bluuebunny/crossref_metadata_2025_split huggingface dataset:
0073 Left Anterior Cingulate Hyperarousal During Sleep Anxiety-Inducing Emotional Tasks Performance in Patients with Insomnia Disorder
Authors: Kang S , Ma H , Cho S , Kang J , Kim N 
Published: May 2020

Abstract

Introduction
Patients with insomnia frequently experience sleep/insomnia-related anxiety; this anxiety has been associated with hyperarousal. We investigated the underlying brain function changes in patients with insomnia during emotional task performance that induced sleep/insomnia-related anxiety.

Methods
Functional magnetic resonance imaging (fMRI) was performed during emotional task performance in healthy individuals and patients with insomnia who met the diagnostic criteria of insomnia disorder based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and had chronic insomnia for more than 6 months. The participants underwent fMRI scanning during three types of emotional task performance—insomnia-anxiety task, reading sentences that cause insomnia-related anxiety; general-anxiety task, reading sentences that cause anxiety for everyone; and neutral task, reading neutral sentences that do not cause emotional anxiety. The images obtained from fMRI and blood oxygen level-dependent (BOLD) signal changes were compared between patients with insomnia and healthy controls. Interim analysis was performed with the data of 13 patients with insomnia and 9 controls.

Results
The brain activity in the left anterior cingulate was higher during insomnia-anxiety task performance than that during general-anxiety task performance in the insomnia group (voxel-wise uncorrected p &lt; 0.05; cluster size, 100). In the insomnia group, the brain activity during insomnia-anxiety task performance was not lower in any brain area than that during general-anxiety task performance.

Conclusion
We show that patients with chronic insomnia experience sleep anxiety related with hyperarousal in the left anterior cingulate area. Additional subject recruitment and re-analysis are needed to confirm the findings of this interim analysis.

Support
This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2017R1D1A1B03032431).
1004 Smith-&lt;Magenis Syndrome (SMS) Circadian Abnormalities And Biological Rhythms
Authors: Brooks J , Gibson M , Kite K , Czeisler E , Fisher M , Xiao C , Polymeropoulos C , Polymeropoulos M 
Published: May 2020

Abstract

Introduction
SMS is a rare neurodevelopmental disorder that manifests with craniofacial abnormalities, behavioral disturbances, and a severe sleep disorder. It has been reported that many SMS patients have an inverted melatonin secretion pattern (peaking during the daytime) although a small minority have near normal patterns. The goal of this study was to better characterize the intra- and inter-patient variability of melatonin secretion patterns and investigate a potential relationship with sleep behavior in SMS patients.

Methods
In this observational study, sleep behaviors of patients (N=8, 1 female, ages: 7 - 35) with SMS were characterized through caretaker surveys. On 3 separate occasions, patients had hourly serum melatonin levels sampled for 36 hours. From these data, peak serum melatonin concentration and time of peak concentration were determined. Inter- and intra-patient variability was characterized by zero lag correlation of the melatonin concentration timeseries across and within patients, respectively. The relationship between peak melatonin concentration, peak time, and sleep latency was analyzed by a generalized linear model, GLM.

Results
Peak melatonin concentrations varied across SMS patients with a range of 3.55pg/ml - 49.65pg/ml (mean 14.18 ± 15.19pg/ml). Time of peak melatonin concentrations ranged from 0400h-2100h (mean 1422 ± 6h). Correlation coefficients characterizing intra-patient variability ranged from -0.0098 to 0.89 (mean 0.55 ± 0.2533). Correlation coefficients characterizing inter-patient variability ranged from -0.75 to 0.79 (mean of 0.18 ± 0.52). Sleep latency ranged from 8.4min - 36.35min (mean of 21.99 ± 9.77 min). GLM analysis demonstrated a significant, positive effect of peak time with sleep latency (p=0.022).

Conclusion
Consistent with previous findings, our study confirms that SMS patients have abnormal circadian rhythms. Our work extends this body of literature by demonstrating a significant degree of inter-patient variability with relatively stable intra-patient variability. Preliminary evidence suggests that the timing of melatonin peak may be related to sleep onset latency.

