bluuebunny/crossref_metadata_2025_split huggingface dataset:
0088 Sleep Structure and Heat Dissipation Influence Subjective Sleep Onset Latency in Young Adult Human Subjects
Authors: Aritake-Okada Sayaka , Iijima Ryusei , Kadooka Akari , Sugawara Kairi , Fushimi Momo , Hosoe Mizuki 
Published: April 2024

Abstract

Introduction
Several previous studies reported that humans can estimate the time that has elapsed during sleep (time estimation ability; TEA). Although research on the TEA during sleep has advanced in the field of sleep research, few studies have focused on the relationship between the subjective sleep onset latency (SOL), which is an indicator of TEA, and objective sleep structures, heat dissipation, and body temperature. The current study examined the relationship between subjective SOL, sleep structure, changes in skin and body temperature, and subjective evaluation of sleep in healthy young adults to elucidate the pathophysiological mechanisms of insomnia.

Methods
Twenty-eight subjects (7 men and 21 women, mean age: 21.54 ± 0.50 years) with no sleep problems participated in a 1-hour polysomnographic recording that obtained objective sleep parameters during the daytime while skin and body temperatures were recorded. The distal–proximal skin temperature gradient (DPG) was calculated. The duration of stage W, stage N1, stage N2, and stage N3 and stage R sleep, sleep latency, wake after sleep onset, total sleep time were calculated for all PSG recordings. Power spectral analysis using the fast Fourier transform algorithm was conducted. Also, subjective parameters, such as subjective SOL, sleep time, and restorative sleepiness, were evaluated before and after sleep. The study was approved by the Ethics Committee of Saitama Prefectural University.

Results
Almost all subjects estimated their sleep latency as being longer than their actual SOL (13.70 min vs. 7.57 min). Objective SOL was significantly correlated with each sleep stage parameter whereas subjective SOL was negatively correlated with stage N2 sleep duration, slow-wave activity and δ-power, and ΔDPG (the degree of reduction of heat dissipation before and after lights-off). Stepwise regression analysis showed that ΔDPG was the strongest predictive factor in explaining the length of subjective SOL.

Conclusion
The degree of heat dissipation before and after lights-off contributed most to the sensation of falling asleep in healthy young adults, and stage N2 duration and slow wave components immediately after falling asleep may be related to the sensation of falling asleep. This finding may be helpful for elucidating the physiological mechanisms of insomnia and its treatment.

Support (if any)
0090 Impact of Evening Binge Alcohol Consumption on Nocturnal Heart Rate Response to Cortical Arousal
Authors: Talukdar Ankita , Solis-Montenegro Tatiana , Beisert Jenna-Marie , Bigalke Jennifer , Bigalke Jeremy , Carter Jason 
Published: April 2024

Abstract

Introduction
Chronic alcohol consumption increases the risk of cardiovascular disease. While acute alcohol intake increases heart rate (HR), the impact of alcohol on HR responses to nocturnal arousals remains unclear. The present study investigated the effect of evening binge alcohol consumption on HR responsiveness to nocturnal cortical arousals. We hypothesized that alcohol intake would lead to an exaggerated HR reactivity to cortical arousals throughout the sleep period.

Methods
Fifteen healthy adults (6 male, 9 female; 27±2 yrs; 28±1 kg/m²) participated in this study. Using a randomized cross-over design, participants underwent two testing conditions (i.e., alcohol vs fluid control) separated by one month. In the alcohol condition, participants consumed the equivalent of 4-5 drinks in the span of two hours prior to sleep. A volume matched fluid-control was utilized for the control condition. The alcohol dose was based on the NIAAA definition of binge drinking (i.e., 1g/kg men, 0.85 g/kg women). Overnight polysomnography (PSG) with continuous electrocardiogram (ECG) was utilized over the course of an 8-hour in laboratory sleep period to quantify sleep, arousals, and nocturnal HR. Arousals were only included if they were not associated with any respiratory events, limb movements, or awakenings. HR responses following spontaneous nocturnal cortical arousals were collected and analyzed across 20 cardiac cycles.

