bluuebunny/crossref_metadata_2025_split huggingface dataset:
0819 Objective Sleep Efficiency is Associated with Longitudinal Risk of High Depressive Symptoms in Pregnant Women
Authors: Tsai S , Lee P , Gordon C , Cayanan E , Lee C 
Published: May 2020

Abstract

Introduction
Sleep disturbances are one of the most frequent complaints identified during routine prenatal care visits. Sleep and mood disturbances are often intertwined, and depression in particular is a leading cause of disability and disease burden worldwide. The purpose of this study was to examine the predictive association of objective actigraphic and subjective sleep disturbances with depressive symptoms in pregnant women.

Methods
We recruited 204 first-trimester pregnant women from a large university-affiliated hospital. They provided baseline socio-demographic and health information, wore a wrist actigraph for 7 days, and completed the Pittsburgh Sleep Quality Index and Center for Epidemiologic Studies - Depression Scale and repeated this again in the second and third trimesters. Each data collection was scheduled at least 8 weeks apart. Unadjusted and multivariable adjusted odds ratios with 95% confidence intervals were used to evaluate sleep disturbances at 1st trimester and risk of high depressive symptoms at follow-up.

Results
A total of 121 (59.3%) women had actigraphic sleep efficiency of &lt; 85% and 92 (45.1%) had Pittsburgh Sleep Quality Index global scores &gt; 5 indicative of poor sleep quality. In multivariable adjusted models, 1st trimester objectively measured sleep efficiency &lt; 85% was associated with 2.65-, 3.86-, and 5.27-fold increased odds having risk of high depressive symptoms at 2nd trimester, 3rd trimester, and both 2nd and 3rd trimesters, respectively. No subjective sleep disturbance variables were significantly associated with risk of high depressive symptoms in multivariate adjusted models.

Conclusion
Objectively assessed poor sleep efficiency in the 1st trimester plays a crucial role in the development of both elevated and persistent high depressive symptoms in pregnancy. Future studies using objective sleep measurements and clinical diagnostic interviews are warranted to examine whether early interventions to improve sleep may help reduce high depressive symptom risk and lower depression rates in women during pregnancy.

Support
This study was funded by the Ministry of Science and Technology, Taiwan (MOST-101-2314-B-002-049-MY3).
0821 Gender Differences in Sailor Well-Being, Sleep-Related Behaviors, and Psychomotor Vigilance Performance in the United States Navy
Authors: Shattuck N L , Matsangas P 
Published: May 2020

Abstract

Introduction
Approximately 18% of US Navy sailors are females. Research has shown gender-related differences in the prevalence of sleep disorders in active duty personnel (Foster et al., 2017). Specifically, insomnia, depression, and anxiety are more prevalent in females, while obstructive sleep apnea is more prevalent in males. We have studied the sleep patterns and fatigue levels of crew members on more than 30 US Navy ships. The current study focuses on gender differences in well-being, sleep-related behaviors, and psychomotor vigilance performance of sailors in the US Navy.

Methods
Using a longitudinal, naturalistic observation paradigm, data were collected from crewmembers on nine USN ships while performing their normal underway duties. Participants (N=1,056) tended to be young (on average 27 years of age), predominantly male (80.6%), and enlisted (84.8%). We assessed average daytime alertness (Epworth Sleepiness Scale), insomnia symptoms (Insomnia Severity Index), mood (Profile of Mood States), and sleep quality (Pittsburgh Sleep Quality Index). Sleep was assessed with actigraphy and logbooks. Sailors performed a 3-minute version of the Psychomotor Vigilance Task (PVT), which was built into their wrist-worn actigraph.

Results
Compared to males, female sailors reported more depressive symptoms (p=0.042) and less vigor (p&lt;0.001). Females slept more (daily sleep duration: p&lt;0.001) but their sleep was split into more episodes than their male counterparts (p=0.029). Fewer females reported a regular exercise routine (p=0.033). In addition, females report consuming fewer energy drinks (p=0.007), and using fewer nicotine products (p=0.013). Lastly, consistent with findings from civilian populations, female sailors had slower reaction times on the PVT (p&lt;0.001) and experienced more lapses combined with false starts (p&lt;0.001) than their male counterparts.

Conclusion
Compared to their male peers, female sailors tend to report higher levels of depression and lower levels of vigor. They experience more pronounced split sleep, are less likely to report having an exercise routine, and have poorer performance on the PVT. Fewer females report using energy drinks and nicotine products.

