bluuebunny/crossref_metadata_2025_split huggingface dataset:
633 Dysregulated REM Sleep in Children with Moebius syndrome
Authors: Edlund Wendy , Kotagal Suresh 
Published: May 2021

Abstract

Introduction
Moebius syndrome (MBS) is a rare disorder characterized by failure of development of the 6th and 7th cranial nerve nuclei located in the pons. Though the congenital lesion abuts the pontine tegmentum, sleep architecture has not been evaluated in MBS.

Methods
We report the clinical features of three children with MBS, and discuss implications for “developmental” RBD.

Results
Three clinically and MRI brain scan-confirmed MBS children, age 0.5 to 16 years, mean 8.5 ± 6.3 years, were evaluated for disrupted sleep, with repetitive crying (1/3), yelling (2/3), agitation in sleep (2/3), and injuring a co-sleeping sibling (1/3); 3/3 had REM sleep without atonia while 2/3 had RBD. REM sleep was reduced in all three: 21.7% in the infant (reference REM percentage value in infancy is about 40%), 11.4% in subject 2 and 3% in subject 3. Treatment with clonazepam (patients 2 and 3) or melatonin (patient 1) had variable results.

Conclusion
Children with Moebius syndrome have both quantitative (reduced percentage) and qualitative abnormalities of REM sleep (RSWA/RBD). The association of MBS with RSWA/RBD suggests more extensive involvement than published in literature, with extension into the sub-laterodorsal pontine tegmentum and “REM-off” neurons. Moebius syndrome might serve as a model for study of “developmental” REM sleep behavior disorder.
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635 Evening Sunglasses Plus Stable Wake Times: Can This Intervention Help Adolescents with Delayed Sleep-wake Phase Disorder?
Authors: Crowley Stephanie , Killen Logan , Robert Auger R 
Published: May 2021

Abstract

Introduction
Evening light can increase alertness and shift the circadian clock later (delay) and, in turn, delay sleep onset timing. We are examining whether reducing evening light exposure (by wearing sunglasses) paired with stable wake times can shift circadian and sleep onset times earlier in adolescents with Delayed Sleep-Wake Phase Disorder (DSWPD).

Methods
Fifteen adolescents (14.7–18.1 years; 4 male) diagnosed with DSWPD are included in this interim analysis. Participants sleep without restriction at home for a baseline week, and then complete a 2-week intervention. One group (Amber; n=7) wears glasses with amber lenses (Cocoons®, Live Eyewear) beginning 7 hours before their baseline mid-sleep time until self-selected bedtime or for 7 hours (corresponds to the phase delay region of the adolescent phase response curve to light). The amber lens transmits 14% of light to the eye and absorbs most short wavelength light. The frame blocks light from all angles. Amber participants are also instructed to wake at their average baseline school-morning wake-up time (±30 mins). Another group (Clear; n=8) wears identical glasses with clear lenses at the same time and wake time is unrestricted. Glasses wear time is monitored with an iButton placed at the temple tip. Dim Light Melatonin Onset (DLMO) is measured after the baseline week and after the 2-week intervention; 2 participants (one from each group) do not have melatonin data due to technical error. Sleep is measured with wrist actigraphy and sleep diaries throughout the study. DLMO and sleep onset changes (baseline-intervention) are compared between groups with t-tests.

Results
Amber DLMOs shifted 1.0±2.0h earlier (min-max: 0.4-h delay-5.0-h advance) and Clear DLMOs shifted 0.4±1.1h later (min-max: 2.0-h delay-0.6-h advance) [t(11)=1.60,p=0.14]. Average school-night sleep onset shifted earlier in both groups (Amber:0.4±1.3h; Clear:0.6±1.0h; t(13)=0.2,p=0.8]. Average non-school-night sleep onset shifted 1.1±1.0h earlier in Amber (min-max:0.6-h delay-2.2-h advance) and remained stable (0.03±1.0h) in Clear (min-max: 1.8-h delay-1.7-h advance) [t(13)=1.92,p=.08].

Conclusion
Trends from this ongoing study suggest that amber-lensed glasses to block evening light plus stable wake-up times may shift circadian rhythms earlier. This strategy appears to help adolescents with DSWPD fall asleep earlier predominantly on non-school nights.

