bluuebunny/crossref_metadata_2025_split huggingface dataset:
0839 Napping Stigma Among Frail Older Adults: Reflections from a Qualitative Study
Authors: Berkley A S , Carter P A 
Published: May 2020

Abstract

Introduction
Napping and other daytime sleep is often overlooked in insomnia research and poorly defined in many studies. Research has shown some correlations between older adults’ napping habits and increased medical co-morbidities and risks of dementia, but it has also shown that napping enhances memory consolidation and broader aspects of cognition in younger adults. Where along the aging spectrum this line between beneficial napping and potentially risky napping falls is not clear.

Methods
This study employed a qualitative descriptive approach in which semi-structured interviews (N=18) were supplemented by the widely used self-report instruments and anxiety scales.

Results
Insomnia in these older adults directly resulted in reduced energy and stamina, poor mood, and reduced functional capacity. Indirect effects included reduced social interaction and increased isolation. Several participants reported napping in qualitative interviews but denied daytime sleep on standard sleep assessments, and associated napping with anxiety and dread of functional and cognitive decline. Planned or intentional napping was viewed with guilt and denial, while dozing off accidentally was considered an acceptable coping strategy.

Conclusion
While research about the relationships between disordered sleep and cognitive impairment is still at an early stage, it seems ironic that the participants in this study stigmatized planned napping, which could potentially benefit their cognitive functioning, but seemed accepting of accidental napping, which may well indicate some more serious cognitive issues. More education about sleep needs for older adults is needed.

Support
I am grateful to the Longhorn Village chapter of Texas Exes for their Gerontology Nursing Scholarship, which helped to fund this project.
0844 Links of Napping With Subsequent All-Cause Hospitalizations and Emergency Department Visits in Older Adults
Authors: Tzuang M , Owusu J T , Huang J , Sheehan O C , Rebok G W , Kasper J , Spira A P 
Published: May 2020

Abstract

Introduction
Few studies have examined whether napping is associated with objective measures of health services use. We investigated links of napping characteristics with all-cause hospitalizations and emergency department (ED) visits in Medicare claims from a nationally representative sample of older adults.

Methods
Participants were 869 community-dwelling Medicare beneficiaries aged ≥65 years from Round 3 (2013) and Round 4 (2014) of the National Health and Aging Trends Study (NHATS) who had continuous fee-for-service coverage 1 year before and after the NHATS interview. Participants reported past-month napping frequency (re-categorized as non-nappers, infrequent nappers, frequent nappers), napping type (intentional, unintentional), and nap duration. Outcomes were from linked Medicare claims measured after napping assessment: all-cause ED visits and hospitalizations (yes vs. no), and number of hospitalizations and ED visits.

Results
Overall, 45.4% of participants were nappers, and 55.2% of the nappers reported taking unintentional naps. After adjustment for demographics, depressive/anxiety symptoms, medical comorbidities and BMI, compared with non-nappers, infrequent and frequent nappers had a higher odds of hospitalization (odds ratio (OR)=1.65 and 1.73, respectively, both p&lt;0.05), as did unintentional nappers (OR=1.85, p&lt;0.05). We found no significant adjusted associations of napping frequency with ED visits. However, compared with non-nappers, unintentional nappers had a higher odds of visiting the ED (OR=1.94, p&lt;0.01). Additionally, compared to nappers taking short naps (≤30 minutes), those with naps &gt;60 minutes had a greater number of ED visits (Incidence Rate Ratio=1.99, p&lt;0.05).

Conclusion
Among older adults, napping—and particularly unintentional napping—may be a modifiable risk factor for health services use. More studies that consider multiple napping characteristics (e.g., duration, frequency), and using objective measures (e.g., actigraphy), are needed to advance understanding of how napping might influence health services use.

