bluuebunny/crossref_metadata_2025_split huggingface dataset:
0259 Shiftworkers are at Increased Risk of Developing Chronic Pain and Opioid Use Disorders: A Study of 116,000 UK Biobank Participants Over a Decade
Authors: Gao L , Li P , Cui L , Luo Y , Vetter C , Saxena R , Scheer F A , Johnson-Akeju O , Hu K 
Published: May 2020

Abstract

Introduction
In the current epidemic of opioid-related deaths, and widespread use of opioids to treat chronic pain, there is a pressing need to understand the underlying risk factors that contribute to such devastating conditions. Shiftwork has been associated with adverse health outcomes. We tested whether shiftwork during middle age is linked to the development of chronic pain and opioid misuse.

Methods
We studied 116,474 participants in active employment between 2006–2010 (mean age 57±8; range 37–71) from the UK Biobank, who have been followed for up to 10 years until 2017. We included participants who were free from all forms of self-reported pain, and were not taking opioid medications at baseline. Chronic pain and opioid use disorder diagnoses were determined using hospitalization records and diagnostic coding from ICD-10. Multivariate logistic regression models were performed to examine the associations of shiftwork status (yes/no) and nightshift frequency (none/occasional/permanent) and with incident chronic pain and/or opioid use disorder during follow-up. Models were adjusted for demographics, education, Townsend deprivation index, major confounders (BMI, diabetes, bone fractures/injuries, operations, peripheral vascular disease, joint/inflammatory diseases, cancer, standing/manual labor at work) and covariates (smoking, alcohol, high cholesterol, depression/anxiety, and cardiovascular diseases).

Results
In total, 190 (1.6/1,000) developed chronic pain or opioid use disorders. Shiftworkers (n=17,673) saw a 1.5-fold increased risk (OR 1.56, 95% CI: 1.08–2.24, p=0.01) relative to day workers. Within shiftworkers, those who reported occasional nightshift work (n=3,966) were most vulnerable (OR 1.57, 95% CI: 1.06–2.34, p=0.02). Results remained similar after adjusting for baseline sleep duration, chronotype and insomnia.

Conclusion
Shiftwork, and in particular rotating nightshift work is associated with increased risk for developing chronic pain and opioid use disorders. Replication is required to confirm the findings and to examine underlying mechanisms.

Support
This work was supported by NIH grants T32GM007592, RF1AG064312, and RF1AG059867.
0264 The Effects of Previous Night’s Sleep, 12-Hour Shift, and Workload on Sleepiness in Emergency Medical Service Providers
Authors: Pavuluri H , Schmidt W M , Amalean A , Fowler L 
Published: May 2020

Abstract

Introduction
Shift-work has been shown to be detrimental to workers in many ways, including having negative effects on sleep. Many factors related to shift-work can contribute to these negative effects, including increased workload and less sleep the previous night. The effects of shift-work on sleep have been studied extensively in nurses and physicians, but this research is lacking in paramedics and emergency medical technicians (EMTs). This study assessed the effects of previous night’s sleep, day- versus night-shift, and workload on sleepiness in paramedics and EMTs.

Methods
Thirty-three EMTs and paramedics were tested before and after their 12-hour (either day- or night-) shift. Testing consisted of questions about previous night’s sleep, pupillometry to assess pupillary response for physiological sleepiness, and the Stanford Sleepiness Scale for subjective sleepiness. The number of calls made per shift was used to quantify workload/call volume.

Results
An analysis of variance assessed the effect of shift (day/night), previous night’s sleep, and workload on post-shift sleepiness. Pupillometry demonstrated that participants were sleepier after 12-hour shifts, but those who slept 8–9 hours the night before were less affected. Pupillary response indicated higher levels of sleepiness following the night-shift compared to the day-shift. This was contrary to perceived sleepiness, which was higher after the day-shift than the night-shift. Higher call volume resulted in a sleepier physiological response, and this effect was shown to be dependent upon the shift.

Conclusion
Performing shift-work results in increased sleepiness in workers, especially after a night shift. However, physiological sleepiness does not always correspond to perceived sleepiness. In addition, increased workload results in increased sleepiness, especially during the day shift. This highlights the importance of obtaining 8–9 hours of sleep before a 12-hour shift to protect against the effects of sleepiness on patient care and EMS workers themselves.

