bluuebunny/crossref_metadata_2025 huggingface dataset:
0255 Comparing Performance, Fatigue and Sleepiness Between Short-Haul And Ultra Long-Haul Commercial Airline Operations
Authors: Lamp A , Rasmussen I , Soriano-Smith R , Keller C , Basiarz E , Belenky G
Published: May 2020

Introduction

Safety performance indicators (SPIs) are used in aviation to determine if a trip that is non-compliant with federal regulations is safe to fly. Exemptions to regulations can be granted if a safety case demonstrates that the SPIs for an alternative means of compliance (AMOC; i.e., a trip outside regulations) are non-inferior to SPIs for a safety standard operation (SSO; i.e. a trip compliant with regulations). Through this process, it has previously been suggested that ultra-long-range flights are non-inferior to long-range flights due to increased sleep opportunity. We determined whether SPIs for non-compliant ultra-long-range (ULR) trips are non-inferior to those for compliant short-haul (SH) trips.

Methods

Performance, fatigue, and sleepiness were assessed at the top of descent (TOD) of flight segments using the Psychomotor Vigilance Task (PVT), Samn-Perelli (SP) fatigue scale, and Karolinska Sleepiness Scale (KSS), respectively. Data were analyzed using non-inferiority testing. Two different ULR trips with different TOD times (ULR trip 1: n=81; ULR trip 2: n=22) were compared to two types of SH trips, including one trip that contained one or more all-night flights (SH trip 1: n=48) and one trip with zero all-night flights (SH trip 2: n=47).

Results

Non-inferiority was found for the SPIs at most comparison points. For example, comparing the SPIs for ULR trip 2 and SH trip 1 at final TOD, non-inferiority was found for all SPIs. In contrast, comparing the SPIs for ULR trip 1 and SH trip 1 at final TOD, non-inferiority was found for SP and KSS, while non-inferiority for PVT was only suggested.

Conclusion

The findings suggest that the AMOC trips are as safe as or safer than the compliant SH trips. This raises questions regarding the structure of SH trips and how differences in the structures play a role in performance, fatigue and sleepiness.

Support

United Airlines
0266 A Brief Nap During a Period of Sleep Deprivation Does Not Mitigate Cognitive Deficits
Authors: Stepan M E , Altmann E M , Fenn K M
Published: May 2020

Introduction

Sleep deprivation consistently impairs vigilant attention and placekeeping, which is the ability to maintain place in a sequence of steps without skipping or repeating steps. Placekeeping is a broadly important component of higher-order cognition. Previously, we found that caffeine benefitted vigilant attention but had no effect on placekeeping for most individuals. Here, we investigated the extent to which another intervention, brief naps, mitigated deficits in vigilant attention and placekeeping during a period of sleep deprivation.

Methods

In the evening, participants completed assessments of placekeeping and vigilant attention, the UNRAVEL task and Psychomotor Vigilance Task (PVT), respectively. Participants were then randomly assigned to either stay awake in the laboratory overnight (Sleep-deprived) or sleep at home (Rested). Sleep-deprived participants were also randomly given a 0, 30, or 60 minute nap opportunity. During the naps, participants were setup with partial polysomnography. In the morning, Rested participants returned and everyone completed UNRAVEL and PVT again.

Results

Sleep deprivation increased placekeeping errors, particularly following interrupted performance, and increased attentional lapses. A brief nap opportunity did not mitigate placekeeping or vigilant attention deficits. Polysomnography data showed that total sleep time was negatively related to placekeeping errors following an interruption; participants who slept more made fewer post-interruption errors. Slow wave sleep (SWS) was negatively related to attentional lapses and placekeeping errors on non-interruption trials; participants who obtained more SWS made fewer lapses and non-interruption errors. Sleep latency was also negatively related to attentional lapses, such that participants who fell asleep quickly, an indication of greater sleepiness, had more attentional lapses.

Conclusion

A brief nap during a period of sleep deprivation is not a viable intervention and longer naps may be required before observable performance benefits emerge. However, specific aspects of sleep architecture were related to performance on the two tasks, suggesting domain-specific deficits due to sleep deprivation.

Support

Funding received by the Office of Naval Research N00014-16-1-2841.
0268 Development of an Integrated Model of Sleep Deprivation in Adolescence
Authors: Kwon M , Park E , Livingston J A , Dean G E , Suzanne D S
Published: May 2020

Introduction

Sleep deprivation is a consistently and widely concerning problem among adolescents. Although a few models have been proposed to explain the relationships and pathways through which factors influence sleep in adolescents, there are lack of theoretical models that apply both biological and behavioral factors that contribute to sleep deprivation across the trajectory of adolescent development. The current study proposes an integrated model that draws upon constructs from several influential theories with an aim to re-conceptualize factors associated with sleep deprivation as a chronic and cyclic problem that emerges from biological and behavioral changes in youth.

Methods

The Two Process Model of Sleep Regulation, Spielman’s 3p model, the theory of planned behavior, dual systems model, and sleep health framework are used to develop an integrated model of factors that lead to sleep deprivation in adolescents.

Results

The resulting integrated model highlights the importance of adolescent’s inherent nature of delayed sleep phase at pubertal onset (two process model); increased reward-seeking that precedes the structural maturation of their cognitive control and emotions (dual systems model); and their attitudes/perceptions towards sleep (theory of planned behavior), which is often geared toward not prioritizing sleep. Sleep health framework adequately frames the pattern of sleep-wakefulness in adolescents using a multidimensional approach of sleep. Moreover, the new model presents contextual factors (Spielman’s 3p model) and the way that these constructs interact in order to maintain a vicious cycle of insufficient sleep which leads to chronic sleep deprivation.

