bluuebunny/crossref_metadata_2025_split huggingface dataset:
1125 Use of a Pillow Designed to Help Users Feel Cool Improves Objective Sleep Quality and Perceived Sleep
Authors: Carmon Kiara , Danoff-Burg Sharon , Rus Holly , Weaver Morgan , Upadhyaya Devanshi , Ledesma Duvia Lara 
Published: April 2024

Abstract

Introduction
Comfort and temperature regulation play important roles in sleep quality. This study compared sleep on a pillow designed to help the sleeper feel cool to participants’ prior sleep on their original pillow.

Methods
Healthy adults (71% female; ages 24-72, mean age=42) who reported difficulties with sleeping hot or night sweats and frequent awakenings or time spent awake at night, participated in a 9-week field study, using a pre-post intervention design. During the 4-week baseline period, participants used their regular pillow at home. During the 5-week intervention period, following a 1-week adjustment period, participants used Sleepy’s SUB-0 Triple Cooling Pillow. The pillow is made with materials designed to help regulate temperature and 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 1,175 nights of tracked sleep across 29 participants. Compared to baseline, objective sleep measurements showed increased REM, indicated by 3 metrics: REM in minutes (9% increase, p=.001), REM as a proportion of the night (13% relative increase, p&lt;.001), and MindScore (4% increase, p=001). There also was improvement in SleepScore, a measure of overall sleep quality (3% increase, p=.005). Self-report measures revealed that the pillow felt cooler and more comfortable compared to the original pillow, and participants perceived that they had less intense night sweats, a reduction in the experience of sleeping hot, and increases in sleep quality, feeling more rested in the morning, and satisfaction with sleep (all ps &lt;.001).

Conclusion
Objectively measured sleep quality and perceived sleep improved when using the cooling pillow compared to the original pillow. Self-report results indicated that the intervention was perceived as comfortable and cool. These perceptions likely are what led to the key sleep improvements.

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Mattress Firm INC.
1126 In-Person Expert Mattress Matcher Process Is Associated with Improved Objective Deep Sleep and Perceived Sleep
Authors: Danoff-Burg Sharon , Rus Holly , Weaver Morgan , Carmon Kiara , Mertz Catalina , Ledesma Duvia Lara 
Published: April 2024

Abstract

Introduction
Unsubstantiated claims about the potential benefits of various mattress types can make it challenging for consumers to choose a mattress that fits their personalized needs. Services that provide information and recommendations regarding mattress selection may help solve this problem. However, more evidence and research are necessary to understand such services' potential to support better sleep. This study examined the sleep of research participants using mattresses selected during an in-store matching process compared to using their original mattresses.

Methods
Healthy adults (75% female; ages 27-73, mean=46) participated in a 10-week field study, using a pre-post intervention design. The intervention consisted of being guided in person through the Mattress Firm Mattress Matcher process. During the 4-week baseline period, participants used their regular mattress at home. After being matched at a store near them with a new mattress, participants slept on that mattress for 6 weeks, including a 2-week adjustment period. Sleep was measured objectively using 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 over 1,189 nights of tracked sleep across 29 participants. Objective sleep measurements showed that deep sleep improved when using the matched mattress compared to baseline, indicated by 3 metrics: deep sleep in minutes (5% increase, p=.003), deep sleep as a proportion of the night (4% relative increase; p=.030), and BodyScore (1% increase; p=.022). Improvements also were found for a variety of self-reported sleep outcomes, including feeling better able to sleep through the night without tossing and turning, waking up feeling refreshed and well-rested, feeling satisfied with sleep more often, and perceiving better overall sleep quality (all ps&lt;.001). Additionally, compared to baseline, the matched mattress felt more comfortable, pressure relieving, supportive, and cooler (all ps&lt;.001).

Conclusion
Objectively measured deep sleep and numerous aspects of self-reported sleep improved among healthy adults using a mattress selected via an expert, in-person mattress matcher process. The results suggest that this process can support sleep by helping individuals find a mattress that provides an optimal fit for their personal needs.

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Mattress Firm INC
0113 Sleep Moderates Depression and Quality of Life in People with Chronic Illnesses in South Africa & the United States
Authors: Diallo Idiatou , Musci Rashelle , Spira Adam , Bass Judy 
Published: April 2024

Abstract

Introduction
In the era of global health challenges, escalating chronic physical and mental health issues, coupled with sleep problems, threaten individual well-being and burden healthcare systems. This study evaluated the moderating role of sleep on the depression-quality of life (QOL) association in individuals aged 50+ with chronic illnesses in South Africa (SA) and the United States (US).

