bluuebunny/crossref_metadata_2025_split huggingface dataset:
O019 Mobile phone use at night, cyber-bullying, sleep, and mental wellbeing in young people aged 7 to 19 years
Authors: Lushington K , Dorrian J , Centofanti S , Wicking A , Wicking P 
Published: October 2021

Abstract

Introduction
Children commonly have access to mobile devices that allow them to send and receive texts at night when they should be sleeping. This may contribute to an increase in cyber-bullying and sleep problems, with negative effects on mental wellbeing.

Methods
Young children (7-11y, n = 22,597), early adolescents (12-14y, n = 19,470) and late adolescents (15-19y, n = 14,156) completed a survey examining mental wellbeing and the frequency of obtaining 8h sleep, texting at night and cyber-bullying.. Generalised structural equation modelling was used to investigate the effects of texting at night on mental wellbeing, directly, and indirectly via effects on sleep. Cyber-bullying was also specified as a moderator of the effect of texting at night on sleep.

Results
Text messaging at night in the last week was reported by 51% and cyber-bullied in the last school term by 15% of children. For all children, obtaining at least 8h of sleep increased the odds of better mental wellbeing, Conversely, texting messaging and cyber-bullied reduced the odds of obtaining 8h sleep in both male and female young children and female early and late adolescents. In all cohorts except late adolescent males, obtaining less than 8h sleep and cyber-bullied accounted for a large proportion of the effects of text messaging on mental wellbeing.

Conclusion
Mobile phone use at night impairs sleep which contributes to poor mental wellbeing. The effect on sleep is exacerbated by cyber-bullying. Strategies to discourage small screen use at night, promote adequate sleep and reduce cyber-bullying are needed.
O023 Impact of weight loss of OSA pathophysiology
Authors: Wong A , Landry S , Yang K , Joosten S , Thomson L , Mansfield D , Sands S , Patel S , Cistulli P , Sutherland K , Hamilton G , Edwards B 
Published: October 2021

Abstract

Introduction
Obesity is a major risk factor for developing obstructive sleep apnoea (OSA), however, the underlying mechanisms are not fully understood. We aimed to assess the impact of weight loss on all OSA endotypes (i.e. upper airway collapsibility, muscle compensation, respiratory arousal threshold, and loop gain).

Methods
We analysed data from 40 OSA patients (collated from 3 centres) who underwent bariatric surgery. Demographics and clinical polysomnograms (PSG) were performed at baseline and at between 6–18 months post-surgery. OSA endotypes were measured during sleep using non-invasive endotyping methods (derived from clinical PSG).

Results
Participants lost 28±14 kg and had a post-surgery reduction in the AHI of 19.6 (Interquartile range[IQR] -9.8 to -35.4) events/hr [from baseline 39.9 (24.3 to 65.6) events/hr to 17.0 (9.9 to 33.3) events/hr]. Following surgical weight loss, there was significant improvement in collapsibility (∆6.2 [IQR -1.4 to 13]%Veupnoea, p&lt;0.0001), as well as significant reduction in loop gain and arousal threshold (∆-0.06 [-0.17 to 0.009], p&lt;0.001 and ∆-13.7 [-24.8 to -1.8]%Veupnoea, p&lt;0.001 respectively). There was no significant change in muscle compensation.

Conclusion
Our findings suggest that weight loss improves upper airway collapsibility and reduces loop gain and the arousal threshold, providing novel insights about the mechanisms by which obesity causes OSA. Further analysis is underway to determine whether knowledge of the baseline OSA endotypes (in isolation and/or in combination) can predict which individuals will have a response to weight loss alone.
O027 The combination of mandibular advancement devices (MAD) and supplemental oxygen dramatically improves OSA severity: preliminary results from the MADOX trial
Authors: Edwards B , Vena D , Thomson L , Gikas A , Radmand R , Calianese N , Hess L , Landry S , Joosten S , Hamilton G , Wellman A , Sands S 
Published: October 2021

Abstract

Introduction
Patients with obstructive sleep apnoea (OSA) considered ‘non-responders’ to mandibular advancement device (MAD) therapy, typically have a high loop gain contributing to their OSA physiology. While MAD does not improve loop gain, other treatments such as supplemental oxygen can have a strong effect on this pathogenic trait. Therefore, we conducted a randomised controlled trial (RCT) to determine whether the administration of supplemental oxygen in combination with a MAD, was associated with greater improvements in OSA severity compared to MAD therapy alone.

