bluuebunny/crossref_metadata_2025_split huggingface dataset:
1048 Prevalence Of Positional Obstructive Sleep Apnea (OSA) In Patients With OSA-COPD Overlap Syndrome
Authors: Rani S , Rengan R , Mandal M , Ramzy J , VegaSanchez M , Jaffe F , Solar X , D’Alonzo G , Criner G J , Chatila W , Shariff T , Weaver S , Krachman S 
Published: May 2020

Abstract

Introduction
Positional OSA (non-supine apnea-hypopnea index [AHI] &lt; 5 events/hr) is present in 30% of patients with OSA. We demonstrated that in patients with OSA- COPD overlap syndrome the AHI inversely correlated with the degree of gas trapping, suggesting a stabilizing effect on the upper airway. We hypothesized that sleep position would be less important, resulting in a lower prevalence of positional OSA.

Methods
Patients underwent a polysomnogram that demonstrated OSA (AHI &gt; 5 events/hr). To confirm COPD, patients had spirometry performed and a chest computed tomography for measurements of percent gas trapping.

Results
Sixteen patients [6 (38%) males, 55±7 years/old, FEV1 1.2±0.5 L, FEV1 % Predicted 45±19%, FVC 2.3±0.8 L, FVC % Predicted 69±20%, FEV1/FVC 51±12%, BMI 33±9 kg/m2)] were diagnosed with OSA (AHI 15±12 events/hour). Four patients (25%) had positional OSA (AHI 13±6 events/hr, non-supine AHI 1±1 event/hr) compared to 12 patients who were non-positional [AHI 16±13 events/hr (p=0.95)]. There was no difference in age [52±8 and 56±7 yrs (p=0.3)] or severity of obstruction in those with and without positional OSA [FEV1 1.4±4 L and 1.1±0.5 L, (p=0.3), FEV1 % predicted 50±17% and 44±20%, (p=0.7), FVC 2.9±0.8 L and 2.1±0.8 L (p=0.1), FVC % predicted 78±21% and 66±20%, (p=0.3), and FEV1/FVC 50±11% and 51±12%, (p=0.8), respectively]. However, patients with positional OSA were less heavy than those with non-positional OSA [BMI 23±3 and 37±8 kg/m2, respectively (p=0.005)]. Finally, there was no difference in the CT-Derived % Gas Trapping in those with and without positional OSA [48±37% and 36±25%, (p=0.6), respectively].

Conclusion
The prevalence of positional OSA in patients with OSA-COPD overlap is similar to OSA patients without COPD. Despite the presence of obstructive disease and gas trapping that may affect upper airway stability, other factors including body position and BMI remain important determinants for developing OSA in patients with COPD.

Support
R01-HL089856, R01-HL089897
0107 Neurocognitive Functioning in Individuals with Comorbid Insomnia and Sleep Apnea: Baseline Functioning and Impact of Treatment
Authors: Turner A D , Ong J , Tu A , Crawford M 
Published: May 2020

Abstract

Introduction
Neurocognitive impairments are common in individuals with insomnia and sleep apnea separately, however, the evidence for impairment in comorbid insomnia and sleep apnea (COMISA) is much less clear. We aim to determine a neurocognitive profile for individuals with COMISA, and evaluate the benefits of treatment on neurocognitive performance.

Methods
Participants with COMISA (n=45; 51.1% female; mean age=52.07±13.29) were from a two-phase, 3-arm randomized clinical trial combining Cognitive Behavioral Therapy for insomnia (CBT-I) with Continuous Positive Airway Pressure (CPAP) administered sequentially or concurrently compared to CPAP alone. The unique groups from this factorial design were used to establish baseline impairment and the effects of treatment on neurocognitive functioning.

Results
Individuals with COMISA had a slower reaction time (365.66±157.39) and more lapses (9.70±16.16) on the Psychomotor Vigilance Task than has been reported in the literature for insomnia and OSA separately. Our COMISA participants had mean scores indicating mild impairment for their age, based on normative data, on digit span (9.71±2.47 forward; 3.95±2.63 backward), verbal paired associates (27.71±11.54 immediate; 8.69±3.16 delayed; 37.17±2.97 recognition), Digit Symbol Substitution (68.83±12.33) and the Stroop (35.46±7.26 color/word; -3.19±7.5 interference). The only significant treatment outcome was in the acute effect after CBT-I on digit span forward (1.7 fewer digits remembered after CBT-I vs. 0.2 fewer after no treatment, t(32)=-2.1, p=0.047). This effect was no longer significant after controlling for multiple comparisons.

