bluuebunny/crossref_metadata_2025_split huggingface dataset:
P028 The Nox A1 ambulatory system is reliable when self-applied
Authors: Cuesta R , Roebuck T , Ho S , Naughton M , McDermott E , VanBraak E , Beranek R , Davis S , Spiteri M , Dabscheck E , Miller B , Yu C 
Published: October 2021

Abstract

Background
Home Sleep Apnea Tests (HSAT) increases access to SDB diagnostic testing (Safadi, 2014). A previous study defined a reliable HSAT if: ≥4hours total recording time, an intelligible position signal and respiratory effort, airflow and oximetry for at least 80% of the night were recorded, however, admits no standardized criteria in the literature (Domingo, 2010).

Aim
To test the reliability of a self-applied HSAT using the Nox-A1 ambulatory system (NOX Medical, Iceland).

Method
Patients self-applied the HSAT guided by industry produced video and written instructions. Signals for the HSAT included; two electro-occulagrams (EOG), two sub-mental electromyograms (EMG), a single modified frontal encephalogram (EEG), a lead I ECG, single leg anterior tibialis EMG, chest and abdominal inductance respiratory effort, nasal pressure airflow, WristOx 2 3150 SpO2 (Nonin Medical, Inc., USA) and 3-D accelerometer and body position sensor. Analysed with ProFusion PSG 4 (Compumedics Limited, Australia) after importing data into Nexus. 33 consecutive studies were recorded during lock-down. Recording satisfactory if SpO2 signal and EEG present &gt;80% of study, it was considered a failure if doctor requested test repeat.

Results
33 subjects, age 43.1 ± 13.7 years, BMI 27.4 ± 6.0 kg/m2, 66.6% male. 81.8% of studies satisfactory. 6% of studies needed a repeat in-lab PSG due to 1) loss of oximetry & EEG and 2) loss of EEG

Discussion
6% doctor request repeat in-lab PSG is comparable to a study (Lloberes, 2001) of partially self-applied HSAT. Demonstrated good reliability with this self-applied COVID-safe method of HSAT.
P031 Associations between sound pressure levels and amplitude modulation from wind farm noise and ambulatory recorded objective macro-sleep parameters
Authors: Dunbar C , Catcheside P , Vakulin A , Zajamsek B , Hansen K , Lack L , Scott H , Micic G 
Published: October 2021

Abstract

Introduction
This study used ambulatory sleep studies to examine potential relationships between wind farm sound pressure level ([SPL] in dBA) and amplitude modulation (AM) on conventional measures of sleep quality in individuals residing within 10 km of a wind turbine in Australia.

Methods
Twenty six individuals (42:58%, females:males) aged (mean ± standard deviation) 53.2±12.2 years and residing 2.9±1.7 km from the nearest wind turbine underwent two consecutive ambulatory sleep studies and detailed indoor time-synchronised acoustic recordings inside their home. Associations between averaged whole night SPL and AM prevalence versus sleep onset latency, wake after sleep onset (WASO), percentage of sleep in each stage, sleep efficiency and total sleep time on each recording night were explored using bivariate and multiple regression analyses, using log-normalised data where required.

Results
Forty-five technically successful sleep studies (24 night 1, 21 night 2) were available for analysis. On night 2, AM prevalence explained 18.9% of the variance in sleep efficiency (R=.434, F(1,19)=4.421, p=0.049) and SPL explained 23.5% of the variance in WASO (R=.484, F(1,19)=5.821, p=0.026) in multiple regression analyses adjusting for age. No other sleep macrostructure variables were associated with AM prevalence or SPL on either night.

