bluuebunny/crossref_metadata_2025 huggingface dataset:
0176 Short Sleep Duration and Poor Sleep Quality Predict Blunted Weight Loss in a Behavioral Weight Loss Intervention
Authors: Kline C E , Lambiase M J , Conroy M B , Brooks M M , Kriska A M , Barinas-Mitchell E J
Published: May 2020

Introduction

Short sleep duration and poor sleep quality have each been associated with obesity and weight gain. However, less is known regarding how sleep may impact attempted weight loss. The purpose of this study was to investigate the associations between sleep duration and sleep quality, both independently and in combination, with weight loss in a 12-month behavioral weight loss intervention.

Methods

Young to middle-aged adults who were overweight or obese (N=296) completed a 12-month behavioral weight loss intervention, with weight assessed at baseline, 6 and 12 months. Sleep duration and quality were derived from the Pittsburgh Sleep Quality Index. Analyses examined the change in sleep over time and the association between baseline sleep and changes in sleep with 6- and 12-month weight loss following adjustment for relevant covariates including age, gender, race, education, baseline body mass index, and baseline risk for sleep apnea.

Results

Participants (with an average baseline weight of 97.0±1.0 kg) lost 6.6±1.1 kg (6.8%) and 6.7±1.2 kg (6.9%) at 6 and 12 months relative to baseline, respectively. Global sleep quality significantly improved over the 12-month intervention (P=.03), but average sleep duration and the prevalence of short sleep duration (<6 h) or poor sleep quality did not change significantly (each P≥.45). Adults with short sleep duration at baseline lost 3.3±0.9% less weight than those with ≥6 h sleep duration (P<.001). Adults with poor sleep quality at baseline lost 1.6±0.8% less weight than those with good sleep quality (P=.04). When considered together, adults with both short sleep duration and poor sleep quality lost at least 5.0% less weight compared with all other sleep duration/quality group combinations (P<.001).

Conclusion

Our findings highlight the importance of both sleep duration and sleep quality as predictors of behavioral weight loss and suggest that screening for sleep disturbance may be useful to determine who may benefit from additional counseling and resources.

Support

R01HL077525, K23HL118318
0205 Remote Collection of Daily Life Information for Japanese Residents
Authors: Hirai N , Kubo M , Sakurai Y , Komatsuzaki K , Tazawa R
Published: May 2020

Introduction

Japanese medical students spend their school days under a dense curriculum. It is often difficult to maintain their healthy lifestyle. After graduation, most of them participate in clinical training programs as residents. It is also difficult to maintain a normal life because they are engaged in different specialized departments every few months. Such an environment is considered prone to mental health problems. In fact, one in four residents are reported to be newly depressed two months after the start of clinical training (Maeno T, et al. 2008). These mental health issues are thought to be affected by changes in daily life, but it is difficult to know such changes. In order to investigate changes in their daily lives, we developed a data collection system related to mental health via the Internet.

Methods

The subjects were 22 medical students who graduated from our university in March 2017. They were asked to wear activity tracker wrist bands from December 2016. They were also asked to answer the questionnaire on a web site every week as much as possible, and the responses were collected via the Internet together with the activity data. The first eight months of the observation period, including four months before the start of clinical training and four month after the start of clinical training, are divided into four quarters every two months, and the averaged sleep time and responses to the questionnaire in each period were investigated.

Results

The average number of days that the sleep was effectively recorded during each two months was 28–48. The average number of responses to the questionnaire during each two months was 6.0–7.2.

Conclusion

Residents in the initial clinical training period should be very busy, but the system we have developed seems to have worked well with them for the first four months after the start of clinical training. Whether this system would work as well a longer period is a further problem.

Support

This study is supported by KAKENHI 16K01753.
0209 The Effect of a Nap on Emotional Reactivity in Individuals with a Chronic Mild Traumatic Brain Injury
Authors: Kurdziel L B , Maier E , Limone N , Azzarto E
Published: May 2020

Introduction

Mild Traumatic brain injuries (mTBIs) affect ~1–3 million people per year in the US alone. Mild TBIs can have lasting (>1 year) impacts on emotional reactivity and regulation. Sleep has also been shown to be significantly altered in individuals with a mTBI, even when tested over a year since the injury. Sleep quality is strongly linked with emotional stability and emotional memory. Therefore, one possible mediating factor between emotional reactivity and mTBIs is sleep. Reduced sleep quality following a mTBI may impair the emotional regulation that typically occurs across sleep. Thus, increasing total sleep time through a nap may help to alleviate some of the emotional symptoms. This study assessed whether individuals with a chronic mTBI showed differences in brain activity associated with emotional regulatory circuits, performance on an emotional reactivity task, and sleep physiology across a nap compared to controls.

Methods

Participants were 53 young adults (mTBI nap group: n=9; control nap group: n=16; mTBI wake group: n=11; control wake group: n=17). Following a nap, or an equivalent bout of wake (both recorded with polysomnography), participants completed an emotional Go/No-Go task in which they were asked to respond when a particular emotional valence was presented (neutral, fearful, or happy), and withhold a response when a different valence was presented.

Results

There was a significant main effect of emotion on reaction time (F(2, 98)=26.55, p < 0.001). Participants were slowest to respond to the neutral images. There was also a significant three way interaction between emotion, group, and condition (F(2,98)=4.085, p = 0.02).

