bluuebunny/crossref_metadata_2025_split huggingface dataset:
0361 Birthplace Moderates Racial/Ethnic Disparities in Multiple Sleep Characteristics Among Non-Hispanic Whites and Hispanic/Latino Heritage Groups in the United States
Authors: Gaston S A , Martinez-Miller E E , Nguyen-Rodriguez S , Aiello A , McGrath J , Jackson W , Nápoles A , Pérez-Stable E J , Jackson C L 
Published: May 2020

Abstract

Introduction
Sleep duration disparities by Hispanic/Latino heritage exist; however, few studies have additionally investigated sleep quality disparities by heritage and birthplace, nor have studies compared foreign-born to US-born Non-Hispanic Whites (NHWs).

Methods
Using pooled 2004-2017 National Health Interview Survey data, we investigated whether sleep disparities varied by birthplace among adult NHWs and Hispanic/Latino heritage groups. Adjusting for sociodemographic and behavioral/clinical characteristics, survey-weighted Poisson regressions with robust variance estimated prevalence ratios (PRs) and 95% confidence intervals (CIs) of self-reported sleep characteristics. Sleep characteristics were compared among foreign-born NHWs and Hispanic/Latino heritage groups vs. US-born NHWs. Sleep characteristics were also compared across Hispanic/Latino heritage groups vs. foreign-born NHWs.

Results
Among 254,699 participants (Meanage±SE: 47±0.9 years; 49% female), 81% self-identified as NHW (n=207,154), 12% Mexican (n=30,100), 2% Puerto Rican n=5,077), 1% Cuban(n=2,518), 1% Dominican (n=1,658), and 3% Central/South American (n=8,162). Compared to US-born NHWs, foreign-born NHWs were more likely to report &gt;9-hours sleep duration (PR=1.11[95% CI: 1.01-1.21]) and poor sleep quality (e.g., PRtrouble staying asleep=1.27[1.17-1.37]), and US-born Mexicans were no more likely to report shorter sleep duration while foreign-born Mexicans were less likely (PR&lt;6-hours=0.52[0.47-0.57], PR6-&lt;7-hours=0.72[0.68-0.76]). Although US-born and foreign-born Mexicans had lower prevalence of poor sleep quality compared to US-born NHWs, PRs were lowest for foreign-born Mexicans. Compared to foreign-born NHWs, US-born Mexicans were more likely to report shorter sleep duration, but foreign-born Mexicans were no more likely. Regardless of birthplace, Puerto Ricans were more likely (e.g., PR&lt;6-hours=1.37[1.24-1.60]) and Cubans were less likely (e.g., PR&lt;6-hours=0.81[0.68-0.96]) to report shorter sleep duration vs. US-born NHWs. Compared to US-born NHWs, Dominicans reported better sleep duration and quality. Sleep duration and quality did not differ among Dominicans vs. foreign-born NHWs.

Conclusion
Sleep disparities varied by birthplace and Hispanic/Latino heritage. Birthplace of both NHWs and racial/ethnic minority groups should be considered in disparities research.

Support
This work was funded by the Intramural Program at the National Institutes of Health (NIH), National Institute of Environmental Health Sciences (NIEHS, Z1AES103325-01) and the Division of Intramural Research, National Institute on Minority Health and Health Disparities.
0364 Sex and Race Influence Objective and Self-Report Sleep and Circadian Measures in Emerging Adults at Risk for Bipolar Spectrum Disorder
Authors: Titone M K , McArthur B , Ng T H , Burke T A , McLaughlin L E , MacMullen L E , Alloy L B , Goel N 
Published: May 2020

Abstract

Introduction
There is a critical need to understand key factors that impact sleep and circadian rhythm function for emerging adults at risk for bipolar spectrum disorder (BSD). Sex and race are common demographic factors contributing to differences in health outcomes; however, the influence of these variables on sleep and circadian rhythm patterns for emerging adults at risk for BSD has not been characterized.

