bluuebunny/crossref_metadata_2025_split huggingface dataset:
313 Sleep Obtained by Cabin Crewmembers During a Long-haul Flight
Authors: Arsintescu Lucia , Hilditch Cassie , Glaros Zachary , Kato Kenji , Gregory Kevin , Evans Erin 
Published: May 2021

Abstract

Introduction
Sleep loss and circadian disruption pose a significant risk in safety-sensitive occupations. In aviation, many studies have demonstrated how inflight rest locations influence alertness and performance among pilots, but few studies have evaluated cabin crew. The purpose of the present study was to evaluate sleep outcomes among cabin crewmembers sleeping in a bunk compared to a jump seat during one long-haul route.

Methods
Thirty-one (6 male) cabin crewmembers (age M = 30, SD = +/-13) flew the same long-haul route (outbound and return) with a flight duration of 10:41 (± 0:14) hours. Participants were randomly assigned to fly on an aircraft with a bunk or a jump seat for their sleep opportunity. Participants wore an Actiwatch (Phillips-Respironics Spectrum) throughout the entire study and completed a sleep diary at bedtime and upon waking. During flight they completed a nap diary entering the start time of the inflight sleep (if any) and the duration.

Results
Sixty-five flights (32 outbound and 33 return) were included in the analyses. Seventy-seven percent of the flights had a bunk and 23% had a jump seat. Crewmembers obtained M = 146.46 (± 67.20) minutes of rest out of which they slept M = 125.33 (± 64.91) minutes in the bunk. While using the jump seat, crewmembers obtained M = 169.53 (± 133.30) minutes of rest out of which they slept M = 142.92 (± 149.72) minutes. When crewmembers slept in the bunk, sleep latency was shorter (M = 13.69 ± 12.64 minutes) and efficiency was better (M = 76.16 ± 16.09 %) compared to the jump seat (sleep onset: M = 16.77 ± 13.89 minutes; sleep efficiency: M = 60.64 ± 17.42 %).

Conclusion
We found that cabin crewmembers slept for longer time when they used the jump seat. They fell asleep faster and their sleep efficiency was better when using the bunk compared to the jump seat. Further research is needed to understand how sleep quality and subsequent performance are influenced by sleep opportunity in a bunk compared to a jump seat.

Support (if any)
NASA Airspace Operations and Safety Program, System-Wide Safety Project.
315 Athlete Sleep and Mental Health: Differences by Gender, Race, and Ethnicity
Authors: Huskey Alisa , Kim Kelly , Emert Sarah , Auerbach Alex , Webb Rachel , Skog Michelle , Grandner Michael , Taylor Daniel 
Published: May 2021

Abstract

Introduction
Sleep is important for athletic and academic performance, injury risk and recovery, and physical and mental health. However, athletes commonly have poor and insufficient sleep, which may be worsened by their inflexible schedules, stress, traveling, and timing of competition. To date, little is known about the relationship between sleep problems and risk for mental health problems in college student athletes. Almost nothing is known about gender, racial and ethnic sleep disparities in this group. The current study aimed to examine the cross-sectional relationships between sleep disorder symptoms and mental health symptoms, further examining differences by gender, race, and ethnicity.

Methods
Student athletes (N = 1033) from four universities within the Pacific Athletic Conference (PAC-12) were surveyed using previously-validated mental health questionnaires. Since few individuals self-identified as Asian, American Indian/Alaskan Native, Native Hawaiian/Pacific Islander, or “Other,” the race variable was recoded into three groups: White, Black, and Other Underrepresented groups. Gender, race, and ethnicity differences on Athlete Sleep Screening Questionnaire (ASSQ) total scores were examined using a three separate MANOVAs. Next, sleep-disorder symptoms were classified as clinically relevant (n=174) or not (n=733) based on established cutoff values on the ASSQ. Gender and sleep disorder differences on mental health total scores were examined using a MANOVA.

Results
Women athletes reported significantly worse sleep disorder symptoms as a whole. In addition, Black athletes had worse sleep disorder symptoms. There was a trend for women with sleep problems to have higher PC-PTSD scores than women without sleep problems. In addition, athletes in the Other Underrepresented race group with sleep problems also had greater depression, PTSD, and psychotic symptom severity than White or Black student athletes. There was also a trend for Hispanic athletes with sleep disorder symptoms to have greater ADHD symptom severity.