Methods
Patients recently diagnosed with OSA underwent an initial screening sleep study to confirm the presence of moderate-severe OSA (Apnoea-hypopnoea index [AHI]&gt;20events/hr). Eligible patients were then enrolled in a randomised single-blind cross-over trial involving 4 sleep studies with the following treatments; MAD, oxygen (4L/min), MAD+oxygen and room-air/sham (control). The primary outcome was the reduction in AHI (%baseline).

Results
Of the 57 participants screened, 35 met the eligibility criteria (Baseline/Screening AHI = 52±22 events/hr). Compared to the sham night, all treatments significantly reduced the AHI; a 35% [CI: 18–48] was seen with oxygen (p&lt;0.0002), a 53% [CI: 40–64] was seen with MAD (p&lt;0.0001) and a 67% [CI: 56–76] was seen with MAD+oxygen (p&lt;0.0001). Importantly, the combination of MAD+oxygen was associated with a significant reduction in AHI relative to MAD alone (15% [CI:4–24] p=0.01).

Discussion
In a population with moderate-severe OSA, preliminary analyses from this trial suggests that the addition of supplemental oxygen in combination with MAD therapy provided greater reductions in OSA severity than either treatment alone.
O040 Sleep restriction impairs the ability to integrate multiple pieces of information into a decision
Authors: Drummond S , Lim J , Boardman J , Anderson C , Dickinson D 
Published: October 2021

Abstract

Introduction
Sleep deprivation impacts overall decision-making, though the impact on specific components of decision-making are less well studied, especially outside of total sleep deprivation. Here, we examine the effects of sleep restriction on the ability to integrate multiple pieces of information into a decision.

Methods
Healthy adults (n=41; age=27.9±6.0 years, 20F) lived in the sleep lab for 2 counterbalanced conditions: well-rested (WR: 9-hour sleep opportunity for 4 nights) and sleep restriction (SR: one 9-hour night, followed by three 3-hour nights). Following the last night of each condition, participants performed the decision task. Across 48 trials, participants first saw two containers, with different numbers of black and white balls. Eight balls were randomly drawn, with replacement, from one unknown container. Participants decided which container was used, based on the “odds” each container was used and draw results (“evidence”). Mathematical modelling determined the amount of weight given to odds/evidence. The “best” decisions integrate both pieces of information.

Results
When WR, participants utilised both pieces of information to make their decisions, though odds were given slightly more weight. During SR, the amount of weight given to the odds did not change, and the weight given to the evidence decreased significantly.

Conclusion
SR impaired the ability to integrate multiple pieces of information into a decision. Instead, participants focused on a single piece of easy-to-understand information and did not fully utilise a harder-to-understand piece of information. This has implications for complex applied environments where individuals have large amounts of information with which to make decisions.
O049 Sleep quality and its impact on children with primary ciliary dyskinesia
Authors: Ewert I , Robinson P , Adams A , Vandeleur M 
Published: October 2021

Abstract

Background
PCD is a rare, progressive disease resulting in upper respiratory manifestations and abnormal lung mechanics that increase one’s risk of obstructive sleep apnoea. This study aims to characterise the sleep quality of children with PCD and its impacts on mood and HRQOL.

Methods
Children with PCD aged 0–19 years with stable respiratory symptoms were recruited. Subjective sleep quality was assessed by the Sleep Disturbance Scale for Children (SDSC), OSA-18, and Paediatric Daytime Sleepiness Scale (PDSS). Mood and depressive symptoms were assessed via QOL-PCD and Children’s Depressive Inventory (CDI) as age-appropriate. Pulmonary function testing was performed via spirometry and Multiple Breath Washout. Patients underwent an ENT assessment. All children completed one night of polysomnography including transcutaneous CO2 and video monitoring.
Progress to date: Twenty participants (45% female) have been recruited with a mean age of 8.5 years. Mean (±SD) FEV1 is 76.5±22.9%. 73% of children assessed have chronic rhinosinusitis. Clinically significant scores for SDSC were observed in 79% of patients and in 30% of patients for OSA-18. 38% of children reported clinically significant scores for PDSS. To date, 7 children have completed polysomnography.
Intended outcome and impact: This is the first study to characterise sleep quality and the impact of sleep disturbance in Australian children with PCD. We aim to identify clinical markers of poor sleep quality to better inform the development of a sleep screening program for use in paediatric PCD clinics.
O050 Hypersomnolence in children: the diagnostic dilemma
Authors: Anantharajah A , Nixon G , Davey M 
Published: October 2021

Abstract

Background
Excessive daytime sleepiness (EDS) is reported to affect up to 20% of pre-pubertal children and 50% of adolescents. EDS can be due narcolepsy and idiopathic hypersomnolence (IH). Currently diagnosis is by a multiple sleep latency test (MSLT) with protocols adapted from adults. The aim of this study was to describe the results of MSLTs in a paediatric population and assess whether a 5th nap altered diagnosis.

