bluuebunny/crossref_metadata_2025_split huggingface dataset:
1116 Naturalistic Sleep Tracking in a Longitudinal Cohort: How Long Is Long Enough?
Authors: Goparaju Balaji , DePalma Glen , Bianchi Matt 
Published: April 2024

Abstract

Introduction
Objective sleep tracking in health research, often via polysomnography or actigraphy, typically involves a small number of nights per person. Given the nightly variability of sleep duration, it remains unclear the extent to which relatively short observation windows may impact inferences in sleep research.

Methods
We attempt to quantify potential limitations of shorter duration sleep tracking research by sub-sampling from longer-term observation windows using both simulated data from known distributions and real-world Apple Watch sleep tracking data (30-365 nights) from over 35 thousand participants who provided informed consent to participate in the Apple Heart and Movement Study and elected to contribute sleep data to the study.

Results
Simulations demonstrate that the magnitude of deviation from truth defined using all available observations per individual, and the direction of bias depended on the sub-sample size, the type of simulated distribution (gaussian vs skewed), and the summary statistics of interest, such as centrality (mean, median) and dispersion (standard deviation (SD), interquartile range (IQR)). For example, n=7 longitdunal observations from a realistic normal distribution (7 + 1 hours) showed a 6.7% median under-estimation bias (IQR 24% under- to 14.7% over-estimation) compared to the true SD value (1 hour). Real-world sleep duration and sleep stage data, when under-sampled and compared to longer observations within-participant, showed similar SD bias at 7 nights, and similar convergence rates approaching the true value as longitdunal samples increase from 7 to 30 or more nights. Shapiro-Wilk tests for normality and log-normality show that 64% of simulated log-normal (skew) distributions fail to reject normality at n=7 samples, while real-world sleep duration data most commonly failed both normality and log-normality tests even using larger samples (180 nights per participant). Finally, simulating cohorts with 7 + 1 hours plus a subset of 6 + 1 hours shows that a single-night observation of “short sleep” (6 hours) is more likely from random variation of a 7-hour sleeper than from a 6-hour sleeper. Extending the observation to n=7 nights mitigates this mis-classification risk.

Conclusion
The results suggest that longer duration tracking provides important benefits to reduce bias and uncertainty in sleep health research that historically relies on small observation windows.

Support (if any)
n/a
1118 Smart Goggles Used Before Bed to Induce Relaxation Improve Objective Sleep and Reduce Self-Reported Stress
Authors: Rus Holly , Danoff-Burg Sharon , Weaver Morgan , Carmon Kiara , Mertz Catalina , Ledesma Duvia Lara 
Published: April 2024

Abstract

Introduction
Previous research has shown that gentle, rhythmic vibrations can help induce relaxation and support sleep. This study examined the effects of smart goggles used before bed to deliver gentle vibration and heat to the eyes and temples. Objective sleep, perceived sleep, and self-reported stress, anxiety, and relaxation were measured.

Methods
Healthy adults (40% female; ages 26-75, mean=50) 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. During the 3-week intervention period, participants used Therabody SmartGoggles before bed. The goggles deliver gentle eye and temple massage through vibrating motors and heat for relaxation. Sleep was measured objectively using a PSG-validated non-contact biomotion device, SleepScore Max, every night and by daily, nightly, and pre-post self-report. Relaxation, stress, and anxiety were measured using visual analog scales. Anxiety also was measured with a validated short form of the State-Trait Anxiety Inventory. Multilevel regression and paired t-tests were used to test for statistical significance.

Results
There were over 676 nights of tracked sleep across 20 participants. Objective sleep measurements showed multiple improvements: increased sleep duration (+12 minutes, p=.014); increased deep sleep, in duration (+6 minutes, p=.002), proportion of the night (7% relative increase, p=.020), and BodyScore (4% increase, p=.002); fewer awakenings (7% decrease, p=.021) and decreased wake after sleep onset (-6 minutes, p=.047); and improved SleepScore, a measure of overall sleep quality (3% increase, p=.020). Immediately after using the goggles each night, compared to immediately before using the goggles, participants felt sleepier, less stressed, less anxious, and more relaxed (all ps&lt;.05). At the end of the 3-week intervention period, compared to baseline, participants felt they had better sleep quality; felt more well-rested in the mornings; and showed reduced anxiety, confirming the nightly analysis (all ps&lt;.05).

Conclusion
Objectively measured sleep quality and duration, as well as perceived sleep, improved when using the goggles before bed compared to baseline. Users also experienced increased feelings of relaxation along with reduced stress and anxiety.