Support
This was funded in part by a UofSC Provost Grant.
0270 Somnolence Profiles in Mice Submitted to Acute and Chronic Sleep Deprivation
Authors: Fernandes G L , Araujo P , Tufik S , Andersen M 
Published: May 2020

Abstract

Introduction
Sleepiness is a behavioral marker of homeostatic sleep regulation and is related to several negative outcomes with interindividual variation, which may amount to central sleep mechanisms. However, there is a lack of evidence linking progressive sleep need and sleepiness with factors of individual variability, which could be tested by acute and chronic sleep deprivation. Thus, the study objective was to investigate the development of sleepiness in sleep deprived mice.

Methods
C57BL/6J male mice (n=340) were distributed in 5 sleep deprivation groups, 5 sleep rebound groups and 10 control groups. Animals underwent acute total sleep deprivation for 3, 6, 9 or 12 hours or chronic sleep deprivation for 6 hours for 5 consecutive days. Sleep rebound groups had the opportunity to sleep for 1, 2, 3, 4 hours after acute sleep deprivation or 24 hours after chronic sleep deprivation. During the protocol, sleep attempts were counted as a sleepiness index. After euthanasia, blood was collected for corticosterone assessment.

Results
Using the average group sleep attempts, it was possible to differentiate between sleepy (mean&gt;group average) and resistant to sleepiness animals (mean&lt;group average). Frequency of resistant mice was 65%, 56%, 56% and 53% for 3, 6, 9 and 12 hours of acute sleep deprivation, respectively, and 74% in chronic sleep deprivation. 52% of the sleepiness variance might be explained by individual variation during chronic sleep deprivation and 68% of sleepiness variance during acute sleep deprivation was attributed to extended wakefulness. A normal corticosterone zenith was observed at the start of the dark phase, independent of sleep deprivation.

Conclusion
Different degrees of sleepiness in sleep deprived mice were verified. Sleep deprivation per se was the main factor explaining sleepiness during acute sleep deprivation whereas in chronic deprivation individual variation was more relevant.

Support
This work was financially supported by Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) (#2017/18455-5), Coordenação de Aperfeiçoamento de Pessoal Nível Superior (CAPES) - grant code 001, ConselhoNacional de Desenvolvimento Científico e Tecnológico (CNPq) (#169040/2017–8)and Associação Fundo de Incentivo à Pesquisa (AFIP).
0284 The Effects of a Circadian-Aligned Watchbill Shift Work Schedule on Sleep Quality and Quantity in U.S. Navy Submarine Personnel
Authors: Dahlquist D T , Chinoy E D , Markwald R R , Chabal S A 
Published: May 2020

Abstract

Introduction
Prior to 2014, the U.S. Navy Submarine Force operated on a non-circadian-aligned watchbill shift work schedule (18-hour day-length) that resulted in insufficient sleep. For instance, prior research reported that submariners received insufficient sleep on this schedule, and modest sleep restrictions can adversely affect performance, alertness, and, ultimately, negatively impact mission outcomes. Thus, the present study characterized sleep patterns of submariners operating on a newer, circadian-aligned 24-hour day-length watchbill.

Methods
Submariners (n=58; 27.8±5.9 years) of various ranks volunteered from a U.S. Navy submarine. Submariners wore a research-grade actigraphy watch over a 30-day underway mission, for objective sleep measurement of time in bed (TIB), total sleep time (TST), and sleep efficiency (SE). Subjective sleep was measured from questionnaires (Pittsburgh Sleep Quality Index [PSQI], Insomnia Severity Index [ISI], Profile of Mood States [POMS-fatigue subscale]) that were taken pre- and post-underway.

Results
Compared with pre-underway, at post-underway submariners reported significantly higher scores on the ISI, PSQI global sleep quality, and POMS-fatigue (all p&lt;0.05, indicating worse sleep and fatigue ratings). According to actigraphy, submariners acquired on average 6.7±1.0 hours TST, 7.5±1.1 hours TIB, and 88.9±3.9 % SE per day throughout the underway mission. Actigraphy-determined TIB and TST were variable compared with PSQI self-reported TIB and TST.

Conclusion
Study results indicate that submariners experience modest sleep restriction on a newly implemented 24-hour watchbill, which is an improvement in sleep relative to prior assessments of the former standard 18-hour watchbill. However, submariners endorsed lower sleep quality and higher fatigue levels from a month-long underway mission. This study is one of the first examinations of sleep under the 24-hour watchbill mandate that was instated in 2014. Future studies should further evaluate sleep and test fatigue mitigation strategies in different shift configurations of the 24-hour watchbill.

