bluuebunny/crossref_metadata_2025 huggingface dataset:
0019 Investigating Novel-Sleep Related Genes in Drosophila Melanogaster: A Follow Up on KOMP2 Identified Genes in Mus Musculus
Authors: Guerriero R , Shaw P , O’Hara B
Published: May 2020

Introduction

Sleep is well-conserved across phylogeny, yet the function of sleep and its underlying mechanisms are currently poorly understood. Novel-sleep related genes were previously identified by our lab in part of the Knockout Mouse Phenotyping Program (KOMP2). This international effort generated single-gene knockouts on a Mus musculus C57BL6/NJ background and proceeded to gather data on over 200 phenotypes, including five days of baseline sleep and wake parameters. Sleep data was gathered using the non-invasive, high-throughput PiezoSleep System (Signal Solutions, LLC) which uses a piezoelectric film to gather movement data which then can be assigned to be wake or sleep. These data identified 122 novel genes that influence sleep phenotypes such as sleep duration and bout length.

Methods

Homologous proteins were identified and a subset of these genes are under investigation in Drosophila melanogaster, including myosin heavy chain (Mhc) and spinophillin (Spn). Using both genetic mutants and RNAi knockdowns, the effect of gene reduction on activity profiles and sleep are being analyzed. Sleep and activity data is recorded using DAM2 monitors (TriKinetics Inc.) while being maintained on a 12:12 light:dark cycle.

Results

Preliminary data analysis show that aberrations in Mhc and Spn impact sleep percentage. Both Mhc and Spn are known to be involved in structure and development of synapses. Spn is involved in the neurexin scaffolding of presynaptic neurons and also help with maintaining these synapses once formed. Synaptic reorganization and regulation is known to take place during sleep, showing a potential connection of these proteins and sleep.

Conclusion

These genes that show effects on sleep in both D. melanogaster and M. musculus show a conservation of the underlying sleep machinery.

Support
0023 Neuropeptidergic Regulation of Drosophila Larval Sleep
Authors: Poe A R , Szuperak M , Kayser M S
Published: May 2020

Introduction

Sleep during early life is thought to be important for brain development. Indeed, disruptions in sleep during development have long-lasting effects on cognitive functioning. Recently, our lab has developed the LarvaLodge platform for monitoring sleep in developing Drosophila larvae. Using this system we can investigate the neural circuits and signals controlling sleep during early neurodevelopmental periods. Neuropeptides play critical roles in regulating many behaviors in both larvae and adult flies.While several neuropeptides modulate sleep in adult flies, it is not known what role neuropeptides play in controlling larval sleep.

Methods

To identify peptidergic neurons that regulate 2nd instar larval sleep, we activated neurons labeled by 34 independent Gal4 driver lines corresponding to 25 different neuropeptide genes using the heat-sensitive cation channel, TrpA1.

Results

Of the 34 Gal4 driver lines, we determined that 2 lines are wake-promoting and 7 lines are sleep-promoting. A subset of these exert effects on sleep without associated changes in wake activity levels. We also observed sleep fragmentation (increase in sleep bout number and decrease in sleep bout length) in 3 lines. Subsequent analysis indicated that manipulation of activity in Diuretic hormone 44 (Dh44)-labeled neurons bidirectionally modulates sleep-wake. Additionally, pan-neuronal knockdown of Dh44 altered sleep duration.

Conclusion

This work indicates that neuropeptidergic signaling modulates sleep during early development and provides a platform to examine how neuropeptidergic regulation of sleep/wake changes throughout the lifespan.

Support

NIH T32
0040 Relationship Between Inflammatory Markers and Sleep in Healthy Adolescents
Authors: Reddy A , Li L
Published: May 2020

Introduction

Multiple studies in different countries show a trend of adolescents having insufficient sleep. Review of literature strongly suggests role of cytokines in sleep regulation. Different inflammatory markers like tumor necrosis factor (TNF)α, C-reactive protein (CRP) and interleukins (IL) are sleep regulatory substances. Most of the studies showing relation between cytokines and sleep are seen in adults. In our study, we were interested in finding the relationship between sleep quality and inflammatory markers in healthy adolescents.

Methods

Twenty eight female and male, African American and White, healthy adolescents aged 15–18 completed the study. Sleep quality was measured using the Pediatric Sleep Questionnaires (PSQ), including snoring, daytime sleepiness and hyperactive behavior. Blood sample was collected from each participant for measuring the inflammatory factors.

Results

Partial Pearson correlation analysis showed that global PSQ score and hyperactive behavior were significantly correlated with TNF α (r=0.37 for both). Snoring was significantly correlated with leptin, CRP and IL-6 in healthy adolescents. No other correlations were observed.

Conclusion

Consistent with findings in adults, we have observed an association between inflammatory markers and poor sleep in healthy adolescents. Our findings suggest the importance to improve sleep quality in adolescents for better health outcomes.

Support

None of the authors have any conflict of interest. This research was supported by awards, P30DK056336 and P30DK079626, from the National Institute of Diabetes And Digestive And Kidney Diseases to Nutrition Obesity Research Center and Diabetes Research Center, respectively, at the University of Alabama at Birmingham.
0043 BDNF Genotype Modulates Circadian Response to Simulated Nightwork in IL-6
Authors: Satterfield B C , Savenkova M I , Karatsoreos I N , Van Dongen H
Published: May 2020

Introduction

Brain Derived Neurotrophic Factor (BDNF) is involved in synaptic plasticity and may be involved in sleep and circadian regulation. The BDNF gene has a single nucleotide polymorphism (Val66Met) resulting in decreased BDNF secretion. The Met allele is associated with reduced nocturnal slow wave activity following sleep loss, and may also enable more flexible adaptation to circadian misalignment. We used IL-6, a pleiotropic cytokine with biphasic circadian secretion, to compare the response of Val and Met carriers to circadian misalignment.