Conclusion
Weak relationships between SPL and AM prevalence and sleep outcomes in a real-world wind farm noise exposure setting support the need for more detailed investigations of potential wind farm noise effects on sleep quality.
P047 Sleep and diet in older adults: what do we know and what do we need to find out?
Authors: Gupta C , Irwin C , Vincent G , Khaleesi S 
Published: October 2021

Abstract
Older adults experience reduced sleep quality and quantity more frequently than younger adults. Inadequate sleep in older adults has been linked to several adverse outcomes such as poor psychological and physical health, cognitive impairments, increased risk of falls, lower quality of life, and greater risk of all-cause and cardiovascular mortality. Diet is one modifiable lifestyle factor that may influence sleep outcomes. The purpose of this review was to synthesise the current literature investigating the impact of diet, including foods and nutrients, on sleep quality and quantity in older adults (defined as &gt;50 years based on age-related changes in sleep quality and quantity that begin age 50). A systematic search of four databases identified 17 articles for inclusion (observational (n=8) and interventional (n=9) studies). Overall, findings suggest that following a Mediterranean diet, consuming milk, fish, bean and egg products, cherries, vitamin D and vitamin E have demonstrated some efficacy in improving sleep outcomes in this population demographic. Given the heterogeneity of the included studies (i.e. aims, methodologies, outcomes assessed), it is difficult to consolidate the available evidence to make specific recommendations. However, this review describes dietary factors that show promise for improving sleep outcomes in older adults. More targeted research exploring the relationship between dietary factors and sleep outcomes in older adults is needed to strengthen the current evidence base. This presentation will provide a much-needed research agenda that includes a need for more randomised control trials that employ rigorous dietary assessments and objective measures of sleep.
P056 Using Polysomnography in Young People with Borderline Personality Disorder: A Pilot and Feasibility Study
Authors: Jenkins C , Thompson K , Chanen A , Nicholas C 
Published: October 2021

Abstract

Introduction
Few studies have assessed sleep in young people (aged 15–25 years) with BPD using polysomnography. The feasibility of using polysomnography in this population might be questioned due to polysomnography’s invasiveness, anxiety and sensory sensitivities in BPD, and misconceptions that individuals with BPD are uncooperative and non-compliant. This study aimed to provide pilot sleep quality and architecture data and assess polysomnography feasibility.

Method
Participants were 13 females aged 15–25, 7 (Mage = 19.97, SD = 3.15) with BPD and 6 age-matched healthy controls (Mage = 20.13, SD = 3.31). Participants completed two non-consecutive nights of polysomnography monitoring (second night’s data were used in analyses). Participants were given the option of completing polysomnography monitoring at home or in a sleep laboratory.

Results
Young people with BPD displayed less arousals across the night and specifically during NREM sleep compared with healthy young people. All other sleep parameters were comparable across groups. There was considerable heterogeneity among participant preferences for in-home vs. sleep laboratory-based monitoring, due to comfort, safety, convenience, interest in seeing a sleep laboratory, or their living situation (eg. presence of bed partner at home). Anxiety was identified as a potential barrier to polysomnography research in this population.

Discussion
There were some indications of more consolidated sleep in BPD, which might reflect a greater sleep need in this population. The feasibility and tolerability of in-home and sleep laboratory-based polysomnography were demonstrated. Future protocols should incorporate ways to minimise anxiety, for example through providing a choice of monitoring location.
P073 Co-morbid insomnia and obstructive sleep apnoea is associated with all-cause mortality and cardiovascular event risk
Authors: Lechat B , Appleton S , Melaku Y , Hansen K , McEvoy R , Adams R , Catcheside P , Lack L , Eckert D , Sweetman A 
Published: October 2021

Abstract

Introduction
Co-morbid insomnia and sleep apnoea (COMISA) is a highly prevalent and debilitating condition. Previous studies have investigated associations between insomnia and mortality, and OSA and mortality, but not COMISA. Thus, this study investigated associations between OSA, insomnia and COMISA on mortality and cardiovascular event risks.

Methods
Sleep Heart Health Study data (n = 5803) were used to identify people with insomnia defined as difficulties falling asleep, maintaining sleep, and/or early morning awakenings from sleep at least 5 times a month and daytime impairment. OSA was defined as an apnoea-hypopnoea index ≥15 events/h. COMISA was defined if both conditions were present. Cox proportional hazard models were used to determine the association between COMISA and all-cause mortality (n = 1210) and cardiovascular events (N = 1243) over 15 years of follow-up.