Support
Joint Program Committee-5 Fatigue Mechanisms and Countermeasures Working Group
0308 DRD2 C957T Genotype Influences Vigilant Attention Performance Impairment During Total Sleep Deprivation
Authors: Muck R A , Skeiky L , Schmidt M A , Satterfield B C , Wisor J P , Honn K A , Van Dongen H 
Published: May 2020

Abstract

Introduction
There are substantial, phenotypical individual differences in the adverse impact of total sleep deprivation (TSD) on vigilant attention performance. Dopaminergic genotypes have been found to contribute to these phenotypical differences. Here we investigated the association between a single nucleotide polymorphism (SNP) of the dopamine receptor D2 (DRD2) gene, C957T (rs6277), on vigilant attention performance measured with the psychomotor vigilance test (PVT) in a laboratory TSD study.

Methods
N=46 healthy adults (ages 26.0±5.3y; 25 females) completed a 4-day in-laboratory study with a baseline day (10h time in bed: 22:00-08:00), a 38h TSD period, and a recovery day (10h time in bed: 22:00-08:00). DNA isolated from whole blood was assayed for DRD2 C957T genotype using real-time polymerase chain reaction. PVT performance was measured during TSD at 2-4h intervals, and analyzed for genotype using mixed-effects analysis of covariance of lapses of attention (RTs&gt;500ms).

Results
The genotype distribution in this sample - 28.3% C/C, 50.0% C/T, 21.7% T/T - was found to be in Hardy-Weinberg Equilibrium (X21=0.0008, p=0.98). As expected, there was a significant effect of time awake on PVT performance (F14,602=26.67, p&lt;0.001). There was a significant main effect of DRD2 genotype (F2,602=3.24, p=0.040) and a significant interaction of time awake by DRD2 genotype (F28,602=1.96, p=0.003). Subjects homozygous for the T allele showed greater impairment during extended wakefulness than carriers of the C allele. Genotype explained 7.6% of the variance in the PVT data observed during the 38h TSD period.

Conclusion
Subjects homozygous for the T allele of DRD2 C957T were considerably more vulnerable to TSD-induced PVT performance impairment than carriers of the C allele. A recent study showed that DRD2 C957T influences PVT performance in interaction with a SNP of the DAT1 gene. Here, DRD2 genotype was by itself also associated with PVT performance impairment during TSD.

Support
CDMRP awards W81XWH-16-1-0319 and W81XWH-18-1-0100.
0313 Is Healthy Sleep Possible for Professional Firefighters? A Comparison of “On-Duty” and “Off-Duty” Sleep Quantity and Quality
Authors: Dautovich N D , Dzierzewski J , Sabet S , Soto P , Donovan E , Kleva C 
Published: May 2020

Abstract

Introduction
Healthy sleep is vital for firefighter safety, health, wellness, and for public well-being. However, professional firefighters experience disturbed sleep at disproportionately high rates. The current study investigated whether firefighters can obtain healthy sleep by identifying (1) differences in sleep while “on-duty” and “off-duty” and (2) risk factors for poor sleep.

Methods
Professional firefighters in Richmond, Virginia’s Department of Fire and Emergency Services (N=268), reported their sleep using the Pittsburgh Sleep Quality Index (PSQI) both on- and off-duty. Good and poor sleepers were identified using the PSQI global score cutoff of 5. Demographic and STOP-BANG questionnaires were also completed.

Results
Using a repeated measures MANOVA, on-duty sleep was significantly worse compared to off-duty sleep across PSQI component and global scores F(7, 253)=45.24 p&lt;.001, η²=.56. On-duty, 76.1% of firefighters were classified as poor sleepers compared to 42.9% off-duty. 34.7% were reclassified as good sleepers or stayed good sleepers (22.4%) when off-duty. A sizeable minority experienced consistently poor sleep while on- and off-duty (41.4%), and a small number reported worse sleep when off-duty (1.5%). More night calls and poorer self-rated mental health predicted worse on-duty sleep (p&lt;.001) and poorer self-rated mental health predicted worse off-duty sleep (p&lt;.001).