Methods
Retrospective analysis of 253 MSLTs at a single tertiary paediatric centre from May 2004 – Jan 2021 with consent obtained in 214 patients. Narcolepsy defined as a mean sleep latency (MSL) &lt;8min with ≥2 sleep onset REM (SOREM). IH defined as a MSL &lt; 8 minutes with &lt;2 SOREMs. Results outside these parameters were grouped as hypersomnolence not otherwise specified (HNOS), with ambiguous HNOS defined as MSL 8–12 minutes or ≥2 SOREM.

Progress to date
There were 108 (50%) females, 132 (62%) &gt;12 years old (range 3.3–19.4 years) and 17 patients had repeat studies. Narcolepsy was diagnosed in 48 (22%) and IH in 22 (10%). Criteria for ambiguous HNOS were met by 43 (20%) patients including 11 (5%) with MSL &gt;12 minutes with ≥2 SOREMs. A 5th nap was performed in 58 (27%) MSLTs which did not change the diagnosis. Obstructive sleep apnoea was diagnosed in 48 (22%) patients and 27 (13%) had elevated periodic limb movement index.

Intended outcome and impact
Applying current MLST criteria in children may significantly under-estimate diagnostic categories for paediatric EDS as evidenced by the ambiguous HNOS.
P003 The impact of forced wake from overnight polysomnography on multiple sleep latency test results
Authors: Amaranayake A , Frenkel S , Lyell P , Southcott A 
Published: October 2021

Abstract

Introduction
The multiple sleep latency test (MSLT) is used to diagnose disorders of hypersomnolence. Although internationally-recognised protocols do not stipulate whether patients should be woken from the preceding overnight polysomnography (PSG), many labs wake their patients for logistic reasons. This study analyses the impact on PSG and MSLT parameters of forced wake (FW) from the overnight PSG compared with unrestricted sleep (US).

Methods
400 consecutive patients (FW=200; US=200) undergoing PSG/MSLT were included and the following parameters were compared: Epworth Sleepiness Scale (ESS), Morningness-Eveningness Questionnaire score (MEQ), PSG total sleep time (TST), wake-up time from the PSG, overall MSLT sleep latency (MSL), individual nap latencies (SLNap 1–4), number of MSLT naps with sleep-onset REM periods (#SOREMP), and percentage of MSLTs with overall MSL&lt;8 minutes (%MSLT&lt;8).

Results
The 2 groups were well-matched for ESS and MEQ. The FW group had more males (49% vs 39%). When compared to FW, patients with US had longer TST (+38 minutes; p=&lt;0.0001), later wake-up time (+52 minutes; p&lt;0.0001), longer MSL (+1.9 minutes; p=0.0049), 50% fewer #SOREMP (p=0.0224), and 16% fewer %MSLT&lt;8 (p=0.0018). SLNap1 increased by 1.5 minutes (p=0.0623), SLNap2 increased by 2.0 minutes (p=0.0067), SLNap3 increased by 0.75minutes (p=0.0533) and SLNap4 increased by 2.5 minutes (p=0.0059).

Discussion
Allowing patients to have unrestricted sleep on the night prior to the MSLT resulted in significantly longer TST, longer sleep latencies during the MSLT, fewer SOREMP and fewer tests with MSL&lt;8 minutes. International protocols should stipulate unrestricted sleep on the PSG prior to the MSLT to improve diagnostic accuracy.
P006 Initiation of Continuous Positive Airway Pressure as an inpatient in Patients with Obesity Hypoventilation Syndrome admitted to General Medical Unit
Authors: Banjade S , Entesari-Tatafi D 
Published: October 2021

Abstract

Background
With higher rates of obesity in regional and rural Australian population, there will be higher rates of Obesity Hypoventilation Syndrome (OHS). The cornerstone of the treatment of OHS is Positive Airways Pressure. We studied the initiation of Continuous Positive Airways Pressure (CPAP) in an inpatient setting in patients with OHS in the regional population of Ballarat and subsequent impact on their hospital stay/readmission.

Methods
We performed a retrospective study of 22 patients with OHS during the 6-month study period (01/07/2021–31/12/2021) admitted into General Medical Unit at Ballarat Base Hospital.