Conclusion

While these results are preliminary, they support that both napping and mTBIs may impact emotional reactivity. Further, napping may help alleviate some of the chronic emotional dysregulation associated with mTBIs.

Support

Zampell Family Faculty Fellow
0210 Evaluating the Sensitivity of Sleep Measures for Monitoring Pilot Fatigue in Operational Settings
Authors: van den Berg M J , Wu L J , Gander P H , Santos-Fernandez E , Signal L
Published: May 2020

Introduction

Previously, combined data analyses of four pilot fatigue monitoring studies including 237 pilots flying long-haul and ultra-long range (ULR) flights found no association between pilots’ actigraphic sleep in flight and psychomotor vigilance task (PVT) performance at top-of-descent (TOD; beginning of the landing phase of flight). The present study aimed to determine whether measures of in-flight sleep recorded with polysomnography (PSG) are more sensitive predictors of pilots’ PVT performance near TOD than actigraphic measures.

Methods

Data were re-analysed from 41 Singapore Airlines A340-500 pilots (median age 47, range 29–58 years) monitored on a ULR trip between Singapore and Los Angeles (average flight duration outbound = 15.6 hrs; inbound = 17.2 hrs). In-flight sleep was recorded simultaneously with PSG (scored in 30-second epochs) and actigraphy (recorded in 30-second epochs and scored in conjunction with sleep diary information). PSG- and actigraphy-determined time awake were calculated as the duration between the end of the last epoch scored as sleep (PSG) or software-scored sleep interval (actigraphy) and the start time of the 10-minute PVT completed near TOD.

Results

Linear mixed modelling indicated that after controlling for flight sector and intra- and inter-individual variability, neither PSG-derived total in-flight sleep (F (1, 44.4) = 0.006, p= 0.941) and time awake (F (1, 34.3) = 0.431, p= 0.516), nor actigraphic total in-flight sleep (F (1, 51.1) = 0.161, p= 0.69) and time awake (F (1, 34.9) = 0.23, p= 0.634) were associated with PVT response speed at TOD.

Conclusion

In this context, actigraphy produced identical findings to polysomnography and remains a valid alternative for monitoring in-flight sleep of groups of pilots during ULR flights. Further research is needed to determine whether PVT performance is a discriminatory measure of fatigue-related impairment in pilots.

Support

This analysis was supported by the Massey University College of Health Research Fund. The Singapore Airlines study was funded by the Singapore Civil Aviation Authority. We thank Dr Jarnail Singh for permission to use these data.
0246 Improve Sleep in College Students Through Lifestyle Change Assignment
Authors: Carter P
Published: May 2020

Introduction

Emerging adults experience a ‘new found freedom’ in college. Many are making decisions about their sleep-wake cycles leading to ineffective patterns. Poor sleep in college students is influenced by non-modifiable (class time, course assignments) and behavior based (sleep schedule, screen time, exercise and diet) factors. Change is difficult! However, GPA is a great student motivator. This project developed and tested the acceptability of a guided lifestyle change assignment for sleep.

Methods

Undergraduate students at a Southern USA R-1 University who were enrolled in a signature course (Sleep: Are We Getting Enough?) were eligible. Context: Twice weekly lectures presented scientific findings related to sleep science and applied findings to human experiences. Intervention: students completed a guided lifestyle change assignment for sleep. Students indentified a specific sleep related behavior to change (change goal) over a 1 month period (November), submitted an initial lifestyle change plan, three progress reports, and a final reflection.

Results

800 students participated over 6 years (Fall semesters 2014–2019). Students were primarily female (56%) and nine majors were represented. Goals were grouped into 4 lifestyle foci (Exercise, Screen time, Sleep Schedule, Diet). Progress reports identified barriers and facilitators and plans to address these. Final reflections evaluated overall performance and major takeaways. Qualitative perceptions and quantitative outcomes will be presented in detail. Additionally, discussions of unanticipated outcomes and guidance for incorporating this assignment into existing courses will be presented.

Conclusion

College students can make positive changes to improve their sleep. Guidance to identify and address facilitators and barriers to change is important to create and sustain change. Motivations to change are different for emerging adults vs. older populations. It may be that the most effective way to improve sleep quality in college students is to ‘attach a grade’ to the activity.

Support
0250 The Day-to-Day Associations Between Sleep Characteristics, Affect, and Affect Reactivity
Authors: Wong P M , Hasler B P , Kamarck T , Wright A , Hall M , Carskadon M A , Manuck S B
Published: May 2020

Introduction

Despite the high co-occurrence of sleep and mood disturbances, day-to-day associations between sleep characteristics (sleep duration, continuity, timing) and dimensions of mood (positive affect, PA, and negative affect, NA) remain unclear. Few field studies have tested whether sleep changes may affect mood by altering people’s emotional response to daily experiences outside the laboratory. The current study aimed to examine how sleep characteristics influence affective states and a measure of emotional response to daily experiences—affect reactivity.

Methods

Participants were healthy, midlife adults (30–54 yrs old, N =462, 47% male) drawn from the Adult Health and Behavior Project- Phase 2 study. Sleep was measured with actigraphy across a 4-day monitoring period; hourly self-report measures of affect, work demand, and social interactions were collected via ecological momentary assessment. Affect reactivity was quantified as hour-to-hour changes in affect following these daily experiences. We used hierarchical linear modeling to examine whether sleep characteristics on a given night predicted average daily affect and moderated affect reactivity the following day.

