bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Teaching Competencies in Physical Therapist Education: A Modified Delphi Study
Authors: Myers Katherine , Bilyeu Catherine , Covington Kyle , Sharp Amanda
Published: May 2022

Objective

Clinical instructors play a key role in physical therapist professional education but may serve with minimal preparation and without clearly defined expectations for their teaching performance. The objective of this study was to utilize a consensus-building process to establish core competencies of clinical teaching within physical therapist education.

Methods

A modified Delphi approach was used to identify core competencies of clinical teaching. An expert panel consisted of clinical instructors, site coordinators of clinical education, and directors of clinical education, representing multiple geographic regions in the United States. The panel assessed the relevance of 30 original competencies. Criteria for consensus included 75% of participants perceiving the competency as very or extremely relevant and a median score of 2 (very relevant) on a 5-point Likert scale. Consistent with a Modified Delphi approach, quantitative and qualitative data analysis were completed for each of the 3 rounds. Revised surveys were used in Rounds 2 and 3 based on the results from previous data analysis.

Results

Twenty-four competencies achieved final consensus. The competencies were categorized within 3 domains: learner-centered educator (n = 8), assessor/evaluator (n = 7), and professional role model (n = 9).

Conclusion

The 24 competencies and 3 domains provide the foundation for a competency framework for clinical teaching in physical therapy. This framework provides clarity for the expected knowledge, skills, and attitudes of clinical instructors in physical therapist professional education.

Impact

This is the first study, to our knowledge, to utilize a consensus-building strategy to clearly define competencies of clinical teaching in physical therapist professional education. Like efforts in nursing and medical education, adoption of these competencies could promote consistency in clinical instructor teaching behaviors and contribute to the creation of assessment and professional development mechanisms for clinical instructors, positively impacting the preparation of the next generation of excellent physical therapist clinicians.
0001 Associations Between Circadian Factors and Travel Distance with Performance: A retrospective analysis of 2014-2018 National Basketball Association Data
Authors: Cook Jesse , Charest Jonathan , Walch Olivia , Bender Amy
Published: May 2022

Introduction

Frequent travel across time zones and travelling long distances interferes with healthy sleep and disrupts the circadian system, often degrading athletic performance. National Basketball Association (NBA) players face a demanding travel schedule often requiring multiple games per week, with games spanning the continental United States. This investigation aimed to clarify the influence of circadian factors and travel distance on NBA performance using a dataset from the 2014-2018 seasons.

Methods

NBA (2014-2018) game data were acquired from an open-access source: (https://www.kaggle.com/ionaskel/nba-games-stats-from-2014-to-2018). Circadian variables of time zone change (TZ∆) and adjusted jet lag (AJL) were formulated, with quadratic versions utilized across analyses. TZ∆ captured circadian delay/advance based on travel for a game, with each TZ going eastward and westward reflected by -1 and +1, respectively. AJL advances TZ∆ by allowing acclimation to a novel TZ, with each day resulting in a 1-unit change towards circadian neutral. AJL is a season-long rolling summation, which was computed using two different travel approaches: Approach1 (AJL1) assumes travel the day before each game, whereas Approach2 (AJL2) was designed to prioritize being home. A standardized flight tracker determined travel distance for each game (GameDistance). Team ability differences, characterized as difference in season win percentages (SeasonWinPerDiff), served as an analytic covariate. Game point differential (PointDiff), defined as a team’s score minus their opponent’s score, and a team’s free throw percentage (FreeThrowPer) served as outcome variables. Linear mixed-effects modeling assessed univariate and multivariate associations, with games nested within both team and year.

Results

AJL2 (β = -0.63; p = .01) and GameDistance (β = -0.73; p<0.0001) significantly associated with PointDiff. TZ∆ (β = -0.002; p = .03), AJL1 (β = -0.002; p =.04) and GameDistance (β = -0.003; p = 0.007) significantly associated with FreeThrowPer. AJL2 and GameDistance maintained significant relationship with PointDiff in fully adjusted model that included AJL2, GameDistance, and SeasonWinPerDiff.

Conclusion

Results suggest that both circadian delay/advance and greater distance traveled for games negatively influence NBA performance, even when controlling for differences in team ability. Season travel and flight plans could be constructed to reduce the effects of circadian misalignment and travel distance.

Support (If Any)

None
0005 Bidirectional associations of sleep and alcohol use within and between regularly drinking young adults
Authors: Reichenberger David , Chang Anne-Marie , Russell Michael
Published: May 2022

Introduction

Young adults can be resistant to drinking interventions, but improving other health behaviors, such as sleep, may indirectly reduce hazardous drinking. Evidence linking sleep to next-day drinking among regular drinkers could support sleep interventions as an indirect pathway to alcohol misuse reduction. We investigate this connection in the natural environments of 222 regularly drinking young adults.

Methods

Regularly drinking young adults (21-29 years; 63% women) wore an alcohol monitor across six days that continuously measured transdermal alcohol concentration (TAC). Participants completed daily smartphone-based surveys reporting the previous night number of drinks and sleep. Predictors were disaggregated into within- and between-person variables. Sleep variables were used to predict next-day alcohol use, and alcohol use variables were used to predict subsequent sleep. Multilevel Poisson and linear models with random intercepts for each outcome were adjusted for weekends, sex, weight, and prior night sleep/drinking.

