bluuebunny/crossref_metadata_2025_split huggingface dataset:
O003 The impact of wind farm noise in a laboratory setting on objective and subjective sleep efficiency
Authors: Liebich T , Lack L , Micic G , Hansen K , Zajamsek B , Dunbar C , Lechat B , Nguyen D , Scott H , Catcheside P 
Published: October 2021

Abstract

Introduction
Well-controlled studies of wind farm noise (WFN) on sleep are lacking despite complaints and known effects of other noise types on sleep. This laboratory-based study investigated the impact of continuous full-night WFN exposure replicated from field recordings on polysomnography-measured (objective) and sleep diary-determined (subjective) sleep efficiency compared to a quiet control night.

Methods
Based on residential location and self-report data, 50 participants were categorised into three groups (14 living &lt;10km from a wind farm and self-reporting sleep disturbance; 19 living &lt;10km from a wind farm and self-reporting no sleep disturbance and 18 controls living in a quiet rural area). Participants underwent full in-laboratory polysomnography during exposure to continuous WFN (25 dB(A)) throughout the night and a quiet control night (background noise 19 dB(A)) in random order. Group and noise condition effects were examined via linear mixed model analysis.

Results
Participants (30 females) were aged (mean±SD) 54.9±17.6 range: 18–80 years. Sleep efficiency in the control condition was (median [interquartile range]) objective: 85.5 [77.4 to 91.2]%; subjective: 85.7 [69.2 to 92.7]%) versus the WFN condition (objective: 86.1 [78.6 to 91.7]% subjective: 85.8 [66.2 to 93.8]%) with no significant main or interaction effects of group or noise condition (all p’s &gt;0.05).

Conclusion
These results do not support that WFN at 25 dB(A) significantly impacts objective or subjective sleep efficiency in participants with or without prior WFN exposure or self-reported WFN-related sleep disturbance. Further analyses to investigate potential sleep micro-structural changes remain warranted.
O008 Embedding digital sleep health into primary care practice: perspectives of general practitioners, nurses, and pharmacists
Authors: Cheung J , Menczel Schrire Z , Aji M , Salomon H , Doggett I , Glozier N , Bartlett D , Wong K , Grunstein R , Gordon C 
Published: October 2021

Abstract

Introduction
Digital health interventions (DHI) have the potential to address the unmet sleep health needs of patients in primary care. The current study explored primary care health providers’ attitudes and beliefs towards DHIs for sleep health and the implementation into practice.

Methods
A mixed-methods study was conducted in a convenience sample of primary care service providers (GPs, nurses, pharmacists). An online survey captured participants’ scope of practice and attitudes towards DHIs. Associations between practice factors and attributes of DHIs were explored. A subset of participants was interviewed to explore perceived barriers/facilitators for implementing DHIs into primary care, which was thematically analysed using the Framework Approach.

Results
71 surveys were returned (GPs = 26, nurses = 21, pharmacists = 24) and 37 interviews were conducted (GPs = 13, nurses = 12, pharmacists = 12). Self-reported familiarity with DHIs was highest for GPs followed by pharmacists and nurses. Three major themes were identified: 1) Technology in Current Practice 2) Education Gaps and Training Needs and 3) Envisioning a Model of Care. Participants reported the “vague” definition of DHIs and mostly spoke in terms of personal experience and/or the health informatics systems used in practice. Despite recognising knowledge gaps, participants were confident in becoming upskilled and welcomed the idea of expanding digitalisation into sleep health. However, implementation success would depend on a supportive practice culture, patient uptake, and revising reimbursement structures.

Conclusion
With appropriate training and support, service providers highlighted the potential for embedding DHIs into primary care to optimise sleep health.
O010 The role of dysfunctional beliefs and attitudes about sleep in the association between daily sleep and affect in adolescents and emerging adults
Authors: Chachos E , Shen L , Maskevich S , Yap Y , Stone J , Wiley J , Bei B 
Published: October 2021

Abstract

Introduction
Sleep and affect are closely related. Late adolescence and emerging adulthood are associated with unique sleep patterns and risk for mood disturbances. This daily study examined whether dysfunctional beliefs and attitudes about sleep (DBAS), a modifiable cognitive vulnerability factor, moderated daily sleep-affect associations.