Results

When participants slept later than their average sleep time on a given night, they reported greater NA the following morning (before 12pm) and afternoon (12-6pm; B’s =.03, p’s<.05). When participants slept longer than their average sleep duration, they subsequently reported greater NA throughout the following day (B’s =.02, p’s<.05). Sleep efficiency was unrelated to affect report (p’s >.05). While episodes of greater work demand and social conflict predicted lower PA and higher NA (p’s<.05), participants’ sleep characteristics did not moderate these associations (p’s>.05).

Conclusion

Overall, our findings suggest proximal associations between sleep characteristics and next-day mood. While previous studies have shown effects of sleep disruptions on affect reactivity, we did not observe such associations in the context of small, day-to-day fluctuations in sleep characteristics among healthy individuals.

Support

National Institutes of Health Grant PO1 HL040962 (to S.B.M.).
0262 An Exploratory Examination of the Relationship Between Negative Affect, Stress and Emotional Reactivity, Mindfulness, and Sleep Incompatible Behaviors
Authors: Nagy S , Pickett S M , Sosa J , Garcell A
Published: May 2020

Introduction

Stress has been identified as a barrier to engaging in positive health behaviors. Sleep interventions, including sleep hygiene recommendations, highlight stress management as an important treatment component. However, the relationship between negative emotion, stress management or emotion regulation, and positive sleep behaviors has largely been unexamined. Therefore, the current study, through secondary analyses, examined the relationships between negative affect, stress and emotional reactivity and sleep incompatible behaviors. Lastly, the indirect effect that dispositional mindfulness, as a possible self-regulatory mechanism, may have on the relationship was also examined. It was hypothesized that greater levels of stress, emotional reactivity, and negative arousal along with lower levels of dispositional mindfulness would predict higher engagement in sleep incompatible behaviors.

Methods

Participants (n=308) identified mostly as female (55.8%) and White/Caucasian (83.2%) and with an average age of 36.76 (SD = 12.20). Participants completed the Perceived Stress and Reactivity Scale (PSRS), the Positive and Negative Affect Scale (PANAS), the Sleep Behaviors Self-Rating Scale, and the Five Facet Mindfulness Questionnaire (FFMQ). A multiple regression analysis was conducted using the relevant subscales from the PSRS, PANAS, and FFMQ to predict the occurrence of behaviors incompatible with healthy sleep.

Results

The hypothesis was partially supported. Results indicated that the model significantly predicted sleep incompatible behavior (R2= .108, F(9, 299) = 4.042, p < .001), with only negative affect (β= .163, t(299) = 2.555, p = .011) and nonreactivity (β= -.219, t(299) = -2.484, p = .014) remaining significant when all variables were entered in the model.

Conclusion

The findings demonstrate that negative affect and reactivity are significant predictors of engagement in poor sleep hygiene practices. They also suggest that certain facets of dispositional mindfulness has an indirect relationship with sleep incompatible behaviors. The results may contribute to the development of sleep health interventions and highlight the need for future research.

Support

N/A
0275 Exposure to Experimentally Induced Sleep Disturbance Affects the Inflammatory Resolution Pathways in Healthy Humans
Authors: Engert L C , Dubourdeau M , Mullington J M , Haack M
Published: May 2020

Introduction

Sleep disturbances are assumed to impair health through induction of low-grade systemic inflammation. Experimental studies have shown that such inflammatory upregulation does not normalize even after a couple of nights of recovery sleep. We hypothesized that sleep disturbances do not only affect inflammatory pathways, but also the recently detected inflammatory resolution pathways, which actively terminate inflammation. Mediators of inflammatory resolution mainly derive from omega-3 fatty acids converted to specialized pro-resolving mediators (SPMs), such as resolvins. We investigated SPMs in healthy humans exposed to a novel model of experimental insomnia.

Methods

Twenty-four individuals (age 18–42 years, 12 women) participated in a study consisting of two 19-day in-hospital protocols (insomnia/control). After three nights of baseline sleep (8h/night, 23:00-07:00), participants in the experimental insomnia condition were exposed to three cycles of three nights of disturbed sleep (delayed sleep-onset, hourly sleep disruption, advanced sleep-offset) followed by one night of 8h-recovery sleep. The protocol ended with three additional nights of recovery sleep. In the control condition, participants had an uninterrupted sleep opportunity (8h/night) across the 19-day protocol. Blood samples were taken at 11:00 at baseline, during experimental insomnia exposure, and after recovery sleep. Several SPMs were measured in plasma using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Data were analyzed using linear mixed models.

Results

Exposure to experimental insomnia affected several SPMs compared to control sleep, including a decrease of resolvin D4 and E2 concentrations, which was still evident after the third recovery night (p<.05).

Conclusion

This is the first investigation on the effects of experimentally induced sleep disturbance on inflammatory resolution pathways. The results support that SPMs, particularly resolvin D4 and E2, are decreased by sleep disturbances, and do not normalize after a couple of nights of recovery sleep. Targeting these pathways by pharmacologically increasing SPMs may help to limit inflammatory consequences of sleep disturbances.