Support
National Institute on Aging: R01AG050507 & R01AG050507-02S (PI: Spira); F31-AG058389; U01AG032947 (PI: Kasper) for the National Health and Aging Trends Study. Johns Hopkins Center on Aging and Health Data Use Agreement (PI: Roth, Co-I: Sheehan) with Centers for Medicare & Medicaid Services titled, “Potentially modifiable factors influencing outcomes in NHATS.”
0868 How Do Sleep Morbidities Differ Amongst Pregnant Women, Women Who Are Intending To Conceive, And Women Who Are Not Intending To Conceive?
Authors: Hartman A R , Geller P A , Morales K , Lee K , Kloss J , Perlis M L 
Published: May 2020

Abstract

Introduction
Maternal sleep disturbance is common during pregnancy and is associated with adverse maternal and child outcomes, such as postpartum depression and preterm birth. The extent to which sleep disorder symptoms are normative among women of reproductive age, however, is largely unknown. The present study’s primary aim was to explore cumulative sleep morbidity and the incidence of disorder-specific symptoms among reproductive-aged women of different childbearing statuses.

Methods
Sleep morbidity variables were examined cross-sectionally among three groups of reproductive-aged nulliparous women: those 1) currently pregnant (n=148), 2) currently intending to conceive (n=233), and 3) not currently intending to conceive (n=379). All subjects self-reported sleep disorder symptoms at baseline using the Sleep Disorders Symptom Checklist-25 (SDS-CL-25). This instrument measures symptoms related to 13 sleep disorders scaled 0 (never) to 4 (&gt; 5 days per week). Average scores were calculated for each item, each of 13 sleep disorders, and for the whole instrument (0-100).

Results
Initial results indicated that pregnant women (M=22.80, SD=11.49) had a higher rate of cumulative sleep morbidity than women who were intending to conceive (M=20.33, SD=11.14) and women who were not intending to conceive (M=20.15, SD=12.03) (p=.05). Pregnant women also had increased rates of insomnia (M pregnant=8.38, SD=3.77; M intending=6.86, SD=3.60; M not intending=6.53, SD=3.47; p&lt;.001) and restless legs syndrome/periodic limb movement disorder (M pregnant=2.77, SD=3.05; M intending=2.02, SD=2.28; M not intending=1.99, SD=2.43; p= .004) as compared to non-pregnant women.

Conclusion
These data suggest, as is widely held, that pregnant women have greater levels of sleep disturbance than women of a common reproductive age who are currently intending to conceive or who are not currently intending to conceive. The observed sleep disturbance appears to be limited to sleep initiation and maintenance and RLS/PLMs symptomatology. Additional analyses are ongoing.

Support
Perlis & Kloss: R21HD083628; Perlis K24AG055602
0901 Role of Nasopharynx Radiography in Diagnosis of Sleep Disordered Breathing in Children
Authors: Rao H S 
Published: May 2020

Abstract

Introduction
Sleep disordered breathing (SDB) in children comprises a wide spectrum of presentation ranging from primary snoring (prevalence 6-12%) to obstructive sleep apnea (OSA; prevalence 1-3%). In younger children, SDB is often secondary to adenotonsillar hypertrophy. Polysomnography is the gold standard test for evaluation of sleep disordered breathing. Yet, many providers order ancillary tests such as Radiography of Nasopharynx (NPX-ray) to assess for adenoidal hypertrophy. Previous studies evaluating efficacy of NPX-rays to diagnose airway obstruction have shown mixed results.

Methods
Retrospective chart review of 65 consecutive normally developed children who have had diagnostic polysomnography and NPX-rays over the past 3 years was performed. Data on age, sex, Obstructive Apnea Hypopnea Index (OAHI) and NPX-ray findings were collected. Our cohort mostly had the following diagnosis such as GERD, Asthma, Allergic rhinitis, ADHD and Obesity. Our cohort did not have neurological disorders or medications that could affect tone of upper airway. Standard pediatric AHI criteria was applied to categorize mild, moderate and severe OSA.

Results
Our cohort’s age ranged from 3-18 years (median age 10 years); 43 were males. Of the 24 children with normal sized adenoids with no obstruction; 6 had severe OSA and 4 had moderate OSA. 3 had hypertrophied adenoids on X-ray with occlusion of nasopharynx but only had mild OSA. Of the 15 children with prominent adenoids with some narrowing but no occlusion; 9 had severe OSA. Of the 9 children that had hypertrophied adenoids with no occlusion; 3 had moderate OSA and 3 had severe OSA. Of the 12 with mild enlargement, 4 had severe OSA. None of the 19 children with severe OSA showed airway occlusion by adenoids.

