bluuebunny/crossref_metadata_2025_split huggingface dataset:
736 Evaluation of suvorexant for trauma-related insomnia
Authors: Mellman Thomas , Birku Kiya , Sandhu Ishaan , Kobayashi Ihori 
Published: May 2021

Abstract

Introduction
Finding medication treatment that improves sleep disturbances with posttraumatic stress disorder (PTSD) has challenged the field of psychopharmacology with debate regarding the desirable profile of effects on sleep physiology. Evidence for fragmentation of REM sleep during the earlier stages of PTSD drew our interest to the first marketed dual orexin antagonist, suvorexant, which has been suggested in some studies to enhance REM sleep. This property has also raised concerns regarding potential exacerbation of nightmares and REM sleep related parasomnias. Insomnia is a common sequela of trauma exposure and can occur with and without other PTSD symptoms. The objective of our study was to evaluate the tolerability and preliminary efficacy of suvorexant for trauma related insomnia in a double blind, placebo controlled trial.

Methods
64 met initial inclusion criteria and 42 participants had evaluable results. 65% were female, and 66% African-American, mean age was 35yrs.All participants were screened by the Duke Sleep Disorders Interview to met criteria for insomnia that began or was exacerbated following a DSM5 Criterion A trauma. Approximately a third of the study group met criteria for either current PTSD, past (remitted PTSD), or no PTSD, and 56% reported histories of traumatic nightmares hat generally had diminished from their initial severity.

Results
Medication intolerance was infrequent with one participant in the med group reporting mild sedation that precluded a dose increase to 20mg, and another, moderate sedation with feelings of derealization that led to discontinuation. There was no evidence for emerging nightmare symptoms or REM-related parasomnias. Overall there was significant improvement in sleep and PTSD symptoms in both the placebo and med group and a modest rise in REM sleep in the med group that did not differentiate statistically from placebo.

Conclusion
Our findings suggest that distressing trauma related insomnia can occur with and without PTSD and that suvorexant is well tolerated in this population. A larger and more symptomatic group is required to more definitively evaluate efficacy.

Support (if any)
supported by a grant from Merck (MISP 53678)
753 The role of circadian activity rhythms in depressive symptoms among female nursing students
Authors: Zhang Xin , Lee Shih-Yu 
Published: May 2021

Abstract

Introduction
Depression is prevalent among nursing students. Rumination and sleep-wake rhythms are associated to mental illness; however, no clear path has been found. This exploratory study aimed to examine the associations among circadian activity rhythms (CAR), rumination, and depressive symptoms in female nursing students; further, to test a hypothesized CAR conceptual model.

Methods
A total of 148 female nursing junior students in China completed a battery of questionnaires, including Athens Insomnia Scale (AIS), Ruminative Responses Scale (RRS), and Self-rating Depression Scale (SDS). Wrist actigraphy was used to collect total sleep time, CAR, and acrophase (time of the peak of the fitted activity curve). The path analysis was explored by using SPSS and AMOS.

Results
The mean age of the students was 20.64 years (SD = 0.86). About 58.8% of the participants were either mild or moderate depressed. About 93.9% of the students reported significant insomnia symptoms (AIS scores &gt;6). Rumination was measured by the RRS (M= 2.01, SD = 0.54), and students scored higher in brooding than that of reflective pondering (2.07 vs. 1.95). The average of TST was 394.59 minutes (SD = 51.92). The CAR ranged from 0.40 to 0.98, with a mean of 0.75 (SD = 0.11). The acrophase ranged from 12:46 to 20:14 (median 16:30), with a later acrophase indicates of a more delayed circadian phase. The final model shows satisfactory fit (χ2= 2.238, p= .327); a better CAR can indirectly reduce depressive symptoms by directly reducing brooding (B = -1.149) and improving insomnia symptoms (B = -6.6443).

Conclusion
In order to prevent psychological problems of nursing students, ruminating and CAR should be part of health screening. The novel conceptual model provides a basis for reforming nursing education to prevent psychological problems.