Support (if any)
AASMF Strategic Research Award (184-SR-17) to RRA
636 Associations among sleep, physical activity and high body mass index in youth: Age differences
Authors: Ji Xiaopeng , Covington Lauren , Brownlow Janeese 
Published: May 2021

Abstract

Introduction
Short sleep duration is associated with overweight and obesity. Less clear is how sleep regularity and physical activity interact with sleep duration in predicting overweight across adolescent stages. This study examined interactions between (1) sleep duration and regularity, and (2) sleep duration and physical activity on overweight in preadolescents (10–11 years), early (12–14), and middle (15–17 years) adolescents.

Methods
Using the National Survey of Children’s Health 2017–2018 dataset, we included youth with sleep, physical activity and overweight data available (n=25,875) in the analyses. Parents reported their children’s sleep duration, sleep regularity and physical activity (&gt;60 min/day) frequency per week. High Body Mass Index (BMI, ≥85th percentile) for age and sex indicated overweight/obesity. Accounting for complex survey design and covariates (age, sex, race, poverty, and resilience), separate logistic regression models (STATA 16.0) estimated the associations in preadolescents, early and middle adolescents.

Results
Preadolescents had the highest odds of high BMI compared to other age groups (OR= 0.64 and 0.78, p&lt;0.001). Every hour increase in sleep duration was associated with 4–18% decrease in the odds of having high BMI, with the highest magnitude shown in preadolescents (OR=0.82, p&lt;0.001), followed by adolescents aged 12–14 (OR=0.89, p&lt;0.001) and 15–17 years old (OR=0.96, p=0.04). For preadolescents, irregular sleep (OR=1.41, p&lt;0.001) and physical activity (OR=0.83, p=0.03) modified the association between sleep duration and BMI. Specifically, the association was attenuated or even reversed among irregular sleepers (OR=1.09, p=0.27) compared with regular sleepers (OR=0.77, p&lt;0.001). Preadolescents with regular physical activity (≥4 days/week) showed stronger associations (OR=0.74, p&lt;0.001) between sleep duration and BMI than their counterparts (OR=0.89, p=0.01). Sleep regularity was not associated with BMI nor a modifier in other age groups. Although there was no interaction with sleep duration, regular physical activity was independently associated with decreased odds of having high BMI (OR=0.62, p&lt;0.001) in early and middle adolescents.

Conclusion
The relationship between lifestyle factors (i.e., sleep duration and physical activity) and BMI varies by age groups. Sufficient sleep duration, regular bedtimes and physical activity represent resilience factors against overweight/obesity, especially in preadolescents who are at greater risk for high BMI.

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N/A
639 An exploratory study of parents-child co-sleeping in Korea
Authors: Kang Solbi , Chung Seockhoon , Suh Sooyeon 
Published: May 2021

Abstract

Introduction
Asian cultures, including Korea, are known to have a higher proportion of parent-child co-sleeping than Western cultures. While recent studies have shown that bed-sharing increases the mother’s depression and causes sleep problems for children, there has never been a study in Asia on the sleep problems of parents and children caused by co-sleeping. Therefore, we aim to investigate the types of sleep problems in children and their mothers’ insomnia severity due to co-sleeping.

Methods
This study was conducted in 79 mothers (mean age 33.65 ±3.98 years) who reported having insomnia due to their children. All participants had children between 6 to 36 months old. Participants were asked to answer the survey includes demographics, sleep environment, child’s sleep problems, child’s health status items and the mother’s insomnia (measured by the Insomnia Severity Index; ISI). Children’s age was divided into 5 age groups (6 – 11, 12 - 17, 18 - 23, 24 - 29, and 30 to 36 months). Frequency analysis and independent t-test were conducted.

Results
Of the total respondents, 72.2% (n=57) reported co-sleeping with their children. The most reported sleep problem in children was waking up in the middle of the night 51.9% (n=41), followed by difficulty in sleep initiation 12.7% (n=10), looking for mother or an attachment object 12.7% (n=10), sleep-limiting problems 7.5% (n=6), multiple problems 12.7% (n=10), and none 2.5% (n=2). An independent t-test results for determining whether co-sleeping caused a difference in the severity of maternal insomnia was significant in the 6 to 11 months group only (t=-2.336, p&lt;.05). The co-sleeping mother’s ISI average score (M=18.28) was significantly higher than mother who slept separate from her child (M=14.31).

