bluuebunny/crossref_metadata_2025_split huggingface dataset:
P106 Evaluating the correlation between objective daytime sleepiness, daytime functioning and subjective sleepiness
Authors: Chee A , Lim P , Lee A , Narayan L , Zhang T , Capomolla T , Suthers B , Paech G 
Published: October 2021

Abstract

Introduction
Daytime sleepiness is typically assessed in clinical settings with the Multiple Sleep Latency Test (MSLT) and Maintenance of Wakefulness Test (MWT). However, these tests do not necessarily assess daytime functioning. This study aimed to assess the correlation between a 10-min Psychomotor Vigilance Test (PVT), as a measure of daytime functioning, and excessive daytime sleepiness as measured with the MSLT or MWT.

Methods
Patients attending the sleep clinic for assessments of daytime sleepiness underwent overnight polysomnography (PSG) and completed the Epworth Sleepiness Scale (ESS). The following day, patients completed four test sessions every 2h starting 1.5h after waking. Testing sessions included the Stanford Sleepiness Scale (SSS), PVT, MWT or MSLT. PVT lapses (reaction time &gt;500ms), SSS score and sleep latencies (MSLT and MWT) were averaged within participants across sessions and regression analyses performed to assess the relationship between PVT lapses and sleepiness measures.

Results
A total of 41 patients (BMI: 33.7±8.7kg/m²; aged 44.8±17.8 years) completed the study. Of these, 22 (19 F) underwent the MSLT and 19 (2 F) underwent the MWT. PVT lapses correlated with MWT mean sleep latency (r²=0.62; p&lt;0.001), ESS (r²= 0.19; p&lt;0.01) and SSS (r²= 0.12; p&lt;0.05) but not MSLT mean sleep latency (r²= 0.02; p = 0.50).

Discussion
In clinical practice, MWT and ESS are often used in conjunction to assess daytime functioning. Results suggest that the PVT could be used alongside MWT to aid clinical judgments around an individuals’ daytime functioning.
P107 Patient self-reported sleep quality, noise and light levels in a tertiary ICU: a prospective observational study
Authors: Martinez F , Seneviratne C , Chrimes A , Paech G 
Published: October 2021

Abstract

Introduction
Sleep is poor in intensive care units (ICU). However, there is limited research examining the causes from the patient perspective, especially in an Australian population. The current study investigated the factors that patients perceive as affecting their sleep in a major Australian tertiary ICU.

Methods
Patients (n=138, 51F; aged 58.1±16.8 years) completed a survey assessing sleep before and during their ICU stay, factors contributing to poor sleep, and factors that may have improved their sleep in the ICU. Night-time sound (16 nights) and light (28 nights) levels in rooms were also measured.

Results
Most patients reported good (38%) to very good (25%) sleep quality before their ICU stay, and poor (28%) to very poor (32%) sleep quality in the ICU. Over half (56%) reported an abnormal sleep-wake cycle and most (60%) felt as though they did not obtain sufficient sleep. Noise (54%), pain (50%) and lights (48%) were the top reasons for self-reported poor sleep. Patients felt as though their sleep would have been improved with dimmed lights (64%), a sleeping pill (57%) and closing door/blinds at night (46%). Median (IQR) overnight noise and light levels were 52.8 (51.4–54.6) dB and 39.9 (8.2–90.9) lux respectively.

Discussion
Of the top three factors that patients perceive to be the primary reasons for poor sleep, two are modifiable (noise and lights). Night-time sound levels exceed standard recommendations and light levels, while mostly low, were higher than indicated for a healthy sleep environment, suggesting that these could be modified to improve patients sleep.
P120 The Relationship Between Sleep Architecture And Cognition In Late-Life Depression
Authors: Ricciardiello A , Mowszowski L , LaMonica H , Kumfor F , Wassing R , D’Rozario A , Naismith S 
Published: October 2021

Abstract

Introduction
Depression in older people is associated with changes in sleep, however associations between sleep architecture and cognition have not yet been delineated. We examined sleep architecture in older people with and without depressive symptoms, and relationships with neuropsychological performance.

Methods
Adults over 50 years underwent overnight polysomnography and memory and executive function tests. Depression and controls groups were defined by a Geriatric Depression Scale-15 cut off score of 6. Sleep architectural outcomes included amount of slow wave sleep (SWS), rapid eye movement (REM) sleep, REM onset latency (ROL), NREM slow wave activity (SWA, 0.5–4 Hz), N2 sleep spindle density and REM density.

