bluuebunny/crossref_metadata_2025_split huggingface dataset:
0352 Association Between Sleep and Cardiovascular Disease Risk Factors in Sedentary Desk Workers
Authors: Sanders Rachel , Gibbs Bethany Barone , Perera Subashan , Patel Sanjay , Cheruka Caitlin , Davis Kelliann , Kline Christopher 
Published: April 2024

Abstract

Introduction
Cardiovascular disease (CVD) is a leading cause of death in US adults. Elevated blood pressure (BP) and arterial stiffness are risk factors for CVD in adults. Unhealthy sleep behaviors, irregular sleep patterns, and sleep disorders have been associated with an increased risk of developing CVD. We sought to examine the associations of device-assessed and self-reported measurements of sleep and BP with carotid-femoral pulse wave velocity (cfPWV) in adult desk workers with elevated BP.

Methods
Using baseline data from RESET BP trial, 175 desk workers with elevated BP were included in analyses (85.2% White; 58.3% female; age 45.5±10.8 y; body mass index [BMI]=31.1±6.7 kg/m2; resting systolic BP [SBP] 128±8 mmHg, resting diastolic BP [DBP] 83±7 mmHg). Participants wore an Actiwatch Spectrum accelerometer on their nondominant wrist for approximately 7 days, from which mean and standard deviation [SD] of sleep midpoint, mean daytime napping duration, mean wake after sleep onset (WASO), and mean sleep duration were obtained. The Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI) and Epworth Sleepiness Scale (ESS) provided self-reported perceptions of sleep quality, insomnia severity, and sleepiness, respectively. Resting PWV was captured via tonometry from the right carotid and femoral arteries. Blood pressure was assessed using 24-hour ambulatory monitoring, with separation into daytime and nocturnal BP based upon diary entries. Multivariable regression models adjusting for gender, age, and BMI were fitted; p-values were adjusted for multiplicity with the Benjamini-Hochberg procedure.

Results
WASO was associated with greater nocturnal BP; for every 30 additional minutes of WASO, nocturnal SBP was 3.0 mmHg (SE=0.72, p=0.048) greater and DBP was 2.9 mmHg (SE=1.1, p=0.008) greater. Poor sleep quality was associated with greater nocturnal SBP, but the association became nonsignificant after multiplicity adjustment. No other actigraphy-assessed or self-reported sleep variables were associated with 24-hour BP or cfPWV.

Conclusion
Our findings suggest greater time spent awake after initial sleep onset may influence nocturnal blood pressure. The relationship between WASO and nocturnal BP should be further explored as targeting decreasing time spent awake after sleep onset could potentially lower nocturnal BP in desk workers.

Support (if any)
Research supported by NIH grants R01HL134809 and R01HL147610
0354 Early to Bed and Early to Rise? A Comparison of Actigraphy-derived Sleep and Circadian Timing Across Chronotypes
Authors: Reis Daniel , Bahraini Nazanin 
Published: April 2024

Abstract

Introduction
Evening chronotype is associated with increased risk for depression and suicide-related outcomes. This may be due to circadian-sleep misalignment, as previous studies have found chronotype-related differences in the relative timing between circadian phase (i.e., dim light melatonin; DLMO) and sleep. However, such differences may be attributable to variation in intrinsic circadian period length across chronotypes, rather than reflect actual circadian misalignment among those with an evening chronotype. The present study sought to compare predicted circadian and sleep timing across chronotypes using a light-based mathematical model of the human circadian pacemaker that controlled for intrinsic period length.

Methods
This was a secondary analysis of the Multi-Ethnic Study of Atherosclerosis (MESA) Sleep and the Hispanic Health Study / Study of Latinos (HCHS/SOL) Sueño datasets. Scores on the Reduced Morningness-Eveningness Questionnaire were grouped into “morning,” “intermediate,” and “evening” chronotypes. Sleep timing was determined by actigraphy and DLMO was predicted (pDLMO) from light and sleep/wake states using the extended Kronauer model. Circadian-sleep alignment was calculated as the timing between pDLMO and either sleep onset or offset (i.e., phase angles). Multivariate analyses of covariance (MANCOVAs) were used to evaluate the associations between chronotype and the timing/alignment of circadian and sleep variables, with post-hoc comparisons conducted using non-parametric bootstrapping.