Results

Between-person results showed that participants who tended to go to bed later had on average 24% more drinks (p<0.01) and achieved 26% higher peak TAC (p<0.02) the next day. Every hour of sleep duration the prior night was associated with a 14% decrease in the number of next-day drinks (p<0.03). Conversely, participants who drank more went to bed on average 12-19 minutes later (p<0.01) and slept 5 fewer minutes (p<0.01). Within-person results showed that on nights when participants drank more than usual they went to bed 8-13 minutes later (p<0.01), slept 2-4 fewer minutes (p<0.03), and had worse sleep quality (p<0.01).

Conclusion

Young adults who went to bed earlier and slept longer on average tended to use alcohol less the next day, and using less alcohol tended to improve subsequent sleep within young adults. Taken together, these results suggest that better sleep health may improve drinking behaviors and intoxication dynamics, which may have implications for interventions targeting sleep as a mechanism to reduce heavy drinking.

Support (If Any)

David Reichenberger was supported by the Prevention and Methodology Training Program (T32 DA017629) with funding from the National Institute on Drug Abuse (NIDA). This research was funded by departmental funds and a pilot mentoring and professional development award through P50DA039838 (NIDA), both awarded to Michael Russell.
0011 Work Hard, Sleep Hard: Vigorous Workdays and Sleep Difficulties
Authors: Jeppson Jake , Mason Brooke , Wills Chloe , Tubbs Andrew , Killgore William , Grandner Michael
Published: May 2022

Introduction

It is common in America to work 5 or 6 days as a full work week. This is exhausting, especially for those with a vocation that requires vigorous physical activity during the work day. Sleep is an important factor when assessing workplace efficiency, as those able to obtain regular healthy sleep will perform better.

Methods

A multinomial logistical regression analysis was conducted on the 2017 - March 2020 data collected from the National Health and Nutrition Examination Survey (NHANES) to explore a relationship between those with self-assessed sleep difficulties and the number of days of vigorous physical activity during work. The specific question used for analysis was, “Does your work involve vigorous-intensity activity that causes large increases in breathing or heart rate like carrying or lifting heavy loads, digging or construction work for at least 10 minutes continuously?” If yes, the number of days during a typical week was recorded. Sleep difficulties were self-reported as difficulties “falling asleep, staying asleep, or sleeping too much” within the previous two weeks, categorized as “never,” “less than half the days,” “more than half the days,” and “nearly every day.” Reported results were unweighted; weighted results are forthcoming. Results were adjusted for sex, age, race/ethnicity, education level, and relationship status.

Results

Compared to those with no days of vigorous physical activity at work, those with 2 days were more likely to report having sleep difficulties several days in the past 2 weeks (OR: 1.13, [1.00,1.73], p=0.049). those reporting 6 days per week of vigorous work-related activity were less likely to report sleep difficulties several days (OR: 0.73, [0.59,0.91], p=0.004), more than half the days (OR: 0.67, [0.48,0.93], p=0.016), or nearly every day (OR: 0.68, [0.50,0.94], p=0.018). Those who reported 6 days per week of vigorous work-related activity were less likely to report sleep difficulties several days (OR: 0.75, [0.51,0.98], p=0.038) or more than half the days (OR: 0.57, [0.34,0.96], p=0.035).

Conclusion

It is possible that a physically demanding job has protective effects on sleep quality when compared to those that did not have any vigorous physical activity related to their profession.

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0017 Murder on the Midnight Express: Nocturnal Wakefulness and Homicide Risk
Authors: Holt Catie , Tubbs Andrew , Hendershot Sierra , Fernandez Fabian-Xosé , Karp Jordan , Klerman Elizabeth , Basner Mathias , Chakravorty Subhajit , Perlis Michael , Grandner Michael
Published: May 2022

Introduction

There is a nocturnal peak in incident suicide risk after adjusting for population wakefulness (Perlis et al., 2016; Tubbs et al., 2020). This peak in risk is hypothesized to result from a series of negative changes in mood, reward processing, and executive function that occur at night and increase the propensity for dysregulated and violent behaviors. Although the unadjusted incidence of dying by homicide is elevated at night, no existing studies of time-of-day and death by violent crime have adjusted for population wakefulness.

Methods

Data from 48,486 homicide victims with a known time of fatal injury were collected from the National Violent Death Reporting System (NVDRS) for 2003-2017, tabulated by clock hour, age, sex, race, and ethnicity, and combined with population wakefulness data from the American Time Use Survey (ATUS) for the same years. Homicide counts were additionally characterized by the proportion of cases with blood alcohol level (BAL) of 0, <80mg/dl, or ≥80mg/dl at autopsy and modeled using robust Poisson regression with population wakefulness entered as an offset term, thus producing hourly incident risk ratios (IRR).

Results

Homicide counts were lowest in the morning (6AM-7AM) and highest at night (10PM-11PM). After adjusting for population wakefulness, the incident risk for death by homicide was elevated between 10PM and 5AM compared to the 24-hour average, with the highest risk between 2AM (IRR: 8.25 [6.62-10.3]) and 3AM (IRR: 7.22 [6.04-8.64]). Moreover, the adjusted risk of dying by homicide was significantly greater at night for those with a BAL≥80mg/dl, such that the risk at 2AM was 13.8-fold greater than the 24-hour average (IRR: 13.8 [10.6-18.1]).

