bluuebunny/crossref_metadata_2025_split huggingface dataset:
0112 Lucid Dreaming Associated with Positive Waking Mood
Authors: Carr M , Stocks A , Mallett R , Konkoly K , Freegard M , Hicks A , Crawford M , Pigeon W , Schredl M , Bradshaw C 
Published: May 2020

Abstract

Introduction
Lucid dreaming (being aware that one is dreaming) is typically a positive experience that may enhance positive mood even after waking. There is concern, however, that lucid dreaming may interfere with sleep quality. In the current experiment, participants practiced common lucid dream induction techniques over the course of a week, and kept a daily sleep and dream diary. The study objective was to assess relationships between dream lucidity and subjective sleep quality, dream emotional content, and subsequent waking mood.

Methods
There were 32 participants aged 19–33 in this open label, single arm study (mean=22.63±3.48; 6 males, 24 females). All participants completed a sleep and dream diary for 7 days that included scaled items (1–7 scale) concerning subjective sleep quality, negative and positive emotional intensity of a dream (if recalled). Participants also completed a 19-item lucidity questionnaire, and the Positive and Negative Affect Schedule. Average scores for the week were computed for all measures and Pearson’s correlations conducted between lucidity and all other measures. Participants with no dream recall (n=5) were excluded. Within-subjects analyses were undertaken by selecting each participant’s highest and lowest lucidity night (n=22; 5 participants with only minimum lucidity excluded).

Results
Positive correlations were found between lucidity and dream positive emotion (r=.490, n=27, p=.009) and positive waking mood (r=.638, n=27, p&lt;.001); there were no other significant correlations (all p&gt;.1). Higher lucidity was associated with more positive dream content (t(21)= -3.214, p=.004) and positive waking mood (t(25)=-4.568, p&lt;.001); no other significant differences were observed.

Conclusion
These data indicate that lucidity is associated with positive dreams and waking mood, with no detriment to self-reported sleep quality. The findings provide preliminary support of lucid dreaming as an intervention to improve wellbeing and mood in the short term.

Support
N/A
1130 Insomnia Short Sleep Phenotype is Associated With Frailty in Patients With Mild Cognitive Impairment (MCI)
Authors: Basta M , Vgontzas A , Koutentaki E , Zaganas I , Fernandez-Mendoza J , Belogianni C , Panagiotakis S , Puzino K , Simos P 
Published: May 2020

Abstract

Introduction
Insomnia short sleep phenotype is associated with cardiometabolic morbidity and mortality and neuropsychological impairment. In elderly untreated insomnia is associated with worse cognitive performance. The goal of the study was to examine the association between insomnia, objective sleep duration and physical and mental health in elderly patients with Mild Cognitive Impairment (MCI).

Methods
A sub-sample of 105 patients with MCI (mean age: 75.9 years, males 36%) were recruited from a large population-based cohort (Cretan Aging Cohort) in the island of Crete, Greece of 3,140 elders (≥ 60yrs). All participants underwent a complete medical history/ physical examination, extensive neuropsychiatric and neuropsychological evaluation and 3-day 24hr actigraphy. Insomnia was defined based on a question “do you have insomnia for more than a year”. Frailty was assessed with the Simple “Frail” Questionnaire Screening Tool. Comparisons between patients with insomnia and without insomnia were made using ANOVA controlling for age, gender and BMI.

Results
MCI patients with insomnia (n=23) compared to those without insomnia (n=82), had significantly shorter objective total sleep time (TST: 377 vs. 410 min, p=0.05) and significantly higher scores on the Geriatric Depression Scale and the Hospital Anxiety Scale (both p &lt;0.001). Furthermore, total frailty score, as well as scores in individual items, were significantly lower in MCI patients with insomnia (p&lt;0.01). This association remained significant after controlling for demographics, depression and anxiety. Finally, there was a statistical trend of association between insomnia and hypertension (p= 0.1).

Conclusion
In MCI patients, insomnia is associated with objective short sleep duration, and frailty. Improving insomnia and lengthening sleep duration may decrease frailty, a major problem associated with morbidity, disability and mortality in elders with cognitive decline.

