bluuebunny/crossref_metadata_2025_split huggingface dataset:
0363 Racial/Ethnic Differences in Actigraphy, Questionnaire, and Polysomnography-Measured Indicators of Sleep Health and Sleep Quality: The Multi-Ethnic Study of Atherosclerosis
Authors: Chung J , Goodman M O , Huang T , Wallace M , Bertisch S , Johnson D , Redline S 
Published: May 2020

Abstract

Introduction
Paradigm shifts in sleep research suggest the importance of considering multi-dimensional sleep health, compared to single metrics, to promote physical and mental well-being and to understand racial/ethnic disparities in sleep.

Methods
We used data from the Multi-Ethnic Study of Atherosclerosis (MESA; n = 1,740) to create a Sleep Health Score (SHS), including questionnaire (quality, sleepiness); 7-day actigraphy (total sleep time, sleep continuity [sleep maintenance efficiency], timing consistency [midpoint variability], fragmentation, wake after sleep onset, sleep onset latency); and in-home polysomnography (%N3 sleep, %REM sleep, AHI). Sleep parameters were dichotomized based on prior literature or by healthiest quartile(s), with positive values denoting healthier sleep (e.g. Epworth scores &lt; 10). All 11 dichotomized parameters were summed to calculate the SHS (mean=4.9, sd=1.58). We used modified Poisson and linear regression for individual sleep outcomes and the SHS, respectively, adjusting for age and sex.

Results
The sample was older (mean age=68.28, sd=9.08) and 54% female. SHSs were associated with Black race (β=-0.60 [-0.78, -0.42]) and Hispanic ethnicity (β=-0.40 [-0.59, -0.21]), but not Chinese ethnicity (β=-0.16 [-0.41, 0.08]). Compared to Whites (n=644), Blacks (n=485) showed lower adjusted probability of obtaining favorable levels of: sleep continuity, fragmentation, timing consistency, alertness/sleepiness, and sleep depth (%N3 sleep). Chinese respondents (n=202) had lower probability of obtaining favorable levels of: sleep continuity and timing consistency, but higher probability of quality. Hispanics (n=409) had lower probability of obtaining healthy levels of: sleep continuity, timing consistency, and fragmentation. Neither healthy total sleep time (middle quartiles) nor AHI (&lt;30) differed by race/ethnicity.

Conclusion
Among MESA-Sleep participants, summary SHSs were lowest in Blacks, followed by Hispanics. Multiple dimensions of sleep - particularly related to continuity and timing consistency - were less favorable across race/ethnic minority groups. A summary SHS may help monitor sleep health across populations, while measurement of specific sleep components may help identify modifiable targets.

Support
Joon Chung is supported by a T-32 NIH training grant.
0370 Objective Differences in Sleep Timing Between African Americans and Non-Hispanic Whites
Authors: Combs D , Patel S , Mashaqi S , Estep L , Provencio-Dean N , Lopez S , Parthasarathy S 
Published: May 2020

Abstract

Introduction
Prior studies have shown a morning circadian preference for African Americans compared to Non-Hispanic whites, but prior research has shown that self-reported sleep timing is delayed in African Americans compared to whites. No prior studies have evaluated this difference in sleep timing using objective measures of habitual sleep such as actigraphy.

Methods
We analyzed the sleep data from the Multi-Ethnicity Study of Atherosclerosis (MESA), a multi-site community-based cohort with both self-reported and actigraphic measures of habitual sleep variables. Self-reported sleep timing, chronotype as measured by the modified Horne-Ostberg Morningness-Eveningness Questionnaire (MEQ) and actigraphic sleep timing were examined using logistic regression and independent t-tests.

Results
1,430 participants had self-reported sleep data, and 1,405 participants had complete actigraphy data as well. There was no self-reported difference in circadian preference between African Americans and whites (mean MEQ score 17.1 ± 3.6 vs. 17.0 ± 4.0). African Americans were 76% more likely to report a bedtime after midnight on weekdays (odds ratio [OR] 1.8, 95% confidence interval [CI] 1.4, 2.3, p&lt;0.001), and 50% more likely on weekends (OR 1.5, 95% CI 1.2, 1.9, p=0.001) as compared to whites. Actigraphic data showed similar results. African Americans were 80% more likely to have actigraphic sleep onset after midnight on weekdays (OR 1.8, 95% CI 1.4, 2.2) and 137% more likely (OR 2.4,95% CI 1.9, 3.0, p&lt;0.001) on weekends as compared to whites. Actigraphic mid-sleep time was delayed 42 (95% CI 20, 64, p&lt;0.001) minutes on weekdays and 24 (95% CI 6,42, p=0.01) minutes on weekends in African Americans compared to whites.

