bluuebunny/crossref_metadata_2025_split huggingface dataset:
1099 Impact of Good Sleep on Recovery and Care Evaluation (iGRACE)
Authors: Gould Erin , Herman Grace , Najam Usman , Mishra Archana 
Published: April 2024

Abstract

Introduction
Sleep is imperative to health and healing. Hospitalization may severely disrupt sleep. Our IRB-approved study aimed to evaluate sleep quality and patterns among patients admitted to general medical wards in two major teaching hospitals. It focused on understanding sleep disruption during hospitalization, intending to implement better sleep hygiene practices for inpatients following this pilot study.

Methods
Ninety patients hospitalized for two or more nights were included in this IRB approved cross-sectional study, using a 14-item questionnaire to assess sleep quality, use of over the counter pharmacological (e.g. melatonin) and non-pharmacological (eye masks and earplugs) sleeping aids. All patients were English speaking, 18 or older, and admitted to the general medicine teaching floors. Patients were excluded if pregnant, incapacitated, encephalopathic, or had a known sleeping disorder.

Results
Results revealed a 100% completion rate for interviewer-led surveys, with 58.9% of patients being male, 41.1% being female. When asked about sleep quality at home, about 30% rated their quality of sleep as poor or very poor, meanwhile in the hospital 64.4% of people rated their sleep as poor or very poor. Among our participants, when asked about their experience in the hospital, 55.5% stated they had difficulty falling asleep often or always, with 67.8% often or always having difficulty staying asleep. Prior to coming into the hospital, about 43.3% of participants had at least occasionally used sleeping aids in the 30 days prior. Only 28.9% of patients were offered a sleeping aid during their hospitalization, yet of those not offered, 56.3% wished they had been offered sleeping aids. Of those who used sleep aids, 42.9% said they were very helpful, 57.1% found them somewhat helpful.

Conclusion
In conclusion, the study highlights a significant decline in sleep quality among hospitalized patients compared to home settings. Patients faced challenges falling and staying asleep while hospitalized, and those not offered sleep aids expressed a desire for them. The study underscores the potential benefits of interventions to improve sleep quality and quantity for hospitalized patients. The high efficacy of sleep aids among recipients suggests the potential positive impact of interventions targeting sleep improvement for inpatients.

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1103 Outcomes of Interventions to Reduce Pediatric Sleep Study Interpretation Time
Authors: Karhoff Iris , Imran Sehyr , Kowatch Robert , Patel Alpa , Blubaugh Kimberly , haile-teklezghi Aregash , Kalra Maninder 
Published: April 2024

Abstract

Introduction
Nationwide Children’s hospital (NCH) Sleep Center mission is to improve overall health through increased access to diagnosis of sleep disorders. Timely sleep study reporting avoids delay in recognition of sleep disorders and enables early intervention. NCH Sleep center providers completes urgent sleep study interpretations within 24 hours. Delay in sleep study interpretation of non-urgent sleep studies has been a patient and referring provider dissatisfier.

Methods
Aim Statement: The project will decrease the time to interpretation of non-urgent sleep studies for outpatient NCH ENT referrals from a baseline of 11 days to a goal of 7 days, accomplished by June 30 th, 2023, and sustained for 1 year. Key Drivers: • Provider workload • Provider expectation • Scoring delay • Workflow technical issues Interventions: • Change provider sleep reading rotation to 1 week • Study number/provider capped to 25/week • Study allocation criteria established • Report templates streamlined • Scoring for weekend studies implemented • Request platform for workflow management

Results
A total of 270 children were referred by NCH ENT and underwent non-urgent overnight polysomnograms from January 2023 to July 2023 as compared to 180 children from January 2022 to July 2022. The time to interpretation of non-urgent studies ordered by ENT specialists reduced from an average of 11 days (SD 7.1 days) in 2022 to an average of 4.5 days (SD 3.3 days) in 2023 (Jan-June).

Conclusion
Our results indicate that process improvement in the pediatric sleep lab using quality improvement methodology can be utilized to improve patient experience and meet referring provider expectations.

