bluuebunny/crossref_metadata_2025_split huggingface dataset:
0929 The Role of Insomnia, Sleep Apnea, and Psychological Distress on Quality-of-Life in Veterans with and Without PTSD
Authors: Krueger Mason , Tsai Thomas , Romaker Emma , Wallace Douglas , Wohlgemuth William 
Published: April 2024

Abstract

Introduction
Obstructive sleep apnea (OSA), insomnia, and psychological distress have been independently linked to various negative outcomes, including poorer quality-of-life (QOL). However, prior literature has not investigated differences in QOL outcomes between veterans with and without PTSD that may be influenced by sleep apnea severity, insomnia, and psychological distress. This study aimed to investigate the relationships of sleep apnea severity, insomnia, and psychological distress with QOL (i.e. physical and social functioning) between veterans with and without PTSD.

Methods
Veterans presenting to the Miami VA Sleep Center who were at risk for OSA (n=645, M age=52 years, 84.5% male) completed the Insomnia Severity Index and the PROMIS-29. The social and physical functioning subscales from the PROMIS-29 were used. Questionnaires were completed the night prior to undergoing a home sleep apnea test. Multigroup structural equation modelling was used to compare the PTSD (n=210) and non-PTSD (n=435) groups, controlling for age, gender, race, education, and BMI.

Results
The final model met statistical criteria for good fit (CFI=0.951, RMSEA=.051). For those with PTSD, higher psychological distress was associated with both reduced social (β=-.54, p&lt;.001) and physical functioning (β=-.35, p&lt;.001). Neither insomnia nor sleep apnea was associated with QOL outcomes in those with PTSD. In those without PTSD, higher psychological distress and higher insomnia were associated with lower social (β=-.38, p&lt;.001; β=-.42, p&lt;.001) and physical functioning (β=-.30, p&lt; 001; β=-.29, p&lt; 001). Sleep apnea was not associated with QOL outcomes in those without PTSD.

Conclusion
The present findings suggest that for those without PTSD both insomnia and psychological distress, but not sleep apnea, are associated with QOL. However, for those with PTSD, only psychological distress was related to QOL. Neither insomnia nor sleep apnea was associated with QOL in those with PTSD. These results indicate that, in those without PTSD, QOL is influenced by both a sleep disorder (insomnia) and psychological distress. However, in those with PTSD, QOL appears to be primarily influenced, not by a sleep disorder, but by psychological distress. The current findings highlight importance of and the need to prioritize treatment for psychological distress in veterans with PTSD to improve their QOL.

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0932 Comparison of Language and Somatic Experiences Between Reports of Trauma & Trauma-Related Dreams
Authors: Hickey Kimberly , Mendelsohn Augustus Kram , Pace-Schott Edward 
Published: April 2024

Abstract

Introduction
Trauma-related nightmares (TRNs) are common sequela of psychological trauma. We explored linguistic and somatic-experience differences between self-reports of a trauma and those of nightmares related to the trauma.

Methods
Seventeen participants with varying severity of PTSD symptoms reporting recurring TRNs (mean age 27, 14 females) recalled traumatic experiences and nightmares related to that trauma. Trauma reports were written by participants, while nightmare reports were transcribed from audio recordings made as soon as the nightmares were recalled. Following reports, participants indicated co-occurring somatic experiences by choosing from a predetermined list. Choices were later grouped into cardiovascular, respiratory, interoceptive, and tension categories. Linguistic content was measured using the Linguistic Inquiry and Word Count (LIWC) program and words were grouped into positive emotion (positive tone, prosocial, power, affiliation), negative emotion (negative tone, anxiety, anger, sadness, conflict), and somatosensory (visual, auditory, feeling) categories. Shapiro-Wilk tests showed non-normally distributed data therefore nonparametric tests (Wilcoxon Signed-Rank Test, Spearman Correlation) were used. Because trauma reports had significantly higher word counts than TRNs (p=0.0495), LIWC data were normalized for word count. Total and symptom-cluster severities were assessed using the PTSD check list for DSM-5 (PCL-5).

