bluuebunny/crossref_metadata_2025_split huggingface dataset:
696 Quality of sleep is the only predictor of suicide during Covid-19 lockdown in University students?
Authors: Castelnuovo Alessandra , Mombelli Samantha , Bottoni Daniela , Somma Antonella , Fossati Andrea , Ferini-Strambi Luigi , Marelli Sara 
Published: May 2021

Abstract

Introduction
COVID-19 epidemic led to great psychological and social stress, related to anxiety, depression, sleep disorders, suicidal risk and behavior, and changes in daily routine. The aim of this study was to assess the psychological impact of COVID-19 lockdown in Italian students. We focused on perceived sleep quality, anxiety and depression symptoms, and mostly on risk of suicide.

Methods
A total of 307 students (mean age 22.84±2.68) completed Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Beck Anxiety Inventory (BAI), and Beck Depression Inventory-II (BDI-II). In our study, we focused on item 9 of BDI-II, that is related to suicide. We divided our sample on presence or absence of suicidal ideation based on this item.

Results
We found that 30.1% showed depressive, while 38.2% anxious symptoms. Concerning item 9 of BDI-II (suicidal thoughts or wishes), 84.7% answered that they do not have any thoughts of killing themselves, while 15.3% answered that they have some suicidal ideation. Concerning sleep variables, we found that 58% of our sample showed a PSQI total score higher than 5 (poor quality of sleep), and a global worsening in sleep quality and increase of insomnia both in student with and without suicidal ideation.

Conclusion
Our results on risk of suicide are in line with literature. Recent reviews focused on suicidal ideation in medical students found that depressive symptoms and suicidal ideation are common among medical students, finding a prevalence of suicidal ideation of 11%. Several studies suggest that sleep disorders are a risk factor for suicidal thoughts and behaviours. Our findings show that sleep cannot considered a predictive factor of risk of suicide during health emergency, because the risk is polyfactorial.

Support (if any)
None
699 Sleep Health Traits and COVID-19: Mortality Risk from the UK Biobank
Authors: Zheng Xi , Ulsa Ma Cherrysse , Li Peng , Gao Lei , Hu Kun 
Published: May 2021

Abstract

Introduction
While there is emerging evidence for acute sleep disruption in the aftermath of coronavirus disease 2019 (COVID-19), it is unknown whether sleep traits contribute to mortality risk. In this study, we tested whether earlier-life sleep duration, chronotype, insomnia, napping or sleep apnea were associated with increased 30-day COVID-19 mortality.

Methods
We included 34,711 participants from the UK Biobank, who presented for COVID-19 testing between March and October 2020 (mean age at diagnosis: 69.4±8.3; range 50.2–84.6). Self-reported sleep duration (less than 6h/6-9h/more than 9h), chronotype (“morning”/”intermediate”/”evening”), daytime dozing (often/rarely), insomnia (often/rarely), napping (often/rarely) and presence of sleep apnea (ICD-10 or self-report) were obtained between 2006 and 2010. Multivariate logistic regression models were used to adjust for age, sex, education, socioeconomic status, and relevant risk factors (BMI, hypertension, diabetes, respiratory diseases, smoking, and alcohol).

Results
The mean time between sleep measures and COVID-19 testing was 11.6±0.9 years. Overall, 5,066 (14.6%) were positive. In those who were positive, 355 (7.0%) died within 30 days (median = 8) after diagnosis. Long sleepers (&gt;9h vs. 6-9h) [20/103 (19.4%) vs. 300/4,573 (6.6%); OR 2.09, 95% 1.19–3.64, p=0.009), often daytime dozers (OR 1.68, 95% 1.04–2.72, p=0.03), and nappers (OR 1.52, 95% 1.04–2.23, p=0.03) were at greater odds of mortality. Prior diagnosis of sleep apnea also saw a two-fold increased odds (OR 2.07, 95% CI: 1.25–3.44 p=0.005). No associations were seen for short sleepers, chronotype or insomnia with COVID-19 mortality.

Conclusion
Data across all current waves of infection show that prior sleep traits/disturbances, in particular long sleep duration, daytime dozing, napping and sleep apnea, are associated with increased 30-day mortality after COVID-19, independent of health-related risk factors. While sleep health traits may reflect unmeasured poor health, further work is warranted to examine the exact underlying mechanisms, and to test whether sleep health optimization offers resilience to severe illness from COVID-19.

