bluuebunny/crossref_metadata_2025_split huggingface dataset:
P091 Evaluating the effect of waterless humidification on long term adherence to PAP therapy in the home environment
Authors: Bindra J , Tellez D , Camacho L , Mastellone J , Banodkar N , Deas R , Zhu X , Sert Kuniyoshi F 
Published: December 2024

Abstract

Introduction
Adherence to Positive Airway Pressure (PAP) treatment in Obstructive Sleep Apnoea (OSA) patients can be challenging. Whilst humidification enhances comfort and may improve adherence, maintenance can be burdensome. Waterless humidification through heat and moisture exchangers (HMX) offers a low-maintenance alternative. This pilot study aimed to determine the effect of waterless humidification via HMX on long term PAP adherence and user feedback, after 12 months of use.

Methods
This decentralised, prospective cohort study enrolled US-based established PAP users, using cloud-connected devices and a patient engagement app. All procedures were conducted remotely. Participants used a HMX device with their home PAP device for 12 months. Average nightly usage was measured at baseline (3 months prior) and monthly post-enrolment. Usability, comfort, and ease of use were assessed monthly via 11-point Likert scale questionnaires. After 90 days of HMX use, average PAP usage and apnoea-hypopnoea index (AHI), and weighted-average patient-reported scores were calculated.

Results
162 participants were analysed after 90 days of HMX use. Average cumulative PAP usage decreased slightly from 6.81 to 6.80 hours, while AHI changed from 2.04 to 1.87 events/hour. The HMX device received favourable ratings, with mean scores of 8.43 (overall performance), 9.43 (overall ease of use) and 8.66 (overall breathing comfort).

Discussion
This analysis demonstrates no deterioration in PAP usage or AHI following 90 days of HMX use, with favourable subjective feedback. Further analysis upon 12-month completion will provide valuable insights into real-world evaluation of waterless humidification with home PAP therapy.
P093 Associated risk factor of metabolic syndrome and relationship between metabolic syndrome and obstructive sleep apnea in Korean adults
Authors: Sim J , Chang S 
Published: December 2024

Abstract

Introduction
Many studies have shown an association between metabolic syndrome (MetS), and obstructive sleep apnea (OSA). However, there are insufficient studies on whether STOP-BANG is associate with MetS in Korean adults. Therefore, we attempted to clarify this relationship in Koreans adults.

Methods
A total of 2,900 participants (1,233 men and 1,667 women) were enrolled in the Korean National Health and Nutrition Examination Survey from 2019 to 2020. We used the National Cholesterol Education Program Adult Treatment Panel III criteria for MetS and STOP-BANG questionnaire for OSA risk. Logistic regression analysis was used to measure the association between MetS and various confounding factors, including high OSA risk (STOP-BANG score≥3).

Results
The percentage of subjects with high OSA risk was significantly higher in subjects with MetS than without MetS (54.9% vs 27.7%; p&lt;.001). In multivariate logistic regression analysis, high OSA risk (OR 1.490, 95% CI 1.139 to 1.948, p=0.004), men (OR 3.966, 95% CI 2.938 to 5.353, p&lt;.001), waist circumference (OR 1.095, 95% CI 1.076 to 1.113, p&lt;.001), fasting glucose (OR 1.038, 95% CI 1.028 to 1.047, p&lt;.001), and systolic blood pressure (OR 1.038, 95% CI 1.030 to 1.047, p&lt;.001) were significantly associated with MetS in Korean adults.