Support (if any)
Therabody
0112 Ethnoracial Differences in the Association Between Witnessing Violence and Sleep Duration Among Young Adults
Authors: Dadzie Adwoa , Master Lindsay , Reichenberger David , Collie Angel , Mathew Gina , Hale Lauren , Chang Anne-Marie , Buxton Orfeu 
Published: April 2024

Abstract

Introduction
Experiences of interpersonal violence negatively influence sleep and health. Prior research has also shown that being aware of interpersonal violence experienced by friends and family is associated with short sleep duration. We seek to understand whether sleep is disrupted by witnessing or experiencing physical violence.

Methods
Data were from the age 22 wave of the Future of Families and Child Wellbeing Study (N=444). Young adults wore a wrist actigraphy device for 14 days and self-reported their experiences with physical violence over the prior year. Witnessing and experiencing violence were classified in four ways: witnessing/experiencing violence by someone not close and witnessing/ experiencing violence by someone close. Separate linear regression models assessed the cross-sectional associations of experiences of violence with nighttime total sleep time (TST), adjusting for race/ethnicity, gender, and educational level. Secondary analyses assessed race/ethnicity as a moderator of violence on night sleep duration.

Results
33% of young adults witnessed violence perpetrated by someone not close to them, 13% experienced violence by someone not close to them, 16% witnessed violence by someone close to them, and 8% experienced violence by someone close to them. There were no significant main effects of any type of violence on TST. There were interaction effects of witnessing violence (not close AND close) and race on mean TST. Post-hoc tests on witnessing violence by someone not close revealed White young adults had lower TST (42 minutes, p&lt; 0.009) compared to White young adults who had not witnessed violence by someone not close to them. In addition, post hoc tests on witnessing violence by someone close revealed Black young adults had higher TST (20 minutes, p&lt; 0.046) compared to Black young adults who had not witnessed violence by someone close to them, whereas White young adults had lower TST (43 minutes, p=&lt; 0.037) compared to White young adults who had not witnessed violence by someone close to them.

Conclusion
We observed ethnoracial differences in associations between witnessing physical violence and sleep. More research is needed to further explain these interactions.

Support (if any)
R25-HL147668, R01HD073352, R01HD36916, R01HD39135, R01HD40421.
1128 Use of a Recliner Designed for Sleep Improves Perceived Sleep Outcomes
Authors: Ledesma Duvia Lara , Danoff-Burg Sharon , Rus Holly , Weaver Morgan , Carmon Kiara , Mertz Catalina 
Published: April 2024

Abstract

Introduction
The positional adjustment of the sleep surface, such as inclining the upper body and/or legs, can potentially contribute to better sleep and alleviation of discomfort associated with a variety of physical problems. This study compared sleep on a recliner designed for sleep to participants’ prior sleep on their original sleeping surface.

Methods
Adults (78% female, ages 29-73, mean age=47) who reported already sleeping at least part of the night on a recliner, chair, or sofa, participated in a 6-week field study, using a pre-post intervention design. During the 3-week baseline period, participants slept at home in their usual environment. During the 3-week intervention period, they slept on the Zecliner at home. This recliner enables users to tailor the sleep surface to their preferences by adjusting the position of the upper body and legs. 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 708 nights of data across 23 participants. While objectively measured sleep did not improve, pre-post analyses revealed increases in self-reported sleep quality (+121%) and feeling well rested in the morning (+119%) compared to baseline (all ps&lt;.001). Satisfaction with sleep and feeling well-rested in the morning increased from 1 to 4 days per week on average (all ps&lt;.001). Also, increases in ratings of comfort (+107%), pressure relief (+240%), sense of weightlessness (+327%), and feeling cool (+180%) were observed compared to baseline (all ps&lt;.001).

Conclusion
Perceived sleep quality at night and feeling well-rested in the morning improved when sleeping on the recliner compared to baseline, likely because the intervention was perceived as more comfortable. Findings highlight the importance of adjustable sleep surfaces in promoting satisfaction with sleep.

Support (if any)
Flexsteel
1129 Effects of a Mattress Protector Designed to Help Sleepers Feel Cool
Authors: Ledesma Duvia Lara , Danoff-Burg Sharon , Rus Holly , Weaver Morgan , Upadhyaya Devanshi , Carmon Kiara 
Published: April 2024

Abstract

Introduction
Previous research has shown that comfort, including comfort of the sleep surface, is essential to sleep quality. In addition to comfort, temperature regulation plays an important role in sleep quality. This study compared sleep on a mattress protector designed to help keep the sleeper cool to participants’ prior sleep on their original bedding.

