bluuebunny/crossref_metadata_2025_split huggingface dataset:
O060 “I wish someone would’ve taught me how to sleep”: qualitative development of co-designed sleep resources for young shiftworkers
Authors: Shriane A , Ferguson S , Gupta C , Hilditch C , Kolbe-Alexander T , Marino J , Paterson J , Rigney G , Sprajcer M , Stanton R , Thomas M , Vincent G 
Published: December 2024

Abstract
Shiftwork – employment outside traditional waking hours – impacts sleep, contributing to circadian disruption and increased risk for numerous poor health outcomes. Young adults are increasingly engaging in shiftwork, therefore requiring tailored, evidence-based sleep resources early in their careers to mitigate sleep and health risks. Despite this need, such resources aren’t readily available for young shiftworkers.
A participatory, co-design approach recruited individuals with lived and/or professional experience in shiftworker sleep to develop resources by participating in two online workshops. Reflexive thematic analysis was applied to workshop transcripts to identify data codes, which were then grouped into themes and populated with information from the current scientific evidence base, allowing for the construction of sleep resources for young shiftworkers.
Co-designers (n=48) stressed the need to support young shiftworkers in prioritising their sleep, as “not doing so comes at a cost, and you often don’t realise that cost until much later”. In addition to prioritisation, analysis identified 33 unique codes, categorised into five overarching themes: sleep science (sleep disorders, circadian rhythms, chronotypes), impacts of poor sleep (health, wellbeing, safety), habits impacting sleep (environment, substances), strategies (fatigue management, napping, stimulus control), and workplace recommendations (education, rostering). Themes were populated with evidence-based content to develop a website, housing comprehensive sleep information; a pictorial infographic, detailing behaviours supportive or detrimental to sleep; and an animated video for resource promotion.
Tailored, evidence-based sleep resources can provide a point of early intervention for young shiftworkers, now requiring formal evaluation to ascertain their impact on knowledge and behaviour change.
O062 Relationship between pulse oximetry derived markers of obstructive sleep apnoea severity and cardiac function in heart failure with preserved ejection fraction
Authors: Stewart G , Tong B , McClintock S , deChazal P , Lal S , O’Sullivan J , Cistulli P 
Published: December 2024

Abstract

Introduction
The pathophysiological implications of Obstructive Sleep Apnoea (OSA) in patients with Heart Failure with Preserved Ejection Fraction (HFpEF) remains unclear. While novel pulse oximetry-derived measures of OSA-related cardiovascular risk have recently been described, these have not been comprehensively assessed in HFpEF.

Methods
Clinical, cardiovascular and polysomnography assessments have been conducted in thirty-five HFpEF patients to date. Pulse oximetry-derived measures of hypoxic burden (HB, cumulative area of respiratory event related SpO2 dips, %min/h) and pulse-wave amplitude drops index (PWADIn, drops in pulse wave amplitude of &gt;30% per hour, events/h) were compared in HFpEF patients with and without moderate to severe OSA (Apnoea-Hypopnoea Index ≥15 events/h). Associations between HB, PWADIn and cardiovascular function were explored.

Results
Twenty-two HFpEF patients had moderate to severe OSA (Age 66±12y; BMI 35.4±7.7kg/m2; BNP 367±554ng/L) and thirteen had no or mild OSA (Age 65±13y; BMI 32.7±8.0kg/m2; BNP 159±142ng/L). Age, BMI, BNP and PWADIn (40.6±20.2 vs 37.4±25.6 events/h, p=0.699) were comparable between groups, while HB (99.4±70.0 vs 29.0±23.5 %min/h, p&lt;0.001) and right ventricular end-diastolic volume (RVEDV, 150±21ml vs 122±22, p=0.016) were higher in moderate to severe OSA. PWADIn correlated with left ventricular (LV) volume (R=0.621, p=0.006), while HB correlated with RVEDV (R=0.463, p=0.014) and aortic augmentation index (R=0.506, p=0.002).

Conclusions
These findings indicate that pulse oximetry-derived measures of hypoxic burden and pulse wave amplitude characteristics may provide additional insight into the severity and pathophysiology of OSA in HFpEF. The impact of nocturnal pulse wave amplitude drops and oxygen desaturations on LV and RV remodelling requires further investigation.
O066 Generalized linear model for characterisation of nocturnal arrhythmia
Authors: Salari Shahrbabaki S , Dharmaprani D , Strong C , Tonchev I , Chapman D , Baumert M , Ganesan A 
Published: December 2024

Abstract

Background
Generalised linear models (GLM) based on point processes have been previously shown helpful for characterising dynamics of sleep-disordered breathing (SDB) events using sleep stages, body position and history of SDB events, and characterising period limb movements. Episodes of non-sustained arrhythmias may occur during sleep in patients with underlying cardiac conditions, and the point process theory may help model their occurrence over time.

