bluuebunny/crossref_metadata_2025_split huggingface dataset:
O036 Performance characteristics of a contactless under-mattress sleep analyser in a clinical sleep laboratory: Are automated sleep analysers ready for prime time?
Authors: Stewart G , Flood J , Tong B , Cohen G , Cistulli P 
Published: December 2024

Abstract

Introduction
Contactless under-mattress sleep analysers which estimate sleep architecture and breathing disturbances have the potential to alleviate wait times for diagnostic sleep studies and enable multi-night sleep assessments.

Objective
To evaluate the performance characteristics of a commercially available pneumatic under-mattress sleep analyser (UMSA) during overnight laboratory-based polysomnography (PSG) in an unselected sleep clinic population.

Methods
To date, simultaneous UMSA and PSG recordings have been obtained in 74 individuals. After removing studies with insufficient sleep duration (i.e., Total Sleep Time (TST) &lt;5-h, n=7) or recording discrepancies (n=12), TST, rapid-eye movement (REM) duration and apnoea-hypopnea index (AHI) were compared between UMSA and PSG.

Results
Average TST (416±56 vs 355±7min, p&lt;0.001) and REM duration (83±48 vs 60±34min, p=0.006) were significantly longer for UMSA than PSG, while mean AHI (19.4±24.2 vs 16.3±21.6 events/h, p=0.495) was similar. Mean AHI difference between UMSA and PSG was 3.1 events/h with 95% limits of agreement between -23.6 to 29.8 events/h. The sensitivity, specificity, and area under the receiver operating curve (AUC) at a threshold of AHI≥5 was 78.6%, 56.5% and 0.744AUC. At a threshold of AHI≥15 the sensitivity, specificity, and AUC were 80.0%, 69.4% and 0.902AUC.

Conclusions
Estimates of TST and REM duration from an under-mattress sleep analyser were not comparable to laboratory-based polysomnography. Mean AHI was similar albeit with large limits of agreement and the under-mattress sleep analyser had moderate diagnostic accuracy to detect an AHI&gt;5 when compared to polysomnography. Caution is required in the application of under-mattress sleep analysers for research and clinical purposes.
O038 Vigilance Testing Accelerated List (ViTAL) week reduces sleep laboratory waiting times
Authors: Huddle S , Young A , O’Driscoll D 
Published: December 2024

Abstract

Introduction
Vigilance testing (MSLT and MWT) is time consuming and labour intensive, requiring close to a 24h admission for five-nap MSLTs. Combined with increased referrals for hypersomnia, waiting times for vigilance testing has increased. Modelled on High Intensity Theatre Lists (UK), we re-directed sleep laboratory resources to run an intensive Vigilance Testing Accelerated List (ViTAL) over 1-week.

Methods
Resource planning and redirection was co-designed with all laboratory staff. All processes ran concurrently for 5 days to maximise throughput. Four beds were allocated for vigilance tests (i.e. 20 vigilance tests), with the remaining two beds available for urgent studies. Urgent sleep study scoring continued; all other operations were suspended. Following approval from hospital executive, laboratory staffing was reconfigured to cover all shifts and other key staff were consulted (kitchen, cleaning).

Results
18 of the 20 slots were filled (15 MSLTs, 3 MWTs). Average wait time for vigilance tests reduced from 98 to 42 days. There was no negative impact on wait-times for regular PSG bookings (52 vs 42 days) or PSG scoring turnaround times (8.7 vs 4.7 days) compared to 1 month prior to ViTAL week. To maintain staffing for all shifts, two of six staff worked over their weekly rostered hours.

Conclusion
This temporary re-direction of resources was effective in managing a ballooning waitlist. Patient response and staff acceptance was high in the setting of co-design. If performed intermittently, this could be a useful tool to reduce waitlist times, noting sustained increases in workload may leave staff susceptible to burnout.
O069 At home lighting intervention as an adjunct to antidepressant treatment: A pilot study
Authors: Fitton R , Phillips A , McGlashan E , Cain S 
Published: December 2024

