bluuebunny/crossref_metadata_2025_split huggingface dataset:
0784 Associations Of Sleep Regularity And Chronotype With Hypertension Among African Americans In The Jackson Heart Sleep Study
Authors: Johnson D A , Guo N , Redline S 
Published: May 2020

Abstract

Introduction
Emerging evidence suggests that disparities in sleep regularity, a marker of circadian disruption, contributes to hypertension disparities; however, data among African Americans are limited. We examined associations of sleep regularity and chronotype with hypertension among African Americans in the Jackson Heart Sleep Study (JHSS).

Methods
Participants underwent 7-day actigraphy, completed questionnaires, and had seated blood pressure (BP) measured as part of the JHSS (2012 - 2016). Sleep regularity was defined as the standard deviation (SD) of actigraphy-measured sleep onset timing or sleep duration. Chronotype was assessed by the Morningness-Eveningness Questionnaire. Prevalent hypertension was defined as either a systolic BP ≥ 130 mmHg or diastolic BP ≥ 80mmHg, antihypertensive medication use, or self-report of diagnosed hypertension. Multivariable logistic regression models were fit to estimate the prevalence odds ratio (OR) and 95% confidence intervals for the associations of hypertension with sleep regularity measures (SD of sleep onset timing and sleep duration) and chronotype adjusted for covariates.

Results
Participants (n=830) on average were 63.4 years (SD:10.7), mostly female (66.3%) and hypertensive (85.8%). Compared to individuals with sleep onset SD &lt; 30 minutes, higher adjusted odds of hypertension was observed with increasing variability: OR:1.87 (CI:0.99-3.56); OR:2.16 (1.06-4.39), and OR:2.41 (1.12-5.20), for SD &gt; 30 & ≤ 60, &gt; 60 & ≤ 90 and &gt; 90 minutes, respectively. Among non-shift workers, definite morning and evening types compared to intermediates had higher adjusted odds of hypertension, OR:1.71 (1.04-2.83) and OR:2.56 (1.12-5.84), respectively. There were no observed associations for the SD of sleep duration with hypertension.

Conclusion
Increased sleep onset variability and extreme chronotypes were associated with prevalent hypertension, supporting interventions targeting sleep hygiene recommendations promoting regular sleep. Future research is needed to understand sleep patterns and risk of cardiovascular disease according to chronotype.

Support
NHLBI K01HL138211 and HL110068-03S1
0786 Non-24 Hour Sleep Wake Syndrome: A Cohort Analysis
Authors: Dalal L , Yuenan N , Pogach M , Thomas R J 
Published: May 2020

Abstract

Introduction
Although commonly described in the blind population, diagnosis in sighted individuals can be difficult due to perceived rarity and underlying co-morbid conditions. Our objective was to identify the characteristics of N24 rhythm individuals, and responses to varied treatments.

Methods
Patients were identified to have non-24-hour sleep wake syndrome (N24) via history, sleep diaries or digital logs, paired melatonin profiling as well as actigraphy through retrospective chart review at the Beth Israel Deaconess Medical Center, Sleep Disorders Clinic.

Results
37 patients were identified from 2007 to 2019 with N24 syndrome, BMI of 28, and 67% male. The mean age of onset was within the teenage years (16), and age at diagnosis of 35 years. Paired melatonin profiles (24-hour salivary melatonin, 3-hourly, separated by 7 days, in the subject’s own home) showed “movement”. Depression and anxiety were seen in 54% and 29% of the cohort respectively. 75% (28) of the patients had a treatment strategy involving light, and 54% (20) included melatonin. The combination of melatonin and light led to a clinical improvement in 41% of individuals under that regimen (17). Low dose lithium (8 subjects) enhanced melatonin/light responses. A strategy of combining the orexin antagonist suvorexant with melatonin or ramelteon (3 subjects) helped stabilize the circadian rhythm. Tasimelteon treatment has been initiated in 4 subjects.

