bluuebunny/crossref_metadata_2025_split huggingface dataset:
0140 The Relationship Between REM Sleep Prior to Analogue Trauma and Intrusive Memories
Authors: Drummond Sean P A , Alkalame Lawra , Ogden Jessica , Clark Jacob , Kate Porcheret , Risbrough Victoria 
Published: April 2024

Abstract

Introduction
Intrusive memories are a core feature of posttraumatic stress disorder (PTSD). They both predict the onset of the disorder and drive broader PTSD symptomology. Three meta-analyses concluded sleep (vs wake) after exposure to an analogue trauma decreases the likelihood of intrusive memories. However, the role of sleep prior to analogue trauma exposure has not yet been examined. This is important, insomnia, OSA, and shift work prior to trauma exposure increases the risk of PTSD 2.5-3.0 fold. Given the role of REM sleep in emotion regulation, REM sleep prior to trauma exposure may be particularly critical in the development of intrusive memories. Here, we examined the association between REM sleep prior to analogue trauma and intrusive memories.

Methods
To manipulate REM sleep, 27 healthy adults (MAge = 25.4, SD = 2.89, 56% Female) were randomised to either to a circadian misalignment (CM) condition or normal control (NC) condition for four nights. In CM, participants slept normally for two nights followed by a 4-hour phase advance on night three and an additional 4-hour phase advance on night four. In NC, participants had 8-hour sleep opportunities each night. On day 5, participants watched a trauma film and kept an intrusive memory diary for the next three days. Analyses focused on the relationship between REM sleep over 4 nights in the lab and subsequent intrusive memories.

Results
Greater REM sleep percentage (p = .004) and REM efficiency (p = .02) across 4 nights prior to analogue trauma, independent of group, were significantly associated with fewer intrusive memories in the 3 days after viewing the film.

Conclusion
Findings suggest REM sleep may serve to protect individuals against experiencing intrusive memories. This is consistent with evidence suggesting REM sleep influences emotional memory regulation. Occupations (e.g., emergency services/military personnel) who experience circadian disruptions likely to decrease REM sleep (e.g., from shift work) may be at heightened risk of experiencing intrusive memories after trauma exposure, and thus at increased risk of developing PTSD.

Support (if any)
US Department of Defence office of the Congressionally Directed Medical Research Programs (ID number: PR170893PI)
0145 Worsening ESS Thresholds Predict Five-year Mortality Risk: An NLP-informed Model
Authors: Bay Katherine , Maghsoudi Arash , Jones Melissa , Ramezani Amin , Sharafkhaneh Amir , Razjouyan Javad 
Published: April 2024

Abstract

Introduction
The Epworth Sleepiness Scale (ESS) is a validated tool for capturing self-reported excessive daytime sleepiness. We examined thresholds for association between ESS changes and risk of 5-year all-cause mortality.

Methods
ESS values were mined from progress note-derived free form texts using a natural language processing (NLP) pipeline with reported accuracy of 91%. Veterans in the VHA diagnosed with a sleep disorder or who had participated in a sleep study from January 13, 2000, to August 13, 2018, and with two exams at least 12 weeks apart were identified. Patients were categorized as having normal (0-10) or abnormal (11-24) ESS and characterized by changes in ESS over time: normal-normal, normal-abnormal, abnormal-abnormal, and abnormal-normal. Cox proportional hazards models and elbow plots were conducted to evaluate magnitude of and thresholds for risk of 5-year all-cause mortality adjustment for age and sex.

Results
At baseline, qualifying Veterans were mostly white (74.2%) and male (92.2%) with a mean age of 55.8 ± 13.3 (N = 21,605). One quarter experienced all-cause mortality within five years of their second exam (25.9%). Veterans with abnormal ESS at the second exam had a 6% greater risk of five-year all-cause mortality (aHR: 1.06; 95%CI:1.00,1.11) than those with normal ESS, after adjusting for age and sex. Mortality risk was 13% higher among those converting from normal-abnormal (aHR: 1.13; 95%CI: 1.08,1.32), compared to normal-normal, particularly among those 60 years (aHR: 1.20; 95%CI:1.08,1.32), after adjustment. Regardless of baseline ESS, participants whose score increased over 3-points had significantly higher risk of five-year mortality compared to lesser changes (aHR: 1.08; 95% CI: 1.01, 1.16), which was intensified among those 60 years of age and over (aHR: 1.14, 95% CI: 1.05, 1.23), after adjustment.