Support (if any)
NIH [T32GM007592 and R03AG067985 to L.G. RF1AG059867, RF1AG064312, to K.H.], the BrightFocus Foundation A2020886S to P.L. and the Foundation of Anesthesia Education and Research MRTG-02-15-2020 to L.G.
700 Young African American Adults Endorse Greater Distress from Racism than COVID though COVID may have Greater Impact on Sleep
Authors: Ndubuizu Nkemdilim , Hurst Travan , Wilson Amanda , Mellman Thomas 
Published: May 2021

Abstract

Introduction
Much attention has been given to stress-related symptoms including insomnia related to the COVID-19 pandemic. Exposure to racially targeted police violence and the disproportionate impact of COVID on their communities have been particularly salient stressors for African Americans. Aims for this presentation are to illuminate the emotional impact of COVID and racism on young adult African Americans and their relationship to sleep problems.

Methods
An online survey was sent to participants in an ongoing study focusing on sleep and health along with new participants recruited through a snowball method. The survey included the Insomnia Severity Index (ISI), Impact of Event scale (IES), as well as items to assess experiences with COVID, exposure to racially targeted violence, and disparate community impact.

Results
Respondents were African Americans age 18–35. 45% endorsed worsening sleep during the pandemic. 25% had ISI scores of probable insomnia and 61% had IES scores above the symptom threshold for clinical concern. Racism-related distress was endorsed at higher levels than worries related to COVID. There was a significant relationship of insomnia severity with the number of COVID related stressors and a trend level relationship with COVID worries. Sleep outcomes were not correlated with racism-related distress.

Conclusion
While distress related to racism was endorsed more than COVID worries, our preliminary findings suggest COVID worries but not racism exposure negatively impact sleep health. This may be a consequence of habituation to the chronic stress of racism in contrast with the novel stress of COVID.

Support (if any)
5R01HL136626 from the National Heart Lung and Blood Institute
705 PAP Use Pattern Change During the COVID-19 Lockdown
Authors: Esmero Veronica , Herdegen James 
Published: May 2021

Abstract

Introduction
The COVID-19 pandemic has greatly impacted not only the physical health of society, but also its social, mental, and economic health. The Illinois shelter in place orders enacted in March and April limited work and activities outside the home. Our aim for this study was to compare the effects of the COVID-19 shelter in place orders on PAP use patterns in patients with OSA.

Methods
We selected 30 patients seen between May and October 2020. Patients had been diagnosed with OSA for at least one year, prescribed PAP therapy and had been compliant with therapy as defined by 70% use greater 4-hour for 30 days prior to their clinic visit. Using data collected from chart review as well as online ResMed AirView cloud data, we evaluated PAP on/off and average use time during shelter in place order for a 90 day period (March through May 2020). We compared this data to a similar period in the year prior.

Results
Average age of our study group was 58.6 years old with 19 men and 11 women. Mean AHI was 51.7. Reported average bedtime was 10:00pm with average wake time 7:30am during the shutdown compared with a bedtime of 9pm and wake up time 6:30am. Patients reported having more time to sleep and required less naps during the day. Average PAP use during shut down was 7 hours 20 minutes and average PAP use prior to shutdown was 6 hours and 50 minutes. An average of 30 additional PAP minutes was observed among patients during the shelter in place order. Only one of our patients was diagnosed with COVID during this time period.

Conclusion
For patients with OSA on PAP therapy we observed an increase in PAP use. Among patients suddenly required to shelter in place, we observed a delayed sleep onset and wake time of more than 1 hour, resulting in a slightly longer overall PAP use time. This circadian phase shift was greater among working patients compared to retired patients. The health effects of longer PAP use and circadian phase shifting remain to be determined.
Support (if any):
717 Sleeping Well During a Pandemic: The Role of Various Forms of Social Support in Protecting Against Insomnia
Authors: Jankowski Samantha , Cloonan Sara , Grandner Michael , Killgore William 
Published: May 2021

Abstract

Introduction
Social support from friends, family, and significant loved ones is critical to sustaining mental health during crises. During the course of the COVID-19 pandemic, the populace has had to restrict many aspects of normal social contact. Consequently, social isolation and accompanying feelings of loneliness have spiked. There has also been a contemporaneous increase in the rates of insomnia. Considering this correlation, we investigated the potential role of various types of social/emotional support on the severity of insomnia. We hypothesized that greater social support from family, friends, and significant loved ones would all contribute to lower insomnia during the pandemic.