Conclusion

The risk of homicide death is higher at night after adjusting for population wakefulness and especially among those with alcohol intoxication. Although homicide victims do not choose when to die (unlike suicide victims), neurophysiological changes at night may promote risky behaviors or put victims in more dangerous circumstances than they would be otherwise. Future research should examine sociodemographic, clinical, and circadian risk factors for death by homicide, as well as examine time-of-day patterns in other violent crimes.

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0018 Sleep Difficulty and Weekly Sedentary Minutes
Authors: Marshall Joseph , Mason Brooke , Wills Chloe , Tubbs Andrew , Grandner Michael
Published: May 2022

Introduction

Decreased energy and activity may be a mechanism linking poor sleep health and cardiometabolic risk. This study aimed to examine, at the national level, whether poor sleep quality was associated with more sedentary time (as opposed to less exercise, which has been difficult to establish).

Methods

Data from the 2017 - March 2020 National Health and Nutrition Examination Survey was used. A linear regression analysis was completed to assess the relationship between sedentary minutes and self-reported sleep difficulties. These were assessed by self-report of difficulty “falling asleep, staying asleep, or sleeping too much” over the past 2 weeks, with options for “never,” “less than half the days,” “more than half the days” and “almost always.” Covariates included sex, age, race/ethnicity, education level, and relationship status. Results are unweighted; weighted results are forthcoming.

Results

All groups experiencing self-reported sleep difficulties demonstrated increased sedentary minutes when compared to those that do not experience sleep difficulties. More specifically, unadjusted results show 21.5 more sedentary minutes (B: 21.5, [95%CI:10.8,32.2], p<0.001) for those that have sleep problems several days a week, 21.8 more sedentary minutes (B:21.8, [95%CI:4.90,38.7], p<0.001) for those that have sleep difficulties more than half the days in a week, and 42.3 minutes (B: 42.3, [95%CI:26.8,57.8], p<0.001) for those that have sleep difficulties nearly every day during the week. Once adjusted for covariates, results showed 17.6 more sedentary minutes (B:17.6, [95%CI:6.76,28.3], p<0.001) for those that have sleep difficulties several days a week, 18.3 more minutes (B:18.3, [95%CI:1.45,35.1], p<0.001) for those that have sleep difficulties more than half the days in a week, and 48.4 more sedentary minutes (B:48.4, [95%CI:32.8,63.9], p<0.001) for those that have sleep difficulties nearly every day during the week.

Conclusion

Those with general sleep difficulties were more likely to report more sedentary minutes per day. Although previous efforts have focused on improving physical activity directly, perhaps future efforts could target sleep health as a way to reduce sedentary behavior.

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0025 Circadian Dysregulation of Human DNA Repair Genes and Elevated DNA Damage in Simulated Night Shift Schedule
Authors: Van Dongen Hans , Koritala Bala , Porter Kenneth , Arshad Osama , Gajula Rajendra , Mitchell Hugh , Arman Tarana , Manjanatha Mugimane , Teeguarden Justin , McDermott Jason , Gaddameedhi Shobhan
Published: May 2022

Introduction

Circadian misalignment from night shift (NS) work is associated with increased risk of cancer. In a simulated NS study, we sought to investigate the potential role of circadian disruption of cancer hallmark pathway genes.

Methods

N=14 healthy adults (aged 22-34) participated in a laboratory study. Seven were assigned to a simulated day shift (DS) schedule involving 3 days of daytime wakefulness (06:00-22:00); the other seven were assigned to a simulated NS schedule involving 3 days of nighttime wakefulness (18:00-10:00). Subjects then underwent a 24-hour constant routine protocol, during which blood was collected at 3-hour intervals. Leukocytes extracted from blood were subjected to transcriptomics using the NanoString nCounter PanCancer Pathways panel augmented with canonical clock genes. Statistical analysis involved mixed-effects cosinor analysis followed by functional enrichment analysis of rhythmic genes. Leukocytes were also subjected to endogenous DNA damage assessment through alkaline comet and immunofluorescence assays. Furthermore, exogenous DNA damage from exposure to ionizing radiation was investigated for blood collected at opposite times of day (07:30 and 19:30) based on DNA damage biomarkers assessed with immunofluorescence and immunoblot assays.

Results

Transcriptomics data showed that the simulated NS schedule, as compared to the simulated DS schedule, significantly altered the endogenous circadian rhythmicity of genes involved in cancer hallmark pathways, as measured under constant routine. A DNA repair pathway showed enrichment of rhythmic genes following the DS schedule (P<0.05), but not following the NS schedule. Functional assessments revealed that the NS schedule was associated with increased endogenous DNA damage, as evidenced by alkaline comet assay (P<0.001) and increased BRCA1 foci (P<0.01) and γH2AX foci by immunofluorescence assay (P<0.001). After exposure to ionizing radiation, there were increased BRCA1 foci (P<0.01) and γH2AX foci by immunofluorescence assay (P<0.005) and elevated DNA damage response signaling biomarkers by immunoblot assay, especially in the samples collected at 19:30.

Conclusion

These results suggest that a NS schedule causes circadian dysregulation of DNA repair genes and increases DNA damage – a primary hallmark of carcinogenesis – which may underlie the elevated cancer risk in NS workers.

