bluuebunny/crossref_metadata_2025_split huggingface dataset:
120 Seeking Treatment for Daytime Sleepiness: Beliefs and Attitudes Among People with Excessive Daytime Sleepiness
Authors: Kapoor Ashna , Wills Chloe , Tubbs Andrew , Grandner Michael 
Published: May 2021

Abstract

Introduction
Sleepiness impacts health and functioning, but many people with sleepiness do not seek care. Beliefs and attitudes about treatments for sleepiness may be useful to know in designing and targeting interventions.

Methods
N=28 participants with excessive daytime sleepiness (ESS&gt;=10) but no other major medical problems were recruited from the community. They were administered an Epworth Sleepiness Scale and Fatigue Severity Scale at baseline, and asked about a wide range of beliefs/attitudes about seeking medical care about sleepiness, and whether they Strongly Agree (SA), Agree (A), Disagree (D), or Strongly Disagree (SD) with them. Ordinal logistic regressions examined agreement associated with baseline sleepiness and fatigue, adjusted for age, sex, and race/ethnicity. Nominal significance was determined as p&lt;0.05.

Results
Rates of baseline agreement were as follows: People with insomnia (SA:50%,A:50%), sleep apnea (SA:68%,A:32%), and daytime sleepiness (SA:50%,A:36%,D:14%) “should discuss their problems with their doctor or health care provider.” “I have talked to my doctor about sleep problems” (SA:18%,A:23%,D:41%,SD18%). “I have talked to my doctor about daytime sleepiness (SA:23%,A:14%,D:45%,SD:18%). “If I had problems sleeping, I would discuss it with my doctor or health care provider” (SA:27%,A:50%,D:23%). “If I had problems with daytime sleepiness, I would discuss it with my doctor or health care provider” (SA:23%,A:50%,D:27%). “Excessive daytime sleepiness is something that can be improved with medical treatment” (SA:14%,A:55%,D:32%). “Excessive daytime sleepiness is something that can be improved with psychological treatment” (SA:9%,A:64%,D:27%). “Excessive daytime sleepiness is something that can be improved with complementary/alternative medicine treatment” (SA:9%,A:68%,D:18%,SD:5%). “I am concerned about side effects of medical treatments for daytime sleepiness” (SA:45%,A:42%,D:14%). These factors were not associated with baseline sleepiness. Those with higher baseline fatigue were more likely to report having talked to their doctor about sleepiness (oOR=1.33, p=0.02) and having talked to their doctor about sleep problems in general (oOR=1.54, p=0.02).

Conclusion
Real-world beliefs and attitudes about treatments for sleepiness reflect a general positive attitude towards addressing these issues with medical providers, not a very strong one. Side effects of medications are a common concern. Baseline fatigue may spur individuals to talk to their doctor.

Support (if any)
This work was supported by Jazz Pharmaceuticals
126 Exposure to simulated military operational stress decreases alertness in the morning but not the evening
Authors: LaGoy Alice , Beckner Meaghan , Sinnott Aaron , Conkright William , Eagle Shawn , Proessl Felix , Connaboy Christopher , Germain Anne , Flanagan Shawn , Martin Brian , Nindl Bradley , Ferrarelli Fabio 
Published: May 2021

Abstract

Introduction
Alertness, essential for optimal performance, may be modulated by acute stressors including: sleep loss, caloric restriction, cognitive load, and physical exertion. Prior sleep may attenuate sleep loss-related alertness decrements, thereby influencing performance and safety. We examined the effects of prior sleep and changes in alertness throughout the day and across days during a simulated military operational stress (SMOS) protocol.