Results
MANCOVAs identified chronotype differences in sleep onset, pDLMO, and pDLMO-sleep onset phase angles in both datasets. Chronotype was associated with pDLMO-sleep offset phase angles in MESA Sleep only. pDLMO and sleep onset were ~1-2 hours later for participants with an evening chronotype (p &lt; .001 for all). In MESA Sleep, participants with an evening chronotype had a pDLMO-sleep onset phase angle that was ~30 minutes (95% CI: 13.5, 46.9; p = .002) shorter than those with a morning chronotype; in HCHS/SOL Sueño, it was ~17 minutes (95% CI: 3.6, 29.1; p = .033) shorter.

Conclusion
Assuming equal intrinsic periods, participants with an evening chronotype had a light exposure profile that predicted sleep onset at an earlier circadian phase than those with a morning or intermediate chronotype. These findings provide further evidence that an evening chronotype may be associated with chronic circadian-sleep misalignment.

Support (if any)
None
0356 Lunch with a Side of Light: Can Afternoon Bright Light Shift Circadian Phase Earlier in Older Adolescents?
Authors: Monterastelli Allison , Poole Elaine , Eastman Charmane , Crowley Stephanie 
Published: April 2024

Abstract

Introduction
Previous work shows an association between afternoon bright light exposure and early circadian phase in adults (Van der Maren et al, 2018; Wilson et al, 2018). Our phase response curve (PRC) to bright light in adolescents also suggests a novel phase advancing region in the afternoon (Crowley & Eastman, 2017). Here, we examined phase shifts in response to bright light timed in the afternoon.

Methods
So far, 30 older adolescents (15F) aged 18.3-20.9 years completed a 13-day protocol during the academic year. On days 1-7 (baseline), participants kept a 9-h individualized sleep schedule at home and then lived in the lab on days 8-13. On day 8, baseline Dim Light Melatonin Onset (DLMO) was measured. After one night (day 9) on their individualized 9-h sleep schedules, sleep/dark advanced by 1h each day on days 10-12. The afternoon bright light (ABL) group (n=18) received 3h of bright intermittent light (four 45-min bright light exposures (8512±795 lux) alternated with 15-min room light exposures (43±24 lux)) in the afternoon on 3 days (days 10-12). Day 10 bright light began 5h after baseline wake time, with the goal of timing bright light 4-7h before baseline DLMO. Subsequent exposures were advanced by 1h daily. The room light (RL) group completed the same protocol, except they remained in room light throughout. Final DLMO was assessed on day 13.

Results
Both the RL and ABL group displayed a phase advance (0.8±0.6; 0.9±0.6, respectively), but groups did not differ [t(27)=0.13, p=0.90]. Post-hoc analysis revealed that participants whose day 10 light exposure ended within the target afternoon phase advancing region (4-7h before baseline DLMO) advanced more (1.0±0.2, n=13) than individuals whose day 10 bright light ended closer in time to baseline DLMO (0.4±0.1, n=5) [t(16)=2.11, p=0.05].

Conclusion
Gradually shifting sleep/dark earlier over 3 days advanced circadian phase by ~1h, and the administration of afternoon bright light did not significantly increase the magnitude of this advance. Afternoon bright light timing, however, may have been too late in some adolescents. Ambient light history and sleep quality will be examined as other potential causes for the insignificant difference.

Support (if any)
R01HL151512 (Crowley)
0357 Older Adults' Sleep Quality: Navigating the Impact of Daily Lighting and Thermal Conditions in Living Environments
Authors: Son Seonghyuk , Sharp Nina , Yeom Dongwoo , Lamp Sophia 
Published: April 2024

Abstract

Introduction
Epidemiological studies have revealed that sleep complaints are prevalent among older adults. Poor sleep quality in older adults is linked with higher levels of depression, anxiety, agitation, and falls as well as diminished cognitive and memory performance. Previous inquiries reported lighting and thermal conditions in residential spaces as important environmental factors impacting sleep in various populations. This study aims to explore how daily lighting exposure and thermal conditions within the residences of older adults influence their sleep quality.

Methods
A three-day cross-sectional study was conducted. Participants were 18 older adults (age &gt; 54 years old) living independently in a senior living facility in Phoenix, AZ. Data collection was conducted in the participants’ residence unit in the facility without any intervention. Non-invasive wearable devices, including actigraphs and light trackers, were employed to measure sleep quality (duration and efficiency) and daily light exposure (intensity, correlated color temperature (CCT), and Melanopic Equivalent Daylight Illuminance (MEDI)) over the course of three consecutive days. In addition, sensors installed in living rooms and bedrooms continuously monitored indoor temperature and light intensity. The data underwent rigorous analysis, employing statistical tools such as ANOVA and correlation, executed using software platforms like SPSS, Minitab, and SAS. Predictive models were developed utilizing machine learning algorithms and deep learning techniques within Python's TensorFlow framework.