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1105 Relevance of Attributes and Preferences for At-home Diagnostic Testing Differ Among Patients with Sleep Disorders
Authors: Braun Marcel , Dietz-Terjung Sarah , Ulrich Sommer , Christoph Schoebel , Heiser Clemens 
Published: April 2024

Abstract

Introduction
The diagnostic workup for assessment of sleep disorders commonly involves an overnight test to assess sleep patterns and identify pathological events. So far, little is known about preferences for the provision of home sleep tests to patients with disturbed sleep. This study aims to close this gap by eliciting preferences and relative importance of attributes of home sleep testing using a discrete choice experiment (DCE).

Methods
A DCE with seven attributes of at-home overnight sleep testing and three levels per attribute, which were selected based on previous qualitative research, was developed using a fractional factorial design. Patients with and without previous sleep testing experience were recruited from two large third-level sleep centers in Germany. The DCE was administered to patients with paper-based forms during their visits to the outpatient clinics. Coefficients for attribute levels were calculated using a conditional logit model with effects coding to estimate their influence on choice decisions and calculate the relative importance of each attribute.

Results
305 patients (age 54.5 ± 13,1 years, male gender 65.3% were enrolled), and 288 surveys with complete data were included for analysis, which resulted in 1,152 choice decisions available for analysis. All of the attributes, except "Diagnostic accuracy" of sleep study had statistically significant influence on choice decisions. Attributes with the greatest relevance were "Waiting time to discuss sleep study results"; "Waiting time to conduct sleep study", and "Sleep quality during measurement". Of lowest importance was "Diagnostic accuracy" of sleep study, followed by "Effort to apply sleep study device", and "Device logistics". Significant heterogeneity in choice behavior was found, including differences by gender, willingness-to-pay for sleep studies, preferred sleep study location, and previous experience with sleep studies. Preferred location for conducting the sleep test was at-home in 50.7% and in-lab in 46.9%.

Conclusion
Preferences and relative importance of home sleep test attributes vary among different subgroups. Considering those preferences and their relevance is important for clinicians and policy-makers when designing individual patient-centric care pathways and high-level planning of diagnostic testing policies for sleep disorders.

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1117 Oral Microemulsion Gel Shows Improvements in Objective and Perceived Sleep
Authors: Rus Holly , Danoff-Burg Sharon , Weaver Morgan , Carmon Kiara , Mertz Catalina , Ledesma Duvia Lara 
Published: April 2024

Abstract

Introduction
More empirical research is needed on the effectiveness of ingestible consumer sleep products. This study investigated the effects of a gel-delivered sleep supplement on both objectively measured and perceived sleep in a non-clinical sample of adults.

Methods
Healthy adults (58% male, ages 40-73, mean age=56) with difficulty falling asleep or staying asleep participated in a 6-week field study, using a pre-post intervention design. During the 3-week baseline period, participants tracked their sleep at home without intervention. During the 3-week intervention period, 30-minutes before bedtime, participants ingested a gel including a blend of melatonin, L-Theanine, magnesium, calcium, vitamin B6, L-Glycine, 5-HTP, lemon balm extract, and GABA. Sleep was measured objectively using a PSG-validated, non-contact biomotion device, SleepScore Max, every night and by daily and pre-post self-report. Multilevel regression and paired t-tests were used to test for statistical significance.

Results
There were 822 nights of tracked sleep across 26 participants. Compared to baseline sleep, objective sleep measurements showed decreased sleep onset latency (p=.019); increased deep sleep, both in duration (p&lt;.001) and proportion of the night (p=.001); fewer awakenings (p=.003); decreased wake after sleep onset, both in duration (p&lt;.001) and proportion of the night (p=.001); and increased sleep efficiency (p&lt;.001) and sleep maintenance (p=.001). Improvements also were observed in SleepScore (p=.010), a measure of overall sleep quality, and BodyScore (p=.005), a measure of deep sleep. Self-report measures revealed improvements in a variety of outcomes compared to baseline: feeling adequately sleepy during bedtime more nights per week (p=.014); feeling it was easier to fall asleep (p&lt;.033); falling asleep in the preferred amount of time more nights per week (p=.006); feeling better able to sleep through the night without waking (p=.023); perceiving better overall sleep quality (p=.014); feeling satisfied with sleep more days per week (p=.007); and feeling well rested more days per week (p=.048).