Conclusion
This is the first study to report baseline neurocognitive impairments and effects after treatment for individuals with COMISA. Baseline impairments appear to be more significant than reported in the literature for conditions individually and published norms. Results indicate a worsening in neurocognitive functioning after CBT-I, however the numbers within the groups are small, and this effect disappears after controlling for multiple comparisons. Future studies are necessary to provide a conclusive answer regarding the effects of treatment on neurocognition.

Support
NIH/NHLBI (R01 HL114529-03S1) Ong 1/7/2015 - 6/30/2017 Project Title: Multidisciplinary Treatment for Obstructive Sleep Apnea and Insomnia - Research Supplement to Promote Diversity in Health-Related Research
0108 Brief Periods of Sleep and Quiet Rest Equivalently Benefit Memory Consolidation
Authors: Baker K C , Wang S Y , Culbreth J L , Morris S C , Arora M J , Tracy O J , Liu T J , Collins M B , Wamsley E J 
Published: May 2020

Abstract

Introduction
Past research has demonstrated that sleep benefits the consolidation of memories. However, more recent studies have suggested that quiet rest could have similar benefits for memory. Here, we examined the effect of a brief period of sleep, quiet rest, or active wakefulness on declarative and procedural memory. We hypothesized that sleep and quiet rest would equally benefit memory, compared to a period of active wakefulness.

Methods
After completing a declarative (Icelandic-English word pairs) and procedural memory task (the Motor Sequence Task (MST)), participants began a 30-min retention period with PSG monitoring, in which they either slept (n=24), quietly rested with their eyes closed (n=22), or completed a distractor task (n=28). Following the retention period, participants were tested on the same memory tasks they completed earlier.

Results
Percent improvement on the MST from the end of training to the end of the test session differed by condition, F(2, 73)=4.21, p=.019. Sleep and quiet rest led to nearly identical improvement (p=.95), with improvement in both of these conditions being significantly greater than in active wake (sleep vs. active wake: p=.01; quiet rest vs. active wake: p=.02). Similarly, retention of the Icelandic-English word pairs differed by condition (F(2, 73)=5.68, p=.005), with sleep and quiet rest demonstrating nearly identical memory change over time (p=.81), and retention in both of these conditions being significantly higher than in active wake (sleep vs. active wake: p=.007; quiet rest vs. active wake: p=.004).

Conclusion
These data suggest that sleep and quiet rest can exert an equivalent effect on memory consolidation for both declarative and procedural memory, at least across very brief retention durations. Therefore, neurobiology specific to sleep might not be necessary to induce offline improvement in memory across short intervals.

Support
This research was supported by National Institutes of Health Award R15MH107891.
1083 Nightmares Are Negatively Associated With Immediate Memory And Visuospatial Performance In Individuals With Ptsd
Authors: Bullock A , Burns A , Alkozei A , Taylor E , Grandner M , Killgore W 
Published: May 2020

Abstract

Introduction
Disturbing dreams and nightmares are common in individuals with post-traumatic stress disorder (PTSD). At present, little research has investigated the associations between nightmares and cognition in these individuals. However, a robust body of research has shown memory and attention impairments among those with PTSD. The present study sought to investigate the potential relationships between cognitive performance and nightmares in this population.

Methods
Seventy-five individuals (49 female; Mage=31.8, SDage=8.8) were administered the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the PTSD Checklist for the DSM-5 (PCL-5), the Insomnia Severity Index (ISI), the Functional Outcomes of Sleep Questionnaire (FOSQ), the Clinician-Administered PTSD Scale (CAPS), and the Disturbing Dreams and Nightmares Index (DDNSI). Five linear regressions were conducted with index scores on the RBANS subscales (immediate memory, visuospatial/constructional, language, attention, and delayed memory) as the dependent variables and PCL-5, ISI, FOSQ, CAPS symptom class subscales (intrusion, avoidance, cognition, and arousal), and DDNSI scores entered stepwise.

Results
A linear regression revealed that nightmares predicted 15% of the variance in RBANS immediate memory scores (R2 change=.152, β=-.390, p=.003). A second linear regression revealed that nightmares predicted 9.6% of the variance in RBANS visual memory scores (R2 change=.096, β=-.310, p=.019). No other independent variables added to either model. None of the independent variables predicted any variance in language, attention, or delayed memory scores.