Methods

15 healthy men (26.7±4.9y) participated in a 16-day laboratory study of simulated nightwork with two nighttime duty cycles and an intervening 58h restart break. The study began with two baseline 10h time in bed (TIB) nighttime sleep opportunities (22:00-08:00) and a 5h TIB afternoon nap (15:00-20:00). Each duty cycle consisted of five nighttime waking periods and four 10h TIB daytime sleeps (10:00-20:00). The restart break began with a 5h TIB morning nap (10:00-15:00), followed by two 10h TIB nighttime sleeps (22:00-08:00). The middle two daytime sleep periods from each duty cycle were monitored polysomnographically and visually scored. During the baseline and restart periods, blood samples were collected at 08:25 and then at 2h intervals until 20:00. Plasma IL-6 was measured by means of ELISA. BDNF Val66Met genotype was determined from whole blood.

Results

The genotype distribution was in Hardy-Weinberg equilibrium (Val/Val:5; Val/Met:10; Met/Met:0). On average, Met carriers slept 52.2min longer (p=0.052) and displayed 27.7min more REM (p=0.013) than Val/Val subjects during the 10h TIB daytime sleeps. Baseline IL-6 concentrations were similar between genotypes. However, during the restart break, Val/Met subjects showed reduced IL-6 compared to baseline and to Val/Val subjects (p=0.022).

Conclusion

BDNF Val66Met heterozygotes exhibited blunted IL-6 levels following simulated nightwork, suggesting this genotype experienced a substantial circadian shift and/or altered response to sleep loss associated with daytime sleep.

Support

FMCSA award DTMC75-07-D-00006; Elliot D. Weitzman, M.D. Research Grant from the Sleep Research Society Foundation.
0048 The Association Between REM Sleep and Risk of Mortality in Three Independent Cohorts
Authors: Leary E B , Watson K T , Ancoli-Israel S , Redline S , Yaffe K , Ravelo L A , Peppard P E , Zou J , Goodman S , Mignot E , Stone K L
Published: May 2020

Introduction

Sleep disorders and sleep characteristics have been linked to higher risk of mortality. Despite the emerging evidence of a sleep-mortality association, the relationship between sleep architecture and mortality aren’t well understood. We hypothesize that reduced REM is associated with increased mortality risk.

Methods

The Osteoporotic Fractures in Men (MrOS) study is a population-based study of 2,675 older men. Cox regression was used to evaluate the association between %REM and mortality rate. Potential covariates were evaluated using 6-fold cross validation. Sensitivity analyses were performed to rule out alternative explanations. Wisconsin Sleep Cohort (WSC) and Sleep Heart Health Study (SHHS) data were used to replicate the findings.

Results

The MrOS sample mean age was 76.3 years (SD=5.51) and the median follow-up time was 12.1 years. There was a 13% higher rate of mortality for every absolute 5% reduction in REM sleep (HR=1.13, 95%CI, 1.08–1.19) after adjusting for multiple demographic, sleep, and health covariates. The association persisted for cardiovascular disease-related mortality (CVD) (HR=1.18, 95%CI, 1.09–1.28), cancer-related mortality (HR=1.14, 95%CI, 1.03–1.26), and other mortality (HR=1.19, 95%CI, 1.10–1.28). The WSC included 45.7% women. The mean age of the 1,388 individuals analyzed was 51.5 (SD=8.5); the median follow-up time was 20.8 years. The effect size for 5% reduction in REM on rate of all-cause mortality was similar in this cohort despite the younger age, inclusion of women, and longer follow-up period (HR=1.17, 95%CI, 1.03–1.34). SHHS data is still being analyzed; however the unadjusted model is consistent with the other cohorts.

Conclusion

We found an association between reduced REM and mortality in two, possibly three independent cohorts, which persisted across different causes of death and multiple sensitivity analyses. Mechanistic studies are needed and strategies to preserve REM may influence clinical therapies and reduce mortality risk.

Support

NHLBI provides funding for the MrOS Sleep ancillary study “Outcomes of Sleep Disorders in Older Men” under grant numbers: R01 HL071194, R01 HL070848, R01 HL070847, R01 HL070842, R01 HL070841, R01 HL070837, R01 HL070838, and R01 HL070839. Wisconsin Sleep Cohort was supported by R01HL62252, RR03186, and R01AG14124 from the NIH. Dr. Redline was partially supported by NHLBI R35 HL135818.
0055 Physiological Based Predictive Models of Vigilance
Authors: Daley M S , Gever D H , Chon K H , Posada-Quintero H , Bolkhovsky J B
Published: May 2020

Introduction

The Naval Submarine Medical Research Laboratory (NSMRL) is developing predictive models to examine how non-invasive, non-disruptive physiological monitoring can be used to track performance decrements due to sleep deficiency. Utilizing biometrics extracted from physiological measures to track performance changes would allow for automated tracking of fatigue and alleviate the overhead necessary to monitor individual schedules and sleep patterns.

Methods

NSMRL collaborated with the University of Connecticut to run a sleep deprivation study that deprived 20 participants of sleep for a period of up to 25 hours. During this time, subjects completed multiple tasks, including the Psychomotor Vigilance Test (PVT) every few hours. A non-invasive monitoring system collected physiological data from participants, which includes eye tracking, electrocardiography, electrodermal activity, and facial tracking (e.g., blink metrics, heart rate variability, skin conductance levels, facial action units). Using this multimodal approach, biometrics were extracted and evaluated to determine their predictive power on PVT performance. Multiple linear regression, using predictors selected via sequential forward selection, was used to develop a model of performance at an individual level based on a subset of these metrics chosen using principal component regression.