Methods
We studied 16,556 participants with at least one chronic illness (i.e., hypertension, diabetes, or cardiovascular disease). Data were drawn from the Health and Retirement International Family of Studies (N=3,379 in SA; N=13,177 in the US). To generate a sleep disturbance score, we averaged responses to three items: 'my sleep is restless' (no=0/yes=1), 'waking up too early' (rarely or never=0/sometimes=1/most of the times=2), and 'feeling rested' (most of the times=0/sometimes=1/rarely or never=2). To generate a QOL score, we summed responses to two questions about ‘life satisfaction as a whole’ (coded 2-10) and ‘position on the life satisfaction ladder’ (coded 0-10). Depressive symptoms were assessed via the 8-item Center for Epidemiological Studies-Depression scale. Pre-statistical harmonization aligned common items across the datasets, and country-specific regression analyses were conducted due to measurement non-invariance.

Results
After adjusting for demographic and health-related confounders, greater sleep disturbance was associated with lower QOL in SA (B=-0.52, 95% confidence interval (CI) =-0.55, -0.48) and the US (B=-0.48, 95% CI =-0.49, -0.47). Higher depression symptoms were associated with lower QOL in both SA (B=-0.26, 95% CI =-0.28, -0.25) and the US (B=-0.42, 95% CI =-0.42, -0.41). Sleep disturbance moderated the depression–QOL association in both countries, such that the negative association between depression symptoms and QOL was stronger among those with greater sleep disturbances, but moderation was much stronger in SA (B=-0.35, 95% CI =-0.38, -0.33) than in the US (B=-0.02, 95% CI =-0.02, -0.01).

Conclusion
The interaction of depression symptoms and sleep disturbances on lower QOL emphasizes the need to integrate routine depression/sleep disturbance screening and treatment in populations with chronic illnesses. Policy recommendations include culturally tailored sleep and depression interventions while future research recommendations include exploring the temporal interrelationships among depression symptoms, sleep disturbance, and quality of life.

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1131 : A Novel Sensor to Track Transient Blood Pressure Changes During Sleep
Authors: Khayat Rami , Kim Joshua , Lee Eugene , Chaudhari Akhil 
Published: April 2024

Abstract

Introduction
Sleep disordered breathing is associated with poor cardiovascular outcomes. However, measurements like blood pressure (BP) using ambulatory BP monitoring (ABPM) are not commonly utilized in sleep assessments because of its difficulty, discomfort, and interference with sleep. ABPM is intermittent and lacks the temporal resolution to identify rapid BP changes. A novel, wearable sensor that captures beat-by-beat BP changes, has been validated against the arterial line. We sought to adapt this device to measure BP changes continuously during sleep.

Methods
We developed a technique that measures transient BP changes during sleep using the novel sensor. The calibration-free technique measures BP changes based on evaluating the sympathetic and vascular tones during steady state breathing and comparing those with that of respiratory events like apneas, hypopneas, and arousals. We developed a machine learning classifier to automatically detect steady state breathing and validated this approach of measuring transient BP changes within twenty-seven patients’ arterial line. For each patient, we compared a total of 50 points that were 30 seconds apart exhibiting at least 15 mmHg systolic or 10 mmHg diastolic change for each point.

Results
In twenty-seven patients undergoing surgery, the 50th percentile and 85th percentile of error rate between the arterial line and our approach for estimating BP change was 23.8 and 42, respectively, meeting ISO 81060-3 (&lt; 25% and &lt; 50% error for the 50th and 85th percentiles, respectively). Using our calibration-free technique, we measured transient BP changes induced by sleep events in twenty-eight patients undergoing polysomnography. We observed BP surges in response to events such as EEG arousals (up to 72 mmHg) and obstructive hypopnea events (up to 84.6 mmHg).

Conclusion
This method leveraging a novel, flexible, and sleep-compatible beat-to-beat BP monitoring device accurately and non-invasively tracks transient BP changes during sleep. Applications of this hemodynamic monitoring include the ability to provide stratification of severity of sleep disordered breathing (SDB) events. Additionally, this device can be worn comfortably throughout the night, enabling real-time monitoring of cardiovascular disorders during sleep. Lastly, this device could allow for titration of SDB therapies using real time BP information and objective evaluation of treatment efficacy.