Results
This analysis included 5236 participants. 2504 (47.8%) did not have insomnia/OSA, 374 (7.1%) had insomnia-alone, 2027 (38.7%) had OSA-alone, and 331 (6.3%) had COMISA. Compared to participants with no insomnia/OSA, COMISA was associated with a 32% (HR, 95%CI; 1.32 (1.06, 1.64)) and 38% (1.38 (1.11, 1.71)) increased risk of mortality and cardiovascular events, respectively. Insomnia-alone and OSA-alone were not associated with all-cause mortality or cardiovascular event risk.

Conclusions
Participants with COMISA have decreased longevity and increased cardiovascular event risks compared to participants with no insomnia or OSA. It remains to be determined if these associations are causal and whether treatment of insomnia, OSA, or combination treatment can effectively decrease mortality and/or cardiovascular event risks in individuals with COMISA.
P078 Oral Appliance Fabrication Settings Impact Treatment Efficacy
Authors: Levendowski D , Sall E , Odom W , Beine B , Cruz Arista D , Fregoso T , Munafo D 
Published: October 2021

Abstract

Purpose
Assess the impact of custom oral appliance (CA) fabrication settings on treatment outcomes.

Methods
CPAP-intolerant patients completed a two-night home-sleep-apnea study (HSAT); Night1=baseline, Night2=Apnea Guard® trial appliance (AG). The AG vertical-dimension-of-occlusion (VDO) selection was based on tongue-scallop (women=5.5/6.5 mm, men= 6.5/8.0 mm), with a target protrusion of 70% from neutral-maximum while in situ.
Study1 CA VDO was dependent on sex (women=2.5 mm, men=5 mm), with protrusion set using a George-Gauge measured 70% from maximum retrusion-protrusion with dentist-directed titration. Study2 CA was fabricated to the AG VDO and target protrusion bite-registration.
Efficacy HSATs were conducted after completion of Study1 CA titration with vertical-elastics optional, and at the AG target protrusion with vertical-elastics mandatory in Study2. Statistics included Mann-Whitney, Chi-squared, and Bland-Altman analyses.

Results
The Study1 (n=84) and Study2 (n=46) distributions were equivalent for tongue-scallop (64/63%) and sex (women=45/41%), however, noted differences in age (53.8±11.9 vs. 58.4±12.2; P=0.052), body-mass-index (29.4±5.7 vs. 27.8±4.0; P=0.128) and pre-treatment AHI severities (24.6±14.4 vs. 29.2±17.4 events/h; P=0.155) were observed.
The Bland-Altman biases were significant different (Study1=4.2±7.8 vs. Study2=1.3±7.0 events/h, P=0.035). The significant Study1 differences between the CA vs. AG AHIs (12.3±9.2 vs. 8.2±5.9 events/h, P&lt;0.0002) were not apparent in Study2 (11.7±8.0 vs. 10.4±6.7 events/h, P=0.362), however, the Study2 AG AHI values were higher (P=0.055).

Discussion
Despite the trend toward greater Study2 pre-treatment and AG AHI severities, CA treatment efficacy was equivalent to the AG once VMO was controlled and fabricated using the AG VDO and protrusion bite-registration. These findings confirmed CA fabrication settings impact treatment outcomes.
P086 The organization of sleep-wake patterns around daily schedules in college students
Authors: Lu S , Klerman E , Stone J , McHill A , Barger L , Sano A , Czeisler C , Rajaratnam S , Phillips A 
Published: October 2021

Abstract
A potential contributor to insufficient sleep among college students is their daily schedule, with sleep sacrificed for other waking activities. We investigated how daily schedules predict day-to-day sleep-wake timing in college students. 223 undergraduate college students (M±SD = 19.2±1.4 years, 37% females) attending a Massachusetts university in the US between 2013–2016 were monitored for approximately 30 days during semester. Sleep-wake timing was measured using daily online sleep diaries and wrist-actigraphy. Daily schedules were measured using daily online diaries that included self-reported timing and duration of academic, exercise-based, and extracurricular activities, and duration of self-study. Linear mixed models were used to examine the association between sleep-wake patterns and daily schedules at both the between-person and within-person levels. An earlier start time of the first-reported activity predicted earlier sleep onset (between and within: p&lt;.001) and shorter total sleep time (within: p&lt;.001) for the previous night, as well as earlier wake onset on the corresponding day (between and within: p&lt;.001). A later end time of the last-reported activity predicted later sleep onset (within: p=.002) and shorter total sleep time (within: p=.02) on that night. A more intense daily schedule (i.e., greater total duration of reported activities) predicted an earlier wake onset time (between: p=.003, within: p&lt;.001), a later sleep onset time (within: p&lt;.001), a shortened total night-time sleep duration (between: p=.03, within: p&lt;.001), and greater sleep efficiency (within: p&lt;.001). These results indicate that college students may organize their sleep and wake times based on their daily schedule.
P125 Sleep and fear conditioning, extinction learning and extinction recall: a systematic review and meta-analysis of polysomnographic findings
Authors: Schenker M , Ney L , Miller L , Felmingham K , Nicholas C , Jordan A 
Published: October 2021

