bluuebunny/crossref_metadata_2025 huggingface dataset:
0611 Intraindividual Variability in Subjective Sleep and Average Fatigue in Parents of Children on the Autism Spectrum
Authors: Hayse Braden , Stearns Melanie , Mazurek Micah , Curtis Ashley , Nair Neetu , Beversdorf David , Golzy Mojgan , Sohl Kristin , Ner Zarah , Davis Beth , Takahashi Nicole , McCrae Christina
Published: May 2022

Introduction

Fatigue is related to various adverse health outcomes. Mean levels of some common sleep variables, such as total sleep time (TST), sleep onset latency (SOL), and wake after sleep onset (WASO), have been associated with fatigue. However, intraindividual variability (IIV) of sleep parameters might play an independent role in sleep’s relationship with fatigue. Understanding fatigue is particularly important for parents of children with autism spectrum disorder (ASD) given fatigue's negative associations with positive parenting and implementation of child interventions. This preliminary study examined linear associations between subjective sleep IIV and mean fatigue levels in parents of children on the autism spectrum.

Methods

The sample included 66 parents who expressed interest in a behavioral treatment sleep study for their school-aged children diagnosed with ASD (6-12 years old; NCT04545606). All parents (Mage=37.03, SD=6.53; 91% female) completed daily electronic diaries over a two-week baseline period. Daily fatigue rating was collected using a visual analog scale (0-100) and averaged within individuals. Within-individual standard deviations of subjective TST, SOL, and WASO were calculated to estimate IIV. Data were analyzed in R (v4.1.2) using multiple linear regression models controlling for participant age, gender, and individual sleep parameter means.

Results

Bivariate correlations between sleep variable IIV and average fatigue indicated a positive association between TST variability and average fatigue, r(64)=0.33, p<0.01. Multiple regression analyses showed that greater IIV of TST was associated with higher average fatigue (β=0.14, 95%CI [0.01, 0.27], sr2=0.06, p=0.041). No significant associations were found between average fatigue level and IIV of WASO or SOL.

Conclusion

Results suggest that greater TST variability may be one factor independently contributing to higher fatigue levels in parents of children on the autism spectrum, which warrants further examination of sleep variability in this population. Future research could explore IIV of additional sleep parameters, fatigue IIV as an outcome, alternative methods of sleep measurement, and study designs that address causation. Increased insight into these connections might inform the importance of considering sleep interventions for both children and parents, and potential subsequent treatment benefits.

Support (If Any)

MU Research Board Grant (McCrae, PI); Department of Defense Autism Research Program (McCrae, PI; W81XWH2010399).
0612 Does Coping Strategy Protect Sleep Quality During COVID-19? An Examination of Racial, Ethnic, Cultural Differences
Authors: Blanc Judite , Seixas Azizi , Small Sean , Locklear Clarence , Dorcent Rodginie , Auguste Evan , Buysse Daniel , Jean-Louis Girardin
Published: May 2022

Introduction

Little has been done to examine within/between group predictors and mediators of race/ethnic differences in sleep health outcomes, due to COVID-19 exposure. We evaluated the effect of COVID-19 exposure on sleep quality in a multiracial/ethnic sample of New York residents.

Methods

We conducted a cross-sectional study among adults exposed to COVID-19 across New York State from September to November of 2020. Comparisons of participant characteristics e.g., mean scores by race/ethnicity status were made using one-way ANOVA for continuous variables, and chi-square tests for categorical variables. Associations between social determinants of health (employment, location), Trauma Coping Self-Efficacy (CES-T), and sleep quality (Pittsburgh Sleep Quality Index-PSQI) were examined using multilinear regression analysis stratified by race/ethnicity.

Results

Of the 541 participants, 373 (68.9%) were female; mean age was 40.9 years (SD=15), 198 (36.6%) identified as Whites, 111 (20.5%) as Black, 97 (17.9%) as Hispanics, and 135(25%) identified as either Asians, Native-Americans, Pacific-Islanders. Sex was the strongest predictor [β = 1.335; p < .05] of sleep quality, but only among Whites. Trauma Coping Self-Efficacy was negatively associated with sleep quality among Asian, Native-American, or Pacific-Islander participants [β = -.114; p < .05 ]; Black [β = -.099; p < .05] and White participants [β = -0.79; p < .05] but not among Latinos/as [β = -.058; p = 0.71].

Conclusion

Coping Self-Efficacy moderated the effect of COVID-19 on sleep quality among some, but not all, racial/ethnic groups. While CSE-T scores during the first wave of COVID-19 acted as a protective factor for sleep quality among Asians, Native-Americans, and Pacific-Islanders, White and Black participants, this was not the case for Latinos/as/Hispanics residing in New York. Clinical interventions that are tailored for racial/ethnic, community and cultural needs may help to mitigate sleep problems associated with COVID-19 exposure.

Support (If Any)

T32HL129953; 7R01HL142066-04; 1R01HL152453-01
0613 COVID-19 Is Associated with Shorter Sleep Duration among American Adults
Authors: Narcisse Marie-Rachelle , Bernard Mark , Briggs Anthony , Locklear Clarence , Rogers April , Sexias Azizi , Jean-Louis Girardin
Published: May 2022

Introduction

The COVID-19 pandemic has deteriorated sleep health in the United States (U.S.) and worldwide. Most studies that have examined the association between COVID-19 and sleep outcomes have used a non-probability sampling with potential sampling bias and limited generalizability. We examined the association between diagnosed COVID-19 and sleep health in a large representative sample of civilian adults aged ≥18 years in the U.S.