Support (if any)
Chinese National Natural Science Foundation [71603279]
756 The Moderating Influence of Depression on Insomnia and Suicidal Ideation in a Military Sample
Authors: Palermo Emma , Goldschmied Jennifer , Boland Elaine , Klingaman Elizabeth A , Gehrman Philip , Perlis Michael 
Published: May 2021

Abstract

Introduction
Military personnel are at an increased risk for suicide compared to the general population, making it important to develop a deeper understanding of which factors contribute to this elevated risk. Given that suicidal ideation (SI) is one of the strongest predictors of suicide attempts, understanding factors that underlie SI may improve prevention efforts. Insomnia and depression both serve as independent risk factors for SI, and therefore the aim of this study was to examine the extent to which depressive symptoms moderate the association between insomnia and SI.

Methods
Data were obtained from the All Army Study of the Army Study to Assess Risk and Resilience in Servicemembers (STARRS). Soldiers (n=21,450) completed questions related to suicidal ideation (5 items), depressive symptoms (9 items), and insomnia (5 items) based on symptom presence in the past 30 days. Items in each domain were summed to create a total severity score. GEE models using a negative binomial linking function were conducted to examine the impact of depression, insomnia, and their interaction on SI.

Results
Both depression (χ2 =117.56, p&lt;0.001) and insomnia (χ2=11.79, p=0.0006) were found to have significant main effects on SI, and there was a significant interaction effect (χ2=4.52, p=0.0335). Follow up simple effects revealed that insomnia was no longer significantly associated with SI when depression severity was low, but was associated with SI in the presence of greater depression severity (χ2=2.91, p=0.0882).

Conclusion
In a large sample of Army soldiers, depression significantly moderated the association between SI and insomnia, such that insomnia seems to amplify the effects of depression on SI. These findings highlight the importance of addressing insomnia severity as a mean of reducing SI in those with depression, potentially allowing for intervention prior to a suicide attempt.

Support (if any)
Perlis: K24AG055602 & R01AG041783. This publication is based on public use data from Army STARRS (Inter-university Consortium for Political and Social Research, University of Michigan- http://doi.org/10.3886/ICPSR35197-v1), funded by U.S. NIMH-U01MH087981.
761 Associations between Depression and Guidelines Met for Physical Activity and Sufficient Sleep in an International Sample
Authors: Bender Amy , Babins-Wagner Robbie , Laughton Angela 
Published: May 2021

Abstract

Introduction
Physical activity (PA) and sleep both influence symptoms of depression. Here we explored relationships between guidelines met for physical activity and sleep and how this related to depression scores.

Methods
N=23,663 respondents (age range 18–98, mean age 40.1y, 51% female) completed the 10-item Harvard Department of Psychiatry National Depression Screening Day Scale (HANDS) online during one week in October from 2018–2020. Higher total scores on the HANDS indicated a higher likelihood of major depressive episode. Additional questions were added to the survey including questions on sleep duration and moderate to strenuous PA. The cut-off guidelines for PA were 150 weekly minutes and 7-9h of sleep per night. We categorized the sample based on those who met PA guidelines or not and whether respondents had short sleep duration (9h), or met the sleep guidelines (7-9h).

Results
One-way ANOVA revealed differences between the groups on HANDS depression score F(5,23657)=262.5, p&lt;0.001. Nearly half of the sample did not meet both PA guidelines or sleep guidelines of 7-9h (N=10,776; 45.5%). The lowest depression scores were associated with those who met both PA and sleep guidelines (8.3 depression score) compared to those with the highest scores who exceeded sleep recommendations (&gt;9h) and did not meet PA guidelines (14.1 depression score). In addition, met sleep guidelines (10.0) appeared to have a bigger influence than met PA guidelines (11.1) in the absence of the other guideline being met on depression score.

Conclusion
We found those who met both sleep and PA guidelines had the lowest depression scores with those who exceeded the sleep guidelines and did not meet PA recommendations had the highest depression scores. Future research on depression could focus on interventions aimed at improving adherence to both PA and sleep guidelines.
Support (if any):
763 Indicators of delayed circadian rhythms are associated with OCD symptoms
Authors: Cox Rebecca , Olatunji Bunmi 
Published: May 2021

Abstract

Introduction
Increasing evidence implicates delayed circadian rhythms in obsessive-compulsive disorder (OCD). Indeed, eveningness prospectively predicts increased OCD symptoms (Cox, Tuck, & Olatunji, 2018), and several studies have highlighted a link between later bedtimes and OCD symptoms (e.g., Nota et al., 2020; Schubert, Stewart, & Coles, 2019). Notably, no study to date has examined the associations between midsleep or delayed sleep-wake phase disorder (DSWPD) status and OCD symptom severity. The present study sought to address these gaps in the literature by utilizing a multimethod approach to characterize the associations between indicators of delayed circadian rhythms and OCD.