Support
National Strategic Reference Framework (ESPA) 2007-2013, Program: THALES, University of Crete, title: “A multi-disciplinary network for the study of Alzheimer’s Disease” (Grant: MIS 377299).
1145 Longitudinal Association Between Circadian Activity Rhythms And Risk Of Incident Parkinson’s Disease In Older Men
Authors: Leng Y , Blackwell T , Cawthon P M , Ancoli-Israel S , Stone K , Yaffe K 
Published: May 2020

Abstract

Introduction
Disruption in circadian activity rhythms are very common in older adults, particularly among those with neurodegenerative diseases. However, the longitudinal association between circadian disruption and subsequent risk of developing neurodegenerative diseases, including Parkinson’s disease (PD), is unclear.

Methods
We examined rest-activity rhythms in 2930 community-dwelling older men (mean age 76.3 ± 5.5 years) without PD and followed them for incident PD over the next 11 years. 24-h rest-activity rhythm parameters (amplitude, mesor, robustness, acrophase) were generated by wrist actigraphy-extended cosinor analysis. Incident PD cases were identified based on physician-diagnosed PD between 2005 and 2016. Logistic regression was used to determine the association between quartiles of rest-activity parameters and risk of incident PD.

Results
78 (2.7%) men developed PD during 11 years of follow-up. The risk of PD increased with decreasing circadian amplitude (strength of the rhythm), mesor (mean level of activity) or robustness (how closely activity follows a cosine 24h pattern); p for trend across quartiles &lt;0.05. After accounting for demographics, clinic site, education, depressive symptoms, body mass index, physical activity, benzodiazepine use, alcohol, caffeine, smoking, comorbidities and baseline cognition, those in the lowest quartile of amplitude, mesor or robustness had approximately three times the risk of developing PD compared to those in the highest quartile of amplitude [ORs (95% CI)= 3.11 (1.54-6.29)], mesor [3.04 (1.54-6.01)] and robustness [2.65 (1.24-5.66)]. The association remained after further adjustment for nighttime sleep disturbances and sleep duration. These associations were somewhat attenuated, but the pattern remained similar after excluding PD cases developed within 2 years after baseline. Acrophase was not significantly associated with risk of PD.

Conclusion
Older men with reduced circadian rhythmicity had an increased risk of incident PD over 11 years. Circadian disruption in the elderly may represent an important prodrome or risk factor for PD. Randomized trials should evaluate whether strategies to improve circadian function impact risk of PD.

Support
This work was supported by the NIA, NIAMS, NCATS, NIH Roadmap for Medical Research and the NHLBI under the grant numbers: U01AG027810, U01AG042124, U01AG042139, U01AG042140, U01AG042143, U01AG042145, U01AG042168, U01AR066160, UL1TR000128, R01HL071194, R01HL070848, R01HL070847, R01HL070842, R01HL070841, R01HL070837, R01HL070838, and R01HL070839.
1150 Obstructive Sleep Apnea-dependent Racial/ethnic And Sex-specific Mechanisms Underlying Alzheimer’s Disease Risk: A Retrospective Cohort Analysis Of In-lab PSG Sleep Study Data
Authors: Bubu O M , Turner A D , Parekh A , Mullins A , Kam K , Umasabor-Bubu O Q , Mbah A K , Williams N J , Varga A W , Rapoport D M , Ayappa I , Jean-Louis G , Osorio R S 
Published: May 2020

Abstract

Introduction
We examined race and sex-specific biologic mechanisms of the relationship between obstructive sleep apnea (OSA) and incident AD.

Methods
Retrospective cohort analysis utilizing in-lab PSG sleep study data conducted among older adults between 2001 and 2005. OSA was defined using AHI4%. Participants had no history of cognitive decline or AD at baseline and included 663 (284 Non-Hispanic White (NHW), 207 Black/African-American (AA) and 172 Hispanic) OSA-patients matched on age, sex, race, BMI, 1:1 ratio to 663 (unexposed cohort I from sleep clinic) and 1:4 ratio to 2652 (unexposed cohort II from non-sleep clinics) non-OSA individuals. Incident AD was assessed annually from 2001-2013 with ICD-9-CM code 331.0. Adjusted cox proportional hazard regression models examined race and sex-specific biologic mechanisms including hypoxia, fragmentation and duration measures of OSA and AD risk.