Methods

This study was based on data from the 2020 National Health Interview Survey (NHIS) of adults (n=17,636). Sleep health was captured by self-reported sleep quantity [(very short (≤ 4 hours), short (5-6 hours), healthy (7-8 hours), or long (≥9 hours)] and sleep complaints (trouble falling and staying asleep; with responses ranging from never to every day) in the past 30 days. To account for correlated residuals among the endogenous sleep outcomes, generalized structural equation modeling (GSEM) was conducted with COVID-19 diagnosis as the predictor of interest. Other covariates (age, sex, race/ethnicity, education, employment, poverty level, marital status, birthplace, health insurance, region of residence, metropolitan areas, number of children and adults in the household, obesity, and sleep medication) were included in the models. NHIS complex probability sampling design was accounted for in descriptive and GSEM analyses.

Results

About 4.2% of adults had a positive COVID-19 diagnosis. Among them, 3.1% had very short sleep, 24.2% had short sleep, 59.9% had healthy sleep, and 12.8% had long sleep; 37.0% had trouble falling some days, 10.9% most days, and 6.5% every day; and 33.7% had trouble staying asleep some days, 13.9% most days, and 6.6% every day. Findings from GSEM revealed that a history of COVID-19 almost doubled the odds of having short sleep (OR: 1.9; 95% CI: 1.1-3.4; p=0.032). No significant associations were found between COVID-19 and the other sleep outcomes.

Conclusion

Individuals with a COVID-19 diagnosis were more likely to report very short sleep, although they did not exhibit a greater likelihood of reporting more sleep complaints. Further research using longitudinal national data and examining environmental factors are needed to determine causality.

Support (If Any)

NIH R01HL142066, R01HL095799, RO1MD004113, R01HL152453, R25HL105444
0614 Polysomnographic Measures of Sleep Architectural Disruption and Incident Atrial Fibrillation and Stroke in a Large Clinical Cohort
Authors: Heinzinger Catherine , Thompson Nicolas , Milinovich Alex , Foldvary-Schaefer Nancy , Van Wagoner David , Chung Mina , Mehra Reena
Published: May 2022

Introduction

Although epidemiologic studies have identified associations of architectural disruptions in sleep and atrial fibrillation (AF), inconsistencies in results limit understanding of longitudinal AF and stroke development in clinic-based cohorts. We hypothesize lower arousal index as a biomarker of prolonged respiratory events and objective measures of sleep disruption increase incident AF and stroke.

Methods

Cleveland Clinic patients (age>18) who underwent polysomnogram (PSG) or split studies 11/27/2004-12/30/2015 were examined. Arousal index, total sleep time (TST,hours), sleep efficiency (SE,%), and wake after sleep onset (WASO,hours) were assessed as predictors of incident AF. Cox proportional hazard models were fit with time from sleep study to AF diagnosis. Secondary analyses were conducted in the subset of patients with baseline AF, with time from sleep study to stroke. Covariates included age, sex, race, body mass index (BMI,kg/m2), cardiovascular risk factors (hypertension, diabetes mellitus, hyperlipidemia), heart failure, coronary artery disease, myocardial infarction, coronary artery bypass grafting, chronic obstructive pulmonary disease, tobacco use, and use of anti-arrhythmic drugs. Data were censored at date of last follow up or the 5-year mark.

Results

The sample comprised 43,634 patients: age 51.7±14.5, 51.9% male, 74.5% White, and 7.1%(n=3,090) with AF. Of those without baseline AF, 1,176(2.9%) developed 5-year incident AF. Incident AF increased by 9% (HR=1.09, 95%CI=1.04-1.13) for each hour of lost TST. For every 10 percentage point decreased SE, incident AF increased by 7% (HR=1.07, 95%CI=1.04-1.11). For every hour increased WASO, incident AF increased by 14% (HR=1.14, 95%CI=1.07-1.21). Arousal index conferred no statistically detectable change of incident AF. In secondary analyses, any association of arousal index and incident stroke was attenuated after accounting for confounding comorbidities (omnibus p=0.055).

Conclusion

Objective measures of disrupted sleep architecture predicted incident AF in this clinical cohort. However, arousal index was not associated with AF development, nor stroke development in secondary analyses. Further investigation is needed to elucidate the role of arousal in SDB, perhaps with hierarchal models to clarify the degree to which confounders attenuate or accentuate any relationship.

Support (If Any)

Cleveland Clinic Neurological Institute Center for Outcomes Research & Education Pilot Grant
0615 Association between Ambient Light Exposure and Sleep Duration among American Adults from Varying Race/Ethnicities: Findings from the National Health and Nutrition Examination Survey
Authors: Narcisse Marie-Rachelle , Bernard Mark , Briggs Anthony , Moore Jesse , Seixas Azizi , Jean-Louis Girardin
Published: May 2022

Introduction

One in three American adults are sleep deprived in the United States (US). Racial/ethnic minorities are more likely to experience shorter sleep duration than are whites. Light exposure is associated with sleep duration. However, whether this association is independent of individuals’ race/ethnicity has not been studied in a nationally representative sample of the US adult population. We examined associations between ambient light exposure and sleep duration and between race/ethnicity and sleep duration. We also assessed whether associations between light exposure and sleep duration are independent of participants’ race/ethnicity.