Methods
421 community adolescents (n=205, 54.1% females, M±SDage=16.9±0.87) and emerging adults (n=216, 73.1% females, M±SDage=21.31±1.73) self-reported sleep and affect (adapted 12-item PANAS) and wore an actigraphy device for 7–28 days, providing &gt;5000 daily observations. Linear mixed models tested whether DBAS moderated daily associations between self-reported and actigraphic sleep duration (total sleep time), sleep efficiency, and next-day affect on between and within-person levels. Both valence (positive/negative) and arousal (high/low) dimensions of affect were examined. Covariates included age, gender, ethnicity, day of week, and previous-day affect.

Results
DBAS significantly moderated associations between average sleep and next-day positive, but not negative, affect. Individuals with higher DBAS had significantly lower high arousal positive affect as average sleep duration (actigraphic: p=.002; self-reported: p=.014) and efficiency (actigraphic: p=.014) decreased. Similar moderation was found for average self-reported sleep duration and low arousal positive affect (p=.032). No significant results emerged on the within-person level. Previous-day affect significantly predicted next-day affect across models and outcomes (all p&lt;.001).

Discussion
Adolescents and emerging adults with more negative views about sleep may experience dampened positive affect in shorter, or poorer, sleep periods. DBAS may constitute a modifiable factor increasing affective vulnerability on a global but not day-to-day level, and a therapeutic target for sleep-related affect disturbances in youths.
O014 Heart rate response to obstructive respiratory events in children born preterm with OSA
Authors: Walter L , Bassam A , Davey M , Gillian N , Horne R 
Published: October 2021

Abstract

Background
Preterm-born (PT) children have an increased risk for obstructive sleep apnoea (OSA) and adverse cardiovascular outcomes. Respiratory events elicit acute changes in heart rate (HR) in term-born (T) children. Whether this response is augmented in PT children with OSA remains unclear. We aimed to analyse the HR response during obstructive respiratory events in PT children with OSA.

Methods
Nine PT children (3–12 y), were matched for obstructive apnoea hypopnoea index (OAHI), age and gender with T children. Beat-to-beat HR was averaged 10s before, during and the peak after (post) each obstructive event, and peak HR was expressed as percentage change.

Results
323 obstructive events in PT and 376 in T children were identified, consisting of 681 hypopnoeas (PT 320; T 361) and 18 apnoeas (PT 3; T 15). There were insufficient apnoeas in the PT group for analysis. For hypopnoeas during total sleep, the PT group had significantly lower HR compared to the T group before median 81bpm (IQR 74–87) vs 88 bpm (79–99); p&lt;0.001), during (76 bpm (69–83) vs 82 bpm (74–92; p&lt;0.001) and post (97 bpm (89–103) vs 105 bpm (95–115; p&lt;0.001) events. The post event increase in HR was significantly higher in the PT (26%, (16–39)) compared with the T (23%, (14–36)) group, p=0.008.

Conclusion
Although HR was lower during obstructive hypopnoeas in preterm compared with term-born children, the post event surge was significantly higher. This heightened HR response to respiratory events in children born preterm may underlie the worse cardiovascular outcomes in these children.
O021 Preferred attributes of care pathways for obstructive sleep apnoea from the perspective of diagnosed patients and high-risk individuals: a discrete choice experiment
Authors: Natsky A , Vakulin A , Chai Coetzer C , Adams R , McEvoy R , Kaambwa B 
Published: October 2021

Abstract

Background
The current health care system is challenged with a large and rising demand for obstructive sleep apnoea (OSA) services. A paradigm shift in OSA management is required to incorporate the preferences of diagnosed patients and individuals at high-risk of OSA. This study aimed to provide empirical evidence of the values and preferences of individuals diagnosed with OSA and high-risk populations regarding distinct OSA care pathway features.

Methods
A discrete choice experiment (DCE) was undertaken in two groups: those with a formal diagnosis of OSA (n=421) and those undiagnosed but at high-risk of having OSA (n=1033). The DCE approach used mixed logit regression models to determine preferences relating to eight salient features of OSA management pathway, i.e. initial assessment, setting and diagnosis costs, waiting times, results interpretation, treatment options, provider of ongoing care and frequency of follow up visits.

