bluuebunny/crossref_metadata_2025_split huggingface dataset:
1094 Who Gets the Stim?: A Demographic Analysis of Hypoglossal Nerve Stimulator Patients
Authors: Magana Linda , Soose Ryan , Kurland Kristen , Harrison Tina , Mazul Angela 
Published: April 2024

Abstract

Introduction
In addition to traditional demographic analysis, Geographic Information System (GIS) tools, provides a unique methodology that allows us to spatially analyze data and capture geographic data related to HNS patients. This study seeks to create geographic maps related to socioeconomic attributes of HNS patients in addition to relevant demographic and clinical data to better understand potential barriers to care for those seeking treatment for obstructive sleep apnea (OSA).

Methods
A retrospective study was performed of patients who underwent HNS implantation at a tertiary care academic hospital from August 2011 to October 2021. Relevant demographic and clinical characteristics were captured for each patient, both pre- and post-operatively. GIS was used to geocode patient addresses and perform spatial analyses to capture socioeconomic dynamics that may produce barriers to care for vulnerable populations. Maps were produced identifying distribution of patients relative to median household income, Area Deprivation Index (ADI), and drive times to the hospital.

Results
229 patients were included in this study. 167 patients were male and 62 were female. 222 patients implanted during this period identified as Caucasian. When considering median home value, median household income, and Area Deprivation Index, the cluster of patients within Pittsburgh most often lived in more affluent areas. However, more than 50% of patients lived greater than a 30-minute drive from the hospital where surgery and clinic appointments occurred. 90% of patients lived within 60 minutes of the hospital.

Conclusion
As hypoglossal nerve stimulation (HNS) continues to expand its footprint in the treatment of patients with obstructive sleep apnea (OSA), there is a dearth of demographic studies related to the populations currently being served by this treatment modality. This study uniquely seeks to meld clinical data with socioeconomic information to better understand recipients of HNS.

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1096 Attitudes Towards Mental Health Service for Sleep Scale (AMHSUS): Development and Psychometric Evaluation
Authors: LoBrutto Lara , Clark Maraya , Nagle Kerensa , Williams Claire , Nielson Spencer , Reid Morgan , Dautovich Natalie 
Published: April 2024

Abstract

Introduction
Poor sleep health is prevalent at the population level and is especially high among college students. There are numerous evidenced-based mental health treatments for sleep disturbance [e.g., Cognitive Behavioral Therapy for Insomnia (CBT-I) and mindfulness-based therapies], but mental health care for sleep continues to be underutilized. The novel Attitudes Towards Mental Health Service Utilization for Sleep (AMHSUS) scale was developed to assess attitudes towards the use of mental health services for sleep disturbance to gain a fuller picture of individual and population-level barriers and facilitators.

Methods
An initial 20-item scale covering four hypothesized dimensions was developed via team consensus, then refined and reduced to 16 items in response to feedback from a graduate student panel. The scale was tested using a sample (n=367) of university students (Mage= 19.0; female= 71.1%; white=43.1%; Black= 31.3%) in the southern region of the United States.

Results
An exploratory factor analysis yielded four factors: “Severity,” “Facilitators,” “Barriers,” and “Priority.” All but one of the original items were retained. The total scale demonstrated good internal consistency, with a Cronbach’s alpha of .71. Reliability was appropriate for two of the four factors, “Severity” (∝=.83) and “Facilitators” (∝=.82), but questionable for “Barriers” (∝=.63) and poor for “Priority” (∝=.46).

Conclusion
Future directions include testing the scale for convergent and discriminant validity, revising the “Barriers” and “Priority” subscales, and removing items as needed. AMHSUS shows strong psychometric potential and, with some modifications, will be a valuable tool for sleep health research.