Results
A main effect of experimental condition was observed whereby alcohol consumption resulted in a significantly elevated heart rate (Fluid Control: 64±2 vs. Alcohol: 72±3 beats/min, p&lt; 0.001). There was no main effect of condition on HR reactivity (Placebo: ∆1.7±1, Alcohol: ∆2.1±1 beats/min, p=0.545). A significant condition x time effect was observed when assessing both raw HR (p=0.005) and HR reactivity (p=0.005). In contrast to our initial hypothesis, HR reactivity during the early phase of the arousal response was reduced in the alcohol condition at cardiac cycles 2, 3, and 4 (all p&lt; 0.05) following nocturnal arousal occurrence.

Conclusion
These findings indicate that evening alcohol intake increases nocturnal HR, leading to a blunted HR response to cortical arousals. The sustained effect of alcohol on nocturnal HR may contribute to cardiovascular risks associated with evening binge alcohol consumption.

Support (if any)
Funding: NIH (AA-024892; U54GM115371; P20GM103474).
0095 Fat Intake Modifies the Association Between Sleep Depth and Cardiac Autonomic Modulation in Adolescents
Authors: Rahawi Anthony , Fang Jidong , Calhoun Susan , Liao Jason , Vgontzas Alexandros , Liao Duanping , Bixler Edward , Fernandez-Mendoza Julio 
Published: April 2024

Abstract

Introduction
Prior data shows an association between the odds ratio product (ORP), a continuous EEG measure of sleep depth, with heart rate variability (HRV), a continuous EKG measure of cardiac autonomic modulation. Nutritional lifestyle choices can impact cardiac health, with densely-caloric diets or those with greater percentage of specific macronutrients being associated with adverse cardiac outcomes. Adolescence, a developmental period marked by physical changes, is also marked by changes in sleep depth and dietary intake. We examined whether the association between ORP and HRV is more adverse in adolescents with inadequate nutritional intake.

Methods
We studied 293 adolescents (median 16y) from the Penn State Child Cohort. We extracted ORP during NREM sleep from 9-hour, in-lab polysomnography (PSG), and low-frequency (LF), high-frequency (HF) and time-domain [e.g., root mean square standard deviation (RMSSD)] HRV indices from 24-h Holter EKG monitoring immediately following PSG. Linear regression analyses examined the association between ORP, and its interaction with nutritional intake (total-calories, protein, total-fat, and carbohydrates), with 24-h HRV indices while adjusting for sex, age, race/ethnicity, obesity, metabolic syndrome, PSG-measured sleep apnea, insomnia symptoms, and actigraphy-measured sleep duration.

Results
The interactions between ORP and total-fat intake on LF, HF and RMSSD were statistically significant (p&lt; 0.05), while the interactions between ORP and total-calories (p&lt; 0.10), proteins (p&lt; 0.10) or carbohydrates (p&gt;0.10) on HRV indices were not statistically significant. Among adolescents with high total-fat intake (≥ 60 gm; n=161), each standard deviation increase in ORP was associated with a -0.1 (0.04) log-Hz, -0.2 (0.07) log-Hz, and -4.3 (1.8) ms decrease in LF (p&lt; 0.001), HF (p=0.009) and RMSSD (p=0.02), respectively, while this association was not significant among adolescents with low total-fat intake (&lt; 60 gm; n=162; β=-0.01, SE=0.04, p=0.846; β=0.1, SE=0.07, p=0.348; and β=1.7, SE=2.1, p=0.403, respectively).

Conclusion
Adolescents who follow high-fat diets are more vulnerable to the impact of shallow sleep on impaired cardiac autonomic balance, making them a targeted group for preventative sleep and cardiovascular strategies.