Support
This research was supported by the Naval Medical Research Center’s Advanced Medical Development Program, the US Navy 21st Century Sailor Office, and the US Navy OPNAV N1.
0833 Midlife Sleep Health is Associated With Later-Life Depression and Anxiety
Authors: Hagen E W , Barnet J H , Sprecher K E , Peppard P E 
Published: May 2020

Abstract

Introduction
Several aspects of sleep - collectively conceptualized as ‘sleep health’ - are associated with anxiety and depression. This study investigated whether specific components of sleep health experienced during midlife are associated with depression and anxiety symptoms in later life.

Methods
A subset of Wisconsin Sleep Cohort participants (n=616; 45% female; mean [SD] baseline age=55 [8] years) completed 4 study visits at 4-year intervals. Visits included polysomnography and questionnaires about sleep, mood, and health. Outcomes (Zung depression score, State and Trait Anxiety) were regressed on sleep health characteristics (AHI, %N3 sleep, %REM sleep, sleep efficiency, sleep latency, sleep duration, sleep debt, nap duration, insomnia symptoms, circadian preference, excessive daytime sleepiness [EDS], Epworth Sleepiness Scale [ESS]) using 2 types of linear models adjusting for age, sex, BMI, education, exercise, smoking, and caffeine consumption: 1) longitudinal models in which baseline sleep health predicted mood outcomes 12 years later (adjusting for baseline levels of the outcome variable), and 2) models in which 12-year change in sleep health predicted 12-year change in outcomes.

Results
Longer nap duration, evening circadian preference, and EDS during midlife were associated with worse depression scores in later life. 12-year increases in nap duration, EDS, and ESS were associated with 12-year worsening of depression. Longer sleep duration and greater EDS during midlife were associated with worse trait anxiety in later life. 12-year increases in sleep duration, nap duration, insomnia symptoms, EDS and ESS were associated with 12-year worsening of trait anxiety. Greater AHI and EDS during midlife were associated with worse state anxiety in later life. 12-year increases in ESS were associated with worsening state anxiety. (P&lt;0.05 for all reported results.)

Conclusion
Multiple aspects of sleep health experienced during midlife are associated with greater depression and anxiety in later life.

Support
NIH grants: National Institutes of Aging (R01AG058680; R01AG036838); National Heart, Lung, and Blood Institute (R01HL62252); National Center for Research Resources (1UL1RR025011)
0853 Fetal Heart Rate Variability Increases During Maternal Sleep Apnea Events
Authors: Pien G , Bei J , Watson H , Sgambati F , Raghunathan R , Henderson J , DiPietro J M 
Published: May 2020

Abstract

Introduction
While studies have established that SDB during pregnancy increases the risk of adverse maternal outcomes, fetal effects are less well studied. Evidence suggests that fetal heart rate decelerations, an indicator of fetal distress, may be elicited by SDB. We examined the relationship between maternal SDB events and fetal heart rate (FHR) and fetal heart rate variability (FHRV).

Methods
Obese (BMI≥30kg/m2) non-smoking women carrying singleton fetuses underwent overnight polysomnography (34-37 weeks gestational age), with simultaneous fetal heart rate monitoring. Standard methods were used to score sleep, SDB events (apneas/hypopneas) and to analyze fetal heart rate parameters. Using linear mixed effect models, we examined changes in mean FHR and FHR variability (expressed by FHR SD) between the 10-second period immediately before individual SDB events, during events to the end of the associated oxygen desaturation period, and the 10-second period immediately following the SDB event.

Results
Valid PSG and FHR data were obtained from 85 third trimester maternal-fetal dyads. Across all participants, there were 2779 maternal SDB events (apneas or hypopneas). Mean AHI for individual subjects was 9.04 (SD 13.75). 39 women had OSA (AHI≥5), which was mostly mild. Mean FHR did not change significantly during and after episodes of SDB episodes compared to pre-event FHR, and did not change afterwards compared to during events, in unadjusted or adjusted (sleep stage, apnea type, degree of desaturation, age) analyses. In unadjusted analyses, FHRV significantly increased during SDB episodes compared to pre-SDB FHRV. After SDB events, FHRV was significantly lower than during SDB events. In fully adjusted models, these findings remained highly significant. FHRV was not significantly different after SDB events compared to pre-SDB event FHRV in unadjusted or adjusted models.

Conclusion
We observed consistent changes in FHR variability during and after maternal SDB events. Mean FHRV significantly increased during maternal SDB episodes compared to baseline FHRV, and decreased after SDB episodes. In contrast, mean FHR did not change significantly before, during and after SDB episodes. These data demonstrate that the fetus reacts to maternal SDB events, and raise questions about persistent effects of maternal SDB on the developing fetus.

