bluuebunny/crossref_metadata_2025_split huggingface dataset:
P065 Heart Rate and Heart Rate Variability in paediatric sleep disordered breathing: Is LF a proxy for vascular motor tone
Authors: Kontos A , Kennedy D , Baumert M , Martin J , Kohler M , Cicua-Navarro D , Pamula Y , Vokolos P , Wabnitz D , Lushington K 
Published: October 2021

Abstract
In children, sleep disordered breathing (SDB) is associated with changes in cardiac and vascular remodeling and hence may alter cardiac rhythm. Heart rate variability (HRV) measured during different sleep stages and at discreet times across the night, where vascular tone is known to change, provides an opportunity to better understand the effect of SDB on the cardiac function.
50 children diagnosed with SDB and 51 healthy children underwent overnight polysomnography to determine sleep staging. HRV (mean NN, SDNN, RMSSD, LF, HF, and LF:HF) was determined for the following segments pre-sleep; 3 slow wave sleep and 3 segments during rapid eye movement sleep (SWS1, SWS2, REM3, REM2, REM1). Children with SDB demonstrated higher heart rate (decreased mean NN) in all sleep segments. All HRV variables were similar between groups pre-sleep and REM3 and SWS3. LF and LF:HF were significantly lower in SWS1&2 and REM1 while as were SDNN and rMSSD were lower in the SDB group in REM1&2. LF remained low in the SDB group but rose to pre sleep levels in the control group.
Children with SDB have increased heart rate across the night even when HRV is similar between the groups. This suggests intrinsic changes to the cardiac components that determine heart rate. The HRV difference between groups was greatest post acrophase (body temperature dropping) and post nadir (body temperature rising) of the circadian cycle. We propose that impaired peripheral vascular control and sustained cardiac remodelling may underlie the heart rate and HRV changes observed in children with SDB.
P075 Travel or cheers? Examining the drivers and mechanisms of home court advantage in the 2020/2021 NBA regular season
Authors: Leota J , Hoffman D , Mascaro L , Czeisler M , Nash K , Drummond S , Anderson C , Rajaratnam S , Facer-Childs E 
Published: October 2021

Abstract

Introduction
Home court advantage (HCA) in the National Basketball Association (NBA) is well-documented, yet the co-occurring drivers responsible for this advantage have proven difficult to examine in isolation. The Coronavirus disease (COVID-19) pandemic resulted in the elimination of crowds in ~50% of games during the 2020/2021 NBA season, whereas travel remained unchanged. Using this ‘natural experiment’, we investigated the impact of crowds and travel-related sleep and circadian disruption on NBA HCA.

Methods
1080 games from the 2020/2021 NBA regular season were analyzed using mixed models (fixed effects: crowds, travel; random effects: team, opponent).

Results
In games with crowds, home teams won 58.65% of the time and outrebounded (M=2.28) and outscored (M=2.18) their opponents. In games without crowds, home teams won significantly less (50.60%, p = .01) and were outrebounded (M=-0.41, p &lt; .001) and outscored (M=-0.13, p &lt; .05) by their opponents. Further, the increase in home rebound margin fully mediated the relationship between crowds and home points margin (p &lt; .001). No significant sleep or circadian effects were observed.

Discussion
Taken together, these results suggest that HCA in the 2020/2021 NBA season was predominately driven by the presence of crowds and their influence on the effort exerted by the home team to rebound the ball. Moreover, we speculate that the strict NBA COVID-19 policies may have mitigated the travel-related sleep and circadian effects on the road team. These findings are of considerable significance to a domain wherein marginal gains can have immense competitive, financial, and even historical consequences.
P076 Sleep Staging Agreement Between Polysomnography and Sleep Profiler in Isolated REM Sleep Behavior Disorder
Authors: Levendowski D , Lee-Iannotti J , Shprecher D , Guevarra C , Timm P , Angel E , Mazeika G , St. Louis E 
Published: October 2021

Abstract

Purpose
Evaluate the sleep staging agreement between polysomnography (PSG) and Sleep Profiler (SP) in patients with suspected isolated REM-sleep-behavior-disorder.

Methods
Twenty-six patients with reported dream-enactment-behavior (Site1=16, Site2=10; 27% women; age 64±13 years) underwent a diagnostic PSG with simultaneously recorded SP. A registered sleep-technologist at each site performed PSG-staging, while SP was auto-staged and technically reviewed/edited.
Across technicians, the initial staging was blinded. Site1 then performed unblinded restaging of PSG=N3(N2) vs. SP=N2(N3) epochs, while Site2 conducted a blinded, carefully-targeted restaging of N3. Statistics included Cohen’s kappa and Chi-square analyses.