Results

Thirty-eight biometrics were extracted from the collected data and used to produce a predictive model of PVT performance. Sequential forward selection was used to select 11 primary biometrics. The criteria for primary metric inclusion in the model was minimization of root mean squared error. The resultant model had a correlation coefficient (r) of 0.71 (p < 0.001) with a root mean squared error (RMSE) of 49.8 ms between the predicted reaction time and true reaction time for each subject.

Conclusion

Non-invasive, non-disruptive monitoring could be used to track individual cognitive performance decrement due to sleep deficiency. This study examined the capability of combining the data from four physiological monitors that can be contained within a wrist worn device and a desk or helmet mounted camera. Utilizing 11 biometrics obtained from these monitors a stepwise regression model was developed that significantly correlates with PVT reaction time at both an individual and group level.

Support

This work was supported by the Military Operational Medicine Research Program.
0061 Does Combining M1 M2 Reference Influence Amplitude of Slow Waves?
Authors: Walker N A , Roth H L , Fan Z , Vaughn B V
Published: May 2020

Introduction

Slow wave amplitudes are critical to determining Stage N3 sleep yet ECG artifact frequently interferes with accurate amplitude measurement. This artifact may be lessened by using a combined M1-M2 reference however theoretically this may decrease the amplitude due to shorter inter-electrode distance (predicted 27% loss). The AASM Scoring Manual recommends scoring slow wave activity using F4-M1 channel or alternatively F3-M2, but does not recognize a combined reference. This study measures the differences in slow wave amplitude using contralateral versus combine reference.

Methods

12 polysomnograms were randomly selected for analysis of amplitude of slow wave using contralateral and combined reference channels. Six separate EEG channels (F3-M1, F3-M2, F3-M1+M2, F4-M1, F4-M2, and F4-M1+M2) were used to analyze 25 different slow waves from each polysomnogram. Individual slow waves from Stage N3 sleep were analyzed using the Natus Sleepworks Amplitude Measurement Tool if their peak and trough were free EKG artifact. Averages and standard deviations of the waveforms were calculated for each patient and channel. Differences were normalized by dividing by the amplitude of the original wave using the contralateral reference.

Results

Subjects age ranged from 30–69 yrs, with 6 being females. Mean amplitudes were as follows: F3-M2 was 131.75µV, F3-M1+M2 125.84 µV, F4-M1 130.57 µV, and F4-M1+M2 128.22µV. The overall average difference of F4-M1 to F4-M1+M2 was 0.92% and the average difference of F3-M2 to F3-M1+M2 was 3.52% with the average standard deviation of 8.47%.

Conclusion

This study shows the average loss in amplitude of converting F4-M1 to F4-M1+M2 was less than 1% and 3.5% for F3-M2 to F3-M1+M2. Combining M1M2 reference may be a valuable alternative to reduce EKG artifact.

Support

None
0087 Childhood Naps Promote Short-Term Destabilization but Long-Term Consolidation of Emotional Memories
Authors: Hanron O , Mason G , Holmes J F , Spencer R M
Published: May 2020

Introduction

Early childhood naps have been shown to support emotional memory consolidation, but this benefit only emerges the following day. It is unknown whether consolidation occurs during the nap itself, or if napping only prepares memories for overnight consolidation. In this study, we used a forced-choice recognition task to determine whether naps protect emotional memories against post-nap interference, which would indicate the occurrence of consolidation.

Methods

Preschool children (33–67 months; N=63) viewed neutral faces paired with negative or neutral descriptions. Following a nap or an equal interval awake (within-subjects, order counterbalanced, ~1 week apart), half of these participants (N=33) were presented with an interfering set of faces and descriptions, while the other half (N=30) did not receive interference. For all participants, recognition of the original faces was probed after encoding, after the nap or wake interval, and the next morning.

Results

To assess the influence of napping on changes in emotional memory, 2 (stimulus valence: negative vs. neutral) x 2 (condition: nap vs. wake) repeated-measures ANOVAs were performed. Recall of negative and neutral items did not immediately differ between the nap and wake conditions for the participants who received no interference. 24 hours later, these children trended towards recalling negative and neutral items better if they had napped the previous day (condition main effect: F(1,29)=3.539, p=0.070). In contrast, participants who received interference recalled fewer negative items than neutral items immediately following a nap (p=0.034), while this difference did not emerge following an interval awake.

Conclusion

Our results suggest that naps initially destabilize emotional memories rather than protecting them against interference. However, this initial destabilization may reflect the partial processing of memories during naps, perhaps allowing for enhanced long-term consolidation. Overall, our findings provide important insight into the mechanism of nap-dependent emotional processing.

Support

Supported by NIH R01 HL111695 and an Honors Research Grant from Commonwealth Honors College
0090 Stage-Specific Sleep Disruption and its Effect on Spatial Navigational Memory
Authors: Parekh A A , Kam K , Mullins A , Fakhoury A , Castillo B , Roberts Z , Fleysher L , Rapoport D M , Ayappa I , Varga A
Published: May 2020

Introduction

The mechanisms by which sleep disruption impact memory may depend on sleep stage, as rapid eye movement (REM) and slow wave sleep (SWS) differ in several significant ways, including degree of neuronal synchrony and frequency of cortical local field potential oscillations. Here we sought to examine the relationship between stage-specific disruption of sleep and its effect on spatial navigational memory.