Conclusion
These results suggest that abnormal ESS may serve as a clinical marker for increased risk of 5-year all-cause mortality. Providers should pay particular attention to ESS increases over 3-points, particularly among those 60 and older.

Support (if any)
NHLBI K25 HL152006 [J.R.]; ZOLL Respicardia (31002) [A.S.], AHBPCE, FY2024-002 [J.R.]; and IQuESt F&A (CIN 13-413) at the Michael E. DeBakey VA Medical Center, and Baylor College of Medicine in Houston, TX.
0150 Promise of Early Completion Recovers Attention Control Performance After 24+ Hours of Extended Wakefulness
Authors: Dunn Timothy , Smith Max 
Published: April 2024

Abstract

Introduction
Extended wakefulness often covaries with effects of fatigue compounding performance decrements. Much work has sought to identify mitigation strategies. However, strategies that can be reasonably applied to operational tasks are lacking. In the current study, we leveraged recent motivational accounts of fatigue to determine the feasibility of the promise of early completion to recover attention control performance after extended wakefulness.

Methods
All participants completed 12 sessions of the antisaccade task and psychomotor vigilance task (PVT), starting at 0700 and completing at 1000 the next morning. The promise of early completion instruction was given prior to the 12th session; it was stated that the total time a participant would spend completing their last task was contingent on their performance: perform better than previous sessions and the time could be reduced, perform worse and the time could increase. In experiment 1a (N = 30), participants received the incentive instruction prior to completing their last PVT and did not receive it for the last antisaccade task (and vice versa in experiment 1b; N = 24). Four time points were considered: two at known high alertness times (session 1 – 0700 and session 3 – 1800), at 24 hours awake (session 11 – 0700), and the final incentivized session (session 12 – 1000).

Results
For experiment 1a, the incentivized final PVT showed a large decrease in the proportion of lapses relative to session 11 (p &lt; .001, d = −1.32). Lapses in session 12 did not differ from sessions 1 or 3. For experiment 1b, the incentivized final antisaccade task showed a large increase in the proportion of correct trials (p &lt; .001, d = 1.14) relative to session 11. Correct trials in session 12 did not differ from sessions 1 or 3.

Conclusion
The promise of early completion appears to be a strong incentive in recovering attention control performance back to baseline levels and was not task specific. Furthermore, these results dovetail with contemporary accounts of fatigue that hypothesize that decrements are due to shifts in motivation. Future work should aim to investigate a wide range of distractor types and apply the incentive to operational tasks.

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0151 Personalized Caffeine Recommendations to Achieve Optimal Alertness Levels
Authors: Vital-Lopez Francisco , Doty Tracy , Anlap Ian , Killgore William , Reifman Jaques 
Published: April 2024

Abstract

Introduction
Sleep loss impairs alertness, leading to increased injury risk and reduced productivity. Caffeine can safely and effectively mitigate the effects of sleep loss on alertness. However, to be effective, caffeine should be consumed at the right time and amount, depending on sleep history, work schedule and, importantly, sensitivity to sleep loss. Here, we present the 2B-Alert app, a unique smartphone application with capabilities to learn an individual’s trait-like response to sleep loss and to provide personalized caffeine recommendations to optimize alertness.

Methods
We conducted a prospective 62-h total sleep deprivation study to validate the capabilities of 2B-Alert. Throughout the challenge, 21 participants used the app to measure their alertness via the psychomotor vigilance test (PVT). The app used the PVT data collected during the first 36 h of wakefulness to learn each participant’s sleep-loss response and provided personalized caffeine recommendations (from 0 to 800 mg) at that time, so that each participant would sustain alertness at a pre-specified target level (PVT mean response time of 270 ms) during a 6-h period starting at 44 h into the challenge. To assess the effectiveness of the personalized recommendations, we counted the number of PVT data points during the 6-h period that fell within the target alertness level +/-2 times the within-subject variability of alertness impairment (i.e., +/-60 ms).