Conclusion

The current model portrays a wide-ranging view of mechanisms underlying sleep deprivation among adolescence by integrating both biological and behavioral aspects. The model is proposed to encourage researchers to explore these conceptual elements of biological and neurobiological changes, and behavioral problems in order to operationalize relevant measures to relate the concepts to sleep deprivation and subsequent health outcomes in adolescents.

Support

None
0269 Restricting Sleep Increases Teens’ Sedentary Behavior Without Impacting Moderate to Vigorous Physical Activity
Authors: Krietsch K , Duraccio K , Zang N , Beebe D
Published: May 2020

Introduction

Short sleep duration has been linked to obesity risk in adolescence. However, most research has focused on potential changes in appetite/intake, rather than physical activity or sedentary behaviors. It remains unknown if, in the daily lives of adolescents, sleep restriction increases moderate- to-vigorous physical activity (e.g., by providing more time for it) or discourages such activity (in favor of sedentary behaviors). This was the first study to use gold-standard objective measures to assess cause-and-effect relationships between sleep duration and the resulting activity levels of adolescents in the naturalistic environment.

Methods

N=104 healthy teens (ages 14–18) completed the 3-week within-subjects crossover sleep manipulation experiment during the summer. Following a 7-night a sleep stabilization week, teens were randomly assigned to 5 nights in Short Sleep (6.5hrs sleep opportunity) or Healthy Sleep (9.5hrs sleep opportunity). Following a 2-night “washout” period, they crossed over to the alternate sleep condition. Throughout the study, they wore validated waist-worn accelerometers to objectively measure sedentary and physical activity levels, and wrist-worn actigraphs to confirm adherence to their sleep condition.

Results

When in Short Sleep (vs. Healthy Sleep), teens on average slept 112 minutes less (p<.0001, d=1.72) per wrist actigraphy. Waist-worn accelerometers reflected 99 more minutes in sedentary behavior (p<.0001, d=.97), and 16 more minutes in light physical activity (p=.002, d=.31) during short sleep. Teens did not differ in moderate-to-vigorous physical activity between conditions (p=.95, d=.03).

Conclusion

Among healthy adolescents, a realistic dose of sleep restriction did not affect moderate-to-vigorous physical activity levels, but did sharply increase time in sedentary behavior. Given the negative weight and health consequences of sedentary behavior, these results have practical implications for obesity prevention/intervention efforts. They suggest that extending teen sleep may neither encourage nor discourage healthy physical activity, but may help curb unhealthy behaviors (e.g., sedentary behavior).

Support

R01 HL120879
0274 Associations of TNFα Gene Polymorphism with Resilience to Sleep Deprivation and Caffeine Sensitivity
Authors: Skeiky L , Hansen D A , Satterfield B C , Petrovick M , Balkin T J , Capaldi V F , Ratcliffe R H , Brager A J , Van Dongen H
Published: May 2020

Introduction

Sleep deprivation degrades the fidelity of human brain information processing, leading to cognitive impairment. Carriers of the A allele of a single nucleotide polymorphism of the TNFα gene (G308A, rs1800629) have been found to be resilient to cognitive impairment due to sleep deprivation as compared to individuals homozygous for the G allele. Caffeine mitigates the cognitive impairment associated with sleep deprivation. We investigated whether the effects of caffeine and TNFα genotype interact.

Methods

In an 18-day, controlled, in-laboratory study, 12 healthy adults (age 27.4±6.9; 6 females) underwent three sessions of 48-hour total sleep deprivation (TSD), with each TSD session preceded and followed by three nights of baseline and/or recovery sleep (10 hours time in bed). In randomized, counterbalanced, double-blind, placebo-controlled fashion, during each TSD session a specific dose of caffeine (0, 200, or 300 mg) was administered four times at 12-hour intervals. Vigilant attention was measured every 2 hours during each TSD session with a psychomotor vigilance test (PVT), for which the log of the signal-to-noise ratio (LSNR) derived from the RT distribution was determined as a measure of the fidelity of information processing. Each subject’s TNFα genotype was assessed from a blood sample.

Results

Subjects homozygous for the TNFα G allele showed greater PVT impairment during sleep deprivation in the 0 mg caffeine (i.e., placebo) condition as compared to carriers of the A allele and as compared to the 200 and 300 mg caffeine conditions (mixed-effects ANOVA, genotype by dose interaction: F2,566=5.23, p=0.005). There was no appreciable caffeine-related difference in performance for carriers of the A allele, who were relatively resilient to TSD regardless of caffeine dose.

Conclusion

These results suggest non-additive, interacting effects of TNFα genotype and caffeine and a potentially shared mechanism of action with regard to the fidelity of information processing during sleep deprivation.

Support

This research was supported by ONR. AJB, TJB, VFC, RHR were supported by DoD MOMRP-USAMRDC. The views expressed here are those of the authors and do not represent the official policy or position of the DoD.
0286 Schedule Characteristics of Heavy Vehicle Drivers are Associated with Eye-Blink Indicators of Real-Time Drowsiness on the Road
Authors: Shekari Soleimanloo S , Sletten T L , Clark A , Cori J M , Wolkow A P , Beatty C , Shiferaw B , Barnes M , Tucker A J , Anderson C , Rajaratnam S M , Howard M E
Published: May 2020

Introduction

While up to 52% of heavy vehicle crashes are drowsiness-related, the contributions of schedule factors to real-time objective drowsiness in heavy vehicle drivers (HVDs) have not been studied. Eye-blink parameters are a reliable indicator of driver drowsiness. This study aimed to examine the relationship between work-related factors and objective drowsiness in HVDs.

