at H3R with less than 50% inhibition at 1 µM against 70 other targets. Unlike pitolisant, SUVN-G3031 has no significant binding affinity at sigma 1 and 2 receptor. SUVN-G3031 has no inhibition and induction liability towards major CYP enzymes and transporters. Pitolisant is reported to be a CYP3A4, CYP2B6, and CYP1A2 inducer and a CYP2D6 and OCT1 inhibitor. SUVN-G3031 has robust wake promoting effects. SUVN-G3031 showed negligible affinity towards hERG channel with IC50 > 10 µM and had no effects on any ECG parameters in dog telemetry study. SUVN-G3031 did not show convulsion in rats up to the tested dose of 100 mg/kg, p.o. Most of the pharmacological agents used for the treatment of narcolepsy have abuse liability; SUVN-G3031 produced no change in the striatal and accumbal dopamine levels in rats suggesting no propensity to induce abuse liability. Unlike competing H3R inverse agonists, SUVN-G3031 has no effects on fertility and embryo-fetal development up to the highest tested doses.

Conclusion

Nonclinical studies demonstrate superiority of SUVN-G3031 over pharmacological agents currently used in the treatment of narcolepsy. SUVN-G3031 is being evaluated in a Phase 2 study as monotherapy for the treatment of narcolepsy with and without cataplexy (ClinicalTrials.gov Identifier: NCT04072380).

Support

None
0168 Effects of School Night Sleep Duration and Circadian Preference on Student Tardiness: An Investigation in a Middle-School Aged Sample
Authors: Tran K M , Cook J D , Blair E E , Peppard P E , Plante D T
Published: May 2020

Introduction

Sleep and circadian factors play an important role in school attendance, academic performance, and daytime behaviors among adolescents. This investigation assessed school night sleep duration (SNSD) and circadian preference (CP) association with first period tardies (FPT) using a middle-aged sample from the Madison (Wisconsin) Metropolitan School District (MMSD), prior to implementation of a planned district-wide delay in middle school start times.

Methods

4,175 middle-school aged students from 12 MMSD schools completed a sleep survey, which included SNSD and a validated 4-level measure of CP. Self-reported SNSD between 4-and-12 hours served as final sample inclusion criterion. Mixed effects modeling was employed with students nested within school. Linear regression determined SNSD and CP effect on student tardiness. Individual, year-long FPT served as outcome variable. Inclusion of SNSD quadratic term was not statistically indicated. Full model covariates included age, sex, race, parent educational level, homelessness, free and reduced lunch, and special education status.

Results

Final sample included 3,860 students. Univariate regression determined a significant CP association with FPT [β=1.20, 95% CI (0.54, 1.86), F(1,10.41)=13.7, p=0.004), but not SNSD [β=-0.31, 95% CI (-0.70, -0.09), F(1,10.21)=2.5, p=0.14]. SNSD and CP interaction was not significant. CP significance was maintained in the full model [β=1.24, 95% CI (-0.70, -0.09), F(1,11.21)=13.7, p=0.004]. Evening preference associated with 3.72 more FPT, relative to morning preference.

Conclusion

Results suggest evening preference is associated with increased risk of tardiness among middle school students. Future research that examines the relationships between delayed school start times, circadian preference, and impact on school tardiness is indicated.

Support

This research was generously supported by a grant from the Madison Education Partnership (MEP).
0175 Light Improves Alertness and Mood During the Sleep Inertia Period Following Slow Wave Sleep
Authors: Hilditch C J , Feick N H , Wong L R , Bathurst N G , Flynn-Evans E E
Published: May 2020

Introduction

Waking from sleep, especially slow wave sleep (SWS), is associated with reduced alertness known as sleep inertia. Light improves alertness during sleep deprivation and circadian misalignment. In this study, we assessed the efficacy of light to improve alertness and mood immediately after waking from SWS.

