bluuebunny/crossref_metadata_2025_split huggingface dataset:
P050 Integrating a same day sleep apnoea assessment into a surgical pre-admission clinic (PAC)
Authors: Kathriachchige G , Cawson E , Dabscheck E , Miller B , Downey G , Naughton M 
Published: December 2024

Abstract

Introduction
Untreated obstructive sleep apnoea (OSA) is often unrecognised pre-operatively and is associated with increased post-operative complications and morbidity. Anaesthetist screening of OSA risk in pre-admission clinic (PAC) prompts referral to a sleep physician to investigate.

Aim
To explore the novel concept of integrating a sleep physician into PAC.

Methods
An audit sampling a PAC service was conducted at a tertiary hospital, pre and post integration of a sleep physician into PAC. Pre-integration, anaesthetists who identified patients at risk of OSA based on STOPBANG questionnaire were referred to the sleep clinic on a future date. Post integration, such patients were referred to the sleep physician in PAC on the same day. Demographic variables, times to assessments and hospital outcomes were reviewed.

Results
382 patients were reviewed in PAC pre-integration (26% bariatric, 31% orthopaedic, 43% other) and 355 post-integration (16% bariatric, 39% orthopaedic, 45% other). Comparing pre-integration with post-integration: 8 (2%) vs 71 (20%) patients were referred for sleep physician assessment. Mean days to: sleep physician assessment (120 vs 0), sleep study (91 vs 25), OSA management (138 vs 13) and surgery (261 vs 38). The 30-day mortality and unplanned non-invasive ventilation (NIV) post-operatively did not occur in either group referred for sleep assessment.

Discussion
Integration of a sleep physician into PAC resulted in 10 times more referrals for assessment of OSA. Time to: see a sleep physician, sleep study, management and surgery was reduced. Limitations of this study include a small sample size and confounders affecting clinical wait times.
P057 Review of longitudinal CPAP compliance in a government funded program
Authors: Carballo A , Madden G , Eriksson N , Roberts C 
Published: December 2024

Abstract

Intro
Compliance to CPAP therapy in patients with significant sleep apnoea improves overall health outcomes. The Government Funded Sleep Disorders Program (GFSDP) supplies CPAP devices to patients with significant sleep apnoea (apnoea-hypoxia index (AHI)&gt;15) or significant symptom burden (Epworth sleepiness score (ESS)&gt;10). To retain a GFSDP device, participants must meet the minimum usage requirements of 4hours/night. The aim of this study is to investigate longitudinal CPAP compliance of patients within the GFSDP. This information will assist with the goal of improving overall patient outcomes and tailoring service provisions offered by the healthcare institution.

Methods
150 GFSDP devices were issued from 2018 to May 2024. A retrospective analysis of patient compliance at commencement of therapy (Group 1), compared with current 3month compliance data (Group 2). 45 devices without remote monitoring were excluded from the study. Usage (hours/night) and AHI comparison between data groups were analysed using a paired T-test.

Results
105 subjects were analysed, age=60.9±12.80SD, 56 female, BMI=42.26±6.59SD, diagnostic AHI=59.4±32.16SD.
Group 1: usage=6.6hrs/night(SD±1.35); Group 2: usage =6.96hrs/night(±1.93SD), p=0.743.
Group 1: AHI=6.7(±1.38SD); Group 2: AHI=3.21(±4.18SD), p=0.492.
9% (n=10) patients were found to be non-compliant with an average usage of 1.26hrs/night.

Discussion
91% of patients showed continued acceptable compliance. There was no statistical difference in usage or AHI between Group 1 and Group 2. Patients identified as not compliant with the program in the past 3 months will be booked into clinic for review. More data is required to further investigate other relationships or trends that might exist within GFSDP participants
P060 Explainable machine learning reveals associations between sleep breathing disorder biomarkers and incident type 2 diabetes
Authors: Nguyen P , Catcheside P , Lechat B , Wittert G , Vakulin A , Adams R , Appleton S 
Published: December 2024

Abstract

Introduction
Obstructive sleep apnoea (OSA) and type 2 diabetes (T2D) show bidirectional relationships that negatively impact overall health. Although this relationship has been extensively studied with multiple reported OSA severity markers derived from polysomnography, no studies have systematically searched for novel OSA biomarkers of T2D. This project sought to investigate if state-of-the-art explainable machine learning (ML) models could identify new OSA biomarkers predictive of incident T2D.