Conclusion
African Americans had delayed sleep timing compared to whites even though no significant racial differences in chronotype were present. Delayed sleep timing in African Americans may be related to factors other than self-reported circadian preference.

Support
Funding to DC from the American Heart Association, University of Arizona Health Sciences Center and NIH-NHLBI. MESA data obtained from NIH-NHLBI BioLINCC and the National Sleep Research Resource.
0383 Outdoor Artificial Light at Night, Sleep Duration, and Sleep Quality in the California Teachers Study Cohort
Authors: Zhong C , Franklin M , Wiemels J , Chung N , Benbow J , Wang S S , Lacey J V , Longcore T 
Published: May 2020

Abstract

Introduction
Artificial light at night (ALAN) is believed to disrupt sleep by suppressing melatonin and altering normal circadian patterns. We assessed the association between self-reported sleep measures and outdoor ALAN in a large cohort of women.

Methods
The California Teachers Study (CTS) is a prospective cohort of 133,479 current and former Californian female public school professionals recruited and given a baseline questionnaire in 1995-1996. A follow-up questionnaire in 2012-2014 assessed self-reported measures of sleep habits, quality, and chronotype. Using geocoded residential addresses, participants were assigned exposures to outdoor ALAN based on the New World Atlas of Artificial Night Sky Brightness to assess the association between ALAN and self-reported sleep initiation, duration, and quality.

Results
Of the 42,706 women who completed the follow-up questionnaire and reported the same sleep patterns over the previous year, 5,968 reported poor sleep quality. The median outdoor ALAN was 2.16 (IQR: 1.04-3.61) millicandela per meter squared (mcd/m2). After adjusting for self-reported chronotype, use of sleep medication, age, race, and socioeconomic status, residing in the highest ALAN quintile was associated with poor sleep (OR 1.16, 95% CI 1.07-1.26). There did not appear to be an association between outdoor ALAN and time taken to fall asleep (OR 1.02, 95% CI 0.96-1.08), but it was associated with sleeping less than 8 hours (OR 1.41, 95% CI 1.33-1.50).

Conclusion
CTS participants who self-reported shorter sleep and poorer sleep quality were more likely to reside in areas with greater levels of outdoor ALAN. We did not see an association with ALAN and time to fall asleep, suggesting ALAN may be contributing to later sleep time or earlier waking. As we continue to follow this cohort, the data collected over the past 20 years provide a rich resource for studying both factors related to sleep and its effect on health.

Support
The California Teachers Study and the research reported in this publication were supported by the National Cancer Institute of the National Institutes of Health under award number U01-CA199277; P30-CA033572; P30-CA023100; UM1-CA164917; R01-CA077398; and R01-CA207020.
0395 “Doctor, I Can’t Sleep”, How Intensivist Cannot Restore Their Sleep Debt
Authors: Chhor V , Leger D , Pepin E , Elbaz M 
Published: May 2020

Abstract

Introduction
Since 2001, intensivist physicians working in France have been organized in 24-hour shifts (in order to provide 24/7 support), followed by a mandatory rest period of at least 24 hours between shifts.. The goal was to survey how intensivists cope with maintaining enough sleep throughout their 24-hour shifts.

Methods
During twelve months, the whole medical staff of our ICU, i.e. 29 individuals (11 senior physicians and 18 residents), agreed to participate in this study. They were allowed to settle into a typical work period of 7 days and 7 nights (i.e. 3 days before and 3 days following the 24-hour shift), separated by at least 5 days from any previous 24-hour shifts. A 24-hour shift typically started at 8:30am in the morning and finished 24 hours later. All physicians wore a wrist actigraphy device (MotionWatch 8) assessing total sleep time (TST) on a 24-hour period. We retained several criteria such as:
The reference TST, i.e. the mean of the TST during the first three days preceding the 24-hour shift
The sleep debt, through the comparison between the average of the TST during the 24-hour shift and the 24 (SD24) or 72 following hours (SD72) and the reference TST.

