bluuebunny/crossref_metadata_2025_split huggingface dataset:
P014 Shift work disorder and the prevalence of help seeking behaviours for sleep concerns in Australia
Authors: Brown B , Crowther M , Appleton S , Melaku Y , Adams R , Reynolds A 
Published: October 2021

Abstract

Introduction
Shift work disorder is a circadian rhythm sleep-wake disorder, defined by symptoms of insomnia and excessive levels of sleepiness resulting from work that occurs during non-standard hours. Sleep problems are common in shift workers, yet our understanding of help-seeking behaviours for sleep in shift workers is limited.

Methods
As a part of a national sleep health survey, data were collected on the help-seeking behaviours for sleep problems in an online sample of Australian individuals on non-standard work schedules (n=448). Of the sample of non-standard workers, 10.5% (n=41) met the criteria for probable shift work disorder (pSWD).

Results
Non-standard workers with pSWD did not seek help for sleep problems at higher rates than workers without SWD (p = .979). General practitioners were the most reported healthcare professional sought out for sleep problems of individuals with pSWD. Self-management was common in workers with pSWD, with a high self-reported prevalence of alcohol use (31.7%) as a sleep management strategy, and caffeine consumption (76.9%) as a sleepiness management strategy. The majority of individuals with pSWD reported the mentality of ‘accept it and keep going’ as a sleepiness management strategy, highlighting a potential barrier to help-seeking behaviour in workers with pSWD.

Discussion
These findings provide novel insight into the help-seeking behaviours of individuals with pSWD. There is a need for further research to understand why individuals at risk for shift work disorder are not actively seeking help, and to develop health promotion and intervention strategies to improve engagement with healthcare professionals.
P015 Home (Level 2) sleep studies are feasible in children
Authors: Russo K , Greenhill J , Burgess S 
Published: October 2021

Abstract

Introduction
In-hospital polysomnography (PSG or Level 1 study) is the “gold-standard” for investigating sleep disorders in children. There are long waiting lists for sleep studies in Australian tertiary centres. Level 2 home-PSG has been proposed as an alternate option. However, there are limited data regarding the feasibility in a clinical population. The aim of this study is to assess the feasibility and patient experience of home-PSG in a clinical cohort.

Methods
The signal quality and outcomes of a home-PSG in young people undergoing sleep investigation in a single centre were reviewed. A successful home-PSG was defined as a study with ≥ 6hrs of sleep and all channels present for ≥90% of sleep time. Feedback from the guardian/young person was collected using a questionnaire.

Results
Fifty-five patients (4m-18yrs) were included. Successful home-PSG, on the first attempt, was achieved for 48/55 (87%) patients. There were no differences in success when accounting for neurodevelopmental conditions, OSA severity or age. A clinical diagnosis was confidently made in 53 (96%) patients. The majority (76%) rated their sleep as the same or better than normal and only 12% found having the study conducted at home difficult. Following the study, only 8% would have preferred a hospital sleep study.

Discussion
Home-PSG produced technically adequate recordings for most subjects and families found the experience of having a home sleep study to be positive. These data support, in appropriate circumstances, home-PSG as a viable alternative to an in-patient sleep study.
P018 The effects of zopiclone on sleep spindles in obstructive sleep apnea: A randomized placebo-controlled trial
Authors: Carter S , Siong J , Hoyos C , Carberry J , Grunstein R , Eckert D , D’Rozario A 
Published: October 2021

Abstract

Purpose
This study aimed to determine the effects of a standard dose of zopiclone (7.5mg) on sleep spindle activity and to assess if potential changes in sleep spindles correlate with improvements in next-day measures of sleepiness and simulated driving performance in people with obstructive sleep apnoea (OSA).

Methods
Thirty-one people with OSA completed polysomnography (PSG) at baseline followed by 1-month nightly treatment with 7.5mg zopiclone or placebo according to a double-blind, parallel design (ANZCTRN12613001106729). Participants completed two further PSGs on the first (night1) and final (night30) night of treatment. A 30-min AusEd driving simulator task and a subjective sleepiness questionnaire (Karolinska sleepiness scale, KSS) on each visit were also performed in the morning. Sleep spindle events and spindle frequency activity (SFA, sigma EEG power) were quantified during N2 sleep from all-night EEG recordings.

