bluuebunny/crossref_metadata_2025_split huggingface dataset:
0880 Relationships Between Multimorbidity and Disturbed Sleep Phenotypes in Chronic Spinal Cord Injury
Authors: Graves Letitia , May Anna , Xu Zixiang , Sun Jiayang , Carter Patricia , Bogie Kath 
Published: April 2024

Abstract

Introduction
Disturbed sleep is a modifiable risk factor for a variety of co-morbidities. Treatment of sleep disorders can provide a key target for improving cardiometabolic health and overall wellness. Despite evidence suggesting higher prevalence of disturbed sleep in Veterans with spinal cord injury (SCI) compared to the non-injured population, the intersectional effects of sleep-wake disruption remain undefined. The purpose of this study is to examine existing data from the spinal cord injury-pressure injury resource (SCI-PIR) database to assess prevalence and identify relationships among sleep disorders and cardiometabolic risk after spinal cord injury.

Methods
This retrospective longitudinal national database cohort study utilized the VA’s SCI-PIR database containing comprehensive clinical data for 29,000 individual Veterans with SCI with over 120,000 encounters. SCI-PIR data includes clinical characteristics of Veterans with SCI, demographics, and comorbidities identified as being relevant to sleep and cardiometabolic risk. We queried the database for ICD9 diagnosis codes related to cardiovascular, metabolic, psychologic, and sleep conditions to identify sleep disorder subgroups defined by clustering of cardiometabolic risk factors and sleep diagnoses within SCI individuals diagnosed with sleep disorders.

Results
In the sample of 18,894 Veterans, sleep disturbances were diagnosed in only 16.25% of the sample. Sleep apnea (6.7%) and insomnia (4.3%) were the most common sleep diagnosis. Correspondence analysis of sleep, cardiac disorders, and other co-morbidities demonstrated two clusters. The first cluster showed a robust link between sleep apnea, hypersomnia, heart failure and arrhythmias, and secondary associations with coronary artery disease, chronic kidney disease, obesity, diabetes, and hyperlipidemia. The second cluster showed a strong relationship between insomnia, anxiety, and post-traumatic stress disorder.

Conclusion
Sleep disturbances are common in Veterans with SCI, but underdiagnosed. Our findings support the link between medical complications and consequences of disturbed sleep and cardiometabolic risk. This will enable development of SCI validated sleep instruments and clinical decision tools that identify those at highest risk for sleep disorders lead to the development of targeted interventions and treatments to advance precision health for Veterans with SCI.

Support (if any)
NIH grant R25 HL105400 and VHA Office of Research, Supplement to Promote Diversity
0882 The Association Between Objective Daytime Sleepiness and Glucose Metabolism in OSA Patients: A Metabolomics Study
Authors: Li Yun , Le Chen  , Chen Baixin , Dai Yanyuan , Vgontzas Alexandros 
Published: April 2024

Abstract

Introduction
Objective, but not subjective excessive daytime sleepiness (EDS) has been proposed to link to cardiometabolic comorbidity in obstructive sleep apnea (OSA). We aimed to examine the joint effect of OSA and objective EDS on glucose metabolism and the underlying mechanisms.

Methods
The multiple sleep latency test (MSLT) and Epworth sleepiness scale (ESS) were used to assess objective and subjective EDS, respectively. Disordered glucose metabolism was defined as either a physician-diagnosis or having fasting blood glucose levels ≥ 5.6 mmol/L. Values of fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR) higher or equal to the median values of our sample were defined as high fasting insulin and insulin resistance. Serum metabolomics was used to explore the underlying pathways.

Results
Among 114 consecutive OSA patients, lower MSLT values was marginally significantly associated with higher levels of fasting blood glucose (β = −0.181, p = 0.052, poor strength), and significantly associated with insulin (β = −0.308, p = 0.002, fair strength) and HOMA-IR (β = −0.321, p = 0.001, fair strength). Furthermore, objective EDS was significantly associated with increased odds of disordered glucose metabolism (OR = 5.781, 95%CI 1.232 - 27.135), elevated fasting insulin (OR = 4.317, 95%CI 1.357 - 13.731) and insulin resistance (OR = 5.621, 95%CI 1.581 - 19.984). Metabolomics analyses showed that dysregulation of valine-related metabolism linked the association between objective EDS and impaired glucose metabolism in patients with OSA. No association between subjective EDS and impaired glucose metabolism was observed.

Conclusion
OSA with objective, but not subjective EDS is associated with impaired glucose metabolism. Dysregulation of valine-related metabolism may contribute to the association between objective EDS and impaired glucose metabolism in OSA.