Methods
Multiple objective and self-report facets of sleep and circadian function, including dim light melatonin onset (DLMO), and measures derived from actigraphy and sleep diaries, were assessed in a 20-day ecological momentary assessment (EMA) study of 150 emerging adults (mean ± SD, 21.8 ± 2.1y; 58.7% female; 57.9% White, 23.4% Black, 10.3% Asian or Pacific Islander, 8.0% Other ethnicity) at-risk for BSD. Bivariate Pearson correlations (two-tailed, p &lt;.05) were conducted between the sleep and circadian measures. ANCOVAs, controlling for BSD status, were conducted to evaluate differences on sleep and circadian characteristics by sex and race.

Results
Males exhibited better actigraphic sleep efficiency and later DLMO phase than females, whereas females exhibited more actigraphic discrete sleep periods. White participants exhibited more actigraphy-measured total sleep time, better sleep efficiency, and fewer sleep periods, and self-reported more total sleep time and better sleep efficiency than Black participants.

Conclusion
We show for the first time that sex and race are significant predictors of objective and self-reported sleep and circadian rhythm measures in a large sample of emerging adults at risk for BSD participating in an EMA study. Our findings extend the existing literature to a novel clinical population and to a naturalistic setting and inform ongoing research on sex and racial health disparities in sleep and circadian rhythms.

Support
This work was supported by NIH R01 MH77908 and R01 MH102310; a Banting Postdoctoral Fellowship from the Social Sciences and Humanities Research Council; and a National Science Foundation Graduate Student Research Fellowship.
0367 Social Determinants of Black-White Disparities in the Work-Sleep Relationship by Occupational Class: A Sequential Mixed Methods Approach
Authors: Jackson C L , Wright I , Winful O T , Feinstein L , Adams I 
Published: May 2020

Abstract

Introduction
Although Black adults disproportionately work in lower-wage, lower-skilled jobs and experience short sleep (&lt;7 hours), which has been shown to vary by employment industry and occupation, there is scant literature regarding the influence of the work-sleep relationship on racial/ethnic sleep disparities. Our prior quantitative research based on nationally-representative data revealed a novel finding that the prevalence of short sleep was generally highest at professional occupational classes among Black adults but was the least prevalent among their White counterparts.

Methods
To identify reasons for short sleep generally increasing with increasing professional occupations among blacks but decreasing among whites, we conducted a qualitative study using a sequential mixed methods design among Black and White workers across a range of industries and occupations. Occupations were classified as “professional” (e.g., doctors; lawyers) or “non-professional” (e.g., retail; food service). Race-matched trained facilitators conducted 36 focus groups that were homogenous in terms of race-sex/gender-occupational class and 63 one-on-one interviews (N=334 overall participants) using semi-structured interview guides. NVivo software was used to identify themes/patterns.

Results
Participants were a mean age of 41 ± 11 years, 42% were men, 58% had an annual income of ≥$50,000, and 57% were professionals. Black professionals overwhelmingly described less informational and emotional support as well as needing to “work twice as hard to get half as far” (i.e., John Henryism) compared to coworkers as potential explanations for work-sleep disparities. Both Black and White professionals identified longstanding social structures, interpersonal discrimination, income disparities, and familial or self-imposed pressures to succeed. White professional women frequently reported experiences with gender discrimination, which - they reported - may intersect with and amplify the effects of racial discrimination among Black women. Regardless of occupational class, Black men additionally described unique stressors (e.g., political climate; finances; police). White men frequently avoided discussing disparities, and the existence of disparities was often denied/questioned by non-professionals across race and sex/gender.

Conclusion
Our findings inform future research and interventions designed to illuminate and/or address sleep disparities emanating from the workplace.

Support
This work was funded by the Intramural Program at the National Institute of Environmental Health Sciences (Z1AES103325-01).
0390 Associations of the Neighborhood Built Environment with Adolescent Sleep Outcomes
Authors: Mayne S , Morales K , Williamson A A , Grant S F , Fiks A G , Dinges D F , Zemel B , Mitchell J A 
Published: May 2020

Abstract

Introduction
Over 75% of U.S. high school students obtain insufficient amounts of sleep. Identification of modifiable environmental determinants of adolescent sleep is needed to inform interventions and public health strategies, yet little is known about the influence of the built environment on adolescent sleep. We examined associations of the built environment with objectively-measured adolescent sleep outcomes.