Results
Twenty nine actigraphy records from 29 individuals were analyzed. The reference TST preceding the shift was 377 min (IQR25-75: 346-396). Doctors participating in the study slept very little during a 24-hour shift: 181 min (IQR25-75: 134-260). Subsequently, we observed that intensivists were unable to completely recover their sleep debt, even after 72 hours. Average TST was significantly shorter at 72 hours compared to reference (343 min [IQR25-75: 304-367], Mann-Whitney test, p=0.015).

Conclusion
These findings raise the question of whether it is possible for intensivist doctors to maintain their energy and intensity in their jobs without sleeping enough. This remains an open question and we are currently unable to respond with only a simple study.

Support
No support
0396 Prevalence of Delayed Sleep Phase Syndrome (DPSP) Among Omani People
Authors: Al-Abri M A , Al-Kindi T 
Published: May 2020

Abstract

Introduction
Delayed sleep phase syndrome (DSPS) is a circadian rhythm sleep disorder with a definition of delayed night sleep by two or more hours beyond the socially acceptable or conventional bedtime. The general reported prevalence of DSPS is 7% to 16%. However, there is no previous study which assess DSPS prevalence in Oman or nearby regions. This study aimed to assess the prevalence of DSPS among Omani population and to establish a connection between demographics and DSPS.

Methods
This community-based study included 186 subjects aged from 18 to 64 who had one week of actigraphy records along with their demographical data in Sultan Qaboos University hospital.

Results
Among the 186, 19 (10.2%) subjects were identified of having DSPS in weekdays, and 15 (11.4%) subjects have DSPS in weekends. The results indicated that marital status had significant relation (P=0.02) more with unmarried group (62.50%, N=10). No significant relationship was found between DSPS and age, gender, BMI, education and employment status in either weekdays or weekends (P&gt;0.05)

Conclusion
A consistent rates of DSPS was found among Omanis which are 10.2% in weekdays and 11.4% in weekends. Also, DSPS have significantly higher rates among unmarried subjects in weekdays. Further studies in DSPS are needed to assess risk factors and possible health impacts.

Support
The research Council of Oman
0404 Jewish-Arab Disparities in Sleep Behaviors and Differential Ethnic Impact on Daytime Functioning, Driving Safety, and Health in Israel
Authors: Rosenberg E , Perlis M L , Parthasarathy S , Jean-Louis G , Chakravorty S , Grandner M A 
Published: May 2020

Abstract

Introduction
In Israel, those with Arabic as compared to Jewish ethnicity, exhibit poorer health and motor vehicle safety behaviors. Their ethnic differences in sleep duration and quality may modulate their vulnerabilities to these behaviors.

Methods
7,230 Israeli individuals (N=5,880 Jewish and N=1350 Arabic) responded to the 2017 Israeli Bureau of Statistics population-based survey of households. Variables were self-reported. Outcomes included sleepiness, sleep medications, functional impairment, drowsy driving, overall health, 1-year health change, and obesity. Predictors included categorical sleep duration (&lt;=5, 6, 7, 8 [reference], or &gt;=9 hours) and sleep disturbance in the past month (none [reference], mild [1/week], moderate [2-3/week], or severe [&gt;3/week]). Covariates included age, sex, and financial status. Ethnicity (Jewish/Arabic) was treated as a predictor of sleep and behavioral outcomes.

Results
When compared to normal (8-hour) sleepers, Jewish as compared to Arabic individuals were more likely to to sleep &lt;=5h (RRR=3.99, p&lt;0.0005), 6h (RRR=4.65, p&lt;0.0005), and 7h (RRR=3.34, p&lt;0.0005), and were more likely to report severe sleep difficulties (RRR=1.49, p&lt;0.0005) and sleepiness (oOR=1.52, p&lt; 0.0005). Yet, they were less likely to report functional impairment (oOR=0.65, p&lt;0.0005), drowsy driving (OR=0.58, p&lt;0.0005), worse health (oOR=0.51, p&lt;0005), worsening health (oOR=0.70, p&lt;0.0005), or obesity (OR=0.64, p&lt;0.0005). Significant ethnicity by sleep duration interactions (p&lt;0.05) characterized sleepiness, sleep medications, functional impairment, health, and health change. Moreover, significant ethnicity by sleep disturbance interactions (p&lt;0.05) characterized the same outcomes, in addition to drowsy driving. Overall, the impact of sleep duration and sleep difficulties was generally greater among Arabs for all variables.

Conclusion
Despite Jewish individuals endorsing relatively shorter sleep and more severe sleep difficulties, Arabs seem to be more vulnerable to the health and functional outcomes. This finding may explain some of the discrepancies in the health and safety outcomes between these ethnic groups.