Methods
We applied explainable ML models to longitudinal MAILES study data from 536 males who were free of T2D at baseline and identified 52 cases of T2D at follow-up (mean 8.3yrs, range 41.9-126.5mths). Beyond ranking biomarker importance, we explored how the explainable ML model approach can identify novel relationships, assist in hypothesis testing, and provide insights into risk factors.

Results
The top most predictive biomarkers included waist circumference, and novel biomarkers: number of desaturations in non-supine sleep, mean heart rate in supine sleep, and mean hypopnea duration. Explainable ML also identified a strong association between the number of desaturation events and incident T2D (Odds ratio=2.4 [95% CI 1.2-4.8], P=0.013). Finally, the explainable ML model revealed an individualized breakdown of risk factors, opening promising new avenues for more personalized precision sleep medicine.

Conclusions
Explainable ML supports the role of established biomarkers and reveals novel biomarkers of T2D likely to help guide further hypothesis testing and validation of more robust and clinically useful biomarkers. Although further validation is needed, these proof-of-concept data support the benefits of explainable ML in prospective data analysis.
P062 Development of a new Stepped Care approach to Insomnia treatment in a public health system
Authors: Crocker S , Szollozi I , Rolls T , Curtin D , Winter S 
Published: December 2024

Abstract

Introduction
Challenges exist in managing the clinical need for Insomnia treatment in the public health system. Traditional insomnia treatments can inflate wait times and are becoming unsustainable in the face of rising patient acuity/demand. The objective of this project is to develop a new Stepped Care (SC) treatment approach within a large tertiary hospital sleep disorders service.

Method
Online surveys on experiences and perspectives of existing and novel insomnia therapies were sent to 121 dyads (patients and their GPs) who had accessed the Sleep Psychology service between January 2021 and June 2023, as well as 41 multi-disciplinary staff from the Sleep Disorder Centre. A consensus group workshop was conducted to co-design the new SC treatment approach, which was informed by consumer and stakeholder feedback.

Results
Most GPs were familiar with online therapies, but few prescribed. Similarly, most patients who completed an online program found it helpful. The consensus group data revealed a preference for patient allocation to one of the following Steps based on clinical presentation/acuity: Level1: self-administered CBTi via validated online program; Level2: supervised small group CBTi delivered by psychology intern; Level3: 1:1 supervised CBTi treatment with psychology intern; and Level4: 1:1 intensive CBTi with an experienced psychologist.

Discussion
Stepped Care (SC) treatment models are flexible, allow intervention adaption based on patient treatment response, as well as offer service efficiencies in a public health setting.
P063 App-delivered Sleep Therapy for Older Individuals with insomnia (ASTEROID Study) – mixed method user experience study
Authors: Rahimi M , Hoyos C , Chapman J , Cheung J , Lee S , Bartlett D , Lillis S , Grunstein R , Gordon C 
Published: December 2024

Abstract

Introduction
Insomnia affects over 40% of older adults, impacting on their health and quality of life, but is often untreated. This study investigated the acceptability of digital therapy for insomnia in older adults using a mixed-methods approach.

Method
Eligible (age≥60, ISI≥10) respondents participated in an online survey exploring their smartphone usage patterns, app design preferences, and experiences with health and sleep-related apps. Additionally, a two-session focus group explored participants’ perceptions of sleep issues, insomnia treatments and their digital health needs. Focus group participants subsequently engaged in the usability testing of a mobile app designed to treat insomnia (SleepFix) for 3 weeks.

Results
203 participants completed the online survey (mean age=68.7±6.2; 66.0% female). Most (63%) used iOS phones, with 37% also using wearable devices, primarily for fitness and sleep tracking. The most desired features reported for an ideal sleep app were sleep diary entry and sleep quality tracking (83%) followed by lifestyle tracking (73%). Participants expressed a willingness to use an app to discover their sleep needs (95%) and improve overall sleep (93%). Preliminary focus group analysis (n=5) revealed long-standing struggles with insomnia and a desire for better solutions. After using SleepFix, participants reported improvements in sleep quality, expressing a willingness to recommend and continue using the insomnia app.