Results
We found significantly more somatic experiences of interoception (p=0.0084) and tension (p=0.024) in trauma versus nightmare reports but no differences in cardiovascular or respiratory experiences. No differences between report type were found for LIWC categories. The PCL-5 Intrusion (cluster B) PTSD symptoms were associated with cardiovascular (rho=0.592, p=0.0156) and respiratory (rho=0.619, p=0.0109) experiences in trauma reports and interoception (rho=0.718, p=0.0033) and tension (rho=0.556, p=0.0224) experiences in nightmare reports. No other symptom clusters, nor PCL-5 total score, were correlated with other somatic-experience categories. No LIWC categories in either report type were correlated with symptom clusters or total PCL-5 score.

Conclusion
More somatic experiences of interoception and tension were recalled from traumas than TRNs. Because the brain is relatively deafferented from sensory input during dreaming, we expected, but did not find, state differences in other somatic experiences. Word categories in narratives also did not show state differences. Only the intrusion symptoms of PTSD predicted bodily sensations in trauma as well as TRN reports.

Support (if any)
R21MH128619
0933 Dreaming Under Anesthesia Occurs During Pre-emergence State
Authors: Ishii Toru , Kawai Makoto , Heifets Boris , Chow Harrison 
Published: April 2024

Abstract

Introduction
Dreaming during anesthesia is defined as any recalled experience that occurs between induction and the first moment of consciousness upon awakening. It is a commonly reported phenomenon in the perioperative period, just like dreaming during natural sleep. It has also been reported that general anesthesia with propofol often results in dreams with positive content, which influences emotions after awakening. However, the details of when and under what conditions the brain undergoes dreaming experiences during anesthesia remain poorly understood. In addition, the homology between dreaming under anesthesia and spontaneous sleep is yet to be uncovered. Herein, we aimed to investigate the relationship between EEG and dreaming experiences under general anesthesia.

Methods
All participants underwent surgery under general anesthesia with propofol at Stanford University Hospital between 2021 and 2022. Standard ASA monitors and Sedline EEG electrodes at the frontal area were recorded during surgery, and the presence and content of dreaming experiences were interviewed immediately after awakening from anesthesia. The data from thirty-four patients (52.5±15.9 yrs.) who reported dreaming and twenty-eight patients (48.8±13.4 yrs.) who did not report dreaming after emergence from anesthesia were analyzed. Time-frequency analysis was performed on EEGs, and parameters between dreamers and non-dreamers were compared.

Results
The pre-emergence state from the steady state of anesthesia to extubation was significantly longer in the Dreamer group (17.1±9.3 min vs. 9.1±8.6 min, d=0.8, p=0.01). During the pre-emergence state, a sharp decrease in frontal alpha-power and a sharp increase in Beta/Gamma power were observed.

Conclusion
The results suggest that dreaming occurs in the pre-emergence state between deep anesthesia and awakening. The finding that this state is characterized by a reduction in frontal alpha oscillation, which is considered to reflect the activity of the thalamocortical loop, provides insight into the neural basis of dreaming, nightmares, and consciousness.

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0940 Frontal Attentional Processes Correlate with Sleep Problems in Veterans with Post Traumatic Stress Disorder
Authors: Lanthier Malika , Tavakoli Paniz , Higginson Caitlin , Richard-Malenfant Claude , Leveille Chloe , Porteous Meggan , Kaminsky Zachary , Shlik Javok , Robillard Rebecca 
Published: April 2024

Abstract

Introduction
Post-traumatic stress disorder (PTSD) instigates a series of neurocognitive dysfunctions, with sleep irregularities and attentional difficulties being key interacting features. Despite the known impact of sleep problems on cognitive performance, there is limited understanding about how poor sleep may be associated with basic attentional processes in individuals with PTSD. This study investigated associations between sleep macroachitecture and brain responses to attention processing involving the frontal cortex in veterans living with PTSD.

Methods
Event-related potentials were recorded before bedtime under two conditions: 1) presentation of an auditory stimulus at a rapid pace (every 2 seconds) and 2) the same auditory stimulus presented at a slower pace (every 16 seconds). Event-related potentials elicited in the slow condition are recognized for activating attentional networks in the frontal lobe, while event-related potentials elicited in the fast condition would activate the auditory cortex. Polysomnography was recorded throughout the night for sleep architecture. Associations between sleep architecture parameters and the N1 and P2 event-related potential components were assessed using Pearson correlations.

Results
Thirteen veterans (1 female, Mean+SD = 49 + 8.9 y.o.) with a PTSD diagnosis based on DSM-V criteria participated in this study. Most participants were using serotonergic medications. The P2 elicited in the slow condition was significantly negatively correlated with REM latency (r=-0.69, p=.008) and positively correlated with minutes spent in REM (r=0.59, p=.033). No other significant correlations were found.