Support (If Any)

WSU, CHHE P30ES025128, USAMRDC W81XWH-18-1-0100, NIH R01ES030113 and R21CA227381, CDMRP CA171123, DOE BRAVE DE-AC05-76RL01830.
0027 Reciprocal Modulation of Cortical Excitatory and Inhibitory Synapses by Wake-Sleep Homeostatic State
Authors: Rybalchenko Volodymyr , Greene Robert
Published: May 2022

Introduction

A widely debated function of sleep involves a homeostatic program of down-regulation of excitatory synaptic strength following an overall increase during the preceding waking period, preserving however the previously existing synaptic weights associated with newly acquired memories. We tested this hypothesis by applying thorough statistical analysis of parameters of excitatory and inhibitory miniature postsynaptic currents (mEPSC/mIPSC) recorded ex vivo in mouse cortical pyramidal neurons at three characteristic wake/sleep stages.

Methods

Cingulate cortex coronal slices were obtained at fixed Zeitgeber time (ZT6, to control for circadian clock) from control C57BL6 (MEF2C f/f) mice subjected to 6h acute sleep deprivation (SD), recovery sleep =4hSD+2h(RS), or 6h control sleep (CS). mEPSCs and mIPSCs were recorded from functionally identified whole-cell patch-clamped pyramidal neurons in cortical layer 2/3 (L2/3). Statistical analysis of frequencies, amplitudes, and charge transfer rates of mEPSCs and mIPSCs was done using non-parametric Kruskal-Wallis multiple comparison test and K-means clustering test.

Results

mEPSC frequency (F) and charge transfer (CT) were significantly reduced for RS and CS compared to SD (F: -57%, -47%; CT: -64%, -55%). mEPSC amplitude (A) was significantly reduced for CS compared to SD (-15%). Two-centroid clustering test revealed that analyzed parameters of F, A and CT for SD condition were approximately evenly split between upper and lower range clusters, while the same parameters for RS and CS conditions revealed a pronounced redistribution (>75% lower-, <25% upper ranges). Wake/sleep state related changes of mIPSC parameters showed opposite pattern compared to excitatory synapses. All three parameters were increased in RS vs. SD (F: +63%, A: +7%, CT: +42%) and this difference reached significance levels in CS vs. SD (F: +88%, A: +24%, CT: +109%). Clustering analysis of mIPSC parameters revealed mostly stable distribution pattern between upper and lower ranges for all wake/sleep states.

Conclusion

Significant changes in excitatory/inhibitory balance in the frontal cortex is part of the homeostatic response upon transition from wakefulness to various phases of sleep. The excitatory component prevails during wakefulness, while the inhibitory component peaks during sleep.

Support (If Any)

NIH grant R01 NS103422 to RWG.
0029 Developing a pipeline for translating genome-wide association signals to behavioral correlates of sleep dysfunction
Authors: Zimmerman Amber , Palermo Justin , Chesi Alessandra , Sonti Shilpa , Lasconi Chiara , Brown Elizabeth , Pippin James , Wells Andrew , Doldur-Balli Fusun , Mazzotti Diego , Pack Allan , Gehrman Philip , Keene Alex , Grant Struan
Published: May 2022

Introduction

Insomnia is a pervasive sleep disorder affecting up to one-third of the adult U.S. population. An extensive amount of genetic association data from genome wide association studies (GWAS) has uncovered hundreds of loci associated with insomnia and other sleep traits, yet few of these targets have undergone full characterization and their contribution to sleep traits remain poorly understood. Additionally, GWAS does not necessarily determine the true effector gene(s) at a given locus, leading to frequent mischaracterization and misinterpretation of genotype-phenotype interactions.

Methods

Our group has developed a variant-to-gene mapping approach that integrates existing insomnia GWAS loci with a combination of ATAC-seq and promoter-focused Capture C-derived data in human induced pluripotent stem cell-derived neural progenitor cells. We identified candidate genes with accessible promoter regions that were contacted at high resolution by insomnia-associated SNPs residing in open chromatin. Target genes with known orthologs and available Drosophila RNAi lines were then subjected to deep phenotyping of sleep traits. Candidate genes producing greater than 20 percent change in sleep duration in Drosophila were then screened in a vertebrate zebrafish model using CRISPR/Cas9 mutagenesis in F0 larvae.

Results

This pipeline revealed fifteen genes producing robust sleep phenotypes with more than a 20 percent change in sleep duration in Drosophila. Of the candidate genes screened thus far in zebrafish, we found that disruption of pigq expression significantly (p<0.05) increased sleep duration in both zebrafish and Drosophila through regulation of sleep bout length and frequency, revealing a conserved, yet novel regulator of sleep duration. Additionally, CRISPR mutations in cbx1b and meis1b in zebrafish resulted in reduced sleep duration similar to results in Drosophila.

Conclusion

This pipeline uses cutting-edge genomic and behavioral approaches to perform high-throughput screening of existing GWAS-identified insomnia loci. This genotype-to-phenotype approach emphasizes the importance of behavioral validation following large cohort studies and narrowed the candidate gene list from more than 200 to fewer than 20 providing a more tractable set of gene targets for further molecular characterization. Cross-species validation also improves our understanding of the conservation of sleep characteristics throughout evolution.