Methods

We used data from the National Health and Nutrition Examination Survey (n=4,277 adults; 2013-2014). Participants (≥ 18 years old) wore an actigraph that collected 24-hour sleep/wake and light data for 7 consecutive days. Objective measurements in our analyses included sleep duration (valid minutes) and light exposure (lux). To determine the associations between light exposure and sleep duration, a weighted mixed-effects linear model was estimated controlling for age, sex, family income to poverty ratio, education, employment, marital status, homeownership status, birthplace, household size, vitamin D, smoking, physical activity, sedentary lifestyle, health status, body mass index, depression, chronic conditions, and time in days. A product term between lux and race/ethnicity was included in a second regression model.

Results

Participants had a mean sleep duration of 468.2 minutes. On average, White adults had the longest sleep duration (mean=478.8), followed by other/multiple races (mean=458.6), Asians (mean=449.1); Blacks (mean=445.0), and Hispanics (mean=444.7). Overall, light exposure was negatively associated with sleep duration (= -0.08 lux; p<0.001). Black slept significantly less than did Whites (= -37.1 p<0.001) followed by Asians ( = -26.5; p<0.01) and Hispanics (= -24.6; p<0.01). The association between light exposure and sleep duration did not significantly differ across all race/ethnic groupings, except for Blacks (= -0.05; p<0.01).

Conclusion

To our knowledge, this is the first study that used national data to assess racial/ethnic disparities in objectively measured light exposure. Future research is needed to shed more light on racial/ethnic disparities in the light-exposure-sleep-duration link.

Support (If Any)

R01HL142066, R01HL095799, RO1MD004113, R01HL152453, R25HL105444
0624 Samelisant (SUVN-G3031), Baseline Characteristics from a Phase-2 Study Evaluating Efficacy and Safety in Patients with Narcolepsy
Authors: Nirogi Ramakrishna , Ravula Jyothsna , Jayarajan Pradeep , Goyal Vinod Kumar , Jetta Satish , Shinde Anil , Benade Vijay , Jasti Venkat
Published: May 2022

Introduction

Histamine H3 receptor (H3R) antagonists/inverse agonists increase histaminergic neurotransmission and offer a therapeutic option for the treatment of narcolepsy. Samelisant (SUVN-G3031) is a potent H3R inverse agonist and exhibits very high selectivity over other targets. In orexin knockout mice, samelisant produced wake-promoting and anticataplectic effects suggesting its potential therapeutic utility in the treatment of excessive daytime sleepiness and cataplexy associated with narcolepsy. It showed dose-dependent H3R occupancy at efficacy doses. Safety and tolerability studies in animals and healthy human volunteers suggested a favorable risk/benefit profile for samelisant.Samelisant is being evaluated in a Phase-2, multicenter, double-blind, placebo controlled, parallel-group study in patients with narcolepsy with or without cataplexy (ClinicalTrials.gov Identifier: NCT04072380).

Methods

Eligibility criteria for the study include subjects diagnosed with narcolepsy as per ICSD-3, aged between 18 to 50 years with an Epworth Sleepiness Scale (ESS) score of ≥12 and mean maintenance of Wakefulness Test (MWT) time of <12 min. A total of 171 subjects will be randomized into 3 treatment arms (placebo, samelisant 2 mg and samelisant 4 mg) in a fixed 1:1:1. Further, the randomization will be stratified according to the type of narcolepsy (Type-1 or Type-2). Each subject will receive either placebo or study drug once daily for 2 weeks. The primary efficacy endpoint is change in MWT score from baseline to week 2. Secondary endpoints are change in ESS and Clinical Global Impressions of Severity (CGI-S) from baseline to week 2. Safety will be monitored throughout the study by medical monitor and by an independent data safety monitoring committee. Baseline clinical and demographic data for the currently enrolled study is summarized descriptively. Since the study is blinded, a breakdown of baseline characteristics by treatment group will not be available until after completion.

Results

At the data cutoff date of Nov30, 2021, a total of 108 subjects were randomized in the study. The median age of subjects was 30 years (range: 18-50 years) with mean BMI of 26.4 (range: 18.3- 43.1 kg/m2). Overall, 58% subjects were of narcolepsy type-1, 69% were female and 74% were Caucasian. Mean (SD) baseline values of MWT and ESS were 6.20 (4.53) and 17.17 (2.93), respectively.

Conclusion

Baseline characteristics are consistent with the general narcolepsy population. The study is currently enrolling subjects with narcolepsy and the data readout is expected in Q3 2022.

Support (If Any)

None
0625 Characterization of Obstructive Sleep Apnea in Active-Duty US Military Personnel Receiving Interdisciplinary Care at the National Intrepid Center of Excellence
Authors: Hedglen Erin , Willing Maegan Paxton , Riley Mark , Srikanchana Rujirutana , Moxley Jasmine , Gottshall Jackie , Brooks Peter , Lippa Sara , Kenney Kimbra , Pickett Treven , DeGraba Thomas , Rhodes Chandler Sours , Werner J
Published: May 2022

Introduction

Among active-duty service members (ADSMs), obstructive sleep apnea (OSA) is associated with decreased quality of life and military readiness/retention. Limited evidence suggests mild traumatic brain injury (mTBI) patients have increased OSA incidence, but little is known about the underlying physiology. This study aims to characterize OSA in treatment-seeking ADSMs with a history of remote mTBI and/or persistent neurobehavioral symptoms to improve detection and early intervention.