Support (if any)
This study was supported by the National Natural Science Foundation of China [No.81970087; No.82270105; No.82300117] and 2020 Li Ka Shing Foundation Cross-Disciplinary Research Grant [2020LKSFG05B].
0884 Slow Wave Sleep Is Associated with Glucose Metabolism in Obstructive Sleep Apnea: A Registry-based Study
Authors: Fu Cong , Yu Huan 
Published: April 2024

Abstract

Introduction
Obstructive sleep apnea (OSA) is a common condition being increasingly recognized and is a known risk factor for cardiovascular and metabolic disease. Impaired sleep architecture and (or) frequent nocturnal hypoxia are characteristic features in patients with OSA. However, little is known about the sleep parameters linking OSA with glucose metabolism. The objective of this study was to evaluate the association between glycated hemoglobin (HbA1c) and sleep traits from polysomnography and subjective sleep diary in a Chinese population with proven OSA (Huashan OSA Registry Study, Hs-OSARS).

Methods
535 participants were recruited in Huashan OSA Registry Study, from January 2018 to August 2021. Objective sleep characteristics were measured via one-night laboratory PSG and biochemical parameters was tested the next morning. Associations were conducted using Pearson’s correlation with adjustments for age, gender, and body mass index (BMI). Regression was used to investigate predictive power of sleep subscales for glucose levels.

Results
Among the participants, 133 subjects underwent HbA1c and lipid profile (triglyceride, total cholesterol, LDL- and HDL-cholesterol, etc). Age, BMI, ApoE, TC and non-HDL-C (rage=0.281, p=0.001; rBMI =0.249, p=0.004; rApoE=0.250, p=0.004; rTC=0.264, p=0.005; rnon-HDL-C=0.281, p=0.002) had positive associations with HbA1c. Among sleep traits, only stage 3 sleep had a negative association with HbA1c (r=-0.219, p=0.011). After controlling for gender, age and BMI, these associations remained and were statistically significant. Stepwise regression analysis found that non-HDL-C, stage 3 sleep and age were significant predictors retained in the model. Upon fixing the covariates (including gender, age and BMI), TC and stage 3 sleep were significant for predicting HbA1c outcomes.

Conclusion
Insufficient slow wave sleep is associated with higher blood glucose levels. Our study shows that other PSG indices, such as total sleep time, sleep efficiency, arousal index, apnea-hypopnea index and hypoxemic burden, are not associated with HbA1c. These findings highlight the importance for clinicians to evaluate and improve the slow wave sleep as part of preventing glucose metabolism impairment in OSA patients.

Support (if any)
0886 Impact of Multidimensional Sleep Health on Glycemic Control and Self-Reported Health Outcomes in Type 1 Diabetes
Authors: Irsheed Ghada Abu , Steffen Alana , Martyn-Nemeth Pamela , Park Minsun , Quinn Laurie , Duffecy Jennifer , Baron Kelly , Mihailescue Dan , Reutrakul Sirimon 
Published: April 2024

Abstract

Introduction
Sleep is important to health in patients with type 1 diabetes (T1D). This study comprehensively explored the impact of individual sleep dimensions, (e.g. satisfaction, alertness, timing, efficiency, duration, and regularity) as well as global multidimensional sleep health (MSH) on glycemic control and other self-reported health outcomes in T1D.

Methods
Data from 118 adults with T1D participating in an ongoing sleep intervention study (NCT04506151) were analyzed. Satisfaction was assessed by the Pittsburgh Sleep Quality Index and alertness by the Epworth Sleepiness Scale. Timing (sleep midpoint), efficiency, duration, and regularity (standard deviation of sleep midpoint) were derived from 7-day actigraphy. A composite MSH score was the sum of “Good” individual sleep health dimensions. Glycemic control was assessed through blinded 7-day continuous glucose monitoring (time-in-range (TIR, % of glucose levels between 70-180 mg/dL) and %CV), and hemoglobin A1C level (A1C). Self-reported outcomes (diabetes self-care and psychological factors) were collected through validated questionnaires. Multiple regression analyses were performed to determine whether individual sleep dimension and MSH scores independently predicted glycemic control or self-reported outcomes.