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1132 Analyzing Spectral Density of EEG During Sleep in COVID-19 Survivors
Authors: Bohra Arwa , Goyal Manish , Mishra Priyadarshini , Goyal Abhishek 
Published: April 2024

Abstract

Introduction
- Long COVID19 patients exhibit persistent symptoms, including dyspnea, anxiety, and neurological issues. - Acute COVID-19 infection is linked to neuropsychiatric complications; 62% had cerebrovascular accidents, and 31% had altered mental status. - Depression (33%), anxiety (36%), and insomnia (41%) are common during acute infections, but COVID- 19's impact on sleep architecture is unknown. - Previous study reported EEG changes in COVID19 survivors; alpha intrusion (78%), cyclical alternating pattern (59%), and increased REM density (38%).

Methods
- Sub-analysis of a prospective study with COVID-19 survivors undergoing Level I Polysomnography. - PSG data compared with pre-COVID era healthy volunteers. - EEG analysis was done in MATLAB and included artifact detection, power spectral densities, and REM analysis. - Statistical analysis was done using JASP 0.16.4.

Results
- 132 participants underwent Level I PSG. - Baseline characteristics showed mean age 43.9±14.6 years, mean BMI 24.31±6.54 Kg/m2. - Sleep characteristics: Total sleep time 359.78±70.29 minutes, sleep efficiency 81.53±12.02%, AHI 19.6±18.2. - Spectral wave percentages in REM and NREM sleep varied significantly between COVID and control groups. -Logistic Regression: Factors like age, REM C3 delta, REM C3 theta, NREM C3 alpha, NREM C3 theta, total AHI predict outcome variable (presence in COVID patients). -Multivariate Logistic Regression: Best fit model includes Age, C3 alpha wave percentage of NREM Sleep, and AHI. McFadden R² value is 0.56, indicating a good fit; AUC value is 0.94, indicating high predictive ability.

Conclusion
- Significantly high alpha frequency was seen in COVID19 survivors. REM density was also significantly elevated in patients with COVID19. - Presence of these abnormal PSG-EEG waves hints that COVID19 might have similar effects as depression, insomnia on these subjects, at least in the short run. - Whether these changes are temporary or permanent needs to be evaluated by performing serial polysomnography in patients with COVID19 ARDS.

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1134 Post-acute Sequelae SARS CoV-2 Related Sleep Study and Symptom-based Factors Associated with Sleep Disturbances
Authors: Zia Zahra , Li Yadi , Lapin Brittany , Mehra Reena 
Published: April 2024

Abstract

Introduction
Post-Acute Sequelae of SARS-CoV-2 (PASC) poses a global public health challenge, manifesting in persistent sleep disturbances beyond four weeks post-acute infection Despite the high prevalence of PASC-related sleep symptoms, there is a critical lack of objective evidence, particularly in sleep study characterization and symptom-based PASC contributors to reported sleep disturbances(SD). We sought to identify distinct sleep study features and PASC-related symptoms associated with patient-reported SD.

Methods
This cross-sectional ReCOVER cohort involved patients presenting with PASC from February 2021-May 2023 who underwent sleep studies following a positive COVID test with PROMIS-Sleep Disturbance(PROMIS-SD) collected within 6 months. Sleep study variables (sleep apnea and sleep architectural indices) and PASC-specific symptoms were stratified by PROMIS-SD score. A dichotomized T-score ≥60 defined moderate-severe SD. Multivariable logistic regression models adjusted for age, sex, race, and COVID hospitalization, assessed the association of sleep study indices and PASC symptom status (never, resolved,recurrent or new) across SD severity group. Statistical interaction of sleep study indices by sex and race were examined.

Results
The sample included 494 patients(age:49.5±12 years,BMI:35±9 kg/m²,73.1% female,82.5% vaccinated). Of 365 patients completing PROMIS-SD,166(45.5%) reported moderate/severe SD. Of all sleep study indices examined, only lower REM % was associated with higher SD, OR=0.95, 95% CI=0.92-0.99, p=0.01. Notably, males and black patients with moderate-severe SD exhibited higher average heart rate during sleep(statistical interaction p-values=0.01). Recurrent PASC symptoms were more common in moderate to severe vs normal/mild SD respectively: dyspnea(75.2 vs 60.9%,p=0.008),joint aches/pains(47.7 vs 31.1%,p=0.04) and headaches(47.7 vs 33.1%,p=0.03).