Methods

This is a retrospective analysis of data collected from ADSMs attending the National Intrepid Center of Excellence Intensive Outpatient Program for persistent symptoms associated with mTBI. Sleep assessment included overnight polysomnography and self-report assessments of sleep quality, somatic and mood symptoms. OSA severity was determined by apnea-hypopnea index (negative: <5, mild: 5-15, moderate/severe: ≥15). Group differences were assessed using analysis of covariance and pairwise least squares regression, controlling for age and body mass index, and corrected for multiple comparisons.

Results

Analyses included 574 ADSMs, mostly male (99%), with a mean age of 39.7. The majority (n=288; 50.2%) were OSA negative (OSA-neg); a third had mild OSA (m-OSA) (n=216; 38%); and a tenth were diagnosed with moderate/severe OSA (mod/s-OSA) (n=70; 12%). Mod/s-OSA patients had increased arousal index (p<0.01), hypoxia time (p<0.001), reduced total sleep time (p<0.01) and sleep efficiency (p<0.001) compared to m-OSA and OSA-neg patients. M-OSA patients had an increased arousal index compared to OSA-neg patients (p<0.01). Patient groups did not significantly differ on subjective measures of sleep (i.e., quality, sleepiness), post-concussive, or behavioral health symptoms (anxiety, depression, post-traumatic stress symptoms, alcohol misuse).

Conclusion

In our sample of treatment-seeking ADSMs, nearly half presented with OSA according to cut-scores derived for AHI, greater than that expected in the general population. As reported in civilian populations, mod/s-OSA patients demonstrated worse objective sleep measures compared to m-OSA and OSA-neg patients, yet in our sample their self-reported symptom severity did not differ. These findings suggest a low threshold for OSA screening is needed in the symptomatic mTBI population and that multiple factors other than OSA likely contribute to perceived sleep disturbances and neurobehavioral symptoms.

Support (If Any)

None.
0628 Epilepsy Control and Night Sleep Duration and Afternoon Siesta
Authors: Al-Abri Mohammed , Al-Asmi Abdullah
Published: May 2022

Introduction

The relationship between sleep and epilepsy has long been recognized but understanding the association between seizure control and sleep duration is not well explored. The study aims to describe the sleep habits in people with epilepsy (PwE) and explore the association between sleep habits, particularly afternoon napping and level of seizure control and anti-epileptic drugs (AEDs).

Methods

this is a cross-sectional study of adult epilepsy patients attending neurology clinic. Sleep parameters are measured using actigraphy for one week and home sleep apnea testing to rule out obstructive sleep apnea (OSA).

Results

total of 250 PwE were screened and 129 patients (male & female) completed the study with mean age of 29.75 ± 9.18 years and mean body mass index (BMI) of 27.12 kg/m2. There was significant association between night sleep duration and time of wake up and number of AEDs (adjusted R2=0.026, P=0.03 & P=0.04 respectively). There is also significant association between number of seizures per night and afternoon napping (adjusted R2=0.043, P=0.05). Other sleep parameters did not reveal any significant association with level of epilepsy control neither with number of AEDs (P>0.05).

Conclusion

The study described that PwE with uncontrolled epilepsy on multiple AEDs are practicing sleep habits that involved longer afternoon napping and shorter sleep duration.

Support (If Any)

Sultan Qaboos University
0631 Actigraphy-based and self-reported sleep quality and cognitive function in midlife
Authors: Leng Yue , Knutson Kristen , Carnethon Mercedes , Yaffe Kristine
Published: May 2022

Introduction

Growing evidence suggests that sleep disturbance might be a risk factor for cognitive impairment in older adults. However, the association between device-based sleep duration, quality and cognitive function in midlife is poorly understood.

Methods

We examined 526 Black and White men and women who completed the sleep examination at baseline from 2003 to 2005 and had cognition evaluated 11 years later from the Coronary Artery Risk Development in Young Adults (CARDIA) study, Sleep duration and quality was assessed objectively using a wrist activity monitor and subjectively by Pittsburgh Sleep Quality Index (PSQI). We evaluated cognitive function using the Digit Symbol Substitution Test (DSST), Stroop test, Rey Auditory Verbal Learning Test (RAVLT), Montreal Cognitive Assessment (MoCA) and Letter Fluency and Category Fluency tests.

Results

This study included 305 (58%) women and 229 (44%) Black people, with a mean age of 40.1±3.6 years at baseline. After adjustment for age, sex, race, education, smoking, body mass index, depression, physical activity, hypertension and diabetes, actigraphy-measured sleep fragmentation index (calculated as the sum of the percentage of time spent moving and the percentage of immobile periods ≤ 1 minute) was significantly associated with all measures of cognition, except for fluency. Every standard deviation increase in sleep fragmentation index was associated with worse executive function [DSST (b=-1.80, 95%CI: -3.20, -0.41) and Stroop (b=-1.23, -0.25, -2.21)], worse verbal learning [RAVLT (b=-0.41, 95%CI: -0.66, -0.82)] and worse global cognition [MOCA (b=-0.41, 95%CI: -0.74, -0.16)]. Poorer sleep maintenance was associated with worse verbal learning (RAVLT) and global cognition (MOCA) of a similar magnitude. We did not find any association between objective sleep duration or subjective sleep quality and cognition.