Results
Sleep spindle events were consistently higher in both frontal and central EEG sites on night1 and night30 treatment nights in the zopiclone group compared to placebo (e.g. F4 night30 = 346[SEM±28] vs. 239[SEM±27] total # of sleep spindles respectively, p=0.009). Additionally, greater sleep spindle density in the zopiclone group correlated with better next-day simulated driving performance on night1 and night30. No correlations were observed between sleep spindle activity and the KSS.

Conclusions
Zopiclone is associated with greater sleep spindle activity in OSA compared to placebo, and sleep spindle increases are associated with better driving simulator performance. Thus, hypnotic-induced increases in sleep spindles may help alleviate certain cognitive performance decrements in people with OSA.
P021 Does Obstructive Sleep Apnea (OSA) lead to impairment within the cochlea?
Authors: Cheung I , Thorne P , Neeff M , Sommer J , Hussain S 
Published: October 2021

Abstract

Introduction
The cessation of breathing with OSA is linked to the continuous decrease in oxygen saturation throughout the night which could impact the inner ear as it is sensitive to hypoxic changes. Inner ear hair cells response from the cochlea is measured through Transient Otoacoustic Emission (TEOAEs). This study aimed to evaluate TEOAEs in suspected OSA patients and its correlation with oxygen saturation.

Methods
TEOAEs were measured before sleep and in the morning in suspected OSA patients and healthy participants. The following frequencies were measured: 1000Hz, 1500Hz, 2000Hz, 3000Hz and 4000Hz. Polysomnography with oxygen saturation was completed overnight. Preliminary analysis was completed on 11 no OSA, 22 mild OSA, 13 moderate OSA and 27 severe OSA patients.

Results
One-way ANOVA with Tukey post-hoc analysis revealed a difference between severe vs mild with average TEOAE only (p = 0.04). A moderate correlation was found between average TEOAE and minimum O2 saturation, rs (72) = 0.444, p&lt; 0.0001) through Spearman’s rank-order correlation. As middle ear function can impact TEOAE results, regression analysis revealed an association between a decrease in TEOAE and lowered minimum O2 saturation (F (1,63) = 8.951, p = 0.004, partial n2 = 0.124) when middle ear pressure was controlled.

Discussion
Oxygen desaturation with OSA is associated with a decrease in inner ear hair cells response, which was independent from middle ear function. Despite this association, a difference in TEOAE was only found between severe vs mild, which could be due to the current sample size of the preliminary data.
P022 Unattended home sleep studies have a high recording failure rate in a preoperative anaesthetic clinic cohort when done as a routine screening procedure for Obstructive Sleep Apnoea (OSA)
Authors: Chuong B , Cho J , Wheatley J 
Published: October 2021

Abstract

Introduction
Preoperative screening for OSA is strongly advised but attended laboratory sleep studies have limited availability. Portable unattended sleep monitors, such as ApneaLink, may provide a practical solution for large scale preoperative OSA screening. However, these unattended monitors may be prone to data recording failure.

Methods
We performed a prospective, uncontrolled, before-after study from March 2017 to December 2018 where patients from a pre-operative anaesthetic clinic were screened for OSA with an ApneaLink home sleep study (AHSS). 24 initial patients were provided with version 1 (v.1) recording instructions, while the next 24 patients received version 2 (v.2) which included colour, more detail and larger pictures compared to v.1. Recording failure was defined as an absence of recorded ApneaLink data. We analysed predictors of recording failure including instruction version and patient factors using logistic regression.

Results
Thirty-three of 48 (69%) patients successfully completed an AHSS. Failure rate was 31%. Median duration of recorded data was 480 minutes. The successful recording group was more likely to have used v.2 instructions than the failure group (61% vs. 27%; p=0.029). The odds ratio for successful recording using v.2 was 4.2 (95% CI: 1.1–16.2). Age, gender, country of birth, and number of days prior to surgery were not associated with recording failure.

Discussion
There was a high failure rate of AHSS for OSA screening from a preoperative anaesthetic clinic. Clear written instructions with greater use of colours and pictures may improve the recording success rate in this cohort.
P023 Quantitative EEG analysis of polysomnography in a case of Fatal Familial Insomnia
Authors: Churchward T , Kao C , D’Rozario A , Wimaleswaran H , McMahon M , Howard M , Tolson J , Ruehland W 
Published: October 2021

Abstract

Purpose
To report on quantitative electroencephalograph (EEG) activity during polysomnography (PSG) in a rare case of confirmed Fatal Familial Insomnia (FFI).

