bluuebunny/crossref_metadata_2025_split huggingface dataset:
263 Use of an Air Purifier in the Bedroom Improves Objective and Perceived Sleep
Authors: Rus Holly , Danoff-Burg Sharon , Weaver Morgan , Rodriguez Rodolfo , Raymann Roy 
Published: May 2021

Abstract

Introduction
This study examined if an air purifier in the bedroom would improve sleep on a broad sample of healthy people (non-smokers without allergies) with sub-optimal sleep living in urban and suburban areas. This way of testing has the advantage of providing insight into the effectiveness of a product under real-life conditions, yielding more ecologically valid results.

Methods
36 adults whose objective data indicated suboptimal sleep participated in an 8-week field study. A within subjects, pre-post intervention design was implemented, comparing 4 weeks of nightly product use to 4 weeks without using the product. Intervention consisted of the use of an Alen BreatheSmart 45i air purifier in the bedroom for 24 hours a day during the duration of the intervention period. Sleep was measured objectively with SleepScore Max every night and by self-report. Multilevel regression and paired t-tests were used to test for statistical significance.

Results
Across all participants there were 1591 nights of tracked sleep. Participants (55% male, age 25-74, avg. 44) showed improvement in both objective and perceived sleep during the intervention. While using the air purifier, there was a small but significant improvement in objective sleep quality (p&lt;.05). In the subgroup of participants who had the poorest objective sleep at baseline (n=16), there were significant improvements while using the air purifier, reflecting improved sleep continuity after falling asleep: fewer awakenings during the night, decreased time awake during the night, increased sleep efficiency, and increased sleep maintenance (all ps&lt;.05). Self-report data showed that, when using the air purifier, participants felt they fell asleep faster, woke up fewer times, spent less time awake at night, and were better able to sleep through the night. In the morning, they were more likely to feel well-rested. They also felt satisfied with their sleep more often and had better sleep quality (all ps&lt;.05).

Conclusion
Using the air purifier in the bedroom can improve sleep. Objectively measured sleep improvement supported self-reported sleep improvements, especially in the subset of participants who showed compromised sleep at baseline.

Support (if any)
Alen Corporation
267 Perioperative sleep study in geriatric cardiac surgical patients using wireless wearable devices
Authors: Kafashan MohammadMehdi , Labonte Alyssa , Smith Kendall , Guay Christian , Hyche Orlandrea , Nguyen Thomas , Wilson Elizabeth , Guan Michael , Lucey Brendan , Ju Yo-El , Palanca Ben 
Published: May 2021

Abstract

Introduction
Sleep is a fundamental necessity for health and is commonly disrupted in the perioperative period. Technological improvements leveraging dry electroencephalographic (EEG) sensors have opened the door for large-scale quantitative assessments of sleep in relation to perioperative outcomes.

Methods
Patients utilized the Dreem (Rhythm, New York USA), a wireless EEG headband, to acquire their own preoperative nocturnal sleep records at home. Following cardiac surgery, postoperative recordings were obtained with staff assistance until postoperative night 7. Sleep records were scored as rapid eye movement (REM) and non-rapid eye movement (NREM) stages N1-N3, using modified American Academy of Sleep Medicine guidelines.

Results
Of 100 patients enrolled for perioperative sleep recordings, 74 patients provided 132 preoperative records; 80% were scorable with a median total sleep time (TST) of 209.8 minutes. TST was distributed as 8.3% N1, 70.6% N2, 2.1% N3 and 19% REM, consistent with expected sleep structure in geriatric populations. EEG markers for staging sleep were evaluated in the scorable records: 92% with sleep spindles, 98% with K-complexes, 69% with slow waves, 92% with sawtooth waves, and 80% with rapid eye movements. Among 26 patients with multiple preoperative sleep recordings, no significant within-subject differences in sleep structure were observed (all p &gt; 0.05, paired Wilcoxon sign-rank test). 270 postoperative nocturnal sleep recordings were obtained from 83 patients, 70% of which were scorable. TST in scorable postoperative records was distributed as 14.9% N1, 78.6% N2, 0.9% N3 and 5.6% REM. Durations of REM and N3 sleep were significantly reduced in postoperative (POD 1-4) overnight recordings compared to preoperative measurements (Skillings–Mack test, p &lt; 0.001 and p = 0.02 for REM and N3, respectively).