Abstract
Evening light exposure is disruptive to sleep and circadian rhythms. This disruption may be amplified for people taking Selective-Serotonin Reuptake Inhibitors (SSRIs), as SSRIs increase sensitivity to the non-visual effects of light. Minimising the amount of evening light exposure may therefore improve antidepressant treatment responses by minimising disruption and improving sleep and mood. We investigated the potential of a home-lighting intervention focused on minimising evening light to reduce depressive symptoms in individuals taking an SSRI. Individuals taking an SSRI who reported moderate or high levels of depressive symptoms, assessed via the Beck Depression Inventory, were recruited (N=24). After completing a baseline week of at-home monitoring of sleep, light, and mood, participants were randomly allocated to four weeks of a smart light intervention (n=12) or a control condition (n=11). Participants in the light intervention group were asked to replace their existing evening lighting with dimmed/warm smart lights. There was no difference in depressive symptoms between groups during the baseline week. Following the intervention period, participants in the intervention group reported significantly reduced depressive symptoms compared to those in the control group, with a large effect (d=2.11) and an average shift from severe to mild depressive symptoms. The intervention group showed a significant reduction in evening light following the intervention, averaging a 21 lux difference in change scores compared to the control group (d=1.11). We conclude that at-home light interventions that reduce evening light exposure hold promise as an adjunctive treatment for individuals experiencing depression while taking SSRIs.
O079 The effect of long-term CPAP on subclinical markers of coronary artery disease in clinic patients with OSA
Authors: Goh J , McArdle N , Sansom K , Shenoy B , Harvey C , Rea C , Dhaliwal S , Reynor A , Ling I , Keenan B , Maislin G , Pack A , McQuillan B , Hung J , Hillman D , Singh B 
Published: December 2024

Abstract

Background
In view of the current uncertainty about the relationship between obstructive sleep apnoea (OSA) and development of major adverse cardiovascular events (MACE) we studied the long-term effect of continuous positive airway pressure (CPAP) on important subclinical markers known to be on the causal pathway to coronary artery disease (CAD)

Methods
We used our database of sleep clinic patients (n=4,226) who had baseline phenotypic assessments, between 2006 and 2010, including level 1 polysomnography to determine the presence and severity of OSA. We performed follow-up assessments between 2019-22 on 2 groups of consenting participants who were alive and free of MACE at baseline and during the follow-up period: those with long-term good CPAP use and those with poor or no use. We will compare follow-up High sensitivity Troponin-I and coronary calcium scores between groups, using propensity score matching methods.

Progress to date
A total of 263 patients completed follow-up assessments and will undergo propensity score matching. Of these, 134 had good CPAP use and 129 had no or poor CPAP use. The two groups had similar baseline characteristics: median age 62 vs 60 years, male 67% vs 64%, body-mass-index 32.6 vs 30.0kg/m2 respectively.

Intended outcome and impact
This project is intended to provide further insight into the relationship between OSA and risk for developing CAD, by studying the effect of long-term good CPAP use, compared to no or poor CPAP use, on changes in established sub-clinical biomarkers of coronary disease.
P031 Does obstructive sleep apnea severity impact sleep spindles in schizophrenia?
Authors: Cho G , Husein N , Faris S , Marshall N , Espinel Diaz P , Yee B , Lambert T , Grunstein R , D’Rozario A 
Published: December 2024

Abstract

Introduction
Patients with schizophrenia have a high prevalence of obstructive sleep apnea (OSA). Sleep disturbance and sleep spindle deficits are observed in both schizophrenia and OSA patients. But whether the spindle deficits seen in schizophrenia are modified across a broad spectrum of OSA severity remains unclear

Methods
We analysed overnight electrocephalography (EEG) from schizophrenia patients with suspected OSA (n=29, mean age=44 yrs, gender (F:M) = 7:22, AHI range=0.0-123.4/hr) and a non-schizophrenia control group (n=29, mean age=44 yrs, gender (F:M) = 7:22, AHI range=8.6-106.6/hr) selected with a similar age and gender distribution. Sleep spindles (11-16Hz) were identified using a validated automated algorithm at a central EEG electrode site. A linear regression model was used to assess the differences between people with and without schizophrenia and examine the association between OSA severity (Apnea-Hypopnea Index; AHI) and its interaction with schizophrenia.