Results
Participants’ response to sleep loss varied widely from being highly resilient to being highly vulnerable. Accordingly, 2B-Alert recommended no caffeine to five participants, 100-400 mg to 11 participants, and 500-800 mg to five participants. Regardless of their sleep-loss response and the caffeine amount consumed, participants sustained the target alertness level ~80% of the time during the 6-h period.

Conclusion
2B-Alert automatically learns an individual’s trait-like response to sleep loss and provides personalized caffeine recommendations in real time so that individuals achieve a desired alertness level regardless of their susceptibility to sleep loss.

Support (if any)
This work was sponsored by the Military Operational Medicine Program Area Directorate of the U.S. Army Medical Research and Development Command (USAMRDC), Fort Detrick, MD. The Henry M. Jackson Foundation was supported by the USAMRDC under Contract No. W81XWH20C0031.
0152 Cabin Crew Alertness and Performance During Long-haul Flights
Authors: Arsintescu Lucia , Hilditch Cassie , Pradhan Sean , Gregory Kevin , Flynn-Evans Erin 
Published: April 2024

Abstract

Introduction
Sleep loss and circadian disruption pose a significant risk in aviation. Previous literature has shown that inflight rest facilities influence alertness and performance among pilots, but few studies have evaluated cabin crew. The aim of this research was to assess alertness and performance among cabin crewmembers sleeping in different rest locations during a long-haul out-and-back trip.

Methods
Twenty-nine (5 male) cabin crewmembers (Mage = 30.61, SD = 2.91) flew the same long-haul route (outbound and inbound) with an average flight duration of 10:41 (± 0:14) hours. Participants were randomly assigned to fly on an aircraft with a bunk in both directions or to fly an aircraft with a bunk in one direction and with a high comfort jump seat (HCJS) in the other direction. Throughout the study, they wore an Actiwatch and completed a sleep diary at bedtime and upon waking. They completed a Karolinska Sleepiness Scale (KSS) and a 5-minute Psychomotor Vigilance Task (PVT) at the beginning and at the end of each flight. Seventy-seven percent of flights had a bunk and 23% had a HCJS. A series of mixed-effects models were performed to assess the changes in KSS and PVT when crewmembers slept in the bunk during both directions of flight (bunk-only) compared to when sleep was obtained in the HCJS during one direction and bunk in the other (bunk + HCJS).

Results
Fifty-seven flights were included in the analyses. Cabin crewmembers who slept in bunk-only reported higher alertness at the end of the flight (b = 0.54, SE = 0.17, p = .002, Hedges’ g = -0.52) and had faster PVT response speed (b = 0.69, SE = 0.12, p &lt; .001, Hedges’ g = 0.18) compared to bunk + HCJS. There were no significant differences in PVT lapses (p = 0.52).

Conclusion
Our results showed that cabin crewmembers reported greater alertness and performed better when they used the bunk-only. Further research is needed to understand how other factors such as duty start time and workload might influence the sleep of cabin crewmembers during long-haul flights.

Support (if any)
NASA Airspace Operations and Safety Program, System-Wide Safety Project.
0156 Subjective Sleepiness Across the Day in Patients with Sleep Disorders
Authors: Garcia-Martinez Alejandra , Jimenez-Genchi Alejandro , Rosenthal Leon 
Published: April 2024

Abstract

Introduction
According to the two-process model, sleep propensity rises during waking and it dissipates during sleep. However, the clinical assessment of subjective sleepiness usually overlooks changes of sleepiness across the day. A modified version of the Epworth sleepiness scale has been found to overcome this gap. With this instrument, an overall pattern of increasing sleepiness across the day has been reported. The aim of this study was to evaluate subjective sleepiness across the day in patients with sleep disorders.

Methods
Participants were recruited from the National Institute of Psychiatry. All patients who attended the sleep unit for the first time between December 2021 and November 2023 and filled the Time of Day Sleepiness Scale (ToDSS) were included. The ToDSS consists of 8 items of the Epworth sleepiness scale (ESS) but modified for gathering subjective perception of sleepiness in the morning, afternoon and evening. A general linear model with repeated measures was conducted to assess changes in sleepiness across the day.