Support

NIH/NINDS R01-NS091177; NIH/National Center for Research Resources UL1-RR02758 and M01-RR01032 to the Harvard Clinical and Translational Science Center.
0277 Sleep Restriction does not Alter the Transcription of Adipose Tissue Insulin-Signaling Regulators
Authors: Singh P , Covassin N , Bukartyk J , Davison D , Svatikova A , St Louis E K , Somers V K
Published: May 2020

Introduction

Voluntary sleep curtailment decreases insulin sensitivity. However, molecular mechanisms underlying impaired insulin signaling are not completely understood. To gain molecular insights, we examined the transcription of known cellular insulin-signaling regulators in adipose tissue obtained from subjects undergoing experimental sleep restriction.

Methods

Nineteen healthy subjects (males: 11; age: 19 - 36 years; BMI: 24.5 ± 3.6 kg/m2) underwent a normal (9 hours/night) and a restricted sleep (4 hours/night) sequence in a random order. Each inpatient stay included a screen visit followed by 4 days of acclimation and 9 days of experimental phase consisting of a controlled sleep opportunity. Eucaloric diet was provided to ensure weight maintenance. Abdominal fat sample was obtained at the screen and end of the experimental phase. mRNA was quantified by RT-PCR. Fasting morning blood draws were obtained at the end of acclimation and experimental phases. Mixed models were used for analysis.

Results

mRNA expression did not differ in normal and restricted sleep condition for SOCS3 [changes in normal Vs. restricted sleep, 0.02 (0.11, -0.01) Vs. 0.01 (0.12, -0.07), p=0.33], PTEN [-0.22 (0.18, -0.39) Vs. -0.10 (0.21, -0.20), p=0.22], PTB1B [-0.003 (0.04, -0.07) Vs. -0.01 (0.06, -0.06), p=0.74] and Cav-1 [-2.45 (0.78, -8.39) Vs. -6.31 (1.68, -8.29), p=0.34]. Further, transcription of insulin-receptor also did not change [0.01 (0.07, -0.06) Vs. -0.03 (0.09, -0.07), p=0.92]. However, within group analysis show significant decreases in Cav-1 mRNA only during sleep restriction (normal: p=0.09; restricted: p=0.003). Importantly, restricting sleep duration was associated with lowering of insulin (0.6 ± 1.9 Vs. -1.6 ± 1.7 uIU/ml; p=0.003), no change in glucose (-1.5 ± 3.8 Vs. -3.7 ± 4.12 mg/dl, p=0.06) and improvement in HOMA-IR index (0.12 ± 0.44 Vs -0.42 ± 0.43, p=0.002).

Conclusion

Chronic sleep restriction does not alter the transcription of cell-signaling regulators in abdominal adipose tissue. Moreover, restricting sleep duration without increasing calorie intake did not seem to decrease insulin sensitivity as determined by HOMA-IR.

Support

NIH grants HL114676, Mayo Clinic CCaTS UL1 TR002377; AHA grant 13POST16420009 to NC
0280 Change in Sleep Depth Across the Night as a Measure of Sleep Adequacy
Authors: Schweitzer P K , Griffin K , Younes M , Walsh J K
Published: May 2020

Introduction

It is well known that sleep becomes lighter towards the end of the night reflecting the reduction in homeostatic sleep pressure. We hypothesized that more adequate nocturnal sleep (i.e. sufficient quantity and quality for the individual) would result in a greater reduction in sleep depth across the night and would be reflected in decreased next-day sleep tendency.

Methods

In a secondary analysis of data from a study in which sleep depth was altered by sleep restriction combined with either placebo or gaboxadol (a delta-promoting drug) we correlated change across the night in two measures of sleep depth with next-day Multiple Sleep Latency Test (MSLT) latencies. Forty-one healthy subjects underwent 8 consecutive sleep studies; two baseline, four sleep restriction (5 hours) and two recovery nights. MSLT was performed following each baseline night and the last two restriction nights. Sleep depth in the first and last hours of NREM sleep was determined by two

methods

1) Log delta spectral power; 2) The odds-ratio-product (ORP), a recently introduced continuous measure of sleep depth. The difference between initial and final values was calculated (ΔDelta, ΔORP). Post-restriction MSLT latency was correlated with baseline MSLT latency, ΔDelta, ΔORP, log delta power and ORP in the last hour, lost total sleep time and lost REM time.

Results

ΔDelta was -0.27 ±0.13 and ΔORP was 0.17 ±0.13, both changes reflecting lightening of sleep across the night. In both univariate and multivariate analysis only baseline MSLT latency (p < 0.001) and ΔORP (p < 0.01) were significantly and positively correlated with post-restriction MSLT latency.

Conclusion

The reduction in sleep depth across the night as measured by ORP, but not by delta power, is significantly correlated with reduced objective sleepiness following sleep restriction. ΔORP may be a useful index that reflects sleep adequacy during the night.

Support

None
0285 Preventative Voluntary Exercise Ameliorate Synaptic-Pruning Defects on Sleep-Deprived Adolescent
Authors: Tuan L , Tsao C , Lee L
Published: May 2020

Introduction

Since adolescent is a critical period for brain development, adequate sleep during this period is essential to cognitive performance as well as the psychological health in later life. Emerging evidence on sleep-deprived animal models has detailed the impacts of sleep loss on the developing brain. For instance, our previous study demonstrated that 72 h sleep deprivation (SD) disrupted microglia-mediated synaptic refinement in the dentate gyrus (DG). Physical exercise is proved to counteract the harmful consequences of various stress or neurodegenerative models by modulating microglial function. Therefore, we hypothesized that physical exercise might be a preventive intervention to rescue the failure of synaptic pruning and microglial function after SD in adolescent mice.