Conclusion

Poorer actigraphy-measured sleep quality rather than sleep duration was associated with worse executive function, verbal learning and global cognition among middle-aged Black and White men and women. Sleep quality is important for cognitive health in midlife.

Support (If Any)
0633 The relationship between sleep and Parkinson's disease progression: A Mendelian Randomization study
Authors: Matar Elie , Mahjoub Mahiar
Published: May 2022

Introduction

Sleep disturbances and disorders are common in Parkinson’s disease and significantly impact quality of life. Often, such sleep disturbances are considered sequelae of neurodegeneration affecting sleep-wake circuitry. However, there is emerging evidence that sleep disturbance may itself play a causal role in neurodegenerative processes via altered clearance of pathological proteins. Whether sleep disturbance affects the pathological progression of Parkinson’s disease is unknown. Recently, a several genetic variants have been discovered for sleep-related parameters through genome-wide association studies (GWAS) providing a unique opportunity to examine the evidence for causal relationships through the use of the Mendelian randomization.

Methods

To elucidate the causality between sleep disorders and progression of Parkinson’s disease, we performed two sample Mendelian randomization analysis using genetic variants identified from publicly available GWAS data for sleep variables including insomnia, sleep duration, chronotype, napping and daytime sleepiness as exposure variables. Outcome measures were derived from a large collective GWAS of PD progression (N=4093 cases) including the Unified Parkinson’s disease rating scale (UPDRS total and UPDRS- III), motor fluctuations, Age of onset of PD (PD-AOO), Mini-mental state examination (MMSE) and Montreal Cognitive Assessment (MOCA). The robustness of results was examined using conventional Mendelian randomization sensitivity analyses.

Results

Genetic liability to increased sleep duration was associated with a lower rate of progression of motor symptoms in PD using UPDRS-III score. Meanwhile insomnia was associated with increased rate of motor progression of PD. Predisposition to daytime sleep was associated with lower rates of progression of cognitive decline in PD measured using MMSE. No robust relationships were determined between markers of progression and chronotype or daytime napping. Statistical measures showed significant pleiotropy for the relationships identified.

Conclusion

Sleep-related variables may have a deterministic role in the clinical progression in Parkinson’s disease and may represent a modifiable target for altering the trajectory of neurodegeneration.

Support (If Any)
0635 Validation of a clinical scale for defining RBD severity in participants of the North American Prodromal Synucleinopathy (NAPS) consortium
Authors: Lee-Iannotti Joyce , Choudhury Parichita , Busicescu Andrea , Rangan Pooja , Shprecher David , Fantini Maria-Livia , Ju Yo-El , Boeve Bradley , Postuma Ronald
Published: May 2022

Introduction

The objective of this study is to assess the validity of the REM Sleep Behavior Disorder (RBD) symptom severity scale (RBDSSS) and its correlation to the clinical global impression of severity (CGI-S) in a cohort of participants enrolled in the North American Prodromal Synucleinopathy (NAPS) study. RBD is a prodromal marker of α-synucleinopathies with no standardized tool for assessing severity in clinical or research practice. Development of a reliable scale is essential to understand risk of phenoconversion and to monitor response to treatments, particularly in future neuroprotective clinical trials.

Methods

Participants and their bedpartners enrolled in the NAPS cohort filled out an 8-item questionnaire, developed by the International RBD Study Group, assessing frequency and severity of dreams, vocalizations, movements, and injuries associated with RBD, with higher scores indicating more severe symptoms. The CGI-S is a 7-point scale ranging from normal (1) to most severely ill (7) and was completed by a clinician based on an independent interview with the participant ± their bedpartners. Data was included when patient (RBDSSS-PT) and bedpartner (RBDSSS-BP) responses were both available. Total scores were derived by multiplying assigned point values for frequency and severity (for each question) and summing them for individual RBDSSS-PT scores (total possible=54) and RBDSSS-BP scores (total possible=38).

Results

This cohort (n=212) included in this analysis was predominantly male (n=175) with a mean ± SE age of 65.16 ± 1.46 years. The median (interquartile range) for RBDSSS-PT, RBDSSS-BP and CGI-S was 11 (4-17), 8 (4-14.3) and 3 (3-4), respectively. Non-parametric Spearman’s rank correlation coefficients (rs) for each variable pair are as follows: RBDSSS-PT vs. RBDSSS-BP, rs=0.575; RBDSSS-PT vs. CGI-S, rs=0.641; RBDSSS-BP vs. CGI-S, rs=0.463 (P<0.0001).

Conclusion

A moderate correlation was observed between RBDSSS-PT and RBDSSS-BP suggesting good construct validity for the scale. CGI-S correlated moderately with RBDSSS-PT and weakly with RBDSSS-BP. Future, larger studies are needed to explore this as a possible universal and clinically applicable scale for designation of RBD disease burden and prognostication.