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1097 Education Intervention Improves Sedative Use for Healthy Sleep & Insomnia Management
Authors: Chang Fong-Ching , Wu Ching-Ying , Chen You-An , Hu Youwun , Liu Chun-Lung , Cheng Ning , Hsieh Yow-Wen , Shiue Ya-Ming , Tseng Chi-Ting , Chang Jungchen , Chi Hsueh-Yun 
Published: April 2024

Abstract

Introduction
Individuals with higher self-efficacy in managing their hypnotics and sedatives use are more likely to adhere to prescribed dosages, follow recommended guidelines, and make necessary behavioral changes. Self-efficacy also influences an individual's decision-making regarding their health and treatment regimen. Misuse or improper use of sedatives and hypnotics poses risks such as dependency, adverse effects, and potential addiction. Enhancing patients' self-efficacy in handling their medication intake could potentially mitigate these risks and promote safer usage.

Methods
The study was a single-arm interventional pre-and post-assessment study conducted nationwide in eight counties. The intervention was a well-consensus health education program. A self-report five-item questionnaire with good psychometrics (0.8 expert content validity and 0.9 internal consistency reliability) assessed the self-efficacy of proper use of hypnotics and sedatives.

Results
Eight institutions across different regions recruited 875 participants comprising elderly (n=337, 38.5%), workers from high-risk workplaces (n=415, 47.4%), native aborigines (n=95, 10.9%), youths (n=117, 13.4%) and others. The participants aged 58.3 ± 17.6 years and half were male (n=447, 51.1%). The self-efficacy of using hypnotics and sedatives was significantly improved after the educational interventions (the changed scores 0.16 ± 0.45, p &lt;.001). After the educational intervention, the participants could re-establish their bedtime routine (e.g., a calmy environment, no 3Cs use), express their sleep disturbance to the physician, learn the medications comprehensively, and keep adherent to the treatment regions, etc.

Conclusion
The intervention, which focused on improving the self-efficacy of proper use of hypnotics and sedatives, resulted in a notable enhancement in participants' abilities. A statistically significant improvement was observed in their self-efficacy scores post-intervention, indicating a positive impact of the educational program. Notably, participants exhibited an improved capacity to re-establish healthy bedtime routines. Additionally, they demonstrated better communication with healthcare professionals regarding sleep disturbances, a comprehensive understanding of medications, and increased adherence to prescribed treatment regimens.

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1100 Innovative Skills Based Workshop on Advanced Positive Airway Pressure Devices for Sleep
Authors: Usman Abira , Woo Emily , Khalil Wajahat , Pusalavidyasagar Snigdhasmrithi , Akpa Bimaje , Khan Anees , Satovich Maria , Rana Izaan , Irfan Rayyan , Irfan Muna 
Published: April 2024

Abstract

Introduction
Chronic advanced respiratory assist device (RAD) management for complex sleep related breathing disorders is an overlooked area in sleep and pulmonary medicine education. Robust educational curriculum on practical management of advanced PAP therapies in sleep medicine fellowship programs is lacking. This void led our team to design innovative practical hands-on skills workshop to help facilitate learning.

Methods
Sleep faculty with area of expertise in education, sleep, medicine, and pulmonary fields designed a practical skills workshop titled “NIV skills workshop” consisting of introductory briefing, 3 clinical vignettes and post session debriefing. Cases were developed to highlight strategies on empiric use, PAP mode selection, setting adjustment and troubleshooting for complicated sleep related breathing disorders including neuromuscular disorders and hypoventilation to improve knowledge and comfort with prescription and management of the devices. RPSGTs helped with conduction of workshop with 3 stations, each dedicated to a clinical case with devices available to practice adjustments based on clinical scenarios. The learners rotated through these stations with a faculty moderating each case. Pre and post session surveys were conducted to assess workshop effectiveness in improving participants' level of comfort in modality selection, empiric settings, adjustment, and troubleshooting. Participants responded with numerical values based on Likert scale. A paired t-test was conducted to assess pre and post workshop skills gain. The workshop was conducted for 2 consecutive sleep fellowship batches and thus survey results were obtained from all the leaners(n=6)

Results
Improvement in mean scores was noted in level of confidence in PAP modality selection (3.3 vs. 4, p= 0.05), empiric device settings (2.3 vs. 3.7, p=0.0007), complex PAP therapy adjustment (2.6 vs. 3.7, p=0.006) and dyssynchrony troubleshooting (2 vs. 3.8, p=0.0009). High mean scores of 4.5 and 4.8 (scale of 0-5) were noted for confidence in RAD management skills and impact on clinical practice from workshop.