Results
The findings indicate that all eight attributes investigated were statistically significant factors for respondents. Generally, both groups preferred low diagnostic costs, fewer follow-up visits, minimum waiting time for sleep study results, and sleep specialists to recommend treatment and as ongoing care providers. Management of OSA in primary care was acceptable to both groups and was the most preferred option by the high-risk group for sleep study testing and ongoing care provision.

Discussion
The DCE results offer a promising approach for systematic incorporation of patient and high-risk groups preferences into the future design and delivery of care pathways for OSA management.
O025 Smart polymer implants as an emerging technology for treating airway collapse in obstructive sleep apnea: proof of concept
Authors: Sideris A , Wallace G , Lam M , Kitipornchai L , Lewis R , Jones A , Jeiranikhameneh A , Beirne S , Hingley L , Mackay S 
Published: October 2021

Abstract

Study objectives
To assess the use of a novel magnetic polymer implant in reversing airway collapse and identify potential anatomical targets for airway implant surgery in an in vivo porcine model.

Methods
Target sites of airway collapse were genioglossus muscle, hyoid bone, and middle constrictor muscle. Magnetic polymer implants were sutured to these sites, and external magnetic forces, through magnets with pull forces rated at 102 kg and 294 kg, were applied at the skin. The resultant airway movement was assessed via nasendoscopy. Pharyngeal plexus branches to the middle constrictor muscle were stimulated at 0.5 mA, 1.0 mA, and 2.0 mA and airway movement assessed via nasendoscopy.

Results
At the genioglossus muscles, large magnetic forces were required to produce airway movement. At the hyoid bone, anterior movement of the airway was noted when using a 294 kg rated magnet. At the middle constrictor muscle, an anterolateral (or rotatory) pattern of airway movement was noted when using the same magnet. Stimulation of pharyngeal plexus branches to the middle constrictor revealed contraction and increasing rigidity of the lateral walls of the airway as stimulation amplitude increased. The resultant effect was prevention of collapse as opposed to typical airway dilation, a previously unidentified pattern of airway movement.

Conclusions
Surgically implanted smart polymers are an emerging technology showing promise in the treatment of airway collapse in obstructive sleep apnea. Future research should investigate their biomechanical role as an adjunct to treatment of airway collapse through nerve stimulation.
O028 Effectiveness of digital brief behavioural therapy for insomnia with wearable technology: pilot randomized controlled trial
Authors: Gordon C , Aji M , Glozier N , Bartlett D , Calvo R , Marshall N , Grunstein R 
Published: October 2021

Abstract

Objective
This pilot trial aimed to test the effectiveness of integration of a wearable device with digital brief behavioural therapy for insomnia (dBBTi) on insomnia symptom severity, sleep metrics and therapy engagement.

Participants and Methods
One hundred and twenty-eight participants with insomnia symptoms were randomised to a 3-week dBBTi program with a wearable device enabling sleep data synchronization (dBBTi+wearable group; n = 62) or dBBTi alone (n = 66). We assessed the Insomnia Severity Index (ISI) and modified Pittsburgh Sleep Quality Index (PSQI; wake-after-sleep-onset (WASO), sleep-onset-latency (SOL), and total sleep time (TST)) at baseline and weeks 1, 2, 3, 6 and 12. Engagement was measured by the number of daily sleep diaries.

Results
There was no significant difference in ISI scores between the groups (d = 0.7, p = 0.061). The dBBTi+wearable group showed greater improvements in WASO (d = 0.8, p = 0.005) and TST (d = 0.3, p = 0.049) compared to the dBBTi group after 6 weeks. There was significantly greater engagement in the dBBTi+wearable group compared to the dBTi group (d =0.7, p = 0.010).

Conclusions
This pilot trial found that wearable device integration with a digital insomnia therapy led to improvements in WASO and TST and enhanced user engagement. We suggest that incorporation of adjunctive wearable technologies may improve digital insomnia therapy.
O037 Genioglossus motor control following the return to sleep after brief arousal
Authors: Dawson A , Avraam J , Nicholas C , Kay A , Trinder J , Jordan A 
Published: October 2021

Abstract

Rationale
Arousal from sleep has been shown to elicit a prolonged increase in genioglossus muscle activity that persists following the return to sleep and may protect against airway collapse. We hypothesised that this increased genioglossal activity following return to sleep after an arousal is due to persistent firing of inspiratory single motor units (SMUs) recruited during the arousal.