Support (if any)
R01HL136587, R01MH118308, UL1TR000127
1003 Daily Morning Blue Light Exposure for Alertness and Sleep Following Stroke
Authors: Honn Kimberly , Crooks Elena , O'Brien Katie , Sprint Gina , Weeks Douglas , Carter Gregory 
Published: April 2024

Abstract

Introduction
In the acute phase following a stroke, circadian rhythmicity is often disrupted, which undermines sleep, produces fatigue, and impedes recovery. Studies have reported post-stroke sleep architecture abnormalities, as well as acute sleep disorders which can range between extremes of clinically significant insomnia to hypersomnia, with sleep complaints sometimes persisting for months or years. Morning blue light exposure as an early, non-pharmacologic intervention targeted for strengthening circadian rhythmicity could provide acute relief and prevent disordered sleep from becoming chronic following stroke.

Methods
A randomized, single-blind, parallel group, placebo-controlled pilot study compared daily morning exposure to blue light or red light (placebo) for improving daytime sleepiness, fatigue, nocturnal sleep, and cognition in patients receiving inpatient rehabilitation for acute stroke. N=43 patients with disordered sleep secondary to first episode stroke (n=34 ischemic, n=9 hemorrhagic; ages 66.2±14.1y) were randomized to receive 25min of morning blue or red light for 5 or more days depending on inpatient rehabilitation length of stay (blue n=21, red n=22). At baseline and study discharge, daytime sleepiness was measured with the Karolinska Sleepiness Scale and Wits Pictorial Sleepiness Scale, fatigue with a visual analogue scale, and cognitive function with the Rey Auditory Verbal Learning Test and Trail Making Test (TMT). Actigraphy measured sleep continuously throughout participation with nighttime sleep defined as 21:00–05:59. Effect sizes per outcome were used to estimate sample sizes for larger follow-up studies.

Results
Participants with blue light exposure experienced significant improvements in daytime sleepiness, fatigue, and auditory verbal learning (all p&lt;.05) relative to red light exposure. There was a trend toward a greater mean duration of nighttime sleep (p=.076) and fewer awakenings after sleep onset (p=.092) in the blue light compared to red light group. Although change in TMT and nocturnal sleep parameters did not reach statistical significance, effect sizes favored blue-light exposure, ranging from .38–.57.

Conclusion
Morning blue light exposure for 5 or more days led to greater improvements in daytime sleepiness, fatigue, and cognitive outcomes than red light exposure after acute stroke. Effect sizes suggest a larger study is warranted to confirm generalizability of pilot findings.

Support (if any)
Empire Health Foundation
1006 Effect of Obstructive Sleep Apnea on the Longitudinal Change in the Glymphatic System Function
Authors: Park Hyo Jin , Paik Sang Min , Kim Jae Rim , Lee Min-Hee , Lee Woo-Jin , Lee Seung-Ku , Shin Chol , Yun Chang-Ho 
Published: April 2024

Abstract

Introduction
Glymphatic cerebral waste-clearance system is activated during sleep, and obstructive sleep apnea (OSA) might have impact on the long-term disruption of the glymphatic system function and the development of neurodegenerative diseases. This study investigated the longitudinal association of OSA with changes in glymphatic system function and cognitive function domains.

Methods
Based on a community-based prospective cohort, participants who had both baseline and 4-year follow-up polysomnography, brain MRI with diffusion tensor imaging (DTI), and comprehensive cognitive assessment data were included. At both baseline and follow-up, participants were categorized as non-OSA (apnea-hypopnea index, AHI &lt; 5), mild OSA (5≤AHI&lt; 15), and moderate-to-severe OSA (AHI≥15) groups. According to the longitudinal change in the OSA severity, participants were categorized as OSA-free (non-OSA at both baseline and follow-up), improved OSA, stationary OSA, and progressed OSA groups. Glymphatic system function was measured using DTI analysis along the perivascular space (DTI-ALPS) index.

