bluuebunny/crossref_metadata_2025_split huggingface dataset:
0369 Sleep Disparities are Established by the First Month of College
Authors: Bermudez V , Fearon D , Wheelis M , Cohenour M , Scullin M K 
Published: May 2020

Abstract

Introduction
Short and poor quality sleep are particularly common in college students, likely impacting their ability to persist and succeed in difficult courses. In the current study, we investigated demographic-based sleep differences (sleep disparities) and demographic-based academic differences (achievement gaps) in first-semester college students, with the goal of informing whether sleep disparities contribute to achievement gaps.

Methods
From 2017 to 2018, first-semester undergraduate students at Baylor University completed the New2BU Survey [N=6,048, 61.9% female, 18.7% first-generation, 23.8% underrepresented racial/ethnic minority (URM)]. Data collection occurred within three to five weeks of classes beginning. The survey included self-reported weekday total sleep time (TST), which we classified as short sleep (≤6.9 hours), normal sleep (7-9 hours), or long sleep (&gt;9 hours). Semester GPA data were obtained from university records for students’ first 4 semesters.

Results
There was evidence for both achievement gaps and sleep disparities. The risk for short sleep was increased in female students (p&lt;.001; OR=1.20, 95%CI: 1.08-1.33), first-generation students (p=.02; OR=1.17, 95%CI: 1.03-1.33), and URM students (p&lt;.001; OR=1.32, 95%CI: 1.16-1.50). The risk for long sleep increased substantially in first-generation students (p=.003, OR=1.92, 95%CI: 1.25-2.97) and URM students (p&lt;.001; OR=2.41, 95%CI: 1.57-3.70), but not in female students (OR=0.88, 95%CI: 0.59-1.30). First-generation and URM students showed a 0.2-0.3 GPA reduction each semester relative to comparison groups (ps&lt;.001), but short sleep and long sleep predicted GPA data up to four semesters later. Sleep-GPA correlations were modest in size (rs=.10-.14), but remained significant even after controlling for numerous demographic variables, high school GPA, and college entrance test scores.

Conclusion
Sleep disparities are noteworthy within the first month of college, and predictive of academic performance across four semesters. Addressing sleep health in all students—but particularly female, first-generation, and URM students—may increase academic success, bridge achievement gaps, and reduce health disparities.

Support
National Science Foundation (DRL 1920730)
0374 Decline in Habitual Sleep Duration Over 10 Years and Worsening Sleep Disparities: Data From NHIS (2006-2015)
Authors: Grandner M A , Fernandez F , Khader S , Jean-Louis G , Seixas A A , Williams N J , Patterson F , Killgore W D , Wills C C 
Published: May 2020

Abstract

Introduction
Despite claims in the media, evidence that habitual sleep has declined in recent years is scant. Few data sources exist that systematically document sleep duration in a nationally representative sample, in the same way, over several years.

Methods
Data from 10 years of the National Health Interview Survey were used (N=305,555). During all years, habitual sleep duration, age, sex, race/ethnicity, and height/weight were recorded in the same way. Weighted regression analyses examined sleep duration as the outcome, year as linear predictor, and sociodemographics as covariates. Then, interaction terms examined whether the linear change associated with years was differentially experienced by different sociodemographic groups.

Results
The linear trend of sleep duration over the past 10 years is a loss of 0.78 minutes per year (95%CI -0.91,-0.64; p&lt;0.0001). After adjustment for age, sex, race/ethnicity and BMI, this remained relatively unchanged at 0.86 minutes (95%CI -0.99,-0.73; p&lt;0.0001). A year-by-race/ethnicity interaction was observed (p&lt;0.05). In stratified analyses, Non-Hispanic Whites showed a loss of 0.68 minutes per year (95%CI -0.84,-0.52, p&lt;0.0001). This was 1.33 minutes/year in Blacks/African-Americans (95%CI -1.74,-0.92; p&lt;0.0001), 1.57 minutes/year in Mexican-Americans (95%CI -1.98,-1.16; p&lt;0.0001), 0.99 minutes/year in other Hispanics/Latinos (95%CI -1.51,-0.47; p&lt;0.0001), 0.74 minutes/year in Asians (95%CI -1.24,-0.25; p=0.003), and 1.80 minutes/year in American Indians/Alaskan Natives (95%CI -3.57,-0.03, p=0.046).