Support
This work was supported by Vanda Pharmaceuticals Inc.
1007 Sociodemographic, Lifestyle and Dietary Correlates of Actigraphy-Measured Irregular Sleep Schedules in the Multi-Ethnic Study of Atherosclerosis
Authors: Huang T , Chung J , Reid M , Johnson D A , Billings M E , Klerman E B , Redline S 
Published: May 2020

Abstract

Introduction
Increasing evidence links daily variability in sleep schedules to increased cardiometabolic risk. Little is known, however, regarding sociodemographic and behavioral correlates of irregular sleep schedules that may help identify causes or consequences of irregular sleep.

Methods
Among 1,946 participants from the Multi-Ethnic Study of Atherosclerosis, we examined the cross-sectional associations of irregular sleep schedules with sociodemographic, lifestyle, dietary factors, and actigraphy-based indices of rest-wake rhythms using multiple linear regression with adjustment for age, sex, race/ethnicity, education, income, marital status and work schedules. Sleep regularity was assessed using standard deviations (SD) in actigraphy-measured sleep duration and sleep onset timing across 7 days.

Results
Compared to Whites, the 7-day sleep duration SD (95% CI) was 17.4min (12.6, 22.2) higher in African-Americans, 10.4min (4.8, 16.0) higher in Hispanics and 7.9min (1.3, 14.4) higher in Chinese. Shift versus regular work was associated with 11.4min (5.1, 17.7) higher sleep duration SD. Irregular sleep duration was associated with lower income (p=0.006), higher depressive symptoms (p&lt;0.0001), higher BMI (p=0.004) and current smoking (p=0.06). Higher sleep duration variability was associated with lower Alternative Healthy Eating Index (p=0.01), mainly due to suboptimal intakes of fruits, whole grains and nuts/legumes. No associations were observed for age, sex, education, marital status or number of meals per day. While sleep duration variability was not associated with self-reported physical activity level or actigraphy-measured 7-day mean activity count, sleep duration SD was inversely associated with relative amplitude (difference between the most versus the least active period; p&lt;0.0001) and inter-daily stability (synchronization between rest-activity patterns and environmental zeitgebers; p&lt;0.0001) of 24-h rest-activity patterns. Similar results were observed for sleep onset timing SD.

Conclusion
Substantial differences by sociodemographic factors exist regarding the consistency of day-to-day sleep schedules. Irregular sleep schedules are associated with overall circadian disruption across the day and some unhealthy lifestyle behaviors. Future studies are needed to understand temporal relationships of the observed associations.

Support
NIH grants K01HL143034, R35HL135818
1019 Subjective Sleep Quality and Sleep Recommendations Received by Patients with Cancer and Depression
Authors: Price S N , Trejo J I , Halaby L M , Guzman D , Liu Y , Verlaque R , Hamann H A , Weihs K L 
Published: May 2020

Abstract

Introduction
Diagnoses of cancer and depression are independent predictors of poor sleep, but less is known about subjective sleep quality among patients with both of these potential risk factors or about recommendations made by physicians for improving sleep among this population. This study examines correlates of poor subjective sleep quality and sleep recommendations received by patients with cancer enrolled in the Collaborative Oncology Project to Enhance Depression Care (COPE-D), a collaborative care intervention to treat depression among patients with cancer.

Methods
Participants were 74 adult cancer survivors. Demographic and clinical characteristics, subjective sleep quality, and provider sleep recommendations were obtained by patient self-report prior to intervention. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI), general health status was measured using the PROMIS Global-10, and depressive symptoms were measured using the PHQ-9.

Results
81% of patients reported significantly poor sleep quality (PSQI global scores &gt;8) and 75.3% reported poor sleep efficiency (&lt;85%). The strongest correlates of poor sleep quality were worse global mental (r=-.431, p&lt;.01) and physical health (r=-.40, p=&lt;.01). 63% reported pain interference with sleep at least once per week. Cancer type and stage, current cancer treatment, and depressive symptoms were not significantly associated with poor sleep quality (p’s&gt;.05). 12% of those reporting sleep disturbances since their cancer diagnosis had not discussed these problems with a medical provider. Among those who talked to their provider, 41.8% reported receiving sleep hygiene recommendations, 40.5% anti-depressants, 14.9% sedative-hypnotic medication (e.g. zolpidem, benzodiazepines), 10.8% cognitive behavioral therapy, 9.6% antihistamines, 6.8% melatonin, and 4.1% were recommended meditation or hypnosis.