Methods
As part of a 5-day SMOS protocol, fifty-eight active-duty or recently-separated military personnel (45 men; 26±6 years) completed subjective (Profile of Mood States, Vigor subscale) and objective (3-minute Psychomotor Vigilance Task; PVT) alertness assessments each morning (~0900) and evening (~2200). PVT outcomes included median reaction time (RT) and lapses. Day 2 (D2) reflected baseline testing, in which participants received an 8-hour sleep opportunity (2300-0700) and 100% of their estimated caloric need. Day 4 (D4) reflected peak stress, after two nights of participants receiving two 2-hour sleep opportunities (0100-0300, 0500-0700) and 50% of their estimated caloric need. Mixed effects ANOVAs were used to assess the effects of day (D2, D4) and time (Morning, Evening) on alertness. D2 and D4 reflected alertness at baseline and peak stress, respectively. Separate ANOVAs were performed to assess the effects of prior sleep: the Pittsburgh Sleep Quality Index (PSQI) assessed at intake, baseline polysomnography-measured sleep efficiency (SE), and baseline frontal slow wave activity (SWA; 0.5-4Hz). All analyses controlled for age.

Results
No significant interaction or main effects of day and time were found for Vigor or PVT lapses. Participants with higher PSQI scores reported lower Vigor (p=.01, η_p^2=.11). A significant interaction was found for PVT RT (p=.04, η_p^2=.07); morning RT was slower on D4 than D2, while evening RT did not differ across days. SE and SWA did not significantly influence alertness.

Conclusion
SMOS led to objective alertness deficits in the morning but not evening. Subjective alertness did not change during SMOS but was influenced by prior sleep quality (PSQI). Thus, both circadian and prior sleep-related factors influence performance during operational stress. Fatigue mitigation strategies delivered before and during military operations may support performance and safety.

Support (if any)
Department of Defense Award #W81XWH-17-2-0070
131 Sleep Quality as a Pathway from Stress to Cold Symptom Severity
Authors: Bansal Muskan , Ghose Sarah , Dautovich Natalie 
Published: May 2021

Abstract

Introduction
Stress is a known contributor to immune system suppression associated with higher illness susceptibility, including acute infectious respiratory illness, or the common cold. Sleep quality, shown to impact immunity, is an additional mechanism that may underlie the association between stress and cold symptomatology. Although the associations between stress and sleep and cold symptomatology have been examined separately, little is known about the mechanistic role of sleep in these associations. The present study examined sleep quality as a potential pathway between stress and cold symptomatology difference scores.

Methods
Archival data from the Common Cold Project (Pittsburgh Cold Study 3) were utilized for the present study. Participants were 213 adults (Mean Age=30.1 yrs., SD=10.9 yrs., 42.3% female) who completed a 5-day viral challenge and self-report measures of cold severity (Jackson Symptom Score; measured from beginning to end of viral challenge), baseline sleep quality (PSQI), and perceived stress as part of study participation. SPSS v 27 and Hayes’ PROCESS mediation macro were used to assess study aims. Age and sex were included as covariates.

Results
Greater perceived stress was significantly associated with worse sleep quality [B=.15, 95% CI .10, .21]. Sleep quality fully mediated the association between stress and changes in symptomatology; better sleep was associated with larger changes in cold severity [B=-.23, 95% CI -.43, -.04], defined as differences in symptomatology from beginning to end of the viral challenge, beyond stress alone. Zero-order correlation analyses revealed a trend level (r=.04, p=.06) association between sleep quality and aggregate cold severity, suggesting that as sleep improves, symptoms decrease.

Conclusion
Within the present sample, sleep quality surfaced as an indirect pathway linking stress to changes in cold severity. Better sleep was associated with greater changes in cold severity above perceived stress. These findings, together with the trend level, positive association between sleep quality and cold symptomatology, suggest that better sleep may be associated with less severe symptomatology. Future research should attend to mechanisms underlying the associations between stress, sleep, and cold symptomatology.
Support (if any):
149 Perceived sleep need, cumulative sleep deficit, and associations with daily affect in adolescents: 28 days over school & vacation
Authors: Shen Lin , Wiley Joshua , Bei Bei 
Published: May 2021

Abstract

Introduction
This study aimed to describe trajectories of daily perceived sleep need and sleep deficit across 28 consecutive days, and examine if cumulative sleep deficit predicts next-day affect.