Methods
34 healthy participants were studied overnight while wearing a nasal mask/pneumotachograph to measure ventilation and with 4 intramuscular genioglossus SMU electrodes. During stable N2 and N3 sleep, auditory tones were played to induce brief (3-15s) AASM arousals. Ventilation and genioglossus SMUs were quantified for 5 breaths before the tone, during the arousal and for 10 breaths after the return to sleep.

Results
A total of 1089 tones were played and gave rise to 236 SMUs recorded across arousal and the return to sleep in 20 participants (age 23±4.2 years and BMI 22.5±2.2kg/m2). Ventilation was elevated above baseline during arousal and the first post-arousal breath (p&lt;0.001). The peak firing frequency of expiratory and tonic SMUs was unchanged during arousal and return to sleep, whereas inspiratory modulated SMUs were increased during the arousal and for 4 breaths following the return to sleep (p&lt;0.001).

Conclusions
The prolonged increase in genioglossus activity that occurs on return to sleep after arousal is a result of persistent activity of inspiratory SMUs. Strategies to elevate inspiratory genioglossus SMU activity may be beneficial in preventing/treating obstructive sleep apnea.
P017 Am I sleepy? – Subjective Sleepiness and Drowsy Driving: A systematic review and meta-analysis
Authors: Cai A , Manousakis J , Lo T , Horne J , Howard M , Anderson C 
Published: October 2021

Abstract

Introduction
Driving impairment due to sleep loss is a major contributor to motor vehicle crashes resulting in severe injury or fatalities. Ideally, drivers should be aware of their sleepiness and cease driving to reduce risk of a crash. However, there is little consensus on how accurately drivers can identify sleepiness, and how this relates to subsequent driving impairment. To examine whether drivers are aware of their sleepiness, we systematically reviewed the literature.

Methods
The research question for this review was “are drivers aware of sleepiness while driving, and to what extent does subjective sleepiness accurately reflect driving impairment?”. Our search strategy led to thirty-four simulated/naturalistic driving studies for review. We then extracted the relevant data. Correlational data were examined using meta-analysis, while predictive data were assessed via narrative review.

Results
Results showed that drivers were aware of sleepiness, and this was associated with both driving impairment and physiological drowsiness. Overall, subjective sleepiness was more strongly correlated (a) with ocular and EEG-based outcomes (rweighted = .70 and .73, respectively, p&lt;.001), rather than lane position and speed outcomes (rweighted = .46 and .49, respectively, p&lt;.001); (b) under simulated driving conditions compared to naturalistic drives; and (c) when the Karolinska Sleepiness Scale was used to measure subjective sleepiness. Lastly, high levels of sleepiness significantly predicted crash events and lane deviations.

Discussion
This review presents evidence that drivers are aware of sleepiness when driving, and suggests that interventions such as stopping driving when feeling ‘sleepy’ may significantly reduce crash risk.
P020 Reduced duration and continuity of N3 sleep is associated with excessive daytime sleepiness in suspected obstructive sleep apnea patients
Authors: Chen X , Korkalainen H , Leppänen T , Oksenberg A , Töyräs J , Terrill P 
Published: October 2021

Abstract

Introduction
Excessive daytime sleepiness (EDS) is a common but not universal-accompanying symptom of obstructive sleep apnea (OSA). The mechanisms explaining the presence of EDS in OSA subjects are not fully understood. We hypothesised that characteristic differences in sleep architecture can be quantified with more comprehensive descriptors of sleep continuity in those with and without severe-EDS according to the Multiple Sleep Latency Test (MSLT).

Methods
2111 participants with suspected OSA and complaints of daytime sleepiness underwent in-lab diagnostic polysomnography (PSG) and next-day MSLT. Sleep continuity was quantified by calculating the cumulative-frequency relationship of continuous sleep-state duration against proportion of sleep time; and continuous sleep-state duration against absolute sleep time.