Results
One hundred and ninety-five patients were included (female 68.4%, mean age 45.1 SD 15.3). All participants had at least one sleep disorder and 91.3% had a comorbid psychiatric disorder. Scores on ToDSS were: Morning 8.8 (SD=7.3) afternoon 10.6 (SD=6.9), evening 11.3 (SD=7.0); ESS=10.3 (SD=7.2). MANOVA showed a significant main effect for time (Pillai’s Trace 0.12; F=11.3, df 2,155, p&lt;.001). There were no significant effects for interactions time x sleep disorder x and time x sleep disorder x psychiatric morbidity. In contrast, a significant effect was found for time x psychiatric morbidity (Pillai’s Trace 0.17; F=2.0, df 14, 312, p&lt;.02). In participants with comorbid psychiatric disorders there was a significant increase in ToDSS from morning to afternoon (df 7, F=2.5, p=.01,) but not from afternoon to evening (df 7, F=2.0, p&gt;.05)

Conclusion
Discussion These results are in line with previous research which has described a pattern of increasing subjective sleepiness across the day. But they also suggest this pattern might be different in patients with psychiatric morbidity. Additional research to characterize the clinical implications of these findings is needed.

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0157 Sleep, Participant-Reported Outcomes, and the Gut Microbiome in Colorectal Cancer Patients and Their Caregivers
Authors: Ahmed Ayaan , Lee Lena , Son Elisa , Ban Yuguang , Maki Katherine , Wallen Gwenyth , Kim Youngmee , Barb Jennifer 
Published: April 2024

Abstract

Introduction
Colorectal cancer is one of the most common cancers worldwide. Patients with this disease may experience gut dysbiosis and various psychoneurological symptoms (PNS) including, sleep disturbance, psychological distress, and pain. Family caregivers involved in managing their day-to-day needs may also experience similar PNS. This study aimed to explore associations between sleep characteristics and the gut microbiome in patient-caregiver dyads stratified by the presence or absence of PNS.

Methods
Patients with colorectal cancer and their sleep-partner caregivers (20 dyads, 55.49 years old, 60% female patients) self-reported PNS using the Patient Reported Outcomes Measurement Information System (PROMIS) once, from which participants were categorized, using K-means clustering, into normal and symptomatic PNS subgroups. Participants also completed the Sleep Consensus Diary daily for 14 consecutive days, from which sleep characteristics (sleep duration, time in bed, sleep onset latency, wake after sleep onset, and sleep efficiency) were derived. Participants provided stool samples, from which gut microbiome features were investigated using shotgun metagenomic sequencing. MetaPhAn3 for taxonomy classification and MicrobiomeAnalyst2.0 for alpha and beta diversity assessment were employed. PNS subgroup differences in differential taxa abundance, alpha and beta diversity, and gut microbiome feature associations with sleep characteristics were tested separately for patients and caregivers.

Results
55% of patients and 35% of caregivers were categorized into the symptomatic subgroup. Although no significant differences were observed in alpha and beta diversity between PNS subgroups, nine taxa were uniquely abundant in patients and five in caregivers (unadjusted p&lt;.05) that differed between the PNS subgroups. Regarding sleep characteristics, among patients, greater sleep efficiency (p=.015), shorter time in bed (p=.043), and longer wake after sleep onset (p=.024) were associated with greater alpha diversity (assessed by the Simpson’s Diversity Index). However, no significant associations of sleep with alpha and beta diversity were found in caregivers.

Conclusion
Findings suggest sleep disturbance may be a psychoneurological contributor to gut dysbiosis in patients with colorectal cancer. Future investigations to elucidate bidirectional associations between sleep and gut health, one’s psychobehavioral impact on the partner’s gut microbiome, and other psychoneurological markers that are attributable to caregivers’ gut dysbiosis, with a larger sample and prospective longitudinal design, are warranted.