Support
Dr. Grandner is supported by R01MD011600
0415 Metabolic Dysfunction and Sleep Disruption in Models of Alzheimer’s Disease
Authors: Carroll C M , Stanley M , Macauley S L 
Published: May 2020

Abstract

Introduction
Metabolic perturbations and sleep disruptions are a cause and consequence of Alzheimer’s disease pathophysiology. A bidirectional relationship exists where impairments in sleep and metabolism contribute to the development of Alzheimer’s disease while the presence of Alzheimer’s disease pathology leads to decreased cerebral metabolism, peripheral glucose intolerance, and disrupted sleep. While the effects of type 2 diabetes (T2D) and Alzheimer’s disease on sleep have been explored separately, no previous studies have examined the effect of acute glycemic variability, a defining feature of T2D, on sleep in the context of Alzheimer’s disease. The goal of this study is to determine how glycemic variability drives sleep disruptions by modifying the relationship between cerebral glucose metabolism and neuronal activity.

Methods
Biosensors are implanted bilaterally into the hippocampus of APP/PS1, a model of amyloid-beta (Aβ) overexpression, and P301S, a model of tau deposition and neurodegeneration, mice to measure ISF glucose and lactate, markers of cerebral metabolism and neuronal activity, respectively. Simultaneous cortical EEG/EMG recordings are used for sleep/wake scoring and analysis.

Results
Glycemic fluctuations cause a decoupling of the typical relationships between cerebral metabolism and neuronal activity, while also increasing arousal in 3-month-old, wildtype mice. The presence of AD-like pathology results in a similar, albeit muted cerebral metabolic response to peripheral glycemic variability, but a diminished effect on wakefulness, likely due to age- and pathology-dependent increases in overall time spent awake. Conversely, in aged, P301S mice, cerebral metabolic responsiveness is lost and a ceiling effect on wakefulness emerges, suggesting differential effects on sleep with tau accumulation. Moreover, aged mice show progressive disruptions to overall sleep quality and quantity, highlighting the synergism existing between AD-like pathology and glucose intolerance in sleep dysfunction. Lactate seems to be a common driver of disruption in this synergistic cycle.

Conclusion
This study represents a novel approach to defining the dynamic interplay between risk factors for AD and T2D and suggests a feedforward loop of disease progression where disrupted sleep can alter the relationship between neuronal activity, metabolism, and pathology.

Support
NIH/NIA 1K01AG050719.
Harold and Mary Eagle Fund for Alzheimer’s Research
New Vision Award through Donors Cure Foundation
0446 A Novel System for Enabling High-Density EEG Recordings in a Mouse
Authors: Thankachan S , Gerashchenko L , Gerashchenko D 
Published: May 2020

Abstract

Introduction
Recent advances in micro-electromechanical system (MEMS) technology have promoted the development of microelectrode arrays (MEA) that allow high resolution recordings in neuroscience research. However, applying MEA in studies in freely moving mice remains very challenging due to the large number of electrical connections required in this type of studies. The use of commutators for a large number of connections is not practical, and headmounts/loggers placed on the animal head are too heavy for small animals such as mice. Therefore, there is a need for a better compact system for using MEA in mice. Herein, we designed such a system and successfully recorded high-density-EEG in freely moving mice.

Methods
We designed a system in which forty flexible ultrathin wires are connected to the headstage enclosed in a container held close to the mouse. The container also houses a logger and battery connected to the headstage. This recording system allows minimizing weighted pressure on the animal using a counterbalance, so that the animal can freely move in the cage.

Results
We tested the system using a signal generator and mouse EEG arrays (NeuroNexus). When potentials produced by the signal generator were recorded via the wires, recorded traces were indistinguishable from the traces that were recorded when the signal generator was connected directly to the logger. We then implanted mice with EEG electrode arrays under surgical anesthesia. The high-density EEG recordings were performed one and four weeks after the surgery. High-quality EEG signals were observed in all the channels of the 32-channel logger (SpikeGadgets) in freely moving mice.

Conclusion
We successfully developed and tested a novel system for enabling high-density EEG recordings in freely moving mice. We expect that this system will be useful for recording biopotentials from different types of MEA in freely moving mice.