Methods
Sleep/wake characteristics of a 32-year-old male patient were quantitatively analysed using central EEG recordings during two PSGs (FFI-1 and FFI-2) first, for investigation of insomnia and PLMS but with no suspicion of FFI and second, 120 days later with suspected but unconfirmed FFI at the time; 89 days prior to death. PSG metrics; absolute EEG power in specified frequency bands; EEG slowing ratio of slow-to-fast frequencies ((delta + theta)/ (alpha + sigma + beta)); and sleep spindle density were calculated. Results were compared with gender and age-matched insomnia and healthy controls (two of each).

Results
FFI-1 and FFI-2 PSGs revealed total time in bed of 413.5 and 392 minutes, total sleep times of 208.5 and 7.5 minute, including NREM 153.0 and 2.5 minutes, and REM 55.5 and 5.0 minutes, respectively. FFI-1 had approximately 1.5 times lower slow wave activity (SWA, 0.5–4.5Hz) during N3 than insomnia and controls.​ FFI-1 had 2 times and 1.8 times higher slowing ratio during REM than insomnia and controls, respectively. Spindle density (per minute of NREM sleep) for FFI-1 was 0.9, compared to pair-averages of 1.2 for insomnia disorder and 4.7 for healthy controls.

Conclusions
PSG in FFI revealed poor sleep efficiency that severely deteriorated with disease progression. Quantitative analysis of EEG revealed lower spindle density, lower SWA in N3, and higher slowing ratio in REM, when compared to insomnia patients and healthy sleepers.
P033 Randomised controlled trial on the efficacy of Audio-visual Health Educational materials on CPAP ADherence: The AHEAD trial
Authors: Ellender C , Samaranayake C , Duce B , Boyde M , Winter S , Hukins C 
Published: October 2021

Abstract

OSA is a prevalent chronic disease with significant health implications, for which achieving &gt;4 hours/night on continuous positive airway pressure (CPAP) is essential for effective treatment. Educational videos to improve CPAP adherence are of interest as a low-cost intervention, however trials have shown mixed results. This study aimed to compare CPAP usage following standard of care education (SOCE), with the usage following the addition of educational videos, customised to incorporate low health literacy communication, motivational and self-efficacy techniques.

Methods
Adults with OSA recommended treatment with CPAP, were recruited and randomised in a single blinded method, to watch short educational videos following their in laboratory CPAP study or SOCE. The primary outcome was CPAP usage at 2mths and secondary outcomes were usage at 12mth and proportion of patients with adequate usage &gt;4hrs/night.

Results
195 patients met the eligibility criteria and were randomised to video education (n = 96) or to SOCE (n = 99). There was no significant difference in compliance at 2mths (median usage 1.7hrs IQR 0–6.2 SOCE, 4.4hrs IQR 0–6.7 video education p = 0.1), however at 12mths there was increased usage in the video education arm (median 0hrs IQR 0–5.4 standard of care, 3.8hrs IQR 0–6.87 p = 0.05). The proportion with adequate CPAP usage &gt;4hrs/night at 12mths was higher in the video education group (33, 33% versus 48, 50% p = 0.01).

Conclusions
Long-term adherence to CPAP is enhanced by the addition of educational videos that incorporate low health literacy communication and motivational techniques, compared to SOCE.
P035 Is the Grael oximetry averaging time interchangeable with a Masimo pulse oximeter algorithm in polysomnography?
Authors: Eritaia J , Suthers B 
Published: October 2021

Abstract
Compumedics recording software (Grael V2) for polysomnography (PSG) calculates SpO2 values using a 3-heartbeat long averaging window. This is derived from the ECG and thus introduces variability in the averaging time that is dependent on the heart rate. Little is known about the effect this has on the common oximetry metrics used in PSG interpretation. This study explorer the interchangeability of the Grael V2 inbuilt 3-beat averaging algorithm with a short averaging window of 2 - 4 seconds using a Masimo Radical 7 pulse oximeter during a PSG.
SpO2 data were collected from 2 oximeter probes (Grael and Radical 7) both attached to a patient’s fingers. After SpO2 artifacts were removed, the following SpO2 parameters from each oximeter were generated: mean sleep SpO2, oxygen desaturation index (ODI) using 2%, 3% and 4% drop in SpO2 in sleep, total sleep time (TST) with SpO2 &lt; 90% and &lt; 80% as well as time spent &lt; SpO2 88% in minutes. 88 sleep studies were included in the data collection.
For ODI2%, 3% and 4%, bias (95% limits of agreement) values were -0.75 events/hr (9.99 to -11.49 events/hr), -0.74 events/hr (10.00 - -11.49 events/hr) and -0.20 events/hr (8.45 - -8.86 events/hr) respectively. There was no significant difference between measurements except for the mean sleep SpO2 values, p &lt; .001.
Although no bias found between measurements, there was poor agreement between the algorithms as demonstrated by the wide 95% limits of agreement suggesting that the two oximeter devices are not interchangeable.
P036 Trajectories of emotional and behavioural problems in Aboriginal and Torres Strait Islander children: Role of sleep and cultural attachment
Authors: Fatima Y , Bucks R , King S , Solomon S , Skinner T 
Published: October 2021