Methods

HVDs (all males, aged 49.5 ± 8 years) undertook 5- weeks of sleep-wake monitoring (Philips Actiwatch, N=15), and 4-weeks of infrared oculography (Optalert, Melbourne, Australia) to monitor their eye-blink parameters (averaged each minute) while driving their own vehicle (N=12). Participants slept for 5.75± 1.4 hours before the drives. Drowsiness events were defined as any Johns Drowsiness Scores (JDS) scores larger than 2.6 based on prior research. The relationships of schedule factors and drowsiness events per hour were assessed via mixed linear regression models.

Results

Drowsiness event rates were 3–5 times greater between 22:00 and 03:00 hours compared to between 16:00 and 17:00 hours (17- 25 events/h vs 5 events/h, P= 0.0001 to 0.007). The frequency of drowsiness events at night varied with shift start time and time into shift (P= 0.0001 to 0.001). Compared to the first hour of driving, drowsiness event rates rose significantly during the 13th to the 21st hours into the shift (13- 59 events/h vs 5.5 events/h, P= 0.0001 to 0.007). During sequential night shifts drowsiness events were 1.8 times more common compared to 1–3 sequential day shifts (9 events/h vs 5 events/h, P= 0.012 to 0.019).

Conclusion

Driving at night, for more than 12 hours and sequential night shifts increase real-time drowsiness in HVDs, with these factors interacting resulting in even higher rates of drowsiness events. Longitudinal studies in larger populations will further define how these factors interact to inform the work scheduling of HVDs to reduce the risk of drowsiness.

Support

This research was supported by the CRC for Alertness, Safety and Productivity.
0289 What is the Optimal Duration to Sleep in on Weekends?
Authors: Stone J E , Cheong F , Phillips A J
Published: May 2020

Introduction

Most individuals in the workforce exhibit differing sleep/wake patterns between work days and weekends. Work days are typically characterized by shorter and earlier sleep. On weekends, sleep debt is repaid by sleeping later and longer, often due to evening events. While social jet-lag (the mismatch in work vs. free sleep timing) is associated with poor health outcomes, repaying sleep debt is beneficial to health. The degree to which individuals should sleep in on weekends is currently unknown.

Methods

We used a mathematical model of human sleep/wake timing, which has been validated for predicting sleep/wake patterns in a variety of field/lab conditions. Sleep timing constraints are inputs, and the model generates predicted sleep/wake patterns and alertness levels. We simulated a traditional 7-day work week, with 7am rise times on week days. Inter-individual differences in chronotype were modeled by varying intrinsic circadian period. The model was applied to two conditions: (i) free choice of sleep onset times on weekends; or (ii) late nights on weekends (2am bedtime). Weekend rise time was systematically varied to optimize predicted daytime alertness.

Results

Optimal weekend rise times varied as a function of chronotype. With free choice sleep onset times, the model predicted optimal rise time was later for late types than early types, ranging from 7:20 to 8:40am across individuals. Sleeping later than optimal was associated with poorer performance due to misaligned circadian phase. The same trend was observed in the late-night condition, but with later optimal rise times, ranging from 8:30 to 9:50am.

Conclusion

Although individuals should maintain a consistent sleep/wake pattern on all days of the week, they often do not, due to work or social commitments. Within real-world constraints, we provided the first objective recommendations for sleep timing on the weekend, finding a compromise between repaying sleep debt and avoiding circadian misalignment.

Support

N/A
0310 Oculometrics Track Performance on the Psychomotor Vigilance Task During Acute Sleep Deprivation
Authors: Feick N H , Tyson T L , Arsintescu L , Cravalho P F , Stone L S , Flynn-Evans E E
Published: May 2020

Introduction

Sleep deprivation and circadian misalignment impairs human sensorimotor performance and reduces vigilant attention, which increases the potential for errors in occupations that require 24-hour operations. The psychomotor vigilance task (PVT) is the gold-standard measure for evaluating the impact of sleepiness on performance, however, it is not practical to administer in many operational environments, because it only provides a snapshot of performance and requires an individual to focus on the task for several minutes, multiple times over a work shift. As a result, passive, continuous monitoring of sleepiness is desirable for operational environments. The goal of the present study was to determine if complex oculomotor behavioral metrics track PVT performance during sleep deprivation.

Methods

Twelve healthy adults (mean age 24.8 ± 5.4 years; 6F) maintained a fixed schedule with 8.5 hours in bed for two weeks, during which they abstained from caffeine, alcohol, and other medications, followed by a ~24 hours constant routine laboratory stay. Participants completed the PVT and a radial step-ramp ocular tracking task hourly throughout the study. Twelve oculometrics were derived from smooth pursuit and saccadic eye movements collected through video-oculography and were compared to the PVT and Karolinska Sleepiness Scale (KSS) using linear regression and receiver operating characteristic curves.

Results

Nine oculometrics spanning pursuit, saccade, and directional motion processing performance correlated with the PVT and KSS (p < 0.05), including: (a) pursuit latency; (b) open-loop pursuit acceleration; (c) proportion smooth; (d) steady-state pursuit gain; (e) saccadic amplitude; (f) saccadic dispersion; (g) saccadic rate; (h) direction asymmetry; and (i) direction noise.

Conclusion

The oculometrics that we examined exhibited a distinct pattern that tracked PVT performance. Future studies should examine whether these metrics can be extracted through passive monitoring techniques.