Methods

C57/BL6 male mice 3 weeks were assigned to the home cage (HC), home cage with voluntary exercise (HC+VE), sleep deprivation (SD), or sleep deprivation with voluntary exercise (SD+VE) group. In the groups with VE, a running wheel was placed in the cage 11 days before the SD paradigm. Following 72 h SD, animals were subjected to a short-term memory test or sacrificed directly for further examination.

Results

Our results showed that impaired memory performance was reversed in sleep-deprived mice after VE. Also, the SD+VE group exhibited less dendritic spine density compared to the SD group, implying VE rescue the synaptic pruning defect after SD. Greater microglia phagocytic ability, characterized by increased internalized postsynaptic materials and lysosomal structure within individual microglia, were observed in the SD+VE compared to the SD group. We also investigated the mRNA expression of microglia-specific receptors critical to developmental synaptic refinement and found an upregulation of CX3CR1 expression in both HC+VE and SD+VE compared to sedentary groups.

Conclusion

Here we provided evidence featuring that developmental VE significantly alleviated the SD-induced memory defects. Moreover, the SD-induced synaptic pruning impairment and microglial maladaptation were also prevented by the VE regimen, suggesting that physical exercise is a possible therapeutic interventions to the cognitive performance as well as the developmental trajectories to the adolescent brain under the influence of sleep insufficiency.

Support

Supported by the Ministry of Science and Technology of the Republic of China (Grant number: 104-2314-B-002-129-MY4).
0287 Motivated Performance While Sleep Deprived: Neurobehavioral Correlates of Attentional Effort Deployment
Authors: Massar S A , Lim J , Sasmita K , Chee M W
Published: May 2020

Introduction

Sleep deprivation (SD) has a negative impact on the motivation to exert effort. This may contribute to the decline in attentional performance observed under SD. In this study we examined how SD affects motivated performance and effort-based decision making. Particularly, we used functional magnetic resonance imaging (fMRI) to uncover the neural mechanisms underlying the interplay between SD and motivated behavior.

Methods

Twenty-seven healthy subjects were tested once after a night of sleep in the lab (9h Time in Bed; Rested Wakefulness = RW), and once after a night of total sleep deprivation (SD). Participants performed an effortful attention task with different incentive levels (0, 10, or 50 cents/fast and correct response). Behavioral performance and fMRI data were collected during task performance. Subsequently, participants performed an effort-based choice task, during which they could choose to earn additional rewards for performing the attention task for a longer duration.

Results

As expected, attentional performance was worse in the SD session compared to the RW session. In addition, performance improved as a function of incentive level both in the RW and the SD session. This reward-effect was accompanied by increased activation in attention-related brain areas, and increased arousal-related thalamus activation. This reward-modulation was more extensive during RW than SD, particularly in the anterior cingulate cortex (ACC) and anterior insula (aIns; both areas involved in effort regulation). Results from the decision making task were less willing to perform the attention task for a further duration after SD compared to RW.

Conclusion

Results show that performance decline after SD is reward-dependent and willingness to perform is reduced. Reward modulation of attention-related brain activation is reduced, particularly in areas that are associated with effort regulation (i.e. ACC and aIns). These findings indicate that motivational factors contribute to decline of vigilance following sleep deprivation.

Support

This work was supported by grants awarded to Dr. Michael Chee from the National Medical Research Council (NMRC/STaR/0015/2013), and the Far East Organization.
0297 Relationship Between Sleepiness Symptoms Questionnaire Ratings and Psychomotor Vigilance Performance in a Total Sleep Deprivation Study
Authors: Skwara A K , Skeiky L , Van Dongen H , Hansen D A
Published: May 2020

Introduction

While measuring the neurobehavioral consequences of sleepiness is arguably best done with performance tasks providing objective assessments of impairment, this often proves challenging in real-world operational settings. Self-report instruments measuring subjective sleepiness provide a practical alternative, but field studies generally fail to show high correlation between objective and subjective assessments of impairment. The Sleepiness Symptoms Questionnaire (SSQ) is a self-report instrument developed to address this issue by asking about observable symptoms of sleepiness and (motor vehicle driving) performance impairment. In a laboratory sleep deprivation study, we compared SSQ sleepiness ratings to performance impairment on a 10min psychomotor vigilance test (PVT).

Methods

N=12 healthy normal sleepers (ages 21-39y, 6 females) participated in a 4-day in-laboratory study. After a baseline day (9h time in bed; 22:00-07:00), subjects underwent 38h total sleep deprivation (TSD) followed by a recovery day (9h time in bed; 22:00-07:00). As part of neurobehavioral testing throughout the experiment, subjects completed the SSQ and PVT back to back at 6.5h, 14.5h, 22.5h, and 30.5h TSD, and 6.5h after recovery sleep. Data from one subject were incomplete and discarded prior to analysis.

Results

As TSD progressed, the SSQ sleepiness ratings and the number of lapses (RTs>500ms) on the PVT were elevated, with sleepiness and performance impairment peaking at 22.5h TSD. Both measures returned to baseline levels after recovery sleep. Mixed-effects analysis of covariance showed moderate correlation between SSQ ratings and PVT lapses (r=0.44, F1,43=24.1, p<0.001).