Abstract

Purpose
This study explored the link between sleep and emotional and behavioural problems and assessed whether cultural attachment reduces the risk of emotional and behavioural problems in Aboriginal and Torres Strait Islander (Indigenous) children.

Methods
The data from wave 5 to wave 10 of the Footprints in Time cohort were used. Multi-trajectory modelling was used to identify sleep trajectories using weekday sleep duration, weekday bedtimes, wake times, and sleep problems (waves 5, 7 & 10). Trajectories of emotional and behavioural problems were derived from the Strengths and Difficulties Questionnaire (SDQ) data (waves 6, 8 & 10). Cultural attachment assessment included the knowledge of Indigenous language, clan, people, family stories/history and other cultural practice. Multivariable logistic regression models were used to assess the link between sleep and emotional and behavioural problems.

Results
Analysis of sleep data from 1270 Indigenous children (50.6% females, mean age 6.3 years (±1.5)) identified four distinct trajectories: early sleepers/early risers (19.3%); early/long sleepers (22.1%), normative sleepers (47.8%), and late sleepers (10.8%). Three emotional and behavioural problem trajectories emerged: low stable (49.1%), high decreasing (40.5%), and high stable (10.4%). Early sleepers//early risers (OR: 0.48, 95% CI: 0.28–0.82) and children with strong cultural attachment (OR: 0.47, 95% CI: 0.27–0.82) had lower odds of being in the high emotional and behavioural problem trajectory group.

Conclusions
Early bedtime in children may reduce the risk of future emotional and behavioural problems. The protective effect of cultural attachment further highlights the need for strengths-based approaches to reduce mental health issues in Indigenous children.
P039 Interventions used to increase sleep duration in young people: A systematic review
Authors: Gadam S , Pattinson C , Soleimanloo S , Rossa K , Moore J , Begum T , Srinivasan A , Smith S 
Published: October 2021

Abstract

Introduction
Habitual short sleep duration affects a substantial proportion of young people, which is problematic due to its association with various adverse consequences. The aim of this systematic review was to identify the effectiveness of current interventions to increase sleep duration in healthy young people (14–25 years).

Methods
A systematic literature search, following PRISMA guidelines was conducted across multiple databases including PubMed, Ovid MEDLINE, CENTRAL, Embase, CINAHL (via EBSCOhost), PsycINFO, Scopus, Web of Science, ProQuest Dissertations and Theses, and Trove. Eligible studies were required to report sleep duration before and after exposure to the intervention, published from 2005 onwards, and participants 14–25 years of age. The Newcastle-Ottawa scale and Cochrane Risk of Bias were used to evaluate quality of studies.

Results
2695 citation were screened, and 29 studies met the eligibility criteria for this review. The included studies implemented differing methodologies, including behavioural (48.3%), educational (24.1%), and combination (24.1%) of behavioural, educational and other methods, such as mindfulness, light therapy, and naturalistic observation (3.4%). Initial findings indicate that educational interventions on their own are not effective at increasing sleep duration as behavioural or combination of both.

Discussion
These results indicate that behavioural interventions which prescribe new sleep schedules show positive treatment effects on sleep duration. Hence, provide promise for mitigating sleep difficulties and improving health in young people aged 14–25 years.
P045 A prospective review of sleep quality in hospitalised respiratory inpatients
Authors: Guo H , O’Driscoll D , Ogeil R , Tse W , Young A 
Published: October 2021

Abstract

Background and Aim
Sleep is an active and restorative state that is vital for maintaining optimal physical and mental health. Hospitalised patients are particularly at risk of poor sleep. We aim to review the sleep quality of respiratory inpatients at a tertiary hospital and to identify modifiable barriers to sleeping well in hospital environments.