Support (If Any)

NIH grants R01 HL143790, P01 HL094307, T32 HL07953
0045 Examining the Association of Trait Sleep Reactivity with Changes in Sleep, Depression, and Anxiety in the COVID-19 Pandemic
Authors: Cirelli Abigail , Krause Adam , O'Hora Kathleen , Osorno Raquel , Sadeghi-Bahmani Dena , Lopez Mateo , Morehouse Allison , Goldstein-Piekarski Andrea
Published: May 2022

Introduction

Sleep Reactivity (SR), a trait-like tendency for stressful events to trigger sleep disturbances, is an established diathesis for insomnia and depression. However, no studies to date have examined SR in the context of the COVID-19 pandemic and it’s related restrictions. Thus, the goal of this analysis is to test whether SR confers a vulnerability for greater sleep and mood symptoms due to the stress of COVID-19 and it’s related restrictions. We hypothesized that (1) The onset of the pandemic will trigger greater increases in insomnia symptoms in highly sleep reactive individuals. 2) Sleep-reactive individuals would experience reduced recovery of insomnia, anxiety, and depression symptoms over the course of the pandemic.

Methods

SR, insomnia, anxiety, and depressive symptoms were assessed by the Ford Insomnia Response to Stress Test (FIRST), Insomnia Severity Index (ISI), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI II), respectively, at two time points (early-pandemic, 6-month follow-up). Additionally, participants retrospectively reported ISI prior to the pandemic. N = 253 adults from Stanford’s COVID-19 Pandemic Sleep Study (April-November 2020) provided baseline insomnia measures, and were excluded if they reported pre-pandemic clinical insomnia (ISI >10). Ranked-correlation tests were used to test the current hypotheses. Paired t-tests were used to evaluate changes in mean insomnia, depression, and anxiety scores. Covariates included essential worker status, sex, and age.

Results

ISI after COVID-19 was significantly higher than retrospective, pre-pandemic ISI (t = 8.2, d = 0.55, p < 0.0001). However, SR was not significantly correlated with the pandemic-related increase in ISI (ρ = 0.07, p = 0.34). Depression significantly increased after 6-months (t = 2.0, d = 0.27, p = 0.047), whereas anxiety did not (t = 1.7, d = 0.26, p = 0.10). Neither changes in depression nor anxiety were predicted by SR (Depression: ρ = 0.15, p = 0.32; Anxiety: ρ = -0.13, p = 0.40).

Conclusion

Insomnia and depression, but not anxiety, increased with the onset of the pandemic. However, trait SR was not a predisposing factor for pandemic-related sleep and mood changes. This is the first analysis examining SR as a risk factor for insomnia and mood symptoms in the pandemic.

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0047 Relationship of Emotions, Social Isolation, and COVID-Related Media to Subjective Sleep Quality during the COVID-19 Pandemic
Authors: Peszka Jennifer , Mastin David , Kennedy Lindsay , Sestir Marc , Harsh John
Published: May 2022

Introduction

The COVID-19 pandemic safety restrictions led to changes in social interactions and information seeking about the virus. For some, these led to increased negative emotions, feelings of social isolation, and increased COVID-related media consumption. We examined the relationship of these variables to subjective sleep quality from participant daily diaries kept early in the pandemic.

Methods

From April 20th-May 12th, 2020, college (students, faculty/staff, alumni, parents) and local (churches, community centers, libraries) community members (N=94, 72 women, ages 18-77) completed a 30-minute survey for before and during social distancing (measuring: mental health, personality, social distancing, and demographics) for possible prizes. Participants then completed daily evening and morning diaries for 5-14 days describing daily affect, social isolation, emotion regulation, COVID media consumption, and subjective sleep quality.

Results

Emotions: During the pandemic, poor sleep quality was predicted by less positive mood (r(91)=.486, p<.001) and more negative mood (r(91)=-.433, p<.001). Participants with poorer sleep quality reported less success regulating their emotions that day (r(90)=.292, p=.005) and greater suppression of emotions (rather than cognitive reappraisals to regulate them) (r(91)=-.260, p=.012). Social Isolation: Subjective sleep quality was not predicted by social distancing behaviors (r(88)=.069, p>.05); however, poorer sleep quality was significantly predicted by greater daily feelings of social isolation (r(91)=-.264, p=.005) and lower feelings of social life satisfaction (r(91)=.338, p<.001). COVID-related media: Sleep quality was not significantly related to COVID-media consumption for all participants; however, moderation analyses showed that participants with low avoidance coping, low neuroticism, and high emotional well-being did experience poorer sleep quality associated with greater COVID media consumption (all p’s<.05).

Conclusion

That mood and social isolation are associated with sleep quality replicates previous findings. The pandemic, however, provided a unique opportunity to observe these relationships in individuals not normally socially isolated because of confounding variables (e.g., health issues, depression, anxiety) with known relationships to sleep quality. That COVID-related media was only related to sleep quality for more well-adjusted participants (low avoidance coping, low neuroticism, high emotional well-being) was surprising, suggesting some may find COVID-19 information anxiety-relieving rather than anxiety-provoking.

Support (If Any)

Nancy and Craig Wood Odyssey Professorship and Charles L. Brewer Endowed Fund
0050 The Role of Poverty and Perceived Stress on Insomnia Symptom Severity During the COVID-19 Pandemic
Authors: Egeler Mara , Hire Veronica , Walker Jamie , Vargas Ivan
Published: May 2022

Introduction

In 2020, poverty in the United States increased as the COVID-19 pandemic led to the loss of work and/or income. Recent research has also shown that stress caused by the pandemic has led to increased rates of poor sleep. While insomnia rates have increased nationwide, it is not yet known if those living in poverty experienced insomnia symptoms at disproportionate rates. This study examined the effect poverty has had on insomnia symptom severity, as well as whether perceived stress mediated this association.