Support
NIH HD079411
0864 Race/ethnicity And Sex-dependent Effects Of Metabolic Burden Across Different Age-categories On Trends In Self-reported Sleep Duration: Findings From The National Health Interview Survey, 2004-2013
Authors: Eirene O , Bubu O M , Donley T , Blanc J , Madera C , Turner A , Mbah A K , Williams N J , Youngstedt S , Shochat T , Seixas A A , Osorio R S , Jean-Louis G 
Published: May 2020

Abstract

Introduction
We examined race and sex-dependent effects of metabolic burden across different age-categories on trends in self-reported sleep duration for the U.S. non-institutionalized civilian population.

Methods
We analyzed data from the National Health Interview Survey (NHIS) adults aged 18-85 from 2004 to 2013 (N=258,158). Metabolic burden was characterized by obesity (BMI&gt;30), dyslipidemia, diabetes, and hypertension morbidity burden levels. Racial/ethnic categories included non-Hispanic Whites (NHW), Blacks/African Americans (AAs) and Hispanics. Sleep duration within a 24-hour period on average was categorized as short sleep (≤ 6hrs), adequate sleep (7-8 hrs.), and long sleep (≥ 9hrs). Age was categorized as 18 - &lt;26, 26 - &lt;65 and 65 - 85. Adjusted multinomial logistic regression models stratified by race, sex and age-categories examined effects of metabolic burden on trends in self-reported sleep duration.

Results
The prevalence of short sleep duration was relatively stable from 2004-2012 for NHW and all females. However, AA and Hispanic males showed consistent increase in the rates of short sleepers beginning in 2007 through 2013 especially for ages 18 - &lt;26, and 26 - &lt;65 (P &lt;.001 for trend). For all racial/ethnic categories, compared to individuals aged 18 - &lt;26, individuals aged 26 - &lt;65 were more likely to report short sleep (aOR: 1.55, 95% CI: 1.50-1.61) and individuals aged 65 - 85 were more likely to be long sleepers (aOR: 1.95, 95% CI: 1.86-2.05). Interestingly, the rate of short sleep increased as the metabolic burden increased (P &lt;.001 for trend). This trend was more pronounced among AA and Hispanic males aged 65 - 85 with ≥ 2 metabolic conditions who were more likely to report short sleep (aOR: 1.77, 95% CI: 1.44-2.19 and aOR: 1.45, 95% CI: 1.17-1.93 respectively), compared to NHW males.

Conclusion
Increased metabolic burden among minority populations and especially in the elderly male, affect sleep and may have consequences for treating these populations.

Support
NIH/NIA/NHLBI (L30-AG064670, CIRAD P30AG059303 Pilot, T32HL129953, R01AG056531, R25HL105444, R25NS094093, K07AG05268503, R01HL142066, K23HL125939)
0867 Gender Differences In The Relationship Between Exercise And Sleep In Young Adults
Authors: Glavin E , Spaeth A M 
Published: May 2020

Abstract

Introduction
Exercise is widely prescribed as a behavioral treatment for sleep health, but generalizations about the benefits of exercise for sleep do not typically consider gender differences. The present study examined relationships between exercise frequency and self-reported sleep outcomes in undergraduate men and women.

Methods
Students were recruited from campus fitness facilities immediately after they finished a workout (N=829, 19.5±1.4 y, 38.5% Female) and completed demographic, Pittsburgh Sleep Quality Index (PSQI) and exercise questionnaires. Department of Health and Human Services Physical Activity Guidelines for Americans were used to dichotomize students into those who met recommendations for weekly aerobic and strength training exercise and those who did not. Multiple regression was used to examine the relationships between exercise frequency and PSQI outcomes and analysis of variance was used to compare PSQI outcomes by gender and exercise guideline groups.

Results
Compared to women, men reported more days of exercise, fewer days of aerobic exercise, more days of strength training, better sleep efficiency and later bedtimes (ps&lt;0.05). Among all participants, exercise frequency associated with an earlier bedtime, higher sleep efficiency, less daytime dysfunction and better sleep quality (ps&lt;0.05). When divided by gender, exercise frequency associated with an earlier bedtime and better sleep quality in women (ps&lt;0.05) but not men and associated with less daytime dysfunction in men (p=0.012) but not women. Approximately 47% of participants met exercise guidelines for both aerobic and strength training. Participants who met the guidelines exhibited an earlier bedtime (p=0.01) and higher sleep efficiency (p=0.08) than those who did not. There was also a significant interaction effect for sleep latency (p=0.042) such that meeting the guidelines associated with a shorter sleep latency in men (p=0.006) but not women.