Results
The results revealed that average daytime MEDI predicted total sleep time significantly. Average daytime CCT and nighttime bedroom temperature had no significant impact on sleep duration. Higher average nighttime bedroom temperature was associated with reduced sleep fragmentation (b = -.493, t(8.52) = -.314, p = .0128) and improved sleep efficiency (b = .025, t(11.6) = 2.89, p = .0141). In terms of temperature and sleep duration, nighttime temperature displayed a significant negative correlation with sleep hours. The regression model explained 31% of the variance in sleep hours, highlighting the significance of nighttime temperature in sleep duration.

Conclusion
This study underscores the importance of optimizing bedroom temperature and increasing daytime light exposure to enhance sleep quality. These findings offer practical strategies for improving the sleep patterns and overall well-being of older adults in residential settings.

Support (if any)
National Science Foundation (Grant Number:R-23-0018)
0358 Effects of Chronotype-tailored Bright Light Intervention on Post-Treatment Symptoms in Breast Cancer Survivors
Authors: Wu Horng-Shiuann , Gao Feng , Given Charles , Davis Jean 
Published: April 2024

Abstract

Introduction
Many cancer-related symptoms emerge or amplify during cancer treatment and persist long after treatment terminates. Bright light therapy holds promise for reducing symptoms, e.g., sleep disturbance, that are commonly experienced by individuals with cancer. This study aimed to examine the effects of a chronotype-tailored bright light intervention on sleep disturbance, fatigue, depressive mood, and cognitive dysfunction among post-treatment breast cancer survivors.

Methods
Thirty women with stage I-III breast cancer 1-3 years post-completion of chemotherapy and/or radiation (mean age= 52.5 ± 8.4 years, 93% White) participated in this two-group randomized controlled trial. Participants were randomized to receive either 30-minute bright blue-green light at 12,000 lux (intervention; n=15) or dim red light at 5 lux (control; n=15) daily for 14 consecutive days. Timing of light exposure, either between 19:00-20:00 hours or within 30 minutes of waking in the morning, was tailored based on individuals’ chronotypes (by Horne-Ostberg Morningness-Eveningness Questionnaire). Self-reported symptom outcomes (e.g., sleep disturbance measured by Pittsburgh Sleep Quality Index) and in-lab overnight polysomnography sleep study were assessed before (pre-test) and after the 14-day light intervention (post-test). Linear mixed models (for continuous outcomes) or generalized estimating equations with cumulative log link function (for ordinal outcomes) were fitted to examine between-group differences, while adjusting for correlation among repeated measures.

Results
There were no significant between-group differences in any of the symptom outcomes (all p&gt;0.05). However, within each group, self-reported sleep disturbance, fatigue, depressive mood, and cognitive dysfunction showed significant improvements over time (all p&lt; 0.05); especially, the extent of improvement for fatigue and depressive mood was clinically relevant. Polysomnography sleep findings showed that number of awakenings significantly decreased (p=0.011) among participants receiving bright light, while stage 2 sleep significantly increased (p=0.015) among participants receiving dim-red light.

Conclusion
The findings support using light therapy to manage post-treatment symptoms in breast cancer survivors. In contrast to our hypothesis, the study results are equally favorable to bright light and dim light condition. The unexpected symptom improvements among dim-red light controls remain unexplained and requires further investigation.

Support (if any)
NIH R15NR016828
0365 Failure to Reduce Glutamate Levels in Medial Prefrontal Cortex During NREM Sleep Could Cause Transient Insomnia
Authors: Yamada Takashi , LaBonte-Clark Theodore , Khan Shazain , Sage Peter , Kalyan Pooja , Berhe Hana , Hopkins Sophia , Cheng Yu-Ang , Nakashima Yusuke , Watanabe Takeo , Sasaki Yuka 
Published: April 2024

Abstract

Introduction
While the social burden of insomnia is substantial, neurochemical mechanisms underlying it are poorly understood. Animal studies suggest the involvement of the medial prefrontal cortex (mPFC) in sleep-wake regulation through glutamatergic and GABAergic signaling. However, the specific roles of these neurotransmitters in human insomnia remain unclear. This study utilized the First-Night Effect (FNE)—a transient sleep disturbance observed during initial sleep experiments— as an insomnia model using healthy participants. To achieve this, we compared the concentrations of glutamate and GABA in the mPFC observed during the first and second sleep sessions using functional Magnetic Resonance Spectroscopy (MRS).

