bluuebunny/crossref_metadata_2025_split huggingface dataset:
1032 Auricular Point Acupressure for Sleep Disturbance in Women With Breast Cancer: A Pilot Randomized Controlled Trial
Authors: Wang Y , Wu J , Li J , Zhou J 
Published: May 2020

Abstract

Introduction
Sleep disturbance is reported in up to 60% of cancer patient. In traditional Chinese medicine, evidence suggests that auricular point acupressure (APA) improves sleep. However, little is known about APA’s effect on sleep disturbance in patients with breast cancer (BC). We tested the preliminary efficacy of APA on sleep in BC women undergoing chemotherapy.

Methods
A pilot randomized controlled trial was conducted in 41 BC patients (mean age=50±14) with self-reported poor sleep [Pittsburgh Sleep Quality Index (PSQI)≥7]. Participants were randomly assigned to an APA group (n=22) and a control group (n=19). All patients received sleep hygiene education. Additionally, for the APA group, magnetic pellets were attached to selected auricular points once a week for 3 weeks at the clinic, and the participants were instructed to self-press the pellets 4 times a day. Sleep were objectively measured by Actiwatch Spectrum and subjectively using PSQI at baseline and post-intervention. Paired t-tests and analyses of covariance using the variable baseline values were used to examine changes in sleep parameters.

Results
Twenty-one participants from the APA and sixteen from the control groups completed the study. Within the APA group, PSQI [mean difference (MD)=3.85, 95% Confidence Interval (C)=3.12~4.60] and sleep onset latency (MD=18.02, 95%CI=5.96~30.09) were significantly decreased, and the sleep duration (MD=-0.53, 95%CI=-0.99~-2.35) and sleep efficacy (MD=-5.00, 95%CI=-8.72~-1.28) were significant increased at post-intervention. Compared to the control group, participants in the APA group had significantly lower PSQI (F=30.77, p&lt;0.001) and greater sleep efficacy (F=5.25, p=0.028) at post-intervention.

Conclusion
APA may be an inexpensive and effective approach to improve sleep in patients with BC. More rigorous research with larger samples is needed to further test the efficacy of APA on promoting sleep in BC patients.

Support
None
0106 The Effects of Caffeine on Blood Pressure and Cognitive Performance in Hypoxic Conditions on the Slopes of Mt. Everest
Authors: Sparks K , Wehling R R , Acharya S , Musliu T , Baniya S , Hackett P H , Ozuru Y , Jung C M 
Published: May 2020

Abstract

Introduction
140 million people live above 2,400m worldwide. High altitude (HA) exposure can lead to sleep disruption, impaired cognitive performance, acute mountain sickness (AMS), elevated blood pressure (BP) and an increase in cardiovascular events in healthy people. Because caffeine can also increase BP, caffeine might need to be avoided at HA. Caffeine is the most widely used drug in the world but has yet to be studied extensively in hypoxic conditions. Therefore, the aim of the current study was to examine the effects of caffeine on cardiovascular variables and cognitive function at HA.

Methods
We conducted a non-randomized, single-blind, mixed model design at 4,300m on Mt. Everest. Thirty-three trekkers (nine females), aged 29.5±10.4 (mean±SD), ingested the study drug (placebo or 200 mg of caffeine) 1.5 hours after awakening. To control for withdrawal effects of caffeine, participants that self-reported consuming less than 47 mg of caffeine per day received the placebo while those that consumed more than that received caffeine. Cognitive function was tested using the Stroop task before and after the pill administration. BP was measured by a trained clinician using auscultatory method prior to and 30, 60 and 90 min after the pill administration.

Results
Caffeine improved cognitive performance when compared to the pretreatment measurement but was worse in the caffeine group prior to the pill administration when compared to the pretreatment placebo group. Additionally, caffeine did not have any major effect on BP when compared to pretreatment measures or the placebo group.

Conclusion
Caffeine does not seem to have an additive effect on increasing BP with HA. Additionally, because cognitive performance was worse in the chronic caffeine users prior to the pill administration, caffeine users might be more dependent on caffeine to perform optimally at HA. Based off of these data, caffeine seems to be a safe and beneficial drug at HA.