Conclusion
Healthy sleep is possible for professional firefighters. Almost a quarter of the sample was classified as “good sleepers” on-duty and over half were classified as “good sleepers” off-duty. Nonetheless, sleep on-duty was significantly worse overall, with over a third of the sample experiencing consistently poor sleep. When working a 24-hour variable shift schedule, it appears that poor sleep may “carryover” from on-duty to off-duty. Poorer self-rated mental health and more night calls were identified as risk factors. Further research is needed to probe risk and protective factors within this population.

Support
N/A
0321 Increased Slow-Wave Activity Predicts Slower Processing Speed in Toddlers
Authors: Waddle A E , Kurth S , Harsh J , Lassonde J M , Lee D , LeBourgeois M K 
Published: May 2020

Abstract

Introduction
Slow-wave activity (SWA) shows an inverted U-shaped time course during development. Specifically, maximal SWA undergoes a posteroanterior shift from 2 to 20 years of age, which may reflect cortical maturation. Previously, we showed that greater slow sigma power during sleep predicted faster reaction time in preschool-aged children. To date, little is known about the relationship between SWA and processing speed (PS), a basic fundament underlying complex cognitive skills in early development.

Methods
This project examined the relationship between SWA and PS in 2.5-3.0-year-old children (n=26, 50% males) via home-based assessments. After a 5-day stabilization sleep schedule, a baseline sleep EEG recording was performed on participants at 4 electrode placements: Fz, Oz, C3, and C4. SWA EEG spectral power was quantified in the 0.75-4.5 Hz rangeduring the first 60 minutes of NREM sleep. PS was obtained as part of a standard cognitive assessment via a computer-based task one hour after waking from a midday nap.

Results
On average, reaction time (PS) was 2111 ± 08 ms and SWA was 856.4 ± 300.7 µV2/Hz. Increased SWA in the occipital region was predictive of a longer reaction time and therefore slower PS (r = 0.44, p = 0.03). This relationship showed differences between sexes, suggesting that females (r = 0.26, p = 0.07) may show a stronger association between SWA in the occipital brain region and PS than males (r = 0.09, p = 0.33).

Conclusion
Interestingly, these findings contradict our hypothesis based on previous data with older children indicating that greater SWA was associated with more advanced behavioral and cognitive skills. This discrepancy may reflect the stark individual differences present within this rapidly maturing age group.

Support
Research support from NIH R01-MH086566 to MKL.
0326 Daily Sleep and Affect in Adolescents: Differential Associations During Constrained Versus Unconstrained Sleep
Authors: Shen L , Wiley J F , Bei B 
Published: May 2020

Abstract

Introduction
Few studies have examined bi-directional associations between daily sleep and affect in adolescents, and even fewer assessed both high and low arousal affect under naturalistically-occurring constrained (school) and unconstrained (vacation) sleep opportunities.

Methods
205 adolescents (54.1% females, age M±SD=16.9±0.87 years) completed daily measures of sleep and affect over 28 continuous days (2-week school and 2-week vacation). Total sleep time (TST) and sleep efficiency (SE) were measured using actigraphy and sleep diary. High- and low-arousal positive and negative affect (PA, NA) were self-reported each afternoon. Cross-lagged, multilevel models were conducted: affect predicted same-night sleep controlling for previous-night sleep; sleep predicted next-day affect controlling for previous-day affect. Day of week, study day, and sociodemographics were controlled.

Results
During both school and vacation, adolescents with overall higher low-arousal PA also had greater self-reported SE. Other aspects of sleep-affect associations differ between school and vacation (all p&lt;.05). During school, significant associations were between, not within individuals. Bi-directional associations were found between longer actigraphy-TST and greater high-arousal PA, and between higher self-reported SE and lower low-arousal NA. High-arousal PA and NA were associated with self-reported TST (positive and negative respectively). During vacation, between-individuals, higher NA was bi-directionally associated with lower self-reported SE, regardless of arousal. Longer self-reported TST was associated with lower low-arousal NA. On the within-person level, regardless of sleep measurement, nights with longer-than-average TST were associated with lower NA the next day (high- and low- arousal). Nights with higher-than-average SE predicted lower next-day low-arousal NA.

Conclusion
Sleep-affect associations differed based on sleep opportunity and arousal, suggesting potentially different mechanisms of action. When sleep is typically constrained, overall levels of sleep-affect associations were stronger than daily fluctuations. When sleep is typically unconstrained, significant associations were found both between- and within- persons. In particular, daily fluctuations in sleep were predictive of next-day NA, rather than the other direction.

