bluuebunny/crossref_metadata_2025_split huggingface dataset:
716 Loneliness and Lockdowns: The Effects of the COVID-19 Pandemic on Insomnia Symptoms
Authors: Cloonan Sara , Grandner Michael , Killgore William 
Published: May 2021

Abstract

Introduction
Insomnia is a critical health issue that has serious consequences for both psychological and physical health. These consequences have become even more exacerbated during the course of the ongoing COVID-19 pandemic, as fears of the virus continue to grow and community lockdowns persist. Loneliness has also become a growing mental health concern as a result of the pandemic, and previous research has identified COVID-19 loneliness as a contributing factor to higher rates of insomnia. The current study aimed to investigate the relationship between insomnia, loneliness, and lockdown orders across the first 6-months of the pandemic. We hypothesized that being lonely and under lockdown would lead to greater insomnia, even after controlling for anxiety, and this would become more pronounced over the course of the pandemic.

Methods
6,101 English-speaking adults from across the U.S. (18–84 years old; 53.6% female) completed an online, monthly, cross-sectional (~1000 participants per month), battery of assessments that included the Insomnia Severity Index (ISI), UCLA Loneliness Scale – Version 3, Generalized Anxiety Disorder-7 scale (GAD 7), demographic questions, and a COVID-19 questionnaire between April 2020 and September 2020. A 2 (lonely vs. not lonely) x 2 (lockdown vs. no lockdown) x 2 (Time 1 April-June vs. Time 2 July-September) ANCOVA was conducted to determine the effects of these variables on insomnia, while also controlling for anxiety symptoms.

Results
Significant main effects of lockdown status, F(1,8) = 22.72, p &lt; .001, time, F(1,8) = 4.94, p = .026, and loneliness, F(1,8) = 65.18, p &lt; .001, were observed, as a well as a significant interaction effect between lockdown status and time, F(1,8) = 8.47, p = .004, after controlling for anxiety.

Conclusion
Overall, lonely people under lockdown had the highest levels of insomnia at both Time 1 and Time 2. Non-lonely people consistently had lower levels of insomnia than lonely people across the 6-month period; however, being under lockdown also contributed to higher levels of insomnia regardless of loneliness, which increased with each passing month of the pandemic. Loneliness and lockdowns each appear to be independently associated with elevated insomnia during the COVID-19 pandemic.
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728 Sleep Apnea Screening in Inpatients Admitted with Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A feasibility study
Authors: Lastra Alejandra , Esmero Veronica , Herdegen James , Durkin Colleen 
Published: May 2021

Abstract

Introduction
Obstructive sleep apnea (OSA) and Chronic obstructive airway disease (COPD) affect millions of Americans. The combination (overlap syndrome) results in increased morbidity, mortality and associated healthcare costs. Type III sleep testing via portable monitoring (PM) is not recommended for patients with COPD, and there is little guidance in regards to inpatient testing. We aim to determine the feasibility of inpatient PM for diagnosing OSA in patients admitted with acute exacerbation of COPD (AECOPD) and hypercapnic respiratory failure requiring noninvasive positive pressure ventilation (NIPPV).

Methods
This is a retrospective review of prospectively collected data. Inpatients 40 year-old and older admitted with AECOPD and PaCO2≥52mmHg on arterial blood gas (ABG) testing requiring NIPPV were included for analysis. One patient died and one withdrew consent. The remaining patients underwent overnight PM (ApneaLink Airtm by ResMed®) once clinically stable, off NIPPV, on oxygen when needed to sustain oxygen saturation at or above 88%. Patients were discharged on volume-assured pressure support ventilation (VAPS) for nightly use at home and followed for 6 months.

Results
Five patients were included. Average age was 60 years, majority were African-American males, former smokers (average 31.2 pack-years), with moderate to severe airflow obstruction (FEV1 24–52 %Pred). Except for one (BMI 17 kg/m2), patients had concomitant morbid obesity (average BMI 39.7 kg/m2). Four out of 5 patients had overlap syndrome (AHI 19.4/h -75/h). Follow-up objective download data demonstrated AHI &lt;10 in all patients with available data (3/5 at 6 months). One patient required in-sleep center VAPS titration.