Methods

Twelve participants kept a sleep schedule of 8.5 h for 5 nights and 5 h for one night prior to the overnight laboratory visit (confirmed by actigraphy). Participants went to bed at their scheduled habitual bedtime in the laboratory and were monitored by standard polysomnography. After at least 5 min of SWS, participants were awoken and exposed to either red ambient light (control) or blue-enriched bright light (light) for 1 h. During this time, participants completed a subjective scale of alertness (Karolinska Sleepiness Scale, KSS) and visual analogue scales (VAS) of mood at 2 min, 17 min, 32 min, and 47 min after waking. Following this sleep inertia measurement period, all lights were turned off and participants were allowed to return to sleep. They were then awoken again from their subsequent SWS period and exposed to the opposite condition (control or light). A linear mixed-effects model with fixed effects of condition, time, and condition*time and a random effect of participant was used to determine the impact of light across the testing period. An average of baseline responses (pre-sleep) was included as a covariate.

Results

Compared to the control condition, participants exposed to blue-enriched bright light reported feeling more alert (KSS: F1,77=4.955, p=.029; VASalert: F1,77=8.226, p=.005), more cheerful (VAScheerful: F1,77=8.615, p=.004), less depressed (VASdepressed: F1,77=4.649, p=.034), and less lethargic (VASlethargic: F1,77=5.652, p=.020).

Conclusion

Exposure to blue-enriched bright light immediately after waking from SWS may help to improve subjective alertness and mood. Future analyses will explore whether these findings extend to effects on cognitive performance.

Support

Naval Postgraduate School Grant. NASA Airspace Operations and Safety Program, System-Wide Safety Project.
0199 Sleep and Risk Taking Behavior in United States Army Soldiers: A Four Study Mega-Analysis
Authors: Mantua J , Sowden W J , Mickelson C , Choynowski J J , Bessey A F , Burke T M , Capaldi V F , McKeon A B
Published: May 2020

Introduction

In military service members, high risk-taking behavior (RTB; e.g., looking to start a fight, reckless driving) leads to injury, judicial reprimand, and removal from military service. Consequently, reducing RTB has become a priority of the United States (U.S.) Army, and identifying modifiable antecedents of RTB has become critical. In non-military populations, in-lab studies have shown sleep restriction/deprivation leads to risky decision-making. We assessed whether sleep duration/quality and RTB are related in U.S. Army soldiers in operationally-relevant settings.

Methods

Sleep and RTB questionnaire data were collected in 4 unique samples: U.S. Army soldiers from an Armored Brigade Combat Team, Reserve Officer Training Corps (ROTC) Cadets, Special Operations infantrymen, and elite mountain warfare instructors. We aggregated data to conduct a mega-analysis, which is a combined analysis of original raw data. We assessed whether RTB (assessed with an in-house measure of soldier-specific RTB) was correlated with nightly sleep hours (n=2175), Insomnia Severity Index (n=1076), and Pittsburgh Sleep Quality Index scores (n=503). Next, using a linear regression, we assessed whether sleep duration was a predictor of RTB while controlling for relevant demographic factors (age, gender, marital status, combat experience, years of education, rank, years of service; n=1198).

Results

Higher RTB was correlated with lower sleep duration (r=-.23,p<.001), more insomnia symptoms (r=.29,p<.001), and poorer sleep quality (r=.20,p<.001). In the full model, lower age (B=-.02,p=.03) and higher combat experience (B=.05,p=.006) predicted higher RTB. Sleep duration remained a significant (and the strongest) predictor of RTB (B=-.18,p<.001).

Conclusion

Military leaders should work to build in more sleep opportunities and remove environmental sleep disruptors during training and deployment operations. Leaders should also monitor soldier behavior after military operations that require sleep loss in order to reduce RTB, and, consequently, increase the readiness of the force.

Support

This work was supported by the Military Operational Medicine Research Program (MOMRP). The opinions and assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the US Army or of the US Department of Defense. This abstract has been approved for public release with unlimited distribution.
0204 The Impact of Sleep on Well-Being and Diurnal Performance in Elite Australian Football League Athletes
Authors: Facer-Childs E R , Drummond S P , Rajaratnam S W
Published: May 2020

Introduction

The ultimate goal in the sports world is achieving optimal health and continuous high-level performance through an adequate balance of training load and recovery e.g. rehab, nutrition, well being and sleep. Athletes often encounter situations that negatively impact their ability to sleep well, disrupt their biological rhythms and increase mental stress e.g. late competition times, travel and high training load. Therefore, there is a need to increase our understanding of how individual variability could be impacting recovery and performance in elite sports.