Conclusion
These data suggest that while comorbid psychiatric conditions are prevalent, a significant proportion of the cohort did not have associated psychiatric disease. Patients reported onset of symptoms in the teenage years, however there was significant delay to diagnosis. Besides light/melatonin, orexin antagonism and low dose lithium may have benefits, but require more systematic assessments. Paired melatonin estimations could be considered as a definitive testing strategy.

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0800 Posttraumatic Stress Disorder and REM Sleep Without Atonia in Veterans
Authors: Lee E , Yoon I , Choi H 
Published: May 2020

Abstract

Introduction
In veterans, the prevalence of rapid eye movement (REM) sleep behavior disorder(RBD) is higher than the general population, and there is some evidence that this is related to posttraumatic stress disorder(PTSD). In addition, trauma related nightmares (TRNs) interfere with REM sleep and are often accompanied by motor activity. (rem sleep without atonia; RSWA). The purpose of this study is to determine whether the frequency of dream enactment behavior(DEB) and RSWA is different according to the presence of PTSD or trauma.

Methods
The patients (n = 2262) who underwent video assisted polysomnography (PSG) and sleep-related questionnaire surveys at Veteran Health Service Medical Center in Republic of Korea were reviewed retrospectively and cross-sectionally. Based on patients diagnosed with PTSD (N = 20; 100% male; 67.9 ± 8.5 years of age), those exposed to trauma but not diagnosed with PTSD (N = 23; 100% male; age 64.0 ± 13.4) and trauma unexposed controls (N = 21; 100% male; age 59.86 ± 10.9) were matched.

Results
In the PTSD group, patients who reported self-reported DEB tended to be more than the traumatic exposure group and the control group (P = 0.022). In-lab video assisted PSG showed no differences in DEB between the three groups, but RSWA. (p = 0.026) After adjusting for age, hypnotics, apnea hypopnea index (AHI), Beck depression inventory (BDI), and periodic limb movement (PLM) arousal factors, RSWA was significantly higher in the PTSD group than in the traumatic exposure group. (p = 0.006)

Conclusion
The result that RSWA was significantly higher in the PTSD group than in the traumatic exposure group suggests that there may be an associated pathophysiology between PTSD and RBD. Longitudinal studies are needed to establish the link between RBD with PTSD and neurodegenerative diseases associated with synucleinopathy.

Support
This study was supported by a VHS Medical Center Research Grant, Republic of Korea. (grant number: VHSMC 19033)
0801 Sleep, Nightmares, and the Maintenance of Posttrauma Symptoms
Authors: Meysing A , Schulte M , Youngren W , Hamilton N 
Published: May 2020

Abstract

Introduction
Most individuals will experience at least one traumatic event in their lifetime. Although most individuals who experience a trauma will exhibit some posttrauma symptoms, only a small subset will experience long-lasting symptoms. In fact, most research suggests that posttrauma symptoms will gradually reduce over time. However, some individuals can exhibit posttrauma symptoms for an extended period of time. Although research has demonstrated that poor overall sleep quality may explain why some people have trouble gradually recovering from posttrauma symptoms, research has yet to examine specific aspects of sleep that can impair the gradual remission of posttrauma symptoms. This study examined how individual facets of sleep quality (such as nightmares and sleep duration) impact posttrauma symptoms over time.

Methods
944 college students completed an online survey battery that included measures of traumatic experiences, time since trauma (TST), posttrauma symptoms, sleep quality, and the presence of nightmares. Regression analyses were used to examine the interaction of sleep quality sub-facets and time since trauma on posttrauma nightmares (PNMs).

Results
Out of 944 participants, 637 (67%) reported at least one trauma. Of those students, time since trauma (TST) and all other sleep variables significantly predicted posttrauma symptoms (p &lt; 0.05). However, the only significant interaction was nightmares and TST (p &lt; 0.01) where individuals who experienced PNMs had significantly (p &lt; 0.01) higher posttrauma symptom intercept (48.19) than individuals who did not experience PNMs (31.19). Furthermore, individuals who experienced PNMs demonstrated statistically significant flatter slopes than those without nightmares (p &lt; 0.01).