Support
NIH 1R43OD023231 (LG), NIH 1RF1AG061774 (DG), and NIH 5R21NS106406 (DG)
0447 ResTNet: A Robust End-to-End Deep Learning Approach to Sleep Staging of Self Applied Somnography Studies
Authors: Jónsson S Æ , Gunnlaugsson E , Finssonn E , Loftsdóttir D L , Ólafsdóttir G H , Helgadóttir H , Ágústsson J S 
Published: May 2020

Abstract

Introduction
Sleep stage classifications are of central importance when diagnosing various sleep-related diseases. Performing a full PSG recording can be time-consuming and expensive, and often requires an overnight stay at a sleep clinic. Furthermore, the manual sleep staging process is tedious and subject to scorer variability.
Here we present an end-to-end deep learning approach to robustly classify sleep stages from Self Applied Somnography (SAS) studies with frontal EEG and EOG signals. This setup allows patients to self-administer EEG and EOG leads in a home sleep study, which reduces cost and is more convenient for the patients. However, self-administration of the leads increases the risk of loose electrodes, which the algorithm must be robust to. The model structure was inspired by ResNet (He, Zhang, Ren, Sun, 2015), which has been highly successful in image recognition tasks. The ResTNet is comprised of the characteristic Residual blocks with an added Temporal component.

Methods
The ResTNet classifies sleep stages from the raw signals using convolutional neural network (CNN) layers, which avoids manual feature extraction, residual blocks, and a gated recurrent unit (GRU). This significantly reduces sleep stage prediction time and allows the model to learn more complex relations as the size of the training data increases.
The model was developed and validated on over 400 manually scored sleep studies using the novel SAS setup. In developing the model, we used data augmentation techniques to simulate loose electrodes and distorted signals to increase model robustness with regards to missing signals and low quality data.

Results
The study shows that applying the robust ResTNet model to SAS studies gives accuracy &gt; 0.80 and F1-score &gt; 0.80. It outperforms our previous model which used hand-crafted features and achieves similar performance to a human scorer.

Conclusion
The ResTNet is fast, gives accurate predictions, and is robust to loose electrodes. The end-to-end model furthermore promises better performance with more data. Combined with the simplicity of the SAS setup, it is an attractive option for large-scale sleep studies.

Support
This work was supported by the Icelandic Centre for Research RANNÍS (175256-0611).
0457 Insomnia and Cause-Specific Mortality in Men and Women
Authors: He F , Fernandez-Mendoza J , Vgontzas A N , Calhoun S L , Liao D , Bixler E O 
Published: May 2020

Abstract

Introduction
The association of insomnia with an increased risk of mortality has remained inconsistent across studies, which contrasts with accumulating evidence linking this prevalent and chronic sleep disorder with cardiovascular, cerebrovascular, oncologic, and psychiatric morbidity. The higher prevalence of insomnia in women compared to men may be an important contributor to the different survival rates reported in large, population-based studies.

Methods
The Penn State Adult Cohort is a random, general population sample of 1,741 adults (48.8±13.6y, 52.2% women) who were studied in the sleep laboratory and followed-up for their cause of death up to December 31, 2018. Insomnia was defined as a chronic complaint lasting at least 1 year (n=199). We assessed the risk of all-cause mortality (n=664) and the two most common causes of death: cardiovascular/cerebrovascular (n=275) and cancer (n=161). Cox proportional hazard models adjusted for age, race, sex, education, smoking, alcohol, BMI, AHI, cognitive impairment, mental health problems and physical health problems, including hypertension, diabetes, heart disease, stroke and cancer at baseline.

Results
The risk of all-cause mortality associated with insomnia was significantly increased in men (HR=1.84, 95%CI=1.18-2.87) but not in women (HR=0.80, 95%CI=0.57-1.13; p for sex-interaction&lt;0.01). Insomnia was significantly associated with an increased risk of cardiovascular/cerebrovascular mortality in men (HR=2.11, 95%CI=1.14-3.99), but not in women (HR=0.98, 95%CI=0.59-1.63; p for sex-interaction=0.06). Insomnia was not significantly associated with an increased risk of cancer mortality either in men (HR=1.41, 95% CI=0.56-3.56) or in women (HR=0.90, 95% CI=0.45-1.80), after adjusting for hypertension, diabetes, heart disease, stroke and cancer at baseline.

Conclusion
Men with chronic insomnia are at an increased risk of mortality, particularly that of cardiovascular/cerebrovascular origin. There is a need for translational studies focused on sex-differences that can disentangle the biological and behavioral mechanisms underlying women’s resilience.

Support
American Heart Association (14SDG19830018), National Institutes of Health (R01HL51931, R01HL40916)