Conclusion
Wireless EEG devices enhance the feasibility of assaying perioperative sleep. A single night of unattended, ambulatory sleep monitoring is sufficient to establish a preoperative baseline. Multiple preoperative and postoperative sleep studies were tolerated by patients, which showed reductions of N3 and REM sleep in the early postoperative period. This study demonstrates the feasibility of using the Dreem for monitoring sleep macro- and microstructural EEG elements in the perioperative setting.
Support (if any):
268 Smart polymer implants as an emerging technology for treating airway collapse in OSA: a proof of concept study
Authors: Sideris Anders , Wallace Gordon , Lam Matthew , Kitipornchai Leon , Lewis Richard , Jones Andrew , Jeiranikhameneh Ali , Hingley Lachlan , Beirne Stephen , Mackay Stuart G 
Published: May 2021

Abstract

Introduction
Implantable 3D printed ‘smart’ polymers are an emerging technology with potential applications in treating collapse in adult obstructive sleep apnea through mechanical airway manipulation. There is a paucity of devices that are commercially available or in research and development stage. Limited studies have investigated the use of implantable smart polymers in reversing the collapsibility of the pharyngeal airway by creating counter forces during sleep. This paper describes an application of implantable magnetic polymer technology in an in-vivo porcine model. Study Objectives: To assess the use of a novel magnetic polymer implant in reversing airway collapse and identifying 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. Magnetic polymer implants were sutured to these sites and external magnetic forces, through magnets with pull forces rated at 102kg and 294kg, were applied at the skin. The resultant airway movement was assessed via nasendoscopy. Pharyngeal plexus branches to the middle constrictor muscle were stimulated at 0.5mA, 1.0mA and 2.0mA 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 294kg 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, a previously unidentified pattern of airway movement.

Conclusion
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.

Support (if any)
Garnett-Passe and Rodney Williams Memorial Foundation, Conjoint Grant, 2016-18.
270 Sleep Enhancement Technology: A Survey of Devices
Authors: Klosterman Grace , Stekl Emily , Simonelli Guido , Collen Jacob , Doty Tracy Jill 
Published: May 2021

Abstract

Introduction
Innovations in consumer sleep technologies have risen exponentially and providers struggle to keep up with patient expectations in this arena. Although there is high quality data on the validity on commercial sleep monitoring devices, there has been a rise in devices for the explicit purpose of sleep enhancement. We sought to identify existing consumer sleep devices that claim to enhance sleep, provide a comprehensive review of the main characteristics of these devices, and look into the types of evidence the developers offered to support their claims.

Methods
Using a scoping review framework we identified and mapped out the main characteristics of sleep enhancement devices in the consumer market. We systematically used a common search engine and the FDA database using various combinations of sleep-related search terms, such as “sleep enhancement device”. Through an iterative process, we identified and categorized devices based on the intervention target. Devices that were exclusively for clinical use and required a prescription, such as for the treatment of obstructive sleep apnea or diagnosed insomnia, were excluded.

Results
We identified 34 sleep enhancement devices, all 34 were found via web search and one was also found in the FDA Database. We defined the following overlapping categories: reduce sleep latency (94.1%), increase restorative sleep (17.6%), and/or “other” (32.4%). About half of the devices use sound (44.1%), 26.5% use visual stimuli, and 11.8% use vibration. Additionally, roughly a third of all devices claim to entrain brain signals associated with sleep. Half of devices found operate near the bed without being in contact with the consumer, 44.1% are worn on the body, and the remaining 5.9% operate in bed, near the consumer.

Conclusion
For the most part, commercial sleep enhancement devices target sleep latency or claim to increase the restorative power of sleep. These devices generally use auditory, visual, and vibratory stimuli, and half are worn on the body. Lack of evidence supporting whether these devices actually improve sleep questions the utility of such devices and demonstrates the need for validation standards for consumer sleep enhancement devices.