Progress
Complete

Outcome/Impact
The mean age in the cohort was 60 with average weight of 139.5 kg. The mean pCO2 and pH were 68.1 and 7.33 respectively. CPAP was initiated in 9 of 22 patients (40.1%) with mean of 7.3 days. Mean days of oxygen use was 4.7 days with mean length of hospital stay 10 days. We did not find any statistical difference in length of hospital stay, ICU stay, supplemental oxygen use or readmission rates between CPAP and non-CPAP group. Subgroup analysis showed that CPAP group had higher rates of COPD (44.4% vs 30.8%) and diabetes (44.4% vs 30.8%) with trend to lower FEV1 (mean FEV1 47.6% vs 57.2%). There were 4 deaths (16.7%), 3 of them did not have CPAP initiated.
The longer duration to CPAP initiation is likely to explain the non-significant difference between the groups. Proactive measures to increase initiation of CPAP is likely to improve patient outcome in terms of their morbidity and mortality.
P008 A systematic review and meta-analysis of inflammatory bowel disease activity and sleep quality
Authors: Barnes A , Spizzo P , Mountifield R , Bampton P , Andrews J , Fraser R , Mukherjee S 
Published: October 2021

Abstract

Background
Poor sleep quality has been associated with active inflammatory bowel disease (IBD) in several studies. This review examines sleep quality in people with active IBD and in those in remission, with meta-analyses performed, considering subjective and objective sleep quality and IBD activity.

Methods
Electronic databases were searched from inception to December 1st 2020. A random effects model was used with separate meta-analyses performed for objective and subjective sleep and IBD activity, considering sleep quality in active and inactive IBD.

Results
19 studies were included in the qualitative review representing 4972 IBD patients. Subjective IBD activity (11 studies) was associated with subjective sleep quality with pooled odds ratio (OR) for subjective poor sleep in active IBD compared to remission of 3.04 (95% CI 2.41–3.83). Including only studies with objective sleep measures (5 studies), sleep efficiency was lower in those self-reporting active IBD and time awake post sleep onset was higher in those with active IBD. Objective IBD activity was associated with subjective poor sleep (4 studies), with pooled OR of 6.64 95% CI (3.02 – 14.59). Insufficient data was available to consider objective IBD activity and objective sleep quality.

Conclusion
IBD activity is associated with poor sleep using subjective and objective measures of sleep quality. This poor sleep manifests as decreased sleep efficiency and increased number of waking episodes post sleep onset. The relationship between objective IBD activity and sleep requires further investigation.
P013 A pilot study for ultrasound examination of the pterygomandibular raphe to predict efficacy of mandibular advancement splint therapy in obstructive sleep apnoea
Authors: Brereton C , Ferreira A , Juge L , Bilston L , Brown E 
Published: October 2021

Abstract

Background
A lack of predictive indicators for mandibular advancement splint (MAS) efficacy limits their use in the treatment of obstructive sleep apnoea (OSA). The absence of a tendinous pterygomandibular raphe (PMR) in the lateral nasopharynx on MRI may predict MAS efficacy, however MRI is time and resource intensive. We aimed to assess the feasibility of ultrasound in determining PMR absence compared to MRI.

Methods
10 healthy participants were recruited to undergo both MRI and ultrasound of the lateral airway. Surrounding anatomical landmarks were examined to establish the presence or absence of the PMR. These results will be compared to MRI to determine parameters on ultrasound which correlate to an absent PMR.

Progress to date
8 of the 10 participants have undergone both MRI and ultrasound, of which half were women, mean age 53 years, mean BMI 28 and mean AHI 3. In all 8 participants so far parameters for assessment of the PMR were identified and described, including presence of anatomical landmarks, localisation and width of the PMR space, and presence of a hyperechoic structure within the space. Comparison of these parameters with MRI to determine predictors of PMR presence or absence is currently underway.

Intended outcome and impact
Validation of ultrasound in the assessment for presence or absence of a tendinous PMR will enable further study of this structure as a predictive marker for MAS efficacy in OSA. This could assist clinicians in identifying suitable patients for MAS therapy.
P016 Daytime light exposure predicts better mood-, sleep- and circadian-related outcomes in &gt;8,000 UK Biobank participants
Authors: Burns A , Windred D , Lane J , Saxena R , Phillips A , Cain S 
Published: October 2021

Abstract

Introduction
Light has powerful effects on mood, sleep, and the circadian system. Humans evolved in an environment with a clear distinction between day and night, but our modern lighting environments have blurred this distinction. While the disruptive effects of night time light exposure are well described, the potential positive effects of daytime light exposure on these systems are less well studied.