Conclusion
Co-sleeping in Asian cultures is prevalent, and may require attention and intervention for mothers who report having insomnia due to their children’s sleep disturbance.
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640 Regular bedtime routines and biological obesity risk among 9-year old children from the Fragile Families Child and Wellbeing Study
Authors: Chung Alicia , Jin Peng , Moore Jesse , Nunes Joao , Seixas Azizi , Jean-Louis Giardin 
Published: May 2021

Abstract

Introduction
Obesity rates among Hispanic (26%) and Black (22%) children are considerably higher compared to their white counterparts (14%), which evidence suggests may be attributable to biological, behavioral, and psychosocial factors affecting the family unit. Bio-behavioral factors in the household may affect child health behaviors, including sleep, a known predictor for obesity. Hispanic and Black children report shorter sleep duration, later bedtimes, and are often lacking in bedtime routines, compared to white children. Evidence suggests that early childhood routines are highly predictive of overweight status in children. Herein, we investigate whether bedtime routines are associated with the genetic allele for obesity in a racially diverse sample of children.

Methods
Data for the present analysis emanated from wave 5 (Year 9--2007–2010) cohort of the Fragile Families Child and Wellbeing Study dataset. During home visits, interviews with children’s mother and father during home visits, around the target child’s ninth birthday collected data on home routines and other parent-child relationship and school connectedness topics. Saliva samples were also collected at Year 9 to assess telomere length and DNA methylation levels and changes. The independent variable was regular bedtime routine, and biological variable for fat mass and obesity (rs9939609) was the dependent variable. Adjusted covariates included child’s age and BMI, and parent household income.

Results
Analysis of the final sample of 466 children showed 52% of the children were male and were 9 years old, on average; 35% were White, 46% Black, 20% Hispanic, 4% Asian and 5% other. The median family income was $42,500. The child’s sleep measures captured was ‘children have a regular bedtime routine’ was associated with (β = -0.137, p = 0.01) decrease in the odds of having the genetic allele for obesity.

Conclusion
Regular bedtime routines among 9-year old Black and Hispanic children may be associated with genetic alleles related to fat mass and obesity. Regular bedtime routines could aid in promoting healthy weight in children.

Support (if any)
NIH (T32HL129953, K07AG052685, R01MD007716, R01HL142066, K01HL135452, R01HL152453.
647 Adolescent and Young Adult Sleep and Sleep-Related Behaviour Change During the COVID-19 Pandemic
Authors: Carmona Nicole , Carney Colleen 
Published: May 2021

Abstract

Introduction
Sleep disturbance, poor sleep quality, and dissatisfaction with sleep are common among adolescents and young adults (AYAs; e.g., Becker et al., 2018; Hicks et al., 2002; Hysing et al., 2013). Environmental and behavioural factors (e.g., early school start times, evening technology use and social pressures) are barriers to healthy sleep among AYAs that contribute to a “perfect storm” of sleep disturbance during this period (Carskadon, 2011; Crowley et al., 2018). Notwithstanding, few AYAs have access to sleep treatments. The COVID-19 pandemic lockdowns decreased academic and scheduling demands, providing an opportunity to study unconstrained AYA sleep and potentially facilitating better access to sleep interventions (Simpson & Manber, 2020). This study evaluated differences in baseline sleep and sleep-related behaviour change (i.e., how AYAs use an evidence-based app for sleep disturbance) before vs. during the lockdown.

Methods
Participants between the ages of 15 and 24 (M=20.66, SD=2.38) completed a 4-week feasibility study evaluating a free, transdiagnostic sleep self-management app (DOZE) before the lockdown (“Pre-Lockdown”; n=51) or during the lockdown (“Lockdown”; n=29). After 2 weeks of completing baseline sleep diaries, participants could set goals based on feedback and access tips, followed by 2 more weeks of completing sleep diaries.

Results
Compared to Pre-Lockdown, Lockdown demonstrated less variability in their sleep schedules (ps≤.011), less napping (p=.002), but increased time in bed (TIB; p&lt;.001) and total wake time (p=.007). Total sleep time, lingering in bed in the morning, and sleep efficiency did not differ between groups. Relative to Pre-Lockdown, Lockdown showed a greater tendency to set goals to reduce schedule variability (p=.010) and to restrict excessive TIB (p=.005). Rates of goal setting for lingering in bed in the morning, sleepiness, naps, and sleep-interfering substance use did not differ between groups. Rates of accessing tips did not differ between groups.

Conclusion
Effects of COVID-19 lockdown on AYA sleep included less variability in their schedule and a decreased need for naps, but negative effects on TWT and TIB. As a result, AYAs set different goals during the COVID-19 lockdowns, focusing more on restricting excessive TIB than on schedule variability.