Support (if any)
Department of Defense Military Operational Medicine Research Program (MOMRP)
271 Sleep staging performance of a signal-agnostic cloud-based real-time sleep analytics platform
Authors: Siting Zhao , Kishan Kishan , Patanaik Amiya 
Published: May 2021

Abstract

Introduction
The coronavirus pandemic has brought unprecedented changes to the health care system, including sleep medicine. Remote monitoring and telemedicine played a significant role in this shift. We anticipate these changes to continue in the future with internet-connected wearables (ICWs) playing an important role in measuring and managing sleep remotely. As these ICWs measures a small subset of signals traditionally measured during polysomnography (PSG), manual sleep staging becomes non-trivial and sometimes impossible. The ability to do accurate and reliable automatic sleep staging using different modalities of physiological signals remotely is becoming ever more important.

Methods
The current work seeks to quantify the sleep staging performance of Z3Score-Neo (https://z3score.com, Neurobit Technologies, Singapore), a signal agnostic, cloud-based real-time sleep analytics platform. We tested its staging performance on the CINC open dataset with N=994 subjects using various combinations of signals including Electroencephalogram (EEG), Electrooculogram (EOG), Electromyogram (EMG), and Instantaneous Heart Rate (IHR) derived from Electrocardiogram (ECG). The staging was compared against manual scoring based on PSG. For IHR based staging, N1 and N2 were combined.

Results
We achieved substantial agreement (all Cohen’s Kappa &gt; 0.7) between automatic and manual staging using various combinations of EEG, EOG and EMG channels with accuracies varying between 81.76% (two central EEGs, one EOG, one EMG), 79.31% (EEG+EOG), 78.73% (EEG only) and 78.09% (one EOG). We achieved moderate agreement (accuracy: 72.8% κ=0.54) with IHR derived from ECG.

Conclusion
Our results demonstrated the accuracy of a cloud-based sleep analytics platform on an open dataset, using various combinations of ecologically valid physiological signals. EOG and EMG channels can be easily self-administered using sticker-based electrodes and can be added to existing home sleep apnea test (HSAT) kits significantly improving their utility. ICWs are already capable of accurately measuring EEG/EOG (Muse, InteraXon Inc., Toronto, Canada; Dreem band, Dreem, USA) and IHR derived from ECG (Movesense, Suunto, Finland) or photoplethysmogram (Oura Ring, Oura Health Oy, Finland) or through non-contact ballistocardiogram/radio-based measurements (Dozee, Turtle Shell Technologies, India; Sleepiz, Sleepiz AG, Switzerland). Therefore, a well-validated cloud-based staging platform solves a major technological hurdle towards the proliferation of remote monitoring and telehealth in sleep medicine.
Support (if any):
272 Long-term monitoring of trait-like characteristics of the sleep electroencephalogram using ear-EEG
Authors: Hemmsen Martin , Mikkelsen Kaare , Rank Mike , Kidmose Preben 
Published: May 2021

Abstract

Introduction
Wearable electroencephalogram (EEG) monitoring has a remarkable potential, it is safe, scalable and can track neural signatures for long periods. One such signature is the power spectra of non-rapid-eye-movement (NREM) sleep which has been shown to demonstrate a trait-like characteristic. Changes in personalized signatures has been associated with biomarkers of Alzheimer’s disease and is of great interest for early detection and clinical management. This work investigates monitoring of signatures using a wearable device that records EEG from the ear (ear-EEG) and compares the intra- and inter-individual similarity of the neural signatures with that from central scalp-EEG.

Methods
We initiated a two phased in-home study, monitoring 20 subjects for 4 nights (A), followed by a delayed but continued monitoring of 10 subjects for 12 nights (B). In A, subjects wore a dry-electrode ear-EEG system and a partial PSG, in B the subjects wore only the ear-EEG system. Subjects were instructed to follow their usual time schedule and lifestyle. Sleep stages were scored manually according to AASM in A and automatically in B. The grand average power spectra of NREM2 sleep were computed and log-transformed prior to calculating the cosine similarity for determination of the intra- and inter-individual similarity.