Conclusion
In addition to conventional didactic teaching on advanced PAP management, a practical hands-on workshop is a highly effective tool to improve trainees’ knowledge and confidence in chronic advanced device management and should be incorporated as integral part of curriculum. Such workshops should be extended to learners across the spectrum of training.

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1101 Long-term Trends in Utilization of Sleep Diagnostic Tests Among Medicare Beneficiaries
Authors: Braun Marcel , Coughlin Steven , Schneider Hartmut 
Published: April 2024

Abstract

Introduction
Evidence underlines the association between disordered sleep and adverse health outcomes such as, hypertension, cardiovascular and cerebrovascular disease, and metabolic disorders. A variety of sleep test modalities are available, ranging from ambulatory single-channel sleep tests to in-lab technician-supervised polysomnography (PSG). These tests are selected by the clinician based on the patients overall health profile, which sleep disorders are being investigated, and which tests are covered by insurance providers. The aim of this research was to evaluate trends in utilization of different sleep diagnostic tests among Medicare beneficiaries.

Methods
A retrospective analysis of sleep test utilization was conducted using a public data set curated by the Center of Medicare and Medicaid Services. Available data included information on services, categorized by HCPCS or CPT code, submitted and paid charges, beneficiary demographics and health characteristics for the years 2011 to 2021.

Results
From 2011 to 2021, sleep service utilization among Medicare beneficiaries decreased from 803,280 to 694,375 with a peak of 963,780 procedures in 2018 (-13.6%; Compound Annual Growth Rate (CAGR) = -1.4%). Despite a slight decline in overall sleep studies, unattended type 3 studies / Home Sleep Apnea Tests (HSAT) grew by 632.6% (CAGR = 22.0%), and replaced attended sleep studies as the main diagnostic test for sleep disorders. Attended sleep studies and split-night study utilization almost halved over the period analyzed (-44.9% and -45.6%, CAGR = -5.8% and -5.9%), while the share of unattended studies / HSAT grew from 4.7% in 2011 to 34.5% in 2021. When excluding the pandemic years 2020 and 2021, overall sleep study utilization grew by 18.0%. This development was entirely driven by increased use of unattended type 3 studies / HSAT (+616.5%; CAGR 25.2%), while attended sleep studies and split-night studies decreased by -15.5 and -7.3% respectively (CAGR -2.4% and -1.7%).

Conclusion
Utilization of sleep diagnostic tests among Medicare beneficiaries underwent significant changes since 2011, with a large shift occurring from in-lab sleep studies to simpler unattended at-home tests. While attended sleep studies, such as in-lab PSG, split-night titrations and vigilance tests were already declining before the pandemic, this event accelerated the transition towards at-home diagnostic testing.

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1102 Museum-Based Sleep Education: Development and Evaluation of Pop-Up Exhibits for Children and Families
Authors: LeBlanc Claire , Cruz Andri , Scullin Michael 
Published: April 2024

Abstract

Introduction
Museums are highly credible communal spaces where people can come together to learn. This immersive environment offers opportunities to engage briefly but meaningfully with the public about sleep health. We developed interactive pop-up exhibits with activities that introduced children to sleep science and encouraged families to change sleep behaviors. We evaluated their efficacy via observational data and visitor survey responses.

Methods
We held 11 pop-up exhibits in a medium-sized children’s museum from June to December 2023. Each exhibit lasted two hours and was designed to communicate three learning objectives: sleep is good, the sleeping brain is active, and changing nighttime behaviors can improve sleep. Pop-up exhibits included professional signage; take home sleep tips and stickers; videos to display sleep laboratory activities and interesting sleep facts; magnetic “electrodes” and a 3D-printed brain for learning about polysomnography; brain maze coloring sheets, and an inflatable dinosaur fitted to a CPAP mask (REM-ee the dino-snore-us). Each exhibit was staffed by 3-4 trainees (undergraduate to post-doctoral level) and observational data were collected by museum staff. Post-visit survey data in adults assessed participant demographics, meeting of learning outcomes, interest in recommending the exhibit to a friend, prioritization of sleep (0 to 100 scale), and changes in one’s perception of what a scientist looks like.