Objective
This study aims to develop a (GLM) to analyse the temporal patterns of nocturnal arrhythmia (NA) and their relationship with sleep disturbances and architecture.

Methods
This study analysed 7341 polysomnography-derived ECG recordings from the MESA and SHHS datasets to detect non-sustained arrhythmias. NAs were defined as any instance where ECG R-R intervals dropped by 30% of the baseline and then returned to 90% of the baseline. we developed our GLM framework to characterise NA events as a function of SDB and sleep arousal events, sleep stages, as well as previously occurring NA episodes.

Results
The likelihood of NA occurrence during light NREM sleep was, on average, 10% higher than during REM sleep (p=0.022), and 16% and 40% higher than during deep sleep and wakefulness, respectively (p&lt;0.001). The influence of SDB on NA occurrence in men was 4% higher than in women (p=0.032). Participants older than 75 years showed nearly an 8% higher impact of sleep arousal compared to those younger than 65 years.

Conclusion
A GLM-framework characterises NAs dynamics and their association with sleep disruptions and architecture.
O075 Update in the management of Pierre Robin Sequence
Authors: Lieu N , Theis L , Yeung C , Jones C , Widmer R , Mehta B , Water K 
Published: December 2024

Abstract

Background
Pierre Robin sequence (PRS) is a congenital triad of micrognathia, glossoptosis and airway obstruction. Current treatment approaches in Australia include nasopharyngeal airway, continuous positive airway pressure, and surgery including mandibular distraction osteogenesis. The Tübingen Palatal Plate (TPP) offers an orthodontic method for jaw distraction that has hitherto not been available in Australia. Since October 2023, we have assembled the team required to implement this treatment. This study evaluates the outcomes of patients managed with TPP at our centre, to date.

Methods
Retrospective analysis comparing treatment outcomes for patients diagnosed with PRS managed at a tertiary paediatric centre from October 2023 to October 2024.

Progress to date
Of ten patients with PRS treated at our centre since October 2023, seven (70%) were treated with TPP. Eight (80%) patients underwent polysomnography (PSG) prior to intervention. The mean apnoea hypopnea index (AHI) was 49.6 events/hr (±24.1; 16.4-88.5) and obstructive apnoea hypopnea index (OAHI) was 43.2 events/hr (±24.4; 15.5-88.5). A repeat PSG within 3 weeks post intervention demonstrated improvement in AHI by 24 events/hr (±24.9; -3.8-66; p=0.06) and OAHI by 18 events/hr (±9.2; 4.9-31.4; p=0.09). At the time of submission, 2 patients have completed TPP treatment with final PSG AHI/OAHI values of 4.5/3.4 and 9.4/3 respectively. This demonstrates mean reduction in AHI scores of 28.8 events/hr (±21.6; 11.9-45.7; p=0.33) and OAHI 22.7 events/hr (±15.5; 12.5-32.9; p=0.27).

Intended outcome and impact
We have successfully implemented TPP therapy for PRS in Australia, confirming its effectiveness as an orthodontic method of jaw distraction.
O078 Sleep quality in children and adolescents with Cystic Fibrosis and non-Cystic Fibrosis Bronchiectasis in Hospital and Hospital in the Home (HiTH)
Authors: Cook J , Adams A , Vandeleur M 
Published: December 2024

Abstract

Purpose
We aimed to investigate and compare the sleep quality (SQ) of children and adolescents with cystic fibrosis (CF) and non-CF bronchiectasis who were admitted to a tertiary paediatric hospital and those receiving hospital-in-the-home (HITH) care.

Design
Children aged 0-18 years diagnosed with CF or a non-CF bronchiectasis underwent seven days of light, sound, and actigraphy measurement and completed five paediatric questionnaires alongside their parent(s). These questionnaires evaluated baseline sleep and sleepiness levels (Sleep Disturbance Scale for Children, Paediatric Daytime Sleepiness Scale), mood (Children’s Depression Inventory), health-related quality of life (Obstructive Sleep Apnoea-18), and in-hospital SQ (Potential Hospital Sleep Disruption and Noises Questionnaire, PHSDNQ). Sleep patterns were documented daily during admission via a sleep diary (SD). Parent and patient demographic data was collected.