Results
1,110 participants (mean [SD] age, 58.0 [6.0] years; 517 [46.6%] men) were included in the final analysis. At baseline, 621 participants were categorized as non-OSA, 338 participants as mild OSA, and remaining 151 participants as moderate-to-severe OSA. At follow-up, 458 participants were categorized as OSA-free, 114 participants as improved OSA, 303 participants as stationary OSA, and 235 participants as progressed OSA. At baseline, non-OSA group exhibited higher DTI-ALPS index compared to the remaining groups (both, P&lt; 0.001) and AHI was inversely correlated with DTI-ALPS index (R=-0.169, P&lt; 0.001). At follow-up, the change in the DTI-ALPS index (∆DTI-ALPS) was the highest in the improved OSA group, followed by the OSA free, stationary OSA, and progressed OSA groups. ∆DTI-ALPS over 4-year was inversely correlated with ∆AHI (R=-0.171, P&lt; 0.001 for the entire study population and R=-0.218, P&lt; 0.001 for the population excluding OSA-free subgroup). ∆DTI-ALPS over 4-year was correlated with the changes in the visual reproduction–immediate recall (R=0.233), delayed recall (R=0.178), and recognition (R=0.188) scores (all, P&lt; 0.001).

Conclusion
The changes in the OSA status has impact on the longitudinal change in the glymphatic system function and this effect might be reversible. Sustained proper management of OSA might be important in the effective prevention and management of cognitive decline.

Support (if any)
1011 Childhood Predictors and Adult Factors Associated with Long-Term Sleep Disturbance in Tourette’s Disorder
Authors: Tooker Maya , Barber Kathryn , McGuire Joseph , Espil Flint , Stiede Jordan , Schild Jennifer , Bennet Shannon , Specht Matthew , Walkup John , Woods Douglas , Piacentini John , Ricketts Emily 
Published: April 2024

Abstract

Introduction
Tourette’s Disorder (TD) is a childhood-onset neurological disorder characterized by motor and vocal tics present beyond one year. Sleep disturbance presents in 80% of individuals with TD and rises with advancing age. Common clinical correlates are tic severity, functional impairment, female sex, and co-occurring psychiatric symptoms, including attention-deficit/hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), anxiety and depression. However, we lack understanding of long-term predictors of sleep disturbance in TD. Therefore, this investigation examined childhood predictors and adolescent/adult factors associated with sleep disturbance in a treatment follow-up sample of adolescents/adults with TD.

Methods
Eighty participants of a randomized-placebo controlled trial of behavior therapy for tics in childhood (M = 11.47, SD = 2.42 years) received follow-up evaluation 11.7 (SD = 1.25) years later in adolescence/adulthood (M = 22.87, SD = 2.70 years). At baseline and long-term follow-up, an independent evaluator assessed tic severity tic-related impairment and psychiatric diagnosis via interviews. At baseline, children rated anxiety and depression, and parents rated ADHD, and provided demographic and psychiatric history (e.g., tic and stimulant medication status). At follow-up, adolescents/adults rated anxiety, depression, and ADHD severity, and reported tic medication and stimulant medication status since trial termination. Multiple linear regression analysis was performed without and with backward elimination to examine childhood predictors and adult factors (sex, tic and stimulant medication status, tic severity and impairment, anxiety, depression, and ADHD severity, OCD diagnosis) sleep disturbance (Pittsburgh Sleep Quality Index) at long-term follow-up.

Results
Childhood tic-related impairment significantly predicted sleep disturbance (β = 0.35, t = 2.66, p = .010). However, with backward elimination both childhood tic-related impairment (β = 0.32, t = 2.81, p = .007) and depression (β = 0.33, t = 2.92, p = .005) significantly predicted sleep disturbance. There were no significant adolescent/adult factors associated with sleep disturbance. However, backward elimination showed depression was associated with sleep disturbance (β = 0.46, t = 3.95, p &lt; .001).

Conclusion
Findings highlight the role of tic-related impairment in childhood and depression in childhood and adulthood in sleep disturbance in adolescents/adults with TD. Findings suggest the utility of targeted intervention for tic-related impairment and depression to minimize their long-term influence on sleep in TD.