Conclusion
On average, the US population has lost 47 seconds of nightly sleep per year over a 10-year period, equating to about 4.7 hours of sleep per year, but racial/ethnic groups were impacted differently. Compared to Non-Hispanic Whites, Blacks/African-Americans lost 96% more sleep, Mexicans lost 131% more sleep, other Hispanics/Latinos lost 46% more sleep, Asians lost 9% more sleep, and American Indians lost 165% more sleep. Thus, sleep disparities may be widening.

Support
Dr. Grandner is supported by R01MD011600
0377 A Strengths-Based Approach to Examine Obstructive Sleep Apnea in Black and White Patients
Authors: Williams N J , Butler M , Roseus J , Blanc J , Barnes A , Bubu O M , Ebben M , Krieger A , Jean-Louis G 
Published: May 2020

Abstract

Introduction
The majority of studies on race/ethnic disparities in OSA are derived from a deficit-based perspective (i.e. &gt;BMI, non-adherence to PAP). It would prove useful to identify which aspects are protective to inform potential treatment approaches. We focused on two potential factors: resilience and social support, in patients newly diagnosed with OSA. Given the high prevalence of insomnia complaints in patients with OSA, insomnia was our outcome of interest.

Methods
91 patients newly diagnosed with OSA provided demographic and socioeconomic status, sleep measures (Epworth, DBAS), resilience (Connor Davidson Resiliency Scale), social support (MOS Social Support Scale) and completed the Insomnia Severity Index. The cross-sectional associations between ISI, race/ethnicity, resilience, social support and their interaction effects were examined using linear regression models with covariate adjustment for participant age, sex and BMI. We ascertained total ISI score and individual items.

Results
The sample was 34.1% black (n=31), mean age of 57.6 years, SD=13.6, 64.8% male (n=59), and mean BMI of 32.4, SD=7.04. Mean sleep duration (as reported by sleep diary) was 6.64, SD=1.35. Black, white differences were not observed for sleepiness (M=8.60; 10.43, p=0.11) or DBAS (M=4.61; M=5.04, p=0.30). Blacks, reported clinically significant insomnia (M=15.00, SD=7.17) compared to whites (M=12.02, SD=6.83, p=0.05). On the individual ISI items, blacks were significantly more likely to endorse difficulty falling asleep (M=1.58, SD=1.54; M=0.75, SD=0.93,p=0.002) and waking up too early (M=2.09, SD=1.26; M=1.45, SD=0.93,p=0.021) compared to whites. Resilience (M=30.04, SD=6.42) and social support scores (M=74.13, SD=21.36) did not differ by race/ethnicity. In adjusted linear analysis, resilience had significant effect on ISI score (b=-0.36, SE=0.12, p=0.003) but not social support (b=-0.06, SE=0.08, p=0.31).

Conclusion
In this study we did not observe race/ethnic differences for sleepiness and dysfunctional beliefs about sleep. With respect to the protective factors, race/ethnic differences were not observed. Resilience, not social support, was related to insomnia complaints. Future studies should examine a variety of factors that may serve black and other racial/ethnic groups with OSA, and help elucidate protective processes.

Support
K23HL125939
0378 Social Well-Being as a Longitudinal Mediator of the Association Between Discrimination and Sleep Quality
Authors: Dautovich N , Ghose S 
Published: May 2020

Abstract

Introduction
Discrimination is a risk factor for poor sleep outcomes. Physiological activation is one mechanism tying the experience of discrimination to disturbed sleep. Discrimination, however, can also impact psychosocial well-being, which is a necessary precursor for healthy sleep. Feelings of safety derived from social connections can be threatened when individuals face discrimination. The objective of the current study was to examine the role of social well-being as a factor underlying the longitudinal association between discrimination and sleep quality.

Methods
An archival analysis was conducted with 937 adults participating in the longitudinal Midlife in the United States (MIDUS) study. Data was collected at three time points across 10 years. Perceived daily discrimination and overall social well-being were assessed via self-report. Sleep quality was assessed via the Pittsburgh Sleep Quality Index, Global Sleep Quality score.