Results
Median (IQR) age was 33.87 (27.4, 43.61) years, 69.49% were female, and mean (SD) A1C was 6.74% (.93). After adjusting for covariates, only less sleep regularity was associated with poorer glycemic control [higher %CV (β=.262, p&lt;.01), less TIR (β=-.280, p&lt;.01) and higher A1C (β=-.175, p&lt;.05)]. Sleep satisfaction was associated with higher diabetes quality of life (β=-.243, p&lt;.01), lower diabetes distress (β=-.189, p&lt;.05), lower fatigue (β=-.249, p&lt;.01), and lower depression (β=-.211, p&lt;.05). Daytime sleepiness was associated with higher fatigue (β=.228, p&lt;.05), while later sleep timing was associated with higher depressive symptoms (β=.211, p&lt;.05). Higher sleep efficiency was associated with lower anxiety and depression (β=-.305, p&lt;.01, β=-.293, p&lt;.01), respectively. Sleep duration was not associated with any outcomes. Higher MSH was significantly associated with higher TIR (β=.191, p&lt;.05), lower A1C level (β=-.266, p&lt;.01), and lower depression (β=-.211, p&lt;.05), Diabetes self-care measures were not predicted by any individual sleep dimensions or MSH score.

Conclusion
Individual sleep dimensions and MSH composite score are linked to glycemic and self-reported psychological outcomes, highlighting the importance of comprehensive sleep health evaluation in T1D.

Support (if any)
NIH/NIDDK R01DK121726
0887 Effects of Melatonin on Glucose, Insulin, and C-Peptide Dynamics in Carriers of MTNR1B Type 2 Diabetes Risk Variant
Authors: Qian Jingyi , Anderson Phillip , Stefanovski Darko , Vujovic Nina , Kelly Lauren , Lepson Joshua , Nguyen Hoa , Byrne Sean , Mandrup-Poulsen Thomas , Adler Gail , Wang Wei , Garaulet Marta , Saxena Richa , Scheer Frank 
Published: April 2024

Abstract

Introduction
Genome-wide association studies identified the common variant rs10830963 in the MTNR1B gene (encoding melatonin receptor 1B) as a risk factor for type 2 diabetes. This sparked great interest in the role of the circadian hormone melatonin in glycemic control; however, the mechanisms underlying this association remain unclear. We investigated whether exogenous melatonin administration worsens glucose tolerance, insulin sensitivity, and beta-cell function, and whether such effect is stronger in MTNR1B G-allele risk carriers compared to non-carriers.

Methods
Twenty-one healthy participants of European ancestry were studied in a double-blind, randomized, cross-over trial, including ten MTNR1B risk carriers (mean age±SD, 29±10y; BMI, 24.4±2.6kg/m2; 5 women) and eleven non-carriers (32±10y; 22.5±3.0kg/m2; 3 women). Each participant underwent a highly-controlled 5-day laboratory protocol, during which they received 5mg oral melatonin or placebo in randomized order on two nonconsecutive days. Elevated circulating melatonin levels after melatonin administration were confirmed by hourly blood draw. Insulin sensitivity (SI), beta-cell function, and disposition index (DI, product of insulin secretion and sensitivity) were derived from insulin-modified frequently-sampled intravenous glucose tolerance test (FSIGT) using minimal models.

Results
The effect of melatonin versus placebo differed significantly between MTNR1B genotypes for glucose incremental area under the curve (iAUC180min, Pinteraction=0.005), insulin iAUC20min (Pinteraction=0.03), and C-peptide iAUC20min (Pinteraction=0.03) during FSIGT, with 11.7% increase in glucose iAUC180min (95%CI 3.1%─20.2%, P=0.03), 25.2% decrease in insulin iAUC20min (4.4%─41.2%, P=0.06), and 19.2% decrease in C-peptide iAUC20min (4.9%─31.2%, P=0.04) in carriers, without significant changes in non-carriers (n.s.). While we did not find significant effects of melatonin nor its interaction effects with MTNR1B genotype on DI and SI, first-phase insulin secretion was affected differently by melatonin in carriers and non-carriers (Pinteraction=0.001), with a 40.0% reduction in carriers (27.6%─50.3%, P&lt; 0.0001), but no significant changes in non-carriers (n.s.).

Conclusion
Exogenous melatonin administration significantly impaired glucose tolerance and beta-cell function in MTNR1B risk carriers, but not in non-carriers. These data suggest that first-phase insulin secretion plays an important role in mediating the effect of melatonin on glucose control and its interaction with MTNR1B genotype.