Conclusion
The results reveal that time since trauma predicts a decrease in posttrauma symptoms, whereas nightmares impede this symptom reduction. Interestingly, the interaction finding suggests that nightmares play a critical role in initial symptom expression and recovery. These results demonstrate the importance of identifying and treating nightmares immediately following a trauma.

Support
“none”
0814 A New Diagnostic Tool for Isolated REM Sleep Behavior Disorder: Automated 3D Video Analysis of Lower Limb Movements During REM Sleep
Authors: Stefani A 
Published: May 2020

Abstract

Introduction
The differentiation of isolated REM sleep behavior disorder (iRBD) or its prodromal phase (prodromal RBD, pRBD) from other disorders with motor activity during sleep is critical for identifying α-synucleinopathy in an early stage. Currently, definite RBD diagnosis requires video-polysomnography (vPSG). Aim of this study was to evaluate automated 3D video analysis of leg movements during REM sleep as objective diagnostic tool for iRBD.

Methods
A total of 122 participants (40 iRBD, 18 pRBD, 64 with other disorders with motor activity during sleep) were recruited among patients undergoing vPSG at the Sleep Disorders Unit, Department of Neurology, Medical University of Innsbruck. 3D videos synchronous to vPSG were recorded. Lower limb movements rate, duration, extent and intensity were computed using a newly developed software.

Results
The analyzed 3D movement features were significantly increased in subjects with iRBD compared to pRBD and other disorders with motor activity during sleep. Minor leg jerks with a duration &lt;2 seconds discriminated with the highest accuracy (90.4%) iRBD from other motor activity during sleep. Automatic 3D analysis did not differentiate between pRBD and other disorders with motor activity during sleep.

Conclusion
Automated 3D video analysis of leg movements during REM sleep is a promising diagnostic tool for identifying subjects with iRBD in a sleep laboratory population and is able to distinguish iRBD from subjects with other motor activities during sleep. For future application as a screening, further studies should investigate usefulness of this tool when no information about sleep stages from vPSG is available.

Support
This study was funded by the Austrian Science Fund (FWF), Project KLI 677-B31.
0826 Gender Differences in Sleep Knowledge of Community-Dwelling Older Adults
Authors: Baldwin C M , Link D G , Coon D W , Quan S F 
Published: May 2020

Abstract

Introduction
This work compares sleep knowledge of community-dwelling older adult men and women.

Methods
Data were derived from a community-based sleep training program that assessed pre- and post-test knowledge of obstructive sleep apnea (OSA), Insomnia, short sleep duration (SSD), restless leg syndrome (RLS), circadian rhythm disorders (CRD), and drowsy driving (DD) on a 1 (none) to 5 (great deal of knowledge) Likert-like scale. Data were analyzed with frequencies for age, sex, and sources of sleep information, and ANOVA to determine gender differences using SPSS (V24) with significance set at p&lt;.05.

Results
Participants (N=158; 68% women) were 56 years and older residing in a retirement community. Pre-test means±standard deviations showed women versus men had greater knowledge of Insomnia (3.5±1.3 vs. 2.9±1.0, p=.004) whereas men showed more knowledge of DD (3.2±1.1 vs. 2.6±1.3, p=.01). A trend was noted for women to have greater knowledge of SSD (3.6±1.2 vs. 3.2±1.0, p=.05). Post-test ANOVA showed a further increase in Insomnia knowledge for women versus men (4.4±0.8 vs. 4.1±0.7, p=.04); however, overall pre/post-test scores for each of the sleep disorders across men and women increased significantly at the p&lt;.001 level. Notably, more women to men reported accessing various resources for sleep information: newspapers/magazines (46:7), friends/family (29:9), the internet (25:11), TV (37:7), and physicians/nurses (45:20).

Conclusion
Findings indicate, prior to sleep training, women have greater knowledge of insomnia and short sleep duration, while men have more knowledge of drowsy driving. Women’s greater understanding of insomnia persists even after sleep training; however, pre- to post-test scores for both sexes across sleep disorders show significant learning outcomes. One possible reason for women’s greater knowledge of insomnia and short sleep could be their greater likelihood to access information on health and healthy lifestyle factors, including sleep, as well as their greater health care utilization.