Discussion
This study found older people used mobile phones in many aspects of their lives, challenging stereotypes regarding older adults’ digital health literacy. There was a willingness to embrace digital health interventions to address long-standing insomnia and improve overall health outcomes.
P067 How much sleep medicine is taught to Australian and New Zealand medical students?
Authors: Bin Y , Chawla J , Dorrian J , Pal Singh A , Falloon K , Wong K , Meaklim H , Ferguson S , Ellender C , Young A 
Published: December 2024

Abstract

Background
Sleep disorders are prevalent with wide-ranging consequences but often underdiagnosed. Previous research indicates low coverage of sleep topics in medical curricula and knowledge gaps in primary care physicians around the world.

Methods
The medical dean and one staff member from the 22 medical programs in Australia and New Zealand were surveyed about sleep content within the curriculum and barriers and facilitators to providing sleep education.

Results
Eleven programs responded (48% responding; 5 undergraduate-, 4 postgraduate-entry, 2 both) and reported a median of 4h of sleep education (IQR 1.0 – 5.9h). Most frequently covered topics were normal sleep (91% of respondents), sleep apnoea (91%), insomnia (55%), circadian disorders (51%), sleep and circadian rhythms as related to student wellbeing (45%), movement disorders (36%), hypersomnias (36%), and parasomnias (27%). More than half gave students the opportunity to meet a sleep specialist (55%), but fewer provided opportunities to attend a sleep clinic (36%), observe a sleep investigation (27%), or visit a sleep laboratory (18%). Most respondents (73%) believed sleep content could be increased; these institutions actually provided more sleep education than their counterparts (median 7.4h vs. 3.3h). Respondents suggested professional bodies can help by advising on educational frameworks, developing standard learning outcomes, and creating reference and teaching materials but noted the main barrier of limited space in the curriculum.

Conclusions
There is scope to improve sleep education in Australian and New Zealand medical programs, however, consensus on core topics and content integration with other disciplines are key, given limited curriculum space and time.
P068 Books, Bath, Bed and Beyond: The role of digital technology and family dynamics in the evening routines of primary school aged children
Authors: Hillier E , Edmed S , Rossa K , Pattinson C , MacKenzie J , Smith S 
Published: December 2024

Abstract

Introduction
Digital technology is reported to impact children’s sleep, yet there is limited knowledge about how it is used and managed in the home. The family dynamics associated with technology use, a child’s bedtime, and family sleep are uncertain. This study examined the evening routines of families by constructing detailed individual timelines of evening routines, including the digital technology use, of 5–8-year-old children in their home environment.

Method
Semi-structured interviews, with time-of-day reconstruction, data prompting, and novel graphical elicitation techniques, were used to gather rich information about family evening routines. Interviews were conducted via Zoom and facilitated with the visual collaborative software, ‘Mural’. Qualitative data were analysed using thematic analysis.

Results
Thirty interviews were conducted with parents (86.7% female) of 5–8-year-old children (66.7% boys). Families’ evening and bedtime routines were characterised variously on dimensions of rigidity or flexibility of routine based on time of day and order of activity, with variations in the tempo of these routines (paced versus rushing). Technology played a diverse range of roles within routines of families, including that of child minder, behavioural reward, distraction during mealtimes, calming device, bedtime aide, and to facilitate family connection.

Discussion
Evening routines and sleep management in daily life are complex and private experiences. This study provides rich contextual narratives about how family dynamics and technology fit into children’s lives during their evening and bedtime routines. This knowledge may inform behavioural strategies to ameliorate the potential negative effects of digital media on sleep health during childhood.
P070 Cultural determinants of Sleep Health for First Nations adolescents: Perspectives of Service Providers in Remote Communities
Authors: Ashby C , Kinghorn M , Von Senden R , Wigginton B , Sullivan D , Yaqoot F , Kalmadka S , Caple R 
Published: December 2024

Abstract

Background
Despite established links between sleep and mental health across the general population, sleep health within a First Nations context is less understood. Moreover, there remains a dearth of culturally responsive approaches for Australian First Nations communities, including adolescents. This qualitative study explores the cultural determinants of First Nations adolescents’ sleep health, drawing on yarning sessions with service providers in remote Northern Queensland (NQ) communities as part of the Let’s Yarn About Sleep Project.