Support (if any)
NIDDK Grant R01-DK102696 to FAJLS and RS, ADA fellowship 1-17-PDF-103 to JQ, and CTSA-UL1RR025758 to Harvard University and Brigham and Women’s Hospital.
0894 Effects of Chronic Rhinosinusitis (CRS) on Sleep Duration and Variability in World Trade Center (WTC) Responders
Authors: Ravi Sri Saranya , Castillo Horacio Romero , De Resende Adriana , Legard Alicia , Martillo Katarina , Varga Andrew , Osorio Ricardo , Parekh Ankit , Black Kathleen , Rapoport David , Mullins Anna , de la Hoz Rafael , Udasin Iris , Lu Shou-En , Sunderram Jag , Ayappa Indu 
Published: April 2024

Abstract

Introduction
43.5% of World Trade Center rescue and recovery workers demonstrate symptoms of chronic rhinosinusitis (CRS). Subjects with CRS report increased sleep complaints and shorter subjective sleep duration compared to those without CRS. Discomfort from nasal symptoms during sleep may result in shorter sleep duration and an increased night-to-night variability. We compare actigraphic assessment of sleep duration and variability in subjects with and without CRS.

Methods
WTC-responders in an on-going study assessing sleep apnea and Alzheimer's disease biomarkers underwent 2-week actigraphy with sleep diary before in-lab polysomnography. Demographics, CRS symptoms, Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), sleep duration and complaint information were obtained. CRS+ was defined as ≥3 symptoms: facial pain, post-nasal drip, nasal congestion, blocked nose, loss of smell, sneezing, sore throat or hoarseness. Nightly actigraphy data were analyzed using Cole-Kripke algorithm and averaged over all nights to obtain mean total sleep time (TST) and coefficient of variability (CV) across nights. Group comparisons were performed using two-sample t-test with significance level at p&lt; 0.05.

Results
42 subjects (74%M/26%F, age 64.7±5, BMI 28.6±6kg/m2) had 14 nights (range=11-17) of actigraphy data. Subjective sleep duration and TST by actigraphy were correlated (r=0.4, p=0.02). 19(45%) were CRS+ vs 23(55%) CRS-. Age, sex, BMI, and sleep apnea prevalence did not differ between CRS+ vs CRS- groups. Mean (SD) ISI in CRS+=8.4(5.4), CRS- =5.4(5.4), p=0.08. ESS in CRS+=4.2(2.5), CRS- =4.6(3.0), p=0.6. Although not statistically significant, mean subjective sleep duration in hours was shorter and more variable in CRS+=7.84(1.3) than CRS- =8.34(0.7), p=0.1. Actigraphic sleep duration (TST) in hours was shorter and more variable in CRS+ [6.59(1.2), CV=22.7(9.5)] than CRS- [6.80(0.8), CV=20.7(7.2)].

Conclusion
WTC-responders with CRS symptoms report shorter subjective sleep and greater insomnia similar to our previous findings. While we did not demonstrate a significant difference in actigraphic sleep duration or variability between CRS groups, we were limited by a small sample size. The high prevalence of CRS and sleep complaints in this population and the association of reduced sleep duration and increased morbidity and mortality highlights the importance of establishing if there is a shorter sleep duration in CRS+ patients through further investigation.

Support (if any)
NIOSH:U01OH011852, K24HL109156, NCATS:TL1TR004420
0896 Years of Life Lost Due to Insufficient Sleep and Associated Economic Burden in China from 2010 to 2018
Authors: Yan Xumeng , Han Fang , Wang Haowei , Li Zhihui , Kawachi Ichiro , Li Xiaoyu 
Published: April 2024

Abstract

Introduction
Research on the health and economic costs due to insufficient sleep remains scant in developing countries. This study aims to estimate the years of life lost (YLLs) due to short sleep and quantify its economic burden in China.

Methods
This study estimated both individual and aggregate YLLs due to short sleep (i.e., ≤ 6 h) among Chinese adults aged 20 years or older by sex and 5-year age groups from 2010 to 2018. Life expectancy estimates were derived from nationally representative prevalence data, relative mortality risks from meta-analyses, and life tables in China.

Results
Younger age groups and males had more YLLs due to short sleep compared to their counterparts. The individual YLLs were 0·98, 0·95, 0·94 for men, and 0·78, 0·74, 0·73 for women aged 20-24 in 2010, 2014, and 2018, respectively. Patterns of individual YLLs were largely stable across the years. In aggregate, China experienced a rise from 66·75 million YLLs in 2010 to 95·29 million YLLs in 2014, and to 115·05 million YLLs in 2018. Compared to 2010 ($191·83 billion USD), the associated economic cost in 2014 increased to $ 422·24 billion USD, and the cost in 2018 more than tripled ($628·15 billion USD). The percentage of cost to Chinese GDP in corresponding years was 3·23%, 4·09%, and 4·62%.

Conclusion
Insufficient sleep is associated with reduced life expectancy in China. The escalating economic toll attributed to short sleep underscores the urgent need for public health interventions to improve sleep health at the population level.