Discussion
These results suggest that there is a strong association between high OSA risk and MetS in Korean adults. Therefore, MetS evaluation is required in high OSA patients, and OSA diagnosis through PSG test and treatment is necessary.
P099 An audit of the diagnostic workup of patients with Idiopathic Hypersomnia at Gold Coast University Hospital
Authors: Gordon L , Saxena K , Sriram B 
Published: December 2024

Abstract

Background
Idiopathic hypersomnia (IH) is a central cause of hypersomnia. The diagnosis involves excluding all other causes of hypersomnia whilst also proving reduced sleep latency without features of narcolepsy. There are many causes of increased fatigue, and therefore proving the diagnosis of IH is an involved process requiring a thorough medical and medication history, a review of basic pathology results and examination. This is then followed by a minimum of a 10-day sleep diary, a diagnostic polysomnography followed by a multiple sleep latency test. Treatment for IH can involve stimulant medication, and therefore the prescribing doctor needs to be confident in the diagnosis. This is an audit of the patients diagnosed or treated for IH at Gold Coast University Hospital (GCUH), looking to identify how often all these work up requirements have been met.

Methods
A list of all the patients treated or diagnosed with IH at the GCUH sleep department will be obtained from the Sleep Disorders Centre Database. The diagnostic workup of the patients identified will then be reviewed to ensure that they have met the diagnostic criteria.

Progress to date
data collection currently in progress.

Intended outcome
Confirmation that the patients diagnosed with or treated for IH at GCUH have been through the required diagnostic workup.
P103 Developing Visual Tools for Participant Information and Consent in Sleep Health Research
Authors: Ashby C , Cooper R , Ison H , Kinghorn M , Sullivan D , Nasir B , Edmed S , Von Senden R , Bucks R , Fatima Y , Jahan I 
Published: December 2024

Abstract

Introduction
Informed consent in research is crucial for meeting ethical standards, transparency, and voluntary participation. However, current institutional research consent processes often rely on text-heavy documents filled with complex academic jargon. This approach can lead to misunderstandings and disengagement, posing a significant challenge to obtaining genuinely informed consent. This study outlines the process of developing visual tools to improve the informed consent process in sleep health research with First Nations peoples.

Methods
Through a collaborative process engaging First Nations visual communication experts and First Nations community researchers, visual consent tools were redesigned to prioritise participant engagement. Iterative feedback was provided regarding accessibility, cultural responsiveness, and suitability for First Nations communities, whilst balancing consumer-centric information and the rigour of the informed consent process. Subsequently, the Lets Yarn About Sleep First Nations Data Governance team assessed the work for cultural responsiveness and suitability for First Nations sleep health research. The final stage involved obtaining institutional ethics committee approval for consumers to test and evaluate the visual tools.

Results
Initial feedback from community researchers and the Data Governance team highlights the potential of the visual consent tools to enhance the informed consent process. Further testing and evaluation will confirm the impact of these tools on participant comprehension and engagement.

Discussion
This study documented initial steps in First Nations-led development of culturally responsive visual tools for seeking informed consent in sleep health research. Future work must evaluate broader acceptability of culturally grounded visual consent approaches, with a view to reforming institutional research ethics processes.
P104 Positional OSA in children: single-centre prevalence and associated CPAP adherence
Authors: Kevat A , Suresh S , Kilner D , Chawla J , Collaro A 
Published: December 2024

Abstract

Background
Positional obstructive sleep apnoea (POSA) is an obstructive sleep apnoea (OSA) phenotype in which most obstructive events occur in supine sleep. For adults, recent guidelines and trials suggest positional OSA devices are suitable treatment alternatives to continuous positive airway pressure (CPAP). We sought to determine prevalence of POSA and associated rates of suboptimal CPAP adherence in children.

Methods
This single centre retrospective cohort study included all children &gt;2 years of age prescribed CPAP from 01/01/2020–01/01/2023 through Queensland Children’s Hospital (QCH) for moderate-severe OSA. Children were classified as having POSA or not through examination of obstructive events and sleep position determined by their diagnostic polysomnography. POSA was defined according to three different established diagnostic criteria (Cartwright’s, Bignold’s and Amsterdam POSA criteria), modified for paediatric use. CPAP adherence was defined as on average &gt;4 hours usage for ≥5 nights/week.

Results
Of 120 eligible participants (median age = 13 years), 34% were female, 62% were obese, 33% had a syndromic or neurodevelopmental diagnosis and 48% had undergone adenoidectomy +/- tonsillectomy. Depending on POSA definition, 34%-68% (41-73) of the 120 participants had POSA. One-third (32-36%, depending on POSA definition used) of those with POSA had suboptimal CPAP adherence based on their first CPAP download.