Support (if any)
1012 Concordance and Test-Retest Consistency of Sleep Biomarker Based Phenotyping of Neurodegenerative Disorders
Authors: Levendowski Daniel , Walsh Christine , Cho Yeilim , Yack Leslie , Tsuang Debby , Lee-Iannotti Joyce , Berka Chris , Mazeika Gandis , Boeve Bradley , Neylan Thomas , Louis Erik St 
Published: April 2024

Abstract

Introduction
In this pilot study, the diagnostic agreement for sleep biomarker-based neurodegenerative disorder (NDD) risk probabilities was evaluated in patients with Alzheimer’s disease dementia (AD), Lewy Body disease (LBD), and isolated REM sleep behavior disorder (iRBD) and controls with a Mini-Mental State Exam scores&gt;28.

Methods
Sleep biomarkers recorded with the Sleep Profiler (Advanced Brain Monitoring, Inc) were used as inputs to a 4-class machine learning algorithm trained to assign NDD risk probabilities to AD=27, LBD=19, iRBD=15 and controls (CG=58). Input variables included age, time-REM, non-REM hypertonia, autonomic-activation index, spindle-duration, atypical-N3, time-supine, sleep-efficiency, relative-theta, and theta/alpha. Records with CG output probabilities &gt;70% were labeled Probably-normal, and from 45-70% Likely-normal with indications of a NDD added when the LBD, AD or prodromal synucleinopathy (pSYN) risks exceeded approximately 25%. Similar thresholds were used to assign Likely- or Probable- LBD, AD, or pSYN based each of the group probabilities. Classification accuracies were evaluated in AD=37, LBD=19, iRBD=19 and CG=61 records. Longitudinal test-retest reliabilities were assessed for CG (n=45, range 8-56 months), and after six-months for LBD (n=10) and AD (n=9).

Results
In the AD group, NDD risk assignments were consistent with diagnoses=85%, with Probable-NDD=59%, Likely-NDD=11%, Normal plus AD/Mixed indications=15%, but with 5%=Probably-normal. In the LBD group, assigned risks were consistent with the diagnosis=79%, with Probable-NDD=74%, Normal with pSYN indications=5%, but with 11%=Probably-normal. In the iRBD group, Probable-NDD=42%, Normal plus pSYN indications=26% and Probably-normal=32%. In the CG group, 89% were assigned minimal NDD risks with Probably-normal=67%, Normal plus indications=22%, but with Likely NDD=8% and Probable NDD=3%. The AD test-retest reliability showed the same NDD classifications=78%, with slightly increasing=11% and decreased=11%. In the LBD group, the same NDD classifications were achieved=80%, with trending equivalence=10%, and decreasing severity=20%. The CG test-retest reliability showed the same NDD classifications=76%, with trending equivalence=22%, and increased severity=2%.

Conclusion
Consistencies between the diagnoses and assigned NDD risks and test-retest classification agreements were approximately 80% in the AD, LBD, and CG groups. In the iRBD group, the NDD risks were disbursed consistent with the range of expected severities. These results needed to be cross-validated in independent NDD datasets.

Support (if any)
NIH grants R44AG050326, R44AG054256, RO1AG060477, R33AG064271, ULRR024150, R34AG056639.
1014 Effects of Sleep on Real-World Daily Decisions to Drive in Older Adults with Neurodegeneration
Authors: Chang Jun Ha , Chen Su , Zhang Ying , Murman Daniel , Rizzo Matthew 
Published: April 2024

Abstract

Introduction
Sleep dysfunction increases the risk of mild cognitive impairment (MCI) and Alzheimer’s Disease (AD). Emerging sensor technologies can index real world (RW) sleep and instrumental activities of daily living affected by neurodegeneration, as outlined below.

Methods
85 legally licensed active drivers with cognitive decline (76 MCI, 9 mild AD) (mean age = 75.6 years; 37 females) and 54 age and education-matched controls (mean age= 74.7 years; 36 females) participated. Cognitive status was assessed using standardized neuropsychological tests according to NIA-AA guidelines. Sensor systems installed in participants’ own vehicles recorded driving incidence (driving or not each day). Sleep was recorded using wrist-worn actigraphy, and verified with self-reported sleep diaries over three continuous months. A mixed-effect logistic regression analyzed daily driving incidence with predictors including z-scores of total sleep time (TST) and sleep efficiency (SE) in previous night, and cognitive status (MCI or AD v. controls), adjusted for age, gender, employment status, and driving season.