Results
Study contained 368 severe-EDS participants (MSLT≤5min) and 385 non-EDS participants (MSLT&gt;15min). Severe-EDS participants had less Wake After Sleep Onset (48.1±37.7 vs. 68.1±44.2-minutes, p&lt;0.05 [mean±SD]), and greater Total Sleep Time (366.5±50.3 vs. 336.2±58.2-minutes, p&lt;0.05).
While total NREM sleep time was similar between groups, severe-EDS participants had less N3 sleep (67.7±38.0 vs. 78.6±32.0-minutes, p&lt;0.05) and more N2 sleep (230.7±59.3 vs. 178.4±45.9-minutes, p&lt;0.05). Moreover, severe-EDS participants had both less cumulative N3 sleep (36.9±2.9 vs. 60.0±3.3-minutes, p&lt;0.05) and a lower proportion of N3 sleep (66.8±5.3% vs. 77.2±4.2%, p&lt;0.05) occurring in periods ≥10mins duration.

Discussion
Whilst OSA participants with severe EDS have similar NREM sleep time to non-EDS participants; they have less N3 sleep, and N3 sleep periods are less consolidated. These preliminary results suggest that individuals with OSA which disturbs both the quantity and consolidation of N3 sleep are at greater risk of severe EDS.
P024 Children’s sleep and fathers’ health and wellbeing: a systematic review
Authors: Coles L , Thorpe K , Smith S , Hewitt B , Ruppanner L , Bayliss O , O’Flaherty M , Staton S 
Published: October 2021

Abstract

Introduction
Night-waking is typical across infancy and early childhood. Although mothers are traditionally primary carers for children overnight, child sleep may impact others in the household, such as co-dwelling fathers. Despite expectations of more ‘hands on’ fathering, the relationship between children’s sleep and fathers’ health and wellbeing has not been previously synthesised.

Methods
This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement and registered with the Prospective Register of Systematic Reviews (PROSPERO). Focusing on fathers, this review synthesised evidence pertaining to effects of children’s sleep (from birth to 12 years) on fathers’ health and wellbeing.

Results
From 4,421 records, 29 studies met inclusion criteria. Findings showed: (1) child sleep was associated with father’s sleep when child sleep was measured through father-report or objective measurement; (2) poorer child sleep was associated with poorer general health and wellbeing among fathers, however, associations of poor child sleep with depression were fewer; and (3) poor child sleep was negatively associated with quality of within-couple and parent-child relationships.

Discussion
Results suggested two principal issues: (1) Systematic variation in measures and findings underscores importance of objective measurement. Yoked actigraphy techniques are vital for understanding inter-relationships of family sleep and attendant outcomes. (2) Different patterns of child sleep and parent outcomes suggest direct and indirect pathways of effect. Understanding patterns of overnight caregiving, and factors underpinning parent decisions, are important for understanding mechanisms linking child sleep to fathers’ outcomes and for designing effective interventions to support parents.
P037 Indigenous Australians’ conceptualisation of sleep health differs from western interpretations
Authors: Fatima Y , King S , Solomon S , Bucks R , Skinner T 
Published: October 2021

Abstract

Purpose
Despite a significant burden of poor sleep, Aboriginal and Torres Strait Islander peoples’ (Indigenous Australians) conceptualisation of sleep health is poorly understood. This research explored Indigenous Australians’ understanding and interpretation of sleep health and how that affects their health.

Methods
Indigenous people from remote Queensland were invited to participate in focus group discussions exploring their understanding of sleep health, the link between dreaming and sleep, and perceived implications of poor sleep. Participants were also asked to complete an adapted pictorial Epworth Sleepiness Scale (ESS). Descriptive statistics were used to summarise ESS data and participants’ demographic data. Thematic analysis was used to analyse focus group data.

Results
A total of 29 Indigenous Australians (82% females), median age 39 years (Interquartile range 26–51 years) from various geographical areas within North West Queensland participated in focus group discussions (n=6). The following themes emerged from the data: interconnection among sleep, emotional and physical health; challenges and successes in obtaining healthy sleep; the impact of dreams on waking life; and lack of support from health services in managing sleep issues. Scores from the modified pictorial scale indicate 24% of the participants had excessive daytime sleepiness (ESS score&gt;10 points).

Conclusion
Indigenous Australians’ conceptualisation of sleep health is different from the western interpretation of sleep health. In particular, the connection between dreams and sleep is not adequately captured in current tools and resources to promote sleep health. This will limit effective prevention and management of sleep issues in Indigenous communities.