Conclusion
This pilot study suggests portable monitoring is feasible in diagnosing OSA in this complex patient population admitted for AECOPD, despite concomitant oxygen use during PM testing. Despite the small number of patients, 4/5 were diagnosed with moderate to severe OSA and objective data on VAPS demonstrated effective treatment. Further studies using PM for screening of OSA in inpatients with COPD and obesity and impact on patient-centric outcomes are needed.
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730 Prevalence and impact of sleep problems in active duty military personnel receiving Cognitive Processing Therapy for PTSD
Authors: Pruiksma Kristi , Taylor Daniel , Wachen Jennifer Schuster , Straud Casey , Hale Willie , Mintz Jim , Young-McCaughan Stacey , Peterson Alan , Yarvis Jeffrey , Borah Elisa , Dondanville Katherine , Litz Brett , Resick Patricia 
Published: May 2021

Abstract

Introduction
Sleep disturbances are common in active duty military personnel and play a key role in the development and maintenance of posttraumatic stress disorder (PTSD). Research indicates that although insomnia and nightmares improve with successful PTSD treatment, they may remain clinically significant. Few previous PTSD studies have assessed sleep disorder constructs using validated instruments. The objectives of this study were to examine the proportion of active duty military personnel seeking treatment for PTSD who reported clinically significant insomnia, nightmares, sleep duration, and excessive daytime sleepiness and to examine the impact PTSD treatment had on these sleep constructs using validated self-report questionnaires.

Methods
Sleep was evaluated in 223 active duty service members participating in a randomized clinical trial comparing group and individual Cognitive Processing Therapy (CPT) for PTSD. Sleep constructs were assessed using the Insomnia Severity Index (ISI), Trauma-Related Nightmare Survey (TRNS), Self-Assessment of Sleep (SAS), and Epworth Sleepiness Scale (ESS) at baseline and 2 weeks posttreatment.

Results
At baseline, 82% of participants reported clinically significant insomnia and 75% reported at least 1 moderately severe nightmare per week. Participants reported averaging 4.76 hours of sleep per night, and 65% reported excessive daytime sleepiness. Over the course of PTSD treatment, there were statistically significant improvements in insomnia, nightmares, and excessive daytime sleepiness, but scores remained in clinically significant ranges. Minimal increases were seen in sleep duration. Of the participants who no longer met criteria for PTSD at posttreatment, 50% continued to report clinically significant insomnia, 52% continued to report clinically significant nightmares, and 44% continued to report excessive daytime sleepiness.

Conclusion
Consistent with previous research, sleep problems persisted for a significant number of service members who completed treatment for PTSD. Insomnia, nightmare, and sleep extension interventions are likely an important part of comprehensive PTSD treatment plans.

Support (if any)
Funding for this work was made possible by the U.S. Department of Defense through the U.S. Army Medical Research and Materiel Command, Congressionally Directed Medical Research Programs, Psychological Health and Traumatic Brain Injury Research Program awards W81XWH-08-02-109 (Alan Peterson), W81XWH-08-02-0116 (Patricia Resick), W81XWH-10-1-0828 (Daniel Taylor), and W81XWH-08-02-0114 (Brett Litz).
751 Heart Rate and Heart Rate Variability During Sleep As Biomarkers for Depression
Authors: Grassi Massimiliano , Caldirola Daniela , Daccò Silvia , Perna Giampaolo , Defillo Archie 
Published: May 2021

Abstract

Introduction
Evidence suggests a high prevalence of depression in subjects with Sleep-Wake Disorders, with impaired sleep being both a risk factor and a symptom of depression. However, depression currently remains for the most undiagnosed in this population, which can lead to a lack or delay in the treatment, and ultimately contribute to chronicity, recurrence of depression, and increase risk of suicide. Depression is characterized by alteration in sleep architecture and imbalanced autonomic nervous system function, and specific alteration may serve as biomarkers to identify ongoing depression in subjects with Sleep-Wake Disorders undergoing polysomnography. Thus, the aim of this study is to investigate differences in sleep architecture and autonomic modulation, measured by heart rate and heart rate variability throughout sleep stages, in subjects undergoing polysomnography in a sleep clinic.