Results
Four children with CF have been recruited to date; three completed the study in-hospital and one patient in both hospital and HITH settings, with recruitment ongoing. Hitherto, subjective questionnaire data (PHSDNQ and SD) reveal sleep disturbance due to bedside equipment noise, overnight staff interventions, and general background noise on the wards.

Conclusion
In this small cohort, children with CF experience reduced SQ within the hospital setting. Subjective and objective SQ data will be presented for a larger population of hospitalised children with chronic respiratory disease to further evaluate the factors contributing to sleep disturbance.
P134 Effectiveness of home non-invasive ventilation for persistently hypercapnic COPD patients
Authors: Bird D , Curtin D , Tay G 
Published: December 2024

Abstract

Introduction/Aim
Approximately 25% of patients with GOLD stage 3 or 4 COPD have chronic hypercapnia with a daytime/awake PaCO2 &gt;45mmHg. Persistent hypercapnia is associated with worse quality of life, increased frequency and severity of exacerbations, increased frequency and length of hospital presentations, increased need for invasive and non-invasive acute non-invasive ventilation (NIV) and increased mortality. Acute NIV is very effective at treating decompensated hypercapnic respiratory failure, but the role domiciliary NIV is less clear in those that remain persistently hypercapnic beyond their exacerbation. The aim of this study is to evaluate an existing cohort of severe COPD patients with chronic hypercapnia who were commenced on home NIV over a 5 year period and assess their outcomes.

Methods
We conducted a five-year retrospective audit of medical records of all patients commenced on home NIV in our institution between January 2017 to January 2023. Only patients who received a home NIV device with confirmed COPD, hypoventilation and chronic hypercapnia were considered for the study. Mortality was assessed at 12 months following NIV initiation. Rehospitalisation rates were assessed 12 month prior and following home NIV initiation. Additional analysis of demographical data, device settings and pressures used will be included for discussion.

Results
During the study period there were 189 patients identified that met the inclusion criteria. Ongoing data analysis is in progress…

Conclusion
The expected conclusions are that our cohort will include a significant proportion of OSA overlap patients, which is a higher risk demographic. This may largely be due to the funding available for subsided devices through the Queensland sleep disorders program. We anticipate a decrease in hospitalisation presentations. We also anticipate much lower pressures than those used in the literature.
O082 A new model of care for perioperative OSA management
Authors: Roberts J , Mansfield D 
Published: December 2024

Abstract

Background
Obstructive Sleep Apnoea (OSA) is a common condition that is associated with poorer perioperative outcomes including higher rates of cardiac complications, an increased risk of intensive care admissions and a longer hospital length of stay. While there is growing evidence in support of a perioperative sleep service, there is limited published data on an effective model of care. Monash Health has established a perioperative sleep clinic with the goal to identify patients with high probability of moderate/severe OSA to improve perioperative OSA workup and management without causing surgical delays.

Methods
This retrospective study includes all patients reviewed in the perioperative sleep clinic over 8 months (60 patients). We reviewed patient characteristics, scores from screening tools and severity of OSA. Time from referral to initial clinic review, evaluation with polysomnography and subsequent surgery was measured.

Progress to date
Data collection to date shows a patient population with a median age of 63 years and BMI of 37kg/m2. Over 90% of new referrals were for patients awaiting category 2 (90 days) or 3 surgeries. The median time from clinic referral to polysomnography was 45 days. A new diagnosis of moderate/severe OSA was made in 52% of patients tested.

Intended outcome and impact
Despite growing evidence in support of perioperative OSA services, there is limited published data in support of a specific model of care. This study aims to provide a detailed overview of a newly established service in an Australian setting that will examine screening and diagnostic rates, treatment effectiveness and postoperative outcomes.
P004 Gender differences in heart rate during respiratory events and arousals in patients with obstructive sleep apnea and chronic obstructive pulmonary disease overlap syndrome
Authors: Behbahani S , Terrill P 
Published: December 2024

Abstract

Introduction
Obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) are associated with increased sympathetic nervous activity, and patients affected by both disorders have a higher risk of mortality than patients with COPD or OSA alone. This preliminary study compared HR during respiratory events and respiratory arousals in men and women with OSA-COPD overlap syndrome.

Methods
121 individuals with both OSA (AHI&gt;=5) and COPD (86 male, 65.4±7.5 years; 35 female, 62.7±10.0 years) were identified from a retrospective clinical dataset of 989 individuals who were studied with clinical diagnostic polysomnography. Continuous electrocardiography was extracted, and the mean HR was calculated during respiratory events terminated with arousals, respiratory arousals, and non-event baseline. The duration of respiratory arousals was calculated.

