bluuebunny/crossref_metadata_2025_split huggingface dataset:
1027 Differences in Polysomnography-Based Sleep Disorders Between HIV-Infected Persons and Matched Controls
Authors: Chen Y , Chen C , Strollo P J , Li C , Ko W , Lin C , Ko N 
Published: May 2020

Abstract

Introduction
Sleep disturbance is a prevalent problem among HIV-infected persons. The recognition of comorbid sleep disorders in patients with HIV is currently hampered by limited knowledge of sleep-related symptoms, sleep architecture, and types of sleep disorders. We aimed to compare the differences in sleep-related symptoms and polysomnography-based sleep disorders between HIV-infected persons and controls.

Methods
The study included 170 men with a Pittsburgh sleep quality index (PSQI) greater than 5, composed of 44 HIV-infected men and 126 male controls who were frequency-matched by sex, age (-/+ 3.0 years) and BMI (-/+ 3.0 kg/m2). For all participants an overnight sleep study using a Somte V1 monitor was conducted. Differences in sleep-related symptoms and sleep disorders between HIV-infected patients and controls were examined using t-tests or Chi-square tests.

Results
HIV-infected persons with sleep disturbances more often had psychological disturbances (72.7% vs. 40.5%, p&lt;0.001) and suspected rapid eye movement (REM) behavior disorder (RBD) (25.0% vs. 4.8%, p&lt;0.01) than that of controls. The sleep-disordered breathing (SDB) in HIV-infected persons was less common than that in controls (56.8% vs. 87.3%, p&lt;0.001). The mean percentage of REM sleep among HIV-infected patients was higher than that among the controls (20.6% vs. 16.6%, p&lt;0.001). Enuresis was more common in HIV-infected persons than controls (40.9% vs. 22.2%, p=0.02).

Conclusion
Psychological disturbances and SDB can be the possible explanations of sleep disturbances in HIV-infected persons, in which suspected RBD is notable. Further studies are warranted to examine underlying factors of suspected RBD among HIV-infected persons with sleep disturbances.

Support
This work was supported by the Ministry of Science and Technology, Executive Yuan of Taiwan [MOST 105-3011-E-006-002], and National Cheng Kung University Hospital [NCKUH-10702022]
1028 Sleep and Enteric Disease: Sleep Now for Less Diarrhea Later
Authors: Mantua J , Gutierrez R L , Isidean S D , Alaca A N , Testa K J , Talaat K , Doty T J , Capaldi V F , Porter C 
Published: May 2020

Abstract

Introduction
The bi-directional relationship between sleep and immune function is well-established. Sufficient sleep supports immune health and can increase vaccine efficacy. Conversely, sickness can disturb sleep quality, which can delay recovery and waking functioning. However, the bidirectional relationship between sleep and infectious diarrhea, the leading infectious disease threat to deployed military populations, has not been studied. We assessed the bi-directional relationship between sleep and enteric disease utilizing data from a recently-completed controlled human infection model (CHIM) with enterotoxigenic Escherichia coli (ETEC).

Methods
During a CHIM to assess the efficacy of an immunoprophylactic targeting ETEC (NCT03040687), we measured sleep via actigraphy over an 8-day inpatient period. Participants ingested prophylaxis 3 times/day during days -2 and -1 and ingested ETEC on day 0. The primary outcome was moderate-severe diarrhea following the ETEC challenge. We hypothesized better sleep pre-challenge would reduce risk of disease after the challenge (assessed using linear regression). We also hypothesized total sleep time (TST) and sleep efficiency (SE) after the challenge would be lower/poorer than baseline (assessed using paired t-test).

Results
Among 59 participants (aged 34.4±8.1yrs, 64% female), longer TST the night preceding ETEC challenge was associated with lower total diarrhea volume (B=-3.13,p=.001). SE was slightly but significantly poorer after the challenge (78 vs. 76%; t(55)=2.2,p=.03), but there was no significant change in TST, potentially due to low TST pre-challenge (316 vs. 329 minutes; p=0.12).

Conclusion
These results - in aggregation with previous work on sleep and vaccines - suggest military sleep regulations should be put in place to increase sleep prior to traveling to an area of responsibility with high risk for enteric disease. These minor behavioral changes could provide lasting benefits to readiness of military servicemembers.