Methods
Ten yarning sessions were conducted with health and wellbeing and education service providers (N= 27; 23 female; 12 Indigenous) in remote NQ. First Nations community researchers reviewed the data and the Lowitja Cultural Determinants of Health and Wellbeing Framework was used to culturally ground the work and thematically organise First Nations adolescents’ sleep health narratives.

Results
Preliminary analysis revealed Family, Kinship and Community; and Self-determination and Leadership as key cultural determinants to First Nations adolescents’ sleep health. Participants emphasised there is no ‘one-size-fits-all’ approach, suggesting sleep health programs should be guided by place-based, culturally sensitive, First Nations-led, methods sensitive to myriad determinants of sleep health.

Discussion
Adopting a strengths-based approach, this study sought to situate First Nations adolescents’ sleep health within a rights-based, First Nations-led framework. Findings suggest future sleep health initiatives must privilege First Nations voices and be guided by a holistic health and wellbeing concept, encompassing place-based, culturally responsive and First Nations-led local service delivery. This study advocates for upstream determinants of health to guide future sleep health research, practice and policy.
O009a Ko Te honoka te whariki o whanau ora: Bridging indigenous and Western world views to create a sleep and connection intervention in the Moemoeā MOST trial
Authors: Russell-Camp T 
Published: December 2024

Abstract

Introduction
Bridging indigenous and Western world views to create a sleep and connection intervention in the Moemoeā MOST trial“aimed to blend Māori cultural practices with Western methods to enhance infant sleep and family wellbeing. Researchers from the University of Otago used Kaupapa Māori Research theory and a Multiphase Optimisation Trial (MOST) design to test culturally tailored sleep intervention components online over six months.

Methods
Caregivers of infants aged 2-12 months were recruited and randomly assigned to one of eight combinations of three intervention components: Rongo time (promoting peace through nature), Uru time (guiding sleep transitions), and Whānau Support (emphasizing family support). Interventions were delivered online through a website and an app. Outcome measures assessed at baseline and 6 months included our Perception of Infant and Toddler Sleep Scale (PoITSS), caregiver wellbeing (WHO-5), and connection measures (researcher developed scales).

Results
Of 503 caregivers (98.6% mothers, 35.4% Māori, 38.8% high deprivation), 377 (75%) completed the study. Most caregivers accessed the online resources, with varying levels of engagement. Qualitative feedback indicated improved connection to Māori culture and a perceived calming effect on infants from Uru Pou. However, there were no significant differences in PoITSS scores for Uru or Rongo time, and only minor improvements for Whānau Support. The intervention did not notably affect caregiver wellbeing or connection.

Discussion
While the intervention showed limited impact on infant sleep health, the positive qualitative feedback highlighted the value of culturally relevant resources and the need for further research in designing Indigenous-led interventions.
Funding was provided by the Ministry of Business, Innovation and Employment as part of the A Better Start National Science Challenge.
P078 Poor sleep quality in Australia: The role of disturbing dreams, nightmares, and psychological distress
Authors: Meaklim H , Turner M , Cunnington D , Burge M , Menzies R , Dunican I 
Published: December 2024

Abstract

Introduction
Disturbing dreams and nightmares can cause night-time awakenings and disrupt sleep. Despite high rates of poor sleep quality in Australia, there has been little investigation into the impact of disturbing dreams and nightmares on sleep quality. This study aimed to determine the relationship between disturbing dreams and nightmares and sleep quality in Australia while also examining the contribution of psychological distress.