Conclusion
A significant proportion of children with OSA prescribed CPAP at QCH have POSA, some of whom struggle to maintain CPAP adherence. Positional device therapy may represent an appropriate alternative management strategy. However, well-designed prospective trials in children are needed.
P106 The contribution of workload to fatigue risk in helicopter Search and Rescue operations
Authors: Ladyman C , Signal L , van den Berg M 
Published: December 2024

Abstract

Introduction
Routine offshore aviation transport services often co-provide Search and Rescue (SAR) operations. SAR crewmembers are required to be on immediate or standby readiness 24-hours a day and perform complex high-risk tasks when called. This study investigated work and sleep-based factors associated with workload and the contribution of those same factors to fatigue in this operation.

Methods
Across two 21-day rosters, SAR crewmembers recorded sleepiness (Karolinska Sleepiness Scale, KSS), fatigue (Samn-Perelli Fatigue Checklist, SP) and workload ratings (Overall Workload, OW and NASA Taskload Index, NASATLX), wore an actigraph to measure sleep, and completed a 3-minute Psychomotor Vigilance Task (PVT). Mixed model ANCOVAs investigated sleep and work-related factors associated with OW and NASATLX ratings and separately work-related factors associated with KSS and SP ratings and PVT performance at the end of a shift.

Results
A callout or training during a shift resulted in higher OW and NASATLX ratings (all p=&lt;0.001). If a shift involved administration, OW and NASATLX were lower (all p≤.05). Prior sleep/wake history and shift worked were not significantly associated with workload measures. End of shift fatigue ratings were higher when a callout or training occurred, and end of shift sleepiness ratings were higher when training occurred (all p≤.05). Administrative work was not associated with changes in fatigue or sleepiness. No work-based factors were associated with PVT.

Discussion
Key contributors to both increased workload and greater fatigue and sleepiness were callouts and training. These aspects of work may directly impact fatigue and sleepiness and also indirectly, via greater workload.
P107 Overnight Oximetry for the Diagnosis of Sleep-Disordered Breathing in Cervical Spinal Cord Injury Patients
Authors: Lim S , Kovacs R , Tung C , Cistulli P , Mohammadieh A 
Published: December 2024

Abstract

Background
Cervical Spinal Cord Injury (cSCI) patients have altered upper airway physiology and breathing mechanics, putting them at risk of clinically significant sleep-disordered breathing, including Obstructive Sleep Apnoea (OSA), Central Sleep Apnoea (CSA) and hypoventilation syndromes. However, polysomnography (PSG) for cSCI patients may be financially and environmentally costly and may not be accessible to all cSCI patients. Overnight oximetry is a portable and cost-effective alternative screening and diagnostic test, but its diagnostic accuracy has not been assessed in a cSCI population.

Methods
Patients will be eligible if they have sustained an acute cervical SCI between Jan 2021 and Dec 2023 and have undergone full PSG as an inpatient or outpatient within one year of their acute injury. Overnight oximetry from the night of the PSG will be compared to the overall PSG result for diagnostic accuracy with respect to OSA, CSA and hypoventilation. ROC analysis will be undertaken using metrics including ODI, time with SaO2 &lt; 90%, as well as a clinician-based “pattern recognition” of the oximetry trace morphology.

Progress to date
668 acute spinal cord admissions have been identified at a single tertiary spinal injury centre between Jan 2021 and Dec 2023. Work is ongoing to identify those patients with cervical SCI only and to analyse the oximetry and PSG data.