Conclusion
In this sample of healthy adults, both objectively measured sleep and self-reported sleep improved when using the gel compared to baseline sleep without intervention.

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HealthyCell
1120 Measuring Sleep Depth with Odds Ratio Product (ORP) and In-ear EEG Earbuds
Authors: Meier Elias , Melnykowycz Mark , Duke Guy , Du Toit Wadda , Lambing Kari , Mozzini Federica , Guadagni Veronica 
Published: April 2024

Abstract

Introduction
Odds Ratio Product (ORP) is a highly validated measure of sleep depth and sleep-wake continuum derived from 3-second EEG epochs using spectral power analysis of the signal. It has been shown to be more sensitive than traditional sleep metrics to detect sleep quality and there is increasing scientific evidence of the ability of ORP to identify patient subgroups of sleep-wake disorders and guide personalized treatment. In-Ear EEG is an evolving method of measuring brain activity using in-ear electrodes. The current investigation assessed the signal quality of in-ear EEG data obtained from a single-channel in-ear EEG device (IDUN Guardian) alongside the frontal EEG using the Cerebra Prodigy to determine whether ORP calculation has the potential to be translated from frontal EEG to in-ear EEG.

Methods
18 healthy participants (9 male) were selected ensuring diversity in age (recruited in 24-60 years old range) and sex. Participants wore the Cerebra Prodigy (with forehead electrodes), IDUN Guardian (with in-ear electrodes) while sleeping at home for 3 nights. Data from the devices was collected, synchronized, anonymized, and analyzed to assess the correlation between ORP values derived from the two systems.

Results
Both in-ear and frontal EEG datasets were pre-processed separately (filtered between 0.3 - 40Hz). No artifact rejection was performed. Pearson correlation coefficient of ORP values was calculated between the two systems. An average correlation of 0.35 was found for raw signals based on 3-second epochs where the in-ear EEG seemed to overestimate ORP values. This was improved (r=0.70) by averaging over 10 ORP values (30 second epoch). This is likely due to masking of variability in signals variability in summary statistics.

Conclusion
The results showed that single channel in-ear EEG has the potential to resolve ORP values similar to forehead EEG signals. These results suggest the need for an in-depth analysis of the spectral powers in the different frequency ranges in both systems to guide work on improving alignment between the systems.

Support (if any)
This research work was made possible through the Eureka Eurostars program E2634 grant and was financially supported in Switzerland by Innosuisse - Swiss Innovation Agency and in Canada by the National Research Council Canada.
1124 Use of Scented Pillow Insert Improves Objective and Perceived Sleep Outcomes
Authors: Danoff-Burg Sharon , Rus Holly , Weaver Morgan , Ledesma Duvia Lara , Gottlieb Elie , Fox Julia , Gibbs Laura , Anderson Stephanie , Jain Anshul , Tabert Matthias 
Published: April 2024

Abstract

Introduction
A non-invasive approach to mitigating sleep disturbances is using scents to promote relaxation and sleep. Preliminary mechanistic evidence suggests that olfactory-relevant areas in the brain can influence areas responsible for sleep-wake functioning, and odor can modulate arousal and respiration, indirectly affecting sleep. However, it remains unclear whether preliminary results of in-lab studies generalize to the at-home, naturalistic environment in non-clinical populations. Here, we examined whether a pillow insert embedded with a formulation of fragrance developed for sleep may improve sleep-wake parameters in healthy adults.

Methods
Healthy adults (62% female; ages 20-60, mean=41) participated in a 6-week field study, using a pre-post intervention design. During the 3-week baseline period, participants tracked their sleep at home without intervention. During the 3-week intervention period, following an initial 3-night fragrance familiarization period, participants used a scented pillow insert each week inside their pillowcase. Made from cotton and lyocell fabric, the formulation includes a proprietary blend of fragrance ingredients with notes of lavender, cedarwood, and jasmine. Sleep was measured objectively using a PSG-validated non-contact biomotion device, SleepScore Max, every night and by daily and pre-post self-report. Multilevel regression and paired t-tests were used to test for statistical significance.