Methods

9 healthy adult subjects participated in this study which involved 3 in-lab polysomnograms (normal, REM-disruption, and SWS-disruption) accompanied by pre- and post-sleep functional neuroimaging of brain during a spatial navigational memory task. Graded auditory stimuli consisting of 0.5 second bursts of high-frequency tones (300-3000Hz) were used to disrupt sleep (REM/SWS) in real time. Primary metrics to ascertain the effect of these auditory tones on sleep were time in sleep stage (REM/SWS) as a % of total sleep time (TST), bout length. The primary metric for spatial navigational memory was %change in overnight completion time on a first-person-experience 3D maze task.

Results

Sleep macrostructure was normal during the normal night (TST:379.9±56.6 min; SWS:19.5±7.6%; REM:19.4±5.3%; mean±std). Stage-specific disruption of sleep was achieved using auditory tones during a) SWS-disruption condition (TST:388.9±47.4 mins; SWS:6.6±4.8%; REM:18.7±5.2%) and b) REM-disruption condition (TST:365.3±69.8 mins; SWS:17.1±7.7%; REM:12.1±6.6%). SWS-disruption reduced mean bout length of SWS as compared to no disruption (1.3±0.8 mins vs. 10.3±8.2 mins; p<0.01) and REM-disruption reduced mean bout length of REM as compared to no disruption (2.2±1.7 vs. 10.6±5.2 mins; p<0.01). When sleep was not disrupted, subjects achieved overnight improvements in performance (25.3±17%) which remained unchanged during REM-disruption (18.8±29.6%, p=0.5) and during SWS-disruption (38.8±24.4%; p=0.2). Morning psychomotor vigilance was also unaffected by condition.

Conclusion

Stage specific disruption of sleep can be achieved using graded auditory tones. While performance on a virtual 3D maze remain unchanged with stage specific sleep disruption, lower sample size may have limited our ability to detect the change. Activation patterns from functional neuroimaging that were acquired during the spatial navigation task may elucidate the interaction between stage-specific sleep disruption and performance.

Support

NIH R21AG059179
1005 Characterizing Sleep and Glycemia in Emerging Adults with Type 1 Diabetes
Authors: Griggs S , Redeker N S , Grey M
Published: May 2020

Introduction

Type 1 Diabetes (T1D) affects 1.25 million Americans, and only 14% of emerging adults (ages 18-30 years) achieve targets for glycemic control (A1C < 7.0%). Sleep deficiency, less than 6.5 hours total sleep time (TST), is associated with poorer glycemic control.

Methods

Emerging adults with T1D wore a wrist actigraph and their own or provided continuous glucose monitor (CGM) concurrently 24 hours/day for 6-8 days. Participants completed a 10-minute psychomotor vigilance test (PVT) on a device, 3-minute Trail Making Test on paper, and questionnaires including twice daily Pittsburgh sleep diaries in Research Electronic Data Capture (REDCap). TST, sleep onset latency (SOL), sleep efficiency (SE), wake after sleep onset (WASO), and sleep fragmentation index (SFI) were determined via actigraphy, glycemic control via A1C, and glucose variability via CGM. The purpose of this descriptive study was to explore associations between TST, sleep variability (SD of TST), neurocognitive function (psychomotor vigilance and executive function) and diabetes outcomes (glycemia and distress).

Results

The sample included 36 emerging adults (mean age 22.8±3.1; 30.6% male; 91.7% White, 86.1% non-Hispanic; A1C mean 7.1±1.0%, BMI 27.3±4.8 kg/m2). Mean TST was 7.1±1.2 hours, SOL was 19.7±13.5 minutes, SE was 85.5±4.6%, WASO was 34.7±18.2 minutes, and SFI was 17.7±6.2. Shorter TST was associated with more severe sleepiness (r=-0.48,p=0.004) and more diabetes distress (r=-0.37, p=0.03). More sleep variability was associated with more severe sleepiness (r=0.36, p=0.03), longer response times (RT) ≥ 500ms (rho=0.39, p=0.02) measured via PVT, more nocturnal glucose variability (r=0.38, p=0.04), greater mean daily differences in glucose levels (r=0.42, p=0.02). Shorter mean RT was associated with more time in glucose range (rho=-0.37, p=0.04).

Conclusion

Improving TST and sleep variability are potential therapeutic targets to improve glucoregulation in this high-risk population. Researchers should consider within-person multi-level modeling to inform our understanding of the true nature of the sleep-glucose association in emerging adults with T1D.

Support

T32 NR0008346, Sigma Theta Tau International, Dexcom provided continuous glucose monitors (G4) free of charge for participants who did not have their own device.
1036 Does Diary and Actigraphy Measured Sleep Differ Between Good and Poor Sleepers During Breast Cancer Treatment?
Authors: Tulk J , Garland S N , Rash J , Lester R , Laing K
Published: May 2020

Introduction

Women may enter in breast cancer (BCa) treatment with poor sleep, or it may begin during treatment. We assessed how subjective and objective sleep changes during the first year of treatment for women with BCa. Further, we examined whether this differs between previously good and poor sleepers and whether there was agreement between subjective and objective measures of sleep.

Methods

Sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST), and sleep efficiency (SE) were measured among 100 patients with newly diagnosed, non-metastatic BCa using 7 days of diary and actigraphy collected at 4 time points: pre-treatment, 4, 8, and 12 months. Women with a score ≥5 on the Pittsburgh Sleep Quality Index at treatment onset were classified as poor sleepers. A 4 (time: 0-, 4-, 8-, 12-months) by 2 (sleep measure: sleep diary, actigraphy) by 2 (group: good, poor sleepers) mixed model ANOVAs was performed for each sleep parameter.