Results
The sample comprised of 71 participants with depressive symptoms and 101 controls (mean age both groups = 64, mean GDS-15 dep= 9.3, con= 1.8). There were no significant group differences in time spent in SWS, REM, REM density or SWA. Those with depressive symptoms had later ROL (p=.008) and less N2 sleep spindles (p=.03) compared to controls. A differential association was observed with less SWS being associated with poor memory recall in the depression group only (z=.342, p=0.008). No associations between sleep and executive function performance were observed.

Discussion
The link between less time in SWS and poorer memory in those with depressive symptoms could suggest that SWS is particularly pertinent for cognition in depression or that both sleep and cognition mechanisms are influenced by depressive state. Further studies are needed to determine if changes in sleep are linked with underlying neurobiological changes.
P122 Comparison of sleep estimation using Apple Watch accelerometry against polysomnography
Authors: Roomkham S , Lovell D , Szollosi I , Perrin D 
Published: October 2021

Abstract

Introduction
Consumer wearables offer new ways to improve our health and well-being, including sleep. Researchers are interested in consumer wearables because their widespread adoption creates the potential for larger studies than could be run with clinically validated measurement methods, as those are more expensive or less convenient. This study investigates sleep tracking using sensor data from Apple Watch in comparison to the gold standard polysomnography (PSG).

Method
We used Apple Watch accelerometer data to establish both activity and heart rate (using ballistocardiography). Thirty participants (13 female, 17 male) wore the Apple Watch on their non-dominant wrist during clinical PSG. We compared predicted sleep status at the epoch level and overall sleep parameters, taking PSG as the ground truth.

Results
Our method achieved sleep-wake classification accuracy of 84%, sensitivity of 95%, and specificity of 47%. Apple Watch overestimated total sleep time (mean+SD) by 39.4 + 57.7 mins, underestimated WASO by 45.5 + 54.6 mins and the number of awakenings by 5.0 + 6.9. We observed worse performance for participants who had PSGs exhibiting frequent respiratory events.

Discussion
Accelerometry cannot replace PSG for diagnostic purposes. However, the Apple Watch results compare favourably to previously published Actiwatch-PSG comparisons. The performance we measured suggests that Apple Watch based accelerometry could be used in longitudinal studies to gather information similar to clinically validated accelerometers, potentially on a larger scale for lower cost. Further study is needed to understand how sleep disorders affect this kind of measurement.
P127 Parliamentary Inquiry into Sleep Health Awareness in Australia: How patient-centric is the process?
Authors: Schokman A , Glozier N , Aji M , Bin Y , Kairaitis K , Cheung J 
Published: October 2021

Abstract

Introduction
The parliamentary inquiry into sleep health represents one of few platforms accessible to patients and their family/carers to contribute to the development of healthcare policy alongside other key stakeholder groups (i.e. healthcare professionals, organisations). Balancing diverse and sometimes divergent views of various stakeholder groups can be challenging, thus we set out to explore how patients and family/carer submissions were interpreted by the inquiry and translated into health policy recommendations.

Methods
Written submissions made to the Parliamentary Inquiry into Sleep Health Awareness in Australia 2018 by self-identified patients or family/carers with narcolepsy (n=13) were extracted and thematically analysed using the Framework Approach. Each submission was systematically coded, with emergent themes evaluated against the final policy recommendations made by the inquiry.

Results
We identified three major themes: 1) ‘Pathways to Treatment & Care’ regarding concerns around lack of healthcare and research resource allocation for narcolepsy; 2) ‘Help-seeking Experience’ related to barriers to help-seeking and accessing care; 3) ‘Patient and Family/Carers’ Lived Experience of Disease’ which encompassed the tangible effects narcolepsy has on the daily lives of patients and family/carers.

Discussion
While patients and their family/carers prioritised issues that affected their daily lives (i.e. mental health sequela, workplace accommodations), policy recommendations focused on healthcare infrastructure, funding and engagement. Increased transparency, developing processes to balance stakeholder priorities and improving accessibility to stakeholder engagement are needed if patient and family/carer needs are to be met, and for healthcare policy to remain targeted and trusted by the public.
P129 A substantial percentage of patients with Chronic Insomnia do not appreciably increase Total Sleep Time after Cognitive Behavioural Therapy for Insomnia
Authors: Scott H , Cheung J , Muench A , Ivers H , Grandner M , Lack L , Morin C , Perlis M 
Published: October 2021

Abstract

Introduction
Total sleep time (TST) does not exceed baseline for the majority of patients after CBT-I. However by follow-up, TST increases by almost 1 hour on average. The current study investigated the extent to which this TST improvement is common and assessed for baseline predictors of increased TST after CBT-I.