Abstract
Sleep may contribute to the long-lasting consolidation and processing of emotional memories. Experimental fear conditioning and extinction paradigms model the development, maintenance, and treatment of anxiety disorders. The literature provides compelling evidence for the involvement of rapid eye movement (REM) sleep in the consolidation of such memories. This meta-analysis correlated polysomnographic sleep findings with psychophysiological reactivity to the danger (CS+) and safety stimuli (CS-), to clarify the specific role of sleep stages before and after fear conditioning, extinction learning and extinction recall. Overall, there was evidence that more pre-learning sleep stage two and less slow wave sleep was associated with higher psychophysiological reactivity to the safety stimulus during extinction learning. Preliminary evidence found here support the role of REM sleep during the post-extinction consolidation sleep phase in clinical populations with disrupted sleep, but not in healthy controls. Furthermore, the meta-regressions found that sex moderated the associations between sleep and psychophysiological reactivity throughout the paradigm providing evidence for diverging correlations in male and females. Specifically, increased post-extinction REM was associated with poorer extinction and safety recall in females while the opposite was found in males. These results have implications for future research in the role of sleep in emotional memory processing.
P126 Systematic review of outcome measures used in narcolepsy clinical trials
Authors: Schokman A , Bin Y , Naehrig D , Cheung J , Kairaitis K , Glozier N 
Published: October 2021

Abstract

Introduction
Treatment of the sleep disorder narcolepsy is primarily symptomatic. With limited population data and insufficient systems to capture patient data, a greater emphasis has been placed on the patient perspective in determining satisfaction and treatment success in clinical settings. While Randomised Controlled Trials (RCTs) are considered the gold standard when determining treatment effectiveness, how effectiveness is measured in a narcolepsy population remains unknown. Therefore, we aimed to explore the outcome measures used in narcolepsy RCTs, and further evaluate the adequacy of any self-reported outcome measures used.

Methods
Electronic databases (MEDLINE, EMBASE, CINAHL, SCOPUS, PSYCHINFO) and clinicaltrials.gov were searched in April 2020, with primary and secondary outcomes extracted from eligible studies. Self-reported outcome measures used at least once as a primary outcome measure were further explored, with validation studies of these systematically searched for (using the above databases) and analysed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias tool.

Results
We identified 82 published RCTs involving patients with narcolepsy, of which 35 objective and 46 subjective measures were used. Of these, the Maintenance of Wakefulness Test (n=29), Epworth Sleepiness Scale (ESS) (n=14) and Multiple Sleep Latency Test (n=9) were the most frequently selected primary outcome measures. While our analysis of self-reported outcome measures is ongoing, preliminary results suggest that few have been adequately validated in a narcolepsy-specific population.

Discussion
Our preliminary results identify a high level of heterogeneity between outcome measures used in RCTs, thus difficult to draw conclusions and compare interventions.
P136 Domiciliary Bilevel Ventilation at Sunshine Coast University Hospital
Authors: Smith D , Anderson J 
Published: October 2021

Abstract

Introduction
Positive airway pressure therapy, including bilevel (BPAP) and continuous positive airway pressure (CPAP), is the mainstay of management of a group of chronic conditions that culminate in chronic hypercapnic respiratory failure such as chronic obstructive pulmonary disease (COPD), obesity hypoventilation syndrome (OHS) and respiratory muscle weakness. Heterogeneously across these conditions, BPAP can decrease hospital admission and prolong quality and duration of life. In COPD (when with comorbid obstructive sleep apnoea) and OHS, there has been some evidence to suggest that the far more economical CPAP is as effective. Here we compare local practice to guideline suggested management and previous Australasian audit data.