Support

None
0315 Gray Matter Volume of the Rostral Medial Prefrontal Cortex is Associated with Resilience to Mood Decline During Overnight Sleep Deprivation
Authors: Anlap I , Taylor E , Grandner M A , Killgore W D
Published: May 2020

Introduction

Vulnerability to sleep deprivation (SD) has been attributed to inter-individual trait-like differences in the ability to sustain vigilance and subjective alertness, which may have distinct neurobiological substrates. We have previously shown that reduced suppression of the Default Mode Network (DMN) during a cognitive task was predictive of global vulnerability to SD. However, little is known about vulnerability to mood decrements during SD and the underlying neurobiological mechanisms. Using voxel-based morphometry (VBM), we assessed structural differences in gray matter volume (GMV) of a region of the anterior DMN, the medial prefrontal cortex and its association with self-reported mood during 29 hours of SD.

Methods

45 healthy participants (23 male; Ages 20-43) underwent 3T structural magnetic resonance imaging (MRI). Within 4 days, participants underwent an overnight SD session (29 hours awake total) which included hourly mood assessments with several visual analog mood scales (VAMS) assessing positive and negative affect. Hourly VAMS data were converted into a comparative metric of percent worsening of mood scores from 19:00 until noon the next day. These scores were averaged to determine a “mood resilience” score, with higher scores indicating greater mood sustainment. Using SPM12, the mean mood resilience scores were correlated with whole-brain gray matter volume, restricted to the medial prefrontal cortex, p<.05, FWE corrected, with a cluster threshold of 137 voxels.

Results

Overnight mood resilience was significantly correlated with greater grey matter volume in right rostral medial prefrontal cortex (p<.05, corrected; k=137).

Conclusion

Individuals with greater gray matter volume within a circumscribed region of the right medial prefrontal cortex demonstrated greater resilience to mood degradation over 29 hours of continuous wakefulness. This same region of the brain has been shown to be critical for the passive maintenance of emotions. We speculate that greater GMV could protect against mood decline by better sustaining emotional state during SD.

Support

Defense Advanced Research Projects Agency Young Faculty Award: DARPA-12-12-11-YFA11-FP-029
0331 Neurological Impact on the Reward Processing of Food Images Imposed by Mild Sleep Restriction in Adolescents
Authors: Alsameen M , DiFrancesco M W , St-Onge M , Beebe D W
Published: May 2020

Introduction

Previous studies indicate that lack of sleep might increase risk for unhealthy eating and obesity. This is particularly important during adolescence, when most youth sleep less than the recommended 8-10 hours/night and dietary habits are developed that extend into adulthood. This study investigated the relationship between multi-night sleep restriction and the appeal of food, including neuroimaging to examine the impact on brain responses to food-related stimuli.

Methods

Healthy 14-17 year-old adolescents (n=39) completed an experimental sleep manipulation across consecutive five-night periods to compare nightly sleep of approximately 9 hours (healthy sleep duration) vs. about 6.3 hours (mild sleep restriction). At the end of each week, participants underwent functional MRI while performing a visual food appeal task. The task included 42 photos in each of four food categories (sweets, snacks, fast-food, meat/fruit/vegetable) and one non-food category. Photos were presented every 3 seconds in blocks of 7 within each category; 6 interleaved blocks per category. Teens rated the appeal of each block of photos. General linear modeling explained regional brain response according to categorical presentation time-courses.

Results

The pattern of brain responses to the different food types was similar across the two sleep conditions. However, the sleep manipulation led to significant regional effects when contrasting the totality of food vs non-food images. Specifically, when compared to non-food, food images overall resulted in greater activation in the ventral tegmental area (VTA) and substantia nigra (SN) during sleep restriction. Both regions have been previously shown to be involved in processing reward-related information.

Conclusion

Our findings suggest neuronal responses in reward circuitry for teens viewing food images are influenced by sleep duration. Sleep restriction may affect reward processing of food in teens by increasing brain activation in VTA/SN network components that underlie dopamine-mediated motivational drive.

Support

Supported by NIH R01HL120879
0345 Poor Sleep Health in Informal Caregivers Mediated by Depressed Affect
Authors: Marino V R , Lee S , Haley W E
Published: May 2020

Introduction

Informal caregiving has been linked to higher perceived stress. Caregiving stress may be associated with poor sleep. Studies report low sleep quality among caregivers, however, little is known about whether informal caregivers have poorer sleep health than non-caregivers across multiple sleep dimensions. Less is known about whether potential poor sleep health in informal caregivers is explained by depressed mood. This study examined the mediating effect of depressed affect on the relationship between caregiving status and multidimensional sleep health.

Methods

208 current informal caregivers were compared to 3,342 non-caregivers from the Midlife in the United States study (Mage=55.77±12.29). Using seven domains of sleep (i.e., regularity, satisfaction in sleep, alertness, sleep duration, sleep latency, insomnia, and chronic sleep problems), a composite score of sleep health was constructed using clinically-relevant and previously-used cutoffs (Range=0-7; higher scores indicating better sleep health). Depressed affect was measured by a continuous scale based on 7 items. The Hayes PROCESS macro with bootstrapping method was used to test mediation with sociodemographic covariate adjustment.

Results

Caregivers had poorer sleep health than non-caregivers (β = -0.17; 95% CI = [-.331, -.016]). This association was mediated by depressed affect (indirect effect = -.026; 95% CI = [-.061, -.000]). Specifically, caregiving status was associated with greater depressed affect (β = 0.234; 95% CI = [.019, .450]) and greater depressed affect was associated with poorer sleep health (β = -.112; 95% CI = [-.136, -.089]). The direct effect of caregiving status on sleep health was attenuated when the mediator was considered (β = -0.148; 95% CI = [-.303, -.008]) indicating full mediation.