Conclusion
The sleep architectural alteration of lower percentage of REM sleep is associated with greater degree or patient-reported sleep disruption in PASC. Males and black individuals experiencing moderate-severe SD showed elevated heart rate during sleep, potentially reflecting sleep-related autonomic dysfunction in PASC. PASC-specific symptoms of dyspnea,joint pain and headaches appear to be clinically relevant sleep disruptors in recurrent PASC. Future investigation should focus on enhanced understanding of REM sleep-specific neural circuitry and memory consolidation in PASC as well as sleep-related autonomic fluctuations in predisposed subgroups. Moreover, targeting treatment of specific PASC symptoms such as dyspnea and pain may mitigate compromise in sleep and improve clinical outcomes.

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1135 Predictors of Post-COVID Clinical and Cognitive Consequences
Authors: Greig Danny , Rastogi Ruchi , Diaz Teresa , Tovar-Torres Maria , Axelrod Bradley , Zhao Lili , Badr M Safwan , Chowdhuri Susmita 
Published: April 2024

Abstract

Introduction
“Post-acute sequelae of SARS-COV-2 infection (PASC)” is a condition with a wide range of physical and mental health consequences that are present or persist four or more weeks after SARS-COV-2 infection. Fatigue is one of the most common PASC symptoms. It is not known whether underlying OSA and sleep disturbances may influence the persistence of chronic physical, mental health and neurocognitive dysfunction post-COVID. This pilot study will systematically examine whether sleep disturbances and severity of OSA comprise modifiable facets of PASC.

Methods
We prospectively collected sleep quality, sleepiness, quality of life (QoL) and neurocognitive data in patients with post-COVID fatigue (PASC) and OSA, and compared with control patients with OSA but without prior COVID infection. Questionnaires were administered at baseline and after 3 months to evaluate sleep disturbances, sleepiness, and general and disease specific QoL. Cognitive testing included Trail Making Test Part A and B, Paced Auditory Serial Addition Test (PASAT), Stroop Task, Digit Coding, Hopkins Verbal Learning Test-R (HVLT-R), Weschler Abbreviated Scale Intelligence II (WASI), Weschler Memory Scale IV (WSM), and Psychomotor Vigilance Test (PVT), respectively. 6-minute walk test and COVID-infection related medical data were also collected.

Results
Thus far, we have enrolled 26 total participants, 16 controls (13 males, 3 females; age: 65.4±11.7 years, BMI: 35.4±12.8 kg/m2, AHI: 49.2±34.6/hr, Education:14.4±3.0 years), and10 patients with PASC (7 males, 3 females; age: 59.3±12.8 years, BMI: 31.7±8.4 kg/m2, AHI: 44.2±33.6/hr, Education:16±2.3 years).Baseline data in controls vs. PASC patients are given as: FSS Total Score: 29.8±16.7 vs. 37.9±11.2, ESS: 8.6±4.7 vs. 8.5±5.6, PROMISE Sleep Disturbance Score: 20.2±10.1 vs. 22.9±11.2, 6-Minute Walk Test Total Distance Walked: 415.5±56.8 vs. 389.1±47.2 meters, FOSQ Total Score: 16.7±3.9 vs. 17.17±3.2, HVLTR Total Recall: 88.2±14.5 vs. 83.2±16.2, WMSIV Visual Reproduction Delayed Recall: 109.2±19.8 vs. 106.2±27.7, TMT-B: 94.2±21.1 vs. 93.0±25.6, Stroop Color-Word Score: 88.7±10.7 vs. 94.5±20.1, WASI-II FISQ4 Score: 97.6±11.2 vs. 96.2±17.2, PASAT Rate 2 Correct: 38.8±25.4% vs. 33.3±33.3%, PVT Mean Reaction Time: 319.2±65.2 vs. 324.7±149.5 ms.

Conclusion
Our study provides preliminary data on important clinical metrics in patients with post-COVID sequelae. Additional data will allow us to determine future targets for management of PASC.