Results
Agreement between SP and Site1 vs. Site2 were significantly different for Wake (kappa:Site1=0.816;Site2=0.650;combined=0.736), stage N1 (kappa:Site1=0.149;Site2=0.228;combined=0.188), stage N2 (kappa:Site1=0.632;Site2=0.718;combined=0.659), stage N3 (kappa:Site1=0.715;Site2=0.368;combined=0.525) and REM (kappa:Site1=0.827;Site2=0.719;combined=0.766)(all P&lt;0.001).
After restaging of N3, the kappa values improved at Site1 (unblinded:N2=0.659/N3=0.883) and Site2 (blinded:N2=0.775/N3=0.736)(combined:N2=0.735/N3=0.851). The proportion of PSG-epochs restaged from N3 to N2 was 17% at Sites1 and 38% at Site2 (P&lt;0.001), while Site1 had fewer remaining PSG=N3 vs. SP=N2 conflicts (5.6% vs. 20.8%, P&lt;0.001).
Compared to Site2, Site1 had a superior: REM kappa due to fewer SP=N2 disagreements (8.5% vs. 16.8%, P&lt;0.001), and Wake kappa resulting from fewer SP=N1 (6.6 vs. 15.6%, P&lt;0.001) and SP=N2 conflicts (5.9 vs. 12.0%, P&lt;0.001). Conversely, the Site1 N1 kappa was inferior due to greater SP=wake disagreement (41.6% vs. 19.8%, P&lt;0.001).

Discussion
N3 was excessively stage by both PSG technicians before restaging. At Site1, Wake, N3, and REM had almost-perfect-agreement with SP, while N2 had substantial-agreement. At Site2 and across-site, substantial-agreement was observed for Wake, N2, N3, and REM.
P079 Effect of sleepwear fibre type on menopausal sleep quality – Study protocol and preliminary data
Authors: Li X , Halaki M , Mahar T , Ropert S , Ireland A , Chow C 
Published: October 2021

Abstract

Introduction
Vasomotor symptoms and sleep disturbances are common in menopausal women. Different fabric types affect thermal comfort through moisture absorption and thermal insulation. This study examined the impact of cotton and wool sleepwear on menopausal women’s sleep quality.

Methods
This is a randomized, crossover, repeated-measures and triple-blinded trial comparing the sleep quality and vasomotor symptoms of healthy menopausal women between cotton and wool sleepwear at 30°C, 50% relative humidity. Participants undergo 6 laboratory visits. After a screening visit and a familiarization night, participants are randomized to 4 nights (2 nights in cotton and 2 nights in wool sleepwear) during which polysomnography and actigraphy recordings are taken including objective hot flush events, room temperature and relative humidity measurements, as well as subjective questionnaires on clothing comfort, mood and vasomotor symptoms.

Results
Eleven participants (age 51.2±4.7 years, BMI 26.8±2.9 kg.m-2, Insomnia Severity Index 11.1±5.5) completed all six visits so far. Reasons for exclusion: 3 didn’t have vasomotor symptoms; 1 on HRT, 5 had severe sleep disturbances, 3 on medications, 4 had diabetes, 1 asthma, and 1 had BMI&gt;30. All sleep-related outcomes are pending analysis (blinding).

Discussion
Recruitment is a major study challenge. Many participants found it hard to arrange a time to attend overnight studies due to family/work commitments. The COVID-19 pandemic changed people’s attitude as some were hesitant to attend the laboratory. Menopause transition status is an important time during women’s lifespan. Effective management, e.g., through appropriate sleepwear, would be helpful to improve menopausal women’s symptom and quality of life.
P081 Assessment of Change in Palatoglossus Length with Mandibular Advancement and Relationship to Response to Mandibular Advancement Splint Therapy in Obstructive Sleep Apnoea
Authors: Lim K , Brown E 
Published: October 2021

Abstract

Background
The palatoglossus is a muscle of the soft palate extending from the palatine aponeurosis inferolaterally along the pharyngeal wall inserting at the posterolateral surface of the tongue. Palatoglossal stimulation dilates the retropalatal space in subjects with obstructive sleep apnoea (OSA). Whether there is alteration in palatoglossus length during mandibular advancement and how this relates to Mandibular Advancement Splint (MAS) outcomes is unknown.