Conclusion
Our analysis revealed a unique contribution of nightmares to immediate memory and visuospatial performance in individuals with PTSD. This finding was not better explained by variation in PTSD severity or sleep. Because sleep and dreams are implicated in memory consolidation, one explanation for our finding is that highly distressing trauma-related dreams (i.e. nightmares) may lack the same memory-improving qualities as ordinary dreams. Additionally, given that immediate memory and visuospatial functioning utilize working memory, perhaps nightmares and deficits in working memory share similar mechanisms.

Support
W81XWH-14-1-0570
1105 A Randomized Controlled Trial of a Psychological Intervention for Decreasing Bedtime Procrastination: The BED-PRO Study
Authors: Suh† S , Kim G , Jeoung S , An H 
Published: May 2020

Abstract

Introduction
Bedtime Procrastination (BP) is defined as the behavior of going to bed later than intended, without having external reasons for doing so. Previous studies have shown that BP has a negative effect on sleep and health, and there is a need to develop interventions to decrease BP. This study (BED-PRO) is an ongoing study evaluating a behavioral intervention to reduce BP.

Methods
Fifteen participants who scored higher than 33 on the Bedtime Procrastination Scale were randomized to either the treatment (TRT, n=6) or control group (CTRL, n=9). Treatment consisted of four face-to-face individual sessions. All participants completed self-report questionnaires on Bedtime Procrastination Scale (BPS), Epworth Sleepiness Scale (ESS), Positive Affect and Negative Affect Schedule (K-PANAS-R) and completed the 7-day sleep diary. Data was analyzed using two-way mixed Measures Analysis of Variance (ANOVA).

Results
Mean age of the participants was 21.78 (±1.8) years and 80% (n=12) were females. Group by time interactions from repeated measures analyses revealed significant post intervention improvements in the TRT group compared to the CTRL group on all bedtime procrastination duration and scores, sleep efficiency, refreshment after waking, daytime sleepiness and negative affect of K-PANAS-R. Specifically, bedtime procrastination duration in the TRT group measured by sleep diaries decreased significantly from 75.30 (±58.57) min to 14.83 (±7.83) min, while the CTRL group did not change from 57.60 (±32.01) to 54.36 (±40.82) min (p=0.019). In addition, the TRT group reported significant improvements in bedtime procrastination scores from 36.00 (±4.05) to 22.50 (±6.72).

Conclusion
Based on results, the behavioral intervention used in this study looks promising in improving bedtime procrastination and sleep.

Support
This work was supported by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea(NRF-2018S1A5A8026807)
1116 Interactions Among Interoceptive Sensitivity And Insomnia Symptoms In Individuals With Generalized Anxiety Disorder
Authors: Daffre C , Oliver K I , Valli B , Kleckner I , Pace-Schott E F 
Published: May 2020

Abstract

Introduction
Abnormal interoception is believed to contribute to anxiety disorders as well as possibly to Insomnia Disorder. We therefore hypothesized that interoceptive sensitivity in persons with Generalized Anxiety Disorder (GAD) would vary with sleep quality and would differ between GAD patients with and without insomnia.

Methods
29 subjects (86% female) who reported GAD-7 scores ≥ 10 underwent psychiatric and sleep-disorders interviews and met DSM-5 criteria for GAD. Participants were assigned into an insomnia group if the Insomnia Severity Index (ISI) score exceeded 12 (N=18) or a non-insomnia group if ISI score &lt; 11 (N=11). Participants completed approximately 2 weeks of actigraphy and sleep diaries (mean=14.09 days; SD=4.85) as well as online surveys of sleep quality including the Pittsburg Sleep Quality Index (PSQI) and interoceptive sensitivity including the Multidimensional Assessment of Interoceptive Awareness, the somatic anxiety scale of the State-Trait Inventory for Cognitive and Somatic Anxiety-Trait (STICSA-T) and the Anxiety Sensitivity Index. In addition, 28 participants underwent the Schandry heartbeat-counting task, an objective measure of interoceptive sensitivity.

Results
GAD-7 scores did not differ between insomnia and non-insomnia groups (t(18.36)=0.074, p = 0.941). However, insomniacs reported significantly higher scores on the somatic anxiety scale of the STICSA than non-insomniacs (t(17.71)=2.094, p=0.051). STICSA-T somatic anxiety scores positively correlated with greater PSQI scores (R=0.588; p=0.002) and trended negatively with actigraphy sleep-efficiency (R = -0.384; p=0.085). Non-insomniacs outperformed insomniacs in the Schandry task (t(25.9)=2.21, p=0.036). Higher Schandry scores were positively correlated with greater total sleep time (R=0.515; p=0.014) and lower ISI scores (R= -0.387; p=0.042).