Methods

Survey data was collected from 3,775 U.S. adults (83.1% White, 78.6% female, age = 18 – 86 years old) during the initial months of the COVID-19 pandemic (April-June 2020). These data were used for a secondary analysis. Participants completed an online survey aimed to assess basic demographics, sleep, physical activity, social engagement, and overall stress levels. Poverty was defined using the poverty guidelines provided by the Department of Health and Human Services (i.e., based on self-reported income and family/household size). The Insomnia Severity Index (ISI) was used to assess insomnia symptoms. Perceived stress was assessed using the Perceived Stress Scale (PSS).

Results

316 participants (8.4%) met criteria to be considered living below the poverty threshold. Those below the poverty threshold had a mean ISI of 10.20 (95% CI: 9.54, 10.86), while those above the poverty threshold had a mean ISI of 8.33 (95% CI: 8.13, 8.53). Put differently, 26.6% of those below the poverty threshold met criteria for clinical insomnia (i.e., ISI > 14), whereas 15.9% of those above the poverty threshold met criteria for clinical insomnia. Finally, a mediation test (with bootstrapping) confirmed that the association between poverty and insomnia was partially mediated by perceived stress (indirect effect = 1.15, 95% CI: 0.76, 1.55).

Conclusion

While poverty guidelines vary by state, these data generally support that there are notable disparities in sleep and insomnia based on family/household income, and that these differences are, in part, due to greater perceived stress. This may be due to increased stress related to loss of work or income. Future studies examining the impact of pandemic stress on insomnia should consider the role of socio-economic status.

Support (If Any)

K23HL141581 (PI: Vargas); R25HL10544 (PI: Jean-Louis); K24AG055602 (PI: Perlis)
0054 A Fear of Dying: How an Obsession with Death During the Pandemic Contributes to More Severe Insomnia
Authors: Jankowski Samantha Samantha , Wellman Camryn Camryn , Reign Deva , Grandner Michael , Dailey Natalie , Killgore William
Published: May 2022

Introduction

The prevalence of insomnia and other sleep disorders increased during the COVID-19 pandemic. While general anxiety, which increased during the pandemic, may account for some of the rise in sleep complaints, other factors may also contribute to insomnia. Here, we examined the potential contribution of fear of dying from the novel coronavirus on the severity of insomnia. We hypothesized that those endorsing a high fear of dying specifically from COVID-19 within 12 months of their assessment would demonstrate more severe insomnia.

Methods

From April 2020 through October 2021, 13,298 U.S. participants (18-92 years old; 57.5% female) completed a online survey (~1,000 participants per month) that included an assessment of their perceived likelihood of dying from COVID in the next year, the Generalized Anxiety Disorder scale-7 (GAD-7), and the Insomnia Severity Index (ISI). We examined insomnia over the course of the first year of the pandemic and divided the sample into those who endorsed at least a 50% or greater perceived likelihood that they would die from COVID-19 in the next year versus those who endorsed a less than 50% perceived likelihood of dying from the illness.

Results

Fear of dying (50% chance or higher) was associated with higher ISI scores (p<.00001) and tended to decline over the course of the year (p<.00001). A significant month x fear interaction (p=.021) suggested that individuals who believed they would die within the year showed significantly fluctuations in insomnia over the course of 13 months with peaks around June and October 2020. Even accounting for situational anxiety (GAD-7), those with a fear of dying still demonstrated higher insomnia levels than their counterparts (p<.00001).

Conclusion

Self-perceived likelihood of dying from COVID-19 in the near future was associated with significantly elevated severity of insomnia, and this remained true even when controlling for a clinical assessment of generalized anxiety levels. These findings suggest that fear of succumbing to the novel coronavirus contributed significantly to the severity of sleep problems during the first year of the pandemic.

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0056 Rest-Activity Rhythms (RARs) and Cognitive Functions in Early Post-menopausal Women
Authors: Paget-Blanc Alexandra , Smagula Stephen , Thurston Rebecca , Chang Yuefang , Maki Pauline
Published: May 2022

Introduction

RAR disruptions are more common among individuals with dementia than healthy individuals. In healthy older women, RAR disruption predicted future diagnosis of Mild Cognitive Impairment (MCI). With no cure for Alzheimer’s Disease, it is crucial to identify modifiable risk-factors for early prevention of cognitive decline. Here we aim to determine whether RAR disruption was associated with cognitive status and cognitive performance in early post-menopausal women, thereby representing a modifiable risk factor for dementia.

Methods

The sample drawn from MsBrain study, included 229 cognitively unimpaired women and 42 women with MCI/dementia, based on score on Montreal Cognitive Assessment (MOCA) adjusted for age and race. Participants completed a 72-hour wrist actigraphy monitoring and neuropsychological assessment including: California Verbal Learning Test (CVLT), Letter Number Sequencing (LNS), Card Rotation Test, Symbol Digit Modalities Test (SDMT). Latent profile analysis (LPA) was performed using five nonparametric RAR variables (intra-daily variability (IV), inter-daily stability (IS), relative amplitude (RA), alpha and F-statistic). The association between RAR clusters and cognitive performance and the relationship between RAR clusters, cognitive status and race/ethnicity were assessed using linear regression models, controlling for age, race/ethnicity, education and body mass index (BMI); and using chi-square test respectively.