Results
Of the 3,978 participants, 2,148 (54%) were women. Mean age at baseline was 72.6 (7.3) years. Over a mean follow-up time of 8.6 (1.4) years, 358 (9%) individuals (212 female) developed AD (119 NHW, 134 AAs, and 105 Hispanics). Relative to non-OSA individuals, OSA-patients had a higher risk of incident AD, with AAs and females showing stronger risk estimates (aHR: 2.24, 1.83, and 1.73, P &lt;.001 for all, for AAs, Hispanics and NHW respectively; and aHR: 2.38, and 1.37, P &lt;.001 for all, for female and male respectively). Measures of hypoxia, sleep fragmentation and sleep duration were associated with increase AD risk (P &lt;.01 for all). Relative to NHW, AAs and Hispanics demonstrated up to 20% stronger effects/estimates on hypoxia and sleep duration measures. Relative to males, females demonstrated up to 25% stronger effects/estimates on sleep fragmentation measures, and 15% weaker effects/estimates on hypoxia measures (P &lt;.01 for all).

Conclusion
Among OSA-patients, mechanisms related to hypoxia, sleep fragmentation and duration measures increase AD risk and may underlie race/ethnicity and sex disparities in AD.

Support
NIH/NIA/NHLBI (L30-AG064670, CIRAD P30AG059303 Pilot, T32HL129953, R01HL118624, R21AG049348, R21AG055002, R01AG056031, R01AG022374, R21AG059179, R01AG056682, R01AG056531, K07AG05268503, K23HL125939)
1168 Preliminary Impact of a Sleep Health Educational Module for Social Work Students
Authors: Spadola C , Groton D , Lopez R , Burke S L , Hilditch C J , Pandey A , Littlewood K , Zhou E S , Bertisch S M 
Published: May 2020

Abstract

Introduction
Social workers are well-positioned to promote healthy sleep behaviors among underserved populations; however sleep health training is rarely integrated into social work curriculums. To address this gap, our interdisciplinary team developed a 2-hour online sleep health educational module for social work students. The module was grounded in best e-learning pedagogical principles, and based on qualitative formative research. We tested the initial impact and acceptability of the module.

Methods
We recruited 32 social work students at a Florida University via a departmental listserve. Pre- to post-intervention changes in the Sleep Beliefs Scale (SBS) and the Sleep Practices and Attitudes Questionnaire (SPAQ) were assessed using Wilcoxon Signed-Rank tests. We conducted qualitative research to assess intervention acceptability,and to inform future iterations of the program.

Results
Mean age was 29.5±11.6 yrs, 100% were female, and primarily Non-Hispanic White (41.9%), followed by African American/Black (35.5%), and Hispanic/Latino (22.6%). Results showed pre/post intervention improvements in both the Sleep Beliefs Scale (14.7±2.2 vs.16.9±2.6 [p=.002]; higher score=higher knowledge) and SPAQ (2.1±0.6 to 1.5±0.6 [p=.001]; lower score=higher importance of sleep) indicating improvements in knowledge surrounding healthy sleep behaviors and the importance of sleep for overall health (respectively). Qualitative data supports the intervention’s acceptability and utility. When asked what participants liked best about the module, responses included: “I was educated and am better prepared to offer some insight to my clients and staff”; “..they offer resources we can use for ourselves and our clients;” and “easy to navigage, and full of useful information.” Suggestions for improvement included shortening the module’s length.

Conclusion
Assessment of an online sleep health educational module indicates a promising impact on sleep health knowledge. A larger study is planned to more definitively evaluate the module’s impact and acceptability among social work students.

Support
American Academy of Sleep Medicine Foundation
1189 Recruiting, Training, And Implementing Sleep Health Educators In Community-based Research To Improve Sleep Health
Authors: Aird C , Seixas A , Moore J , Nunes J , Gyamfi L , Garcia J , Blanc J , Williams N , Zizi F , Jean-Louis G 
Published: May 2020

Abstract

Introduction
Adherence to OSA assessment and treatment is low among racial/ethnic minorities, particularly among blacks. Navigating patients along the continuum of care from assessment to treatment adherence requires motivation, social support, and self-efficacy. Previous studies indicate that community health educators can provide motivation, social support, and skills to patients to better navigate the complex OSA care continuum. However, recruiting, training, and implementing sleep health educators in clinical or research settings is complex. For the current study, we describe how we recruit, train, and implement sleep health educators in research and clinical settings and assess what makes a sleep health educator successful.