Methods
During October 2020, 1020 participants (58.2% female) completed an online survey that included the Multidimensional Scale of Perceived Social Support (MSPSS), a measure of social support, and the Insomnia Severity Index (ISI), a measure of insomnia. The severity of insomnia was predicted using multiple linear regression, with the three sources of support from the MSPSS (family, friend, and significant other) entered stepwise.

Results
All three sources of support were significantly correlated with lower ISI scores (family, r=-.163, p= p = 1.6x10-7; friend, r=-.125, p=6.5x10-5; significant other, r=-.095, p=.002). However, when all three variables were entered into stepwise regression, only increased familial support was significantly associated with lower insomnia levels (R2 = 0.027, β =-.163, p = 1.6x10-7). In contrast, neither the support of friends nor support from significant others added any additional predictive power once family support was in the model.

Conclusion
While perceived social support from friends and significant others was correlated with lower insomnia, we found that ISI scores were most significantly associated with perceived family support. In fact, once family support was accounted for, other sources of support did not account for additional variance. Ongoing family support plays a critical role in mental health and wellbeing, which is clearly demonstrated in the quality of sleep. During the social distancing imposed by the pandemic, it is vital that we find creative ways to maintain familial social support. Future work may benefit by examining the association between the use of electronic technologies to sustain social support and sleep outcomes.
Support (if any):
727 Impact of Washington State COVID-19 Lockdown on Sleep
Authors: Peterson Mary , Lundholm Kirsie , Skeiky Lillian , Van Dongen Hans , Hansen Devon 
Published: May 2021

Abstract

Introduction
The COVID-19 pandemic caused a global disruption to daily routines. Studies using surveys and sleep-related applications on mobile devices suggest that the pandemic has contributed to increases in sleep disruption or onset of new sleep disturbances. We present results from a naturalistic at-home study in which objective sleep measurements were made using both a wrist actigraph (Actiwatch-2, Philips Respironics) and a non-contact monitoring device (SleepScore Max, SleepScore Labs), comparing sleep measurements obtained immediately before and after the start of the first mandatory COVID-19 stay-at-home order in Washington State.

Methods
As part of a larger study, nine Washington State residents (ages 22–48, 5 female, 4 male; 6 insomniacs, 3 normal sleeper) were enrolled in a 10-week at-home sleep monitoring study, which involved 1 week of actigraphy, 8 weeks of non-contact monitoring (data available for 6 subjects), and 1 week of actigraphy. During the study, the Washington State governor issued a stay-at-home order, effective March 15, 2020. We compared sleep measurements obtained before this date (mean ± SD: 25.0 ± 15.0 nights) and after this date (25.2 ± 13.9 nights) using mixed-effects ANOVA.

Results
Non-contact monitoring measurements indicated that after the start of the lockdown, participants woke up later by 63.2 ± 12.1 min (mean ± SE; F[1,299]=27.40, p&lt;0.001) without significant change in bedtime (F[1,299]=0.29, p=0.59). Sleep latency lengthened by 4.0 ± 2.3 min (F[1,295]=4.92, p=0.027), and there were increases in number of awakenings (F[1,295]=6.22, p=0.013) and wake after sleep onset (F[1,295]=12.58, p&lt;0.001). Actigraphy data complemented these results, showing delayed sleep onset by 53.4 ± 15.1 min (F[1,101]=12.46, p&lt;0.001) and delayed final awakening by 104.3 ± 19.6 min (F[1,101]=28.43, p&lt;0.001), with longer sleep duration (F[1,101]=6.06, p=0.016), increased number of awakenings (F[1,101]=13.00, p&lt;0.001), and a trend for increased intermittent wakefulness (F[1,101]=3.88, p=0.052) post-lockdown.

Conclusion
In this sample, we found evidence of increased sleep disruption following the first Washington State stay-at-home order related to COVID-19. Our findings are consistent with previous studies based on self-report data, which observed later wake times and decreases in sleep quality post-lockdown.

Support (if any)
NIH grant KL2TR002317. Non-contact monitoring devices provided by SleepScore Labs.
737 Prediction of drop out in an adjunctive light treatment trial in patients with non-seasonal depression and evening chronotype
Authors: Chan Joey W , Wing Y K , Lam S P , Li Shirley Xin , Zhang J 
Published: May 2021

Abstract

Introduction
Drop out during treatment hampers therapeutic effect of interventions. The current study examines the possible predictors of drop out during the five-week light treatment in patients with unipolar non-seasonal depression and evening-chronotype.