Methods

This study examined the relationships between individual sleep and circadian patterns, well-being and performance variables in Australian Football League (AFL) athletes. Actigraphy combined with daily sleep diaries were used to gather objective sleep data over a period of 14 days. Performance tests were conducted in the morning (between 07:00 - 08:00am) and afternoon (between 14:00 - 15:00) on days 3, 5, 7, 10, 12 and 14. Performance measures included a strength test (force plate jump), a skilled based accuracy test (goal kicking) and a reaction time test (psychomotor vigilance task).

Results

Preliminary results show that sleep and circadian parameters differed significantly between individuals and were correlated with measures of well-being and diurnal performance.

Conclusion

The Australian Football League (AFL) is one of the largest growing sports industries in Australia and New Zealand with annual revenues reaching a billion dollars. These findings add to the growing literature showing how sleep impacts performance in elite athletes and highlights the need to take sleep and time of day into account. This is of critical importance to the global sports industry, who are constantly seeking marginal gains.

Support

n/a
0206 Sleep Opportunity and Duration are Related to Risk Injury in Elite Athletes
Authors: Shaw L , Cohen R , Altman Y , Eyal S , Baharav A
Published: May 2020

Introduction

Sleep is essential to musculoskeletal recovery, acquisition of new skills and emotional regulation in athletes. Insufficient sleep is detrimental to performance. Recent publications indicate that sleep duration is related to risk for injury in young athletes. We aimed at analyzing the relation between sleep opportunity and duration and the likelihood of an injury among adult elite athletes.

Methods

We studied 7,237 nights recorded with the Sleeprate application by 71 adult elite athletes from diverse sports, during the period September 2018-October 2019. Night recordings included perceived and measured sleep parameters. In addition, athletes reported their previous day nap duration, injuries and illness status. Out of the total number of nights, 4,205 included reported injury status with no injury and no illness for the previous night. Nightly total time in bed (TIB), TIB including reported naps (TIB24hr) and measured total sleep time (TST) were examined.

Results

Average TIB was significantly shorter (508±77 minutes, mean±STD) in healthy days preceding injuries than in healthy days preceding days with no injury (525±70 minutes, p<.001). Similar results were found when comparing the TIB24hr (injury: 517±83 minutes, no injury: 543±76 minutes, p<.001) and TST (injury: 443±72 minutes, no injury: 457±69 minutes, p<.001).

Conclusion

Average sleep opportunities of the elite athletes in this study were in accordance with their age and workouts load. The time athletes allow themselves as an opportunity for sleep is inversely correlated to the chances of developing an injury. These findings corroborate published research regarding sleep duration and risk of injury in athletes, yet our findings are based on real life data of elite athletes, and demonstrate the importance of sleep as part of the elite or professional athlete’s routine, suggesting that even as little as around 20 minutes of added sleep may be efficient in preventing injury.

Support

N/A
0213 The Association Between Work-Related Job Demands and Daytime Impairment in Professional Firefighters
Authors: Soto P , Dzierzewski J M , Dautovich N D , Ravyts S G , Perez E , Donovan E K
Published: May 2020

Introduction

Sleep is an important predictor of daytime functioning and is impaired in first responders. The present study investigated whether job demands were associated with daytime impairment in professional firefighters. We hypothesized that the frequency of emergency calls would predict daytime impairment above and beyond years of service, sleep apnea risk, and sleep duration.

Methods

Participants were 267 (251 males; mean age=41.94) firefighters from the Richmond, Virginia Fire Department who completed pen-and-paper surveys in small groups assessing sleep duration (Pittsburgh Sleep Quality Index; PSQI), sleep apnea risk (STOP-BANG), job demands (number of emergency calls received per day), and sleep-related impairment (Patient Reported Outcomes Measurement Information System 8-item short-form; PROMIS). A three block hierarchical regression was used to assess the contribution of job demands to daytime impairment.

Results

The final model significantly predicted sleep-related daytime impairment, F(4,260)=11.51, p<.001, R2=.15. Each block in the model accounted for significant change in variance, years of service and sleep apnea risk (R2=.05), sleep duration (∆R2=.08), number of calls (∆R2=.01). Number of emergency calls significantly predicted daytime impairment (β=.14) above and beyond number of years of service (β= -.24), sleep duration (β= -.29), and sleep apnea risk (β=.03).