Support
This work was supported by Joint Warfighter Medical Research Program (JWMRP) and the Military Operational Medicine Research Program (MOMRP). The opinions and assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the US Army or of the US Department of Defense. This abstract has been approved for public release with unlimited distribution.
1040 Post-ICU Daytime Sleep And Activity Impact Hospital Discharge Outcomes For Older ICU Survivors
Authors: Elias M N , Liang Z , Munro C L 
Published: May 2020

Abstract

Introduction
The aims of this study were to: describe post-ICU daytime sleep and activity among older ICU survivors within 24-48 hours post-ICU discharge, and to examine differences in post-ICU daytime sleep and activity by prospective acuity of discharge disposition at time of hospital discharge.

Methods
Within 24-48 hours of ICU discharge, we enrolled 30 ICU survivors who were at least 65 years old, functionally independent prior to hospitalization, and mechanically ventilated while in ICU. Actigraphy was used to estimate daytime total sleep time (TST, hours) and daytime activity (mean activity counts/minute) for one daytime period (06:00 AM to 22:00 PM) within 24-48 hours post-ICU discharge. Independent samples t-tests examined differences in mean daytime TST and daytime activity counts, between subjects who were discharged home versus those who were discharged to a facility (inpatient rehabilitation facility, skilled nursing facility, or long-term acute care hospital).

Results
The mean age was 71.37 ± 5.35 years; 63.3% were male and 76.7% were White non-Hispanic/Latino. The mean daytime TST was 7.61 ± 4.31 hours; the mean daytime activity count was 41.2 ± 28.24 counts/minute. Subjects who were discharged to a facility (8.88 ± 3.69 hours) slept significantly longer than those discharged to home (5.54 ± 4.21 hours; t(26) = 2.083, p = .047). Additionally, subjects who were discharged to a facility (32.96 ± 24.26 counts/minute) were significantly less active during the daytime than those discharged to home (54.42 ± 29.30 counts/minute; t(25) = -2.157, p = .041).

Conclusion
Older ICU survivors who were ultimately discharged to a facility slept significantly longer and were less active during the daytime hours immediately following transition out of ICU, compared to subjects who were discharged home. Intervention studies should investigate whether increasing daytime activity while promoting nighttime sleep consolidation following transfer out of ICU improves discharge outcomes.

Support
N/A
1042 Sleep Characteristics In Ehlers Danlos Patients With Hypermobile Type: A Polysomnographic Study
Authors: Metlaine A , Leger D , Sauvet F , Gomez-Merino D , Chennaoui M , Hamonet C 
Published: May 2020

Abstract

Introduction
Ehlers-Danlos syndrome (EDS) is an heritable collagen disorder with various multisystemic clinical manifestations affecting primarily skin, ligaments and joints, blood vessels and internal organs. The clinical spectrum is very large from mild skin and joint hypermobility to severe physical disability. Patients with Ehlers-Danlos syndrome often complain of poor sleep quality and fatigue with impaired quality of life. The purpose of this study was to assess any objective sleep disturbances in EDS by polysomnography.

Methods
In this case-control study, we included 47 patients EDS type III (hypermobile type) (29 F et 18 M) which were one to one strictly matched to 47(29 F et 18 M) controls according to sex, age, and BMI. Participants underwent level-1 polysomnography for a complete sleep study.

Results
The two group were strictly similar for age and BMI (mean age 29.3 ± 9.2 years, BMI 23.3 ± 4.4 kg/m²). Total Sleep time (TST) was significantly reduced in EDS (343.7 ± 69.3 min versus 395 ± 74.8 min; F= 11.9; p&lt; 0.01). Sleep quality was significantly impaired, with a decreased Sleep efficiency (SE): 74.4 ± 10.5 versus 90.2 ± 7.8 F= 68.5; p&lt; 0.001), an increased wake after sleep onset (WASO) time (116.5 ± 45.7 min versus 43.3 ± 36.8 min; F= 73.2; p &lt;0.01) and micro arousal index (14.8 ±7.8 versus 6.5 ±4.3; F= 41.2; p&lt;0.01). We also found a significant reduction of slow wave sleep length, but REM sleep was not affected. The apnea-hyponea index (IAH) and periodic leg movement index (PLMI) were higher in EDS patients (IAH: 10.8±4.8 versus 5.8±3.9; F= 30.4; p&lt;0.01 et PLMI: 4.5 ±4.6 versus 2.6± 2.5; F= 6; p&lt;0.01). In patients with EDS type III, the prevalence of OSA (AHI&gt;10/hour) was 75% versus 7.1 % in the control group (OR 5.1 (95% CI 2.3 to 14.7); p&lt;0.001).