Results
There were nearly 600 nights of tracked sleep across 21 participants. Objective sleep measurements showed a reduction in wake after sleep onset (7% decrease, p=.034) and fewer awakenings (9% decrease, p=.045) when compared to baseline sleep. Improvements also were found for self-reported sleep outcomes, including increases in sleepiness at bedtime, perceived sleep quality, and feeling well-rested and refreshed in the morning (all ps&lt;.01). Participants felt satisfied with their sleep 2 more days per week compared to baseline (p&lt;.001).

Conclusion
Among healthy adults, aspects of both objectively measured sleep and self-reported sleep improved when using the scented pillow inserts compared to baseline sleep. These improvements occurred without using invasive or pharmacological interventions, which can be uncomfortable, expensive, and associated with adverse side effects.

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1127 Use of an Adjustable Bed Base Is Associated with Improvements in Objective and Perceived Sleep
Authors: Weaver Morgan , Danoff-Burg Sharon , Rus Holly , Carmon Kiara , Mertz Catalina , Ledesma Duvia Lara 
Published: April 2024

Abstract

Introduction
Previous research has shown that comfort of the sleep surface is essential to sleep quality. Additionally, positional adjustment of a sleep surface can help improve sleep and alleviate discomfort. This study compared sleep in an inclined position on an adjustable bed base to participants’ prior sleep when sleeping flat in their usual bed environment.

Methods
Healthy adults (71% male; ages 27-75, mean age=44) reporting difficulties with frequent awakenings or time spent awake at night participated in an 8-week field study, using a pre-post intervention design. During the 4-week baseline period, participants slept flat on their regular bed. During the 4-week intervention period, they slept in an inclined position of their choosing using Sleepy’s Adjustable Bed Base. Sleep was measured objectively using a PSG-validated, non-contact biomotion device, SleepScore Max, every night and by daily and pre-post self-report. Multilevel regression and paired t-tests were used to test for statistical significance.

Results
There were 951 nights of tracked sleep across 27 participants. Objective sleep measurements showed increased total sleep time (+6 minutes, p=.038) and an increase in light sleep duration (+5 minutes, p=.045) compared to baseline. Also, improvement was observed in BodyScore, an objective measure of deep sleep quality (+2%, p=.030). Self-report measures revealed that using the bed base felt more comfortable compared to sleeping flat using the original bed base (p=.011). Improvements also were found for a variety of perceived sleep outcomes, including the perception of falling asleep more easily, less tossing and turning, better sleep quality, and feeling more well-rested in the morning (all ps&lt;.001).

Conclusion
Several important aspects of objectively measured sleep and self-reported sleep improved when using the adjustable bed base compared to sleeping flat on the original bed base. Additionally, qualitative and quantitative self-report results indicated that the intervention was perceived as comfortable.

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Mattress Firm INC.
1136 Sleep Disorders in Children and Adolescents with Long COVID
Authors: Mistry Shikha , Rodgers-Melnick Samuel , Murphy Jennifer , Miller David , Edwards Amy , Ibrahim Sally 
Published: April 2024

Abstract

Introduction
Recognition of Long COVID is increasing and sleep disturbances are common to this population. This study describes sleep disorders and associated comorbidities in youth with Long COVID.

Methods
This is a retrospective cross-sectional study of patients initially presenting to the Long COVID clinic. We examined the prevalence of sleep disturbances (SD) and compared those with and without SD in comorbidity and symptomatology. Single-factor regression analyses were used to explore the relationship between SD and patient well-being. Multi-factor regressions analyses with PROMIS SD score as the predictor and age as a continuous covariate were analyzed for the several response variables: child well-being, general fatigue, sleep/rest fatigue, cognitive-fatigue, total fatigue, anxiety, and depression scores.