Results
1,336 people visited the sleep exhibits (32% of total museum visitors). Adult visitors (18+) were invited to complete a post-visit survey (N=102; M=37.25 years; 63.7% female; 37.25% non-white). Survey responses indicated that most learning objectives were met (89.2%), that most visitors would recommend the exhibit to a friend (91.2%), that visitors’ prioritization of sleep changed from 67.9% before the exhibit to 87.5% after the exhibit (p&lt;.001), and that many visitors intended to change their sleep habits (73.5%). More than half of visitors (62.2%) reported that their perception of a scientist had changed (e.g., demographically diverse, friendlier).

Conclusion
Pop-up museum exhibits are a feasible and effective method for communicating sleep information in local communities. Additional work is needed to determine whether permanent installations of sleep exhibits retain their efficacy when sleep experts are not actively staffing the exhibit.

Support (if any)
National Science Foundation (1920730 and 1943323).
1104 Personalisation of Breathing Comfort for CPAP Users Through a Machine-Learning Algorithm
Authors: Pongrass Sarah , Liu Nathan , Nguyen Chinh , Tran Vinh , Emami Hussein , Armistead Jeff , Wimms Alison 
Published: April 2024

Abstract

Introduction
Many factors impact CPAP adherence, some common issues include trouble falling asleep, difficulty breathing against pressure, and being disturbed by high pressures. Various settings to address breathing comfort have been developed, such as ramp time, reducing pressure during exhalation, and APAP response rate, though evidence of their impact is minimal. We sought to develop a machine-learning model to recommend personalised combinations of comfort settings at setup with the goal of improving CPAP adherence in patients newly starting CPAP therapy.

Methods
Data sets from 718,421 anonymous OSA patients (myAir, ResMed) were used to create the machine-learning model (MLM). The model was developed using a causal inference approach to control for bias from observational data and utilised features such as age, sex, diagnostic AHI, mask type and start pressure to predict optimal comfort settings for various patient types. These comfort settings can then be applied on an individual level. A proof-of-concept, double-blinded, randomised controlled study was conducted with people newly diagnosed with OSA (AHI≥5) and indicated for CPAP therapy attending a sleep clinic. The primary outcome was treatment continuance after 30 days comparing those set up on MLM vs default comfort settings (control).

Results
58 patients (26% female, mean age 49.9±14.9, 46.6% non-white, mean diagnostic AHI 43.6±30.4) were included in the study analysis. At 30 days the MLM group had greater treatment continuance vs control (96% vs 80%) though not statistically significant. All other endpoints were also not statistically significant. 54% of MLM group had zero setting changes vs 37% control. In this subgroup, MLM showed increased average daily usage (+46.9min), number of days used (+2.9days), and number reaching CMS compliance (+11%), however these endpoints did not reach statistical significance.

Conclusion
This program developed a machine-learning model to predict optimal comfort setting combinations for individual CPAP patients to improve CPAP adherence. The proof-of-concept study did not reveal any harm to patients assigned personalised settings and showed some trends towards positive outcomes. Personalising comfort settings may benefit new CPAP patients, however a larger study is required to fully validate the machine-learning model.

Support (if any)
Funded by ResMed
1113 A Personalized Smartphone App Improves Sleep and Stress in Poor Sleepers: A Randomized Wait-List Controlled Trial
Authors: Gottlieb Elie , Gahan Luke , Munt Oliver , Fischer Susanne , Schredl Michael , Christoph Schoebel 
Published: April 2024

Abstract

Introduction
Smartphone applications (Apps) offer a highly scalable, engaging, and cost-effective approach to improving sleep-promoting behaviors and attitudes. In this randomized wait-list controlled trial, we evaluated the efficacy of a novel smartphone app, the Dein Schlaf Dein Tag app from SleepScore Labs, designed to objectively measure sleep via PSG-validated sonar methods and improve sleep by providing personalized, dynamic, and evidenced-based sleep and circadian advice and education founded in the principles of sleep hygiene and cognitive-behavioral skills.