Methods
Participants with OSA referred for MAS underwent upper airway MRI with and without mandibular advancement. The linear distance between the origin of the palatoglossus muscle at the palatine aponeurosis and its insertion at the tongue was measured to approximate palatoglossus length. The difference in measured lengths with and without mandibular advancement was calculated. Change in palatoglossus with advancement was compared to treatment outcomes.

Progress to date
71 participants with mean±SD AHI 26.0±16.1 events/hr were included in our study. Mean±SD palatoglossus length was 49.58±5.74mm. With mandibular advancement, mean±SD palatoglossus length was 51.21±5.46mm this was a significant change in length of mean±SD 1.63±4.3mm. This was a mean±SD 4.79±9.08% alteration in length with mandibular advancement. Treatment response was not significantly related to change in palatoglossus length (p&gt; 0.05).

Intended outcome and Impact
Our intention was to demonstrate significant length alteration in palatoglossus with mandibular advancement and correlate this to treatment outcome. This may highlight palatoglossus as a target for MAS or other OSA therapies for future clinicians.
P084 Is Cognitive Behaviour Therapy for insomnia (CBTi) responsiveness a function of objective sleep efficiency rather than objective sleep duration?
Authors: Lovato N , Micic G , Lack L 
Published: October 2021

Abstract

Introduction
Past research and our own has not shown a differential response to Cognitive Behaviour Therapy for insomnia (CBTi) based on objective sleep duration. It is valuable to investigate CBTi responsiveness is a function of objective sleep efficiency (SE) instead of objective sleep duration. This study is a secondary exploratory analysis of our earlier clinical trial to assess the differential therapeutic response to CBTi for older insomniacs based on SE prior to treatment.

Method
Seventy-nine adults (male=34, mean age=63.38, SD=6.25) with sleep maintenance insomnia were selected. Participants were grouped into 3 ordinal groups; the top 50% of participants (above the median percent sleep time-normal SE), the 25% of participants in the third quartile (moderately low SE), and the bottom 25% of participants (severely low SE) based on 1-night of home-based polysomnography. Participants were randomly allocated to CBTi or wait-list control. One-week sleep diaries, actigraphy and a battery of questionnaires evaluated the efficacy of CBTi for each SE group. Outcome measures were taken at pre-treatment, post-treatment, and 3-month follow-up.

Results
CBTi produced robust improvements in sleep quality including reduced wake after sleep onset, and improved sleep efficiency. Participants reported a reduction of scores on the Insomnia Severity Index, Flinders Fatigue Scale, Epworth Sleepiness Scale, Daytime Feeling and Functioning Scale, Sleep Anticipatory Anxiety Questionnaire, Dysfunctional Beliefs and Attitudes Scale, and increased Sleep Self-Efficacy Scale. All improvements were significant relative to waitlist and comparable regardless of objective SE at pre-treatment.

Discussion
CBTi responsiveness did not differ as a function of objective SE.
P087 A validation study of the limited channel single and multi-use NightOwl sleep testing systems compared to laboratory polysomnography in the diagnosis of obstructive sleep apnoea
Authors: Lyne C , Mansfield D , Stupar D , Turton A 
Published: October 2021

Abstract

Background
Obstructive sleep apnoea (OSA) is common, and its prevalence is increasing. Opportunities to screen for OSA using simplified diagnostic devices may be important to addressing this clinical burden. The NightOwl (Ectosense NV, Leuven, Belgium) is a small dual channel device that acquires data from a single fingertip and is available in a disposable version, in addition to the previously validated reusable option. The devices will provide a measure of sleep duration and derived apnoea-hypopnoea index (AHI) using a proprietary algorithm.

Methods
A prospective cohort study of patients undergoing laboratory polysomnography (PSG) for suspected OSA is underway at Monash Medical Centre, Clayton (ACTRN12621000444886). Participants are fitted with a NightOwl Sensor Mini (disposable) and a NightOwl Sensor Reusable on their index and middle fingers, in addition to the standard PSG setup (Compumedics Grael, Profusion 3). The primary outcome is the level of agreement between the NightOwl Sensor Mini, NightOwl Sensor Reusable and PSG derived AHI. We also intend to compare the proprietary algorithm against Compumedics Profusion 3 for determination of oxygen desaturation index. Level of agreement will be determined utilising Bland-Altman plots.
Progress to date
Recruitment is currently underway with 29 of an intended 100 participants having completed their sleep studies.
Intended outcome and impact
The intended outcome of this study is to externally validate the two NightOwl devices against PSG for detecting OSA and accurately assessing severity. We anticipate this will enable screening for OSA in an efficient and cost-effective manner.
P091 The impact of cognitive fitness and gender on sleep quantity and timing and mental health of competitive athletes
Authors: Mascaro L , Drummond S , Leota J , Boardman J , Hoffman D , Rajaratnam S , Aidman E , Facer-Childs E 
Published: October 2021