Results

LPA revealed three clusters: Robust with high F-Stat, RA and IS and low IV; Normal;Weak with low RA and high alpha. The proportion of subjects with MCI/dementia did not differ between clusters however there was a significant association between race and RAR clusters, X2 (2, N = 271)=14.18, p<0[P1] .001, with non-white women more likely than white women to belong in the Weak group (p < .01). In an adjusted analysis of healthy women, the Weak group performed worse than the Robust group in LNS control (p<.050 ). In the unadjusted model, the Weak group performed worse than Robust group in CVLT Total Learning and Long Delay Recall and SDMT (p=.0074, p=.011and p= .0041, respectively).

Conclusion

Non-white women had weaker RAR than their white counterparts. Weaker RARs related to poorer working memory as measured by LNS; and poorer verbal memory and processing speed, measured by CVLT and SDMT however these effects were largely influenced by covariates, particularly race/ethnicity and education.

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0059 Does Discrimination Moderate the Relationship between Insomnia and Telomere Length in Older Adults from Three Racial/Ethnic Groups?
Authors: Roussett Greg , Prather Aric , Wallhagen Margaret , Weiss Sandra
Published: May 2022

Introduction

Both insomnia and discrimination have been associated with adverse physical and mental health outcomes. Evidence suggests that discrimination may moderate the effects of sleep on telomeres, DNA sequences at the end of chromosomes that protect them from degradation. The purpose of this study was to determine the relationship between insomnia and telomere length among older non-latinx white, black, and latinx individuals and whether discrimination moderated this relationship differently based on race or ethnicity.

Methods

This study is a secondary analysis from the Health and Retirement Study, a longitudinal project sponsored by the National Institute on Aging. Our analysis consisted of 3,205 US participants who provided information on sleep problems as well as salivary samples from which telomere data were assayed. We computed a linear regression to examine the relationship between insomnia symptoms and telomere length in each racial/ethnic group, including interaction terms to assess moderating effects of discrimination.

Results

Insomnia symptoms were associated with shortened telomere length among non-latinx white participants (β -0.046, p=0.015, [-0.06, -0.01]). Discrimination had a moderating effect between insomnia symptoms and telomere length among black participants (β -0.28, p=0.045, [-0.33, -0.00]). Analyses remained significant after adjusting for age, medical co-morbidities, smoking status, and a history of depression.

Conclusion

Our results suggest that symptoms of insomnia may contribute to telomere erosion, with potentially adverse effects on genomic integrity. For black individuals, those who experienced discrimination were at greater risk of telomere damage associated with insomnia.

Support (If Any)

Funding has been made available by the NIH, granted to UCSF School of Nursing Biobehavioral Research Training Program in Symptom Science (NIH: T32 NRO16920).
0064 Youth Sleep-Wake Experience in Juvenile Justice Facilities: A Descriptive Analysis
Authors: Woodard Kelsey , Adornetti Julianna , Nogales Josefina Munoz , Foster Mea , Leask Lauren , McGee Ryann , Carlucci Marianna , Crowley Stephanie , Wolfson Amy
Published: May 2022

Introduction

Adolescents are susceptible to sleep loss due to biological and environmental factors such as delayed circadian timing and schedule demands. Few studies have examined sleep-wake patterns for adolescents residing in juvenile justice facilities. The current study assessed youth’s self-reported sleep-wake schedules, sleep environment perceptions, and sleep quality.

Methods

Participants were recruited from 11 juvenile services detention and treatment facilities in Maryland. For seven consecutive mornings, youth completed a sleep-wake diary reporting their bed/wake times, sleep onset, and type of (nocturnal) light exposure. Youth wore digital wristwatches to accurately depict their sleep-wake schedules. Sleep quality and wake difficulty were rated on a scale from 1-10 (1=very poor/easy to 10=very good/hard, respectively).

Results

Participants (N= 64) were 13-19 years old (M= 16.7, SD= 1.3 years) and 85.9% male. Racial backgrounds: 61% Black, 18% White, 8% Multiracial, and 13% Other. Youth-reported bedtimes (M= 21:04, SD= :50) were about 50 minutes earlier than their sleep onset times (M= 21:52, SD= 1:02) while wake times (M= 6:41, SD= :46) were about 20 minutes earlier than the time youth reported leaving their bed (M= 7:00, SD= :44). Youth disclosed waking up throughout the night (M= 1.7, SD= 9) for an average 16.8 minutes (SD= 14.9). Multiple diary-responses (58%) noted “partial or overhead” lights were on in youth’s sleeping areas; 23.4% wrote in “other” types of light sources, most of which were blue lights (63%). Average sleep quality (M= 5.7, SD= 2.1) and difficulty waking up ratings (M= 5.4, SD= 2.2) indicate mediocre sleep.

Conclusion

Findings summarize youth’s sleep-wake experience while residing in a juvenile justice facility. Reported bedtimes are earlier than sleep onset times which increases the likelihood for conditioned insomnia. Circadian dysregulation of sleep behavior can develop from frequent night awakenings and light exposure, particularly, blue light. Ultimately, these findings will help develop facility-wide interventions, improving the youth’s sleep-wake schedules and other environmental influences.