Methods
Adults with (n=57) and without (n=20) elevated OCD symptoms were recruited. Of those with elevated symptoms, 20 met criteria for OCD. Of those who did not meet criteria for OCD, 29 were identified as healthy controls (no diagnoses). On day 1, participants were administered the MINI International Neuropsychiatric Interview (Sheehan et al., 1988) to determine diagnostic status, the Diagnostic Interview for Sleep Patterns and Disorders (Merikangas et al., 2014) to diagnose DSWPD, and the Morningness-Eveningness Questionnaire (Horne & Ostberg, 1976) to measure eveningness tendency. Participants then completed 7 days of sleep monitoring with the Consensus Sleep Diary (CSD; Carney et al., 2012) to measure midsleep. On day 9, participants completed the Obsessive-Compulsive Inventory-Revised (Foa et al., 2002) to measure OCD symptom severity.

Results
Results indicated a significant relationship between OCD and DSWPD status, X2(2, n=49)=13.91, p&lt;.01, such that 40% of those with OCD also met criteria for DSWPD, relative to 0% of healthy controls. Similarly, those with OCD reported significantly increased eveningness tendency (M=40.60, SD=9.54) compared to healthy controls (M=53.66, SD=13.15), t(47)=3.80, p&lt;.01, d=1.14. Among those with elevated OCD symptoms, there was trend level increase in OCD symptom severity between those with DSWPD (M=25.45, SD=11.23) and without DSWPD (M=19.44, SD=9.80), t(52)=1.76, p=.08, d=0.57. Finally, across the whole sample, later midsleep significantly predicted increased OCD symptoms (b=.27, p&lt;.05).

Conclusion
These results replicate and extend the growing literature on delayed circadian rhythms in OCD and suggest that circadian dysregulation may represent a novel target for treatment.
Support (if any):
765 Anxiety and sleep in Generalized Anxiety Disorder with and without Insomnia Disorder
Authors: Mendelsohn Augustus Kram , Daffre Carolina , Oliver Katelyn , Seo Jeehye , Lasko Natasha , Pace-Schott Edward 
Published: May 2021

Abstract

Introduction
Insomnia Disorder (ID) elevates risk of incident anxiety disorders and vice versa. We examined whether ID and poor sleep are associated with greater self-reported anxiety in persons with Generalized Anxiety Disorder (GAD).

Methods
Twenty-one participants with GAD and ID (GAD+/ID+) having Insomnia Severity Index (ISI) scores ≥ 13 (mean 17.8, SD 3.6) and 14 with GAD but not ID (GAD+/ID-) having ISI scores ≤ 12 (mean 6.4, SD 3.4) completed 14 days of actigraphy and sleep diaries as well as a night of ambulatory polysomnography (PSG) following an acclimation night. Participants completed the Pittsburgh Sleep Quality Index (PSQI), the State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA-T/C, -T/S), the Ford Insomnia Response to Stress Test (FIRST), the Penn State Worry Questionnaire (PSWQ), and the Anxiety Sensitivity Index (ASI). Differences in self-reported anxiety (STICSA, ASI, PSWQ) between GAD+/ID+ and GAD+/ID- were analyzed using t-tests. Relationships of anxiety with retrospective (PSQI, FIRST, ISI), longitudinal (actigraphy, diaries) and physiological (PSG) sleep variables were analyzed using simple regression.

Results
GAD+/ID+ versus GAD+/ID- participants showed trends toward higher anxiety on the PSWQ (p=0.075), ASI (p=0.072) and STICSA-T/S (p=0.078). PSQI scores were positively associated with STICSA-T/S, (R=0.417, p=0.018, N=32). Greater insomnia reactivity (FIRST) was associated with increased worry on the PSWQ (R=0.352, p=0.044, N=33). STICSA-T/C was negatively associated with mean diary (R= -0.440, p=0.015, N=30) and actigraph (R= -0.517, p=0.01, N=24) total sleep time (TST). Actigraph mean TST trended toward lower PSWQ (R= -0.376, p=0.058, N=26) while actigraph mean sleep efficiency (SE) trended toward lesser STICSA-T/C (R= -0.397, p=0.058). Greater REM% was associated with greater STICSA-T/C (R=0.613, p=0.0005, N=28) and STICSA-T/S (R=0.516, p=0.005), a relationship also seen in GAD+/ID+ alone (p=0.03 and 0.015 respectively, N=16). Slow Wave Sleep% (SWS%) was not associated with lesser STICSA-T/S across both groups (p=0.14) but was so in GAD+/ID+ (R= -0.539, p=0.031, N=16).