Method
Participants were a subset of the UK Biobank cohort who were invited to complete a seven day wrist-worn actimetry and light sensor study (n = 8,372, 61% female, age range: 39–70). Hierarchical linear models assessed the association between average daytime light exposure and mood-, sleep- and circadian-related outcomes, adjusted for age, sex, and season of assessment.

Results
Greater daytime light exposure was associated with earlier chronotype (p &lt; .001), greater ease of getting up in the morning (p &lt; .001), lower odds of using antidepressant medication (p &lt; .001), less frequent low-mood (p = .002), less frequent anhedonia (p &lt; .001), greater happiness (p &lt; .001), less frequent insomnia symptoms (p = .01) and less frequent tiredness (p &lt; .001).

Conclusions
In the largest study to-date, we observe that greater daytime light predicts better outcomes across a range of mood-, sleep- and circadian-related measures. Our findings are consistent with the known effects of light on the circadian system, whereby greater daytime light enhances the strength of the rhythm allowing for greater distinction between sleep and wake states. These findings
P019 Obstructive sleep apnoea endotypes in people with multiple sclerosis
Authors: Carter S , Hensen H , Krishnan A , Chiang A , Carberry J , Eckert D 
Published: October 2021

Abstract

Purpose
Obstructive sleep apnoea (OSA) is common in people with multiple sclerosis (MS) despite a lack of typical risk factors for OSA in people with MS such as obesity and male predominance. Therefore, underlying factors other than sex and obesity may be particularly important in the pathogenesis of OSA in people with MS. Thus, the primary aim of this study was to determine the relative contributions of OSA endotypes in people with MS and compare this to matched controls with OSA only.

Methods
Eleven people with MS and OSA (MS-OSA group) (apnoea-hypopnoea index [AHI]&gt;5events/h) and eleven controls matched for OSA severity, age and sex without MS (OSA group) were studied. Participants underwent a detailed overnight polysomnography with an epiglottic pressure catheter and genioglossus intramuscular electrodes to allow for quantification of pathophysiological contributors to OSA. This included the respiratory arousal threshold, genioglossus muscle responsiveness, respiratory loop gain and upper airway collapsibility.

Results
Measures of the four primary OSA endotypes were not different between the MS-OSA and OSA groups (e.g. NREM respiratory arousal threshold -27±15 vs. -23±8 cmH2O respectively, p=0.24). Within group analysis indicated higher loop gain in non-obese MS-OSA participants compared to obese MS-OSA participants (0.53±0.11 vs. 0.37±0.11, p=0.04).

Conclusions
Overall, OSA endotypes are similar between MS-OSA participants and matched OSA controls. However, within the MS-OSA group, non-obese participants have higher loop gain (unstable respiratory control) compared to obese participants. Thus, unstable respiratory control may play an important role in OSA pathogenesis in many people with MS.
P025 Expert Opinions to Develop a Sleep Intervention for Patients with Low Back Pain: A Nominal Group Study
Authors: Comis J , Hodges P , Gordon C , Ho K , Ferreira P 
Published: October 2021

Abstract

Introduction
Insomnia is a common comorbidity of low back pain. Research has investigated the use of cognitive behavioural therapy interventions for insomnia (CBT-I) to treat these conditions but show little effect on improving pain outcomes. This study sought the opinion of experts to explore how existing online CBT-I interventions could be optimised to improve sleep and pain outcomes in patients with comorbid insomnia and LBP.

Methods
This study was conducted using the nominal group technique, a structured meeting to generate ideas and rank priorities amongst a panel of experts. Musculoskeletal researchers (n=7) and clinicians (n=1), sleep researchers (n=2), and a consumer advocate (n=1) were purposively sampled to participate in a 2-hour online nominal group workshop. A quantitative analysis was conducted to rank ideas by their relative importance. A qualitative analysis was used to provide context on the highest ranked ideas.

Results
A total of 58 ideas were generated and subdivided into 11 primary categories, each of which contained a varying number of sub-ideas. The primary categories, personalisation of care, assessment guided management, understanding the user experience, personalised advice on physical and environmental factors, and continual re-assessment to guide management, were ranked one to five respectively and accounted for 73% of all votes from the panel.

Discussion
An intervention framework consisting of three interacting domains, personalisation of the intervention, assessment guided management, and user experience was proposed. This framework outlines recommendations that should be considered to improve online CBT-I interventions to treat patients with comorbid insomnia and low back pain.