Support
N/A
0831 Hot Flashes and Insomnia Throughout the Life Span of Women from the Episono Cohort
Authors: Hachul H , Castro L S , Bezerra A G , Poyares D , Andersen M L , Bittencourt L , Tufik S 
Published: May 2020

Abstract

Introduction
Hormonal changes may trigger sleep disturbances in women. Insomnia affects one in every three-to-four of them, most likely during pre to post menopause, and especially in association with hot flashes. Thus, the present study aimed to investigate the occurrence of hot flashes among women with and without insomnia and on different reproductive stages.

Methods
Sampling procedure was a three-stage clustering of the population of Sao Paulo, Brazil according to gender, age (20-80 years), and socio-economic status. A total of 574 women were interviewed, underwent polysomnographic recording (PSG), and had fasting-blood samples collected. Hormone levels and a gynecological questionnaire were used to classify reproductive stages. Premenopausal women were classified either in the follicular, luteal, or periovulatory stage or as anovulatory or under hormonal contraceptives; whereas those menopausal were classified in perimenopause or in early or late stages. Individuals reporting frequent and persistent insomnia symptoms accompanied by relevant daytime impairment were classified with insomnia syndrome. Objective insomnia was defined by increased sleep onset latency and/or awake after sleep onset, decreasing sleep duration.

Results
The final sample included 550 women, representing 53% of the EPISONO cohort (n=1,042). Hot flashes were reported by 9% of the premenopausal women (n=339) and by 42% of the menopausal. Complaints were more frequent among women in perimenopause (67%) and those in use of hormonal therapy (60%), and it tended to decrease in later stages (33%); whereas before menopause, hot flashes were especially reported by anovulatory women (26%), while significantly less by those using contraceptives (6%). Hot flashes were associated with a 2-fold increase in insomnia symptoms and while it predicted objective sleep alterations among premenopausal women, they did not after menopause, when alterations in sleep were better explained by an effect of aging.

Conclusion
Our current findings suggest that hot flashes are associated with irregular menstrual cycles among premenopausal women, and particularly with early stages of menopause, predicting both subjective and objective sleep alterations.

Support
This research was supported by fellowships from Associação Fundo de Incentivo à Pesquisa (AFIP) and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) - Finance Code 001.
0848 The Relationship Between Sleep Disturbance & Sleep Hygiene In Japanese Pregnant Women
Authors: Asaka y , Morioka A 
Published: May 2020

Abstract

Introduction
Pregnant women are more likely to develop sleep disorders due to poor sleep quality. Sleep hygiene has been reported as a method for dealing with sleep disorders. However, studies on the relationship between sleep hygiene and sleep disorders in Japanese pregnant women remain insufficient. This study aimed to clarify the actual state of sleep disorders during pregnancy and the relationship between sleep disorders and sleep hygiene.

Methods
A cross-sectional study was conducted on 147 Japanese pregnant women. We used the Japanese versions of the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (JESS) for evaluation of sleep. We used 32 items of habitual behavior important for sleep improvement for evaluation of sleep hygiene; these items were self-selected.

Results
The average PSQIG scores of women in their first, second, and third trimesters were 5.6 ± 4.3, 5.4 ± 2.4, and 6.6 ± 2.8, respectively; 22.2%, 46.4%, and 62.2% of women in their first, second, and third trimesters, respectively, exceeded the cut-off score. The average JESS scores were 12.2 ± 4.5, 9.9 ± 4.1, and 10.0 ± 4.6 for first, second, and third trimester women, respectively; 55.6%, 35.7%, and 41.9% of first, second, and third trimester women, respectively, slept excessively during the day (JESS score≥11). Following factor analysis, sleep hygiene was categorized into four factors: ”thinking positively,” ”adding rhythm to the day,” “avoiding going out and caffeine before bedtime,” and “avoiding eye irritation.” Pregnant women who “added rhythm to their day” had lower PSQI scores, and sleep hygiene was not related to JESS scores in the multiple regression analysis of sleep hygiene and sleep disorders.

Conclusion
Sleep disorders in pregnancy are related to habitual behavior such as being active during the day, eating and sleeping regularly, and basking in the sunlight every morning.