Methods
Healthy adults (69% female, ages 21-76; mean age=44) who reported sleeping hot or night sweats, as well as difficulties with frequent awakenings or time spent awake during the night, participated in a 6-week field study, using a pre-post intervention design. During the 3-week baseline period, participants used their regular bedding at home. During the 3-week intervention period, they used Sleepy’s Cooling Knit Protector. This mattress protector includes breathable materials designed to draw heat away from the body. 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 973 nights of tracked sleep across 33 participants. Objective sleep measurements showed decreased sleep onset latency (-7 minutes, p=.010) when using the mattress protector compared to baseline. Self-report measures revealed that participants felt cooler and more comfortable, perceived a reduction in sleeping too hot or experiencing night sweats, felt they had better overall sleep quality, and felt more well-rested in the morning (all ps&lt;.05).

Conclusion
Objectively measured sleep onset latency and many aspects of self-reported sleep improved when using the cooling knit protector compared to the original bedding, suggesting that a comfortable and cool sleep surface can lead to improvements in sleep.

Support (if any)
Mattress Firm INC
1130 Use of a Mattress Designed to Help Sleepers Feel Cool Improves Objective and Perceived Sleep Quality
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, including comfort of the sleep surface, is essential to sleep quality. In addition to comfort, temperature regulation plays an important role in sleep quality. This study compared sleep on a mattress designed to help the sleeper feel cool to participants’ prior sleep on their original mattress.

Methods
Healthy adults (72% female; ages 24-73, mean age=42) who reported sleeping hot or night sweats, as well as difficulties with frequent awakenings or time spent awake at night, participated in a 10-week field study, using a pre-post intervention design. During the 4-week baseline period, participants used their regular mattress at home. During the 4-week intervention period, which occurred following a 2-week adjustment period, participants slept on a TEMPUR-LuxeBreeze Medium Hybrid mattress. 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 1,331 nights of tracked sleep across 32 participants. Compared to baseline, objective sleep measurements showed increased time spent in bed (+8 minutes, p=.029) and improved SleepScore, an overall sleep quality metric (+1%, p=.044). Self-report measures revealed improvements in perceived coolness, comfort, support, pressure relief, sleep quality, amount of tossing and turning, satisfaction with sleep, and feeling well-rested in the morning (all ps&lt;.001).

Conclusion
Participants reported a more comfortable sleep, in numerous ways, when using the mattress being tested compared to baseline. In turn, they spent more time in bed, and objective measurements showed improved sleep quality.

Support (if any)
Mattress Firm INC.
1133 IoT and Sleep Health Dynamics: Evaluating Policy Impacts in the COVID-19 Era
Authors: Kaur Jasleen , Oetomo Arlene , Chauhan Vivek , Morita Plinio 
Published: April 2024

Abstract

Introduction
The political determination to prioritize public health can significantly influence disease outcomes. In the United States of America, the partisan divide has notably affected the enactment and adherence to public health policies, particularly during the COVID-19 pandemic. This study examines the impact of politically driven public health initiatives on sleep duration in the US population during the COVID-19 pandemic. Leveraging zero-effort technology and IoT device data, the research identifies variations in sleep patterns associated with political climates, providing the intricate relationship between politics and health outcomes during a global health crisis.

Methods
Data from 4,405 households in politically distinct cities within California and Texas are sourced from the ecobee ‘Donate Your Data’ (DYD) initiative. The dataset was preprocessed for clarity and consistency and stratified into two periods: pre-pandemic (March 2019 to February 2020) and during the pandemic (March 2020 to February 2021). Sleep duration is quantified using motion sensor inactivity as an indicator of rest periods. A Gaussian mixture model is used to identify the sleep cycle clusters, and inferential statistical methods are applied to evaluate the impact of public health policies on sleep duration across different political affiliations.

Results
A significant decrease in average sleep duration was observed post-pandemic onset, from 8.0±3.71 hours to 7.75±3.87 hours. Different sleep patterns were observed between political affiliations, with Democratic regions showing a consistent decline in sleep duration while Republican regions experienced varied changes.

Conclusion
This study highlights how political leanings and consequent health policies significantly impacted sleep health during the COVID-19 pandemic. The integration of IoT data and advanced analytics offers a novel approach to continuously monitor and enhance population health behaviours. The methodologies applied in this approach could inform public health strategies in future emergencies, with political leanings considered as a key factor in sleep health. The findings set a framework for future studies to explore the relationship between political climates and sleep health and to develop demographic- and politics-sensitive predictive tools for sleep health risks. This research supports more robust public health systems capable of sustaining sleep health despite political and societal shifts.