Methods
This study is an archival analysis of data from a randomised clinical trial comparing acute CBT-I to acute CBT-I plus maintenance therapy (N = 80). The percent of patients that exceeded baseline TST by ≥30 minutes was assessed at post treatment and 3, 6, 12, and 24 months following treatment. Linear mixed models were conducted to assess the effect of patient demographics (age, sex, ethnicity, marital status), and baseline Sleep Diary-reported sleep continuity and Insomnia Severity Index (ISI) scores on changes in TST.

Results
17% of patients achieved an appreciable increase in TST by treatment end, and this proportion only increased to 58% over time. Sleep Diary-reported sleep latency, wake after sleep onset, early morning awakenings, total wake time, TST, and sleep efficiency at baseline were associated with greater increases in TST after CBT-I (interaction ps &lt; .03). Demographics and ISI scores were not significant predictors (interaction ps &gt; .07).

Conclusion
A substantial proportion of patients do not appreciably increase TST after CBT-I, but patients with more severe sleep continuity disturbances at baseline exhibited the largest improvements. Whether all patients could increase their TST even further after CBT-I is a topic for further investigation.
P134 Modified uvulopalatopharyngoplasty and radiofrequency-in-saline tongue in the management of snoring
Authors: Lindsay B , Sideris A , Sarkis L , Lam M , Mackay S 
Published: October 2021

Abstract

Objective
The modified uvulopalatopharyngoplasty has not been investigated as an option in primary snoring. The aim of this study was to determine whether combined palatal and tongue surgery to enlarge and stabilize the upper airway is an effective treatment for patients with primary snoring who cannot tolerate or decline device therapy.

Study design
This was a retrospective cohort study, and included adult patients with primary snoring who underwent modified uvulopalatopharyngoplasty and radiofrequency-in-saline tongue between January 2009 and December 2020. Patients with clinically significant obstructive sleep apnoea were excluded.

Setting
Single centre study, based in New South Wales, Australia.

Methods
Primary outcome measures were the Snoring Severity Scale (a questionnaire, which indicates loudness and frequency of snoring) completed both prior to and following surgery, and the Epworth Sleepiness Scale. Mean questionnaire scores prior to and at three-month follow-up were analysed.

Results
97 adult patients underwent upper airway surgery for simple snoring, of which 68 were included in the present study (37.3 ± 11.5 years, n=17 female). The mean SSS prior to surgery was 7.0 ± 1.6 and 1.9 ± 2.3 at 3-month follow up (P &lt; 0.0001).The mean ESS prior to surgery was 9.0 ± 4.8 and 4.1 ± 2.8 at 3-month follow up (P &lt;0.0001).

Conclusion
The results of this study indicate that modified uvulopalatopharyngoplasty with radiofrequency-in-saline tongue is an effective treatment modality with a low complication rate. This procedure should be offered to carefully selected patients with primary snoring who have failed or declined device therapy.
P135 An audit investigating the length of time from GP referral to diagnostic polysomnography testing in an Australian tertiary center
Authors: Sriram B , Singh V , Bandaralage S , Bashford J 
Published: October 2021

Abstract

Introduction/Aim
Obstructive sleep apnoea is increasingly prevalent, with shorter referral to treatment time being associated with improved outcomes. Current studies describe a mean wait-time from initial referral to first outpatient review of 88 days, and from first review to diagnostic polysomnography of 123 days. This quality assurance initiative assessed how our sleep disorders centre in an Australian tertiary hospital compared to existing literature, and attempted to verify how triaging affected wait-time.

Methods
We retrospectively reviewed patients undergoing diagnostic polysomnography from 1st January 2019 to 30th June 2021. Time from initial referral to first clinic review, plus time from initial review to polysomnography, were recorded. Patient demographics and triage category of requested polysomnography were noted. Microsoft Excel was used to collect data and derive descriptive statistics.