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0162 Preliminary Findings on the Moderating Effects of Exercise on Alcohol and Sleep
Authors: Nechyba Ashley , L’Houtellier Nina , Montalvo Jessica , Oliveira Bruno , Elvariste Stessie , Moise Rhoda , Blanc Judite , Seixas Azizi , Jean-Louis Girardin 
Published: April 2024

Abstract

Introduction
We sought to gauge how sleep was being affected by alcohol and how other factors that affect may contribute to sleep impairments may be moderated by exercise.

Methods
The overall sample comprised of 743 Black or African American participants from the New York City or the South Florida area from NIH funded studies called ESSENTIAL and MOSAIC. This data was collected from January 2020 to November 2023. A wearable device called Fitbit was used to capture steps. The baseline assessment comprised of questions about the frequency of substance use, Insomnia Severity Index, PROMIS Sleep Disturbance 8a, the Sleep Related Impairment 8a, Everyday Discrimination Scale, Assessment of Sleep Environment, and Holmes-Rahe Stress Inventory. To find the homogeneity of variances between groups, a Levene's test was performed between alcohol and a variety of factors that affect sleep.

Results
In the participant pool (n=743), 57% were female(n=424) and 43% were male(n=221). 27% of participants lived in the New York City area and 73% of participants lived in the South Florida area. 603 participants having at least one drink a month for all data captured in the baseline assessment. We carried out Levene's test statistic for stress (t=–8.408, df=741, m=.95, sd=1.076), everyday discrimination (t= –18.642, df=741, m=39.9, sd=12.846), sleep disturbance (t= –5.644, df=741, m=4.51, sd=9.441), insomnia (t= –11.899, df=741, m=10.24, sd=6.973), sleep environment (t= –42.931, df=741, m=39.43, sd=.572). The p-value was &lt;.001 so there was a significant difference in variance between alcohol and each factor. For steps, 222 out of 234 participants reported at least one drink a month. We carried out Levene's test statistic for sleep disturbance (t= 7555.4862, sd= 4150.84545). The p-value was .040 so there was a significant difference in variance between alcohol and steps.

Conclusion
In South Florida and New York, alcohol consumption was associated with variance in sleep disturbance, sleep impairment, and insomnia symptoms. Alcohol consumption was associated with variance as sleep environment, stress, and discrimination.

Support (if any)
NIH R25HL-10-5444 R01HL142066, R01AG067523.
0164 The Effect of Delaying Class Times on Cognitive Performance in College
Authors: Jung Christopher 
Published: April 2024

Abstract

Introduction
High school start times have been studied in detail over the past two decades. Findings include better standardized test scores, absenteeism, GPA and fewer sick days with a delayed start time. Few studies to date have examined college course start times, however. The impacts of early college courses on GPA are mixed with one article reporting a better GPA while another reporting the opposite. Many other factors can influence overall GPA such as absenteeism, illness and drug and alcohol use. Because of this, I wanted to determine if there was an impact of early class times on exam scores. I hypothesized that exam scores would be lower on the 7:30 am exam when compared to the 7:30 pm exam.

Methods
Cumulative freshman level anatomy and physiology final exam scores were analyzed from two different sections during the fall 2017 semester at the University of Alaska Anchorage. Both exams had the same 100 questions, students were given 165 minutes to complete the exam and the same instructor taught both sections. The two exams were administered in different lecture halls. There were 67 students in the 7:30 pm section and 153 students in the 7:30 am section.

Results
Independent t-tests revealed that there was significantly (p &lt; 0.05) better performance on the 7:30 pm exam (72.9 ± 15.3; mean ± STD) compared to the 7:30 am exam (64.1 ± 17; mean ± STD). Additionally, 19.4% received a failing grade in the 7:30 pm section compared to 46.4% in the 7:30 am section.

Conclusion
Sleep restriction, sleep inertia and an adverse circadian phase most likely contributed to worse performance on the morning exam, which should be further studied. These results suggest that college start times can have drastic and detrimental impacts on student success. College is expensive and time consuming. Administrators and faculty should be cognizant of class start times to optimize student success. These data suggest early morning classes may be detrimental to student performance and college class start times should be studied in further detail.

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