Conclusion
PSG may help in better understanding the diagnosis and treatments of EDS patients.

Support
1043 The Relationship Between Nighttime Eating And Body Mass Index
Authors: Low D , Leroux A , Urbanek J , Crainiceanu C 
Published: May 2020

Abstract

Introduction
Late night eating has been associated with higher odds of being overweight or obese. This study aims to evaluate the relationship between late night eating and body mass index in a nationally representative sample.

Methods
Actigraphy was used to estimate the average bedtime, waketime, duration and midpoint of sleep in the National Health and Nutrition Examination Survey 2003-04 and 2005-06 cohorts. Given the circular nature of clock time, the average was calculated to be the point that minimized the sum of squares of differences between time points. Dietary data was collected through two detailed interviews of the participants. Nighttime calories were defined as the average amount of calories consumed between the average bedtime and the average midpoint of time-in-bed, based on the data recorded during the dietary interviews.

Results
Higher average nighttime caloric consumption (in units of 100 kcal) was associated with higher BMI [B(95% CI): 0.062 (0.003, 0.121)]; this remained significant after adjustment for age, gender, and race [B(95% CI): 0.084 (0.026, 0.142)]. Higher nighttime caloric consumption (as a percentage of total average daily calories consumption) was associated with higher BMI [B(95% CI): 1.522 (0.312, 2.733)]. This remained significant after adjustment for age, gender, and race [B(95% CI): 1.718 (0.505, 2.931)].

Conclusion
Higher nighttime caloric consumption, both in average amount (in units of 100 kcal) and as a percentage of average daily calories consumption, was associated with higher BMI. Additional study is needed to further elucidate the relationship between nighttime eating habits and body mass index.

Support
NHLBI T32HL110952
1045 Impact Of Pre-treatment Sleep And Menopausal Status On Sleep Quality In The 12 Months Following A Breast Cancer Diagnosis
Authors: Squires L , Mahon K , Rash J , Powell E , Seal M , Garland S N 
Published: May 2020

Abstract

Introduction
Sleep disturbances are a prevalent and enduring problem in women who have completed treatment for breast cancer. Less is known about whether sleep during and after cancer treatment is influenced by pre-treatment sleep quality and menopausal status. The present study aims to examine the trajectory of sleep quality in the 12 months following a cancer diagnosis and assess whether trajectory is influenced by pre-treatment sleep quality and menopausal status.

Methods
Newly-diagnosed women (N=88) with non-metastatic BCa were recruited before beginning treatment. They completed the Pittsburgh Sleep Quality Index (PSQI) before treatment and 4, 8, and 12 months later. Women with a score ≥5 on the Pittsburgh Sleep Quality Index at treatment onset were classified as poor sleepers. Menopausal status (pre- or post-menopausal) was chart abstracted. A mixed ANOVA assessed the impact of pre-treatment sleep quality and menopausal status on sleep quality trajectory.

Results
The mean age of the sample was 60 years, 70% were classified as poor sleepers, and 72% were post-menopausal. There was a significant linear time by sleep quality interaction, F(1, 83)= 5.79, p =.02. Good sleepers experienced a greater initial worsening of sleep quality than poor sleepers. At 12 months, poor sleepers had returned to baseline levels whereas scores in good sleepers remained higher than baseline. The 3-way time x sleep quality x menopausal status and the 2-way time by menopausal status interactions were not significant.

Conclusion
Baseline sleep quality is a more powerful determinant of sleep trajectory during treatment than menopausal status. Early intervention is necessary to treat existing sleep problems and prevent the development of sleep problems in women with a history of good sleep.