Conclusion
These findings highlight the importance of taking an individual’s gender and specific sleep issue into account when implementing an exercise prescription to improve sleep.

Support
Rutgers University Aresty Foundation
0872 Correlates Of Restless Sleep Among Female Sex Workers In Baltimore, MD
Authors: Urquhart G J , Spira A P , Park J N , Sherman S G 
Published: May 2020

Abstract

Introduction
Sleep quality is understudied among street-based female sex workers (FSW), a population characterized by high rates of structural vulnerability. FSW may be at higher risk for poor sleep due to food and housing insecurity, violence, substance use and irregular work hours. We studied correlates of restless sleep in an urban, street-based risk environment.

Methods
Data are from a year-long observational prospective cohort study of street-based FSW (n=250) in Baltimore, MD. Baseline survey data, collected April 2016 to February 2017, included topics such as structural vulnerability, mental and physical health, substance use and lifetime violence. Sleep was measured with item 7 on the CES-D-10 Scale; respondents indicated how many days in the past week their sleep was restless (&lt; 1 day, 1-2 days, 3-4 days, 5-7 days). We conducted bivariate and multivariable logistic analysis to identify correlates of experiencing 5-7 days of restless sleep vs. fewer.

Results
Median age was 35 years. Most (66%) were Non-Hispanic White, 62% were homeless, 61% reported food insecurity, and 65% injected heroin. We documented a high prevalence of trauma; 81% reported lifetime sexual or physical violence by family members, intimate partners, paying clients, or police officers, and 62% screened positive for PTSD on the PCL-5 Checklist. 54% reported 5-7 days of restless sleep in the past week. Independent associations with frequent restless sleep included older age (age 35+ aOR: 2.67 [1.64-4.36]), food insecurity (aOR: 2.02 [1.42-2.88]), self-reported poor health (aOR: 3.98 [1.99-7.96]), and lifetime violence: a greater number of violent experiences corresponded with higher odds of restless sleep (1-2 vs. 0 experiences aOR: 2.38 [1.43-3.99], 3-4 vs. 0 experiences aOR: 3.67 [2.22-6.05]).

Conclusion
These data demonstrate high prevalence of restless sleep among street-based FSW with higher risk among those who experience intersecting vulnerabilities and multiple exposures to violence. Trauma-informed structural interventions may improve sleep quality among this population.

Support
This work was supported by the National Institute of Drug Research (R01DA038499-01).
0874 Patients with Congenital Central Hypoventilation Syndrome Do Not Wake Up to Ventilator Alarms
Authors: Mathur S K , Kun S , Keens T G , Perez I A 
Published: May 2020

Abstract

Introduction
Congenital Central Hypoventilation Syndrome (CCHS) requires lifelong ventilatory support during sleep. CCHS patients are vulnerable to sleep disturbances associated with treatments, monitoring alarms, and care they receive. We hypothesized that sleep would be disrupted in CCHS patient’s due to ventilatory support and other treatments at night.

Methods
An anonymous survey of CCHS patients aged 0-17 years was conducted through REDCAP. Patients were recruited in person, by flyer, email, and social media. Data collected included demographics, PHOX2B genotype, ventilatory support, treatments, nursing, and sleep parameters.

Results
We received 22 responses (27% Female, 8.1 years ± 5.7). PHOX2B genotypes were 20/27 PARM (8), 20/26 PARM (2), 20/24 PARM (2), 20/25 PARM (4), ≥ 20/28 PARM (2), and 2 NPARM (2). Two respondents did not indicate the PHOX2B genotype. 13/22 were ventilated by PPV via tracheostomy, 7/22 by BPAP, and 2/22 by diaphragm pacing. Additional treatments received at night included suctioning (8), aerosol (1), G-tube feeding (2), and none (11). Only 9 received nursing at night. 13 used pulse oximetry for monitoring, and 9 used both pulse oximetry and end tidal CO2 monitor. 16/22 rarely woke up due to ventilator or monitor alarms. 15/22 slept within 20 minutes after going to bed. Sleep latency was not affected by mode of ventilation. 11/22 reported night waking ≥ 2 nights/week and 10/22 returned to sleep without help after night waking. 6/7 BPAP dependent patients reported low frequency of night waking (0-1 time/week). Of the PPV + trach group, 7/13 reported high frequency of night wakings, mostly 5-7 times/week.

Conclusion
Most CCHS patients do not awaken in response to ventilator alarms. Sleep is rarely disrupted by nursing or feeding intervention. We speculate that CCHS patients contemplating to live independently should be tested to see if they awaken in response to ventilator alarms.