Results
The overall model accounted for 15.6% of variance in global sleep quality. Controlling for multiple covariates, more frequent experiences of discrimination predicted worse global sleep quality 10 years later (β=.06, p=.03). Worse overall social well-being was a significant mediator of the discrimination-global sleep quality association (95% CI [.0001, .0118]), such that more frequent discrimination predicted lower overall social well-being, which, in turn, was associated with worse global sleep quality.

Conclusion
Given the persistence of sleep disparities among stigmatized and marginalized groups and the importance of sleep as a means of health disparity reduction, there is a need to identify mechanisms linking discrimination to poor sleep outcomes. Daily experiences of discrimination, such as being given less respect or treated as though less intelligent, have long-lasting associations with social well-being. Furthermore, social well-being is a predictor of future sleep quality. In addition to addressing discriminatory practices, targeting the effects of social well-being on sleep is a direction for future research.

Support
N/A
0381 Association of Social Jetlag with the 2018 WCRF/AICR Cancer Prevention Score Among Parent-Adolescent Dyads in the FLASHE Study
Authors: O’Connor S G , Shams-White M M , Czajkowski S , Oh A 
Published: May 2020

Abstract

Introduction
Social jetlag (SJL), or the mismatch between biological and social time, is a marker of circadian misalignment. SJL is linked to biological and behavioral alterations (e.g., adiposity, unhealthy food intake) which over time may increase cancer and chronic disease risk. While developmental changes exacerbate SJL among adolescents, parents may also influence adolescent behavioral patterns. This study examined associations of SJL with multiple cancer preventive behaviors among parent-adolescent dyads using the 2018 World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR) Cancer Prevention Score in the National Cancer Institute’s Family Life, Activity, Sun, Health, and Eating (FLASHE) Study.

Methods
Online cross-sectional surveys examining cancer-preventive behaviors were administered to 1,479 parent-adolescent (aged 12-17y) dyads in 2014. SJL was defined as the absolute difference between sleep midpoint on weekend and week days. The adapted 2018 WCRF/AICR Score ranged from 0-6 and was the sum of six sub-components representing adherence to specific cancer prevention recommendations concerning body weight, physical activity, and diet. Dyads with missing data on either variable were excluded. Actor-partner interdependence modeling was used to determine within-dyad correlations, actor (i.e., effect of a dyad member’s SJL on own score), and partner (i.e., effect of a dyad member’s SJL on partner’s score) effects.

Results
The analytical sample included 936 dyads. Mean SJL was 2.0 hours (SD: 1.2) for adolescents and 1.2 hours (SD: 0.9) for parents. Mean WCRF/AICR Scores were 4.1 (SD: 0.9) for adolescents and 4.0 (SD: 0.9) for parents. Within dyads, SJL (r=0.29) and the WCRF/AICR Score (r=0.41) were positively correlated (all p &lt;0.0001). Among adolescents, greater SJL was associated with a lower WCRF/AICR Score (β= -0.077, SE: 0.03, p=0.003), but this relationship was not observed among parents. No partner effects were detected.

Conclusion
Among adolescents, SJL was associated with poorer adherence to cancer prevention recommendations. SJL may represent a modifiable risk factor with the potential to improve multiple health behaviors and decrease disease risk.

Support
FLASHE was funded with federal funds from the National Cancer Institute, National Institutes of Health (NIH), under contract number HHSN261201200039I issued to Westat, Inc
0410 Insufficient Sleep Among Healthcare Professionals
Authors: Jenkins D , Peprah R , Donley T , Sexias A , Khosrof A , Jean-Louis G 
Published: May 2020

Abstract

Introduction
Insufficient sleep (IS) is a common problem among healthcare professionals, especially those who are shift workers. Evidence has shown that sleeping less than eight hours can lead to sleep debt. Sleep debt can have a negative impact on the mental, emotional and cognitive well-being of health care providers. In addition to sleep debt, having long shift hours reduces the opportunity for sleep because there is less time to recuperate.