Support
Dr. Garland is supported by a New Investigator Award and seed funding from the Beatrice Hunter Cancer Research Institute (BHCRI).
1051 Level Of Agreement Between Objective And Subjective Sleep Measures In Lung Cancer Survivors With Insomnia
Authors: Weiss C , Kwon M , Dickerson S , Dean G 
Published: May 2020

Abstract

Introduction
Lung cancer survivors (LCS) have the second-highest incidence of impaired sleep among cancer population. Clinical studies use self-reported and objective measures to assess insomnia in LCS. However, negative beliefs of sleep patterns may impair sleep perception, impact psychological state, and influence insomnia treatment and survivorship outcomes. This study aims to assess the level of agreement between subjective and objective sleep measures in LCS.

Methods
Forty-four non-small cell lung cancer survivors, stage I-III, at least 6 weeks after treatment completion, with Insomnia Severity Index &gt;7, were recruited from two sites from 2014-2016. Individuals with sleep apnea, menopause, rotating shift work, uncontrolled substance abuse, or unstable medical/psychiatric illnesses were excluded from the study. Agreement between total sleep time (TST), sleep latency (SL) and sleep efficiency (SE) from Sleep Diary and wrist-actigraphy (i.e. CamNtech) were assessed with Intraclass Correlation (ICC) and Bland-Altman plots. Analysis of ICC, mean difference, standard deviation (SD) and 95% confidence interval (CI) were conducted using SPSS 24.

Results
LCS were male (63.6%), 60-69 years old (52.3%), married or living with a partner (50%). Self-reported measurements underestimated TST (-68.2 minutes, ICC 0.45, CI 95%, SD 108.1) and SL (-25.9 minutes, ICC 95%, ICC -0.54, DS 17.5). Objective and self-reported measurements largely overlapped for SE, with a small actigraphy-based overestimation (9.2, ICC 0.2, CI95%, SD 7.3). Bland-Altman plots revealed that the agreement increased with lower SE values.

Conclusion
LCS tended to underestimate TST and SL. An apparent agreement between objective and self-reported measures for SE may indicate sleep state misperception. Differences in various sleep parameters and potential covariates should be investigated for contribution to the unexplained considerable individual variability in behavioral treatment response among cancer survivors in larger sample sizes.

Support
1R01NR018215-01 (GED); T32GM099607(CW).
1052 Continuous Blood Pressure Monitoring In Sleep
Authors: Roth R H , Bonner H , Logan J , Baruch M , Calhoun D , Berry R , Cho Y , Kwon Y 
Published: May 2020

Abstract

Introduction
Abnormal nocturnal blood pressure(BP) such as non-dipping or nocturnal hypertension(reverse-dipping) represents a potent marker for cardiovascular risks. Standard cuff-based ambulatory nocturnal BP measurement yields limited data points potentially resulting in imprecise results, especially compared to continuously recorded BP. We hypothesized nocturnal BP based on periodic measurement would be different from true average beat-to-beat based BP.

Methods
We prospectively enrolled patients undergoing clinically indicated in-lab polysomnography, both CPAP and non-CPAP studies, for sleep apnea evaluation. Nocturnal BP was continuously monitored beat-to-beat by a noninvasive Caretaker™ device, which uses the Pulse Decomposition Analysis(PDA) algorithm. We compared BP recorded at 30-minute intervals with average BP continuously recorded over 30 minutes, both recorded by Caretaker™. We also looked at the differences between recording spot and continuous BP from an awake or sleeping state and BP variability(SD) based on continuously recorded BP. Using first 30 min as a reference, we determined dipping status (dipping: 10-20% reduction, level: 0-10% reduction, riser: any increase) by the two methods.

Results
A total of 18 patients were recruited(male:11, mean age:52.2). Among a total of 261 periodic BP measurements, 60 (30.0%) were obtained while awake. Mean nocturnal SBP by periodic BP measurement was higher compared with beat-to-beat-derived average BP(135.6mmHg[24.2] vs. 131.5[20.3], p&lt;0.0001). The difference between the two methods remained similar when continuous BP was derived from sleep vs. awake period(4.5mmHg[3.1] vs. 7.7[9.9], p=0.202). BP variability was more pronounced during awake compared with sleep period(6.7mmHg[8.1] versus 3.95[7.5], p=0.047). 8 patients were dippers by spot check measurement, but 11 were dippers by continuous BP.