Conclusion
In our study, the size of the adenoids on X-ray of the Nasopharynx did not correlate with severity of SDB in children. Airway obstruction in OSA is dynamic and can occur at multiple sites affected by anatomical factors and upper airway collapsibility. As use of Nasopharyngeal radiography involves exposure to radiation, it should be used judiciously in diagnosis of SDB in children. Polysomnography is the gold standard test for evaluation of SBD in children.

Support
None.
0923 Doxepin in Children and Adolescents With Symptoms of Insomnia: A Single Center Experience
Authors: Shah Y , Kothare S 
Published: May 2020

Abstract

Introduction
Pediatric insomnia is a widespread problem and especially difficult to manage in children with neurodevelopmental disorders. There are currently no FDA- approved medications for pediatric patients to use once first line therapy fails. Doxepin is FDA-approved at low doses for use in transient or chronic sleep maintenance insomnia in adults. The objective of this study is to determine the tolerability and efficacy of doxepin in the pediatric population.

Methods
This is a retrospective single center chart review of children and adolescents (2-17 years of age) whose sleep failed to improve with behavioral intervention and melatonin who were then trialed on doxepin. Treatment was initiated at a median starting dose of 2mg and slowly escalated to a median maintenance dose of 10mg. Improvement in sleep was recorded using a 4-point Likert scale reported by parents on follow up visits.

Results
Total of 29 patients were included in analysis. Mean follow-up duration was 6.5 months (±3.5). Out of 29 patients, 4 (13.8%) patients discontinued doxepin due to lack of efficacy or side effects. 8 (27.6%) patients showed significant improvement of their insomnia, 8 (27.6%) showed moderate, 10 (34.5%) showed mild and 3 (10.3%) showed minimal to no improvement on treatment with doxepin (P&lt;0.05) Only two patients (6.8%) experienced adverse effects in the form of behavioral side effects (aggression) and enuresis.

Conclusion
Our data suggests that doxepin is effective, safe and well-tolerated in the treatment of sleep initiation and maintenance insomnia as well as psychophysiological insomnia in child and adolescents with Ausitsm specutrm disorder, other neuro-developmental disorders and attention deficit hyperactivity disorder. It is also an effective, safe, and well-tolerated alternative in children suffering from chronic persistent insomnia. The results of this study suggests a promising emerging therapy for the treatment of insomnia in the pediatric population.

Support
None
0932 Media Use and Short Sleep Duration Among Children Aged 3-17 Years—National Survey of Children’s Health, 2016-2017
Authors: Wheaton A G , Greenlund K J 
Published: May 2020

Abstract

Introduction
Media use, such as television viewing and computer use, has been associated with insufficient sleep among children.

Methods
Analyses used data collected from parents of children aged 3-17 years via the National Survey of Children’s Health in 2016 and 2017 (N=60,547). The prevalence of age-specific short sleep duration (&lt;10 hours for ages 3-5 years, &lt;9 hours for ages 6-12 years, and &lt;8 hours for ages 13-17 years) was calculated by time spent (none, &lt;1 hour, 1 hour, 2 hours, 3 hours, ≥4 hours) in front of a television (television time) and with computers or other electronic devices not for homework (computer time) on an average weekday. The prevalence of short sleep duration was also calculated adjusting for child sex and race/ethnicity, household income, parental education, special health care needs, general health, and bedtime regularity.

Results
The prevalence of short sleep duration was 35% for ages 3-5 years, 37% for ages 6-12 years, and 32% for ages 13-17 years. There was a significant linear relationship between both television and computer time and short sleep duration prevalence for all age groups, with the exception of television time for 13-17 year olds. For ages 3-5 years, prevalence of short sleep duration ranged from 18% (none) to 48% (≥4 hours) for television time (linear trend p&lt;0.0001) and 23% (none) to 49% (≥4 hours) for computer time (linear trend p&lt;0.0001). For ages 6-12 years, prevalence ranged from 23% (none) to 57% (≥4 hours) for television time (linear trend p&lt;0.0001) and 26% (none) to 58% (≥4 hours) for computer time (linear trend p&lt;0.0001). For ages 13-17 years, prevalence ranged from 15% (none) to 41% (≥4 hours) for computer time (linear trend p&lt;0.0001). The associations remained significant after adjustment for covariates.