Conclusion
To further examine individual differences in specific components of sleep symptoms, sleep duration, insomnia symptoms, medication, quality will be reported in the poster presentation. Future studies are needed to understand whether frequency and chronicity of athletic and external stressors, explain elevations in sleep and other psychiatrics symptoms in student athletes.

Support (if any)
This project was funded by a PAC-12, Mental Health Coordinating Unit Grant.
316 Comorbidities among medically diagnosed insomnia patients: A MarketScan database study
Authors: Zhong Wenjun , Liu Xinyue , Mott Katrina , Qureshi Zaina 
Published: May 2021

Abstract

Introduction
A large proportion of patients with insomnia frequently suffer from comorbid medical conditions. Literature on the relationship between insomnia and associated comorbidities is severely limited due to challenges of generalizability, focus on a specific comorbidity and concerns of information biases. We conducted a comprehensive secondary database analysis to describe comorbidities among medically diagnosed insomnia patients.

Methods
All patients in the MarketScan database in 2018 with a full year of enrollment were included. Insomnia patients were identified using ICD-10-CM diagnosis codes (at least 2 outpatient claims or 1 inpatient claim of insomnia in 2018), along with their comorbidities recorded in that year. The frequencies of comorbidities among patients with insomnia were estimated. For comorbidities with prevalence &gt; 1%, we further grouped them when appropriate to reduce the number of comorbidities.

Results
Among 20,209,292 enrollees, 259,035 (1.3%) had insomnia in 2018. Patients with insomnia had a median of 2 (IQR: 1–3) insomnia claims. The mean age of these insomnia patients was 49.3 years (std: 15.7), most of them were female (62.5%). About 172 comorbidities with &gt;1% were found in this patient population, and 35 comorbidities had a frequency greater than 10%. The common comorbidities among these insomnia patients included 1): common physical disorders among middle aged and older adults: hyperlipidemia (39%), hypertension (39%), skin diseases (37%), back pain 35%; 2):common mental health disorders such as anxiety disorder (41%), depression (28%); and 3): other diseases such as GERD and thyroid diseases also had high frequencies among insomnia patients (18% and 18.7%, respectively).

Conclusion
Using claims data, we provided a quantitative assessment of comorbidities among patients with medically diagnosed insomnia. These results could help clinicians become aware of the most frequently occurring comorbidities and assist in integrating management of the insomnia.
Support (if any):
319 Validation of the Insomnia Severity Index Short-Form for Identifying Insomnia Disorder in Young Adult Cancer Survivors
Authors: Chevalier Lydia , Michaud Alexis , Zhou Eric , Chang Grace , Recklitis Christopher 
Published: May 2021

Abstract

Introduction
Insomnia is a common and impairing late effect experienced by many young adult cancer survivors (YACS). Although routine evaluation of sleep disorders in cancer survivors is recommended, lack of consensus on appropriate screening measures contributes to under-identification and under-treatment of these disorders in YACS. As screening measures are ideally as brief as possible while maintaining validity, we sought to validate the recently published three-item Insomnia Severity Index Short-Form (ISI-SF) in YACS.

Methods
250 YACS completed the ISI and the Structured Clinical Interview for the DSM-5 (SCID-5). The ISI-SF was created by summing three ISI items: distress (item #6), interference (item #7), and satisfaction (item #4). In receiver operating characteristic (ROC) analyses, area under the curve (AUC) was calculated to compare discrimination on the ISI-SF to two criteria: the full-scale ISI using a cutoff of ≥8 recently validated in this sample, and the SCID-5 insomnia module. Consistent with previous research, we specified a priori that a cut-off score on the ISI-SF with sensitivity ≥.85 and specificity ≥.75 would be acceptable.

Results
The ISI-SF had excellent discrimination when compared to the full-scale ISI (AUC = .97) and a cut-off score of ≥4 met criteria with a sensitivity of 97% and specificity of 86%. The ISI-SF had good discrimination when compared to the SCID-5 (AUC = .88), but none of the cut-off scores met a priori criteria for sensitivity and specificity. A cut-off score of ≥4 came closest with a sensitivity of 94% and specificity of 70%.