Results
The schizophrenia group had lower NREM sleep spindle density compared with controls (0.6/min vs 1.8/mins; p&lt;0.05). Sleep apnea severity (AHI) was not associated with spindle density, schizophrenia did not modify this association. We incidentally observed that the schizophrenia group had increased N1 (58.4 vs 15.0 minutes) and N3 (85.7 vs 25.1 minutes) sleep, and reduced N2 (195.7 vs 250.8 minutes) and REM (46.5 vs 69.0 minutes) sleep (all p&lt;0.05).

Conclusion
Our preliminary findings suggest that sleep spindle deficits observed in schizophrenia are not further impaired by OSA severity. Future research exploring the possible therapeutic effects of OSA treatment on sleep spindles and restoring sleep architecture in schizophrenia are now warranted.
P040 How do Children with Neurodisability Use Technology Around Bedtime? Results from a Cross-Sectional Survey
Authors: Shin I , Anderson M , Robinson J , Vandeleur M , Waters K , Chawla J 
Published: December 2024

Abstract

Introduction
Anecdotally caregivers of children with neurodisability (ND) express that using an electronic device before bed helps to calm their child and prepare them for sleep. The aim of this study was to determine how children with ND use technology prior to bedtime.

Methods
Caregivers of children 1-18yrs with a diagnosed ND condition, undergoing a sleep study at one of 3 tertiary hospitals completed a study-designed questionnaire exploring the type, frequency and nature of technology use by their child around bedtime. Sleep-related symptoms experienced by their child (e.g, daytime tiredness) were also reported. Descriptive statistical analysis was performed, and results were stratified by age, sex and underlying ND condition.

Results
133 completed responses were available for analysis (55% male, median age 11yrs). 32% of participants were reported to “always” use a screen-based device around bedtime, 19% “often”, 25% sometimes, 8% rarely and 16% never. 47% reported their child used a device “everyday” prior to bedtime. 59% of parents felt that use of a device helped their child around bedtime. There was a positive association between the frequency of technology use at bedtime and sleep symptoms reported.

Conclusion
Bedtime digital technology usage was high in children with ND and appeared to be associated with greater report of sleep symptoms. However, more than half of parents felt the technology was helpful for their child around bedtime. Comparison to a group of neurotypical children is underway and will determine if recommendations for device usage in children with ND around bedtime require adaptation.
P045 Association between childhood cystic fibrosis lung disease and adolescent sleep and mental health
Authors: Pham H , Vandeleur M , Mainzer R , Jordan B , Clark N , Du Berry C , Schultz A , Ramsay K , Pettigrew G , Harper A , McCappin S , Carzino R , Ranganathan S 
Published: December 2024

Abstract

Background
Sleep disruption imposes deleterious physiological and psychological effects. We aimed to describe the relationship between school age respiratory health on adolescent sleep disturbance and mental health symptoms in people living with cystic fibrosis.

Methods
We conducted a prospective longitudinal study of adolescents aged 10 to 18 years from October 2020 to June 2024. Sleep was evaluated via serial measures of the pediatric daytime sleepiness scale (PDSS) and sleep disturbance scale for children (SDSC), while mental health was assessed with the Patient Health Questionnaire-9 (PHQ-9) for depression and Generalised Anxiety Disorder-7 (GAD-7) for anxiety. Respiratory health was measured alongside, using FEV1 percent predicted and multiple breath washout (MBW). Childhood chest CT scan were previously collected via DEFEND CF (Biomarkers to define the treatment end-points for pulmonary exacerbations in CF) and scored using the Perth-Rotterdam Annotated Grid Morphometric Analysis for CF (PRAGMA-CF).
Linear regression was used to estimate mean difference in sleep and mental health change per school age CT bronchiectasis score.

Results
64 adolescents were studied. 56% of participants experienced sleep disturbance symptoms, 45% for mental health symptoms, with no significant association between childhood bronchiectasis score and adolescent PDSS, SDSC scores. Adolescent anxiety and depression scores also did not significantly correlate with childhood bronchiectasis scores.