Conclusion
Cancer patients seeking treatment for depression report very high rates of poor subjective sleep quality, which was most strongly associated with global mental and physical health. Improved screening and patient-provider communication about sleep may be especially beneficial for this at-risk population.

Support
Merck Foundation Alliance to Advance Patient-Centered Cancer Care
0104 The Effect of Time, Sleep, and Wake on Motor Memory Consolidation: A Partial Replication of Walker, Et Al. (2002)
Authors: Tucker M , Wani I 
Published: May 2020

Abstract

Introduction
Findings from Walker, et al (2002) ‘Practice with Sleep Makes Perfect: Sleep-Dependent Motor Skill Learning’ demonstrate that performance on a widely used motor memory task (motor sequence task (MST)) benefits from a 12hr period of sleep (and not wake) even if the sleep period does not occur for approximately 12hrs after task acquisition, suggesting that sleep is crucial for motor memory consolidation. Using a larger sample, we attempted to replicate this finding, which is derived from Groups B & D from Walker et al (2002).

Methods
Participants (64 medical students: Age 21.2±0.8; N=33 females) were trained on the MST in the morning (10am; N=40) or evening (10pm; N=24) and then returned 12 and 24hrs later to be retested. The MST is a simple typing task that requires participants, at training, to type a 5-digit sequence (e.g., 4-1-3-2-4) as fast and accurately as possible over a series of 12 30-second trials with a 30-second break between each trial. At each retest, participants performed three 30-second trials.

Results
With 75% of the data collected we have found that when sleep follows training in the evening (first 12hr interval), the number of correctly typed sequences increased by 19.1% (cf. 20.5% in Walker (2002)). After a subsequent day of wake (second 12hr interval) performance increased by an additional 7.3% (cf. 2.0%). However, when a day of wake spanned the first 12hrs following training, performance increased by 14.5% (cf. 3.9%) followed by another 14.5% increase over the subsequent night (cf. 14.4%). Performance differences between sleep and wake participants were nonsignificant over the first 12hrs (p=0.38) and second 12hrs (p=0.49).

Conclusion
With most of data collection complete, our findings only partially replicate those of Walker et al (2002), and may draw into question the robustness of sleep for the processing motor memory.

Support
None
1029 Objectively-Measured Sleep Following a Time Restricted Eating Intervention in Adults With Obesity
Authors: Simon S L , Fleischer J G , Manoogian E N , Panda S , Mashek D G , Chow L 
Published: May 2020

Abstract

Introduction
Time-restricted eating (TRE), limiting food intake to a consistent daily window, is emerging as a novel weight loss intervention but impact of TRE on sleep remains unclear. Prior studies reported mixed results but are limited by subjective sleep measurements and lack of a randomized control group. Thus, we examined changes in actigraphy-measured sleep following a 12-week TRE protocol.

Methods
Participants were 20 adults ages 18-65 years with BMI ≥24kg/m2. Participants were randomized to either TRE (8-hour eating window) or non-TRE (typical eating). At baseline and follow-up, all participants had anthropometric measurements, oral glucose tolerance test, logged eating occasions in a smartphone application, and wore an ActiGraph Link for two weeks. Independent samples t-tests compared groups on actigraphy-estimated sleep variables. Pearson correlations examined associations between sleep variables with health outcomes.

Results
The TRE (N=11) and non-TRE groups (N=9) were predominantly female and had a baseline eating window of approximately 15 hours. There were no differences in actigraphy-assessed sleep variables at baseline or follow-up between groups. Participants did not significantly change their sleep from baseline to follow-up. Median weekday sleep duration was 6.2 hours at follow-up for all participants, suggesting insufficient sleep compared to the recommended 7-9 hours of sleep. Participants who obtained greater than the median weekday sleep duration at follow-up had significantly lower BMI, better insulin sensitivity (HOMA and Matsuda Index), and greater percent improvement in insulin sensitivity.