Conclusion

With 2–18 emergency calls per 24-hour period, the results suggest that job-related demands are a unique contributor to daytime functioning in professional firefighters. As such, it will be important for interventions aimed at improving sleep in professional firefighters to incorporate information unique to the profession (i.e., job specific demands and intensity of work) as specific treatment factors.

Support

This work was supported by the National Institute on Aging (K23AG049955, PI: Dzierzewski).
0217 Adolescents’ Evening Preference is Associated with Specific Sleep Hygiene Behaviours
Authors: Gauthier-Gagne G , Dimakos J , Somerville G , Boursier J , Gruber R
Published: May 2020

Introduction

Circadian tendencies are associated with individual differences in preferred timing of behaviour. Sleep hygiene encompasses a variety of habits that are necessary for healthy. Given the later bedtimes of individuals with evening circadian preferences, more time is spent being awake in the evening and this could be associated with increased or longer engagement in poor sleep hygiene. Specific sleep hygiene practices that are common in adolescents with high evening preferences may therefore be a target to improve sleep. However, the relationship between specific sleep hygiene behaviours and circadian preferences in adolescents has not been examined. The objective of this study was to examine the associations between circadian preference and specific domains of sleep hygiene behavior.

Methods

127 adolescents (86 female) between 13 and 18 years old (M = 14.83, SD = 1.20) participated in the study. Circadian preferences were measured by the Morningness-Eveningness subscale of the School Sleep Habits Survey. Sleep hygiene was measured using the Adolescent Sleep Hygiene Scale (ASHS).

Results

Higher eveningness scores were significantly negatively associated with the ASHS physiological, behavioural arousal, cognitive emotional arousal, sleep environment, sleep stability, daytime sleep, substances use factors (r = -.20, p = <.05, r = -.27, p = <.01, r = -.32, p = <.01, r = -.18, p = <.05, r = -.41, p = <.01, r = -.28, p = <.01, r = 0.20, p = <.05 respectively) and with total sleep hygiene score (r = -.45, p = <.01).

Conclusion

Higher eveningness preferences in adolescents is significantly associated with poorer sleep hygiene in all domains with the exception of bedtime routine. Behavioural arousal, cognitive emotional, and sleep stability domains show the strongest inverse correlations. These findings could be used to inform the development of tailored sleep health interventions for adolescents with strong evening tendencies

Support

Social Sciences and Humanities Research Council (SSHRC) support for Dr. Reut Gruber.
0226 Sleep Duration and Symptoms Associated with Race/Ethnicity in Elite Collegiate Athletes
Authors: Ramsey T , Athey A , Auerbach A , Turner R , Williams N , Jean-Louis G , Killgore W D , Wills C C , Grandner M A
Published: May 2020

Introduction

Previous studies have documented sleep disparities in the general population. Given the increased interest in sleep among athletes, and the degree to which demographics and schedules among athletes differ from the general population, this analysis aims to examine the relationship between race/ethnicity and sleep duration and symptoms among elite college athletes.

Methods

Data were obtained from N=189 Division-1 collegiate athletes across a wide range of sports played. Race/ethnicity was self-reported and categorized as Non-Hispanic White, Black/African-American, Hispanic/Latino, Asian, and American Indian/Alaskan Native. Outcomes of interest included self-reported typical sleep duration (in hours), CESD depression score, and frequency of sleep symptoms, assessed using items from the Sleep Disorders Symptom Check List (difficulty falling asleep, difficulty staying asleep, early morning awakenings, tiredness, sleepiness, loud snoring, choking/gasping, fragmentation, hypnogogic/pompic hallucinations, sleep paralysis, and nightmares). Sleep duration and depression were evaluated with linear regression, and symptoms were evaluated as ordinal. Covariates included age and sex.

Results

Compared to Non-Hispanic Whites, Blacks/African-Americans reported less sleep (B=-0.80, p<0.0005), more depression (B=2.85, p=0.046), more difficulty maintaining sleep (oOR=2.12, p=0.034), early morning awakenings (oOR=3.15, p=0.001), and sleepiness (oOR=2.11, p=0.048); Hispanic/Latinos reported more hypnogogic/pompic hallucinations (oOR=2.90, p=0.007), sleep paralysis (oOR=2.72, p=0.026), and nightmares (oOR=2.22, p=0.035); Asians reported more depression (B=4.46, p=0.028), sleepiness (oOR=5.06, p=0.003), loud snoring (oOR=4.71, p=0.018), and sleep paralysis (oOR=3.57, p=0.031); and American Indians/Alaskan Natives reported less sleep (B=-1.00, p=0.018).