Conclusion

Self-reported sleepiness on the SSQ reflected the expected homeostatic and circadian changes in sleep pressure during TSD and following recovery sleep, as did PVT performance impairment. The moderate correlation between subjective ratings on the SSQ, with its emphasis on observable sleepiness symptoms, and objective impairment on the PVT suggests that the SSQ may be a reasonably reliable instrument for measuring sleepiness under conditions of acute sleep deprivation.

Support

Jazz Pharmaceuticals
0305 Grey Matter Volumetric Differences are Predictive of Attentional Lapses During Sleep Deprivation
Authors: Vanuk J R , Raikes A C , Dailey N S , Grandner M A , Killgore W D
Published: May 2020

Introduction

Inter-individual differences in resistance to cognitive effects of sleep loss are well established and extend from basic vigilance capacities to more nuanced emotional processing. Neurobiological markers related to gray matter volumetric differences associated with resilience to sleep deprivation (SD) have yet to be explored. We collected anatomical magnetic resonance imaging on well-rested healthy adults and correlated gray matter volume (GMV) with the number of lapses on a psychomotor vigilance test (PVT) subsequently occurring over 29-hours of SD.

Methods

45 individuals (23 males; mean age: 25.36 ± 5.62y) completed a baseline neuroimaging session while well-rested and returned 2-4 days later to complete 29h of SD. The PVT was administered at one-hour intervals across SD. High-resolution T1 structural scans were used for a volume-based morphometric analysis (CAT12). Images were segmented and normalized following automated procedures and smoothed at 8 mm FWHM. Regions of interest were constrained to the anterior cingulate and ventral frontal areas of the cortex. GM volume was correlated with the total number of lapses across all PVT administrations, after controlling for age, sex, and total intracranial volume.

Results

Total number of lapses positively correlated with GMV in two clusters comprised of areas in the anterior cingulate cortex (FWE corrected, p = 0.046), as well as the opercular and triangular parts of the inferior frontal gyrus (FWE corrected, p = 0.006).

Conclusion

Susceptibility to attentional lapses was predicted by greater gray matter volume in the ventrolateral prefrontal and anterior cingulate cortices. Current findings support that individual differences in attentional resiliency during SD may be, in part, due to differences in gray matter volume within cortical areas previously shown to be functionally affected by sleep loss.

Support

DARPA (12-12-11-YFA11-FP-029)
0318 Prospective Association of Actigraphy-Assessed Sleep with Physical Growth in the First 6 Months of Life
Authors: Li X , Rueschman M , Kaplan E R , Yu X , Davison K , Redline S , Taveras E M
Published: May 2020

Introduction

Suboptimal sleep is associated with weight gain and related chronic diseases in adults, adolescents, and older children. However, little is known regarding the associations between sleep and physical growth in infants. We investigated prospectively the associations between objectively-measured sleep patterns at 1 month and physical growth in the first 6 months of life.

Methods

We studied 344 full term infants in the ongoing longitudinal Rise & SHINE (Sleep Health in Infancy & Early Childhood) birth cohort study. At 1 month, infants underwent 7-day ankle actigraphy, estimating average sleep duration (24-hour, nighttime, and daytime) and sleep fragmentation (number of nighttime awakenings). Weight and length were measured at birth and 6 months and used to calculate weight-for-length z (WFL-z) scores. We used linear and logistic regression analyses to examine the associations between sleep patterns at 1 month with WLF-z at 6 months and rapid weight gain from birth to 6 months, defined as an increase in WFL-z greater than or equal to 0.67, controlling for covariates.

Results

Each 1-hour increase in 24-hour sleep duration was associated with a 0.07-unit (95% CI [0.01, 0.12]) increase in WFL-z at 6 months. Daytime, but not nighttime, sleep duration was positively associated with WFL-z. Greater number of nighttime awakenings was associated with higher WFL-z (beta = 0.28; 95% CI [0.08, 0.49]). 24-hour and nighttime sleep duration were positively associated with a 18.5% (95% CI [1.04, 1.35]) and a 23.4% (95% CI [1.02, 1.49]) higher odds of rapid weight gain from birth to 6 months, respectively.

Conclusion

Longer 24-hour sleep duration was associated with higher 6-month WFL-z and more rapid increases in WFL-z from birth to 6 months. Greater nighttime sleep fragmentation was associated with higher 6-month WFL-z. Sleep at 1 month might provide modifiable targets to help avoid lifetime complications of excess weight.

Support

R01DK107972.
0324 Effect of Sleep Restriction on Sleep Electroencephalogram Waveforms in Adolescents
Authors: Campbell I G , Cruz Basilio A , Zhang Z Y , Darchia N , Feinberg I
Published: May 2020

Introduction

Over the past 18 years, our laboratory has been carrying out longitudinal studies of sleep and sleep need across adolescence. Our current study uses a dose-response design to examine daytime performance and sleep EEG after varied sleep durations. Here we present results for 1-30 Hz EEG power in NREM and REM sleep.

Methods

Home EEG recording in children 10-16 years old (N=77, mean age = 13.2). Adhering to their habitual rise time participants kept an assigned TIB schedule of 7, 8.5, or 10 hours for four consecutive nights. Participants completed all three conditions each year of the 3 year study. EEG recordings from the fourth night of each condition were scored and analyzed with FFT.