Conclusion
Results suggest that GAD patients with insomnia have lesser objective interoceptive sensitivity and more subjective somatic anxiety than those without insomnia. Greater somatic anxiety predicted poorer subjective and objective sleep quality. Hence interoceptive sensitivity may vary with sleep disturbance in GAD.

Support
R21MH115279
1137 Sleep Duration, Physical Activity And Cognitive Decline In Chinese Older Adults: Findings From The CHARLS
Authors: Li J , Alfini A J , Yu F , Schrack J A , Cotter V , Taylor J L , Spira A P 
Published: May 2020

Abstract

Introduction
Lack of physical activity and disturbed sleep have been linked to older adult’s poor cognitive outcomes; however, little is unknown how they interact to affect cognition long-term. The purpose of this study was to examine the association of baseline sleep duration and physical activity (PA) with change in cognition independently and interactively over four years.

Methods
The sample included 1126 community-dwelling older adults aged 60+ (mean age 67.1±5.9 years, 51% female) from the 2011 baseline and 2015 follow-up data of the China Health and Retirement Longitudinal Study (CHARLS). All variables were assessed through interviews. Sleep duration was measured with hours per 30-minute interval and categorized as very-short (&lt;5h), short (5-6.5h), normal (7-8.5h), and long (≥9h). PA was calculated based on PA intensity, duration, and number of days. Cognition was a composite score of mental capacity, episodic memory, and visuospatial abilities. Data were analyzed using multiple regression (primary outcome: change in cognition; main independent variables: baseline sleep, PA, and sleep PA interaction).

Results
At baseline, 19% of participants had very-short sleep duration, 34.4% had short sleep, 39.2% had normal sleep, and 7.2% had long sleep. At follow-up, 57.5% of participants experienced cognitive decline (-3.5±2.5). After controlling for age, gender, education, region, body mass index, smoking, drinking, number of chronic conditions, pain, depression, and cognition at baseline, compared to participants reporting 7-8.5h sleep, those with ≥9h sleep had significantly greater decline in cognition [β=-1.4, 95% CI=2.4, -0.4], while those with &lt;5h sleep [β=-0.5, 95% CI=-1.2, 0.2] and 5-6.5h sleep did not [β=-0.1, 95% CI=-0.7, 0.5]. PA was neither associated with cognitive decline, nor moderated the relationship between sleep duration and cognitive decline.

Conclusion
Long sleep might be a marker of cognitive decline in older adults. Prospective analysis, using objectively measured PA and sleep should be conducted to further examine these associations.

Support
National Institute of Nursing Research R00NR016484
0116 Opposing Effects of Sleep on The Misinformation Effect: Sleep Promotes and Prevents Memory Distortion
Authors: Day A J , Fenn K M 
Published: May 2020

Abstract

Introduction
The effect of sleep on false memory is equivocal. In the Deese-Roediger-McDermott illusory memory paradigm, some work shows that sleep increases false recall whereas other work shows that sleep decreases false recognition. Given these ambiguous findings, we sought to investigate the effect of sleep on false memory using the misinformation paradigm.

Methods
Participants watched a short film depicting a home burglary, received misinformation about the film, and were tested on their memory for the film. The recognition test was given after a 12-hour retention interval that included either sleep or wake. We manipulated the time at which participants received misinformation. Half were given misinformation after encoding (before sleep or wake) and the other half were given misinformation after the retention interval (after sleep or wake).

Results
There was a main effect of condition on correct recognition; participants in the sleep group showed higher correct recognition than those in the wake group. On false memory, there was a main effect of timing of misinformation and an interaction between condition and timing of misinformation. That is, the effect of sleep on false memory depended on when misinformation was administered. If misinformation was given after the retention interval, false memory tended to be lower after sleep than wake whereas if misinformation was given before the retention interval, false memory tended to be higher after sleep than wake.

Conclusion
Sleep can both protect against and facilitate memory distortion depending on when misinformation is encountered. These results inform our understanding of consolidation processes. When consolidation acts on true memory alone, it strengthens that memory making it resistant to distortion. Conversely, when misinformation is presented before consolidation, sleep may integrate misinformation into memory for the true event, increasing distortion. This work has important theoretical implications for memory consolidation and important applied implications for interrogation practices.