Results
Of 250 patients: age ranged 3-24 years(mean 14.6± 3.4years), predominantly female(157/250;63%), white(202/81%);and non-Hispanic(204/250;82%). Patients with SD made up 26%(64/250): 28% circadian rhythm disorders, 31% insomnia, and 1.2% hypersomnia. Compared to the non-SD group, the SD group was more likely to report comorbidities: abdominal pain(52% vs37%, p=0.035), nausea(64% vs52% p=0.084), constipation(50% vs26% p&lt; 0.001), anxiety(89% vs53% p&lt; 0.001), depression (48% vs27% p=0.002), ADHD(27% vs27% p=0.008), headaches(88% vs67%, p=0.002), dizziness (83% vs52%, p&lt; 0.001), POTS(28% vs16%, p=0.027), brain fog(47% vs29%, p=0.009), fatigue (95% vs77%, p=0.001), appetite loss(47% vs29%, p=0.007), and fever(47% vs72%, p=0.053). Using regression analyses, higher PROMIS SD scores negatively associated with child well-being scores (β2= -0.71±0.2; F2, 63=6.37, P&lt; 0.001, R2=0.17), sleep/rest fatigue(β2=-0.51±0.26; F2, 63=5.81, P=0.004, R2=0.16), and total fatigue(β2=-0.65 ±0.2; F2, 63=8.05, P&lt; 0.001, R2=0.20). No significant relationships were found with general/cognitive fatigue scores. Positive correlations found between PROMIS SD scores and anxiety and depression t-scores(β2= 0.26±0.10; F2, 63=3.08, P=0.05, R2=0.09; and β2=0.30±0.11; F2, 65=3.74, P=0.03, R2=0.11, respectively).

Conclusion
Sleep disorders are prevalent among youth with long-COVID, often coexisting with higher rates of physical, neurological, and psychological symptoms. Higher PROMIS SD scores predict lower child well-being, and higher mood disorder scores. While other factors likely impact long-COVID outcomes, sleep plays an integral role. These findings suggest that SD is a key factor in the overall health and mood of children with Long-COVID, emphasizing the need for integrated care approaches that address both sleep and psychological health.

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1147 Sleep Enigmas in Primary Ciliary Dyskinesia: An Atypical Case of Sleep Movement Disorders and Alpha-Delta Sleep
Authors: Cardona-Quiñones Roberto , Hernandez Saidy Salem , Ramírez-Rivera Edicer , Alvarez-Torres Edwin , Vargas-Perez Noel , De Jesus-Rojas Wilfredo 
Published: April 2024

Abstract

Introduction
Sleep disorders are characterized by the impairment of the quality, timing, and amount of sleep, which results in daytime distress and functioning. Primary Ciliary Dyskinesia (PCD) is a rare genetic condition with oto-sino-pulmonary complications associated with various comorbidities, including sleep-related disorders. However, sleep-related research and its implications in PCD are substantially limited.

Report of case(s)
A 40-year-old Puerto Rican female with a history of RSPH4A [c.921 + 3_921 + 6delAAGT] PCD founder mutation was evaluated for sleeping difficulties. Upon taking history, the patient mentioned that she has been struggling with getting adequate sleep, where she complains of difficulty falling asleep, occasional snoring, and unexplained movements while sleeping. Physical examination presented with Mallampati (4+) but did not show significant neck circumference enlargement, body-mass index, or other neurologic deficits. Diagnostic polysomnogram did not show obstructive sleep apnea (OSA), with a baseline Apnea-Hypopnea Index (AHI) of 1.3/hr. The patient had a prolonged wake after sleep onset (WASO) period, resulting in poor sleep efficiency. The EEG showed alpha delta sleep. Moreover, Periodic Limb Movements in Sleep (PLMS) were present with important sleep fragmentation during the first half of the study (Periodic Limb Movement Index of 15.9/hr); eventually improving when the patient was able to consolidate sleep. Other movements during sleep/drowsiness were appreciated, with large amplitude and rhythmic artifacts in the EEG and legs EMG channels. These movements are most consistent with Rhythmic Movement Disorder, more notoriously in the lower extremities.

Conclusion
To our knowledge, this is a unique documented PCD case with the presence of Alpha-Delta Sleep, presenting PLMS, and Rhythmic Movement Disorder. Comprehensive screening protocols, neuropsychiatric evaluation, and additional sleep studies should be considered to evaluate these complexities in patients with PCD. Further studies are required to identify whether these sleep-related disorders are due to neurophysiologic manifestations as seen with Alpha-Delta Sleep, a neurodevelopmental or neurodegenerative process associated with this ciliopathy. Multicentric clinical trials are essential for this type of ciliopathy, especially among Puerto Rican and Hispanic populations.

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