Conclusion
GAD+/ID+ versus GAD+/ID-, show greater worry, anxiety sensitivity and somatic anxiety. In GAD, shorter and poorer quality sleep measured retrospectively or averaged longitudinally, as well as greater REM%, are associated with greater somatic and cognitive anxiety. Among those with ID, greater SWS% is associated with less somatic anxiety.

Support (if any)
R21MH115279, R01MH109638
771 Sleep Health Knowledge, Attitudes, Beliefs, and Practices among Mothers with a History of Perinatal Depression or Anxiety
Authors: Hash Jonika , Walker Amy , Ward Teresa , Spieker Susan 
Published: May 2021

Abstract

Introduction
Tailored interventions could optimize sleep health for mothers with a history of perinatal depression or anxiety. The purpose of this study was to describe sleep health knowledge, attitudes, beliefs, and practices among mothers who were previously treated for perinatal depression or anxiety, to inform future tailored sleep health interventions.

Methods
Mothers (N = 16) who had previously received treatment for perinatal depression or anxiety from a clinic serving low-resourced communities completed a single-occasion research home visit that included a demographics questionnaire and semi-structured interview. Interview data were analyzed using inductive content analysis, adapted from grounded theory.

Results
Mothers were, on average, 28.19 (SD = 7.71) years and had a child who was between 12 and 36 months. Of the mothers, 43.8% were White, 18.8% Black, 23.5% multiracial, 25.0% other race, 37.5% Hispanic, and 75.0% reported an annual household income of &lt; $40,000. “Needing to focus on sleep” was the core construct that emerged from the interview data, which was comprised of three domains. The first domain, “Having pretty good sleep,” described mothers’ experiences of good sleep health including easily falling and staying asleep, feeling satisfied with their sleep, and feeling well-rested. The second domain, “Trying to get normal healthy sleep,” described mothers’ experiences of poor sleep health and its consequences for physical and mental health. The third domain, “Wondering how to get better sleep with everything going on,” described everyday realities that got in the way of good sleep health including child sleep problems, competing demands on time, irregular work schedules, symptoms of depression or anxiety, and significant life transitions around school/work and pregnancy/postpartum.

Conclusion
Findings showed a range of maternal sleep health experiences. Mothers’ sleep health overlapped with mental health and wellbeing, children’s sleep health, and social determinants of health. Future sleep health interventions for mothers with a history of perinatal depression or anxiety could include tailored approaches that build on existing maternal strengths, integrate with existing mental health care services and child sleep health interventions, address social determinants, and attend to significant life transitions.

Support (if any)
2018 Sigma/Rosemary Berkel Crisp Award; NINR (T32NR016913); NICHD (R01HD080851, U54HD083091).
777 Sleep and non-suicidal self-injury in college students
Authors: Hendershot Sierra , Tubbs Andrew , Fernandez Fabian-Xosé , Perlis Michael , Grandner Michael 
Published: May 2021

Abstract

Introduction
Non-suicidal self-injury (NSSI) can increase suicide risk and is highly prevalent among young adults, including college students. While there is mounting evidence that disrupted sleep increases suicide risk, it is unclear how sleep influences NSSIs. Therefore, the present study explored how sleep variables were associated with NSSIs in a college sample.

Methods
Data from N=506 respondents were collected as part of the Assessing Nocturnal Sleep/Wake Effects on Risk of Suicide (ANSWERS) Survey of college students. The primary outcome, lifetime NSSI, was assessed using a self-report question derived from the Columbia Suicide Severity Rating Scale. The predictors were weekday short sleep (≤ 6h; assessed by retrospective sleep diary), Insomnia Severity Index (ISI) score, Brief Inventory of Sleep Control (BRISC) score, and Disturbing Dreams and Nightmares Severity Index (DDNSI) score. Binomial logistic regression models estimated the associations between NSSI and sleep variables in models that were unadjusted, adjusted for age, sex, race, and ethnicity, and additionally adjusted for thwarted belongingness or perceived burdensomeness from the Interpersonal Theory of Suicide.