Methods
Baseline characteristics including demographics, sleep diary parameters, light treatment prescribed, and early clinical outcomes changes were compared between the Drop out and Non drop out group. Logistic regression analysis was used to examine predictors for drop out. All data were analyzed in a modified intention to treat analysis with last observation carried forward approach.

Results
A total of 91 subjects (Female 79%, 46.3 ± 11.8 years old) were included in the analysis. There was no significant difference in the baseline demographic and clinical characteristics between the Drop out and Non drop out group. There was also no significant difference in the improvement of clinical parameters over the first week among the two groups. However, treatment non-adherence (in terms of compliance of less than 80% of prescribed duration) over the first treatment week predicts a five-fold increase in risk of drop out during light therapy. (OR: 5.85, CI: 1.414–24.205, p=0.015) after controlling for potential confounders including age, gender, treatment group, patient expectation, and treatment-emergent adverse events.

Conclusion
This study found that baseline clinical characteristics including depression severity and improvement of depressive symptoms in the initial week did not differ between the Drop out and Non drop out group. The drop out was also not affected by the type of light (dim red versus bright red light), indirectly supporting dim red light as a valid placebo in bright light therapy trial. Treatment adherence is the early phase of light treatment is an important predictor of drop out.
Support (if any):
742 Linkages between sleep quality and mental health among couples coping with type 1 diabetes across survey and daily diary methods
Authors: Tracy Eunjin , Berg Cynthia , Butner Jonathan , de Grey Robert Kent , Allen Nancy , Porter Margot , Helgeson Vicki 
Published: May 2021

Abstract

Introduction
Sleep serves an important role in maintaining and promoting metabolic and mental health. The interdependent nature of couple relationships makes examining sleep quality from a dyadic perspective critical. This study examined the effect of sleep quality on mental health among couples coping with type 1 diabetes across survey and daily diary methods and investigated whether relationship satisfaction moderated these relations.

Methods
199 persons with type 1 diabetes (Mage = 46.82) and their spouses (Mage = 46.41) completed one survey questionnaire reporting their own sleep quality (PSQI), depressive symptoms (CESD), and relationship satisfaction (CSI). They also completed 14-day diaries reporting on their own sleep quality and negative affect. The actor-partner interdependence model and multi-level model were used to examine the effect of sleep quality on mental health across the cross-sectional and daily diary surveys. Multi-level modeling examined effects of within-person and between-person effects of sleep quality on next-day daily negative affect (controlling for prior day affect).

Results
Cross-sectional survey data revealed an association between poorer global sleep quality and higher depressive symptoms for both partners (actor effects). Spouses’ poorer sleep quality was associated with higher depressive symptoms for persons with T1D (partner effects). Daily diary data demonstrated an association between within-person and between-person effects of own poor sleep quality and higher negative affect for both partners. Poorer daily sleep quality for persons with T1D was associated with higher negative affect for spouses (partner effects). When examining the moderating role of relationship satisfaction, spouses’ poorer overall sleep quality was associated with greater depressive symptoms and overall negative affect respectively for those with lower relationship satisfaction but not for those with higher relationship satisfaction across both methods.

Conclusion
Findings support the conceptualized link between sleep quality and mental health as both an intraindividual and dyadic process among couples coping with T1D across survey and daily diary methods. Additionally, better relationship satisfaction may buffer the effect of overall poor sleep quality on mental health for spouses.

Support (if any)
This work was supported by NIH NIDDK program project grant (DP3DK103999). Individual support was provided by T32 MH019986 (ELT).
746 Delayed Rhythm Is Associated with Enhanced Discrimination for Negative Emotional Information
Authors: Chen Ivy , Neikrug Ariel , Adams Joren , McMillan Liv , Mander Bryce , Yassa Michael , Benca Ruth 
Published: May 2021

Abstract

Introduction
Mnemonic discrimination, the ability to differentiate novel and highly similar but not identical stimuli, is negatively associated with sleep deprivation and depression. Depression is additionally associated with increased discrimination specifically for negative emotional stimuli. While sleep and circadian activity rhythm (CAR) disturbances are common in depression and have been reported to have negative impact on hippocampal-dependent memories, their relationship with emotional discrimination has yet to be investigated.