Methods
Prospective data were collected from respiratory ward patients at time of discharge by completion of a medical records review and a Sleep Questionnaire created by Working Group Sleep Health Foundation, including patient rating of sleep quality (very poor, poor, fair, good, very good) and sleep disrupting factors. These data were stratified by pertinent environmental, patient and clinical care factors.

Results
Data from 6 patients were analysed; median age was 65 years, 3 (50%) were male and median length of hospital stay was 5 days. Four (67%) patients used sedating medications, 1 (17%) used this for treatment of insomnia. Two (33%) of patients characterised their sleep quality as poor or very poor and 3 (50%) patients described their sleep in hospital as slightly worse or much worse than sleeping at home. The main contributing factors to poor sleep quality were noise, checking of vital signs by hospital staff, medical treatments and medical condition relating to admission (eg. pain, dysnpea). Data collection is ongoing.

Conclusion
A significant proportion of patients experienced poorer sleep quality as a result of their hospital admission, attributable to both extrinsic factors (noise and clinical care) and underlying medical conditions.
P055 Mechanisms Underlying Sleep Disturbance in Young People with Borderline Personality Disorder Features
Authors: Jenkins C , Thompson K , Nicholas C , Chanen A 
Published: October 2021

Abstract

Introduction
Sleep problems are common in young people (aged 15–25 years) with features of borderline personality disorder (BPD). Yet the mechanisms underlying this relationship remain largely unknown. This study explored the indirect roles of emotion regulation difficulties, depression, anxiety and stress in the relationship between BPD features and sleep disturbance in young people.

Method
Sleep was measured subjectively (self-report) and objectively (10 days wrist actigraphy) in 40 young people with BPD features (36 females, Mage = 19.77, SD = 2.51) and 38 healthy young people (34 females, Mage = 20.06, SD = 2.52). Participants also completed the Difficulties in Emotion Regulation Scale and the Depression, Anxiety and Stress Scale.

Results
Mediation analyses revealed that impulse control difficulties, limited access to emotion regulation strategies, and anxiety played an indirect role in subjective sleep disturbances in young people with BPD features. Lack of emotional awareness and anxiety indirectly contributed to associations between BPD features and objectively longer time in bed and bedtime variability, respectively.

Discussion
Targeting impulse control difficulties, emotion regulation strategies and anxiety through improving impulse control, improving emotion regulation skills and reducing pre-sleep arousal might be beneficial for improving subjective sleep in this population. Similarly, improving emotional awareness and reducing anxiety might help to normalise objective sleep patterns. Overall, these findings help to guide the development of targeted sleep-improvement strategies that might serve as useful adjuncts to current interventions for young people with BPD features.
P062 Sleep parameter validation of a home-based ballistocardiograph sleep tracker
Authors: Kholghi M , Szollosi I , Hollamby M , Bradford D , Zhang Q 
Published: October 2021

Abstract

Introduction
Consumer home sleep trackers are gaining popularity for objective sleep monitoring. Amongst them, non-wearable devices have little disruption in daily routine and need little maintenance. However, the validity of their sleep outcomes needs further investigation. In this study, the accuracy of the sleep outcomes of EMFIT Quantified Sleep (QS), an unobtrusive and non-wearable ballistocardiograph sleep tracker, was evaluated by comparing it with polysomnography (PSG).

Methods
62 sleep lab patients underwent a single clinical PSG and their sleep measures were simultaneously collected through PSG and EMFIT QS. Total Sleep Time (TST), Wake After Sleep Onset (WASO), Sleep Onset Latency (SOL) and average Heart Rate (HR) were compared using paired t-tests and agreement analysed using Bland-Altman plots.

Results
EMFIT QS data loss occurred in 47% of participants. In the remaining 33 participants (15 females, with mean age of 53.7±16.5), EMFIT QS overestimated TST by 177.5±119.4 minutes (p&lt;0.001) and underestimated WASO by 44.74±68.81 minutes (p&lt;0.001). It accurately measured average resting HR and was able to distinguish SOL with some accuracy. However, the agreement between EMFIT QS and PSG on sleep-wake detection was very low (kappa=0.13, p&lt;0.001).

Discussion
A consensus between PSG and EMFIT QS was found in SOL and average HR. There was a significant discrepancy and lack of consensus between the two devices in other sleep outcomes. These findings indicate that while EMFIT QS is not a credible alternative to PSG for sleep monitoring in clinical and research settings, consumers may find some benefit from longitudinal monitoring of SOL and HR.