Conclusion
Veterans living with PTSD often experience increased REM pressure, as reflected by shorter REM latency and higher amounts of REM sleep. This study highlights an association between REM abnormalities with increased brain resources mobilized by frontal attentional processing. Investigating how sleep interventions may influence attentional processes may help improve our understanding of how good sleep could counteract the adverse effects of PTSD on brain functions.

Support (if any)
This project was funded by a competitive grant from the Canadian National Defence (Innovation for Defence Excellence and Security (IDEaS)).
0941 Limb Movements in Sleep [LMS] and PTSD-related Physical Symptoms: Preliminary Observations
Authors: Gupta Madhulika 
Published: April 2024

Abstract

Introduction
Periodic Limb Movements in Sleep [PLMS] can be present in over 60% of Posttraumatic Stress Disorder [PTSD] patients versus about 10% in the general population. PTSD is often associated with physical complaints. In the general population PLMS can be associated with physical symptoms . To my knowledge the association of PLMS and physical complaints in PTSD has not been reported.

Methods
106 PTSD patients [all from MAG’s practice] completed a battery of instruments. 44/106 patients (mean age+/-SD = 47.04+/-13.27 years; 89.6% female) met the inclusion criteria (no current use of benzodiazepines or narcotics; ability to have LMS ratings completed by bed partner). All participants met the DSM-5 criteria for moderate-to-severe PTSD during their initial consultation, with a Clinician Administered PTSD Scale for DSM-5 (CAPS-5) score of at least 55. The PTSD Checklist for DSM-5 (PCL-5) was used to obtain an index of the current PTSD severity (mean = 37.41, SD = 19.84; PCL-5 &gt; 30 cut-off for PTSD). Limb Movements in Sleep [LMS] were considered a proxy for PLMS [ICSD3, 2014] and were measured using Item 10c of the Pittsburgh Sleep Quality Index [PSQI] [Buysse DJ,1989] where the patients’ bed partner rated the patients’ severity of “Legs twitching or jerking while they slept”; Low-LMS frequency included "&lt; one time per week" or "not during the past month" and High-LMS frequency included " once or twice a week " and " three or more times a week".Physical symptoms were rated using the Pennebaker Inventory of Limbic Languidness [PILL][Pennebaker JW,1982] which rates 54 physical symptoms using the following scale: 1=Have never or almost never experienced the symptom; 2=Less than 3 or 4 times per year; 3=Every month or so; 4=Every week or so; and 5=More than once every week.

Results
The mean scores of 20/54 PILL items were significantly [ p&lt; 0.05] lower between the Low- versus High-LMS groups. The total 54 item mean PILL score was significantly [p=0.002] greater in the PTSD group with High-LMS [PILL score of 105 ] versus the Low-LMS scores [PILL score of 73].

Conclusion
PTSD patients with more frequent limb movements during sleep had greater daytime physical complaints.

Support (if any)
None
0942 The Mediating Role of Emotional and Behavioral Problems Between Nightmares and Suicidality in Adolescents
Authors: Li You , Sit Hao Fong , Cheung Forrest Tin Wai , Li Shirley Xin 
Published: April 2024

Abstract

Introduction
Adolescence is a transitional period that is susceptible to sleep and mental health problem. Previous research has shown that sleep problems, including both insomnia and nightmares, as well as emotional and behavioral problems, are respectively associated with the suicidal risk. However, it remained unclear whether nightmares play an independent role in this link. The present study aimed to examine the association between nightmares and suicidality, and the potential mediating role of emotional and behavioral problems in this relationship in a community-based sample of Hong Kong Chinese adolescents.

Methods
A total of 2475 adolescents (12–20 years; mean age 14.8 ± 1.8 years; female: 63.80%) were recruited from the local secondary schools in Hong Kong. Participants completed a battery of self-report questionnaires: nightmares were measured using a single item in the Pittsburgh Sleep Quality Index (PSQI); suicidality was measured by the suicidality item in the Patient Health Questionnaire (PHQ-9); emotional and behavioral problems were measured by the Strengths and Difficulties Questionnaire (SDQ); and insomnia severity was measured by Insomnia Severity Index (ISI). Frequent nightmares were defined as having nightmares at least once per week. Suicidality was defined by the presence of suicidal ideation over the past two weeks.