Conclusion

Compared to non-caregivers, informal caregivers have poorer sleep health, and this is mostly due to their greater depressed affect. Stress adaptation techniques such as mindfulness and positive reappraisal may promote better sleep health in informal caregivers through improved affect.

Support

N/A
0355 Neurobiological Correlates of Sleepiness in Middle Aged and Older Adults: A FDG-PET Study
Authors: Carvalho D Z , St. Louis E K , Schwarz C G , Bradley B F , Lowe V J , Przybelski S A , Reddy A , Mielke M M , Knopman D S , Petersen R C , Jack C R , Vemuri P
Published: May 2020

Introduction

Sleepiness has been associated with functional and cognitive decline, and may present with excessive daytime sleepiness (EDS) and/or increased sleep duration. We investigated whether sleepiness and changes in sleep patterns are associated with FDG-PET levels in wake-promoting regions.

Methods

From the Mayo Clinic Study of Aging cohort, we identified 373 cognitively-unimpaired middle-aged and older adults (mean +/- s.d. 66.1 +/- 13.2 yo) who underwent FDG-PET. EDS was defined as ESS score >=10. Changes in sleep patterns (sleeping more, less, or no change) were assessed using question #16 of the Beck Depression Inventory-2. We used probabilistic maps to create regions of interest (ROIs): the locus coeruleus (LC), posterior lateral hypothalamus (PLH), and the basal forebrain divided in 1) medial septum/diagonal band of Broca (MS/DB) and 2) nucleus basalis of Meynert (nbM). FDG-PET levels were referenced to the pons (SUVR). In this cross-sectional analysis, we fit linear models to assess the association between EDS and changes in sleeping patterns with FDG SUVR in in each ROI, while controlling for age, sex, education, BMI, witnessed apneas, and cardiovascular risk factors.

Results

10.5% had EDS, 15% reported sleeping more and 21% reported sleeping less than usual. 30.7% of participants with EDS reported sleeping more, 25.6% less, and 43.5% the same. EDS was associated with an elevation in FDG-PET SUVR in the MS/DB region (.035 [95% CI .008; .063], p=.012), while sleeping more was associated with a decrease in FDG-PET SUVR in the same region (-.027 [95%CI -.052; -.002], p=.036). Sleeping less was associated with an increase in FDG-PET SUVR in the PLH (.021 [95% CI .005; .03], p=.019). No associations were found in other ROIs.

Conclusion

Our results suggest that sleepiness and changes in sleep patterns in cognitively-unimpaired middle-aged and older adults were associated with measurable metabolic changes in areas of the brain involved in sleep and wakefulness. Further research should clarify whether these findings could represent different phenotypes of sleepiness with potential diagnostic and prognostic implications.

Support

NIA/NIH
0356 Associations Between Ethnicity, Socioeconomic Deprivation and Preschoolers’ Sleep Health in Aotearoa/New Zealand
Authors: Muller D , Paine S , Wu L J , Signal T L
Published: May 2020

Introduction

In Aotearoa/New Zealand (NZ) ethnic and socioeconomic inequities exist in adult sleep health but less is known about relationships between ethnicity, socioeconomic position and sleep in early childhood.

Methods

Maternally-completed questionnaire data from a pregnancy-birth cohort were analysed cross-sectionally. Log-binomial regression models investigated independent associations between ethnicity, socioeconomic position and sleep of 340 Māori (Indigenous) and 570 non-Māori 3-4 year olds. Independent variables included child ethnicity, gender, area-level deprivation (NZDep quintiles; 5=most deprived) and individual-level deprivation (NZiDep scores 1-5; 5=most deprived). Dependent variables included typical weekday and weekend sleep duration (<10hrs/10-13hrs), difference in week/weekend sleep duration (>1hr/≤1hr) and midsleep time (≥1hr/<1hr), problems falling asleep and problematic sleep patterns (no vs. moderate/large problem).

Results

Māori preschoolers were more likely to have short sleep (weekdays: PR=2.23, 95% CI 1.31-3.82; weekends: PR=2.04, 95% CI 1.24-3.36), week/weekend sleep duration difference >1hr (PR=2.47, 95% CI 1.59-3.84), week/weekend midsleep difference ≥1hr (PR=2.38, 95% CI 1.30-4.36) and a moderate/large problem falling asleep (PR=1.43, 95% CI 1.00-2.06) than non-Māori preschoolers. Preschoolers living in most deprived areas were more likely to have short sleep on weekdays (NZDep quintile 4: PR=3.91, 95% CI 1.43-10.72; NZDep quintile 5: PR=4.14, 95% CI 1.54-11.12) and week/weekend sleep duration difference >1hr (NZDep quintile 4: PR=2.34, 95% CI 1.23-4.43) than preschoolers in least deprived areas. Children with higher individual-level deprivation scores were more likely to have short sleep on weekends (NZiDep 5: PR=2.38, 95% CI 1.21-4.67) and a moderate/large problem falling asleep (NZiDep 3: PR=1.72, 95% CI 1.10-2.67) compared to children with lowest scores.

Conclusion

Ethnic and socioeconomic sleep health inequities exist as early as 3 years of age in NZ. Socio-political drivers of social and economic disadvantage experienced by Māori children and children from families who hold low socioeconomic position must be addressed to achieve equitable sleep health early in the lifecourse.