Abstract

Introduction
Mental fitness is increasingly considered key to an athlete’s competitive arsenal. Its active ingredients include cognitive fitness factors, such as impulse control, and recovery factors, such as sleep, which may differ between male and female athletes. Our study investigated: 1) gender differences in cognitive fitness; and 2) the associations of gender and cognitive fitness with sleep and mental health in competitive athletes during the COVID-19 lockdown.

Methods
84 athletes competing at levels from regional/state to international (42F, mean age=23.2) completed a questionnaire battery containing validated measures of: a) depression, anxiety, and stress; b) sleep (Total Sleep Time, Sleep Latency, mid-sleep time on training- and competition-free days); and c) self-control, intolerance of uncertainty, and impulsivity (representing cognitive fitness constructs).

Results
Female athletes reported significantly higher depression, anxiety, and stress, a later mid-sleep time on free days, lower self-control, higher intolerance of uncertainty, and higher positive urgency impulsivity compared with male athletes. Self-control was negatively associated, and intolerance of uncertainty was positively associated, with depression, anxiety, and mid-sleep time on free days.

Discussion
Female athletes in our sample reported poorer mental health and cognitive fitness, and later sleeping times on free days. Greater cognitive fitness was associated with better mental health, independent of gender. Overall, these findings are consistent with prior work in community samples. Future work should examine the source(s) of these gender differences. If replicated, our findings would suggest a need to develop interventions aimed at improving athlete well-being, potentially with a particular focus on female athletes.
P092 Improving Postgraduate Psychology Students’ Sleep and Insomnia Knowledge with a Sleep Education Workshop
Authors: Meaklim H , Meltzer L , Junge M , Rehm I , Monfries M , Kennedy G , Bucks R , Jackson M 
Published: October 2021

Abstract

Introduction
Trainee psychologists receive limited sleep and insomnia education during postgraduate study. This study examined the delivery of a sleep psychology training workshop for postgraduate psychology students and examined changes in sleep knowledge from pre- to post-workshop.

Methods
A 6-hour Sleep Psychology Workshop was delivered to postgraduate psychology students around Victoria. Online pre- and post-workshop questionnaires were used to evaluate changes in sleep psychology knowledge and collect feedback on the workshop.

Results
The participants were 187 students (82% female, M age = 32), most of whom were in their 5th year of psychology training (69%) and had not received any sleep education during their postgraduate studies at the date of the intervention (77%). Students’ sleep knowledge significantly improved after workshop completion (pre: 56% vs. post: 80% correct), t(107)= -21.41, p &lt; .001. Students provided positive feedback about the workshop, with 96% rating the workshop as excellent/very good and 86% reporting that they would recommend the workshop to other postgraduate students. Overall, 94% of students agreed/strongly agreed that the sleep psychology workshop improved their confidence to manage sleep disturbances in their future psychology practice.

Discussion
Postgraduate psychology students require sleep and insomnia education. This study demonstrates that students’ sleep psychology knowledge can improve after a 6-hour sleep education and training workshop and provides initial positive feedback about the benefits of sleep and insomnia education for postgraduate students.
P105 Endocrine, autonomic and vascular function in children with Sleep Disordered Breathing
Authors: Noone A , Lushington K , Kennedy D , Martin J , Vokolos P , Wabnitz D , Kontos A 
Published: October 2021