Support (If Any)

This research is made possible by the American Academy of Sleep Medicine (AASM) Foundation Award #22-CS-19 and Department of Juvenile Services’ supportive collaboration.
0069 Trajectories of Sleep Characteristics in Black and White Women During the First Year Postpartum
Authors: Kishman Erin , Sparks Joshua , Youngstedt Shawn , Wang Xuewen
Published: May 2022

Introduction

In the postpartum period, many women experience sleep deficiency due to caring for their infant. Racial disparities exist in sleep characteristics in the adult population, with Black adults having shorter total sleep time (TST) and worse sleep efficiency (SE) than White adults. However, few studies have investigated sleep changes in postpartum Black and White women. The purpose of this study was to examine trajectories of sleep characteristics from 6-8 weeks to 12 months postpartum in Black and White women.

Methods

Black (n=48) and White (n=86) women who gave birth to a singleton infant at ≥37 weeks gestation, wore an Actiwatch Spectrum Plus (Phillips Respironics, Inc) at 6-8 weeks, 4, 6, 9, and 12 months postpartum. Participants were instructed to wear the monitor, complete a sleep diary, and to maintain their normal daily activities over 7 days. Daily time in bed (TIB), TST, SE, and wake after sleep onset (WASO) were determined.

Results

Trajectories of TIB, TST, SE and WASO were not different between Black and White women from 6-8 weeks to 12 months postpartum. However, Black women had shorter TIB and TST, and lower sleep efficiency (p<0.001 for all). WASO was similar between Black and White women. For the entire sample, TIB significantly decreased from 470±74 (mean±SD) minutes at 6-8 weeks to 459±54 minutes at 12 months (p=0.0038). TST significantly increased from 347±86 minutes at 6-8 weeks to 369±70 minutes at 4 months (p=0.0085) but did not change at the later timepoints. SE increased from 80±8% at 6-8 weeks to 83±7% at 6 months (p=0.0034) but did not change at the later timepoints. WASO decreased from 54±24 minutes at 6-8 weeks to 46±21 minutes at 4 months (p<0.0001) but did not change at later timepoints.

Conclusion

In the first year postpartum, Black and White women had similar trajectories for sleep characteristics, but Black women had shorter TIB and TST and lower SE than White women. TIB and WASO decreased while TST and SE increased over time. The first 4 to 6 months show the greatest changes.

Support (If Any)

NIH Grant R21MD012740
0073 A Mexican Spanish Version of the Sleep Disorders Symptom Checklist
Authors: Begay Tommy , Valencia Dora , Granados Karla , Delgadillo Marcos , Ghani Sadia , Molina Patricia , Alfonso-Miller Pamela , Perlis Michael , Klingman Karen , Wills Chloe , Grandner Michael
Published: May 2022

Introduction

The Sleep Disorders Symptom Checklist (SDSCL-25) is a brief assessment of patient-reported symptoms that suggest risk for a wide range of sleep disorders. To ensure the validity of study subject responses, the SDSCL-25 was translated into Spanish by a bilingual research study team. It was then administered to study subjects in their preferred language.

Methods

Data were collected from a sample of N=100 individuals of Mexican Descent in Nogales, Arizona, US-Mexico border. The SDSCL-25 is a screening tool that assesses the presence of a wide range of symptoms for sleep disorders. To translate the measure into Spanish, the following procedure was followed: (1) a bilingual study team member performed an initial translation; (2) a bilingual community member edited the translation; (3) a certified medical translator edited the revision; (4) a focus group of N=5 bilingual community members made contextual edits; (5) a back-translation was performed; (6) an additional bilingual focus group examined the final version for compatibility; and (7) the medical translator certified the accuracy of the final version. T-tests examined differences between those who completed the measure in Spanish vs English.

Results

Of the N=100 survey respondents, N=42 completed the SDSCL-25 in Spanish. Those who took the measure in Spanish showed no differences in frequency of reports of delayed sleep phase (p=0.28), snoring (p=0.85), morning dry mouth (p=0.87), choking/gasping (p=0.09), uncomfortable sensations in legs (p=0.25), urge to move legs (p=0.09), cataplexy (p=0.09), sleep paralysis (p=0.12), sleepwalking (p=0.08), or bruxism (p=0.13). Respondents in Spanish reported lower frequency of insufficient sleep (p=0.01), variability in bedtime (p=0.02), difficulty falling asleep (p=0.002), difficulty staying asleep (p=0.01), early morning awakenings (p=0.02), daytime tiredness/fatigue (p=0.006), phase advance (p=0.0003), daytime sleepiness (p=0.03), loud snoring (0.002), breathing pauses (p=0.049), frequent awakenings (p=0.0007), hypnogogic/pompic hallucinations (p=0.003), nightmares (p=0.047), panic awakenings (p=0.01), and overall sleep disturbance (p=0.043).

Conclusion

The present study describes a Spanish translation of the SDSCL-25. For those that took the Spanish version, there were lower reported frequencies of insufficient sleep, variability in bedtime, insomnia symptoms, daytime sleepiness and tiredness/fatigue, phase advance, sleep apnea symptoms, frequent awakenings, hypnogogic/pompic hallucinations, nightmares, panic awakenings, and overall sleep disturbance.

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