Intended outcome and impact
This study will help to standardise and streamline the diagnostic pathway for SDB in cSCI patients in a tertiary referral centre, and allow more time efficient access to therapy in this vulnerable patient group.
P110 Does better adherence to Sleep Restriction Therapy produce a faster clinical response in CBT-I?
Authors: Ogden J , Lim J , Bei B , Drummond S 
Published: December 2024

Abstract

Introduction
Sleep Restriction Therapy (SRT) is a key component of CBT-I. The goal of SRT is to build sleep debt to consolidate sleep and increase sleep efficiency. Given that, one would expect greater adherence to SRT to predict a faster clinical response, defined as fewer weeks of restriction prior to the first increase in time-in-bed (once 85% sleep efficiency is reached). Here, we examined this hypothesis for the first time.

Methods
83 participants were randomized to 7 weeks of therapist-led CBT-I. 78 initiated SRT (age: 48.0±14.3, 57.7% F). A Poisson regression was conducted to investigate the relationship between adherence to SRT (deviation from bed and wake times, naps) and the number of weeks in SRT prior to the first increase in time-in-bed. Age and diary-based sleep efficiency in week 1 (prior to beginning SRT) were added to the model as covariates.

Results
There was a significant positive association between waking later than prescribed wake time and number of weeks in SRT prior to increasing time-in-bed (p &lt;.05). However, deviation from prescribed bedtime and napping were not significantly associated with time in SRT.

Conclusion
Overall, better adherence to morning wake time is associated with faster response to SRT. Adhering to morning wake time may further promote sleep deprivation and stabilise circadian rhythms, thereby improving the sleep efficiency required to increase time-in-bed. Given the challenging nature of SRT, a relationship between adhering to wake time and faster titration upward of time-in-bed may improve both therapist treatment fidelity and client motivation.
P111 Chronic Pain and Sleep: The feasibility of tailored group cognitive behavioural treatment for insomnia for individuals with chronic pain
Authors: Bensen-Boakes D , Dunbar C , Paterson J 
Published: December 2024

Abstract
Sleep disruption is a common comorbidity for individuals living with chronic pain but avenues for referrals and treatment are often difficult in these populations with competing medical demands. The ongoing struggle with sleep difficulties can result in the development of insomnia. Recent research supports that addressing difficulties with sleep may significantly improve the patient’s ability to manage their chronic pain and lighten overall illness burden. Cognitive Behavioural Therapy for Insomnia is the currently accepted gold standard for the treatment of Insomnia, however adaptations for its use in chronic pain populations is necessary. This program first aimed to investigate common presentations and the practical adaptations necessary for safe and effective implementation of CBTi in this population. This research targets the need for greater understanding of the benefits and safe use of CBTi in diverse populations. Secondly, this program explored the implementation of group-delivered CBTi within the chronic pain population to provide insight into new implementation methods and the overall feasibility. This research addresses the understudied area of individuals with chronic pain patients and sleep difficulties, and also directly relates to and promotes the need for greater multi-disciplinary approach to chronic illness management. It highlights the need for greater awareness of an understudied group and promotes opportunities for individuals to access supports beyond their chronic illness which enables them to achieve greater autonomy over their treatment journey.
P118 Sleep in adults exposed to a major flooding event in Australia
Authors: Edmed S , Rossa K , Pattinson C , Alam M , Lorimer N , Smith S 
Published: December 2024

Abstract

Introduction
Residents in communities impacted by major flooding events, such as those experienced in Brisbane in 2022, face a range of challenges that may impact their recovery. Poor sleep health may be a direct and potentially ongoing outcome of these events.

Method
An online survey was completed by 134 adults affected by flooding in 2022/3 in Australia (Mdn Age=27; 79% female). Data were collected12-18 months post-flood. The survey consisted of standardized assessments of socioemotional functioning and sleep, predominantly drawn from the Patient Reported Outcomes Measurement Information System® (PROMIS®), with a tailored measure of flood exposure.

Results
Residents living in a flood affected suburb whose home was affected by flood waters, or with residual problems due to flood waters, had higher PROMIS Sleep Disturbance T-Scores (PROMIS-SD; p=0.05, p=&lt;0.01, respectively) and higher PROMIS Sleep Related Impairment T-Score (PROMIS-SRI) (p=0.02, p=.03) compared to those who did not; but there was no significant association for sleep duration (p=0.83, p=0.41) and sleep regularity (p=0.33, p=0.69). Greater worry about future extreme weather, but not worrying about climate change, was associated with greater PROMIS-SD (p&lt;0.01, p=0.33) and PROMIS-SRI (p&lt;0.01, p=0.34).