Results
380 patients (202-male, 178-female) were included. 251 GP referrals were received. 112 patients were triaged for polysomnography within 30 days of initial review (category 4), 204 patients were triaged within 90 days (category 5), and 44 patients were non-urgent (category 6). Mean number of days between initial referral and first review was 136.13 days. Mean number of days between first review and polysomnography was 28.95 days in category 4, 93.38 days in category 5, and 180 days in category 6.

Conclusion
Time from initial referral to initial review appeared longer in this study compared to published standards. However, time from initial review to polysomnography appeared shorter. Adjusting patient triaging and/or our ability to see new referrals sooner is required to match the published standards.
P142 Head flexion has the greatest impact on OSA severity during REM sleep
Authors: Tate A , Kurup V , Shenoy B , Freakley C , Eastwood P , Walsh J , Terrill P 
Published: October 2021

Abstract

Introduction
Recent work has shown that head flexion has a modest worsening effect and head rotation has a modest protective effect on OSA severity. However, there is substantial variability both within and between individuals. In this analysis we aimed to identify if this variability is explained by sleep-state, BMI, age or sex.

Methods
28 participants provided informed consent and were studied using diagnostic polysomnography with the addition of a customised, accelerometry based, head posture measurement device. For each epoch during supine sleep, the sleep state (NREM/REM), average head flexion (degrees) and average head rotation (degrees) were recorded. A logistic mixed effects model was fit across all epochs with the anthropometrics (BMI, sex, age), sleep state, average head flexion and average head rotation as explanatory variables with the absence/presence of one or more respiratory event(s) as the binary outcome variable.

Results
In total, 2122 of 5369 supine sleep epochs had a respiratory event. Three participants had no supine sleep. There were significant interaction effects for flexion-rotation, BMI-rotation and REM-flexion. The REM-flexion interaction effect was the strongest interaction effect with an odds ratio per 5 degrees of head flexion in REM sleep of 1.47 (95% CI: 1.13 – 1.86).

Discussion
Head flexion related worsening of OSA severity is greatest during REM sleep. This may be explained by attenuated upper airway neuromuscular activation in REM sleep compared with NREM sleep.
P144 Sleep-Related Limb Movements and Subjective Sleepiness in a Professional Rugby League Team
Authors: Teuwen P , Dalman M , Scott A 
Published: October 2021

Abstract

Introduction
This study aims to assess the relationship between LMs, PLMD and limb related arousals during sleep and subjective sleepiness in a group of professional athletes (National Rugby League (NRL) players).

Methods
25 type II HSAT polysomnographic (PSG) studies were performed on 23 male individuals (2 repeated studies). 2 x Piezo limb EMG sensors were applied to each HSAT. PSG data analysed as per AASM Manual for the Scoring of Sleep and Associated events. Epworth Sleepiness Scale (ESS) collected for each participant obtaining subjective daytime sleepiness. PSG data was checked for normality using the Shapiro-Wilk normality test. Parametric data was then subsequently analysed using Pearson correlation coefficients, whereas non-parametric data was analysed with the Spearman correlation coefficient. A line of best fit was implemented using Deming’s linear regression model to report r2.

Results
The most significant relationships were noted between daytime sleepiness and the frequency of limb-related arousals (Pearson’s r 0.273) and the relationship between PLM arousals and ESS (p-0.082). No significant relationships were noted between LMs, PLMs, limb related arousals and daytime sleepiness were found. No results were found to be statistically significant.

Conclusions
This PSG data demonstrates a mildly positive correlation with all limb movement parameters measured against the athletes’ self-reported sleepiness. This may therefore be of significance with their performance and recovery. Further research is recommended to verify these relationships.
P151 Short-term mandibular advancement splint therapy for Obstructive Sleep Apnoea improves parasympathetic modulation
Authors: Ucak S , Dissanayake H , Sutherland K , Bin Y , de Chazal P , Cistulli P 
Published: October 2021

Abstract

Introduction
Altered autonomic function (specifically, sympathoexcitation and vagal withdrawal) contributes to cardiovascular risk. Obstructive sleep apnoea (OSA) is associated with altered autonomic function. Heart rate variability (HRV) is a non-invasive measure of autonomic function. We aimed to assess whether short-term OSA treatment with mandibular advancement splints (MAS) improves autonomic function measured by HRV.