Conclusion
Standard ambulatory periodic nocturnal BP recording may not yield true sleep BP patterns due to its spot-check nature and lack of sleep-awake information, which leads to inaccurate dipping measurements. Incorporation of beat-to-beat continuous BP measurement can provide more accurate and meaningful nocturnal BP information.

Support
N/A
1053 Sleep Duration And Timing Associated With History Of Breast Prostate And Skin Cancer: Data From A Nationally-representative Sample
Authors: Piro B , Garland S , Jean-Pierre P , Gonzalez B , Seixas A , Muench A , Killgore W D , Wills C C , Grandner M A 
Published: May 2020

Abstract

Introduction
Sleep disturbances are a common problem among cancer survivors. Also, cancer patients can have altered circadian rhythms and these changes can continue to affect the patient long after the conclusion of their treatment. This analysis aims to investigate how the sleep and wake times of cancer survivors differ from the rest of the population, depending on the type of cancer.

Methods
Data from the 2015-2016 National Health and Nutrition Examination Survey were used. Population-weighted data on N=5,581 individuals provided complete data. History of breast, prostate, and skin cancer (melanoma or other) was self-reported. Sleep duration was self-reported in half-hour increments, and typical bedtime and waketime was self-reported. Covariates included age, sex, and race/ethnicity. Weighted linear regressions with sleep duration, bedtime and waketime were examined, with each cancer type as predictor.

Results
Prevalence was 1.7% for prostate cancer, 1.5% for breast cancer, 2.3% for non-melanoma skin cancer, and 0.8% for melanoma. In adjusted analyses, prostate cancer was associated with an additional 26.5 minutes of average total sleep (95%CI 2.2,50.9, p=0.03), a 23.1 bedtime minutes earlier (95%CI -40.4,-5.8, p=0.009), and no difference in waketime. Breast cancer was associated with a bedtime that was 41.1 minutes later (95%CI 10.3,72.0, p=0.009) and a waketime that was 48.7 minutes later (95%CI 12.5,84.9, p=0.008), but no difference in sleep duration. No statistically significant effects were seen for either type of skin cancer, melanoma or non-melanoma.

Conclusion
Prostate cancer was associated with an earlier bedtime and associated increased sleep time. Breast cancer, on the other hand, was associated with a phase delay of the sleep period but no change in sleep duration. Skin cancer was not associated with differences in sleep duration or timing. These findings may have implications for not only treatment of sleep problems in different types of cancer, but also possible circadian mechanisms.

Support
Dr. Grandner is supported by R01MD011600
1054 Improving Sleep By Reducing Allergy Symptoms
Authors: Rus H , Danoff-Burg S , Cruz Martir L , Raymann R J 
Published: May 2020

Abstract

Introduction
Allergies can impact sleep quality and, in turn, quality of life. Sleep is affected because allergens irritate nasal passages, which can make breathing more difficult, start an immune response, and directly interfere with sleep. Nasal congestion often is worse at night, and during the night some anti-allergic control processes of the body dip, which can lead to increased symptoms. We tested if an air purifier in the bedroom would improve sleep and reduce allergy symptoms.

Methods
29 adults with self-reported allergy complaints participated in an 8-week field study, using a non-counterbalanced pre-post intervention design. Intervention consisted of the use of an Alen BreatheSmart 45i air purifier at home for 24 hours a day during the duration of the test period. Sleep was measured with self-report and objectively with ResMed S+ every night. Allergy symptoms were measured using self-report. Paired t-tests and multilevel regression were used to test for statistical significance.

Results
28 individuals reported a reduction in allergy symptoms and 27 reported better sleep during the intervention. Overall, participants reported a 38% improvement in allergy symptoms and a 59% improvement in sleep continuity. Moreover, participants felt they fell asleep faster (20% faster), experienced better sleep quality (14% better), and felt more rested in the morning (14% more rested). Objective data showed an 11% improvement of Wake After Sleep Onset and a 1.1% increase in sleep efficiency during intervention (all ps &lt; 0.05), but only in the subgroup (n = 11) of participants with the poorest sleep at baseline.

Conclusion
Using an air purifier in the bedroom can reduce allergy symptoms and improve sleep. Objectively measured sleep improvements supported the self-reported improvements, but only in the subset of participants who showed compromised sleep at baseline.

Support
Alen Corporation