Methods
A preliminary analysis of 412 participants with subclinical poor sleep (Regensburg Insomnia Scale score 13-24) randomized to either an App/intervention group (n=128) or a waitlist control group (n=298) was conducted. Changes in subjective sleep quality, perceived stress, and quality of life were measured using validated questionnaires at baseline, 6-weeks, and 12-week time-points. Statistical significance was tested via the interaction of an ANOVA (factor 1: app group vs. waitlist control; factor 2: baseline vs. 6 and 12 weeks).

Results
At both 6 and 12-week follow-up assessments, perceived sleep quality as measured by the sleep quality component of the Schlaffragebogen-B (SF-B) significantly improved among the App/intervention group when compared with controls (12-week effect size 0.646 App vs. 0.250 control group, F: 11.7, p=0.0007). Overall sleep problems as measured by the PSQI also significantly improved at 6 and 12-weeks among the App group when compared with controls (12-week effect size -0.448 app vs. -0.172 control, F: 7.5, p=0.0065). Feelings of being refreshed after sleep significantly improved among the App/intervention group after both 6 and 12-week assessments as measured by the GES component of the SF-B (12-week effect size 0.429 app vs. 0.143 control, F: 5.4, p=0.002). At 12-weeks, perceived stress significantly improved among the App/intervention group as measured using the Perceived Stress Scale (12-week effect size -0.526 app vs. -0.235 control, F: 4.1, p=0.0436), but not at 6-weeks (p=0.08). No significant differences in quality of life as measured using the SF-12 were observed between groups.

Conclusion
This randomized controlled trial demonstrated that a personalized and dynamic sleep improvement and measurement App can improve perceived sleep and stress in individuals with poor sleep.

Support (if any)
SleepScore Labs and ResMed Science Center
1114 Evidence for Deep Sleep Homeostasis in Real World Sleep Tracking Data
Authors: Goparaju Balaji , Bianchi Matt 
Published: April 2024

Abstract

Introduction
Investigations of sleep homeostasis often involve tightly controlled experimental sleep deprivation in service of understanding mechanistic physiology. The extent to which the deep sleep response to recent sleep loss occurs in naturalistic settings remains under-studied. We tested the hypothesis that a homeostatic increase in deep sleep occurs on the first recovery night following occasional short duration nights that arise in naturalistic settings.

Methods
We analyzed sleep staging data in participants who provided informed consent to participate in the Apple Heart and Movement Study and elected to contribute sleep data. The analysis group included n=33,358 participants with at least 30 nights of sleep staging data from Apple Watch.

Results
Short nights of sleep that were &gt;=2 hours shorter than each participant’s median sleep duration occurred at least once in 65.1% of the cohort, most often in isolation (&lt; 5% of instances were consecutive short nights). Assessing the amount of deep sleep on the recovery night revealed that deep sleep increased in proportion to the amount of sleep loss on the preceding short night, for short night definitions ranging from 30 minutes to &gt;3 hours below the within-participant median sleep duration. Focusing on short nights that were at least 2 hours below median, we found that 64.9% of participants showed any increase in deep sleep on the recovery nights, with a median increase of 23.9% (absolute increase: median 11 minutes, interquartile range 5 to 19). Among participants with at least three short nights at any time in a 6-month window (28.6%), the percentage of recovery nights having &gt;=5 minutes extra deep sleep showed small but significant Spearman correlations with two measures of sleep consistency, the standard deviation of sleep duration (r = -0.16), and the standard deviation of sleep start time (r = -0.12).

Conclusion
The results provide evidence for homeostatic responses in a naturalistic setting. Although the deep sleep recovery amounts are modest, naturalistic short nights are a lesser perturbation compared to experimental conditions of greater restriction or total deprivation. The findings illustrate the utility of longitudinal sleep tracking to assess real-world correlates of sleep phenomenology established in controlled experimental settings.

Support (if any)
n/a