Methods
Daily sleep and affect were measured over 2 weeks of school and 2 weeks of vacation in 205 adolescents (54.1% females, Mage = 16.9 years). Each day, participants completed actigraphy and self-reported the amount of sleep needed to function well the next day (i.e., perceived sleep need), sleep duration, and high- and low-arousal positive and negative affect. Cumulative actigraphy and diary sleep deficit were calculated as difference between perceived sleep need and sleep duration, weighted by sleep deficit over the past 3 days. Cross-lagged, multilevel models were used to test cumulative sleep deficit as a predictor of next-day affect. Lagged affect, day of the week, study day, and sociodemographics were controlled.

Results
Perceived sleep need was lower early in the school week, before increasing in the second half of the week. Adolescents accumulated sleep deficit across school days and reduced it during weekends. During weekends and vacations, adolescents’ self-reported, but not actigraphy sleep duration, met perceived sleep need. Higher cumulative actigraphy sleep deficit predicted higher next-day high arousal negative affect; higher cumulative diary sleep deficit predicted higher negative affect (regardless of arousal), and lower low arousal positive affect the following day.

Conclusion
Adolescents experienced sustained cumulative sleep deficit across school days, and whilst non-school nights appeared to be opportunities for reducing sleep deficit. Trajectories of sleep deficit during vacation suggested recovery from school-related sleep restriction. Cumulative sleep deficit was related to affect on a daily basis, highlighting the value of this measure for future research and interventions.
Support (if any):
162 Age, sex, and sleep continuity disturbance: Does binary sex impact sleep continuity while co-varying for age across the lifespan?
Authors: Boyle Julia , Muench Alexandria , Vargas Ivan , Bashian Hannah , Williams Natasha , Perlis Michael 
Published: May 2021

Abstract

Introduction
It is well-documented that insomnia symptoms can worsen with age and that women have a greater predisposition to insomnia symptoms than men. Additionally, it has been found that women are more likely to report insomnia symptoms across the lifespan (i.e., increased prevalence of insomnia regardless of age). The aim of the present study was to 1) confirm the finding that women are more likely to endorse having insomnia problems (specifically as they pertain to SL, WASO, and EMA) and 2) evaluate if there are binary sex differences with respect to sleep continuity disturbance (SCD) while accounting for age.

Methods
Sleep continuity (SL, WASO, EMA) duration (in minutes) and problem endorsement data was collected from individuals with insomnia complaints in an archival/community-based sample (n=1837;56.9% female; ages 18-87) (www.sleeplessinphilly.com). A multivariate analysis of covariance was conducted to determine a significant difference between sex (male, female) on SL, WASO, and EMA in minutes while controlling for age. Pearson correlations were run to determine relationships between age and SL, WASO, and EMA. Chi-Square tests were run to determine if there were sex differences in problem endorsement of SL, WASO, and EMA.

Results
Significant sex differences were observed in reports of SCDs as problematic, where more women endorsed SL (58.5%;p&lt;.001), WASO (58.1%;p&lt;.001), and EMA (56.9%;p&lt;.001) as a problem than men. There were no significant effects of binary sex on sleep continuity disturbances when controlling for age. Age was significantly negatively related to SL(p&lt;.001) and significantly positively related to WASO(p&lt;.001) and EMA(p&lt;.001).

Conclusion
These results confirm that women are more likely to report SCDs as a problem and that men and women experience similar levels of insomnia severity with respect to SL, WASO, and EMA. Clinically speaking, it may be important to evaluate insomnia with explicit questions about specific measures of SCD, followed by an inquiry regarding whether each SCD symptom “is a problem.” Future studies should consider gender identification as a relevant factor when evaluating for sleep continuity disturbances across the lifespan.
Support (if any):
164 Greater Light Exposure Is Associated with More Robust Rest-Activity Rhythms in Community-Dwelling Older Adults
Authors: Kim Minjee , Reid Kathryn , Maas Matthew , Vu Thanh-Huyen , Braun Rosemary , Daviglus Martha , Zee Phyllis 
Published: May 2021

Abstract

Introduction
Disrupted circadian rest-activity rhythms in older adults have been associated with an increased risk of cognitive decline and mortality. While light is one of the most potent synchronizing agents for the human circadian system, little is known about how light may influence rest-activity rhythms in older adults. We aimed to investigate the relationship between the amount of light exposure and rest-activity rhythm parameters using actigraphy data from a large cohort study.