Support

Funding support was provided by Massey University New Zealand (Massey University Strategic Innovation Fund; Massey University Research Fund; and Massey University Doctoral Scholarship) and the Health Research Council of New Zealand (HRC 09/233, 08/547).
0362 Women are Underrepresented in Major US Sleep Societies Recognition Awards
Authors: Naime S , Karroum E G
Published: May 2020

Introduction

Recognition awards are reflective of personal achievement and contribute to professional growth and academic promotion. Underrepresentation of women in recognition awards of various medical societies has been described. The Wayne A. Hening Sleep Medicine Investigator Award of the American Academy of Neurology was only given to two women since 2011. This finding prompted us to further investigate the gender distribution of major recognition awards in national US sleep societies.

Methods

Publicly available lists of recognition awards recipients were retrieved and analyzed from the American Academy of Sleep Medicine (AASM) and the Sleep Research Society (SRS) websites. Recognition awards that reflect major contribution to the sleep field were included. The primary outcome measures were the overall proportion of women award recipients across selected recognition awards and the trend over time (1981-2019) analyzed by decade using the Cochran-Armitage test.

Results

We identified seven major sleep recognition awards (four by the AASM and three by the SRS) with a wide variation in the proportion of awards presented to women (4.8% to 31.3%). There were overall 184 individual awards presented by the two US sleep societies, including 154 (83.7%) awarded for men and 30 (16.3%) awarded for women. The analysis of the awards over time by decade revealed a significant increasing trend (P < 0.0001) in the proportion of awards recognizing women relative to men with a progression from 0.0% in the 1980s, to 3.0% in the 1990s, to 14.3% in the 2000s, and to 27.0% in the 2010s.

Conclusion

Overall in the last four decades, women have been underrepresented among major recognition awards from the AASM and the SRS, but it is encouraging to see a reduction in the gender gap, particularly over the last ten years. The reasons behind gender inequality in sleep recognition awards are unclear and need further investigation.

Support

This study was not funded.
0365 Sleep Quality Associated with Perceived Stress and Autonomic Nervous System Measures: Implications for Sleep and Health Disparities
Authors: Ng L , Tkacs N C , Richmond T S , Hanlon A L , Grandner M A
Published: May 2020

Introduction

It is not known whether the restorative nature of sleep mediates the effects of perceived stress on the autonomic nervous system (ANS).This study explored the relationships between stress and autonomic biomarkers, and aimed to assess potential mediation by sleep quality.

Methods

A secondary data analysis was performed using data from the Midlife in the United States (MIDUS, MIDUS II & Milwaukee). Multiple regression models examined the association between perceived stress using the Perceived Stress Scale (PSS) and two autonomic biomarkers-heart rate variability(HRV) (n=888) and urine catecholamines (n=1,058). The roles of sleep quality (using the Pittsburg Sleep Quality Index (PSQI)) and race/ethnicity were explored in post-hoc analyses.

Results

No statistically significant relationships were found between PSS and autonomic stress measures. However, perceived stress (b=0.09;p<0.01; 95% CI=0.06,0.13) and the covariate Likert stress scale at baseline (b=0.13;p=<0.04;95% CI=0.005,0.26) were significantly related to PSQI. Post hoc analyses explored racial differences. Baseline stress, PSS, depressive symptoms and PSQI scores were significantly higher in Blacks/African-Americans than Non-Hispanic Whites. Yet, Blacks/African-Americans had lower sympathetic responses (epinephrine means 1.56 vs 2.00;t=-4.82;p<0.01, norepinephrine means, 24.15 vs 27.30;t=3.14;p<0.01) and higher parasympathetic responses (lnHF, natural log of High Frequency HRV means 5.48 vs 4.75; t=6.17;p<0.01), compared to Non-Hispanic Whites.

Conclusion

Blacks/African-Americans and Non-Hispanic Whites had significant differences in their sleep quality and ANS biomarkers. Sleep quality may play a role in the effect of discrimination on mental and physical health. Different stress sources may lead to variable expression in biomarkers of autonomic tone. Future prospective studies incorporating longitudinal biomarkers and alternative statistical models will help elucidate the relationships among stress, sleep, and the pathways linking these factors to poor health, and effect targeted treatments.

Support

The MIDUS I study was supported by the John D. and Catherine T. MacArthur Foundation Research Network. MIDUS II was supported by the NIA(P01-AG020166), M01-RR023942(Georgetown), M01-RR00865(UCLA) and 1UL1RR025011(UW) grants. Many thanks to Dr. James McNally, Dr. Barry Radler, Dr. Gayle Love and Suzanne Hodge for access to the Milwaukee dataset.
0366 Sleep Health Dimensions, Disturbances, and Disruptors Among White, Black, Hispanic/ Latina, and Asian Women
Authors: Jackson C L , Gaston S A , McGrath J , Sandler D P
Published: May 2020

Introduction

Despite the importance of sleep for health promotion and disease prevention, data are limited regarding the distribution of multiple sleep health dimensions, disturbances, and disruptors among women, especially racial/ethnic minorities who disproportionately experience poor sleep.

Methods

To determine the prevalence of sleep health, disturbances, and disruptors (e.g., short sleep duration, sleep debt, insomnia symptoms, light exposure at night) overall and among Black, Hispanic/Latina, and Asian compared to White women, we used cross-sectional data collected by the Sister Study at enrollment (2003-2009) and two follow-ups (2012-2014, 2014-2016). Adjusting for sociodemographics, health behaviors, and health conditions including depression, we used Poisson regression with robust variance to estimate prevalence ratios (PRs) for unfavorable sleep among racial/ethnic minority compared to White women.