Methods
We analyzed data gathered from healthcare workers (n=4,093) from the 2017 and 2018 National Health Interview Survey (NHIS), a nationally representative study of the US civilian non-institutionalized population. Sleep was categorized as short (≤6 hrs), normal/healthy (7-8 hrs), and long (≥9 hrs) sleep. Using STATA 15.0 for Windows, we report weighted frequencies and Chi square tests. Alpha of 0.05 was used for all significance levels.

Results
Of the sample, 18% were male and 82% were female. The mean age was 50.7±17.5. The majority of the sample was White (77%), 12% were Black and 9% were of other minority”. The proportion of women who reported short sleep (31%) and normal (45%) were significantly higher than men (p&lt;0.000). Healthcare workers under 30 had the highest proportions of short sleep compared to any other age groups (p&lt;0.000). Lower numbers were associated with long sleep among those who worked directly with patients compared to workers who did not (p&lt;0.000). Healthy sleep was significantly associated with not having trouble falling asleep, staying asleep, not taking sleep medications, and feeling rested 7 or more times in the past week (p&lt;0.000).

Conclusion
Our study explores sleep patterns among healthcare professionals. Previous studies have shown that this population is more susceptible to insufficient sleep which leads to sleep debt. We found that the current data suggest that this association may have changed for healthcare professionals today.

Support
This study was supported by funding from the NIH: R01MD007716, R01HL142066, K01HL135452, and K07AG052685.
0419 IL-6 Moderates the Association Between Obstructive Sleep Apnea Severity and Incident Alzheimer’s Disease: The Framingham Heart Study
Authors: Baril A , Beiser A S , Redline S , McGrath E R , Aparicio H J , Gottlieb D J , Seshadri S , Himali J J , Pase M P 
Published: May 2020

Abstract

Introduction
Both sleep disturbances and inflammation are potential risk factors for Alzheimer’s disease (AD). However, it is unknown how inflammation and sleep interact together to influence the risk of developing AD dementia. Our objective was to evaluate whether interleukin-6 (IL-6) levels interact with sleep disturbances when predicting incident clinical AD.

Methods
We studied participants in the Framingham Heart Study Offspring cohort who completed in-home overnight polysomnography. Sleep characteristics were continuous and included sleep duration, wake after sleep onset (WASO), and apnea-hypopnea index (AHI). Participants were stratified into quartiles of IL-6 levels. Surveillance for incident AD dementia occurred over a mean follow-up of 13.4±5.4 years. Using Cox proportional hazards regression models, we tested the interaction of sleep measures by IL-6 quartiles on incident AD dementia. All analyses adjusted for age and sex and P&lt;0.05 was considered significant.

Results
The final sample included 291 dementia-free participants at baseline (age 67.5±4.9 years, 51.6% men). Approximately one quarter of participants had obstructive sleep apnea (OSA; AHI&gt;15) at baseline (median:6.2, Q1:2,3, Q3:14.3). We observed 33 cases of incident AD dementia during follow-up. Although no interaction was observed for either sleep duration or WASO with IL-6 levels, there was a significant interaction of AHI with IL-6 in predicting AD dementia (p=0.002). In the lowest IL-6 quartile, higher AHI was associated with an elevated risk of AD dementia (hazard ratio, 4.15 [95%CI, 1.42, 12.1], p=0.01) whereas no association between AHI and incident AD was observed in other IL-6 quartiles.

Conclusion
Our findings suggest that the pro-inflammatory cytokine IL-6 moderates the association between OSA and incident AD risk. The association between increasing OSA severity and incident AD was only observed in those with lower IL-6 levels, suggesting that this association might be especially apparent when no other confounding risk factors such as inflammation are present.

Support
The Framingham Heart Study is supported by contracts from the National Heart, Lung and Blood Institute, grants from the National Institute on Aging, and grants from the National Institute of Neurological Disorders and Stroke.
0422 Apocalypse Tau: The Relationship Between Inflammaging and Local Sleep Disruption in Older Adults is Mediated by Tau Burden
Authors: Dave A , Sprecher K E , Lui K K , Chappel-Farley M G , Chen I Y , Blennow K , Zetterberg H , Riedner B A , Bendlin B B , Mander B A , Benca R M 
Published: May 2020

Abstract

Introduction
Chronic inflammation in aging is independently associated with tau burden and sleep disruption, though the mechanism linking inflammation with sleep disruption remains unknown. Recent evidence associates tau burden with deficits in local expression of sleep spindles and slow wave activity (SWA). Here we test the hypothesis that age-related central inflammation disrupts local sleep by influencing tau pathology.