Methods
553 community-dwelling older adults (aged 72±5, 142 (25.5%) female) from the Chicago Healthy Aging Study cohort underwent recording of activity and ambient light exposure for a minimum of five 24-hour periods, using Actiwatch-L (Phillips Respironics). The average recording duration was 6.7±0.5 days. An extension to the traditional cosine model was used to compute circadian rest-activity rhythm parameters, including the amplitude (a measure of strength), the goodness of fit (pseudo F statistic; a measure of robustness), and acrophase (timing of peak activity). Light exposure was measured by time spent above light thresholds of 100, 200, 500, and 1000 lux per day (TAT100, TAT200, TAT500, TAT1000, respectively). Bivariate associations between rhythm parameters and TAT values were examined with Spearman’s correlation coefficients. Variables that met a significant threshold (p&lt;0.05) were entered into multivariable models to adjust for potential confounders including age, sex, race, and season.

Results
Robustness of the rest-activity rhythm, measured by extended cosine pseudo-F statistics, was associated with TAT100 (partial Spearman’s correlation coefficient 0.12, p=0.008), TAT200 (coefficient 0.13, p=0.03), TAT500 (coefficient 0.16, p&lt;0.001), and TAT 1000 (coefficient 0.18, p&lt;0.001). TAT100/200/500/1000 were also associated with the strength of the rest-activity rhythm, measured by amplitude of the extended cosine fit (partial Spearman’s correlation coefficient vs. TAT100: 0.12, p=0.006, TAT200: 0.14, p=0.002, TAT500: 0.16, p&lt;0.001, TAT1000: 0.18, p&lt;0.001), after adjusting for age, sex, race, and season.

Conclusion
Across the seasons, greater daily light exposure is associated with more robust circadian rest-activity rhythm in community-dwelling older adults. Whether the enhancement of light exposure can improve the strength and robustness of rest-activity rhythm needs to be tested with future intervention studies.
Support (if any):
165 Sex differences in the relationship between self-reported sleep quality and frailty in South Florida older adult outpatients
Authors: Kaur Sonya , McInerney Katalina , Slugh Mitchell , Bure Annelly , Sarno Marina , Getz Sarah , Levin Bonnie 
Published: May 2021

Abstract

Introduction
Frailty, a multidimensional construct of decreased reserve is an important predictor of functional independence and quality of life in older adults. There is a growing body of evidence highlighting reduced sleep efficiency and sleep duration predicts frailty in older adults. However, the sex differences in these relationships have been understudied.

Methods
253 participants (163) ranging in age from 50-92 years (mean= 67.59 years, S.D.= 9.22 years), underwent frailty assessment and completed the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Statistical moderation was assessed using nonparametric bootstrapping. All models statistically controlled for age, education and depression status.

Results
Higher scores on the PSQI predicted higher levels of fatigue (β=1.87, 95% CI= 0.48-3.27) and higher grip strength with the left hand (β= 0.81, 95% CI= 0.85-1.53). These relationships were significantly moderated by sex (β=-0.77, p=0.05 & β=-0.52, p=0.01). Specifically, high scores on the PSQI predicted more fatigue stronger grip strength in men (β=1.11, 95% CI=0.41-1.81) and weaker grip strength in women (β=-0.25, 95% CI=-0.51--0.02). There was no association between scores on the ESS and any of the frailty measures.

Conclusion
The relationships between PSQI scores and measures of fatigue and grip strength were statistically moderated by sex. These differences are not explained by sex differences in overall sleep quality or baseline frailty. This is consistent with the literature emphasizing sex differences in the effects of risk/lifestyle factors. It is possible that the relationship between sleep quality and frailty is altered by additional hormonal factors and warrant further investigation.