Methods
In this longitudinal, prospective study, we used actigraphy to assess sleep outcomes for 14 days each in 8th grade and 9th grade: duration (hours/night), onset (hours from 00:00), offset (hours from 00:00), and sleeping &gt;8 hours. Home addresses were linked to built environment exposures based on half-mile Euclidian buffers (overall/human-made sound levels, percent tree canopy cover, street density, intersection density) and census block group (population density, housing density). Mixed-effects linear (sleep duration, onset, offset) and logistic (&gt;8 hours) regression estimated associations of each built environment measure with sleep outcomes, adjusting for sex, race, parent education, household income, grade and weeknight status (school or non-school night).

Results
Among 108 adolescents - 53% female and 25% Black - providing 2,388 nights of sleep data across 8th and 9th grades, a 1-standard deviation increase in neighborhood sound (overall and human-made) associated with 11 minutes later sleep onset (β=0.19; 95% CI: 0.01, 0.38) and 20% lower odds of sleeping for &gt;8 hours (OR=0.80, 95% CI: 0.62, 1.02). A 1-standard deviation increase in neighborhood tree canopy cover associated with 11 minutes earlier sleep onset (β= -0.19, 95% CI: -0.35, -0.03) and 7 minutes earlier sleep offset (β= -0.12, 95% CI: -0.23, -0.02). No associations were observed for “density based” exposures.

Conclusion
Higher tree canopy cover associated with more favorable sleep timing while higher neighborhood sound level associated with later timing of sleep onset. These modifiable neighborhood built environment factors should be considered when intervening to support healthier sleep among adolescents.

Support
NIH/NHLBI K01HL123612 (JM) and Sleep Research Society Foundation and K23HD094905 (AAW)
0392 The Effect of Benzodiazepine Use on Non-REM Sleep Instability in Community-Dwelling Older Men
Authors: Hartmann S , Baumert M 
Published: May 2020

Abstract

Introduction
Previous studies on the implications of benzodiazepine (BZD), a widely prescribed pharmacotherapeutic treatment method for sleep insomnia, on sleep architecture demonstrated significantly reduced EEG activity in low-frequency bands. In this study, we explore the effect of BZD on NREM sleep instability also known as cyclic alternating pattern (CAP) in community-dwelling older men.

Methods
CAP was scored in overnight EEG recordings from 30 older men on long-acting BZD (LBZD), 35 older men on short-acting BZD (SBZD), and 50 age-matched men who did not use BZD (NBZD), participating in the Osteoporotic Fractures in Men Sleep Study (MrOS sleep). A high performance automated detection system determined the ratio between CAP time and NREM sleep time (CAP rate), the number of A1-phases per hour of NREM sleep (A1 index), and the number of A2+A3-phases per hour of NREM sleep (A2+A3 index). The relationship between CAP parameters and BZD use was determined using the Kruskal-Wallis test by ranks with Bonferroni correction for post-hoc analysis.

Results
CAP rate was significantly decreased in older men using long-acting BZD (NBZD: 59.6±18.0%, LBZD: 46.9±13.1%, SBZD: 53.0±20.1%) as compared to non-BZD user (p &lt; 0.01). All BZD users demonstrated significantly lower frequencies of A1-phases (NBZD: 19.9±23.0 no./h, LBZD: 6.9±13.3 no./h, SBZD: 4.5±9.9 no./h) as compared to non-BZD users (LBZD: p &lt; 0.01, SBZD: p &lt; 0.001). The A2+A3 index did not show any variations between the three groups.

Conclusion
Older men using long-acting BZD demonstrate a significantly reduced CAP rate during sleep, particularly less frequent A1-phases, compared to the control group. Moreover, short-acting BZD user show significantly less frequent A1-phases but no difference in CAP rate and A2+A3-phases than older men using no BZD. Hence, BZD usage has a major adverse effect on the occurrence of EEG slow waves.