Support
0851 Sleep Disturbance But Not Sleep Duration Is Associated With Perceived Stress And Self-esteem In Postpartum Women
Authors: Wang X , Kishma E E , Sparks J R , Liu J , Castleberry L A , Cook J W , Youngstedt S D 
Published: May 2020

Abstract

Introduction
Healthy sleep is known to contribute to psychosocial well-being. Pregnancy and postpartum could have profound influences on women’s psychosocial well-being related to physiological changes and interrupted sleep due to caring for the infant. The purpose of this study was to determine the associations between self-reported sleep characteristics and psychosocial well-being.

Methods
Forty-seven women who delivered a singleton infant after ≥ 37 weeks of gestation were interviewed at 6-8 weeks, 4 months, and 6 months after delivery. The Pittsburgh Sleep Quality Index (PSQI) was used to obtain sleep duration, sleep disturbance, and the global PSQI score, and the Epworth Sleepiness Scale total score was used to assess daytime sleepiness. The Edinburgh Postnatal Depression Scale, Perceived Stress Scale, and Rosenberg Self-Esteem Scale were used to assess psychosocial well-being, and a summary score of each instrument was calculated.

Results
The self-reported nightly sleep duration decreased over time (535 ± 95, 505 ± 78, 488 ± 66 minutes, respectively at each timepoint, mean ± SD, p = 0.007). Other sleep characteristics did not change. There were also no significant changes over time in the scores of depressive symptoms, stress, or self-esteem. At 6-8 weeks postpartum, sleep disturbance was associated with stress (r = 0.32, p = 0.026) and self-esteem (r = -0.38, p = 0.008) so that women who had greater sleep disturbances perceived greater stress and lower self-esteem. These associations did not exist 4 months or 6 months after delivery. Sleep duration, global PSQI score, and sleepiness were not associated with any of the psychosocial measures.

Conclusion
Sleep disturbance is an important correlate of psychosocial well-being in early postpartum. The decreased sleep duration likely indicates recovering from pregnancy and delivery, and adapting to routine lifestyle.

Support
National Institute On Minority Health And Health Disparities of the National Institutes of Health under Award Number R21MD012740
0854 Exploration Of Sleep Health Among Middle-aged And Older Adults
Authors: Lorenz R A , Auerbach S L , Li C , Chang Y 
Published: May 2020

Abstract

Introduction
Sleep health, a construct introduced to characterize the multidimensional attributes of sleep, has been explored in a variety of populations; however has not been adequately examined for middle-aged and older adults. As attributes of sleep may change with age, the dimensional structure of sleep health may differ in this population. This study aimed to validate a composite measure of sleep health among middle-aged and older adults using data from the Health and Retirement Survey (HRS).

Methods
Data from the 2014 Core survey of the HRS was used to create a composite measure of Sleep Health including sleep efficiency, duration, timing, satisfaction, and alertness. We standardized and averaged the original variables before transforming to T scores. Sleep Health T scores (ranging 0-100, higher scores indicating better sleep health) were examined using exploratory and confirmatory factor analysis (EFA; CFA).

Results
Our sample included 6,095 adults with mean age of 68 years (SD=10.1; range 50-99 years). The majority were female (59.7%), white (77%), with high school education (53.9%). Sleep Health T scores ranged from 27-61 (mean=50; SD=6.7). EFA identified one factor. Timing was removed due to low factor loading (&lt;0.4). The revised four-dimension composite Sleep Health measure had acceptable reliability (Cronbach’s alpha 0.6). CFA showed a well-adjusted model (REMSA=0.097; NFI=0.964; RMR=0.035; GFI=0.990; AGFI=0.951).

Conclusion
These results suggest that the composite measure was valid for assessing sleep health among middle-aged and older adults. Limitations include the use of secondary data, as sleep health dimensions were based on variables not created specifically for our research question. Future research should further examine the role of sleep timing in overall sleep health among middle-aged and older adults.

Support
This study was supported by the University at Buffalo Clinical and Translational Science Institute (CTSI) funded by the National Institutes of Health (Lorenz, PI).