Conclusion
Although the ISI-SF did not meet sensitivity and specificity criteria for a stand-alone screening measure when compared to a diagnostic interview, it demonstrated utility as the first step in a two-step screening procedure. Specifically, the high sensitivity of the ≥4 ISI-F cut-off score is well-suited to accurately screening out YACS who do not need insomnia services; as a second screen, the SCID-5 insomnia module could be administered only to those elevated on the ISI-SF in order to identify false positives cases before making referrals for insomnia specialists.

Support (if any)
National Cancer Institute (1R21CA223832), Swim Across America
322 Comparisons of clinical and polysomnographic characteristics between negative and positive sleep state misperception in insomnia
Authors: Yoon Gahui , Lee Mi Hyun , Oh Seong Min , Choi Jae-won , Lee Yu Jin 
Published: May 2021

Abstract

Introduction
Most of insomnia patients tend to underestimate their sleep duration and quality. In current study, we classified insomnia patients into negative sleep state misperception (NSSM) group and positive sleep state misperception (PSSM) group according to difference between subjective and objective sleep duration. We compared clinical and polysomnographic characteristics between two groups.

Methods
Objective sleep measures using nocturnal polysomnography (nPSG) and subjective measures including Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI) and subjective questionnaire at the morning after overnight nPSG of 150 insomnia patients were reviewed. The questionnaire included subjective total sleep time (subjective TST), subjective sleep latency (subjective SL). Additionally, TST/SL discrepancy was calculated by subtracting objective variables of nPSG from the morning subjective questionnaire. We calculated misperception index (MI) using the following method; MI=(objective TST-subjective TST)/objective TST. According to MI value, insomnia patients were classified into NSSM (MI&gt;0, n=115), and PSSM (MI&lt;0, n=35) groups.

Results
There were no significant differences in nPSG parameters, except N3 sleep (%); the PSSM group had significantly higher N3 sleep than NSSM group (p=0.002). On the subjective measures, the NSSM group had significantly higher PSQI score (p&lt;0.001), longer subjective SL (p=0.001) and higher SL discrepancy (p=0.001). In the NSSM group, MI showed positive correlations with N1 sleep proportion (r=0.250, p=0.011), PSQI (r=0.250, p=0.011), BDI (r=0.211, p=0.032), subjective SL (r=0.441, p&lt;0.001) and SL discrepancy (r=0.453, p&lt;0.001). Meanwhile, there were no significant correlations of MI with subjective measures in PSSM group. In the multiple regression analysis, MI was related with SL discrepancy and BDI (R2=0.216, p=0.004) in NSSM group. For belonging the PSSM group, associated factors were N3 sleep (OR=1.075, p=0.001), PSQI (OR=0.813, p=0.002) and SL discrepancy (OR=0.956, p&lt;0.001) on binary logistic regression analysis.

Conclusion
In the NSSM group, MI was related with high SL discrepancy and depressive mood. High N3 sleep, low PSQI score, and low SL discrepancy were associated factors in the PSSM group. Perception of sleep should be properly evaluated and managed, since they vary with different characteristics of sleep state misperception.

Support (if any)
This study was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF-2018R1D1A1B07049704).
323 Is daytime napping a risk factor for persistent insomnia symptoms?
Authors: Pereira Rui , Hartescu Iuliana , Morgan Kevin , Jackson Robin , Ellis Jason , Morales Knashawn , Perlis Michael 
Published: May 2021

Abstract

Introduction
Napping, episodes of short daytime sleep separated from the main sleep period, can compensate for the detrimental effects of inadequate night-time sleep or, as ‘siestas’, may form an integral part of personal sleep-wake schedules. Napping may also precipitate or perpetuate insomnia symptoms through the erosion of homeostatic sleep pressure at night. Using longitudinal data, these analyses were designed to evaluate links between daytime napping styles and the incidence of persistent insomnia symptoms, in a sample of middle aged and older adult good sleepers at baseline.