Support
N/A
1154 Self-reported Sleep Duration And Quality Are Associated With Post-traumatic Stress Disorder Following Stroke
Authors: Romero E K , Kronish I M , Shechter A 
Published: May 2020

Abstract

Introduction
Up to one in eight patients may experience post-traumatic stress disorder (PTSD) within the year following a stroke or transient ischemic attack (TIA). Sleep disturbance is a chief complaint in PTSD and is common following stroke. We therefore examined whether sleep was associated with post-stroke PTSD.

Methods
The Reactions to Acute Care and Hospitalization (REACH)-Stroke study is an observational cohort study examining factors related to long-term health outcomes following stroke/TIA. Typical sleep duration (self-report) and quality (1: very good to 4: very bad) over the month following hospital discharge was assessed at 1-month follow-up. At 1 month, patients also completed the PTSD checklist for DSM-5 (PCL-5 cued to the stroke/TIA event). Binary logistic regression was conducted, producing odds ratios (OR) on the association between sleep within the month following discharge and PTSD symptoms at 1 month post-stroke, controlling for age, sex, and race/ethnicity.

Results
Analyses included 459 patients (age: 61.1 ± 15.6 y, 53.2% female). Short sleep (&lt;7 h/night) and poor sleep quality (fairly/very bad) was reported in 49.2% and 25.5% of patients, respectively. Elevated PTSD symptoms (PCL-5 score ≥30) at 1 month were reported in 10.9% of patients. Sleep was significantly shorter and worse quality in those with PTSD vs. without (p-values&lt;0.001). Short sleep duration vs. not short duration throughout the month following discharge was significantly associated with elevated PTSD symptoms at 1-month (OR=3.34, 95% CI: 1.51-7.38, p=0.003). Poor sleep quality (fairly or very bad rating) vs. good sleep (fairly or very good rating) was also significantly associated with elevated PTSD symptoms at 1-month (OR=2.23, 95% CI: 1.13-4.41, p=0.021).

Conclusion
Patients with short duration and poor quality sleep in the month following stroke are at an increased risk of having elevated PTSD symptoms. Understanding factors related to the development of post-stroke PTSD is important since PTSD in stroke survivors can reduce quality of life, contribute to non-adherence to prescribed medications, and increase risk of recurrent stroke and/or cardiovascular events. Future studies should be conducted to determine whether sleep is a modifiable determinant of PTSD symptoms after stroke.

Support
R01HL141494, R01HL132347
0117 Circadian- and Wake-Dependent Effects on Recall for Face-Name Pairs
Authors: Yuan R K , Münch M Y , Cain S W , Ronda J M , Czeisler C A , Duffy J F 
Published: May 2020

Abstract

Introduction
The ability to remember the face and name of a person we have recently met is a critical skill often impacted by cognitive impairment and Alzheimer’s disease. We used a forced desynchrony protocol to explore whether recall of recently-learned face-name pairs is affected by time awake and/or circadian phase in healthy adults.

Methods
13 healthy, cognitively normal adults (20-70yrs; 7F) participated in a 39-day inpatient protocol with 3 baseline days (10h time-in-bed/24h) and a 3-week forced desynchrony (FD) segment, where they lived on a 28-h day with sleep restriction (6.5h time-in-bed/28h, equivalent to 5.6h/24h). Core body temperature was collected throughout to estimate circadian period and phase. The face-name test was administered every 4h, beginning 3h after wake. Each test included a learning session with 6 novel face-name pairs. Recall was tested 2h later, when each face was presented twice in random order, once with a correct and once with an incorrect name. Participants were asked to respond whether each face-name pair was correct. Data were averaged across 4-h circadian phase or time awake bins and normalized as a percentage of each participant’s baseline performance.

Results
Face-name recall varied by time awake (p&lt;0.05), with performance deteriorating ~12% over the course of 12h of wakefulness. Face-name recall also varied by circadian phase (p&lt;0.05), with a ~10% difference in recall performance from the peak at circadian phase 240° (corresponding to the early biological evening) to the nadir at circadian phase 60° (corresponding to the early biological morning).

Conclusion
Both duration of prior wake and biological time of day impact the ability to correctly recall face-name pairs. Under normal entrained conditions, opposing circadian- and wake- dependent effects on memory for face-name associations may interact to produce stable performance across the day.

Support
Study supported by P01 AG009975 and conducted at Brigham and Women’s Hospital Center for Clinical Investigation, part of Harvard Clinical and Translational Science Center supported by UL1 TR001102. Authors supported by T32HL007901 and F32HL143893 (RKY); fellowships from the Novartis Foundation, the W.&T. La-Roche Foundation, and Jazz Pharmaceuticals (MYM); a fellowship from the Natural Sciences and Engineering Research Council of Canada (SWC).