Methods
As part of a larger study, 14 patients with DSM-5 major depressive disorder (22.9±4.1 years, 71.4% female) and 13 healthy controls (29.4±8.5 years, 61.5% female) were evaluated with wrist-actigraphy (7–14 days) and completed an emotional discrimination task. Lure discrimination index (LDI) for each emotion type (i.e., negative, neutral, and positive) was calculated to indicate how well participants discriminated among highly similar lures. Actigraphy-derived sleep parameters included total sleep time (TST), sleep efficiency (SE), and midsleep time. Minute-by-minute actigraphy-derived activity counts were used to characterize CAR and parametrized using cosinor analysis and Generalized Additive Models (GAM) deriving the rhythm Acrophase, Amplitude, UP time, and DOWN time. A repeated measures ANOVA (within-subjects: emotion, between-subjects: group) assessed whether mnemonic discrimination differed between patients with MDD and controls. Partial correlations examined the association between sleep and CAR parameters with mnemonic discrimination, while controlling for age, state anxiety, depression severity, TST, and groups.

Results
We found a significant effect of emotion [F(2,90)=3.25, p=0.043], where neutral information was remembered better than emotional information (p’s&lt;0.005); no significant effect of group (MDD vs. control) was observed. Midsleep time and Acrophase were each positively associated with negative LDI (r=0.576, p=0.008; r=0.540, p=0.014, respectively). Exploratory GAM results suggested a significant positive correlation between UP time and negative LDI (r=0.497, p=0.022). TST, SE, Amplitude or DOWN time was not associated with LDIs.

Conclusion
Delayed CAR, characterized by latter midsleep time and delayed acrophase and peak time of the morning activity, is associated with increased discrimination for negative emotional information, independent of depressive symptom severity. Future studies are needed to replicate these findings and further explore the potential cognitive benefits of adjunctive interventions addressing sleep/CAR in mitigating symptoms of depression.

Support (if any)
National Institutes of Health R01 432MH102392.
748 Impact of Deep Transcranial Magnetic Stimulation on Insomnia Comorbid with Treatment Resistant Depression
Authors: Chopra Amit , Kodya Suzanne 
Published: May 2021

Abstract

Introduction
Deep Transcranial Magnetic Stimulation (dTMS) is an FDA-approved non-invasive brain stimulation treatment for management of treatment-resistant depression (TRD). However, the efficacy of dTMS on Insomnia, a commonly prevalent and one of the most refractory symptoms of depression, is not clearly established. Our study aims to assess the impact of dTMS on outcomes of insomnia comorbid with TRD.

Methods
Single center retrospective study examining mood and insomnia outcomes in TRD patients (n=25), with greater than 3 failed psychotropic medication trials, undergoing dTMS for unipolar major depression.. Questionnaires including Patient Health Questionnaire (PHQ-9), Insomnia Severity Index (ISS),Generalized Anxiety Disorder-7 (GAD-7) were compared at baseline and at the end of dTMS treatment course.

Results
TRD patients with ‘low insomnia’ (n=12; ISS=7.9) and ‘high insomnia’ (n=13; ISS=20) were examined in terms of mood and insomnia ouctomes. No significant differences at baseline were noted between two groups in terms of demographic, mood, and anxiety variables. Depression and anxiety symptoms for patients in ‘Low Insomnia’ group significantly improved from baseline to final dTMS session- PHQ-9 [t(11) = 6.021, p &lt; .0001]], GAD-7 [t(11) = 2.389, p = .036]. TRD patients in ‘High Insomnia’ group also reported significant improvements in depression [t(12) = 5.596, p &lt; .0001], anxiety [t(12) = 2.743, p = .018], and insomnia [t(12) = 6.057, p &lt; .0001]] at final dTMS session as compared to baseline. Non-responders in ‘High Insomnia’ group did not achieve statistically significant improvements in either depression or insomnia outcomes.

Conclusion
Insomnia comorbid with TRD responds to treatment with dTMS irrespective of the insomnia severity at baseline. Prospective research with the use of objective assessment measures for insomnia is warranted to confirm these findings. Non-response to insomnia was associated with poor mood outcomes as well in TRD patients. The probable mechanistic action of insomnia improvement in patients with TRD undergoing dTMS is unclear and further systematic research to understand the clinical and neural correlates of insomnia response with dTMS is needed.

Support (if any)
N/A