Conclusion
While childhood bronchiectasis score did not predict adolescent sleep or mental health, sleep disturbance and symptoms of anxiety and depression were prevalent in the cohort. The need for ongoing monitoring and support in these areas remains crucial for adolescents with cystic fibrosis.
P095 Temporalis and Masseter EMG leads in the assessment of Sleep Bruxism scoring in individuals with Obstructive Sleep Apnea and Sleep Bruxism
Authors: Chow S , Leow L , Song P , Nur Izzianie B 
Published: December 2024

Abstract

Study Objectives
Sleep bruxism (SB) is defined as the repetitive jaw muscle activity characterized by the clenching or grinding of teeth. Untreated SB may lead to dental complications, orofacial pain, OSA and insomnia. We postulate that SB scoring is more accurate with the addition of bilateral masseter and temporalis EMG leads (SB leads) to conventional PSG.

Methods
Full-night PSG of 25 individuals with OSA and history of SB were included. An independent sleep technologist (RPSGT) scored bruxism episodes according to the AASM criteria. The Bruxism Episode Index (BEI) measures the number of bruxism episodes per hour of sleep (&lt;2: irrelevant SB; 2–4: mild/moderate SB; &gt;4: severe SB.) SB-related EMG jaw muscle activity recorded are Rhythmic Masticatory Muscle Activity episodes and bursts (RMMA), which were scored using SB leads in addition to conventional PSG leads. Masseter and temporal EMG bursts with duration &gt;0.25sec were selected according to published criteria. RMMA is categorized as phasic (≥3 rhythmic bursts 0.25-2sec) or tonic (sustained burst lasting &gt;2sec). The same PSG were re-scored without these additional SB leads and the results were compared.

Results
Of the 25 PSGs without SB leads, incidence of none, mild to moderate and severe SB is 7, 11 and 7. With addition of the SB leads, incidence of none, mild to moderate and severe SB is 2, 5 and 18. Median Bruxism Episode Index (BEI) was 6.4 and 2.8 with and without SB leads respectively.

Conclusions
Conventional PSG without SB leads results in significant underestimation of SB incidence and severity.
P096 Sleep Behaviours and Nutritional Knowledge in Amateur and Professional Combat Sport Athletes
Authors: Dunican I , Galpin A , Turner M , Reale R 
Published: December 2024

Abstract

Introduction
Combat sports is a term applied to various competitive contact sports involving two competitors engaging in a bout or contest under a specific ruleset. Little is known about combat sports athletes’ sleep and nutritional knowledge. This study aimed to assess (i) sleep behaviours, (ii) alcohol and shiftwork disorders and (iii) the nutritional knowledge of combat sports athletes.

Methods
Participants completed various demographic questions and estimations of their body mass management practices and validated surveys, including the Athlete Sleep Behaviour Questionnaire (ASBQ), Shiftwork Disorder Screening Questionnaire (SWD), Alcohol Use Disorders Identification Test (AUDIT), and the Abridged Nutrition for Sports Knowledge Questionnaire (A-NSKQ).

Results
A total of 858 combat sports athletes completed the survey, 79% male, height of 177 ± 10 (cm), weight of 79 ± 15 (kgs). Sleep quality was average for all combat sport types, risk prevalence of shiftwork disorder at 11%. Amateur strikers, boxers and BJJ athletes consumed significantly more alcohol. Most combat sports athletes reduce weight for competition, with an overall nutritional knowledge average of 55%.

Conclusion
This study highlights a critical gap in the knowledge and practices of combat sport athletes in relation to sleep behaviours and disorders, alcohol consumption, and nutritional knowledge, emphasising the need for targeted educational interventions.
P109 Role of Multiple Sleep Latency Test (MSLT) in the workup of children with hypersomnolence
Authors: Malhotra N , Goyal V , Sclip K , Kilner D , Kapur N 
Published: December 2024

Abstract

Introduction
Hypersomnolence and excessive daytime sleepiness (EDS) can be idiopathic or associated with narcolepsy. The Multiple Sleep Latency Test (MSLT) is gold standard for diagnosing narcolepsy, though significant gaps currently exist in understanding the interpretation of MSLT in diagnosing and managing paediatric hypersomnolence. This retrospective study aims to describe a) a cohort of children investigated for hypersomnia and b) their MSLT outcomes.

Methods
Clinical, demographic, and MSLT data were retrospectively collected from children who underwent hypersomnolence investigation at a tertiary paediatric hospital (January 2015-December 2023). Data included age, gender, BMI, comorbidities, medications, polysomnography, MSLT results, diagnoses, treatment, and outcomes. The association between MSLT parameters and diagnostic outcomes was explored using American Sleep Association criteria.