Results

There was a time by sleep measure by group interaction for TST, [F(3,294)= 3.014, p = .03). Good sleepers reported greater TST on diaries- than actigraphy at pre-treatment and 12 months, whereas there were no differences in poor sleepers. There was a group by time effect for good vs. poor sleepers [F(3,294)= 2.909, p = .035]. Good sleepers experienced decreased TST and SE from pre-treatment through 4-mo, followed by increases. Poor sleepers showed the opposite pattern. Neither group returned to pre-treatment levels. Sleep diaries and actigraphy are concordant over time for TST, but not SOL, WASO, or SE.

Conclusion

Sleep parameters worsen during the first year following onset of BCa and concordance between sleep diaries and actigraphy differ between good or poor sleepers.

Support

Dr. Garland is supported by a Scotiabank New Investigator Award and seed funding from the Beatrice Hunter Cancer Research Institute (BHCRI).
1039 Sleep And Daytime Activity Among Mechanically Ventilated Adults During Early Critical Illness
Authors: Liang Z , Elias M N , Ji M , Munro C L
Published: May 2020

Introduction

The purpose of this study is to report 5 consecutive days’ descriptive data for sleep efficiency (SE), total sleep time (TST), and daytime activity ratio (DAR) among critically ill mechanically ventilated adults from 9 intensive care units (ICU) across two hospitals. To our knowledge, this is the first study to describe sleep and activity patterns among mechanically ventilated adults during the early critical illness period.

Methods

We enrolled 31 critically ill mechanically ventilated subjects within 48 hours of ICU admission. Daytime periods were defined as 06:00-21:59; nighttime periods were defined as 22:00-05:59. Actigraphy estimated nighttime SE, TST, and the DAR. We calculated mean DARs [DAR = (daytime activity count per minute / 24-hour activity count per minute) x 100], which may be an indicator of altered rest/activity cycles. In our study, a DAR of >80% was used to define normal rest/activity patterns. Descriptive analyses were used for this sub-analysis of our parent randomized controlled trial.

Results

Among the 31 subjects included, the mean age was 59.6 ± 17.3 years, 41.9% were male, 80.6% were White, and 67.7% were Hispanic/Latino. The mean nighttime SE and TST over the 5-day ICU period were 83.1% ± 16.1 and 6.6 ± 1.3 hours, respectively. The mean DAR over the 5-day ICU period was 66.5% ± 19.2. Only 17.5% of subject days (14 days out of a total of 80 recorded days) met the definition of normal rest/activity patterns (DAR >80%).

Conclusion

Throughout the early ICU period, among mechanically ventilated patients, both the sleep/wake as well as the rest/activity cycle were disturbed. Intervention studies targeting the optimization of nighttime sleep consolidation and daytime activity should be investigated.

Support

This project was supported by a federal grant from the National Institutes of Health/National Institute of Nursing Research (R01NR016702). This clinical trial is registered with ClinicalTrials.gov (NCT03128671).
1048 Prevalence Of Positional Obstructive Sleep Apnea (OSA) In Patients With OSA-COPD Overlap Syndrome
Authors: Rani S , Rengan R , Mandal M , Ramzy J , VegaSanchez M , Jaffe F , Solar X , D’Alonzo G , Criner G J , Chatila W , Shariff T , Weaver S , Krachman S
Published: May 2020

Introduction

Positional OSA (non-supine apnea-hypopnea index [AHI] < 5 events/hr) is present in 30% of patients with OSA. We demonstrated that in patients with OSA- COPD overlap syndrome the AHI inversely correlated with the degree of gas trapping, suggesting a stabilizing effect on the upper airway. We hypothesized that sleep position would be less important, resulting in a lower prevalence of positional OSA.

Methods

Patients underwent a polysomnogram that demonstrated OSA (AHI > 5 events/hr). To confirm COPD, patients had spirometry performed and a chest computed tomography for measurements of percent gas trapping.

Results

Sixteen patients [6 (38%) males, 55±7 years/old, FEV1 1.2±0.5 L, FEV1 % Predicted 45±19%, FVC 2.3±0.8 L, FVC % Predicted 69±20%, FEV1/FVC 51±12%, BMI 33±9 kg/m2)] were diagnosed with OSA (AHI 15±12 events/hour). Four patients (25%) had positional OSA (AHI 13±6 events/hr, non-supine AHI 1±1 event/hr) compared to 12 patients who were non-positional [AHI 16±13 events/hr (p=0.95)]. There was no difference in age [52±8 and 56±7 yrs (p=0.3)] or severity of obstruction in those with and without positional OSA [FEV1 1.4±4 L and 1.1±0.5 L, (p=0.3), FEV1 % predicted 50±17% and 44±20%, (p=0.7), FVC 2.9±0.8 L and 2.1±0.8 L (p=0.1), FVC % predicted 78±21% and 66±20%, (p=0.3), and FEV1/FVC 50±11% and 51±12%, (p=0.8), respectively]. However, patients with positional OSA were less heavy than those with non-positional OSA [BMI 23±3 and 37±8 kg/m2, respectively (p=0.005)]. Finally, there was no difference in the CT-Derived % Gas Trapping in those with and without positional OSA [48±37% and 36±25%, (p=0.6), respectively].

Conclusion

The prevalence of positional OSA in patients with OSA-COPD overlap is similar to OSA patients without COPD. Despite the presence of obstructive disease and gas trapping that may affect upper airway stability, other factors including body position and BMI remain important determinants for developing OSA in patients with COPD.

Support

R01-HL089856, R01-HL089897
0107 Neurocognitive Functioning in Individuals with Comorbid Insomnia and Sleep Apnea: Baseline Functioning and Impact of Treatment
Authors: Turner A D , Ong J , Tu A , Crawford M
Published: May 2020

Introduction

Neurocognitive impairments are common in individuals with insomnia and sleep apnea separately, however, the evidence for impairment in comorbid insomnia and sleep apnea (COMISA) is much less clear. We aim to determine a neurocognitive profile for individuals with COMISA, and evaluate the benefits of treatment on neurocognitive performance.