Support (if any)
0114 “My Mother Doesn't Sleep When It Rains at Night”: Assessing the Impacts of a Climate-Related Flood on Sleep
Authors: Moloney Mairead , Quinkert Ellie , PhD Caitlyn Hood , PhD Christal Badour 
Published: April 2024

Abstract

Introduction
Climate change and climate-sensitive disasters pose a serious threat to sleep health. Populations with pre-existing sleep and health disparities are particularly vulnerable to disaster related stress. In 2022 Eastern Kentucky, home to some of the nation’s largest “hotspots” of insufficient sleep, experienced thunderstorms resulting in 14-16 inches of rain. Subsequent catastrophic flooding and landslides claimed more than 40 lives and left thousands homeless. The present study used mixed methods to investigate the impacts of this flood disaster on the sleep and health of flood survivors.

Methods
We collected two waves of qualitative and quantitative data from 25 participants (18+) living in five flood-impacted counties in Eastern KY. Data were collected at 9- and 15-months post-flood. Semi-structured qualitative interviews at both waves explored perceived flood impacts on sleep and health. Quantitative surveys assessed sleep, stress, trauma symptoms, and other health outcomes via well-validated scales. Interviews were professionally transcribed and coded using an inductive process and NVIVO software. Insomnia symptoms were assessed using the Insomnia Severity Index (ISI).

Results
At 9 months post-flood 77% of participants’ ISI scores were ◻15 suggesting clinically significant insomnia. Fifteen months post-flood, 68% of participants reported ISI scores ◻15. Most (72%) participants reported that the flood event and its aftermath directly impacted their sleep. Sixty-one percent reported delays in falling asleep and increased nighttime awakening; 22% woke up too early. Over half (56%) had racing or recurring thoughts related to the flood and 44% had nightmares. In interviews participants specifically linked increased anxiety to their difficulties with sleep. Many said that the sound of rain triggered an inability to fall or stay asleep in themselves or a family member. Changes in sleep environment also disrupted sleep; issues included destroyed or damaged housing, temporary housing, and mold problems.

Conclusion
Flood survivors in Eastern KY, a region already rife with sleep and health disparities, reported disturbed sleep at 9- and 15-months post flood. The sound of rain and/or changes in sleep environment impacted survivors’ sleep long after the flood event. As climate-sensitive disasters increase, sleep health in vulnerable populations must remain a focus of research and intervention.

Support (if any)
R01MD016236, UL1TR001998 and ES026529
1153 Many Reasons for Restless Legs, Not to Rest
Authors: Adesina Joyce , Patel Abha , Khan Safia 
Published: April 2024

Abstract

Introduction
Restless leg syndrome (RLS) involves an urge to move the legs that is exacerbated by rest, relieved by movement, and most prominent in the evening. While RLS is commonly associated with low ferritin, here we present a complex case in a patient requiring phlebotomy for symptom control related to elevated ferritin levels.

Report of case(s)
A 52 year-old male presented with uncontrolled RLS diagnosed 12 years prior. Sleep history included obstructive sleep apnea (OSA) on CPAP and hypersomnolence. Diagnostic polysomnogram was notable for an AHI 36.4 events/hr with associated hypoxia. Ferritin was 374ng/mL. He presented to our clinic on melatonin and wearing socks with bars of soap atop his feet. On exam, he was obese and plethoric with significant hypersomnolence despite excellent CPAP compliance. He was previously treated unsuccessfully with a combination of phenobarbital, trazodone, and ropinirole, which exacerbated his hypersomnia. He drank 4-5 liters (L) of soda daily. In the 5 years after initial presentation, he went through periods of total cessation to drinking up to 12L a day. He eventually developed uncontrolled diabetes, hypertension, hyperlipidemia, and NASH with advanced fibrosis. He was referred to Hematology and underwent therapeutic phlebotomy every 2-4 months. He was found to have HFE-C282Y Heterozygous mutation and NASH fibrosis without iron overload on MRI. His RLS was eventually controlled with a combination of pramipexole 1.5 mg, gabapentin 1800 mg, alprazolam 0.5 mg along with therapeutic phlebotomy to maintain a ferritin level less than 250 ng/mL. His hypersomnia was managed with amphetamine-dextroamphetamine.

Conclusion
RLS has been associated with high serum ferritin, iron, and saturation transferrin index levels with a low transferrin level due to impaired mobilization of stored iron. Iron deposits can be seen on MRI in the globus pallidus, dentate, red nuclei and substantia nigra. In this patient, soda cessation would help improve his diabetes, thereby decreasing chronic inflammation and lowering ferritin levels. Chronic liver disease, HFE C282Y mutations, and hypoxia from OSA can also contribute to increased ferritin levels. Abstaining from caffeine can likewise improve symptoms of RLS as caffeine is known to heighten proprioceptive awareness and increase neuromuscular reactivity which may include myoclonus.

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