Results
From 9,214 days of data on nightly sleep and next day driving, increase in TST significantly reduced driving incidence (21% per standard deviation [SD]; Odds Ratio [OR] = 0.79, 95% Confidence Interval [CI] = 0.74 – 0.84, p &lt; 0.001). Increase in SE was associated with increased driving incidence among those with cognitive decline, compared to controls (15% per SD; OR = 1.14, 95% CI = 1.03 – 1.27, p = 0.01).

Conclusion
Findings underscore the value of RW digital biomarkers to track the effects of neurodegeneration on sleep and instrumental activities of daily living. Deciding to drive increased with greater sleep efficiency, particularly for those with cognitive decline. Quantitative profiles of sleep and driving behavior offer novel opportunities for early detection of the effects of AD.

Support (if any)
The present study is supported by the National Institute on Aging at the National Institutes of Health (5R01AG17177-18).
1023 Solriamfetol and Maintenance of Wakefulness Outcomes in Patients with Narcolepsy and Obstructive Sleep Apnea
Authors: Thorpy Michael , Eglit Graham , Floam Samantha , Parks Gregory , Krahn Lois 
Published: April 2024

Abstract

Introduction
Patients with excessive daytime sleepiness (EDS) associated with narcolepsy or obstructive sleep apnea (OSA) struggle to maintain wakefulness. Solriamfetol (Sunosi®) is a dopamine/norepinephrine reuptake inhibitor with agonistic properties at TAAR1 and serotonin 1A receptors; it is approved to treat EDS associated with narcolepsy (75–150 mg/day) or OSA (37.5–150 mg/day). This post-hoc analysis characterized the effects of solriamfetol on the propensity of participants with EDS associated with narcolepsy or OSA to maintain wakefulness.

Methods
The safety and efficacy of solriamfetol has been evaluated in participants with EDS and narcolepsy or OSA in the phase 3 trials, TONES 2 and TONES 3. Participants were randomized to placebo or solriamfetol (37.5 mg [OSA only], 75 mg, 150 mg, or 300 mg) once daily for 12 weeks. This post-hoc analysis evaluated the proportion of participants who achieved improvement from baseline on various 40-minute Maintenance of Wakefulness Test (MWT) thresholds (≥5, ≥10, ≥15, and ≥20 minutes) and mean sleep latencies ≥30 and ≥40 minutes at weeks 1, 4, and 12. Comparisons between solriamfetol and placebo were evaluated using Fisher’s exact test.

Results
A greater proportion of participants with narcolepsy achieved improvement from baseline of ≥15 and ≥20 minutes on the MWT with solriamfetol 150 mg (36% and 18%, respectively) and 300 mg (38% and 28%) compared with placebo (4% and 4%) at week 12 (P≤0.028); findings were similar at week 12 in participants with OSA with solriamfetol 75 mg (28% and 13%), 150 mg (37% and 25%), and 300 mg (44% and 28%) compared with placebo (8% and 3%; P≤0.034). A greater proportion of participants with narcolepsy achieved MWT sleep latency ≥30 minutes at week 12 with solriamfetol 150 mg (24%) and 300 mg (30%) compared with placebo (2%; P≤0.002); results were similar in participants with OSA for MWT sleep latency ≥30 minutes at week 12 with solriamfetol 75 mg (28%), 150 mg (34%), and 300 mg (44%) compared with placebo (11%; P≤0.012).

Conclusion
These findings suggest solriamfetol leads to substantial improvements on objective propensity to stay awake in a large proportion of patients with narcolepsy or OSA when compared with placebo.

Support (if any)
Axsome Therapeutics, Jazz Pharmaceuticals