Results

Of the 49,874 eligible women (mean age ± standard deviation: 55.7 ± 9.0 years, 84.8% ≥high school education, 74.7% married) 85.3% were White, 9.0% Black, 5.1% Hispanic/Latina, and 0.7% Asian. Overall, 70% reported the recommended amount of sleep, 15.7% inconsistent weekly sleep patterns, 26% sleep debt, and 14% insomnia symptoms plus short sleep. Racial/ethnic minorities were much more likely than whites to report very short (≤5 hours) sleep (PRBlack)=5.98[95% Confidence Interval: 4.67-7.66]; PRLatina=2.83[1.98-4.04]; PRAsian=5.41[2.41-12.13] and to report needing <7 hours to feel their best (PRBlack=2.95[2.75-3.17]; PRLatina=1.85[1.65-2.07]; PRAsian=2.66[2.10-3.37]). Black and Hispanic/Latina women had a higher prevalence than whites of insomnia, short sleep plus insomnia, inconsistent sleep, sleep debt, and frequent napping; however, all racial/ethnic minorities were less likely to report daytime sleepiness (PRBlack=0.82[0.78-0.85]; PRLatina=0.94[0.89-0.98]; PRAsian=0.79[0.69-0.92]) and restless leg syndrome. Witnessed sleep apnea was higher among Black women, and REM sleep disorder did not differ across racial/ethnic groups. Sleeping with room lights or a television on was more prevalent among racial/ethnic minorities (PRBlack=1.78[1.71-1.86]; PRLatina=1.27[1.17-1.37]; PRAsian=1.62[1.32-1.99]).

Conclusion

Poor sleep health, disturbances, and disruptors were prevalent among women and varied across racial/ethnic groups in ways that may contribute to health disparities.

Support

This work was funded by the Intramural Program at the National Institutes of Health, National Institute of Environmental Health Sciences (Z1A ES103325-01 to (CLJ) and Z01 ES044005 to (DPS)).
0369 Sleep Disparities are Established by the First Month of College
Authors: Bermudez V , Fearon D , Wheelis M , Cohenour M , Scullin M K
Published: May 2020

Introduction

Short and poor quality sleep are particularly common in college students, likely impacting their ability to persist and succeed in difficult courses. In the current study, we investigated demographic-based sleep differences (sleep disparities) and demographic-based academic differences (achievement gaps) in first-semester college students, with the goal of informing whether sleep disparities contribute to achievement gaps.

Methods

From 2017 to 2018, first-semester undergraduate students at Baylor University completed the New2BU Survey [N=6,048, 61.9% female, 18.7% first-generation, 23.8% underrepresented racial/ethnic minority (URM)]. Data collection occurred within three to five weeks of classes beginning. The survey included self-reported weekday total sleep time (TST), which we classified as short sleep (≤6.9 hours), normal sleep (7-9 hours), or long sleep (>9 hours). Semester GPA data were obtained from university records for students’ first 4 semesters.

Results

There was evidence for both achievement gaps and sleep disparities. The risk for short sleep was increased in female students (p<.001; OR=1.20, 95%CI: 1.08-1.33), first-generation students (p=.02; OR=1.17, 95%CI: 1.03-1.33), and URM students (p<.001; OR=1.32, 95%CI: 1.16-1.50). The risk for long sleep increased substantially in first-generation students (p=.003, OR=1.92, 95%CI: 1.25-2.97) and URM students (p<.001; OR=2.41, 95%CI: 1.57-3.70), but not in female students (OR=0.88, 95%CI: 0.59-1.30). First-generation and URM students showed a 0.2-0.3 GPA reduction each semester relative to comparison groups (ps<.001), but short sleep and long sleep predicted GPA data up to four semesters later. Sleep-GPA correlations were modest in size (rs=.10-.14), but remained significant even after controlling for numerous demographic variables, high school GPA, and college entrance test scores.

Conclusion

Sleep disparities are noteworthy within the first month of college, and predictive of academic performance across four semesters. Addressing sleep health in all students—but particularly female, first-generation, and URM students—may increase academic success, bridge achievement gaps, and reduce health disparities.

Support

National Science Foundation (DRL 1920730)
0374 Decline in Habitual Sleep Duration Over 10 Years and Worsening Sleep Disparities: Data From NHIS (2006-2015)
Authors: Grandner M A , Fernandez F , Khader S , Jean-Louis G , Seixas A A , Williams N J , Patterson F , Killgore W D , Wills C C
Published: May 2020

Introduction

Despite claims in the media, evidence that habitual sleep has declined in recent years is scant. Few data sources exist that systematically document sleep duration in a nationally representative sample, in the same way, over several years.

Methods

Data from 10 years of the National Health Interview Survey were used (N=305,555). During all years, habitual sleep duration, age, sex, race/ethnicity, and height/weight were recorded in the same way. Weighted regression analyses examined sleep duration as the outcome, year as linear predictor, and sociodemographics as covariates. Then, interaction terms examined whether the linear change associated with years was differentially experienced by different sociodemographic groups.