Methods
Four hundred and thirty-nine Australian adults (310 females, average age: 44.9 years) completed an online survey investigating sleep, dreams, nightmares, and mental health. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), nightmares were assessed with the Disturbing Dreams and Nightmares Severity Index (DDNSI), and psychological distress was assessed using the Depression Anxiety Stress Scale (DASS-21) total score. Two linear regression models (adjusted for age and sex) examined the contribution of DDNSI and DASS-21 on PSQI scores.

Results
In the first model, disturbing dreams and nightmares were a significant predictor of PSQI scores (p &lt; 0.001), explaining 10% of the variance. Once psychological distress was added to the model, both disturbing dreams and nightmares (p = 0.004) and psychological distress (p &lt; 0.001) significantly predicted PSQI scores. The final model explained 22% of the variance in PSQI scores.

Discussion
Disturbing dreams and nightmares contribute to poor sleep quality in Australia. Psychological distress also plays a key role. Sleep health researchers, therefore, need to include validated measures of disturbing dreams, nightmares, and psychological distress when investigating factors contributing to poor sleep quality in Australia.
P083 Sleep in an ageing society: Key propositions for future sociological research
Authors: Gibson R , Coveney C , Martin W , Green R , Hine C , Ryan C , Sabatini S , Jin H , della Monica C , King A , Meadows R 
Published: December 2024

Abstract

Introduction
Recent policy reports have identified the importance of healthy ageing as well as sleep but rarely together. When they are, it often neglects existing sociological insights. It is possible that this is because this work is becoming historical or less applicable. This project considers the past and present contributions of sociology in ageing-related sleep research to identifying future research agendas.

Method
A group of scholars based in New Zealand and England and active in sociology, sleep and/or ageing-related research came together to map past and present research and workshop future agendas. Following extensive discussion, a range of consensus points were developed and refined.

Results
Three key propositions were identified as a foundation for future work in this space. These related to (i) ontological and epistemological questions; (ii) issues related to agency, autonomy, habits and routines; and (iii) time and temporality. Specific examples include the increasing trend towards datafication of ageing sleeping bodies and the implications for older individuals’ independence as well as the complexities of risk, uncertainty and surveillance.

Conclusion
If we are to meet the aims of leading policies for healthy ageing; it is imperative that we bring a sociological lens via ageing-related sleep research. This approach should not create new silos but encourage interdisciplinary reflection on what constitutes ‘sleeping well’ in the context of ageing.
P087 Pharmacotherapy and prescribing practices for paediatric insomnia
Authors: Bartlett H , Vandeleur M , Griffiths M , Efron D , Maraffa C 
Published: December 2024

Abstract

Background
Paediatric insomnia is common, with prevalence estimate ranging from 2-36%, with up to 86% of patients with neurodevelopmental disability effected. It is associated with lower quality of life and increased risk of poor developmental and health outcomes. Currently there is no pharmacotherapy approved for treatment of insomnia in the paediatric population. This scoping review aims to summarise the current literature available for efficacy, safety and prescribing practices for pharmacological agents used to treat insomnia in the paediatric population.

Methods
Searches were conducted in MEDLINE, Cochrane Database of Systematic Reviews, and Pubmed using terms for antihistamines, alpha-adrenergic agonists, benzodiazepines, chloral hydrate, melatonin and nonbenzodiazepine hypnotics. Studies were limited to those undergone peer review, available online and published in English.

Progress to date
1538 abstracts reviewed for inclusion, grouped and critically appraised according to drug class category.

Antihistamines
4 papers included, 3 demonstrating antihistamines as most common medication prescribed for insomnia.

Benzodiazepines
11 papers included with no randomised controlled trials. 6 papers demonstrating common prescription by General Paediatricians and Psychiatrists, and 3 papers showing improvement in parental perceived sleep quality in patients with neurodevelopmental disability.

Chloral hydrate
No papers meeting inclusion criteria

Clonidine
14 papers, with 7 describing prescribing practices and common usage for insomnia in neurodiverse populations and5 case series showing improved sleep latency and reduced frequency of night waking.
Melatonin and Nonbenzodiazepine hypnotics
Pending review
Intended impact
To identify current prescribing practices and identify areas of further research to guide clinicians in prescribing pharmacotherapy to treat paediatric insomnia.