Conclusion

Racial/ethnic differences in sleep duration and sleep symptoms were seen among athletes. Future studies will be needed to replicate and further explain these findings.

Support

The REST study was funded by an NCAA Innovations grant. Dr. Grandner is supported by R01MD011600
0238 Campus Food Pantry Assistance is Related to Better Physical And Mental Health Through Adequate Sleep Among College Students in a Public University System
Authors: Martinez S , Kalaydjian S , Ritchie L , Nazmi A , Prather A
Published: May 2020

Introduction

Food insecurity is an issue among students in higher education and has been linked to insufficient sleep, and poor mental and general health. College campuses have quickly responded by establishing campus food pantries. However, the extent to which campus food pantries are ameliorating the impacts of food insecurity is unknown.

Methods

Online survey data were collected from a cross-sectional sample of 1,855 students who were food pantry users in the 10-campus UC system. Students were asked to report their number of visits to a food pantry in the past month, and to rate their general health, depressive symptoms, and number of days of enough sleep (in a week) before and after food pantry access. Changes in days of enough sleep, depressive symptoms and general health were computed. Demographic characteristics were obtained from institutional data. Path analysis was used to examine direct and indirect pathways from food pantry use to depressive symptoms and general health through enough sleep days, controlling for workstudy receipt, Pell grant receipt and family income.

Results

Students on average were 21.7 years old (SD= 3.5), and had more days of adequate sleep (25%), and improved depressive symptoms (43%) and general health (31%) after obtaining services from a campus food pantry. An increase in monthly food pantry use was directly related to a decrease in depressive symptoms (β= 0.08, p<0.001) and an increase in general health (β= 0.07, p=0.001). Additionally, an increase in food pantry use related to an increase in getting more days of enough sleep (β=0.07, p=0.001), which in turn positively related to a decrease in depressive symptoms (β=0.18, p<0.001) and improved general health (β=0.24, p<0.001).

Conclusion

Food pantry use had a positive relationship with student health outcomes, and enough sleep days played an important mediating role. Findings suggest that emergency food access may have a positive impact on student health outcomes.

Support

This study was funded by the UC Campus Basic Needs Committees.
0272 Effects of Gestational Sleep Restriction on Maternal Behavior in Rodents: A Systematic Review and Meta-Analysis
Authors: Pires G N , Baenninger T , Mello V , Andersen M L , Tufik S
Published: May 2020

Introduction

Sleep restriction during pregnancy is related with postpartum depression in clinical settings. Preclinical studies have been conducted in rodent models of maternal behavior, intending to evaluate the mechanisms behind this relationship, but have raised inconsistent data so far. Our aims were to perform a preclinical meta-analysis, evaluating the actual effects or prenatal sleep restriction on maternal behavior in rodents.

Methods

A bibliographic search was conducted in Pubmed, Scopus, Web of Science, Psychinfo and Lilacs. Search strategy encompassed three domains: sleep restriction during pregnancy (as intervention), maternal behavior (as outcome) and experimentation animals (as population). Studies were first selected based on titles and abstracts, followed by full text analysis and data extraction. Individual effect size for each articles was calculated using standardized mean difference and meta-analysis was conducted using a DerSimonian and Laird random effects model.

Results

144 articles were included in our initial data screening. Sample was reduced to six records after screening. A meta-analysis was performed, including data from two maternal behavior tests (pup retrieval test and ethogram-based analyses). A total of 115 animals were included. Meta-analysis showed that sleep restriction during pregnancy have no significant effects on maternal behavior.

Conclusion

Clinical studies and meta-analysis have shown that sleep restriction and disorders during pregnancy increase risk for postpartum depression. However, preclinical studies fail to corroborate these results, as sleep restriction during pregnancy does not reduce maternal behavior in rodents. The presence of negative effects in women and the maintenance of normal maternal behavior levels in rodents under comparable intervention demonstrate that other factors might mediate this relationship (among which, sociocultural factors might play a role). The maintenance of maternal behavior seems to be an adaptive behavior, assuring the suitability and survival of the litter, even in face of environmental stresses.