Support (if any)
This research was supported by the Evelyn F. McKnight Brain Research Foundation
170 Hispanic Ethnicity May Be Associated with Short Sleep Duration and Elevated Sleep Distress in U.S. Air Force Trainees
Authors: Burns Rosemary Estevez , Wang Xin Qun , Patience Marc , Ellis Jordan , Talcott Wayne , Hryshko-Mullen Ann , Star John Blue , Copeland Carol 
Published: May 2021

Abstract

Introduction
Sleep research among Hispanic populations is limited. Hispanics may be at higher risk of poor sleep when compared to other race/ethnicities. Non-white and other socioeconomically disadvantaged populations have higher rates of chronic health conditions. Epidemiological studies have substantiated the correlation between short sleep and a variety of negative health outcomes. Sleep is foundational to overall good health and functioning, impacting academic and physical performance in technical training, and crucial for an airmen’s adjustment to the rigor of a military career. Authors explored the role of race/ethnicity on perceived sleep health (e.g., sleep duration and sleep distress) among airmen attending technical school.

Methods
Sleep health survey was administered to two groups of Airmen at an Air Force technical training: In-processing: Airmen who just arrived to begin technical training, (n=187), Age: M= 20.83 (SD 3.26), 82.55% Male; upon completion of training, i.e., Out-processing: Airmen about to complete technical training, (n=302), Age M = 20.7 (SD 3.09), 85.81% Male. To account for correlations between Airmen from the same squadron, a covariates-adjusted generalized mixed-effects model was used. Associations between race/ethnicity and short sleep duration (≤6 hours), and between race/ethnicity and sleep pattern distress—among shorter sleepers as a sub-group—were examined. Racial/Ethnic frequency among short sleepers (n=135): 19.3 % Hispanic, 13.3% NH-Black, 55.6% NH-White, 6.6% NH-Multiracial, and 5.2% NH-Other.

Results
Among Hispanic Airmen, the out-processing group was 2.25 times as likely as the in-processing group to be short sleepers on weekdays (95% CI: 1.15 to 4.38, p=0.017). Among short sleepers in the out-processing group, Hispanic Airmen were significantly more worried/distressed about their sleep pattern than Black and White Airmen (OR=2.29, 95% CI: 1.18 to 4.42, p=0.014 and OR=2.29, 95% CI: 1.10 to 4.76, p=0.026, respectively).

Conclusion
Short sleep duration is a significant problem in the military and results suggest that race/ethnicity-related contextual factors may point to at risk subgroups. Others have considered the influence of perceived prejudice, access to social capital, cultural barriers to academic success, and potential sensitivity to somatic discomfort on sleep complaints. Future directions involve repeating this assessment with another cohort of technical training Airmen to see if findings replicate.

Support (if any)
none
185 Associations between Diet and Sleep Health in the UK Biobank Study
Authors: Hepsomali Piril , Groeger John 
Published: May 2021

Abstract

Introduction
It is well known that the prevalence of clinical and subclinical sleep issues is quite high, with a great economic and social burden on the society. As it is expected that the numbers of people suffering from clinical and subclinical sleep problems will increase in the coming years, new primary and/or complementary methods to improve and prevent poor sleep health across the population are urgently needed. In the current study, we aimed to conduct the largest investigation of diet and sleep health to date, through systematically examining the UK Biobank (UKB) data to find out whether diet quality and food groups play a role on sleep health.

Methods
This cross-sectional population-based study involved 502,494 participants. UKB food frequency and sleep questionnaires at baseline were used. Also, healthy diet, healthy sleep, and partial fibre intake scores were created. ANCOVA and regression models were used to examine the associations of healthy diet and dietary fibre intake scores with sleep health. Adjusted models included age, sex, BMI, and mental health symptomatology.

Results
We showed that both healthy diet and high partial fibre intake scores were associated with increased healthy sleep scores. Also, higher intakes of vegetables, fruits, fish, and unprocessed red meat were found to be associated with increased healthy sleep scores. On the other hand, processed meat intake was inversely associated with sleep health.

Conclusion
A healthy dietary pattern, and food groups (vegetables, fruits, fish, water) and nutrients (fibre) that are consumed as a part of a healthy dietary pattern were associated with better sleep health. Further work is needed to identify underlying mechanisms behind the impact of diet on sleep health.

Support (if any)
Acknowledgements: This research has been conducted using the UK Biobank Resource under Application Number ‘61818’. Funding: Funds received from Unilever UK Central Resources Limited to cover application fees.