Results
The ear-EEG and scalp-EEG analysis showed that mean intra-individual similarity was higher than mean inter-individual similarity. Permutation tests indicate that the observed mean difference is statistically significant p&lt;0.01 for both montages. Comparing the distributions of intra-individual similarities for ear-EEG and scalp-EEG, the observed mean difference is statistically significant p&lt;0.05, in favor of a more stable ear-EEG signature. Comparing ear-EEG signatures between A and B, considering nights from A as reference, all subjects from B were most similar with its own reference signature. Considering signatures from individual nights the accuracy paring subjects from A and B were 88% correct.

Conclusion
Nocturnal ear-EEG measures trait-like characteristics as reliable as scalp-EEG. The neural signature is stable over time within healthy subjects and demonstrated its ability as a personalized signature.
Support (if any):
274 Multimodal longitudinal sleep tracking combining wearable, smartphone tap analysis and electronic questionnaires
Authors: Massar Stijn A , Chua Xin Yu , Soon Chun Siong , Ng Alyssa , Ong Ju Lynn , Chee Nick , Chee Michael 
Published: May 2021

Abstract

Introduction
The proliferation of wearable and smartphone technologies has enabled continuous monitoring of sleep using data from different channels (physiological [wearables], behavioural [phone usage] and ecological momentary assessment [EMA self-report]). As these modalities use different methods to assess sleep, information gaps suggested by discrepancies between estimates may be filled in through cross-referencing among the modalities to produce a more accurate sleep measurement. Moreover, the pattern of discrepancies could inform about specific sleep and peri-sleep behaviors (e.g. phone use before bedtime).

Methods
198 staff and students from the National University of Singapore (61 male, mean age 26.15±5.83 years) were recruited for an 8-week study. Sleep timings were assessed daily from three modalities: a wearable sleep and activity tracker (Oura ring), estimations from smartphone touchscreen interactions (tappigraphy) and smartphone derived EMA self-reports. Sleep estimates from the different modalities were compared for agreement (bivariate correlation) and discrepancies (t-test). Additionally, clustering analysis of high-discrepancy nights (&gt;1h discrepancy between modalities) was performed to identify pattens of sleep behaviors that could lead to specific discrepancies.

Results
Adherence throughout the 8-week monitoring period (total 11,088 nights) was = high for the Oura ring; 9826 nights [80%]), Tappigraphy; 9740 nights [88%)), and EMA; 9166 nights [83%]). Sleep estimates across the three modalities showed high agreement (r=0.79-.91), with some discrepancies: Relative to self-report data, Oura wake time tended to be a later (Mean diff=9mins, t=18.58, p&lt;.001), while tappigraphy estimates of bedtime tended to be early (Mean diff=15mins, t=26.48, p&lt;.001). On 23% of nights (1755 nights), however, large discrepancies were detected (&gt;1h). K-means clustering identified three distinct patterns of discrepancy, which were dominantly expressed in different individuals. Group comparison revealed that these individuals differed in demographic variables (age, student/work status), sleep variables (sleep timing, duration, subjective sleepiness), and phone usage characteristics (overall and pre-bedtime phone usage).

Conclusion
These data show that the combined use of three streams of data concerning sleep is complementary. Moreover, discrepancy patterns provide specific insights into sleep and peri-sleep behaviors facilitating digital phenotyping.

Support (if any)
This research was supported by the National Medical Research Council Singapore (NMRC/STaR/015/2013 and NMRC/STaR19may-0001).
281 Feasibility, Acceptability, and Preliminary Impact of a School-Based Sleep Promotion Program for Adolescents
Authors: Levenson Jessica , Goodkind Sara , Albert Sara , Macuga Bryan , Golden Dawn , Karadus Clay , Wehrer Edward , Miller Elizabeth 
Published: May 2021

Abstract

Introduction
Poor sleep is common among adolescents and has been linked with school absenteeism. Though improved sleep has been associated with improved school outcomes, intervention programs for insufficient sleep are not standard in schools, few have used an individualized approach, and none have focused on youth with absenteeism. We conducted an open trial of the feasibility, acceptability, and initial impact of our school-based sleep promotion program among adolescents.