Methods
Adult patients currently managed with domiciliary BPAP by the SCUH Sleep Department were identified from local a database. Demographics, medical diagnoses, premorbid functional status, indications for BPAP, funding of BPAP, outcomes of therapy and attempts to de-escalate to CPAP were collected.

Results
64 patient were identified. Data collection and analysis is ongoing and will be presented at full at the conference.
Intended Outcome and Impact: We aim to review local practice managing chronic hypercapnic respiratory failure with BPAP with hope it could inform future local practice.
P138 Nocturnal oxygen desaturation and MET call criteria during in-laboratory sleep studies
Authors: Stonehouse J , Perkins A , Irving L , Goldin J , Wallbridge P , Hii S , Rees M , Manser R , Kee K 
Published: October 2021

Abstract

Introduction
Patients undergoing sleep studies can experience frequent and profound oxygen desaturation. Most hospitals have standard MET (Medical Emergency Team) call criteria which obligate a response to severe oxygen desaturation. At our tertiary institution this is “Pulse oximetry/oxygen saturation: &lt; 90 despite oxygen administration”. For most sleep studies provision of oxygen overnight would not be appropriate. We sought to examine the proportion of our sleep study patients who would meet MET call criteria.

Method
We retrospectively examined the data of all sleep studies which were performed in our laboratory between 01/01/2021 and 30/04/2021. Demographic and pulse oximetry data was collected.

Results
We collected data from 448 studies (95 CPAP, 342 diagnostic, 9 Split, 2 other). Patients were 40% female, 49±15 (mean±SD) years old and had a median AHI of 10 events per hour. 290 (65%) patients had a nadir SpO2 of &lt;90%. The percentage of patients below with nadir SpO2 of 80%, 70%, 60% and 50% was 20%, 9%, 5% and 3% respectively. These proportions did not significantly change if treatment studies were excluded. In contrast, 23 (5%) of patients had a mean overnight SpO2 &lt; 90%. During the period studied no serious adverse event was recorded.

Discussion
Most patients presenting for a sleep study to our tertiary institution would potentially meet standard hospital MET call criteria. This demonstrates the need for hospitals to be flexible in terms of hospital wide protocols when it comes to sleep laboratories. Evidence based criteria for medical escalation in sleep laboratories are required.
P140 A study of sleep quality, smartphone use and chronic neck pain among male and female university students
Authors: Szeto G , Chow C , Chu A , Ng B , Kwok A 
Published: October 2021

Abstract

Purpose
Intensive smartphone use may contribute to chronic neck and shoulder pain and sleep disturbance. This study aimed to examine the relationship of sleep quality with daytime smartphone use and self-reported neck-shoulder symptoms among university students in Hong Kong.

Methods
Nineteen university students participated (11 males, 9 females, mean age=21.7±3.9). The actigraphy device Actiwatch 2 (Philips Ltd) was used to record 7 nights of sleep data. Daytime smartphone use and neck and shoulder pain scores (on a Pain scale 0–10) were recorded.

Results
Total sleep time (TST) was significantly longer in females (410.2min) than males (359.6min) (p=0.012), as was the sleep efficiency (females: 87.8%, males: 79.8%, p=0.003). Their sleep onset latency was similar at around 18min. The mean weekly Screen time and pre-bed Screen time were 430.1min and 37.9min for females, and 427.2min and 26.7min for males respectively. All the participants reported mild neck-shoulder symptoms (mean pain scores=0.9±1.8 for neck, 1.5±2.4 for shoulder). Pearson correlation showed no statistically significant association between sleep parameters, neck/shoulder pain score, screen time during day, and pre-bed screen time.

Conclusion
The present results showed that university students in Hong Kong were sleep deprived with on average, ~6h of sleep per night and spending ~30min each night on screen devices. Female students slept ½h more than male students. Given the low pain scores and small sample size, no significant relationship was found with musculoskeletal symptoms and smartphone use. Future study should recruit those with more severe symptoms and increase the sample size.