Results

Reducing TIB from 10 to 7 hours effectively decreased total sleep time (TST) from an average of 531 min to an average of 407 min. Decreasing TIB (from 10 to 7 h) produced a small increase (4.6%, p=0.0004) in delta (1-4 Hz) power and a larger decrease (9.0%, p=0.0032) in alpha (8-11 Hz) power in the first 5 h of NREM sleep. In REM periods 2 and 3, the same TIB reduction also increased (12.1%, p<0.0001) delta power and decreased (14.2%, p<0.0001) alpha power. Decreasing TIB reduced (11%, p<0.0001) sigma (11-15 Hz) power in the first 5h of NREM sleep and reduced (28%, p<0.0001) all night NREM sigma energy.

Conclusion

Reducing TST changes EEG power in several frequency bands. The increase in NREM delta power, expected from homeostatic models, may be too small to be biologically significant. The larger loss of sigma power may be of greater consequence. Sigma frequency activity is an indicator of sleep spindles which have been affected in aging, learning, memory and psychopathology. The sigma response to sleep restriction could be used to study these relations.

Support

PHS grant R01 HL116490 supported this work.
0337 Association Between Free-living Sleep and Memory and Attention in Healthy Adolescents
Authors: Stefansdottir R , Gundersen H S , Haraldsson H , Rognvaldsdottir V , Lundervold A S , Gestsdottir S , Gudmundsdottir S L , Chen K Y , Brychta R J , Johannsson E
Published: May 2020

Introduction

Sleep is important for people of all ages, especially children during development. However, adolescents often sleep less than the recommended eight hours per night. Clinical trials have found that even partial sleep deprivation- shorter than the recommended duration- can reduce cognitive function in adolescents. The association between objectively measured free-living sleep and cognition function in adolescents has not been studied.

Methods

Free-living sleep duration and sleep efficiency were measured over one week with wrist actigraphy in 199 healthy normal adolescents (140 girls, mean±SD, 17.7±0.3 years). The day after the sleep measurement concluded, sustained attention was assessed with a validated Posner cue-target task, and working memory was measured with an n-back task. Associations between sleep measures and response times during attention and memory tasks were explored with multiple linear regression adjusted for task accuracy.

Results

Over the entire week, participants’ average sleep duration was 6.2±0.7 h/night and average sleep efficiency was 88±4.4% and averages for sleep the night prior to the cognitive testing were similar. Response times on memory (1-back: 420.6±73.9, 2-back: 522.6±101.9, and 3-back: 551.8±137.2 msec) and attention tasks (valid cue: 309±31.2, invalid cue: 365.8±36, and no cue: 393.6±38.9 msec) were similar to previous reports and not associated with average weekly sleep measures. Sleep duration of the night before cognitive testing was negatively associated with response times for the most challenging memory task (3-back; p=0.02). However, sleep measures of the night before did not correlate with any of the attention task scores.

Conclusion

Our data suggests that performance on difficult memory tasks may be negatively impacted by shorter free-living sleep durations the night prior to testing, even in healthy adolescents who average less than the recommended amount of sleep. Future studies should explore whether recovery sleep or other improvements in sleep habit might mitigate such effects on memory.

Support

The Eimskip University of Iceland Fund, Icelandic Centre for Research, National Institute of Diabetes and Digestive and Kidney Diseases.
0376 Demographic and Socioeconomic Implications of Excessive Daytime Sleepiness in the Community
Authors: Begay T , Tubbs A , Jean-Louis G , Hale L , Branas C , Patterson F , Killgore W D , Wills C C , Grandner M A
Published: May 2020

Introduction

Daytime sleepiness impairs daily functioning and may be directly related to insufficient nighttime sleep. Previous studies have assessed disparities in sleep duration and quality, but community-level disparities in daytime sleepiness using validated measures are lacking.

Methods

Data were from the Sleep and Healthy Activity, Diet, Environment, and Socialization (SHADES) study of N=1007 adults age 22-60. Daytime sleepiness was assessed with the Epworth Sleepiness Scale (ESS). Predictors included age, sex, race/ethnicity, education, and social class (“Upper middle class or above,” “Middle class,” “Lower middle class,” “Poor,” or “Very Poor”). One-way ANOVAs evaluated group differences. Stepwise linear modeling evaluated ESS score relative to sociodemographic predictors. Final models included all variables entered together to evaluate independent effects. Finally, habitual sleep duration was entered as an additional covariate.

Results

ESS score was higher among racial/ethnic minorities (p=0.0006), men (p<0.0001), those with less education (p=0.008) and lower social class (p=0.0007), and those who are retired or unable to work (p=0.03); marginal differences were seen according to age (p=0.06). Using a model-building approach, age, sex, race/ethnicity, education, social class, and employment were evaluated. Only race/ethnicity (F=5.1, p=0.0004), education (F=4.8, p=0.003), and social class (F=2.14, p=0.046) incrementally added variance to model R2. No 2-way interactions were found. In the final model, significant predictors included Black/African-American race/ethnicity (B=0.94, p=0.01), some college (B=0.99, p=0.005), and being very poor (B=2.16, p=0.005). When controlling for nocturnal sleep duration, the increased sleepiness associated with being Black/African was attenuated (p=0.06), but the other relationships were still significant.