Support
NIH BUILD EXITO, University of Alaska Faculty Development Grant
1065 A Bout of Sleep Apnea or a Posttrauma Nightmare Occurrence?
Authors: Youngren W A , Miller K 
Published: May 2020

Abstract

Introduction
The enigmatic nature of Posttrauma Nightmares (PTNs) has left research without an agreed upon operational definition. This is partially due to PTNs often containing well remembered content that is similar to the triggering trauma, but also manifesting as severe nighttime awakenings without a concise or remembered dream narrative. Given that recent research has linked episodes of Obstructive Sleep Apnea (OSA) to PTNs, this study aimed to examine if OSA could explain why some distressed awakenings occur without memory of nightmare content.

Methods
Participants included 36 trauma survivors who reported experiencing PTNs, recruited from a clinical referral or at a Veterans Affairs Hospital. Presence of OSA was captured from self-reports of previous polysomnography-based sleep study results. PTNs were measured via a self-report measure that assessed past month nightmare frequency and if the content was remembered upon awakening. Analysis included descriptive statistics and chi-square tests.

Results
Out of the group with a reported diagnosis of OSA (N = 8), 75% (n = 6) reported they did not remember the content of their nightmares upon awakening, whereas out of the group without a reported OSA diagnosis (N = 28), only 4% of participants (n = 1) reported not remembering the content of their nightmares. There was a significant difference between OSA diagnosis and remembering nightmare content (X2 = 57.83, p &lt; 0.001).

Conclusion
Individuals with diagnosed OSA commonly experienced nightmares that were often not remembered upon awakening, while the group without OSA most often remembered the content of their nightmares. Due to this relationship, it is possible that some PTNs experienced by the OSA group may instead be misinterpreted respiratory events. Understanding the relationship between OSA and PTNs is crucial for developing the most effective treatment course.

Support
None.
1068 Using Sleep to Avoid Inpatient PTSD Treatment
Authors: Woodward S H , Jamison A L , Souter T , Shin H J , Loew D E , Armontrout J A 
Published: May 2020

Abstract

Introduction
During inpatient psychiatric treatment, mattress actigraphy can be used to track nightly sleep in a zero-burden fashion to examine its relationships with other markers of treatment progress. We report here on associations between actigraphic sleep parameters and treatment markers in combat veteran engaged in inpatient treatment for posttraumatic stress disorder. We focus first on sleep scheduling, the best-validated outcome available from actigraphic data.

Methods
140 combat veteran inpatients provided between 5 and 164 nights of mattress actigraphy over the course of their inpatient psychiatric hospitalizations. The sample was characterized by multiple traumas and a high prevalence of comorbid mood and substance use disorders. Approximately one-half of the sample had undergone objective screening for OSA and for this subsample AHI &lt; 20 was used as an inclusion criterion. Unscreened participants were required to have a BMI &lt; 35. Inclusion also required mean actigraphic SE &gt; 60%. The PTSD Checklist and Combat Exposure Scale were obtained at admission, from which a trauma load index was created by adding z-scores obtained from standardizing these scales.

Results
In a multiple regression analysis, after accounting for secular change in LOS, higher trauma loads (p &lt; 0.001) and earlier bed times (p = 0.001) were both significantly associated with shorter lengths of stay (LOS; F(3,137) = 10.4, p &lt; 0.001; adj. R-squared = 0.17). Trauma load and bed time did not interact (p = 0.7).

Conclusion
Avoidance is a criterial symptom of PTSD. Early bed times and early exits from treatment may both reflect the impact of syndromal avoidance on treatment, limiting its dosage and benefit. If so, prescribing later bed times may have utility in inpatient treatment programming.