Methods

Participants with COMISA (n=45; 51.1% female; mean age=52.07±13.29) were from a two-phase, 3-arm randomized clinical trial combining Cognitive Behavioral Therapy for insomnia (CBT-I) with Continuous Positive Airway Pressure (CPAP) administered sequentially or concurrently compared to CPAP alone. The unique groups from this factorial design were used to establish baseline impairment and the effects of treatment on neurocognitive functioning.

Results

Individuals with COMISA had a slower reaction time (365.66±157.39) and more lapses (9.70±16.16) on the Psychomotor Vigilance Task than has been reported in the literature for insomnia and OSA separately. Our COMISA participants had mean scores indicating mild impairment for their age, based on normative data, on digit span (9.71±2.47 forward; 3.95±2.63 backward), verbal paired associates (27.71±11.54 immediate; 8.69±3.16 delayed; 37.17±2.97 recognition), Digit Symbol Substitution (68.83±12.33) and the Stroop (35.46±7.26 color/word; -3.19±7.5 interference). The only significant treatment outcome was in the acute effect after CBT-I on digit span forward (1.7 fewer digits remembered after CBT-I vs. 0.2 fewer after no treatment, t(32)=-2.1, p=0.047). This effect was no longer significant after controlling for multiple comparisons.

Conclusion

This is the first study to report baseline neurocognitive impairments and effects after treatment for individuals with COMISA. Baseline impairments appear to be more significant than reported in the literature for conditions individually and published norms. Results indicate a worsening in neurocognitive functioning after CBT-I, however the numbers within the groups are small, and this effect disappears after controlling for multiple comparisons. Future studies are necessary to provide a conclusive answer regarding the effects of treatment on neurocognition.

Support

NIH/NHLBI (R01 HL114529-03S1) Ong 1/7/2015 - 6/30/2017 Project Title: Multidisciplinary Treatment for Obstructive Sleep Apnea and Insomnia - Research Supplement to Promote Diversity in Health-Related Research
0108 Brief Periods of Sleep and Quiet Rest Equivalently Benefit Memory Consolidation
Authors: Baker K C , Wang S Y , Culbreth J L , Morris S C , Arora M J , Tracy O J , Liu T J , Collins M B , Wamsley E J
Published: May 2020

Introduction

Past research has demonstrated that sleep benefits the consolidation of memories. However, more recent studies have suggested that quiet rest could have similar benefits for memory. Here, we examined the effect of a brief period of sleep, quiet rest, or active wakefulness on declarative and procedural memory. We hypothesized that sleep and quiet rest would equally benefit memory, compared to a period of active wakefulness.

Methods

After completing a declarative (Icelandic-English word pairs) and procedural memory task (the Motor Sequence Task (MST)), participants began a 30-min retention period with PSG monitoring, in which they either slept (n=24), quietly rested with their eyes closed (n=22), or completed a distractor task (n=28). Following the retention period, participants were tested on the same memory tasks they completed earlier.

Results

Percent improvement on the MST from the end of training to the end of the test session differed by condition, F(2, 73)=4.21, p=.019. Sleep and quiet rest led to nearly identical improvement (p=.95), with improvement in both of these conditions being significantly greater than in active wake (sleep vs. active wake: p=.01; quiet rest vs. active wake: p=.02). Similarly, retention of the Icelandic-English word pairs differed by condition (F(2, 73)=5.68, p=.005), with sleep and quiet rest demonstrating nearly identical memory change over time (p=.81), and retention in both of these conditions being significantly higher than in active wake (sleep vs. active wake: p=.007; quiet rest vs. active wake: p=.004).

Conclusion

These data suggest that sleep and quiet rest can exert an equivalent effect on memory consolidation for both declarative and procedural memory, at least across very brief retention durations. Therefore, neurobiology specific to sleep might not be necessary to induce offline improvement in memory across short intervals.

Support

This research was supported by National Institutes of Health Award R15MH107891.
1083 Nightmares Are Negatively Associated With Immediate Memory And Visuospatial Performance In Individuals With Ptsd
Authors: Bullock A , Burns A , Alkozei A , Taylor E , Grandner M , Killgore W
Published: May 2020

Introduction

Disturbing dreams and nightmares are common in individuals with post-traumatic stress disorder (PTSD). At present, little research has investigated the associations between nightmares and cognition in these individuals. However, a robust body of research has shown memory and attention impairments among those with PTSD. The present study sought to investigate the potential relationships between cognitive performance and nightmares in this population.

Methods

Seventy-five individuals (49 female; Mage=31.8, SDage=8.8) were administered the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the PTSD Checklist for the DSM-5 (PCL-5), the Insomnia Severity Index (ISI), the Functional Outcomes of Sleep Questionnaire (FOSQ), the Clinician-Administered PTSD Scale (CAPS), and the Disturbing Dreams and Nightmares Index (DDNSI). Five linear regressions were conducted with index scores on the RBANS subscales (immediate memory, visuospatial/constructional, language, attention, and delayed memory) as the dependent variables and PCL-5, ISI, FOSQ, CAPS symptom class subscales (intrusion, avoidance, cognition, and arousal), and DDNSI scores entered stepwise.

Results

A linear regression revealed that nightmares predicted 15% of the variance in RBANS immediate memory scores (R2 change=.152, β=-.390, p=.003). A second linear regression revealed that nightmares predicted 9.6% of the variance in RBANS visual memory scores (R2 change=.096, β=-.310, p=.019). No other independent variables added to either model. None of the independent variables predicted any variance in language, attention, or delayed memory scores.