Support
None
0879 Outcomes of Adenotonsillectomy in Children with Down Syndrome and Obstructive Sleep Apnea
Authors: Morello Gearhart A , Gunaratnam B , Senthilvel E 
Published: May 2020

Abstract

Introduction
Obstructive sleep apnea (OSA) is highly prevalent in children with Down Syndrome (DS). The aim of this study was to assess the effectiveness of adenotonsillectomy (T&A) on polysomnographic parameters of children with DS.

Methods
Retrospective chart review of children with DS who underwent T&A between 2012-2019 was performed. Preoperative OSA severity was categorized by obstructive apnea-hypopnea index (OAHI): mild = 1-4.9 events/h; moderate = 5-9.9 events/h; severe ≥ 10 events/h.

Results
We identified 43 DS children with pre and post T&A polysomnographic data in a population of 162 DS patients. A total of 25 were male, mean age 5.1 years (± 3.8 years) and 56% Caucasians. Preoperative data showed 19% mild OSA, 30% moderate and 51% severe. Postoperatively, apnea-hypopnea index (AHI) normalized in 9.3%, 37.2% had mild OSA, 18.6% moderate and 34.9% severe. Overall, T&A resulted in significant improvement (p-value &lt;0.05) in mean AHI, (18.51 ± 28.05 vs 11.72 ± 16.43), SaO2 nadir (80.00 ± 14.82 vs 85.51 ± 5.94), sleep efficiency (81.97 ± 11.15 vs 85.9 ± 8.28), arousal index (16.14 ± 10.23 vs 14.45 ± 12.34), and wake after sleep onset (67.19 ± 46.89 vs 50.55 ± 40.83) and no statistical difference (p-value &gt;0.05) in end-tidal carbon dioxide (43.86 ± 9.56 vs 44.17 ± 3.78), Rapid Eye Movement (REM)% (15.86 ± 7.75 vs 15.92 ± 7.41), sleep latency (24.03 ± 34.39 vs 22.55 ± 21.11), and central apnea index (0.86 ± 1.38 vs 0.66 ± 0.82) in pre and post T&A data. There was no statistically significant difference in pre and post T&A polysomnographic parameters between 17 DS and 17 age and gender-matched non-DS control subjects.

Conclusion
Adenotonsillectomy resulted in improvement in AHI, oxygen desaturation nadir, sleep efficiency, arousal index and wake after sleep onset. However, a significant portion of children with DS continued to have moderate to severe OSA after T&A.

Support
None.
0881 Clinical Evaluation of Adeno-Tonsillar Hyperplasia in Non-Syndromic Children and Adolescents During Growth Hormone Treatment
Authors: Nasser R , Vervloet T , Eckley C A , Amade S , Dokkedal-Silva V , Pires G N , Andersen M L , Tufik S , Longui C , Xavier S D 
Published: May 2020

Abstract

Introduction
Recombinant human Growth Hormone (rhGH) is an important pharmacological agent for linear growth stimulation and body composition in children with growth hormone deficiency (GHD). However, reports indicate that treatment with rhGH can be associated with adeno-tonsillar hyperplasia. This condition can lead to occurrence of obstructive sleep apnea (OSA) and worsening of sleep and life quality. Nonetheless, studies assessing this outcome in non-syndromic children are scarce.

Methods
We evaluated the difference in size of pharyngeal and palatine tonsils in patients aged between 5 and 17 being treated with recombinant human Growth Hormone (rhGH). We conducted a prospective longitudinal observational study. Twelve patients in treatment with rhGH were evaluated by otorhinolaryngological physical examination, nasofibrolaryngoscopy and obstructive sleep apnea (OSA)-18 questionnaire in two different time-points: when selected (T0) and after 6 months (T1).

Results
No significant associations were found regarding palatine and pharyngeal tonsil size with rhGH treatment. In relation to OSA 18 questionnaires, there was no statistically significant result in the absence of covariables for the general score as well as for the five domains that it comprises. When covariables were included in the analyses, controlled by the patients age, we observed statistically significant increases in the general score and in the domains relating to sleep disorders, emotional suffering, diurnal problems and the caretaker′s concerns.

Conclusion
In the present study, pharyngeal or palatine tonsils hyperplasia were infrequent during treatment with rhGH in the non-syndromic children and adolescents. However, the impact on sleep and quality of life that may arise warrant careful monitoring during therapy.

Support
Associação Fundo de Incentivo à Pesquisa (AFIP).