Conclusion

There is a “sleepiness disparity” in the population associated with race/ethnicity and socioeconomics. Daytime sleepiness in the community is associated with being Black/African-American, having some college, and being “very poor.” The race/ethnicity difference in daytime sleepiness may be partially explained by differences in total sleep time.

Support

This work was supported by a grant from Jazz Pharmaceuticals. The SHADES study was funded by R21ES022931. Dr. Grandner is supported by R01MD011600.
0405 Sleep Duration and Sleep Disturbance Related to Obesity, Health, Motor Vehicle Safety, and Daytime Functioning in Israel: Data From the 2017 Israel Social Survey
Authors: Rosenberg E , Perlis M L , Parthasarathy S , Chakravorty S , Grandner M A
Published: May 2020

Introduction

Previous studies suggest the Israeli population exhibits relatively short sleep duration and experiences sleep difficulties. This analysis evaluates the relationships between habitual sleep and outcomes of interest in this population.

Methods

Data were obtained from 7,230 Israeli individuals. The sample consisted a 2017 population-based survey of households, conducted by the Israeli Bureau of Statistics. All variables were self-reported. Outcomes of interest included drowsy driving, sleep medication use, functional impairment, sleepiness, overall health, 1-year health change, and obesity. Predictors included categories of sleep duration (<=5, 6, 7, 8 [reference], or >=9 hours) and sleep disturbance in the past month (none [reference], mild [1/week], moderate [2-3/week], or severe [>3/week]). Covariates included age, sex, ethnic group, and financial status. Binary and ordinal logistic regressions were employed to evaluate the relationship between them and post-hoc analyses evaluated the relationships between subgroups.

Results

Drowsy driving was associated with <=5h, 6h, and 7h sleep duration categories, and severe sleep disturbance. The use of sleep medication use was associated with <=5h and >=9h, and all levels of sleep disturbance. Functional impairment and sleepiness were both associated with <=5h, 6h, 7h, and >=9h, and all levels of sleep disturbance. Their reported overall health was linked to sleep duration of <=5h and >=9h, and all levels of sleep disturbance. Worsening health was associated with <=5h and all levels of sleep disturbance. Obesity was associated with <=5h and severe sleep disturbance. In post-hoc analyses restricted to individuals with no sleep disturbance, habitual sleep duration was still statistically significantly related to drowsy driving, sleep medications, sleepiness, and health change.

Conclusion

Short sleep duration and sleep disturbance are associated with worse motor vehicle safety, health, and functioning in the Israeli population. Effects of sleep duration were generally maintained even for those without sleep disturbance. These results may help focus public health efforts on improving sleep health.

Support

Dr. Grandner is supported by R01MD011600
0420 Fibre-Specific White Matter Neurodegeneration is Associated with Long Sleep Duration After Stroke
Authors: Gottlieb E W , Egorova N , Khlif M S , Khan W , Werden E , Pase M P , Howard M , Brodtmann A
Published: May 2020

Introduction

Long sleep duration in aging populations has recently been proposed as a key modifiable risk factor and sequela of stroke. It is unclear whether the pathogenesis of post-stroke sleep-wake dysfunction is due to focal infarction to regional sleep-wake hubs in the brain, or to accelerated whole-brain neurodegeneration. We utilise a novel technique known as whole-brain fixel-based analyses (FBA) to characterize the first fibre-specific white-matter markers of long sleep duration after stroke.

Methods

We included 98 radiologically-confirmed ischemic stroke participants (67 male; mean age = 68) and 40 age-matched controls with no history of neurodegenerative disease imaged 3-months post-stroke. Sleep-wake was measured for one week using BodyMedia’s SenseWear armband. Diffusion-weighted MRI (DWI) were acquired using echoplanar imaging and preprocessed using MRtrix3. FBA were employed to identify tracts with altered white-matter fibre-density and fibre-bundle cross-section (FDC) in the long sleep duration (>8 hr, n=20) and normal sleep duration groups (between >6 hr and <8 hr, n=59) compared to controls. Statistical comparisons of FDC between groups were performed at each FDC fixel by a general linear model controlling for age, sex, and intracranial volume.

Results

Stroke participants with long sleep duration exhibited significant FDC reductions of up to 40% within the cortico-ponto-cerebellar tract when compared to healthy controls (family-wise-error-corrected p=<0.05). Bilateral pontine degeneration was observed at the decussation of the superior cerebellar peduncles. Stroke participants with normal sleep duration exhibited diffuse whole-brain degeneration most apparent along the corpus collosum and cingulum; however, the distribution was less extensive relative to long sleepers (i.e., no cortico-cerebellar projections) and percentage effect reductions did not exceed 20%.

Conclusion

Long sleep duration after stroke is associated with cortico-ponto-cerebellar degeneration when compared to controls or stroke-participants with normal sleep duration. Excessively long sleep may contribute to post-stroke neurodegeneration beyond the effects of direct infarction and may be a modifiable pharmacological target for abating brain volume loss after stroke.

Support

This work was supported by the National Health and Medical Research Council project grant (APP1020526), the Brain Foundation, Wicking Trust, Collie-Trust, and Sidney and Fiona Myer Family Foundation. NE was supported by the Australian Research Council DECRA award DE180100893.