Support
Monash International Postgraduate Research Scholarship and Monash Graduate Scholarship
0328 The Associations Between Self-Reported Symptoms of Sleep Disorders, Objective Sleep Patterns and Affect in Adolescence
Authors: Dimakos J , Gauthier-Gagne G , Somerville G , Boursier J , Gruber R 
Published: May 2020

Abstract

Introduction
Developmental changes in adolescence make adolescents prone to experiencing negative mood and increased emotional lability. Experimental studies employing sleep restriction paradigms have shown that decreased sleep increased negative affect, but a gap exists regarding the association between sleep disorders and negative affect in adolescence. The objective of this study was to examine this association. It was hypothesized that higher levels of reported symptoms of sleep disorders would be associated with lower positive affect and higher negative affect in adolescents.

Methods
Participants: 101 adolescents (65 females) aged between 13 and 18 years old (M=14.69, SD=1.16). Measures: Sleep Disorders Inventory for Students was used to measure symptoms of sleep disorders and sleep patterns were measured objectively using actigraphy. Positive and Negative Affect Schedule (PANAS) was used to measure positive and negative affect.

Results
Correlational analyses were conducted to assess the relationship between symptoms of sleep disorders, sleep patterns, and positive and negative affect. Higher levels of reported symptoms of sleep disorders were associated with later bedtimes (r= .26, p&lt; .01), shorter sleep durations (r= -.20, p&lt; .05), increased sleep onset latency (r= .21, p&lt; .05), decreased sleep efficiency (r= -.23, p&lt; .05), and less immobile minutes (r= -.23, p&lt; .05) measured by actigraphy. Higher levels of reported symptoms of sleep disorders were associated with lower levels of positive affect (r= -.20, p&lt; .05) and higher levels of negative affect (r= .39, p&lt; .001)

Conclusion
Reported symptoms of sleep disorders were associated with overall poorer sleep patterns in adolescents as well as decreased positive affect and increased negative affect. Sleep specialists assisting adolescents with sleep disorders should inquire about mood regulation.

Support
Social Sciences and Humanities Research Council
0329 Poor Prenatal Sleep and Postpartum Depression are Associated with Infant Sleep Problems
Authors: Chen I Y , Glynn L M , Benca R M 
Published: May 2020

Abstract

Introduction
Childhood sleep problems are associated with increased risk of psychiatric conditions later in life. Sleep disturbances are prevalent during pregnancy and associated with postpartum depression and persistent sleep disturbance. Although maternal sleep and mood likely contribute to infant sleep problems, relationships between these factors are understudied. The present study examined associations of prenatal maternal sleep and postpartum depression with infant sleep patterns.

Methods
The sample included 235 women (29.2±5.8 years old), who were enrolled in a longitudinal study beginning in the first trimester of pregnancy. Maternal sleep and mood were assessed with the Pittsburgh Sleep Quality Index, the Center for Epidemiologic Studies Depression Scale, and the Edinburgh Postnatal Depression Scale during 3 prenatal and 2 postpartum visits. Infant sleep patterns were assessed with the Brief Infant Sleep Questionnaire at 2-, 6-, and 12-months. Mixed model repeated measure analyses were conducted to examine changes in maternal and infant sleep across time. Partial correlation adjusted for age, depression, and postpartum maternal sleep was performed to estimate the association between prenatal maternal sleep and infant sleep. ANCOVAs controlling for age were conducted to assess the effect of postpartum depression on infant sleep.

Results
Maternal sleep quality deteriorated during the third trimester and 2-months postpartum, and improved at 6-months postpartum (ps&lt; .001). Infant sleep became more consolidated with age, with decreased nocturnal awakenings (frequency and duration) and increased nighttime sleep duration (ps&lt; .001). Poorer prenatal maternal sleep was associated with shorter infant sleep duration at 6 months (r=-0.33, p&lt;.001). Mothers with persistent postpartum depression reported their child as having longer daytime sleep compared to their counterparts (F=3.55, p&lt;.05).

Conclusion
Prenatal sleep problems and persistent postpartum depression are associated with poorer infant sleep. Our findings suggest that screening and preventive interventions for sleep problems during pregnancy may have beneficial impact on infant sleep.

Support
Research supported by National Institutes of Health MH-96889.