Methods
Twenty healthy adults (12 females), aged 18-30, participated in the experiment involving two afternoon-nap sessions (Day-1 and Day-2), separated by approximately one week. It was anticipated that sleep would be affected by the FNE on Day-1, but not on Day-2. During each session, participants slept inside the MRI while 90-min polysomnography was conducted. Within this period, nine 10-min MRS scans were performed to measure the glutamate (Glx) and GABA concentrations in the mPFC. The Changes in Glx and GABA concentrations during NREM sleep were calculated relative to wakefulness baseline, following the temporal co-registration between MRS data and sleep stages. Sleep onset latency (SOL) served as a sleep quality indicator.

Results
The SOL was significantly longer on Day-1 than Day-2, indicating poorer sleep on Day-1. On Day-2, a significant Glx level decrease from wakefulness to NREM sleep was observed, strongly correlating with SOL. This relationship suggests a close association between reduced Glx levels and shorter SOL. Conversely, there was no substantial Glx level decrease during NREM sleep on Day-1, although a significant correlation between Glx reduction and SOL was present. Mediation analysis revealed that glutamate levels mediated SOL differences between the two sessions. In contrast, GABA levels remained unchanged during NREM sleep from baseline with no significant correlation with SOL on each session.

Conclusion
These findings suggest that the failure to reduce glutamate concentrations, rather than the failure to increase GABA is linked to the FNE. A similar mechanism might contribute to the development of certain types of transient insomnia.

Support (if any)
NIH (R01EY031705, R01EY019466, R01EY027841), KAKENHI (JP20KK0268).
0367 The Independent and Interactive Effects of Insomnia Symptoms and Short Sleep on Sleep Physiology
Authors: Larson Olivia , Lee Ruda , Younes Magdy , Gerardy Bethany , Pack Allan , Keenan Brendan , Gehrman Philip 
Published: April 2024

Abstract

Introduction
The presence of subjective insomnia complaints with objective short sleep duration (total sleep time [TST] &lt; 6 hours/night) has been associated with more severe health outcomes compared to insomnia or shortened sleep alone. The differential and possibly interacting effects of insomnia and shortened sleep on sleep physiology have not yet been comprehensively characterized.

Methods
1,014 participants from the Sleep Apnea Global Interdisciplinary Consortium (SAGIC) without sleep apnea (apnea-hypopnea index &lt; 5 events/hour) were included. Participants were categorized as having insomnia or good sleepers based on self-reported symptoms and as short (&lt; 6 hours/night) or normal (≥6 hours/night) sleepers based on in-laboratory TST. Analysis of variance models adjusted for age and sex assessed the effects of insomnia, shortened sleep, and their interaction on traditional sleep architecture (percent of TST in each sleep stage), EEG power metrics, and novel odds ratio product (ORP; indexes sleep depth ranging from 0 [deep sleep] to 2.5 [full wakefulness]) metrics (average ORP in each sleep stage and ORP-9 [speed with which sleep deepens following arousal]).

Results
Neither insomnia status, sleep duration, nor their interaction had significant effects on the percent of TST spent in any sleep stage. The interaction between insomnia status and sleep duration was not significant for any ORP or EEG metrics. However, individuals with insomnia demonstrated lighter sleep (higher NREM ORP [p=0.02, η2=0.01], REM ORP [p =0.002, η2=0.02], and ORP-9 [p=0.0002, η2=0.03]), cortical hyperarousal (higher beta power in 14-20 Hz [p=0.0003, η2=0.03] and 20-35 Hz [p=0.001, η2=0.02]), and higher sigma power (12-16 Hz [p=0.04, η2=0.01]) compared to good sleepers. Short sleepers also demonstrated lighter REM sleep (higher ORP [p=0.0004, η2=0.03]) and cortical hyperarousal (higher beta power in 14-20 Hz [p&lt; 0.0001, η2=0.04] and 20-35 Hz [p&lt; 0.0001, η2=0.04]) as well as lower delta power (1-4 Hz [p=0.0009, η2=0.02]) and theta power (4-7 Hz [p&lt; 0.0001, η2=0.05]) relative to normal sleepers.

Conclusion
While insomnia and shortened sleep did not influence traditional sleep architecture, they were differentially associated with alterations in sleep physiology. These more granular metrics may be useful in future investigations of potentially separable mechanisms that underlie adverse health consequences in insomnia versus shortened sleep.

Support (if any)
0369 Mortality in Veterans with Insomnia, Sleep Apnea and Comorbid Insomnia and Sleep Apnea (COMISA): A Cohort Study
Authors: Sharafkhaneh Amir , Razjouyan Javad , Crew Earl , Wallace Douglas , Azarian Mehrnaz , Melaku Yohannes , Sweetman Alexander 
Published: April 2024

Abstract

Introduction
Insomnia and Sleep Apnea (SA), the two most prevalent sleep disorders, can occur separately or concurrently as comorbid insomnia and sleep apnea (COMISA). This study utilized a large national Veterans Health Administration (VA) database to compare all-cause mortality among them.