Conclusion
Reducing media use may increase sleep duration for children. The association between media use and sleep duration is similar for television and computer time for younger children; however, focusing on recreational computer use may be beneficial among teens.

Support
0938 Sleep, Perfectionism and Cognitive Anxiety in Sports: An Exploratory Study
Authors: Ramos Socarras L , Bourgon V , Mercier K , Forest G 
Published: May 2020

Abstract

Introduction
Perfectionism has been related to cognitive anxiety in sports. The bidirectional association between sleep and anxiety has also been well studied. However, the relationship between sleep habits, anxiety and perfectionism in physically active young individuals hasn’t been documented yet. This was the objective of the present study.

Methods
150 young, physically active participants (10 to 18 years old; 47% boys, 51% girls) completed an online survey comprised of questions extracted from the Sport Multidimensional Perfectionism Scale-2, the Competitive State Anxiety Inventory-2R and the Adolescent Sleep Habits Survey. First, independent t-tests were conducted to compare sleep habits, personal standards (PS), perceived parental pressure (PPP) and perceived coach pressure (PCP) of more anxious (ANX) to less anxious (NOANX) participants. Then, stepwise multiple linear regression analyses were computed to examine the significant sleep habits and perfectionism variables associations with competitive cognitive anxiety.

Results
Results show that ANX participants have higher PS (t(148)=3.19, p=0.002), less total sleep time on weekend (TST; t(148)=-2.94, p=0.004), longer sleep onset latency (SOL) on weeknights (t(128.09)=2.28, p=0.03) and report more daytime sleepiness (t(148)=3.06, p=0.003) compared to NOANX participants. The significant sleep variables and PS collectively explained 17.7% of competitive cognitive anxiety variance (p=0.00). PS was the largest predictor (β=0.27, p=0.00), followed by daytime sleepiness (β=0.21, p=0.007), weekend TST (β=-0.17, p=0.023) and weeknight SOL (β=0.16, p=.038).

Conclusion
These results suggest that, even though PS is associated with cognitive anxiety, sleep seem to be an important factor to consider. Specifically, increased daytime sleepiness accompanied by difficulties falling asleep during school nights and no recovery sleep during weekends significantly contribute to competitive cognitive anxiety. These results could have important implications when addressing competitive anxiety issues in young athletes.

Support
N/A
0948 Sleep Quality, Depressive Symptoms, and Stress in Maternal Caregivers of Young Children with Bronchopulmonary Dysplasia
Authors: Feeley C , Chasens E 
Published: May 2020

Abstract

Introduction
Maternal caregivers of young children with a chronic illness, like bronchopulmonary dysplasia (BPD), often report increased levels of stress and depressive symptoms, as well as poor quality of sleep. Caregiving duties are time-intensive and extend into the nighttime hours. The purpose of this study is to examine sleep, depressive symptoms, and stress in maternal caregivers of young children with BPD, as well as determine if depressive symptoms is a mediating variable between sleep quality and stress.

Methods
61 maternal caregivers (mean age 29 yrs) of young children with BPD (mean age 14 mos) were recruited. Mothers had no reported history of a sleep disorder, and had a child diagnosed with BPD. The child had to have been home from the hospital for at least two months, and not require a ventilator or tracheotomy. Maternal caregivers were asked to complete a demographic questionnaire, as well as the Pittsburgh Sleep Quality Index (PSQI), the Perceived Stress Scale (PSS), and the Center for Epidemiological Studies-Depression Scale (CES-D). Upon completion, 56.9% of the sample was single, 67.2% were African American, and child had been home from hospital a mean of 8 mos.

Results
Over two thirds (67.2%) of the sample reported sleeping 6 or fewer hours a night, with a mean PSQI score of 7.6. Significant correlations were found between PSQI and CESD (; r=.546; p=.000), as well as PSQI and stress (r=.284; p=.031). Depressive symptoms were not found to mediate the relationship between sleep quality and stress, however, sleep quality was a significant predictor of stress (t=2.171; p=.034) and depressive symptoms (t=4.876; p=.000).