Conclusion
Our data show that TRE does not significantly alter sleep behaviors in participants with obesity. However, longer sleep duration at follow-up was associated with lower BMI, better insulin sensitivity, and greater improvement in insulin sensitivity, indicating that sleep may be an important variable to consider in dietary interventions. Future research examining behavioral sleep strategies in combination with TRE is needed to evaluate whether improved sleep leads to better weight loss and glycemic outcomes for individuals with obesity.

Support
This work was support by the Healthy Foods Healthy Lives program (17SFR-2YR50LC to LC) and the National Institutes of Health (NIH National Center for Advancing Translational Sciences, UL1TR002494).
1061 Problems During Daytime Due To Poor Sleep Are Associated With Indicators Of Poor Dental Health In A Largely Non-smoking Population
Authors: Postolache T T , Wadhawan A , Daue M L , Dagdag A , Reynolds M A 
Published: May 2020

Abstract

Introduction
Growing evidence connects periodontal disease, a major and modifiable cause of local and systemic inflammation, with metabolic and cardiovascular morbidity and mortality, as well as mental illness. Sleep has been previously predictively associated with metabolic and psychiatric morbidity and mortality, and has recently been linked with periodontal disease. We are now evaluating associations between self-reported insomnia measures and surrogate indicators of periodontal disease in a population with a very low prevalence of smoking — a major confounder in previous studies.

Methods
Dental and sleep questionnaires (Pittsburgh Sleep Quality Index) were obtained from 3881 Old Order Amish from Lancaster county. Difficulty falling or staying asleep, sleep quality, problems during the day due to poor sleep, and sleepiness during daytime were related to self-reported loose teeth, partial dentures, full dentures and any dentures using linear models with adjustment for age and sex.

Results
Significant associations emerged between problems falling asleep and loose teeth (p&lt;0.05), problems staying asleep and any dentures (p&lt;0.05), sleep quality with loose teeth and partial, as well as complete dentures (p&lt;0.05 for both). Problems during daytime due to poor sleep were associated with loose teeth (p&lt;0.05), any dentures (p&lt;0.003) and full dentures (p&lt;0.0001 — the only associations resisting Bonferroni correction). Sleepiness during daytime, which is the most important marker associated with sleep apnea was not associated with any dental health measures.

Conclusion
Limitations include not accounting for family aggregation, limited generalizability, not fully differentiating between respiratory versus non-respiratory sleep impairment, and periodontal versus traumatic dental pathology. Yet, the results of our study, which minimizes the strong potential confounding by smoking, confirm associations between sleep-related problems and periodontal disease, and justify future longitudinal and interventional research to dissect causality and identify multi-target treatment modalities.

Support
This work was supported by the Mid-Atlantic Nutrition Obesity Research Center Preliminary Developmental NORC grant (Postolache, PI), a sub-award of the parent grant P30 DK072488 (Mitchell, PI), and intramural funds from the University of Maryland, Baltimore.
1069 Posttraumatic Stress Disorder is Associated With Poorer Sleep Specific Quality of Life, but Not With Sleep Apnea
Authors: Holty J C , Pandey A , Ho J Q 
Published: May 2020

Abstract

Introduction
The degree that posttraumatic stress disorder (PTSD) contributes to obstructive sleep apnea (OSA) or sleep specific quality of life (QOL) remains uncertain.

Methods
We evaluated consecutive military veterans (n=3,155) with suspected OSA using multivariable regressions to test associations between sleep and QOL measures including the apnea-hypopnea index (AHI), Pittsburgh Sleep Quality Index (PSQI) and Short-Form-12 mental component score (MCS). A mental health expert determined PTSD presence with severity measured utilizing the PTSD Checklist (PCL). Subjects were evaluated with prospectively collected questionnaires, sleep studies, and detailed electronic medical record reviews.