Methods
We constructed a cohort of veterans who used any sleep services in the VA from 10/1999 to 10/2023. Using ICD 9/10 codes and a VA-validated algorithm, we identified veterans with confirmed diagnoses of insomnia and/or SA. For insomnia, we required the presence of relevant medications or CBT-I. We extracted mortality data for three groups: insomnia-only, SA-only, and COMISA. We estimated the association of these conditions using multivariable logistic regression, adjusting for age, sex, race, ethnicity, Charlson Comorbidity Index (CCI), and exposure time (time from the initial insomnia or SA diagnosis).

Results
Out of 4,722,693 veterans who used VA sleep services, we identified 2,159,412 participants with a confirmed diagnosis of either SA or insomnia, who had ≥2 specialty visits in the past three years. We observed 518,574 (24%) with insomnia-only (mean age 58.5, 77.2% male, 71.4% white, 22.6% with CCI &gt; 2), 1,343,035 (63%) with SA-only (mean age 57.6, 93.5% male, 70.1% white, 25% with CCI &gt; 2), and 297,803 (13.8%) with COMISA (mean age 52.5, 89.2% male, 68.3% white, 18.5% with CCI &gt; 2). All-cause mortality rates were 33.2%, 23.3%, and 16.2% for insomnia-only, SA-only, and COMISA, respectively. Compared to the SA-only group as a reference, the insomnia-only group was associated with a 73% increased risk (adjusted Odds Ratio [aOR] 1.73; 95% Confidence Interval [CI]: 1.72, 1.75) and the COMISA group with a 12% decreased risk of mortality (aOR 0.88; 95%CI: 0.87, 0.89).

Conclusion
In a cohort referred to VA sleep centers, SA, insomnia, and COMISA were prevalent. Mortality was highest in the insomnia-only group, compared to the SA-only and COMISA groups. Further studies are needed to explore the causes of this increased mortality.

Support (if any)
Supported by NIH-NHLBI-K25 funding (#1K25HL152006-01 [J.R.]); seed funding by AHBPCE (#FY2024-002 [J.R.]); and Center for Innovations in Quality, Effectiveness, and Safety (CIN 13-413), Michael E. DeBakey VA Medical Center, Houston, TX.
0373 Moderating Factors in the Relationship Between Insomnia and Alcohol Use
Authors: Verlinden Justin , Moloney Mairead , Weafer Jessica 
Published: April 2024

Abstract

Introduction
Insomnia and Alcohol Use Disorder are highly comorbid and share a bidirectional relationship. However, little research has examined which factors contribute to this alarming relationship. Contributing factors may include circadian preference (specifically eveningness), depression symptom severity, and global stress levels. Here, we used cross-sectional baseline data from two randomized control trials of an online CBT-I treatment program in samples of heavy drinkers with insomnia in order to elucidate whether these factors moderate the relationship between drinking behaviors and sleep.

Methods
Heavy drinking men and women with insomnia (n = 238) completed measures of drinking behaviors (Alcohol Use Disorder Identification Test), insomnia severity (Insomnia Severity Index), circadian preference (Composite Morningness Scale), depression (CESD-R), and global stress (Perceived Stress Scale) during the baseline phase of an online insomnia treatment study. Baseline data from two randomized control trials were pooled together for these analyses. Hierarchical linear regressions were used to examine the interactive effects of circadian preference, depression, and stress on the relationship between insomnia and drinking behaviors. Significant interactions were probed using bootstrapped estimates of simple slopes.

Results
Evening preference was associated with higher ISI scores (p = .02), and a trend level association with higher AUDIT scores (p = .07). However, no significant interactive effect was found between CSM and ISI scores on the AUDIT (p = .86). In contrast, significant interactions were found between the CESDR and ISI (p = .02) and PSS and ISI (p = .02) on the AUDIT. Specifically, there was a positive relationship between the ISI and AUDIT for those with either high or moderate CESDR or PSS scores (ps ≤ .05) but not for those with low CESDR or PSS scores (ps ≥ .77).

Conclusion
These findings suggest that the relationship between insomnia and drinking behaviors are strong among those with high to moderate levels of depression or stress but not among those with low levels. In contrast, circadian preference does not appear to impact the relationship between insomnia and drinking behaviors. Future longitudinal and treatment studies should further investigate the role of depression and stress on this problematic relationship.

Support (if any)
NIAAA R21 AA029201 & T32 AA027488