Results
A total of N=142 (28.1%) respondents endorsed lifetime non-suicidal self-injury. Individuals with NSSI were more likely to be female (p=0.015), in poorer health (p&lt;0.001), and have more severe depression (p&lt;0.001) and anxiety (p&lt;0.001) than those without NSSI. In unadjusted models, higher BRISC scores were associated with lower odds of NSSI (OR 0.55 [0.43–0.71]), DDNSI scores of &gt;=10 increased the odds of NSSI (OR 2.65 [1.70–4.11], and ISI scores of &gt;=8 increased the odds of NSSI (OR 2.05 [1.38–3.08]), while short sleep was not associated with NSSI. Adjusting for age, sex, race, ethnicity, and thwarted belongingness did not eliminate any of these relationships but adjusting for perceived burdensomeness rendered the association between insomnia and NSSI non-significant.

Conclusion
Individuals with significant insomnia symptoms or nightmares were more likely to report a history of NSSI, while individuals with greater perceived control of sleep had lower odds of NSSI. These findings were generally independent of the Interpersonal Theory of Suicide. Further research is needed regarding the timing of NSSI (i.e., do they occur more often during nocturnal wakefulness) and whether sleep interventions can reduce the risk of NSSI.
Support (if any):
780 Perceived Deprivation Of Social Touch And Sleep Symptoms: Results From A Pre-COVID19 Community Study
Authors: Gupta Madhulika , Begin-Dyck Haylee 
Published: May 2021

Abstract

Introduction
The impact of social isolation and touch deprivation on sleep symptoms (insomnia, nightmares) during the SARS-CoV-2 (COVID19) pandemic has been recognized. These results however may have been confounded by various other disease-related factors that can directly impact sleep eg., medical complications associated with COVID19; trauma response and the economic impact of the pandemic. We examined previously unpublished data, from an earlier Canadian community-based survey (1997–1998) of psychosomatic factors (including sleep symptoms), associated with perceived touch deprivation (PTD).

Methods
360 consecutive consenting participants (316 community volunteers,44 psychiatric outpatients; 270 women; 94% white; mean±SD age: 38.3±14.5 years) completed a large battery of questions related to psychosomatic factors and the skin. The methods are described in previous publications [Gupta MA 2004; Gupta MA 2006] from this study. PTD was measured with the following item (rated on a 10-point Likert-type scale where “0” denoted “not at all” and rating of “9” denoted “very markedly”): “At the present time I wish I could get more hugs from others”’. Some of the sleep ratings in the survey read as follows: Insomnia1: “How long do you generally take to fall asleep at night?”(rating of “1” denoted “immediately”, “2” denoted ”1hour”). Secondly, participants rated how frequently they experienced the following sleep symptoms using a 4-point scale: “Awakenings from sleep”(Insomnia 2); “Dreams”; “Nightmares: “Snoring”; and “Jerking of arms or legs” (rating of “1” denoted “Never”, “2” denoted “Sometimes”, “3” denoted “Often”, 4 denoted “Always”).

Results
PTD scale scores (mean±SD: 3.81±2.85; range 0–9) correlated significantly with the following: Insomnia1 (r=0.219, p&lt;0.001); Insomnia2 (r=0.130, p=0.014); Nightmares (r=0.118, p=0.018); Limb jerking (r=0.209, p&lt;0.001), and age (r=-0.208, p&lt;0.001). Stepwise multiple regression analysis using PTD as dependent variable and all sleep ratings, age and sex as independent variables revealed the following predictors for PTD: Insomnia1(β=0.171,t=3.3267, p=0.001), Limb jerking (β=0.151,t=2.876, p=0.004), age (β= -0.179, t= -3.456, p=0.001).

Conclusion
In a pre-COVID19 community study, PTD was more problematic among the younger age group, and correlated with sleep onset and maintenance difficulties, nightmares and limb jerking, highlighting the importance of social touch in sleep.

Support (if any)
None