Methods
A preliminary sample of forty subjects undergoing polysomnography was recruited in three different sleep clinics. The Patient Health Questionnaire–9 was administered to participants before the beginning of the sleep study. A cut-off of 10 was applied to identify subjects with possible current depression. The polysomnography recordings were processed with the MEBsleep software (Medibio Limited) which automatically calculats sleep architecture indices, and heart rate and heart rate variability parameters throughout sleep stages. The Mann-Whitney U test was used to investigate differences between the depressed and non-depressed groups.

Results
Possible current depression was found in fourteen subjects (35%). These Subjects had statistically significant higher heart rate (median depressed=78.01, median non-depressed=64.61, p=0.01) and lower Root Mean Square of the Successive Difference (RMSSD; median depressed=18.41 ms, median non-depressed=26.52 ms, p=0.02), number of pairs of successive NN intervals that differ by more than 50 ms (pNN50. Median depressed=1.62%; median non-depressed=5.64%; p=0.03), and High Frequency (absolute power) in REM (median depressed=104.17 ms2; median non-depressed=214.58 ms2; p=0.03) than those without depression. No significant differences resulted in the sleep architecture indices.

Conclusion
These results preliminary indicates a decreased parasympathetic activity in subjects with possible depression during REM, suggesting that heart rate and heart rate variability during sleep may be used as biomarkers to identify current depression in subjects undergoing polysomnography in sleep clinics.
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752 Associations Between Sleep Neurophysiology and Personality Functioning Support Dimensionality in Mental Health
Authors: Wild Salome , Fontanellaz-Castiglione Chiara , Markovic Andjela , Salvatore Vanessa , Kaess Michael , Tarokh Leila 
Published: May 2021

Abstract

Introduction
Most psychiatric disorders in adolescence are linked to alterations in sleep behavior and neurophysiology. Similar but less pronounced changes to sleep have been reported in healthy adolescent and sub-clinical samples, suggesting that the association between sleep and mental health may lie on a continuum. The current study takes a dimensional approach to better understand the link between personality functioning as assessed using the alternative DSM-5 approach to assess personality (AMPD) and brain activity measured with the sleep electroencephalogram (EEG).

Methods
The current study included 26 medication free participants (10 with Major Depressive Disorder (MDD) and 16 healthy controls; aged 14 to 17 years (mean = 15.2 (±1.1); 14 girls) recruited as part of a longitudinal study on sleep and depression. All night high-density (58 channel) sleep EEG recordings were conducted and power in the delta (0.6 to 4.6 Hz) and sigma (11 to 16 Hz) bands, corresponding to slow waves and sleep spindles respectively, was computed. Dimensions of personality were assessed using the PID-5, which consists of the five trait domains: detachment, psychoticism, antagonism, disinhibition, and negative affect. Stepwise regression analysis was performed to examine the association between PID-5 dimension and delta and sigma power. The Benjamini-Hochberg procedure was used to correct for multiple comparisons.

Results
Greater negative affect was associated with diminished delta power for 28 electrodes over frontal, temporal, central and parietal regions (0.03 &lt; p &lt; 0.04). No associations between sigma power and any of the PID-5 dimensions were found.

Conclusion
In a sample of adolescents with and without depression, we find associations between negative affect and delta power independent of other dimensions of personality functioning. Using a dimensional approach, our findings are in line with previous literature showing diminished delta power in those with MDD compared to healthy controls. Our findings provide neurophysiological support for the notion that personality functioning in youth is accurately conceptualized on a continuum.

Support (if any)
This research was supported by the Interfaculty Research Cooperation Grant “Decoding Sleep: From Neurons to Health and Mind” from the University of Bern and the Swiss National Science Foundation Grant 32003B_184943 (to L.T.).
755 A Novel Modularized Intervention to Improve Sleep in Older Hospitalized Veterans
Authors: Li Yihan , Miller Megan , Torrence Nicole 
Published: May 2021

Abstract

Introduction
Disturbed sleep in hospitalized patient populations is a highly prevalent phenomenon, with patients commonly reporting problems with shorter sleep duration, more frequent awakenings, and overall poorer sleep quality during hospital stay compared to at home. Sleep disturbance during hospitalization is especially problematic as sleep is associated with both physical and psychological well-being. Poorer sleep has been found to impact recovery outcomes in a number of patient populations including mild traumatic brain injury, chronic pain, and most recently, in hospitalized COVID-19 patients. The current analyses examined pilot data from a novel brief modularized sleep intervention implemented with older adult Veterans living on a subacute rehabilitation unit.