Results
45.4% of the participants reported having frequent nightmares, and 29.4% of the participants reported suicidal ideation over the past two weeks. Frequent nightmares (OR =1.53, 95% CI: 1.36 - 1.71), insomnia (OR = 1.13, 95% CI: 1.10 - 1.15) and emotional and behavioral problems (OR = 1.04, 95% CI: 1.03 - 1.05), age (OR = 0.93, 95% CI: 0.88- 0.98) were all found to be significantly associated with suicidality. Path analyses revealed that emotional and behavioral problems partially mediated the relationship between frequent nightmares and suicidality among adolescents (b = .03, 95% CI = .016, .051). The meditation effect remained significant after controlling age, gender, and insomnia severity.

Conclusion
Psychopathology mediates the relationship between nightmares and suicidality independent of the severity of insomnia. Nightmare disturbance and psychopathology should be taken into account in suicide prevention among adolescents. Future exploration on the mechanism underlying the link between nightmares and suicidality is needed.

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0947 Suvorexant Improves Symptoms of Opioid Withdrawal and Depressive Symptoms Through Changes in Oscillatory Band-power
Authors: Reid Matthew , Abraham Liza , Gamaldo Charlene , Mun Chung-Jung , Coon-Dekuiper William , Smith Michael T , Finan Patrick , Huhn Andrew 
Published: April 2024

Abstract

Introduction
Opioid withdrawal exacerbates depressive symptoms and poor sleep. Previous findings demonstrate suvorexant’s ameliorative effect on sleep disturbances during this period, but is unknown whether these changes also confer benefit for depressive or withdrawal symptoms. therefore, we aimed to examine the effects suvorexant oscillatory sleep-EEG power during inpatient opioid withdrawal, and to examine their association with withdrawal severity and depressive symptoms.

Methods
Participants with Opioid Use Disorder (N=38: age-range = 21-63years, 87% male, 45% white) underwent an 11-night withdrawal (3-night stabilization, 4-night buprenorphine taper, 3-night buprenorphine post-taper) and were randomly assigned to suvorexant (20mg [n=14] or 40mg [n=12]), or placebo [n=12], while ambulatory sleep-EEG data was collected. Linear mixed-effect models were used to test associations between sleep-EEG band power change, depressive symptoms, and withdrawal severity.

Results
Across the 11 night withdrawal period, reductions in oscillatory delta power were observed in all study groups, and increases in beta power (20mg: β = 2.579, pval = 0.009 | 40mg (β = 5.265, pval &lt; 0.001) alpha power (20mg: β = 158.304, pval = 0.009 | 40mg: β = 250.212, pval = 0.001) and sigma power (20mg: β = 48.97, pval &lt; 0.001 | 40mg: β = 71.54, pval &lt; 0.001) were observed in the two suvorexant groups. During the four-night taper, decreases in delta power was associated with decreases in depression (20mg: β= -190.90, p = 0.99 | 40mg: β= -433.33, p = &lt; 0.001 [*Bonferroni corrected]), and withdrawal severity (20mg: β= -215.55, p = 0.006* | 40mg: β= -192.64, p = &lt; 0.001*), in both suvorexant groups and increases in sigma power were associated with decreases in withdrawal severity (20mg: β= -357.84, p = 0.004* | 40mg: β= -906.35, p = &lt; 0.001*). Post-taper decreases in delta (20mg: β= -740.58, p = &lt; 0.001* | 40mg: β= -662.23, p = &lt; 0.001*) and sigma power (20mg only: β= -335.54, p = 0.023*) were associated with reduced depressive symptoms in the placebo group.

Conclusion
Results highlight a complex and nuanced relationship between sleep EEG power and symptoms of depression and withdrawal. Changes in oscillatory delta power may represent a mechanism influencing depressive symptoms and withdrawal.

Support (if any)
UG3DA048734
0948 Sleep Problems and Mental Health in Bus Drivers: A Cross-sectional Study
Authors: Cheng Hanrong , Li Xiao , Tang Yuming , Li Shirley Xin 
Published: April 2024

Abstract

Introduction
Public transit bus drivers, crucial to urban mobility, face unique challenges such as irregular schedules and prolonged driving hours, making them vulnerable to sleep problems. Despite the acknowledged impact of sleep issues on mental health in the general population, there is limited research exploring the relationship between sleep problems and mental health outcomes within this special population. This cross-sectional study aims to investigate the prevalence of self-reported sleep problems among bus drivers, and to analyze the relationship between sleep problems and mental health.