Support
Award W81XWH-15-2-0005 from the Department of Defense, Military Operational Medicine Research Program and the Department of Veterans Affairs. This material is the result of work supported with resources and the use of facilities at the Palo Alto VA Medical Center.
1077 The Association Between Sleep Problems And Risk-taking Behavior Differs Between Racial Majority And Minority Groups
Authors: Burns A I , Bullock A , Taylor E , Grandner M A , Alkozei A , Killgore W D 
Published: May 2020

Abstract

Introduction
Individuals with Post-Traumatic Stress Disorder (PTSD) often experience poor sleep quality and elevated self-destructive behaviors. Among healthy individuals, poor sleep quality can lead to increased risk-taking behavior through decreased inhibition and/or increased willingness to take risks. However, it is unclear whether racial/ethnic background may influence this relationship, in particular among individuals with PTSD. We examined whether the relationship between sleep quality and risk propensity would differ between majority and minority racial groups in individuals with PTSD.

Methods
Seventy-six individuals (61.8% female; mean age=31.7, SD=8.8) with a clinical diagnosis of PTSD were administered the Functional Outcomes of Sleep Questionnaire (FOSQ) as a measure of sleep-related functional impairment of daily activities, and the Evaluation of Risk (EVAR) Scale as a measure of risk-taking propensity. Forty-seven individuals identified with the majority racial group (Caucasian) and 29 individuals identified themselves within the minority.

Results
There were no significant group differences for FOSQ and total EVAR risk-taking scores. However, the strength of association between measures differed significantly between groups (Z=1.95, p=.051). For the racial/ethnic majority, functional impairments due to lack of sleep were positively associated with risk-taking propensity (r=.460, p=.001); this relationship was not present for the minority group (r=.016, p=.936).

Conclusion
Self-reported functional impairments due to sleep loss significantly correlated with risk-taking propensity for those who identified themselves as part of the majority racial group but not for individuals who identified as part of a racial minority. Findings suggest that broad conclusions regarding the association between sleep disruption and risk-taking may not apply equally across racial/ethnic groups and such factors should be considered when evaluating studies of sleep and risk behaviors. Whether these differing effects are due to cultural factors or stable differences in biology is not known and will require additional research.

Support
W81XWH-14-1-0570
1089 Water Intake Moderates the Relationship Between Sleep Quality and Depressive Symptoms: The Latino Health and Well-Being Study
Authors: Blanc J , Williams N , Jean-Louis G , Lemon S , Rosal M 
Published: May 2020

Abstract

Introduction
This study examined the relationships between sleep quality and depressive symptoms, and whether this relationship is moderated by frequency of water intake in a sample of Latino adults.

Methods
Participants in this community-based study were 574 Latino adults from Lawrence, Massachusetts. Assessments included surveys and anthropological measures. Variables in this study included sleep quality (Pittsburgh Sleep Quality Index- PSQI), depressive symptoms (Center for Epidemiologic Studies Depression Scale -CES-D) and frequency of water intake in the previous three months (investigator-developed question). Covariates included demographics, stress (Perceived Stress Scale-PSS), and body mass index (BMI). Multiple linear regression analyses were conducted to explore associations between sleep and depressive symptoms. Potential moderating effect of frequency of water intake was assessed using hierarchical, moderated, multiple regression analysis.

Results
The sample was 51.2% female, with a mean age of 46.6 years (SD=15.4) and mean BMI of 29.6 (SD=5.9); 31% of the sample had CES-D scores &gt; 22 (cut off for elevated depressive symptoms), the mean PSQI score was 13.11(SD=3.4) and 92% reported water intake two or more times daily. Sleep quality correlated positively with depression (r=.558; p=.000). After adjusting for covariates, sleep quality was strongly associated with depression (B = .417; SE=13; p =.000). The relationship between sleep quality and depressive symptoms was moderated by frequency of water intake (B= -.186, SE =1.107; p= 0.11).

Conclusion
This study is among the first to examine the association between sleep quality and depressive symptoms among Latino adults, and to show that frequency of water intake may moderate this association in this population.