Methods
We recruited and trained twenty-five self-identified black sleep health educators for a randomized clinical trial (R01MD007716) focused on increasing OSA assessment and treatment adherence among blacks. During recruitment, we assessed key personality attributes that translate to being an effective sleep health educator, via behavioral and personality surveys, focused groups, and process forms filled out by educators. Sleep health educators underwent an 8-week training program on sleep health and motivational interviewing. In order to be certified, sleep health educators had to pass a written and scenario-based assessment. During the implementation phase of the trial, we assessed how many interviews each health educator conducted and whether individual characteristics were related to how many interviews.

Results
Of the trained educators, 80% were female, ranging from 25 to 58 years old. They all completed at least high school. All educators rated the program highly and were very satisfied with dispensing tailored sleep health education. Educators who displayed the highest knowledge about sleep health, provided frequent emotional and strategic support, committed to helping their assigned participants, and who rated their rapport highly with their assigned participants were most effective in getting their participant to adhere to OSA assessment and treatment.

Conclusion
Sleep health educators can be vital to increasing OSA assessment and treatment adherence among blacks. In order to ensure success, sleep health educators must undergo a thorough recruitment, training, and implementation and dissemination process.

Support
K01HL135452, R01MD007716, R01HL142066, K01HL135452,and K07AG052685
1196 Machine Learning Derived-Interpretative Algorithm Better Differentiates Sleep and Wake Epochs and Estimates Sleep Parameters from Wrist Actigraphy Data
Authors: Haghayegh S , Khoshnevis S , Smolensky M H , Diller K R , Castriotta R J 
Published: May 2020

Abstract

Introduction
Several different interpretive algorithms (IAs) are available for scoring actigraphy-obtained body movement data for sleep and wake epochs. Although most have high sensitivity in detecting sleep epochs, they identify wake epochs poorly. We derived a machine learning (ML) based IA that improves differentiation of sleep and wake epoch to better estimate sleep parameters.

Methods
Forty-one adults (18 females) 26.6±12.0 years old underwent at-home single-night sleep assessment. Motionlogger® Micro Watch Actigraph recorded in zero crossing mode body movement per 30s epoch, with automated sleep scoring by single-channel electroencephalography (EEG) device (Zmachine® Insight+) as reference. The popular Cole-Kripke IA was applied to score body movement time series data of the following combination of current 1, preceding 4, and following 2 minute long epochs. Data of 21 subjects were utilized to train/derive the ML IA (logistic regression), and data of the other 20 subjects were used to test performance of it and the Cole-Kripke IA.

Results
In reference to the EEG, the Cole-Kripke actigraphy IA showed sensitivity of 0.98±0.02, specificity of 0.48±0.19, and kappa agreement of 0.53±0.16 in detecting sleep epochs, while the ML-derived IA showed corresponding values of 0.90±0.06, 0.71±0.14, and 0.57±0.11. The Cole-Kripke IA, relative to EEG, method significantly (P&lt;0.05) underestimated sleep onset latency (SOL) by 18.0 min and wake after sleep onset (WASO) by 35.1 min, and overestimated total sleep time (TST) by 53.1 min and sleep efficiency (SE) by 9.6%. The ML-derived IA, relative to EEG significantly underestimated SOL by 15.1 min, but comparably (P&gt;0.05) estimated WASO, TST, and SE.

Conclusion
The ML-derived IA, in comparison to Cole-Kripke IA, when applied to sleep-time wrist actigraphy data significantly better differentiates wake from sleep epochs and better estimates sleep parameters.

Support
This work was supported by the Robert and Prudie Leibrock Professorship in Engineering at the University of Texas at Austin.
1198 Efficacy of Direct Thermoelectric Forehead Cooling for Treating Insomnia Symptoms
Authors: Schirm J , Bellamy B , Nofzinger E 
Published: May 2020

Abstract

Introduction
Prior studies have shown beneficial effects of forehead cooling in insomnia patients using a device that circulates cooled fluids through a forehead pad. The current study aimed to determine if a device that cooled via direct thermoelectric contact to the forehead via a Peltier cooler would have similar effects in individuals with insomnia symptoms. Such a technology may allow for form factors that may have advantages for some individuals.