Methods
A retrospective analysis of participants in MAS treatment studies (N=105, 56% male, age, 56±1 years; BMI, 30±5 kg/m2) was undertaken. Nocturnal HRV was assessed using electrocardiograms from pre and post-treatment polysomnograms. HRV was calculated across 2-minute epochs over the entire electrocardiogram and divided into each sleep stage (wake, non-rapid eye movement (NREM), and rapid eye movement (REM)). HRV measures reflecting sympathetic (normalised low frequency (LFnu)), parasympathetic (pNN50%, RMSSD (ms), normalised high frequency (HFnu)), total HRV (SDNN (ms) and HTI) and R-R interval were calculated. Changes in HRV measures following treatment were assessed (paired t-test) and compared to AHI change (linear regression, with adjustment for age, sex, BMI).

Results
Following MAS treatment, HTI increased (14.78±39.99, p=0.008), and LFnu reduced during wake (-0.43±38.18, p=0.03). Linear regression, showed AHI reduction related to increased R-R interval during wake (-0.002, 0.001), p=0.009) [unstandardised β/SE] and REM (-0.002, 0.001) [unstandardised β/SE], p=0.008), and increased pNN50% during wake (-0.24, 0.08), p=0.005) [unstandardised β/SE] suggesting MAS efficacy relates to these improvements.

Conclusion
We found evidence of reduced sympathetic and increased parasympathetic modulation, following short-term MAS therapy. This suggests MAS therapy has potential to improve cardiac autonomic function and hence reduce cardiovascular risk.
P160 A trial of a position modification device for the prevention of supine sleep during pregnancy
Authors: Wilson D , Whenn C , Walker S , Barnes M , Howard M 
Published: October 2021

Abstract
Self-reported supine position at sleep onset during late pregnancy is related to a 2.6x increase in stillbirth risk, possibly due to the enlarged uterus compressing major blood vessels supplying the placenta. This study aimed to test the effectiveness of a pillow designed to decrease supine sleep in pregnant women.
Twelve women in the third trimester of pregnancy used their own pillows for a control week and the intervention pillow for 1 week, in randomised order. Sleep position for each night of both weeks was monitored with the Night Shift Sleep Positioner, with a sleep study (WatchPat300) on the last night of each week to measure the impact of the intervention on SDB.
During the control week, the women slept supine for a median of 19.9% (IQR = 11.6, 27.4) of total sleep time (TST), compared to a median of 20.4% (10.2, 31.0) TST using the intervention pillow (p = .64). Use of the intervention pillow did not impact sleep efficiency (control = 85.3% (80.7, 88.0) v. intervention = 85.2% (78.3, 89.0), p = .48). On the sleep study night, supine sleep was reduced in the intervention compared to control condition (12.9% vs. 17.7%, p = .04), but AHI did not differ (intervention = 2.6/hr (0.8, 6.7) vs. control = 1.5/hr (0.6, 3.6), p = .11).
We found that the adoption of a pillow designed to discourage supine sleep was not effective in late pregnancy. Considering the reasonably high amount of supine sleep in our participants, alternative devices should be investigated.
P163 Slow wave transcranial electrical stimulation during wake to investigate the consolidation of new learning
Authors: Wood J , Bland N , Brownsett S , Sale M 
Published: October 2021

Abstract

Introduction
Slow, oscillatory, transcranial electrical stimulation (so-tES) applies a current over the scalp that oscillates in intensity at a frequency associated with slow wave sleep (SWS; 0.75Hz). When applied during SWS, so-tES can enhance SWS EEG power compared to sham stimulation, as well as overnight declarative memory consolidation. When applied during wake, so-tES can enhance local EEG power in the slow wave frequency range (0.5–4.5Hz) compared to sham. Therefore, this study will investigate whether so-tES can enhance the early consolidation of new learning compared to sham, when applied during wake. A preliminary analysis of data will be presented.

Methods
Healthy, young, right-handed adults (18–35 years) practiced a motor sequence learning task for 30 minutes, before receiving 15 minutes of active or sham so-tES (0.75Hz) during quiet wakefulness. Task performance was assessed by recording the total number of correct sequences performed in 30 seconds before practice, after practice, and after stimulation. Performance improvements will be compared between stimulation conditions. Non-invasive, electrophysiological corticospinal excitability measurements (i.e., motor-evoked potentials) were also recorded at six timepoints throughout each session, to investigate whether active so-tES can modulate corticospinal excitability differently to sham.
Progress to date
Data collection is ongoing, and completion is expected by late 2021.
Intended outcome and impact
We expect so-tES to enhance early skill consolidation during wake, and that enhanced consolidation will be associated with less variable measurements of corticospinal excitability, when compared with sham stimulation.