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VHA RR&D # RX004396 (SPiRE)
1137 Sleep Quality of Undergraduate Medical Students During and Post Lockdown: A Cross Sectional Study
Authors: Sebastian Loana , Fathima Farah 
Published: April 2024

Abstract

Introduction
The global upheaval caused by the COVID-19 pandemic significantly influenced healthcare and medical education. Faced with in-person learning restrictions, institutions globally adopted online platforms, disrupting the daily routines and sleep patterns of medical students. This study aims on the assessment of sleep quality among undergraduate medical students affiliated with the National Medical Council in India, exploring effects of COVID-19 lockdown measures on their sleep patterns both in the short and long term.

Methods
Conducting a cross-sectional survey, participants included undergraduate medical students from NMC-registered colleges, encompassing all genders. Ethical approval and written consent were obtained, employing respondent-driven sampling to recruit 165 participants over six months (October 2021 to March 2022). The study utilized the Pittsburgh Sleep Quality Index (PSQI), a validated questionnaire with 19 self-rated questions and five partner-rated items, if available. Statistical analysis involved SPSSv2021 for descriptive analysis, PSQI score calculations, and tests examining associations between PSQI components and sociodemographic variables.

Results
Among the 171 participants, 9.4% reported poor sleep quality during the lockdown, decreasing to 4.7% post-lockdown—a substantial 50% improvement. Noteworthy changes were observed in specific PSQI components, such as sleep quality and habitual sleep efficiency, with sleep duration decreasing by 23.4% during lockdown and increasing by 45.6% post-lockdown. Weak correlations between PSQI scores during and post-lockdown suggested persistent sleep challenges for those initially affected. Sociodemographic factors showed no significant associations with PSQI score changes.

Conclusion
This study accentuates the pandemic's impact on the sleep quality of undergraduate medical students, revealing a significant 50% enhancement post-lockdown. It underscores the importance of addressing reduced sleep quality among this demographic and emphasizes the need for strategies promoting good sleep hygiene and offline study habits. Future research should delve into the academic consequences of poor sleep during the pandemic and assess students' readiness to seek advice or treatment for sleep-related issues. In summary, the study highlights the critical significance of sleep quality among undergraduate medical students and underscores the imperative for interventions supporting their well-being amid and beyond the COVID-19 pandemic.

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1138 The Association Between Racial Discrimination During COVID-19 and Sleep Quality Among Asian Americans
Authors: Giorgio Luciana , Lee Hee Yun 
Published: April 2024

Abstract

Introduction
The positive association between racial/ethnic discrimination and poor sleep health has been well documented among racial/ethnic minoritized populations in the US. Although Asian Americans experienced a rise in anti-Asian discrimination during the COVID-19 pandemic, they remain underrepresented in sleep studies. Studies suggest that the positive association between discrimination and poor health outcomes is stronger with increased levels of acculturation among Asian Americans, however, this modifying effect has not been tested in sleep studies. Our aims were to examine the association between racial discrimination experienced during COVID-19 (COVID discrimination) and poor sleep quality(SQ) and test differences in this association by English proficiency, a proxy for acculturation, among a sample of Asian Americans.

Methods
Using survey data from a sample of Korean American adults living in the Southeastern US (n=360), we conducted logistic regression analyses to test the association between COVID discrimination and poor SQ. We progressively adjusted for age, gender, education, nativity status, and English proficiency. We conducted moderation analyses (COVID discrimination*English proficiency) in fully adjusted models. COVID discrimination was assessed using a count of discriminatory experiences reported during the COVID-19 pandemic. Self-reported English proficiency was dichotomized into high and low proficiency. Poor SQ was determined using Pittsburgh Sleep Quality Index scores &gt;5.

Results
Most participants were immigrants (98.61%) and highly educated (79.17%). About half of the sample identified as women (49.33%) and had high English proficiency (55.28%). Mage=40.67 years (SD=12.18). On average, participants reported &lt; 1 experience of COVID discrimination and the majority reported good SQ (68.33%). Every additional COVID discrimination experience was associated with 33% increased odds of poor SQ (OR=1.33, 95%CI: 1.10-1.61, p&lt; 0.001) in fully adjusted models. English language fluency did not moderate this association.

Conclusion
Although the height of COVID-19 pandemic has subsided, these findings shed significant light on the persistent impact of racial discrimination, specifically its adverse effects on the sleep quality of Asian Americans. There is urgent need to advocate for a proactive approach in tackling anti-Asian discrimination. If replicated through larger-scale studies, the findings may suggest that addressing anti-Asian discrimination is essential to supporting good sleep quality among members of the Asian American community.

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