Support

AFIP, FAVC, CNPq, FAPESP
0276 Does Losing Sleep Unleash Anger?
Authors: Krizan Z , Miller A , Hisler G
Published: May 2020

Introduction

Sleeping is understood as essential to affective function, yet little is known about how sleep shapes more specific and contextualized emotional responses besides anxiety and depression, such as anger. Anger itself involves arousal and can disrupt sleep. To examine the causal role of sleep in anger, a daily-diary study and an experimental study tested whether shortened sleep amplifies angry feelings, while exploring mediating mechanisms of this influence.

Methods

The daily-diary study (N = 202) collected daily reports of last-night’s sleep, daily stressors, and state anger across one month from college students, examining sleep and anger within everyday life. The experimental laboratory study (N = 147 community residents) examined changes in anger experienced during aversive noise following random assignment to either at-home sleep restriction (by about 5 hours across 2 nights), or to individuals’ regular schedule.

Results

In the daily-diary study, individuals experienced more anger on days following less sleep than their usual, with half of this effect attributed to the increased frequency of stressors experienced on such days, and somewhat independently from the effect of sleep duration on negative affect more generally. In the experimental study, well-slept individuals adapted to noise and reported less anger and negative affect after 2 days. In contrast, sleep-restricted individuals exhibited higher and increased anger responses. The impact of sleep restriction on anger held even after accounting for negative emotions more generally. Subjective sleepiness accounted for most of the experimental effect of sleep loss on anger.

Conclusion

Together, these results provide compelling evidence that lost sleep amplifies anger in both the laboratory and everyday life, while also pointing to short-term (subjective sleepiness) and mid-term (stress) mediators of these influences. The findings also point to the value of examining specific emotional reactions (and their regulation) in the context of sleep disruption, alongside affect more broadly.

Support

N/A
0301 Different Indices of Vigilant Attention During Sleep Deprivation: Evidence of Multiple Vigilance Constructs?
Authors: Lawrence-Sidebottom D , Hinson J M , Whitney P , Honn K A , Van Dongen H
Published: May 2020

Introduction

Total sleep deprivation (TSD) causes profound vigilant attention deficits, with large, trait-like individual differences, as evidenced convincingly by response lapses on the psychomotor vigilance test (PVT). There is debate, however, about the role of vigilant attention deficits in the effects of TSD on other speeded performance tasks besides the PVT. We addressed this issue by testing whether PVT response lapses are related to delays in responding to stimuli under strict deadlines in two decision making tasks.

Methods

N=54 healthy adults (aged 21-38y; 31 females) completed an in-laboratory TSD study. Following a 10h baseline sleep opportunity, cognitive testing occurred after 25h and 29h of TSD (09:00 and 13:00). Testing included an AX continuous performance task with switch (AX-CPTs), which is a dynamic decision making task requiring subjects to respond to a frequently occurring cue-probe combination; an identical pairs continuous performance task (CPT-IP), which is a 1-back go/no-go task; and a 10min PVT. Lapses (RTs>500ms) on the PVT and target accuracy on the AX-CPTs and CPT-IP were calculated as indices of vigilant attention. Intraclass correlation coefficients (ICCs) were used to quantify the stability of individual differences, and absolute rank-order correlation (|ρ|) was used to compare the three indices.

Results

The stability of individual differences ranged from fair to substantial (PVT: ICC=0.44; AX-CPTs: ICC=0.73; CPT-IP: ICC=0.31). The rank-order correlation between the AX-CPTs and CPT-IP vigilant attention indices was relatively high (|ρ|=0.44), whereas correlations with PVT lapses were much lower (AX-CPTs: |ρ|=0.14; CPT-IP: |ρ|=0.04).

Conclusion

Individual differences during TSD were moderately stable for each index of vigilant attention, but the relationships between PVT lapses and the other indices were weak. This suggests that any or all of the indices considered here are not pure measures of vigilant attention, or that vigilant attention may constitute multiple, distinct constructs.

Support

CDMRP grant W81XWH-16-1-0319