Conclusion
The majority of maternal caregivers of children with BPD reported insufficient and poor quality of sleep, which may affect their stress and depressive symptoms. Healthcare providers need to discuss the importance of sleep with caregivers, and ensure the child’s care schedule allows for sleep during the nighttime hours.

Support
0962 Sleep and Daytime Functioning in Gifted and Twice Exceptional Children
Authors: Théoret R , Bastien L , Godbout R 
Published: May 2020

Abstract

Introduction
Gifted (G) children display an asynchrony between intellectual development and social and emotional development. Twice exceptional (2e) children are G children with a neuropsychological disability. We compared the sleep and daytime behavior of G, 2e and typically developing (TD) children and we sought for group-specific relationships between sleep and daytime behavior.

Methods
23 children were recruited: seven G (8.7 years old, SD = 1.7), six 2e (9.8 years old, SD = 1.8) and 10 TD children (10.0 years old, SD = 2.2). Giftedness was diagnosed with neuropsychological tools. The Children’s Sleep Habits Questionnaire (CSHQ) assessed sleep quality, the Child Behavior Checklist (CBCL) assessed daytime functioning. Sleep quality and its impact on daytime functioning was measured with a MANCOVA, with the CBCL’s three main factors as dependent variables (internalizing problems, IP; externalizing problems, EP and total problems, TP), children group as the independent variable and the CSHQ total score as the covariate.

Results
G, 2e and TD groups scored 39.86, 39.17 and 39.70 on the CSHQ, respectively (n.s.). The three groups were not different on the CBCL, with respective mean T scores of 57.86, 50.33 and 48.60 for IP, 56.43, 55.67 and 47.80 for EP and 55.29, 53.83 and 46.40 for TP. Pillai’s trace statistics disclosed a significant relationship between CSHQ and CBCL scores regardless of groups (p = 0.04) but the influence of sleep quality did not differ among the groups for any of the three factors. The CSHQ total score was positively and significantly related to IP (p = 0.03, r = 0.47); relationships were not significant for EP (p = 0.96, r = -0.01) and TP (p = 0.17, r = 0.31).

Conclusion
Sleep quality influences internalizing problems in children, without group-specific relationships, but this association does not seem to differ between gifted, twice exceptional and TD children.

Support
N/A
0978 Snoo: A Wellness Device To Improve Infant Sleep
Authors: Okun M , Karp H , Balasubramanian S 
Published: May 2020

Abstract

Introduction
One of the primary contributors to new parent sleep deprivation is infant sleep disturbances. Evidence shows that increasing sleep in infants has a positive effect on parental sleep. SNOO, a wellness device, was developed to provide sleeping babies 3 of the 5 S’s (safe swaddling, sound and swinging) in a response fashion (increasing levels of motion and white noise if babies cry) to soothe crying and improve infant sleep.

Methods
The current study compares infant sleep derived from SNOO to a reference group of a compilation of 13 peer reviewed studies of normative sleep data on sleep in traditional cribs/bassinets. Participants were 7157 babies using SNOO beginning within one week of birth and for at least 6 hours per night for 6 months. Sleep metrics calculated on a day to day basis include Longest Sleep Period: Maximum uninterrupted sleep at night (7 PM - 7 AM); Total Sleep Duration: Total time spent sleeping at night (7 PM - 7 AM); and Night Awakenings: Number of times parents attended to the baby (10 PM - 6 AM).

Results
Improvement in the longest sleep duration varied with age. Across the 6 month collection period, longest sleep period increased between 42 minutes - 2 hours 0 minutes and total sleep duration increased between 33 minutes - 1 hour 24 minutes. Babies in SNOO averaged one less waking per night compared to the reference population (1.09±.89 vs 1.89 ±1.1). The improvements in all three sleep metrics were statistically significant with p’s &lt; 0.0005 across all ages from birth to 6 months.

Conclusion
This large-scale study suggests that infant sleep can be significantly improved by using SNOO compared to babies who slept in normal cribs or bassinets. We believe there are myriad areas of public health that may be positively impacted as a result of this significant level of improvement of infant sleep.

Support
Happiest Baby, Inc.