Support
The National Heart, Lung, and Blood Institute (NHLBI) provides funding for the MrOS Sleep ancillary study “Outcomes of Sleep Disorders in Older Men” under the following grant numbers: R01 HL071194, R01 HL070848, R01 HL070847, R01 HL070842, R01 HL070841, R01 HL070837, R01 HL070838, and R01 HL070839.
0399 The MSSA: A Novel Instrument to Assess Sleep and Sleep Disturbances in Military Men and Women
Authors: Gerwell K , Pruiksma K E , Brock M S , Peterson A L , Carrizales F A , Brundige A , Taylor D J , Vanecek R , Hansen S , Foster S N , Young-McCaughan S , Straud C L , Mysliwiec V 
Published: May 2020

Abstract

Introduction
Military personnel experience unique stressors (e.g., deployments, shift work, family separation) which can cause sleep disturbances. However, little is known regarding the general sleep quality of military personnel and how it changes throughout their service, what types of stressors precipitate sleep disturbances, and how this differs among military men and women. We present findings from a new self-report measure, the Military Service Sleep Assessment (MSSA), which was designed to assess (1) current primary problems with sleep, (2) sleep quality throughout military service (3) life events that may have impacted their sleep and (4) the specific events which most effected sleep.

Methods
A total of 69 military personnel (22 women and 47 men) completed the MSSA and 49 also completed a diagnostic polysomnogram (PSG). Chi-square tests were run to differences in responses between men and women.

Results
No significant differences were found between men and women. In general, sleep quality progressively decreased over a participant’s military career from 3 to 2 on a 5-point Likert scale (1=low, 5=high). For those with at least one deployment (n=52), 73% reported that deployment and 54% reported that a redeployment (return from deployment) negatively impacted sleep quality for 3 months. Women reported that permanent change of station (PCS) negatively impacted their sleep more frequently than men (36% vs. 28%). The reported events that most significantly impacted sleep quality were deployment, military service other than deployment and trauma.

Conclusion
The MSSA is a novel instrument that can be used to increase understanding of sleep disturbances in military men and women which can inform prevention and treatment strategies. This measure is being used to systematically evaluate the factors which may precipitate or perpetuate sleep disturbances in military men and women such as military service-associated factors, training, deployment history, changing stations, and exposure to trauma or other stressful life events.

Support
This study is supported by the Defense Health Agency, Defense Medical Research and Development Program, Clinical Research Intramural Initiative for Military Women’s Health.
0408 Myths About Infant, Child, and Adolescent Sleep: Addressing False Beliefs That Hinder Sleep Health During These Crucial Developmental Stages
Authors: Robbins R , Hale L , Beebe D , Wolfson A R , Grandner M A , Mindell J A , Owens J , Tapia I , Byars K C , Gruber R , Montgomery-Downs H , Wise M , Carskadon M A 
Published: May 2020

Abstract

Introduction
Sleep is vital for healthy development from infancy through adolescence. Despite its importance, false beliefs that conflict with scientific evidence (myths) may be common among caregivers and impair sleep health during these crucial stages.

Methods
Researchers compiled a list of potential myth statements using internet searches of popular press and scientific literature. We utilized a Delphi process with experts (n=12) from the fields of pediatric, sleep, and circadian research and clinical practice. Selection and refinement of myths by sleep experts proceeded in three phases, including: focus groups (Phase 1); email-based feedback to edit, add, or remove myths (Phase 2); and closed-ended questionnaires (Phase 3) where experts rated myths on two dimensions: (1) falseness and (2) public health significance using 5-point Likert scale: 1 (“not at all”) to 5 (“extremely false/important”).

Results
Thirty-two sleep myths were identified across three developmental categories: infant (14 myths), child (6 myths), and adolescent (12 myths). Mean expert ratings illuminated the most pressing myths in each developmental category: infant sleep (“Sleep training causes psychological harm, including reduced parent-child attachment:” falseness =4.7, s.d.=0.7; public health significance=4.0, s.d.=1.1); child sleep (“Heavy, loud snoring for my child means he’s sleeping deeply:” falseness=4.8, s.d.=0.6; public health significance=4.7, s.d.=0.7), and teenager sleep (“Falling asleep in class means your teenager is lazy and not motivated:” falseness=4.8, s.d.=0.5; public health significance=4.3, s.d.=0.8).