Support (If Any)
0642 Characterizing Actigraphy-Measured Sleep Disturbance in Veterans and Service Members with Post-traumatic Headache following Mild Traumatic Brain Injury
Authors: Li Yihan , Rau Holly , Engle Conner , Gunn Heather , Raskind Murray , Mayer Cynthia
Published: May 2022

Introduction

Post-traumatic headache (PTH) frequently occur following traumatic brain injury (TBI) is particularly prevalent in Veterans with deployment-related TBI. PTH is associated with a range of physical and mental health symptoms, including post-traumatic stress disorder (PTSD), depression, anxiety, post-concussive symptoms, and subjective sleep complaints. Subjective sleep disturbance is associated with greater pain severity, and headaches (HA) are associated with poorer sleep. Poor sleep may be a mechanism by which PTH exerts both direct and indirect effects on health outcomes Despite the high prevalence of sleep problems in individuals with PTH, we know little about sleep disturbance in Veterans and military personnel with PTH. This study sought to characterize the relationship between objective sleep disturbance and HA in Veterans and military personnel with chronic PTH following mild TBI.

Methods

Veterans and active-duty service members (N=39, Mage= 49.4, 89.7% male) were included from a larger study evaluating prazosin as prophylactic treatment for persistent PTH. Participants completed baseline measures of PTSD symptoms, insomnia, sleep quality, HA frequency and impairment, as well as 7-day actigraphy, sleep diary, and HA logs. Actigraphy-derived sleep parameters include sleep onset latency (SOL), total sleep time (TST), sleep efficiency (SE), and wake after sleep onset (WASO). Daily HA logs were used to assess HA severity and duration. Analyses were conducted in SPSS 26.0 using multilevel modeling, controlling for the effects of time.

Results

Preliminary results suggest number of HA days at baseline was significantly associated with self-reported sleep quality (r=-.398, p= .016), but not with subjective SOL, TST, or WASO. Number of HA days was significantly correlated with actigraphy-measured WASO (r=.178, p=.003). Actigraphy-measured SOL, SE, WASO, and TST were not significantly associated with same-day HA severity and duration.

Conclusion

This preliminary data suggest examination of sleep fragmentation may be important in enhancing our understanding of PTH and related impairment. Findings support the importance of using both subjective and objective measures in the assessment of sleep in Veterans and service members with PTH.

Support (If Any)

This project was supported by a VA Career Development Award 5IK2RX001136 from the United States Department of Veterans Affairs Rehabilitation Research and Development Service. The contents of this work do not represent the views of the Department of Veterans Affairs or the United States government.
0644 Longitudinal sleep instability contributes to cognitive decline and Alzheimer’s pathology: Findings from the Seattle Longitudinal Study
Authors: Keil Samantha , Schindler Abigail , Wang Marie , Lim Miranda , Piantino Juan , Elliott Jon , Werhane Maddi , Thomas Ronald , Iliff Jeffrey
Published: May 2022

Introduction

Although emerging data suggest a link between sleep duration, aging, and dementia diagnosis, the impact of longitudinal patterns of sleep behavior on Alzheimer’s disease-associated pathology and cognitive decline remains unclear.

Methods

Utilizing longitudinal data on self-reported sleep duration collected within the Seattle Longitudinal Study (n=535 subjects, age 75.18 +/- 11.6 years), we first used a Cox proportional hazard (CPH) regression model to evaluate the overall effect of mean sleep duration, longitudinal changes in sleep duration, and variability in sleep duration on the development of cognitive decline, including APOE4 genotype, sex, years of education, and depression as covariates within the model. In a secondary study, within the subset of subjects for whom postmortem histopathological assessment has been conducted (n=105 subjects, age 86.6 +/- 8.0 years), we used supervised machine learning to predict Alzheimer’s pathology, measured by CERAD neuritic plaque score and Braak stage.

Results

Multivariable CPH regression analysis demonstrated that there was a significant association between cognitive decline risk and APOE status (hazard ratio 2.28, 95% CI 1.41-3.69, p<0.005), depression (hazard ratio 1.09, 95% CI 1.04-1.14, p<0.005), sleep stability (hazard ratio 2.78, 95% CI 1.43-5.43, p<0.005), and sleep restlessness (hazard ratio 0.70, 95% CI 0.51-0.97, p<0.03). Notably, sleep variability across time and not median sleep duration was significantly associated with cognitive impairment. Adding these sleep parameters to the model improved model performance (base model concordance = 0.66, model including sleep = 0.72). Sleep parameters also improved performance on models predicting Alzheimer’s disease-associated pathology.

Conclusion

While these findings support a mixed effect of sleep duration on cognitive decline and the development of Alzheimer’s-associated neuropathology, they further suggest that variability in longitudinal sleep duration may exert a previously unappreciated influence on these pathological processes. Future studies should seek to replicate these findings in an independent cohort and to assess whether sleep variability of different time scales (weeks, years, decades) exerts similar effects on these outcomes.

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0646 Sleep Disorders and Sleep Medication Use in Youth with Persistent Tic Disorders
Authors: Ricketts Emily , Qu Christine , Rissman Ariel , Swisher Valerie , Burgess Helen , Coles Meredith , Colwell Christopher , Piacentini John
Published: May 2022

Introduction

Sleep disturbance is present in 80% of youth with persistent tic disorders (PTD). However, studies examining rates of sleep disorders in youth with PTD are limited, and reports on sleep medication use in this population are lacking. Such knowledge would inform understanding of assessment and treatment needs of youth with PTD. Therefore, the present study examined rates of sleep disorders and sleep medication use among youth with PTD, and their associations with tic severity and ADHD symptoms.