Methods
An intelligent, portable and battery-operated forehead cooling system using thermoelectric coolers (TECs) with a user selectable temperature range between 14C and 18C was used in the study. Individuals with insomnia symptoms (N=30, 25 female) were recruited and studied at 2 geographic locations. Each participant received pre- and post- treatment insomnia severity as well as daily sleep diary assessments over 1 week of baseline and 4 weeks of treatment.

Results
Participants’ insomnia symptoms improved over baseline in insomnia severity index (M + SD = 19.7 + 3.8 pre- vs 9.4 + 5.3 post-treatment, t = -9.3, p&lt;0.00001), in sleep latency (M + SD = 43.0 + 40.8 minutes pre- vs 20.7 + 22.7 minutes post-treatment, t = 6.8, p&lt;0.00001), in minutes awake after sleep onset (M + SD =63.0 + 59.2 minutes pre- vs 24.5 +34.5 minutes post-treatment, t = 8.0, p&lt;0.00001) and in sleep quality (0-10 scale with 10 = best, M + SD = 4.1 + 1.9 pre- vs 6.8 + 2.2 post-treatment, t = -13.4, p&lt;0.00001).

Conclusion
Forehead cooling via direct thermoelectric contact to the forehead via a Peltier cooler had beneficial effects on subjective insomnia symptoms. These promising preliminary data suggest the need for further large scale randomized controlled trials to establish the efficacy of forehead-cooling using direct thermoelectric contact to the forehead via a Peltier cooler on insomnia symptoms.

Support
Ebb Therapeutics, Pittsburgh, PA 15222
1212 A Systematic Assessment Of Engagement, Functionality, Aesthetics, Information, And Recommendation Features In Sleep Mobile Applications
Authors: Hollimon L , Moore J , Richards S , Robbins R , Grandner M , Chung A , Chung D , Jean-Louis G , Seixas A 
Published: May 2020

Abstract

Introduction
Initial download and use of sleep tracking is very high, but prolonged use is very low. Poor prolonged use may be attributable to several factors such as engagement, functionality, aesthetics, information, and recommendation. We appraised these five factors in 16 consumer- and research/medical- grade digital sleep devices.

Methods
Three reviewers independently assessed 16 consumer- and medical-grade sleep digital devices using the Mobile Application Rating Scale (MARS) App quality ratings, which measures engagement (engagement, entertainment, interest, customization, interactivity, target group), functionality (functionality, performance, ease of use, navigation, gestural design), aesthetics (layout, graphics, visual appeal), information (Accuracy. Goals, Quality of information, Quantity of information, Visual information, Credibility, and Evidence base) and recommended on a Likert scale, with 1- Inadequate to 5 Excellent. Each subcategory is rated on a 1-5 Likert scale which is summed for each category: engagement (30), functionality (25), aesthetics (15), information (35) and recommended (yes or no).

Results
Devices that had the highest engagement score were Fitbit (27), Apple Watch (27), Garmin (27), and Dreem 2 headband (25.5). Apple Watch (30) had highest score; while Fitbit (13), Apple Watch (13), Garmin (13), Samsung Gear (13) had highest aesthetic score. While for information, ActiGraph (35), SOMNOwatch plus (35), CleveMed SleepView Monitor (35), CleveMed Sapphire PSG (35), SOMNOscreen plus (35), Nox T3 Sleep Monitor (35) and Nox A1 PSG System (35) had the highest ratings. The Dreem 2 headband has the potential induce prolong use among users with and without sleep disorders, based on high scores on engagement (25.5), Functionality (20.5), and Information (26.5).

Conclusion
Consumer- and research-grade digital devices that measure sleep have varying levels of engagement, functionality, aesthetics, information and recommendations to facilitate prolong use. Consumer grade devices had higher engagement, functionality and aesthetics scores, while research grade devices had higher information and recommendation scores. If consumer- and research-grade devices are to have prolonged use, standardization is needed across the five MARS components.

Support
K01HL135452, R01MD007716, R01HL142066, and K07AG052685