Discussion
Climate change has implications for sleep health on a global scale. The frequency of extreme weather events is predicted to increase. Poor sleep may amplify and reinforce health and social risks for people after flooding. Further analysis of these data will explore the mediating impact of sleep on psychosocial trajectories of recovery.
P119 Exploring sleep in people experiencing homelessness: A scoping review
Authors: Edmed S , de Waal L , Rossa K , Pattinson C , Salom C , Lorimer N , Gadam S , Smith S 
Published: December 2024

Abstract

Introduction
People experiencing homelessness are among the most socially and economically disadvantaged. Homelessness is associated with a higher risk of adverse health, social and economic outcomes. This review aimed to describe published evidence available regarding sleep in adults experiencing homelessness.

Method
Guided by the Scoping Review framework in the Joanna Briggs Institute Manual for Evidence Synthesis, a systematic search of 7 databases was conducted. English language studies were included if they examined any dimension of the sleep experience reported by adults (≥18 years) experiencing homelessness in high income countries. No publication date limits were set.

Results
101 studies met inclusion criteria (45 quantitative, 43 qualitative, 6 mixed-methods studies, and 7 narrative reviews). Most studies (66%) did not explicitly investigate sleep as a core research objective. Half (52%) were conducted in the United States, with 9 Australian studies (9%). Most (94%) quantitative studies used predominantly purpose-developed, subjective sleep measures. Despite measurement heterogeneity, insufficient sleep and poor sleep quality were frequently endorsed. Qualitative studies identified safety and security, weather exposure, and comfort as important factors impacting sleep. No sleep specific intervention studies were found.

Discussion
Findings suggest that more high-quality research is needed, with greater consistency and standardization of measurement to allow evidence to be synthesised. An integrated view of sleep health should be adopted, incorporating expertise across broad sleep health areas with consideration of individuals’ neurophysiology, their beliefs, habits, and experiences, physical environment, and the broader social context. These factors are particularly important in developing public health-focussed interventions for vulnerable populations.
P120 The relationship between digital technology and sleep-wake behaviour in children aged 5-8 years
Authors: Pattinson C , Edmed S , Rossa K , Mann D , MacKenzie J , de Waal L , Smith S 
Published: December 2024

Abstract

Introduction
Children are growing up in 24-hour digital-enriched environments. Digital life may have significant impacts on a child’s 24-hour sleep-wake behaviours and wellbeing. This study aimed to explore the relationships between sleep, digital technology use, and daytime functioning in children.

Method
Data for this study were drawn from a pilot study investigating wearable devices in children aged 5-8 years, in their naturalistic environment. Children (N=20, Mage=7.03, SD=1, f=40%) wore an actigraph continuously for 48-hours to monitor sleep. Parents completed a daily digital technology time-use survey, as well as questionnaires to assess the purpose of digital technology use (Child Regulatory Media Use Scale) and daytime sleep related impairment (PROMIS®).

Results
Mean(SD) sleep onset and offset were 19:55 (00:39) and 05:58 (00:42), respectively. Using digital technology in the 2-hours before sleep was associated with increased parental use of media to regulate children’s emotions and behaviours (r=.59, p=.006), and poorer sleep related daytime impairment (r=.52, p=.02), but not with sleep onset, offset, or duration.

Discussion
Use of devices 2-hours prior to bedtime was associated with poorer parent-perceived daytime function, but not with objective measures of sleep duration. Use of digital media by children, including personal devices, is increasingly common. Parental choices around the role of screens in the family may be an important determinant of wellbeing. Based on findings from this study, a larger scale study is warranted to quantify and map digital exposures of children in the early years of primary school (5 – 8 years old).