Methods

Participants were 52 parents of youth with PTD who responded to an internet survey evaluating sleep-wake patterns. Youth were predominantly male (n = 37, 72.5%); and 88.5% (n = 46) were reported to have Tourette’s disorder and 11.5% (n = 6) were reported to have persistent motor tic disorder. Parents provided demographics and medical history, including lifetime sleep disorder diagnosis by a health professional and current prescription or over-the-counter sleep medication use. Parents rated youth tic severity (Parent Tic Questionnaire) and ADHD symptom severity (Swanson, Nolan, and Pelham-IV Parent Rating Scale).

Results

Descriptive statistics and independent samples t-tests were performed. Per parent report, 39.2% (n = 20) of youth with PTD had one or more lifetime sleep disorders. Insomnia (n = 9, 17.3%), nightmares (n = 9, 15.7%), sleep walking (n = 5, 10.0%), bruxism (n = 5, 10.0%), and restless leg syndrome (n = 5, 10.0%) were most commonly endorsed. Fifty percent of parents of youth with PTD endorsed youth sleep medication use. The most commonly endorsed sleep medications were melatonin (n = 23, 44.2%), valerian (n = 6, 11.5%), and diphenhydramine (n = 5, 9.6%). There were no significant group differences in tic severity or ADHD symptom severity.

Conclusion

Findings highlight the presence of disorders of sleep initiation and maintenance, parasomnias, and sleep-related movement disorders in youth with PTD. Results indicate that sleep medication use, particularly melatonin, is common in this population. Future research is needed to test the efficacy of melatonin use for addressing sleep problems in youth with PTDs.

Support (If Any)

NIMH K23 MH113884 funding to Dr. Ricketts.
0651 Daily Associations Between Insomnia and Depression: Emotion Regulation as a Mediator
Authors: Tsui Helen Tsz Ching , Chan Wai Sze
Published: May 2022

Introduction

Insomnia has been shown to prospectively predict depression in longitudinal studies. The mechanisms underlying this relationship have not been fully elucidated. Emotion regulation (ER) has been proposed as a potential mediating mechanism; however, empirical tests of it are limited. This study aimed to examine the within-individual relationship between insomnia and depressive symptoms in a 14-day daily study. It was hypothesized that insomnia symptoms on a given night would positively predict depressive symptoms in the subsequent day via ER.

Methods

This study was conducted in 60 adults (65% female, age = 18-65 years) with elevated insomnia symptoms (Insomnia Severity Index ≥10). They were asked to fill out morning and evening diaries and wear an actigraph for 14 days. The morning diary measured their sleep parameters in the previous night with the Consensus Sleep Diary. The evening diary measured emotional reactivity with the International Positive and Negative Affect Schedule, ER strategy use with the Emotion Regulation Questionnaire and Cognitive Emotion Regulation Questionnaire, and depression with the Center for Epidemiologic Studies Depression Scale. Multilevel modeling was used to analyze the within-individual associations, controlling for between-individual factors such as age and gender.

Results

Shorter total sleep time on one night predicted greater next-day depressive symptoms (β = -0.063, SE = 0.009, p = .028). Sleep quality was negatively associated with next-day depression at the between-individual level (β = -0.387, SE = 0.882, p = .003). Negative reactivity partially mediated the relationships between sleep quality and depression (β = -0.463, SE = 0.030, p = .008), total sleep time and depression (β = -0.611, SE = 4.938 , p = .011), and sleep efficiency and depression (β = -0.702, SE = 0.007, p = .002), all at the between-individual level.

Conclusion

The findings suggest that total sleep time is associated with depressive symptoms on a daily level. They also suggest that one of the facets of emotion regulations, namely negative reactivity, plays a mediating role in the insomnia-depression relationship. Nonetheless, we did not find evidence for the mediating role of ER at the within-individual level. Emotional reactivity and ER strategy use may not vary substantially across days.

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0655 The Impact of Slow-Wave Sleep Disruption on Response Inhibition in Individuals with Depression
Authors: Goldstein Elena , Palermo Emma , Costello Samantha , Games Margaux , Goldschmied Jennifer
Published: May 2022

Introduction

Individuals with Major Depressive Disorder (MDD) exhibit reductions in slow-wave sleep (SWS) and impairments in neuroplasticity. For example, decreased executive functioning, including poorer response inhibition compared to healthy controls, has been reported. SWS has been implicated in the homeostatic regulation of neuroplasticity, however it is unclear if the cognitive deficits seen in MDD are directly associated with SWS. In this study, we aimed to examine if disrupting SWS, thereby altering neuroplasticity, could improve response inhibition in patients with MDD.

Methods

Participants in this study (n=29) included 19 individuals with depression and 10 healthy controls. Data were collected after two overnight sleep studies separated by one week. During one of the two nights, participants’ slow-wave sleep was disrupted via auditory tones. In the morning following each night, participants completed a neurocognitive task battery including an auditory Go/No-Go task. Accuracy scores were calculated as the percentage of trials on which the participant responded correctly to the “Go” or “No-Go” stimulus. Repeated measures ANOVA and paired t-tests were then performed to examine changes from baseline to SWD, assessing the role of SWD on response inhibition.