Support (if any)
Canadian Institutes of Health Research eHealth Innovation Partnership Program (#143551).
648 Associations between objective afternoon and evening physical activity and polysomnographic sleep in fibromyalgia
Authors: McGovney Kevin , Curtis Ashley , McCrae Christina S 
Published: May 2021

Abstract

Introduction
Patients with fibromyalgia (FM) suffer from pain which limits physical activity and disrupts sleep. Research examining the relationship between pre-bedtime physical activity, pain, and objective sleep is limited. This study examined whether objectively measured activity levels (via actigraphy), pain intensity, or their interaction are associated with polysomnographic sleep outcomes and sleep architecture.

Methods
Adults with FM (n=158, Mage=52, SD=12, 93% female) completed 14 daily pain ratings, 14 days of actigraphy, and a single night of polysomnography. Activity levels (i.e., magnitude of wrist motion captured per 30 second epoch) were recorded, and average afternoon/evening activity for intervals 12:00-15:00, 15:00-18:00, and 18:00-21:00 was computed, removing days in which participants slept during these periods. Sleep architecture was quantified as the percentage of sleep time in rapid eye movement (%rem) and non-rem (i.e. %stage 1, %stage 2, and %stage 3). Multiple regressions examined whether average afternoon/evening activity, average evening pain [0 (no pain)–100 (most intense pain imaginable)], or their interaction predicted polysomnographic sleep onset latency (SOL), wake after sleep onset (WASO), sleep efficiency (SE), %stage 1, %stage 2, %stage 3, and %rem, controlling for age, body mass index, average individual bedtime, time in bed, and sleep or pain medication usage.

Results
Greater afternoon activity from 12:00-15:00 was independently associated with lower SE (B= -.08, p=.01), greater WASO (B=.45, p&lt;.001), and greater %stage 1 (B=.04, p&lt;.01). Pain intensity interacted with physical activity from 12:00-15:00 such that the association between physical activity and higher WASO (p=.05) and greater %stage 1 (p&lt;.01) was stronger for individuals with higher pain. Pain intensity and activity from 15:00-18:00, and 18:00-21:00 were not associated with sleep outcomes.

Conclusion
Our results suggest greater afternoon activity is associated with greater polysomnographic sleep fragmentation and greater %stage 1 sleep in FM, and these relationships are stronger for individuals with higher pain. These relationships are consistent with activity pacing recommendations for chronic pain and suggest pacing in the afternoon may be important for good sleep in FM. However, future research examining causal pathways linking physical activity levels and timing, pain, and sleep is needed.

Support (if any)
Support: NIAMS (R01AR055160/R01AR005160- S1;PI McCrae). Data collected at University of Florida (Clinical Trial-NCT02001077;PI McCrae).
653 Are Daily Variations in Sleep Quality and Quantity Related to General Stress and COVID-19-Related Anxiety?
Authors: Hire Veronica , Thurmon Casey , Snyder Hope , Harra Ryan , Walker Jamie , Vargas Ivan 
Published: May 2021

Abstract

Introduction
Sleep modulates a number of psychological and cognitive processes, such as emotion regulation, executive control, and coping with stress. It is therefore not surprising that insufficient sleep quality or quantity are associated with greater self-reported stress levels. The COVID-19 pandemic has led to a particularly stressful and unprecedented time in history. While stress has been undoubtedly high during the past year, it’s less clear to what extent sleep has affected people’s perceived stress on a daily basis. The aim of this research was to estimate whether daily variations in sleep quality and duration were associated with general stress and/or stress related to COVID-19.

Methods
The study used a nationally representative sample to assess daily variations in sleep and stress for a period of two weeks during the COVID-19 pandemic. Morning assessments were conducted using online sleep diaries. These diaries were used to estimate sleep duration (in minutes) and sleep quality (subjective rating on a 5-point Likert scale). Evening assessments were also completed online and prompted participants to rate (0 to 100) their current “general” stress level, as well as their current anxiety in relation to COVID-19. Separate mixed effects models were conducted with days (Level 1) nested within participants (Level 2). Stress variables were lagged by a day to estimate the association between sleep (AM assessment) and stress (PM assessment). TST and SQ were entered as fixed effects and intercepts were allowed to vary randomly.

Results
4,048 participants (Mage = 46.3 years; 78% women) were included as part of the analyses. The results supported that lower self-reported sleep quality predicted greater general stress levels (b = -1.43, p &lt; 0.001). Lower self-reported sleep quality also predicted greater COVID-19 related anxiety (b = -0.543, p &lt; 0.001). In contrast, sleep duration was not significantly related to general stress or COVID-19 anxiety after controlling for sleep quality.