Methods
Cognitively asymptomatic older adults from the Wisconsin Alzheimer’s Disease Research Center underwent overnight polysomnography with high-density electroencephalography (hdEEG; 256 channels) at the University of Wisconsin-Madison (n=33, 61.9±6.7 years, 23 female). EEG data were subjected to multitaper spectral analysis (0.5-40Hz) to yield topographic maps of SWA (SWA1:0.5-1Hz, SWA2:1-4.5Hz) and spindle (sigma1:11-13Hz; sigma2:13-16Hz) power during NREM sleep. Cerebrospinal fluid assay-based measurements of YKL-40 (indicating glial activation), phosphorylated tau (Ptau), and total tau (Ttau), were correlated with SWA and sigma topographical power employing Holm-Bonferroni correction. Multiple linear regression models were implemented controlling for age, apnea-hypopnea index (AHI), and sex at significant derivations. Finally, Sobel testing was employed to assess whether tau burden mediated YKL-40-sleep associations.

Results
Age was associated with YKL-40 (r=0.53, p=0.002), and YKL-40 was associated with both Ptau (r=0.66, p&lt;0.001) and Ttau (r=0.68, p&lt;0.001). Correlations between sigma2 activity and both Ptau and Ttau were detected at 14 derivations, 12 of which remained significant after controlling for age, sex, and AHI. YKL-40 was associated with sigma2 power (r=-0.39, p=0.025) across derivations expressing peak significance with tau. Sobel mediation analyses indicated that both Ptau (t=-2.15, p=0.031) and Ttau (t=-2.36, p=0.018) mediated the relationship between YKL-40 and sigma2 activity at these derivations. SWA was not associated with Ttau, Ptau, or YKL-40.

Conclusion
These results suggest that age-related increases in central glial activation may disrupt local expression of fast spindles by increasing tau burden, highlighting a potential role for chronic inflammation in sleep deficits observed in aging and Alzheimer’s disease.

Support
Supported by R56 AG052698, P50AG033514
0424 Effect of Chronic Intermittent Hypoxia on Global Cerebral Metabolic Rate of Oxygen Consumption in Rats
Authors: Xu J , Geng E , Brake L , Wiemken A , Keenan B , Kubin L , Schwab R 
Published: May 2020

Abstract

Introduction
Patients with obstructive sleep apnea (OSA) commonly exhibit grey and white matter loss, which may be related to hypoxic damage in the brain during sleep. Our preliminary data demonstrated lower values of cerebral metabolic rate of oxygen (CMRO2) consumption in apneics versus controls. As such, reduced CMRO2 may be an important contributor to the neurologic consequences of OSA. Here we report a rodent model for chronic intermittent hypoxia (CIH) to quantify effects on CMRO2 consumption. We hypothesized that increased severity of CIH results in decreased CMRO2 levels.

Methods
Three groups of rats were subject to varying levels of hypoxia: sham (21% oxygen; n = 19), moderate (11% oxygen; n = 14), and severe (6% oxygen; n = 21). To deliver hypoxia, rats were exposed to three-minute cycles of oxygen between 21% and condition-specific nadir O2 for 12 hours daily during their sleep cycle. CMRO2 values were measured with MRI techniques, performed on anesthetized rats before and after 3 months exposure to CIH.

Results
Rats from the three hypoxia groups did not differ significantly in CMRO2 values at baseline (0 months). After 3 months of exposure to hypoxic conditions, there was a trending difference (p=0.0726) in percent change from baseline between severely hypoxic (-35.3%) and sham (+12.3%) rats. Moderately hypoxic rats demonstrated an intermediate decrease from baseline after 3 months (-19.0%).

Conclusion
Our findings suggest that increased severity of intermittent hypoxia yields a dose-response decrease in brain oxygen consumption. Our data add to the growing body of evidence on the relationship between obstructive sleep apnea and hypoxic damage in the brain, suggesting that CMRO2 levels may be an indicator of the neurologic consequences of OSA.

Support
Funded by NIH P01 HL094307