Results

Following SWD, depressed participants’ performance on the Go/No-Go task was significantly more accurate (t=-2.067, p=.027) than following baseline sleep, while healthy controls showed no significant change between nights (t=-.231, p=.411). The interaction between group (MDD vs. healthy control) and condition (baseline vs. SWD) did not reach statistical significance (p=.175).

Conclusion

In a sample of individuals with depression, accuracy on the Go/No-Go task improved significantly after undergoing SWD compared to following baseline sleep, indicating improved response inhibition. However, healthy controls did not exhibit this same improvement in accuracy. These findings highlight a possible disparity in the role that SWS plays in the regulation of neuroplasticity in those with depression and those without.

Support (If Any)

Goldschmied: K23MH118580 (NIMH)
0658 Slow-Wave Sleep Disruption Decreases Ability to Recognize Certain Negative Emotions
Authors: Palermo Emma , Goldstein Elena , Costello Samantha , Games Margaux , Owens Kendall , Goldschmied Jennifer
Published: May 2022

Introduction

Research has demonstrated that sleep deprivation may alter emotion recognition. Given that emotion recognition is critical for effective human communication, it is essential to understand how sleep is involved in this process. Slow-wave sleep (SWS) has been suggested to be important for the consolidation and processing of emotional memories and neuroplasticity. This study aimed to examine the impact of experimental disruption of SWS on emotion recognition to further understand the contribution of SWS.

Methods

31 participants (20 individuals diagnosed with Major Depressive Disorder (MDD), 11 healthy controls (HC)) completed two overnight sleep studies spaced one week apart. One night served as baseline (BL) and on the other night participants underwent slow-wave disruption (SWD), where SWS was disrupted using auditory stimulation. In the morning following each overnight visit, participants completed an emotion recognition task. Accuracy scores were computed as the percentage correct in each of 10 categories of emotions (anger, contempt, disgust, embarrassment, fear, joy, neutral, pride, sadness, and surprise). Repeated measures ANOVA was used to assess the impact of SWD on emotion recognition with group (HC, MDD) as the between subjects factor and condition (BL, SWD) as the within subjects factor.

Results

Results revealed a significant main effect of condition for disgust (F=13.72, p< .001), embarrassment (F=6.23, p=.019), and surprise (F=8.06, p=.008), with follow-up t-tests demonstrating that accuracy for the recognition of disgust and embarrassment decreased following SWD and accuracy for surprise increasing following SWD. No significant interactions were found for group*condition (ps>.105).

Conclusion

These results suggest that while SWD decreases the ability to recognize certain negative emotions, it also increases the ability to recognize surprise, which is in line with previous research examining acute total sleep deprivation. Interestingly, there appears to be no difference in the ability to recognize emotions between individuals with and without depression. Slow-wave sleep deficits, common in disorders such as depression and schizophrenia, may therefore contribute to poor communication abilities through decreased ability to recognize emotions, increasing the risk of interpersonal distress and mental health problems.

Support (If Any)

Goldschmied: K23MH118580 (NIMH)
0665 Mindfulness as a Protective Factor for Chronic Insomnia in College Students
Authors: Shah Chandni , Garland Sheila , Perlis Michael , Muench Alexandria
Published: May 2022

Introduction

College students are at high risk for developing insomnia and co-morbid psychological distress. The aim of this research was to assess whether the lack of endogenous mindfulness was a risk factor for insomnia.

Methods

In order to address this issue, an archival analysis was conducted with a data set from MUN where the relationship between chronotype, mental health, sleep quality, and social support was assessed (n=3,160; 2,266 women; X̅age=22 years). The proband subsample of interest were subjects that completed the HADS, MEQ, the ISI, and the Mindful Attention Awareness Scale (MAAS). The MAAS is a 15 item self-report measure, where each item is scored on a six-point Likert scale. Scores range from 15-90, higher scores are indicative of greater mindfulness. In order to evaluate the relevance of mindfulness, the overall sample was split into two groups (endogenous mindfulness [average score of ≥4.2]): n=647; X̅age=22.4 years; nonendogenous mindfulness [average score of ≥4.2]: n=1,505; X̅age=22.04 years).

Results

Subjects (n=2,152) were between the ages of 18-35 (X̅=22+/- 3.72) and included primarily Caucasian individuals (86.6 %) and individuals who identified as female (71.7%). The means and ranges for the ISI, MAAS, and HADS were as follows: 9.0 + 5.6 (0-28), 3.7+.98 (1-6), and 5.3 + 3.9 (0-21), respectively. A correlation of -0.27 (p<0.001) was found for endogenous mindfulness (scale score range 1-6) and insomnia (scale score range 0-28) and -0.25 (p<0.001) for non-endogenous mindfulness (scale score range 1-6) and insomnia. Moderator analyses were conducted, and it was found that depression moderates the relationship between mindfulness and insomnia, (HADS depression, ΔR2 = .2, ΔF(3, 643)=57.6, p=.012, b=-.3, t(643)=-2.5 p< .05. Results should be interpreted with caution as the effect size was less than 0.1.

Conclusion

There was a relationship found, in both groups, between mindfulness and the ISI, where the scores on the ISI were lower when mindfulness was high. This suggests that there is a moderate linear relationship between mindfulness and insomnia. This association needs to be further evaluated in samples that have a broader range of ISI scores and with analyses that more carefully parse the moderating influence of depression. Analyses are ongoing.

Support (If Any)

Support: K24AG055602