Methods
Participants were screened for sleep problems upon admission to the unit. Veterans who screened positive were invited to participate in the sleep intervention. Components of the intervention were selected based on screener responses and included group sleep hygiene psychoeducation, environmental accommodations (e.g. ear plugs, eye mask, soothing music), and CPAP use education. Measures completed at pre- and post- intervention assessed sleep quality (Pittsburgh Sleep Quality Index, PSQI), global health functioning (PROMIS Global Health Scale), and depressive symptoms (Patient Health Questionnaire, PHQ-9). Pre- and post- scores were compared using paired sample t-tests. Two samples t-tests compared change scores in PHQ-9 between groups.

Results
A total of 33 Veterans were included in the analyses (Mage = 69.6, 3 female, intervention group n = 21). Participants showed a trend toward decreased PHQ-9 scores following the intervention (t(16) = 1.58, p = 0.100). There were no significant effects of the intervention on sleep quality or global health. Compared to the non-intervention group, the intervention group showed greater decrease in PHQ-9 scores at the time of post-intervention (t(25) = .828, p = .025).

Conclusion
Preliminary data suggests that a brief modularized sleep intervention may benefit depressive symptoms for older adults during hospitalization. Additional research is needed to better understand the impact of a brief intervention on self-reported sleep quality during the hospitalization period.

Support (if any)
This project was funded by a VISN 20 Seed Grant as a Whole Health promotion in alignment with the National VA Office of Patient Centered Care & Cultural Transformation.
773 The relationship between personality and sleep: Subjective cognition as a mediator
Authors: Schmiedeler Anthony , Connell Maggie , Curtis Ashley 
Published: May 2021

Abstract

Introduction
Research has found relationships between sleep quality and personality traits. Poor subjective sleep quality has been observed within individuals scoring high in Neuroticism and low in Conscientiousness. Personality traits have also been associated with cognitive functioning and the link being worse cognition and poor sleep quality is established. However, less is known regarding the role of cognitive functioning in the relationship between personality and sleep quality, particularly in aging populations. This study investigated whether subjective cognition acted as a mediator between individual personality traits and subjective sleep quality in middle-aged and older adults.

Methods
Middle-aged and older adults (N=269; Mage= 64.5, SD=7.8; 123 women/146 men) who were cognitively healthy completed an online survey through Qualtrics measuring demographics, personality (Big Five Inventory-10; BFI-10), self-reported sleep (Pittsburgh Sleep Quality Index; PSQI), and subjective everyday cognition (Cognitive Failures Questionnaire; CFQ). Separate mediation analyses using SPSS PROCESS macro [and testing for indirect effects using 5,000 bootstrapped samples and 95% Confidence Interval (CI) and controlling for conditional associations among all pathways] examined whether subjective everyday cognition (CFQ scores) mediated the relationship between different personality traits (BFI-10 Conscientiousness and Neuroticism scores) and self-reported sleep (PSQI-Total Score), controlling for age and sex.

Results
Neuroticism and PSQI-Total Score was partially mediated by CFQ. There was a significant association between Neuroticism and total PSQI (total effect=0.588, SE=0.110, p&lt;0.001). There were positive associations between Neuroticism and CFQ (a-path effect=2.765, SE=0.383, p&lt;0.001) and CFQ and PSQI (b-path effect=0.068, SE=0.017, p&lt;0.001). The indirect effect was significant (effect=0.187, SE=0.054, 95% CI=0.088 to 0.301). There was no association between Conscientiousness and PSQI-Total Score (total effect=-0.123, SE=0.133, p=0.358), therefore mediation analysis (testing of CFQ as a mediator) was discontinued.