Results

The linear trend of sleep duration over the past 10 years is a loss of 0.78 minutes per year (95%CI -0.91,-0.64; p<0.0001). After adjustment for age, sex, race/ethnicity and BMI, this remained relatively unchanged at 0.86 minutes (95%CI -0.99,-0.73; p<0.0001). A year-by-race/ethnicity interaction was observed (p<0.05). In stratified analyses, Non-Hispanic Whites showed a loss of 0.68 minutes per year (95%CI -0.84,-0.52, p<0.0001). This was 1.33 minutes/year in Blacks/African-Americans (95%CI -1.74,-0.92; p<0.0001), 1.57 minutes/year in Mexican-Americans (95%CI -1.98,-1.16; p<0.0001), 0.99 minutes/year in other Hispanics/Latinos (95%CI -1.51,-0.47; p<0.0001), 0.74 minutes/year in Asians (95%CI -1.24,-0.25; p=0.003), and 1.80 minutes/year in American Indians/Alaskan Natives (95%CI -3.57,-0.03, p=0.046).

Conclusion

On average, the US population has lost 47 seconds of nightly sleep per year over a 10-year period, equating to about 4.7 hours of sleep per year, but racial/ethnic groups were impacted differently. Compared to Non-Hispanic Whites, Blacks/African-Americans lost 96% more sleep, Mexicans lost 131% more sleep, other Hispanics/Latinos lost 46% more sleep, Asians lost 9% more sleep, and American Indians lost 165% more sleep. Thus, sleep disparities may be widening.

Support

Dr. Grandner is supported by R01MD011600
0377 A Strengths-Based Approach to Examine Obstructive Sleep Apnea in Black and White Patients
Authors: Williams N J , Butler M , Roseus J , Blanc J , Barnes A , Bubu O M , Ebben M , Krieger A , Jean-Louis G
Published: May 2020

Introduction

The majority of studies on race/ethnic disparities in OSA are derived from a deficit-based perspective (i.e. >BMI, non-adherence to PAP). It would prove useful to identify which aspects are protective to inform potential treatment approaches. We focused on two potential factors: resilience and social support, in patients newly diagnosed with OSA. Given the high prevalence of insomnia complaints in patients with OSA, insomnia was our outcome of interest.

Methods

91 patients newly diagnosed with OSA provided demographic and socioeconomic status, sleep measures (Epworth, DBAS), resilience (Connor Davidson Resiliency Scale), social support (MOS Social Support Scale) and completed the Insomnia Severity Index. The cross-sectional associations between ISI, race/ethnicity, resilience, social support and their interaction effects were examined using linear regression models with covariate adjustment for participant age, sex and BMI. We ascertained total ISI score and individual items.

Results

The sample was 34.1% black (n=31), mean age of 57.6 years, SD=13.6, 64.8% male (n=59), and mean BMI of 32.4, SD=7.04. Mean sleep duration (as reported by sleep diary) was 6.64, SD=1.35. Black, white differences were not observed for sleepiness (M=8.60; 10.43, p=0.11) or DBAS (M=4.61; M=5.04, p=0.30). Blacks, reported clinically significant insomnia (M=15.00, SD=7.17) compared to whites (M=12.02, SD=6.83, p=0.05). On the individual ISI items, blacks were significantly more likely to endorse difficulty falling asleep (M=1.58, SD=1.54; M=0.75, SD=0.93,p=0.002) and waking up too early (M=2.09, SD=1.26; M=1.45, SD=0.93,p=0.021) compared to whites. Resilience (M=30.04, SD=6.42) and social support scores (M=74.13, SD=21.36) did not differ by race/ethnicity. In adjusted linear analysis, resilience had significant effect on ISI score (b=-0.36, SE=0.12, p=0.003) but not social support (b=-0.06, SE=0.08, p=0.31).

Conclusion

In this study we did not observe race/ethnic differences for sleepiness and dysfunctional beliefs about sleep. With respect to the protective factors, race/ethnic differences were not observed. Resilience, not social support, was related to insomnia complaints. Future studies should examine a variety of factors that may serve black and other racial/ethnic groups with OSA, and help elucidate protective processes.

Support

K23HL125939
0378 Social Well-Being as a Longitudinal Mediator of the Association Between Discrimination and Sleep Quality
Authors: Dautovich N , Ghose S
Published: May 2020

Introduction

Discrimination is a risk factor for poor sleep outcomes. Physiological activation is one mechanism tying the experience of discrimination to disturbed sleep. Discrimination, however, can also impact psychosocial well-being, which is a necessary precursor for healthy sleep. Feelings of safety derived from social connections can be threatened when individuals face discrimination. The objective of the current study was to examine the role of social well-being as a factor underlying the longitudinal association between discrimination and sleep quality.

Methods

An archival analysis was conducted with 937 adults participating in the longitudinal Midlife in the United States (MIDUS) study. Data was collected at three time points across 10 years. Perceived daily discrimination and overall social well-being were assessed via self-report. Sleep quality was assessed via the Pittsburgh Sleep Quality Index, Global Sleep Quality score.

Results

The overall model accounted for 15.6% of variance in global sleep quality. Controlling for multiple covariates, more frequent experiences of discrimination predicted worse global sleep quality 10 years later (β=.06, p=.03). Worse overall social well-being was a significant mediator of the discrimination-global sleep quality association (95% CI [.0001, .0118]), such that more frequent discrimination predicted lower overall social well-being, which, in turn, was associated with worse global sleep quality.

Conclusion

Given the persistence of sleep disparities among stigmatized and marginalized groups and the importance of sleep as a means of health disparity reduction, there is a need to identify mechanisms linking discrimination to poor sleep outcomes. Daily experiences of discrimination, such as being given less respect or treated as though less intelligent, have long-lasting associations with social well-being. Furthermore, social well-being is a predictor of future sleep quality. In addition to addressing discriminatory practices, targeting the effects of social well-being on sleep is a direction for future research.

Support

N/A