Conclusion
The present data supports that daily variations in sleep quality are related to a person’s overall stress levels and COVID-19 anxiety. These findings may have implications for the role of good sleep in mitigating the increases in stress that have resulted from the COVID-19 pandemic.

Support (if any)
Vargas: K23HL141581
656 Self-isolation due to COVID-19 was not associated with changes in depression, sleepiness, and insomnia in Shiga prefecture, Japan
Authors: Kadotani Hiroshi , Ubara Ayaka , Sumi Yukiyoshi , Ito Kazuki , Matsuda Arichika , Miyamoto Towa , Omichi Chie 
Published: May 2021

Abstract

Introduction
We aimed to analyze the changes in depression, sleepiness, insomnia, and sleep habits in relation to the degree of self-isolation due to COVID-19 pandemic. A state of emergency was declared for the whole of Japan on 7 April 2020. People in Shiga prefecture were recommended to stay at home and refrain from moving to other prefectures from 8 April to 31 May 2020.

Methods
We enrolled 54 patients who regularly visited the sleep outpatient clinic in Shiga University of Medical Science Hospital, Japan. We compared the sleep habits, depression (Patient Health Questionnaire-9: PHQ-9), insomnia (Athens Insomnia Scale: AIS), and sleepiness (Epworth Sleepiness Scale: ESS) of patients, one year before (from April to July 2019), during (May 2020) and six months after (Nov 2020) the self-isolation period due to the COVID-19. We conducted repeated measures ANOVA to examine changes.

Results
PHQ-9 (3.89±0.64, 3.65±0.62 and 3.52±0.66: p=0.410), AIS (4.78±0.59, 4.65±0.57 and 4.63±0.57: p=0.843) and ESS (7.93±0.76, 7.07±0.68 and 7.00±0.73: p=0.088) were not significantly different among three visits. Sleep duration (6.06±0.23hr, 6.29±0.19hr and 6.16±0.22hr: p=0.248) and sleep onset latency (24.8±5.55min, 19.2±3.97min and 21.0±4.85min: p=0.445) were also not significantly different.

Conclusion
Self-isolation due to COVID-19 was not associated with changes in depression, sleepiness, and insomnia among patients for sleep outpatient units in in Shiga prefecture, Japan.

Support (if any)
The present study was supported by MEXT/JSPS (KAKENHI Grant Number: 17H00872).
669 Increased Nightmares During the COVID-19 Pandemic: Exploring the Role of Resilience and Emotions
Authors: Potvin Jérémie , Socarras Laura Ramos , Forest Geneviève 
Published: May 2021

Abstract

Introduction
COVID-19 had a tremendous impact on many aspects of our lives and has caused an increase in stress and mental health issues in many people. We have recently found that there was an increase in nightmares during the pandemic in young adults. Since emotions have been associated with both resilience and nightmares, the objective of this study was to investigate the role of resilience and emotional changes in the increase in nightmares observed during the pandemic, in a group of young adults.

Methods
Resilience, emotions and nightmares were assessed using the Connor-Davidson Resilience Scale-10, the Differential Emotions Scale-IV and an adapted version of the Pittsburgh Sleep Quality Index. Measures were administered to 209 young adults (18–25 years old, 76.1% females). Hierarchical multiple regression models were computed to examine the unique contribution of changes in positive and negative emotions during the pandemic to the increase in nightmares during the pandemic. Analyses were controlled for nightmares and emotions prior to COVID-19, and for gender. The sample was separated in two groups: resilient and less resilient young adults.

Results
Results show that in less resilient young adults, nightmares prior to COVID-19 (β=.79, p&lt;.001) and increase in negative emotions (β=.21, p=.033) significantly predicted nightmares during the pandemic and explained 67.0% of their variance. In resilient young adults, nightmares prior to COVID-19 (β=.56, p&lt;.001) and gender (β=-.15, p=.04) significantly predicted nightmares during the pandemic and explained 52.0% of the variance.

Conclusion
Our results show that increase in negative emotions during the pandemic is associated with an increase in nightmares in less resilient young adults, but not in resilient young adults. Furthermore, our results show that in resilient young adults, being a woman is associated with an increase in nightmares during the pandemic. These results suggest that resilience may be a protective factor in managing the impact of negative emotions on nightmares, but only in men.
Support (if any):