Conclusion
In middle-aged and older adults, subjective everyday cognition mediates the relationship between Neuroticism personality trait and self-reported sleep quality. Individuals scoring higher in Neuroticism report worse subjective sleep quality as their subjective cognitive failures increase. Findings underscore the interacting roles of personality and everyday cognition on perceived sleep. Clinicians should consider individual personality profiles (via personality assessments) and subjective everyday cognitive ratings for a better understanding of the factors impacting middle-aged and older adults’ sleep profiles.
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774 Insomnia precedes suicidal ideation in a national longitudinal study of sleep continuity (NITES)
Authors: Tubbs Andrew , Morales Knashawn , Grandner Michael , Ellis Jason , Vargas Ivan , Fernandez Fabian-Xosé , Perlis Michael 
Published: May 2021

Abstract

Introduction
Suicide is the 10th leading cause of death among US adults, and disrupted sleep significantly increases suicide risk. It is unclear, however, how quickly changes in sleep can affect suicidal thoughts and behaviors. Therefore, the present study explored whether insomnia, sleep continuity, and nightmares predicted subsequent suicidal thinking.

Methods
Data were drawn from N=1,248 individuals 35 years and older who were part of a 1-year prospective study of the natural history of insomnia. Suicidal ideation was measured biweekly from the Patient Health Questionnaire – 9 and dichotomized (Score = 0, No; Score &gt; 0, Yes). The primary predictors were Insomnia Severity Index (ISI) score and total wake time, total sleep time, difficulty initiating/maintaining sleep, and nightmares (from daily sleep diaries). Predictors were averaged over the previous 2 weeks and measured 2 nights prior to measuring suicidal ideation. Data were modeled using generalized estimating equations to account for within-subject correlations and adjusted for age, sex, and race/ethnicity.

Results
A total of N=124 individuals (65% female) reported suicidal ideation during the study. In unadjusted models, no sleep variable was associated with subsequent suicidal ideation. However, after adjusting for age, sex, and race/ethnicity, insomnia severity was associated with subsequent suicidal ideation when averaged over the preceding 2 weeks (OR 1.09 per point on the ISI, 95% CI [1.03–1.16]) and measured 2 days prior (OR 1.11 per point on the ISI, 95% CI [1.01–1.22]). Stratified analyses showed that this effect was driven by age, with insomnia predicting suicidal ideation in individuals 55–64 and 65 and older.

Conclusion
Insomnia is a significant, proximal risk factor for suicidal ideation, particularly in older adults. Consequently, treatment of insomnia may represent an effective suicide risk reduction strategy.

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K24AG055602 R01AG041783
790 Adaptive Body Awareness Mediates the Relationship between Quality of Sleep and Symptoms of Central Sensitization
Authors: Colgan Dana Dharmakaya , Lim Miranda , Marshall Lynn , Oken Barry 
Published: May 2021

Abstract

Introduction
Sleep disturbance is associated with chronic pain. Central sensitization (CS), defined as the amplification of neural signaling within the central nervous system that results in pain hypersensitivity, may be one pathway through which sleep disturbance contributes to chronic pain. Sleep disturbance and CS are both associated with maladaptive body awareness, characterized by increased hypervigilance and catastrophizing in response to body sensations. Impaired sleep, increases maladaptive body awareness, which then contributes to CS. Less is known about the relationship between quality sleep, adaptive body awareness (i.e., increased attention to and awareness of body sensations, devoid of negative evaluations of sensations), and CS. Primary aims were to evaluate mediational pathways through which (1) sleep disturbance might be related to increased pain intensity via CS-related symptoms and (2) quality sleep might be related to lower CS-related symptoms via adaptive body awareness.

Methods
In a cross-sectional study, online surveys were administrated to 301 individuals with chronic pain. Pearson’s correlations characterized overall relationship between self-reported sleep quality (PROMIS-Sleep), adaptive body awareness (Multidimensional Assessment of Interoceptive Awareness; MAIA-2), and CS-related symptoms (Central Sensitization Inventory; CSI). Two path analyses using PROCESS were conducted.

Results
Results revealed that a one-unit increase in sleep disturbance was associated with a 1.7 unit increase in pain intensity, which was partially explained by CS-related symptoms [point estimate=.16; 95% bootstrap confident intervals (CI)=0.10 to 0.22]. In a separate path analysis, a one-unit decrease in sleep disturbance was associated with a 3.5 unit decrease in CS-related symptoms, which was partially explained via adaptive body awareness [point estimate=.25; 95% CI=0.03 to 0.52].

Conclusion
Novel findings provide greater understanding into pathways through which sleep might contribute to chronic pain. Results support longitudinal studies to explore effects of sleep and adaptive body awareness on self-reported symptoms and biological markers of CS within chronic pain populations.
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