Conclusion

Our analysis revealed a unique contribution of nightmares to immediate memory and visuospatial performance in individuals with PTSD. This finding was not better explained by variation in PTSD severity or sleep. Because sleep and dreams are implicated in memory consolidation, one explanation for our finding is that highly distressing trauma-related dreams (i.e. nightmares) may lack the same memory-improving qualities as ordinary dreams. Additionally, given that immediate memory and visuospatial functioning utilize working memory, perhaps nightmares and deficits in working memory share similar mechanisms.

Support

W81XWH-14-1-0570
1105 A Randomized Controlled Trial of a Psychological Intervention for Decreasing Bedtime Procrastination: The BED-PRO Study
Authors: Suh† S , Kim G , Jeoung S , An H
Published: May 2020

Introduction

Bedtime Procrastination (BP) is defined as the behavior of going to bed later than intended, without having external reasons for doing so. Previous studies have shown that BP has a negative effect on sleep and health, and there is a need to develop interventions to decrease BP. This study (BED-PRO) is an ongoing study evaluating a behavioral intervention to reduce BP.

Methods

Fifteen participants who scored higher than 33 on the Bedtime Procrastination Scale were randomized to either the treatment (TRT, n=6) or control group (CTRL, n=9). Treatment consisted of four face-to-face individual sessions. All participants completed self-report questionnaires on Bedtime Procrastination Scale (BPS), Epworth Sleepiness Scale (ESS), Positive Affect and Negative Affect Schedule (K-PANAS-R) and completed the 7-day sleep diary. Data was analyzed using two-way mixed Measures Analysis of Variance (ANOVA).

Results

Mean age of the participants was 21.78 (±1.8) years and 80% (n=12) were females. Group by time interactions from repeated measures analyses revealed significant post intervention improvements in the TRT group compared to the CTRL group on all bedtime procrastination duration and scores, sleep efficiency, refreshment after waking, daytime sleepiness and negative affect of K-PANAS-R. Specifically, bedtime procrastination duration in the TRT group measured by sleep diaries decreased significantly from 75.30 (±58.57) min to 14.83 (±7.83) min, while the CTRL group did not change from 57.60 (±32.01) to 54.36 (±40.82) min (p=0.019). In addition, the TRT group reported significant improvements in bedtime procrastination scores from 36.00 (±4.05) to 22.50 (±6.72).

Conclusion

Based on results, the behavioral intervention used in this study looks promising in improving bedtime procrastination and sleep.

Support

This work was supported by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea(NRF-2018S1A5A8026807)
1116 Interactions Among Interoceptive Sensitivity And Insomnia Symptoms In Individuals With Generalized Anxiety Disorder
Authors: Daffre C , Oliver K I , Valli B , Kleckner I , Pace-Schott E F
Published: May 2020

Introduction

Abnormal interoception is believed to contribute to anxiety disorders as well as possibly to Insomnia Disorder. We therefore hypothesized that interoceptive sensitivity in persons with Generalized Anxiety Disorder (GAD) would vary with sleep quality and would differ between GAD patients with and without insomnia.

Methods

29 subjects (86% female) who reported GAD-7 scores ≥ 10 underwent psychiatric and sleep-disorders interviews and met DSM-5 criteria for GAD. Participants were assigned into an insomnia group if the Insomnia Severity Index (ISI) score exceeded 12 (N=18) or a non-insomnia group if ISI score < 11 (N=11). Participants completed approximately 2 weeks of actigraphy and sleep diaries (mean=14.09 days; SD=4.85) as well as online surveys of sleep quality including the Pittsburg Sleep Quality Index (PSQI) and interoceptive sensitivity including the Multidimensional Assessment of Interoceptive Awareness, the somatic anxiety scale of the State-Trait Inventory for Cognitive and Somatic Anxiety-Trait (STICSA-T) and the Anxiety Sensitivity Index. In addition, 28 participants underwent the Schandry heartbeat-counting task, an objective measure of interoceptive sensitivity.

Results

GAD-7 scores did not differ between insomnia and non-insomnia groups (t(18.36)=0.074, p = 0.941). However, insomniacs reported significantly higher scores on the somatic anxiety scale of the STICSA than non-insomniacs (t(17.71)=2.094, p=0.051). STICSA-T somatic anxiety scores positively correlated with greater PSQI scores (R=0.588; p=0.002) and trended negatively with actigraphy sleep-efficiency (R = -0.384; p=0.085). Non-insomniacs outperformed insomniacs in the Schandry task (t(25.9)=2.21, p=0.036). Higher Schandry scores were positively correlated with greater total sleep time (R=0.515; p=0.014) and lower ISI scores (R= -0.387; p=0.042).

Conclusion

Results suggest that GAD patients with insomnia have lesser objective interoceptive sensitivity and more subjective somatic anxiety than those without insomnia. Greater somatic anxiety predicted poorer subjective and objective sleep quality. Hence interoceptive sensitivity may vary with sleep disturbance in GAD.

Support

R21MH115279
1137 Sleep Duration, Physical Activity And Cognitive Decline In Chinese Older Adults: Findings From The CHARLS
Authors: Li J , Alfini A J , Yu F , Schrack J A , Cotter V , Taylor J L , Spira A P
Published: May 2020

Introduction

Lack of physical activity and disturbed sleep have been linked to older adult’s poor cognitive outcomes; however, little is unknown how they interact to affect cognition long-term. The purpose of this study was to examine the association of baseline sleep duration and physical activity (PA) with change in cognition independently and interactively over four years.