Conclusion
The current study identified commonly-held myths about infant, child, and adolescent sleep that are not supported by (or worse, counter to) scientific evidence. If unchecked, these myths may hinder sleep at a critical developmental stage. Future research may include public health education to correct myths and promote healthy sleep among infants, children, and teenagers.

Support
5T32HL007901
0426 Time Restricted Feeding Consolidates Sleep in the BACHD Mouse Model of Huntington’s Disease
Authors: Nichols I S , Chiem E , Tahara Y , Anderson S , Trotter D , Whittaker D , Ghiani C , Colwell C , Paul K 
Published: May 2020

Abstract

Introduction
Disturbances in the daily sleep-wake cycle are common in individuals with neurodegenerative disorders. Huntington’s disease (HD) is a genetic neurodegenerative disorder in which patients exhibit a variety of impairments that include, poor motor function, disrupted circadian rhythms, and sleep abnormalities such as difficulty initiating sleep at bedtime and more frequent nighttime arousals. In the BACHD mouse model time restricted feeding (TRF) has been successful at improving motor functions and circadian rhythms. The BACHD mouse model has a bacterial artificial chromosome that expresses the full-length human mutant huntingtin gene.

Methods
In order to determine the effects of TRF on sleep-wake architecture, EEG/EMG polysomnographic records were examined in mice between 3-4 months old bearing the BAC knock-in of a human genetic mutation of HD and WT litter mates, first during ad libitum (ad lib) feeding then during an 18 hour fasting protocol. TRF protocol consisted of 6 hours of food access limited between ZT15-ZT21 and 18 hours of fasting.

Results
A two-way ANOVA revealed that TRF significantly decreased the amount of total sleep (p=0.04) and NREM sleep (p=0.04) in the dark phase in both WT and BACHD mice. TRF did not significantly affect sleep in the light phase, however trends suggest that BACHD mice have more sleep in the light phase under TRF than ad lib.

Conclusion
This data suggests that TRF improves sleep by consolidating sleep to the light phase and wake to the dark phase. In conclusion, TRF may be a promising tool that can improve the negative effects of neurodegenerative diseases on sleep-wake processes.

Support
These experiments were supported by R01-NS078410 and UCLA start-up funds.
0430 Meta-Analysis on the Effects of Caffeine on Neurodegenerative Cognitive Decline
Authors: Taylor E , Killgore W D 
Published: May 2020

Abstract

Introduction
Mild cognitive impairment (MCI), Alzheimer’s disease (AD), and dementia are common forms of neurodegenerative cognitive decline in aging populations. Alertness, attention, and sleep patterns are often impaired in dementia and MCI and can affect ongoing cognition. Given the current lack of treatment options, it is important to identify protective factors. Caffeine is a commonly consumed substance which has been demonstrated in previous observational studies to have a protective effect on the onset of MCI and the progression of MCI to AD.

Methods
A meta-analysis of longitudinal prospective cohort studies published up to December 2017 was conducted comparing highest vs lowest reported category of caffeine consumption on neurodegenerative outcomes. Three databases were searched including PubMed, EMBASE, and Web of Science. Two investigators independently extracted data and assessed study quality. 13 studies were selected including 94880 participants. The effect size was reported as RRs with ORs and HRs treated as approximations of the RRs.

Results
A meta-analysis conducted using random effects showed a pooled RR of .84, 95% CI (0.75, 0.93) indicating a moderate protective effect in higher levels of caffeine consumption compared to lower levels. By outcome, AD had a RR of 1.14 with 95% CI (0.69, 1.90); dementia had a RR of 0.81 (0.72, 0.92); cognitive decline had a RR of 0.81 (0.55, 1.18); and MCI had a RR of 0.78 (0.65, 0.93).

Conclusion
Overall this meta-analysis suggests that compared with the lowest category, the highest caffeine intake category is inversely related to the incidence of age-related cognitive disorders, with this relationship being most apparent for dementia and MCI. Given that caffeine is well accepted and consumed widely in a variety of forms, caffeine in moderate doses, may prove beneficial in sustaining cognitive functioning. Further work will examine the hypothesis that increased alertness and attention with caffeine may sustain cognition through use dependent plasticity or circadian modulation.

Support
None