Abstract
SDB is a risk factor for cardiovascular disease and co-exists with chronic endocrine disorders such as type II diabetes and metabolic syndrome. Children with SDB have increased blood flow velocity, an indicator of reduced vascular compliance and early vascular aging. Increased blood flow velocity is positively associated with sympathetic activity, increased arterial sympathetic nerve fibre density and endothelial damage. Whether changes in endocrine function occur concomitantly with altered autonomic and vascular function in children with SDB was assessed.
Thirty six children scheduled for tonsillectomy underwent overnight polysomnography (SDB severity), pupil light reflex (autonomic function), fasting brachial artery blood flow assessment (vascular function - Doppler Ultrasound). Leptin and Ghrelin - both hormonal markers associated with sympathetic activity were measured in urine using ELISA and serum using MagPlex. The following dimensions of the dorsal lingual artery (tonsil) were measured – medial thickness, medial area, smooth muscle cell number/layers.
We observed a positive correlation between serum and urine leptin and ghrelin concentrations. Increased blood flow velocity and arterial medial thickness were both associated with increased serum and urine leptin and ghrelin concentrations. Pupil light reflex was negatively associated with serum leptin and ghrelin levels. OAHI was positively correlated with leptin and ghrelin concentration (urine and serum) but not blood flow velocity. Blood flow velocity was inversely correlated with SpO2 nadir (REM).
Our findings suggest that SDB has a global effect on the autonomic, vascular and endocrine systems.The impact of untreated paediatric SDB on the development of comorbidities in later life needs urgent attention.
P111 Sleep disturbances are associated with poor neurobehavioural outcomes following traumatic brain injury: A study of military service members and veterans
Authors: Pattinson C , Brickell T , Bailie J , Hungerford L , Lippa S , French L , Lange R 
Published: October 2021

Abstract

Introduction
Sleep disturbances are pervasively reported in military service members and veterans, especially following traumatic brain injury (TBI). The purpose of this study was to examine the association between sleep disturbances and neurobehavioural outcomes in a large group of U.S. military service members and veterans, with and without a history of TBI.

Methods
Participants were enrolled into the Defense and Veterans Brain Injury Center/Traumatic Brain Injury Center of Excellence, 15-Year Longitudinal TBI study (N = 606). Participants self-reported sleep disturbances (PROMIS 8A) and neurobehavioral symptoms. Data were analyzed using analysis of variance with post-hoc comparisons. Four groups were analyzed separately: uncomplicated mild TBI (MTBI; n=218); complicated mild, moderate, severe, or penetrating - combined TBI (CTBI; n=118); injured controls (IC, i.e., orthopedic or soft-tissue injury without TBI; n=162); and non-injured controls (NIC; n=108).

Results
Participants in the MTBI group reported the highest proportion of moderate-severe sleep disturbances (66.5%) compared to the IC (54.9%), CTBI (47.5%), and NIC groups (34.3%). Participants classified as having Poor Sleep reported significantly worse scores on almost all TBI-QOL scales compared to those classified as having Good Sleep, regardless of TBI severity or even the presence of TBI (ps&lt;.05, Cohen’s ds&gt;.3).

Discussion
This study demonstrates that sleep disturbances remain a prevalent and debilitating concern in service member and veteran populations. Regardless of group (injured or NIC), sleep disturbances were common and were associated with significantly worse neurobehavioral functioning. When assessing and treating neurobehavioural symptoms, it is important to assess sleep, especially in service member and veteran populations.
P112 Under-mattress sleep monitoring to predict readmission risk after COPD exacerbation
Authors: Proctor S , Molloy W , Chai-Coetzer C , Catcheside P , Adams R , Mukherjee S 
Published: October 2021

Abstract

Background
Recurrent hospitalisation for COPD exacerbations is a major contributor to disease burden and healthcare costs. This study aims to establish if post-discharge sleep or vital sign parameters are predictive of hospital readmissions after COPD exacerbations.

Methods
Patients admitted with a COPD exacerbation were recruited from November 2019 until May 2021. Sleep parameters were assessed for at least one night in hospital and 10 nights post-discharge using an under-mattress device (EarlySense). Analysis on data from the first 26 participants were conducted using independent sample Mann-Whitney U tests comparing device-estimated sleep parameters between participants admitted versus not readmitted at one- and three-months post-discharge.

Progress to date
Thirty-four participants have consented. In the 26 participants completing the study to date, all-cause hospital readmission rates at one- and three-months were 26% and 65% respectively. Participants readmitted versus not readmitted at one-month had lower percentage of time in light sleep (43 ± 12% vs 58 ± 12%, p=0.029) and lower estimated AHI (5.6 ± 1.9 vs 17 ± 11 /hr, p=0.042). There were no differences at three-months.

Intended outcome and impact
Data from the full cohort will be used to assess heart rate and respiratory rate across each night and stage of sleep which could reveal clinically useful methods in the emerging field of ambulatory sleep monitoring. The feasibility and challenges of using ambulatory monitoring devices in patients with chronic respiratory disease will be reported. This study will guide future work that could potentially improve ambulatory monitoring through user-friendly and clinically feasible devices.