Results
125 children (56F) were identified through our hospital database, with data on 72 (30F; median age 12.42 years, IQR=4.11) collected. 19 (26%) were HLA-positive for narcolepsy. MSLT parameters suggested narcolepsy in 13 (18.1%) children; 1 additional child had low orexin levels. Median sleep latency was significantly shorter in the narcolepsy group compared to non-narcolepsy (01:39 minutes vs. 12.58 minutes, p&lt;0.001). No age or gender differences were observed between groups. Diagnostic PSG on the preceding night led to alternate diagnoses in 5 children.

Discussion
While the data is only partially complete, interim analysis suggests narcolepsy is present in a minority of this cohort. PSG from the preceding night changed in the diagnosis in 5 children. However, the fifth nap did not change any outcomes, so the utility of this practice needs to be re-explored.
The lack of thematic continuity in dreams with scene and plot discontinuities
Authors: Stickgold Robert , Sangodeyi Funke 
Published: December 2024

Abstract
A central tenet of Freudian dream theory holds that there is thematic coherence within all dreams, even those containing scene and plot discontinuities. While other models support varying degrees of dream coherence, none address the question of how, or even whether, coherence can be identified in dreams with such discontinuities. Here, we objectively test the ability of judges to evaluate the coherence of individual dream narratives. Twenty reports with complete scene and plot discontinuities were collected, and half were cut apart at their discontinuities and their two halves spliced together with segments from dreams of other subjects. The remaining 10 reports were left intact. Judges correctly identified reports as intact or spliced only 57% of the time, a rate only slightly better than chance. Only 3 of the 20 reports, one intact and two spliced, were reliably scored correctly, while one intact report was mis-scored by 80% of the judges. Judges had no greater confidence in correct decisions than incorrect ones. Dream report features identified by the judges that were effectively used in scoring dreams included characters, locations and objects, while psychoanalytic content and writing style were least effectively used. In sum, we find no evidence that dream construction consistently results in identifiable thematic coherence. Rather, scene and plot discontinuities in many cases represent such complete breaks as to be unrecognizable. We conclude that the finding of continuity by those reading these reports reflects ineluctable synthetic activity in the mind of the dream researcher or analyst rather than in the mind of the dreamer.
This paper is part of the Festschrift in honor of Dr. Robert Stickgold.
Regressing from the Gold Standard: The UK’s Slavery and Human Trafficking Regulations and the Narrowing of Victim Protection
Authors: Haynes Jason 
Published: December 2024

Abstract
The UK’s 2022 Slavery and Human Trafficking (Definition of Victim) Regulations represent a significant departure from established international standards in human trafficking victim protection. This article critically examines how the Regulations’ definitional framework creates three fundamental concerns that risk excluding legitimate victims from protection. First, while Clause 3(5)(a) aligns with international law’s ‘means’ elements, Clause 3(6)(d) problematically narrows this list for those required to provide services or benefits, potentially excluding victims who face exploitation through means other than force, threats, or deception. Second, the Regulations create unnecessary ambiguity around child trafficking through Clause 3(5)(b)’s unclear phrasing ‘any method’, potentially requiring evidence of the ‘means’ element contrary to international law which recognizes children’s inherent vulnerability. Third, the Regulations fail to explicitly include certain forms of exploitation, such as ‘practices similar to slavery’ in Clause 3(6)’s characterization of exploitation, departing from both the Council of Europe Convention on Action against Trafficking in Human Beings (ECAT) and the Palermo Protocol’s established frameworks. Drawing on recent European Court of Human Rights jurisprudence, particularly V.C.L and A.N v United Kingdom, this article demonstrates how the Regulations’ restrictive approach conflicts with the UK’s international obligations and risks excluding vulnerable groups from protection, including migrant workers, child victims, and those subjected to debt bondage or forced marriage. The analysis reveals how these limitations, coupled with the broader ‘hostile environment’ policy context, create significant barriers to victim identification and support. This article argues for urgent amendment of the Regulations to align with the Palermo Protocol’s comprehensive definition of trafficking victims, ensuring adequate protection for all forms of exploitation and maintaining the UK’s commitment to international protection standards.