Methods
567 participants (65% female; &gt;35 years old) were sub-sampled from the NITES cohort (Perlis et al, 2019). All were self-rated good sleepers, reporting typical sleep latencies (5 nights/week) and WASO durations of = 1 nap/baseline period) or habitual (&gt;= 2 naps/week). ‘Persistent insomnia symptoms’ cases reported sleep initiation and/or maintenance complaints on &gt;= 3 nights/week for at least two consecutive weeks. Relationships between nap categories and the incidence of persistent insomnia symptoms arising in months 4–12 of the study were assessed in logistic regression models adjusted for age, gender, employment status and depression. Risk is expressed as the odds ratio (OR) with 95% confidence interval (CI).

Results
Prevalence rates for ever/habitual napping were 57% and 10%. Unemployed status and aged 50+ significantly increased habitual nap probability. The 1-year incidence of persistent insomnia symptoms was 5.6%. In logistic regression models, ‘ever’ napping was associated with an almost 3-fold increase in the risk of developing persistent insomnia symptoms (OR=2.994; 95% CI 1.244–6.969; p=.014). When the logistic regression model was rerun with habitual napping, the risk attenuated substantially (OR = 1.4, 95% CI .592–3.163; p=.463).

Conclusion
These results suggest that napping patterns serve as a marker for insomnia symptom development, with haphazard non-habitual napping patterns associated with significantly greater risk.

Support (if any)
RP: Loughborough University doctoral studentship; MP: K24AG055602 & R01AG041783 (NITES).
325 Stress-Induced Physiological Profiles Among Different Phenotype Insomniacs
Authors: Huang Ya-Chuan , Lee Hsin-Chien , Yang Chien-Ming 
Published: May 2021

Abstract

Introduction
Stress reactivity and autonomic nervous system (ANS) dysregulation have been suggested to be the pathophysiology of insomnia. Based on the finding PSG-measured short sleep duration was associated with higher morbidity of metabolic and cardiovascular disease. Vgontzas and Fernandez-Mandoza (2013) proposed that objective sleep duration is a biomarker for insomnia phenotypes. The phenotype with short objective sleep duration is associated with increased stress-related physiological hyperarousal. The present study aims to test this hypothesis by comparing the stress-induced cardiovascular reactivity between insomnia patients with short and long objective sleep durations.

Methods
27 insomnia patients (age mean 34.48 ±12.87, Male: Female= 6:21) without comorbidity of psychiatric, medical or sleep disorders participated in this study. They went through one night of 8-hour PSG recording and were divided into two groups by their total sleep time with a cutoff of 6 hours. Nine participants were in short sleep duration group and 18 in longer sleep duration group. Psychophysiological reactivity profile, as recorded with EKG, skin conductance (SC), body temperature (BT), blood volume pulse (BVP), respiration rate (RR), was measured under three conditions: baseline resting state, arithmetic word problems solving, and recovery resting state.

Results
Both groups showed similar stress physiological response with increased heart rate (HR) and SC, nearly equivalent BT and BVP, and decreased RR when solving arithmetic problems, and opposite reaction during recovery resting state. Mann-Whitney U test comparing the changes from baseline resting state on all the psychophysiological measures between two phenotypes of insomnia showed no significant differences: stress-induced heart-rate (U=106, p=.119.) recovery heart-rate (U=44, p=.095), stress-induced skin conductance (U=104.5, p=.132),recovery skin conductance (U=51.5, p=.198), stress-induced body temperature (U=79, p=.897),recovery body temperature (U=60.5, p=.418), stress-induced blood volume pulse amplitude (U=77, p=1.0), and recovery blood volume pulse amplitude (U=69, p=.735), stress-induced respiration rate (U=76, p =.696), and recovery respiration rate (U=85, p=.658).

Conclusion
Our results indicate that the insomnia phenotypes with short and long objective sleep duration are not different in their stress-induced physiological responses. Future studies are needed to confirm these results and to explore other mechanisms for the increased metabolic and cardiovascular disease risk in insomnia patients with short objective sleep duration.
Support (if any):
329 High Prevalence of Sleep Difficulties and Low Rate of Seeking Professional Help in Polish Population
Authors: Gustavsson Katarzyna , Wichniak Adam 
Published: May 2021

Abstract

Introduction
The number of people suffering from sleep disorders is on the rise. Insomnia is a complex issue with an impact on numerous aspects on everyday functioning. At the same time it is highly dependent on an individual’s lifestyle and untreated episodic sleep issues may lead to chronić insomnia. The aim of the present study was to assess complaints regarding sleep difficulties among men and women in Poland, as well as their severity and whether it leads to seeking treatment.