Methods: Methods
A total of 551 bus drivers (99.8% male, mean age: 49.07 ± 5.23 years) participated in the study. They underwent assessments for risk of obstructive sleep apnea (OSA, using STOP-Bang), insomnia symptoms (Insomnia Severity Index, ISI), excessive daytime sleepiness (Epworth Sleepiness Scale, ESS), and mood symptoms (Hamilton Anxiety Rating Scale, HAM-A; Hamilton Depression Rating Scale, HAM-D). Linear regression models were used to examine the associations between sleep problems and mental health, while controlling for age, sex, and BMI.

Results: Results
Ninety-eight (18%) drivers were identified as at risk of OSA (defined as STOP-BANG score ≥ 3), 35 (6%) had insomnia (defined as ISI score ≥ 15) and 62 (11%) had excessive daytime sleepiness (defined as EDS score ≥ 10). After controlling for age, sex, and BMI, anxiety symptoms demonstrated positive associations with the risk of OSA (St. β = 0.26, p &lt; 0.001), insomnia symptoms (St. β = 0.52, p &lt; 0.001), and excessive daytime sleepiness (St. β = 0.40, p &lt; 0.001). Furthermore, depressive symptoms were positively associated with insomnia symptoms (St. β = 0.27, p &lt; 0.001) and excessive daytime sleepiness (St. β = 0.01, p = 0.032).

Conclusion: Conclusion
Among bus drivers, the prevalence of OSA, insomnia, and EDS is noteworthy. These symptoms are associated with exacerbated mood symptoms. Prompt treatment for sleep problems is crucial to alleviate these effects and enhance overall well-being.

Support (if any)
This work was funded by Shenzhen People's Hospital clinical research project SYLCYJ202001.
0950 Social Rhythm Regularity and Mood: Two Forms of Impulsivity with Differential Moderating Effects
Authors: Maddox Mackenzie , Walsh Rachel , Alloy Lauren 
Published: April 2024

Abstract

Introduction
Circadian rhythm dysregulation can elicit maladaptive consequences, including mental and emotional health problems. The social zeitgeber model theorizes that irregular social rhythms can disrupt biological rhythms, which negatively impacts mood. This relationship is particularly apparent among individuals diagnosed with bipolar spectrum disorders (BSD), such that social rhythm disrupting life events can trigger episode onset. Impulsivity, a core feature of BSD, has also been shown to differentially effect mood symptom pathophysiology (hypo/mania vs. depression). This study examined whether two forms of impulsivity moderated the association between social rhythm regularity (SRR) and mood symptoms (hypo/mania vs. depression) in individuals at low-risk, high-risk, and diagnosed with BSD.

Methods
Adolescents and young adults (n = 490) were recruited based on levels of trait reward sensitivity and diagnostic interviews. For this study, participants completed a self-report measure of attentional, motor, and non-planning impulsivity (Barratt Impulsiveness Scale [BIS]), and a behavioral task of reward-related impulsivity (the Balloon Analog Risk Task [BART]). Participants also completed measures of SRR, depressive, and hypo/manic symptoms. Models were estimated with SRR as the focal predictor and impulsivity as the moderator. Significant interactions were probed using simple slopes analyses.

Results
Both forms of impulsivity moderated SRR - mood symptoms relationship. BIS score moderated the association between SRR and hypo/manic symptoms, and simple slopes analyses revealed that only those low in impulsivity exhibited a positive association between SRR and hypo/manic symptoms. This finding was not obtained for the BART. BART score moderated the association between SRR and depressive symptoms, and simple slopes analyses found that only those who scored low in impulsivity exhibited a negative association between SRR and depression. This finding was not obtained with the BIS.

Conclusion
Individuals with low levels of impulsivity were most vulnerable to the effects of SRR on mood, although the polarity of the mood (hypo/mania versus depression) differed based on the impulsivity measure used (BIS versus BART). It is not clear whether the difference is due to self-report vs. behavioral measurement or to the differing forms of impulsivity assessed by the BIS vs. BART.

Support (if any)
NIMH R01 MH77908 to Lauren B. Alloy