Methods
Participants included 8th and 9th grade students with mild absenteeism, insufficient sleep, and sleep timing shift on the School Sleep Habits Survey (SSHS). The program included a smartphone-based sleep diary and 1-2 tailored sessions with a school staff member. Participants completed baseline and follow-up research assessments. The sleep program focused on education about sleep; cognitive strategies targeting sleep beliefs; stimulus control; and regularization of sleep and wake. We descriptively report program feasibility, acceptability, and change in sleep duration.

Results
Of 33 participants approached by school staff, 12 agreed to participate and 10 completed the study. Seven participants had two program sessions and 5 participants had one program session. Sleep duration increased by 19 minutes across the entire week based on daily sleep diary, and by 31 minutes on weekdays on the SSHS. Most participants (89%) reported that the program was not a burden on their time, that the program length was just right (88%), and that they were likely to participate in research again (75%). While program feasibility was high, most youth (56%) rated program relevance as low or unknown. The most salient implementation barrier was the challenge of embedding the program into each school’s existing procedures.

Conclusion
A school-based sleep promotion program for adolescents with insufficient sleep and mild absenteeism is feasible, acceptable, and associated with improved sleep. An individualized approach, with sessions delivered by school staff, shows great promise for being feasible and clinically significant. Future work should focus on selecting a sample of youth with greater investment in the program to improve school attendance and implementing the program flexibly and with fidelity across schools.

Support (if any)
University of Pittsburgh Center for Interventions for Improve Community Health
282 Effect of circadian misalignment on the sleep of police officers across a series of night shifts
Authors: Kosmadopoulos Anastasi , Kervezee Laura , Boudreau Philippe , Boivin Diane 
Published: May 2021

Abstract

Introduction
Misalignment of behavior and circadian rhythms due to night work can impair sleep and waking function. While both simulated and field-based studies suggest that circadian adaptation to a nocturnal schedule is slow, the rates of adaptation in real-world shift-work conditions are still largely unknown. The aim of this study was to evaluate the extent of adaptation of 24-h rhythms in 6-sulfatoxymelatonin (aMT6s) and cortisol in police officers across night shifts and to compare their effect on sleep.

Methods
A total of 76 police officers (20 women; aged 32.3±5.5 years, mean±SD) from the province of Québec, Canada, participated in a field study comprising their 28- or 35-day work-cycle. Urine samples were collected for ~24-h before and after a series of 3–7 night shifts. Rhythms of urinary aMT6s were considered adapted if midpoints following night shifts occurred during participants’ average daytime sleep period. Cortisol was considered adapted if midpoints occurred within 2h of their average daytime sleep offset. Sleep was measured with actigraphy and sleep logs on a cell phone. Data were analyzed with circular and linear mixed-effects models.

Results
Analyses were based on a subset of 37 participants with rhythms of both hormones suitable for circadian phase assessment before and after their series of night shifts. After night shifts, the group acrophase of adapted rhythms (aMT6: n=11, cortisol: n=9) occurred significantly later than for non-adapted rhythms (aMT6s: 10.9 h vs. 3.4 h, p&lt;.001; cortisol: 14.9 vs. 9.9 h, p&lt;.001). Participants with adapted aMT6s rhythms obtained cumulatively more sleep per day throughout the series of shifts than those with non-adapted rhythms (average 6.4 h per day vs 5.8 h per day; p=.026).

Conclusion
Consistent with prior research, our results from both urinary aMT6s and cortisol midpoints indicate that a large proportion of police officers remained in a state of circadian misalignment following their night shifts. The minority of officers who adapted to night work were able to obtain more sleep across consecutive night shifts.

Support (if any)
Project funded by the Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail (IRSST). A.K. received a postdoctoral fellowship from the Fonds de Recherche en Santé du Québec (FRQS).