Methods
Data was gathered as a part of an online-based nationwide campaign on insomnia, which included a survey assessing sleep quality. The survey was developed for the purpose of this study. Statistical analysis included Chi-Square and Mann-Whitney tests as well as Spearman’s correlations.

Results
Responses were obtained from 3807 individuals – 2616 (68.7%) women and 1191 (31.3%) men. Sleep issues with the highest prevalence were sleep maintenance difficulties reported by 62.8% of the respondents, snoring among 61.2%, sleep initiation difficulties (sleep latency of over 30 minutes) among 55.6%, daytime sleepiness among 49.5%, and symptoms of Restless Leg Syndrome among 45.1%. Out of the participants who reported at least one sleep issue, the rate of having been to a professional consultation was 20.8% - 22.8% among women and 16.4% among men.

Conclusion
Even though the prevalence of different sleep troubles was very high, it did not correspond to the rate of seeking professional help. The vast majority of both men and women who experienced sleep difficulties had never consulted with a specialist regarding their sleep quality. There is a great need for psychoeducation of the general public on sleep as a vital component of health and on benefits of professional help.

Support (if any)
This study was supported by an unrestricted educational grant by Polfarmex. The funding source had no role in the design and conduct of the study, collection, management and analysis of the data, or preparation of the abstract. The authors declare no other conflicts of interest.
331 Adverse Childhood Experience and Sleep Quality in Adulthood
Authors: Bakour Chighaf , Desch Jill , Mansuri Fahad , Schwartz Skai W 
Published: May 2021

Abstract

Introduction
Poor sleep quality, a risk factor for many negative health outcomes, may result from physical or emotional disturbance including chronic stress. Adverse childhood experiences (ACEs) have been linked with chronic stress, and may therefore be associated with poor sleep quality in adulthood. This study examines the longitudinal association between specific ACEs and the number of ACEs and sleep quality in adulthood.

Methods
Using data from the National Longitudinal Study of Adolescent to Adult Health, we examined the association between ACEs and trouble falling asleep or staying asleep (rarely or never, sometimes, frequently) in waves 1 (age 12–18), 4 (age 24–32), and 5 (age 33–43). We examined ten ACEs (physical, sexual, or emotional abuse; neglect; parental death, incarceration, alcoholism, divorce or separation; foster home placement; poverty; and exposure to community violence) and the number of ACEs (0, 1, 2–3, 4+), using weighted logistic regression to calculate odds ratios and confidence intervals for each of the ACEs and ACE score and each of the outcomes after adjusting for relevant confounders.

Results
The analysis included 12,768 participants, 75.3% of whom experienced at least one ACE, including 14.7% who experienced 4 or more. Physical and emotional abuse were associated with frequent sleep complaints at waves 1, 4, and 5. Sexual abuse, neglect and community violence were associated with frequent complaints in two waves, while parental alcoholism, parental incarceration, and foster home placement were associated with frequent complaints in one wave. The number of ACEs experienced showed a dose-response association with frequent sleep complaints in wave 1 ([1 ACE: aOR=2.12 (1.16, 3.9), 2–3 ACEs: aOR=2.86 (1.70, 4.82), 4+ ACEs: aOR=4.17 (2.33, 7.48)], wave 4 [1 ACE: aOR=1.02 (0.77, 1.36); 2–3 ACEs: aOR= 1.66 (1.30, 2.10); 4+ ACEs: aOR=2.68 (1.99, 3.61) and in wave 5 [1 ACE: aOR=1.22 (0.93, 1.60)), 2–3 ACEs: aOR=1.42 (1.11, 1.81), 4+ ACEs: aOR=1.88 (1.40, 2.53)]

Conclusion
Certain adverse childhood experiences such as physical, sexual, and emotional abuse and neglect have a lasting impact on sleep quality in adulthood, highlighting the need to mitigate their impact to prevent negative health outcomes associated with poor sleep quality
Support (if any):