Results
The mean HR during respiratory-arousals was higher in women compared to men (72.4±5.0 vs 69.3±5.3; p&lt;0.05 Wilcoxon rank-sum test). The duration of respiratory arousals was also greater in women (10.1±1.0 vs 9.3±0.7; p&lt;0.05). The difference in HR in respiratory arousal compared with baseline was greater in females (5.2±1.3 vs. 2.3±0.9, p&lt;0.05) The mean HR during respiratory events did not significantly differ between males and females.

Discussion
Literature has previously speculated that women with OSA-COPD overlap have greater sympathetic modulation of heart rate. This is consistent with our results showing higher HR during respiratory-arousals (and greater HR increase relative to baseline) in women. However, substantial further work is required to distinguish the relative effects of gender, OSA-COPD overlap, and numerous other confounding factors (i.e., OSA severity and endotype/phenotype, age, and sleep state).
P007 A Comparison of Sleep Study Parameters between COPD+OSA (Overlap Syndrome) and Obstructive Sleep Apnoea
Authors: Moman A , Hukins C , Duce B 
Published: December 2024

Abstract

Background
Comorbid Chronic Obstructive Pulmonary Disease (COPD) and Obstructive Sleep Apnoea (OSA)—Overlap Syndrome (OVS) is associated with worse sleep study parameters than OSA alone. The patient demographics and severity of OSA often confound these sleep study parameters. Aim: In this study, we aim to compare OVS to OSA PSG parameters in a case-control study.

Methods
We matched OVS and OSA patients for age, sex, BMI, and AHI, then compared the PSG data. We also compared additional measures of hypoxic burden, including desaturation severity, desaturation slope, and desaturation recovery.

Results
We suitably matched a total of 83 patients in each group. There were no differences in sleepiness (Epworth Sleepiness Scale; OVS 10±5 vs. OSA 10±5, P = 0.978), PVT lapses (OVS 30±30 vs. OSA 25±30, P = 0.260), or comorbidity. The OVS group has poorer quality of life (SF36 Physical Component Score (OVS 37±11 vs. OSA 41±11, P = 0.001). There were no differences in sleep duration (OVS 274±82 min vs. OSA 284±78 min, P = 0.383) or sleep efficiency (OVS 63% vs. OSA 66%, P = 0.204). There were no differences in the number of ≥3% desaturations scored (OVS 149±117 vs. OSA 125±126, P = 0.072). The OVS had greater desaturation severity (0.40% vs. 0.25%; P&lt;0.035) and greater sleep time below SpO2 90% (11% vs. 1%; P&lt;0.001). There were no differences in desaturation duration, desaturation slope, or recovery slope.

Discussion/Conclusion
When controlling for demographics and AHI, OVS shows no differences in sleep study parameters except for oxygen saturation.
P008 Ventilatory burden predicts change in self‑reported sleepiness following continuous positive airway pressure treatment in obstructive sleep apnoea
Authors: Staykov E , Mann D , Duce B , Kainulainen S , Leppänen T , Töyräs J , Azarbarzin A , Sands S , Terrill P 
Published: December 2024

Abstract

Introduction
Excessive daytime sleepiness is an important symptom of obstructive sleep apnoea (OSA) and commonly quantified using the Epworth Sleepiness Scale (ESS). Measures of ventilatory burden, flow limitation, and hypoxaemia could be used to predict sleepiness change (i.e. ΔESS) following continuous positive airway pressure (CPAP) treatment. We hypothesised that ΔESS can be predicted from baseline polysomnography.

Methods
Associations between OSA severity measures and ESS were evaluated in three cross‑sectional cohorts (n=3117), adjusting for age, sex, BMI, total sleep time, and depression. ΔESS prediction was evaluated using CPAP treatment studies (HomePAP, BestAIR, and ABC) in three steps: severity measures were compared (adjusted regression predicting ΔESS, n=64), a prediction model was developed using baseline ventilatory burden and baseline ESS (n=139), then evaluated in holdout participants (n=74).