Methods

The sample included 1126 community-dwelling older adults aged 60+ (mean age 67.1±5.9 years, 51% female) from the 2011 baseline and 2015 follow-up data of the China Health and Retirement Longitudinal Study (CHARLS). All variables were assessed through interviews. Sleep duration was measured with hours per 30-minute interval and categorized as very-short (<5h), short (5-6.5h), normal (7-8.5h), and long (≥9h). PA was calculated based on PA intensity, duration, and number of days. Cognition was a composite score of mental capacity, episodic memory, and visuospatial abilities. Data were analyzed using multiple regression (primary outcome: change in cognition; main independent variables: baseline sleep, PA, and sleep PA interaction).

Results

At baseline, 19% of participants had very-short sleep duration, 34.4% had short sleep, 39.2% had normal sleep, and 7.2% had long sleep. At follow-up, 57.5% of participants experienced cognitive decline (-3.5±2.5). After controlling for age, gender, education, region, body mass index, smoking, drinking, number of chronic conditions, pain, depression, and cognition at baseline, compared to participants reporting 7-8.5h sleep, those with ≥9h sleep had significantly greater decline in cognition [β=-1.4, 95% CI=2.4, -0.4], while those with <5h sleep [β=-0.5, 95% CI=-1.2, 0.2] and 5-6.5h sleep did not [β=-0.1, 95% CI=-0.7, 0.5]. PA was neither associated with cognitive decline, nor moderated the relationship between sleep duration and cognitive decline.

Conclusion

Long sleep might be a marker of cognitive decline in older adults. Prospective analysis, using objectively measured PA and sleep should be conducted to further examine these associations.

Support

National Institute of Nursing Research R00NR016484
0116 Opposing Effects of Sleep on The Misinformation Effect: Sleep Promotes and Prevents Memory Distortion
Authors: Day A J , Fenn K M
Published: May 2020

Introduction

The effect of sleep on false memory is equivocal. In the Deese-Roediger-McDermott illusory memory paradigm, some work shows that sleep increases false recall whereas other work shows that sleep decreases false recognition. Given these ambiguous findings, we sought to investigate the effect of sleep on false memory using the misinformation paradigm.

Methods

Participants watched a short film depicting a home burglary, received misinformation about the film, and were tested on their memory for the film. The recognition test was given after a 12-hour retention interval that included either sleep or wake. We manipulated the time at which participants received misinformation. Half were given misinformation after encoding (before sleep or wake) and the other half were given misinformation after the retention interval (after sleep or wake).

Results

There was a main effect of condition on correct recognition; participants in the sleep group showed higher correct recognition than those in the wake group. On false memory, there was a main effect of timing of misinformation and an interaction between condition and timing of misinformation. That is, the effect of sleep on false memory depended on when misinformation was administered. If misinformation was given after the retention interval, false memory tended to be lower after sleep than wake whereas if misinformation was given before the retention interval, false memory tended to be higher after sleep than wake.

Conclusion

Sleep can both protect against and facilitate memory distortion depending on when misinformation is encountered. These results inform our understanding of consolidation processes. When consolidation acts on true memory alone, it strengthens that memory making it resistant to distortion. Conversely, when misinformation is presented before consolidation, sleep may integrate misinformation into memory for the true event, increasing distortion. This work has important theoretical implications for memory consolidation and important applied implications for interrogation practices.

Support

N/A
1154 Self-reported Sleep Duration And Quality Are Associated With Post-traumatic Stress Disorder Following Stroke
Authors: Romero E K , Kronish I M , Shechter A
Published: May 2020

Introduction

Up to one in eight patients may experience post-traumatic stress disorder (PTSD) within the year following a stroke or transient ischemic attack (TIA). Sleep disturbance is a chief complaint in PTSD and is common following stroke. We therefore examined whether sleep was associated with post-stroke PTSD.

Methods

The Reactions to Acute Care and Hospitalization (REACH)-Stroke study is an observational cohort study examining factors related to long-term health outcomes following stroke/TIA. Typical sleep duration (self-report) and quality (1: very good to 4: very bad) over the month following hospital discharge was assessed at 1-month follow-up. At 1 month, patients also completed the PTSD checklist for DSM-5 (PCL-5 cued to the stroke/TIA event). Binary logistic regression was conducted, producing odds ratios (OR) on the association between sleep within the month following discharge and PTSD symptoms at 1 month post-stroke, controlling for age, sex, and race/ethnicity.

Results

Analyses included 459 patients (age: 61.1 ± 15.6 y, 53.2% female). Short sleep (<7 h/night) and poor sleep quality (fairly/very bad) was reported in 49.2% and 25.5% of patients, respectively. Elevated PTSD symptoms (PCL-5 score ≥30) at 1 month were reported in 10.9% of patients. Sleep was significantly shorter and worse quality in those with PTSD vs. without (p-values<0.001). Short sleep duration vs. not short duration throughout the month following discharge was significantly associated with elevated PTSD symptoms at 1-month (OR=3.34, 95% CI: 1.51-7.38, p=0.003). Poor sleep quality (fairly or very bad rating) vs. good sleep (fairly or very good rating) was also significantly associated with elevated PTSD symptoms at 1-month (OR=2.23, 95% CI: 1.13-4.41, p=0.021).

Conclusion

Patients with short duration and poor quality sleep in the month following stroke are at an increased risk of having elevated PTSD symptoms. Understanding factors related to the development of post-stroke PTSD is important since PTSD in stroke survivors can reduce quality of life, contribute to non-adherence to prescribed medications, and increase risk of recurrent stroke and/or cardiovascular events. Future studies should be conducted to determine whether sleep is a modifiable determinant of PTSD symptoms after stroke.

Support

R01HL141494, R01HL132347