Support
This study was supported by funding from the NIH: R01 MH085653; 1U48DP006381; and T32HL129953.
1093 Population-level Suicide Ideation: Impact Of Combined Roles Of Sleep Duration, Sleep Disturbance, And Daytime Sleepiness
Authors: Jajoo A , Tubbs A , Perlis M L , Chakravorty S , Seixas A , Killgore W D , Wills C C , Grandner M A 
Published: May 2020

Abstract

Introduction
Poor sleep has been shown to be related to suicide ideation and depressed mood, but population-level studies have not been done to explore the specific issues within sleep that effect mood, specifically leading to suicide ideation.

Methods
Data from adults 18 and older in the 2015-2016 National Health and Nutrition Examination Survey (NHANES) who provided complete data were used (N=5,123). Suicide ideation was recorded as the presence of thinking that “you would be better off dead” in the past 2 weeks. Sleep duration was recorded in half-hour increments and transformed to represent absolute distance from 7 hours (to model u-shaped association). Sleep disturbance was recorded as presence of “difficulty falling asleep, staying asleep, or sleeping too much” non, several days, or more than half the days of the past 2 weeks. Sleepiness was frequency feeling “overly sleepy during the day” in the past 12 months. Covariates included age, sex, race/ethnicity, and presence of depressed mood in the past 2 weeks. Additional impact of difficulty thinking/concentrating in the past 2 weeks was explored. NHANES sample weights were used in analyses.

Results
In adjusted analyses, increase likelihood of suicide ideation was associated with distance from 7hrs (OR=1.24/hr, p=0.008), sleep difficulties most of the time (OR=2.46, p=0.001), but not sleepiness. When both sleep variables were adjusted for each other, results remained significant for U-shaped sleep duration (OR=1.21/hr, p=0.02) and sleep disturbance (OR=2.31, p=0.003). These were attenuated but remained significant when difficulty thinking/concentrating was introduced; a significant sobel test (p&lt;0.0001) suggested partial mediation, with this variable accounting for approximately 13% of the variance of the relationship to sleep.

Conclusion
In the population, improper and poor sleep was associated with a greater risk of suicide ideation.

Support
Dr. Grandner is supported by R01MD011600
1094 Depression Is Not Associated With The Presence Of Or The Severity Of Obstructive Sleep Apnea: Retrospective Study Of 841 Polysomnography Subjects
Authors: Im K , Kim L , Immen R 
Published: May 2020

Abstract

Introduction
Both depression and obstructive sleep apnea (OSA) are very common medical conditions. Studies showed a co-occurrence of depression and OSA with a higher prevalence of one if the other is present. However, there is relative paucity of studies assessing the rate of depression based on the OSA severity.

Methods
Retrospective analysis of data collected from patients undergoing polysomnography (PSG) at an academic sleep disorders center was performed. A total of 841 subjects were included and stratified into four groups using AHI. A Chi-square analysis was applied to assess the association of varying levels of AHI and the presence of depression.

Results
Although a significant proportion of patients with AHI greater than 5 endorsed depression (60/165 in group with AHI 15 or greater and 115/278 in group with AHI between 5 and 15), this finding was also replicated in patients with AHI less than 5 (86/202 in AHI between 1 and 5 and 88/196 in those with AHI less than 1). As there was significant difference in rate of depression among women (54.1%) and men (26.1%) (p &lt;0.0001), Chi-square analysis was performed for the rate of depression based on the level of AHI, adjusted for gender. In women the rate of depression from the most severe AHI to less severe AHI group were 0.48, 0.53, 0.60, and 0.53 respectively and in men it was 0.30, 0.27, 0.20, and 0.27 respectively, with no statistical difference between any groups.

Conclusion
Among patients who seek PSG assessment, depression appears to be more prevalent than the general public. Rate of depression is much higher among women than men in this group. However, the presence of OSA or severity of OSA does not have any correlation with the rate of depression in both women and men. These findings might be suggestive of the complexity of the association between depression and OSA. One limitation of this study is the dichotomous nature of depression (presence or absence of). The finding from this study warrants a future study utilizing a numerical rating scale of depression for severity measure to correlate it with the severity of OSA.