Support (if any)
0898 Social Vulnerability and Sleep Health in Young Adults with Type 1 Diabetes
Authors: Howard Quiana , Hickman Ronald , Griggs Stephanie 
Published: April 2024

Abstract

Introduction
Young adults aged 18 to 26 years with type 1 diabetes (T1D) are at high risk for social vulnerability and poor sleep health (sleep disturbance and shorter sleep duration) due to social, economic, and geographic shifts. However, the role of social vulnerability in the sleep health of young adults with T1D is not well understood. The purpose of this quantitative descriptive study was to examine the association between indicators of individual- and neighborhood- level social vulnerability and sleep health among young adults with T1D.

Methods
The Centers for Disease Control/Agency for Toxic Substances and Disease Registry Social Vulnerability Index was used to measure neighborhood-level social vulnerability (socioeconomic status, housing type/characteristics, racial and ethnic minority status, and transportation). Individual-level social vulnerability was measured with a 7-item composite based on the National Patient Social Determinants of Health Risk Assessment Protocol for Responding to and Assessing Patient Assets, Risks, and Experiences (race, ethnicity, education, language, income, employment, and stress). Sleep disturbance was measured with the 4-item Patient-Reported Outcomes Measurement Information System was used to measure sleep disturbance and research grade actigraphy over 14 days.

Results
Forty-four young adults with T1D (38.6% female, mean age 20.9 years, mean A1C 8.6%) completed the baseline measures of a 12-week interventional study. Higher individual level social vulnerability was associated with higher sleep disturbance in the unadjusted and adjusted models (B = .414, p &lt; .001, R2 = .171; B = .446, p = .010, R2 = .218). Higher neighborhood level social vulnerability was associated with shorter actigraphy-derived sleep duration in the unadjusted models (B = -.326, p = .043, R2 = .106); however, the association was no longer significant in the adjusted models (p = .068). Models were adjusted for sex, T1D duration, and BMI. The associations between individual level social vulnerability and sleep duration or neighborhood level social vulnerability and sleep disturbances were not significant.

Conclusion
More research is warranted to better understand the intricate relationship and role of multiple individual and neighborhood-level social drivers in the sleep health of young adults with T1D.

Support (if any)
National Institute of Nursing Research R00NR018886 & Dean’s Legacy Fellowship Case Western Reserve University.
0899 Bidirectional Links of Daily Sleep Quality and Duration with Pain in Veterans with Alcohol Use Disorder
Authors: tracy Eunjin , So Christine , Kanaley Jill , Trull Timothy , Manrique-Acevedo Camila , McCrae Christina , Miller Mary Beth 
Published: April 2024

Abstract

Introduction
Military Veterans tend to experience chronic pain and sleep problems of higher intensity and prevalence than the general population, and may be more likely to self-medicate with substances such as alcohol. Research suggests that sleep and pain are interrelated. However, few studies have examined bidirectional links between daily sleep quality and duration with pain among Veterans, especially those with alcohol use disorders. Furthermore, it has not been studied whether daily alcohol consumption (whether they drank or not) moderates everyday associations between sleep and pain among Veterans with alcohol use disorders.

Methods
114 Veterans with alcohol use disorder (82.5% men: mean age = 38.86 [range 21–67]) completed 14 days of diaries assessing their sleep quality, sleep duration, pain, and drinking quantity. Multilevel modeling examined the effects of daily variability in sleep (within-person effects) and average levels of sleep (between-person effects) on pain the following day. To examine the effects of pain on sleep, multilevel modeling examined the effects of daily variability in pain and average levels of pain on sleep.

Results
Regarding bidirectional links of sleep quality and pain, greater daily (b=−.86, se=.41, p=.04) and average (b=−15.51, se=3.28, p&lt;.001) sleep quality were associated with lower next-day pain. Higher average pain was associated with poorer sleep quality (b=−.01, se=.002, p&lt; .001), but daily pain was not associated with daily sleep quality. Regarding bidirectional links of sleep duration and pain, there was no daily association between sleep duration and pain, but greater average sleep duration was associated with lower pain levels (b=−4.84, se=1.60, p=.003). Daily drinking did not moderate these associations.

Conclusion
Both sleep quality and sleep duration are closely associated with pain among Veterans with alcohol use disorder. Fluctuations of daily sleep quality affected Veterans’ pain experience in everyday life regardless of alcohol consumption; in contrast, fluctuation of daily pain did not affect daily sleep quality, implying that Veterans with alcohol use disorder are sensitive to poor sleep quality. The results support that sleep quality may buffer daily pain experiences among this patient population.

Support (if any)
5K23AA026895