Results
Current-PTSD (n=1,172, 37%) were younger, more likely single, unemployed on disability, report non-white ethnicity or have current alcohol or drug dependence, report past suicide attempt, have current insomnia, restless sleep or nightmares, report lower MCS or higher Epworth Sleepiness, Fatigue Severity, Beck Depression Inventory-II (BDI) and PSQI scores than non-PTSD (n=1,880) or past-PTSD (n=103) veterans. Among current-PTSD, instigating trauma was 75% combat and 13% sexually related. In multivariable regressions, male gender (OR 4.5, p&lt;0.001), age &gt;65 years (OR 2.3, p&lt;0.001), BMI ≥35 kg/m2 (OR 3.5, p&lt;0.001), prior stroke (OR 1.8, p&lt;0.006), current hypertension (OR 1.4, p&lt;0.001), neck circumference &gt;40 cm (OR 1.3, p=0.032), and non-white ethnicity (OR 1.2, p=0.034) were associated with moderate-severe OSA (AHI ≥15/h), however current (OR 0.9, p=0.06) or past-PTSD (OR 1.2, p=0.41) were not. PCL (p=0.937) was not associated with AHI. Factors most associated with lower MCS included current-PTSD (scaled standardized beta[SSB]=0.09, p=0.001), depression (SSB=0.09, p=0.001), age &lt;50 years (SSB=0.09, p&lt;0.001), non-white ethnicity (SSB=0.07, p=0.004), female gender (SSB=0.06, p=0.007) or single/no-partner (SSB=0.05, p=0.03). Likewise, factors most associated with a higher PSQI included depression (SSB=0.19, p&lt;0.001), current-PTSD (SSB=0.15, p&lt;0.001), unemployed on disability (SSB=0.14, p&lt;0.001), non-white ethnicity (SSB=0.13, p&lt;0.001) or age &lt;50 years (SSB=0.10, p=0.001). Among current-PTSD, higher PSQI was associated with BDI ≥20 (SSB=0.31, p&lt;0.001), PCL ≥50 (SSB=0.24, p&lt;0.001) and non-white ethnicity (SSB=0.11, p=0.034), but not with moderate-severe OSA (SSB= -0.09, p=0.095).

Conclusion
In the largest PTSD sleep cohort to date, PTSD is associated with insomnia, restless sleep, poorer sleep specific QOL, and greater daytime sleepiness and fatigue, but is not associated with OSA.

Support
None
1076 Self-referential Language In Trauma Narratives Predicts Shorter Sleep Duration In Women With Ptsd
Authors: Bullock A , Burns A , Taylor E , Grandner M , Miller M , Alkozei A , Killgore W 
Published: May 2020

Abstract

Introduction
The use of self-referential language, defined as first-person singular pronouns (e.g. I, me, my), in trauma narratives has been found to predict post-traumatic stress disorder (PTSD) severity. Additionally, taking a self-immersed perspective correlates with higher blood pressure reactivity than a self-distanced perspective. Given this relationship between self-immersed perspectives and physiological processes, we investigated the relationship between self-referential language and sleep in people with PTSD, as dysfunctional sleep is a major treatment target in this disorder.

Methods
Seventy-five participants (49 females; Mage=31.8, SDage=8.8) meeting DSM-5 criteria for PTSD were administered the PTSD Checklist for the DSM-5 (PCL-5) and the Pittsburg Sleep Quality Index (PSQI). Sleep duration was assessed with the PSQI. Participants provided typed descriptions of their traumatic event, which were then analyzed using the Linguistic Inquiry and Word Count 2015 software to count instances of first-person singular pronouns (“I” words). Linear regression, with PCL-5 scores and “I” words entered stepwise, was used to predict scores on the PSQI sleep duration subscale. Use of “I” words between the sexes was also compared.

Results
For females but not males, PTSD severity significantly predicted sleep duration (R2=.207, p=.001). Additionally, the number of “I” words in the trauma narratives predicted an additional 8% of the variance in sleep duration for females (R2 change=.083, β=.288, p=.029) but not males. Females used significantly more self-referential language in their narratives (M=11.84, SD=8.42) compared to males (M=5.25, SD=6.10, p=.001).

Conclusion
After controlling for PTSD severity, self-referential language in trauma narratives significantly predicted shorter sleep duration in females. While speculative, this finding suggests that treatment approaches for PTSD may benefit from a focus on targeting self-referential processes to improve sleep and PTSD in females but not males. As dysfunctional sleep is a hallmark of PTSD, further investigation into this relationship may illuminate a new treatment avenue for this disorder.

Support
W81XWH-14-1-0570