Results
In cross‑sectional analyses, increased ESS was associated with increased ventilatory burden (0.27 points/SD; 95% CI 0.07−0.48), the apnoea‑hypopnoea index (AHI) (0.25; 0.05−0.45), flow limitation severity (0.24; 0.05−0.43), and hypoxic burden (0.21; 0.00−0.42). Comparison analysis revealed that ΔESS was most strongly associated with baseline ventilatory burden (‑1.07 points/SD; ‑2.12 to ‑0.05) and baseline ESS (‑2.75; ‑3.83 to ‑1.69); the AHI association was weaker (‑0.97; ‑2.01−0.05). Predicted and actual ΔESS were associated in holdout participants (adjusted R²=0.315); median [IQR] actual ΔESS of predicted responders (≥2 ESS reduction) was ‑5.0 [‑10.0 to ‑2.0] and non‑responders was 0.0 [‑1.0−1.0] (p&lt;0.001).

Discussion
Baseline ventilatory burden and baseline ESS were independently associated with ΔESS and could be used together to inform clinicians whether CPAP treatment will likely improve a patient’s sleepiness.
P009 Sharper Minds Better Sleep: Results from a pilot brief intervention for improving sleep health in young adults
Authors: Rossa K , Edmed S , Lorimer N , Smith S 
Published: December 2024

Abstract

Introduction
The transition to university can be associated with increased stress, poorer mental health and increased risk of sleep problems. This pilot study assessed the effectiveness of a brief, skills building sleep education program (Sharper Minds Better Sleep) designed to increase knowledge about healthy sleep and its relationship to mental health, and to promote healthy sleep behaviours.

Method
Using a single arm pre-post design, participants completed an electronic sleep diary, a range of standardised sleep related questionnaires and wore an actigraph for 7 days pre-and post- program. The intervention consisted of 4x45 minute online group (6-8 people) learning sessions delivered via Zoom by trained Provisional Psychologists to first year university students in 2022/3.

Results
81 students participated in the program (71% female; Mage =21.1, SD = 4.6). Preliminary paired t-tests conducted on available actigraphy data indicate no significant change in sleep duration from pre- to post- program, however sleep regularity [Mpre=75.65, Mpost=82.66, Cohen’s d=-.75], and intradaily variability [Mpre=.81, Mpost=.71, Cohen’s Cohen’s d=.37) significantly improved. Preliminary assessment of questionnaire data revealed significant improvements in scores on the Insomnia Severity Index (Mpre=11.70, Mpost=9.74, Cohen’s d=0.40) and Bedtime Procrastination (Mpre=13, Mpost=11, Cohen’s d=0.38) from pre- to post- program.

Discussion
The Sharper Minds Better Sleep program has demonstrated benefits in improving sleep health behaviours in young adults. Since sleep is intrinsically linked to a range of wellbeing functions, further analyses of these data will seek to understand the utility of the program as part of a stepped care model.
P010 The characteristics of patients with symptomatic unilateral diaphragm dysfunction and hypoventilation
Authors: Hynes D , Lee E , Chew C , Treanor D , Bruzzese K , Brazzale D , Crump N , Dobson J , Barnett S , O’Donoghue F , Howard M 
Published: December 2024

Abstract

Introduction
Despite the diaphragm being the primary muscle involved in respiration, clinical manifestations in those with unilateral diaphragm dysfunction (UDD) are heterogeneous. Though often asymptomatic, UDD can be implicated in breathlessness, sleep disordered breathing and hypoventilation. The characteristics of those with UDD and sleep hypoventilation are poorly described. We aimed to provide a descriptive analysis of patients with UDD considered for plication, and the characteristics of those with hypoventilation.

Methods
A clinical audit was performed at a tertiary centre providing evaluation of UDD for consideration of plication. Anthropomorphic data, symptom scores and respiratory function measurements were collected. Patients underwent polysomnography, with hypoventilation assessed based on PaCO2 &gt;45mmHg and/or transcutaneous CO2 rise of ≥10mmHg for over 10minutes. Characteristics of those with- and without hypoventilation were compared using unpaired t-test or Mann-Whitney U test.

Results
39 patients were included (median age 65 [50—73]). Of the 34 participants who underwent polysomnography, 14 (41.2%) demonstrated hypoventilation. Compared to those without hypoventilation, the group with hypoventilation had a lower forced vital capacity (74±17.3% vs 61.8±13.4%, p&lt;0.05), lower maximal inspiratory muscle pressures (55.8±16.4% vs 39.3±13.4%%, p=0.02) and lower maximal expiratory muscle pressures (84.5 [74—93.8]% vs 66 [47.5—86.5]%, p=0.03). There were no differences in body mass index.

Discussion
Hypoventilation was common amongst patients with symptomatic UDD referred for plication, who may benefit from nocturnal ventilatory support. Though respiratory function was found to be worse in those with hypoventilation, it was surprising that BMI was no different.