Support
NA.
1099 Sleep Restriction Leads To Greater Next-day Anxiety: The Moderating Role Of Anxiety And Depression
Authors: Bean C A , Ciesla J A 
Published: May 2020

Abstract

Introduction
Evidence from both experimental and daily-diary studies suggests that a single night of sleep restriction leads to higher levels of anxiety the following day. Depressive symptoms also increase the next day in healthy populations, although sleep restriction has demonstrated short-term antidepressant properties in depressed populations. Relatively little research has examined symptoms of anxiety and depression separately on days following naturally-occurring sleep restriction and whether any change from the previous day might be moderated by baseline levels of anxiety or depression.

Methods
Undergraduates completed electronic daily diaries twice per day for 14 days (N = 96). Upon waking, participants answered questions assessing their sleep, and every evening, before going to bed, completed the Mood and Anxiety Symptom Questionnaire - Short Form to assess daily levels of general distress, anxious arousal, and anhedonic depression. The State-Trait Anxiety Inventory - State and the Center for Epidemiologic Studies Depression Scale provided baseline measures of anxiety and depression, respectively. A night of sleep restriction was operationally defined as one for which participants reported obtaining 4 hours of sleep or less.

Results
Multilevel modeling revealed that anxious arousal was higher following sleep restriction (β =.92, z=2.40, p=.017). This was moderated by baseline anxiety (β =.09, z=2.89, p=.004) and baseline depression (β =.09, z=3.39, p=.001) so that anxious arousal was even higher the next day for individuals reporting a high number of anxious and depressive symptoms. These effects remained significant after controlling for lagged anxious arousal, gender, baseline anxiety and depression, substance use, and napping. Conversely, no significant results were found when next-day general distress or anhedonic depression were examined.

Conclusion
Our results suggest that naturally-occurring sleep restriction is accompanied by increases in anxiety, but not depressive symptoms, the following day. This effect is heightened in individuals with higher baseline levels of anxiety and depression.

Support
N/A
1102 Relationship Between Emotional Distress And Sleep Duration Among Hispanics Using The 2018 National Health Interview Survey Dataset
Authors: Garcia J , Moore J , Payano L , Rogers A , Poke P , Casimir G , Jean-Louis G , Seixas A 
Published: May 2020

Abstract

Introduction
Although Hispanics experience a high level of shorter sleep duration (&lt; 7 hrs./24 period), a clear mechanism or cause is lacking. Previous research indicate that emotional distress may explain the burden of shorter sleep among blacks. Applying these findings to Hispanics, we investigated whether emotional distress explains the burden of short sleep duration (&lt; 7 hrs.) among Hispanics and if this relationship varies by sex

Methods
We used data from the 2018 National Health Interview Survey (NHIS) dataset, a nationally representative sample, in which only Hispanic ethnicity participants (N=3,091) were analyzed. Average sleep duration was self-reported and measured in hours. Emotional distress was measured using Kessler 6, which measures how an individual felt over the past 30 days: nervous, hopeless, restless/fidgety, depressed, effortful and worthless. To assess the association between short sleep duration and emotional distress, we performed Pearson correlation, hierarchical regression analyses, and stratified this relationship by sex to determine if this relationship differed between males and females, adjusting for covariates.

Results
Of the total sample of 3,091 Hispanics, 1,762 were female, and 1,329 were male. Sleep duration and emotional distress were negatively correlated among females (r = -.27, p &lt;.001) and males (r=-.18, p &lt;.001). Among Hispanic females, sleep duration significantly predicted emotional distress, β = -.27, t = -11.60, p &lt;.001, and explained a significant portion of variance in emotional distress, R2 = .07, F= 134.63, p &lt;.001. While, among Hispanic males, sleep significantly predicted emotional distress (β = -.18, t =-6.5, p &lt;.001) and explained a significant portion of the variance in emotional distress (R2 = .03, F= 42.37, p &lt;.001).

Conclusion
Our findings indicate that a negative sleep-ED relationship, suggesting that shorter sleep was predictive of higher levels of emotional distress among Hispanics and that this relationship is greater among Hispanic females, compared males.

Support
K01HL135452, R01MD007716, R01HL142066, and K07AG052685