bluuebunny/crossref_metadata_2025_split huggingface dataset:
0727 Sleep Timing and Depression Risk in Pregnancy
Authors: Dunietz Liana , Olson Anna , Tittle Lucas , Kalmbach David , Pitts D'Angela , Yang Chia-Lun , Jansen Erica , Kerver Jean , Hirko Kelly , Burgess Helen , Swanson Leslie , O'Brien Louise 
Published: April 2024

Abstract

Introduction
There is growing evidence that sleep timing is linked to health outcomes. Poorly timed sleep has been associated with metabolic risk factors and mood problems although there is a lack of data in the pregnant population. Emerging data suggest that late sleep timing during pregnancy may be associated with gestational diabetes, gestational hypertension, and preterm birth. However, data on sleep timing and mood during pregnancy are lacking.

Methods
Pregnant women were recruited from prenatal clinics at a large Midwestern tertiary referral center. Women were eligible if they were at least 18 years old and pregnant in their second or third trimester with a single fetus. There were no other exclusion criteria. Participants were queried about their sleep including questions about the time they went to bed, the time they woke up and their typical nocturnal sleep duration. Sleep mid-point was calculated as the time midway between bedtime and wake time and a delayed midpoint was defined as being after 4:00am. Demographic information was abstracted from medical records. Women were considered to have depression with a score of 13 or more on the Edinburgh Postnatal Depression Scale (EPDS) or a clinical diagnosis of depression.

Results
A total of 1349 women were included in the analysis, of which 15% were classified as having depression. Mean age was 30.7 years (SD 5.6 years) and mean gestational age was 33.8 weeks (SD 4.3 weeks). Overall, 26% of women had a sleep midpoint after 4:00am. In a regression model, women with a delayed sleep midpoint had a significantly increased odds ratio for depression (OR 1.4, 95%CI 1.1-1.8), which did not appreciably change after controlling for age, race, presence of hypertension or diabetes, first pregnancy, marital status, and sleep duration (aOR 1.5, 95%CI 1.1-2.2).

Conclusion
We provide initial evidence suggesting a link between self-reported late sleep midpoint and depressive symptoms in pregnancy. Assessment of sleep timing during pregnancy may have potential for identification of women at risk of depression.

Support (if any)
0730 Immigration Status and Acculturation Level Are Prospectively Associated with Sleep in a Diverse Population of Women
Authors: Benasi Giada , Cho Annabel , Aggarwal Brooke 
Published: April 2024

Abstract

Introduction
Sleep, diet, and physical activity are key to cardiovascular health (CVH). Recent immigrants have healthier habits than native-born US adults, and greater acculturation is linked to poorer diets, less physical activity, and worse CVH. However, little is known about sleep in immigrant women. We aimed to investigate prospective associations between immigration status, acculturation, and sleep in a diverse sample of women from a New York City community-based cohort.

Methods
This prospective cohort study of 447 women (60.4% racial/ethnic minority, mean age=36.37±15.43 y) evaluated whether immigration and/or acculturation predicted sleep patterns at 1y follow-up. Immigration status, region of origin (Asia, Caribbean, Latin America, other), and acculturation measures including language preference, length of US residency, and age at immigration were self-reported at baseline. Sleep duration, quality, and sleep-onset latency were measured using the Pittsburgh Sleep Quality Index at baseline and 1y follow-up. Linear and logistic regression models were adjusted for age, health insurance, education, BMI, and corresponding baseline sleep measure.

Results
Among all participants, being born in the US was associated with poorer sleep quality (β:0.57, SE:0.25, p=0.022) at 1y. Among immigrant women, longer residency in the US (β:-0.02, SE:0.01 p=0.008), younger age at immigration (β:0.02, SE:0.01, p=0.012), and being from the Caribbean (β:-0.46, SE:0.19 p=0.017) were associated with shorter sleep duration at 1y. In logistic regression models adjusted for confounders, women who were from the Caribbean vs. other regions (OR:3.09, CI:1.13-8.51, p=0.029) and who had a longer US residency (OR:1.06, CI:1.02-1.10, p=0.002) had higher odds of sleeping &lt; 7h/night. A lower risk of short sleep (&lt; 7h/night) was observed among those who had been in the US for &lt; 10y vs. ≥10y (OR:0.33, CI:0.11-0.96, p=0.042) and with an older age at immigration (OR:0.94, CI:0.90-0.98, p=0.003).

Conclusion
Poorer sleep quality was reported by US born women, while shorter sleep was observed among immigrant women from the Caribbean compared to other regions, those with a younger age at immigration, and those with a longer residency in the US. These findings may help to identify women at greater risk for poor sleep and, consequently, at increased risk for poor CVH.

Support (if any)
American Heart Association (AHA16SFRN27960011).
0731 Bisexual Women Are More Prone to Nightmares and Insomnia Compared to Straight Women in a Sample of College Students
Authors: Virnoche Regan , Gratton Matthew , Baber Garrett , Hamilton Nancy 
Published: April 2024

Abstract

Introduction
Frequent nightmare and insomnia severity are associated with sequelae including increased risk of substance abuse, cardiovascular disease, and suicide. Women and sexual minorities report higher incidence of nightmares and insomnia and as such may be at greater risk for negative associated outcomes. However, most research has consolidated all sexual minority members into a heterogeneous group. To address this gap, we investigated the risk of nightmares and insomnia among women who identified as heterosexual, lesbian, and bisexual.

Methods
Using the Student Trauma and Nightmare Development (STAND) data set, we analyzed the differences in frequency of nightmares and insomnia between straight and bisexual women. The data were collected from a sample of women enrolled at an American midwestern university (N = 957). Insomnia was measured using the 7-item Insomnia Severity Index (ISI) questionnaire. The 5-item Nightmare Disorder Index (NDI) questionnaire was used to assess the severity and frequency of one’s nightmares. Sexual orientation could be endorsed as straight/heterosexual, gay/lesbian, bisexual, queer, asexual, prefer not to say, or prefer to self-describe. We fitted two general linear models using sexual orientation to predict insomnia and nightmare severity while controlling for age.

Results
Women who identified as bisexual reported significantly higher ISI and NDI scores compared to those identifying as a straight/heterosexual (NDI: β = -2.46, 95% CI: [-3.65, -1.26], p &lt; 0.001; ISI: β = -2.52, 95% CI: [-4.00, -1.04], p &lt; 0.001). There was no significant difference between straight/heterosexual women and lesbian women (NDI: β = 0.04, 95% CI: [-3.67, 3.76], p = .981; ISI: β = -2.85, 95% CI: [-7.464, 1.767], p = .226).

Conclusion
These results show that bisexual women in college may be at higher risk for insomnia and nightmares compared to heterosexual/straight college women. These findings highlight a significant sleep health disparity affecting bisexual women, a group with marginalized sexual identities. While these outcomes provide valuable insights, future studies should investigate the potential impact of trauma and utilize a larger and more diverse sample. This study may provide clinical utility for the treatment of bisexual women.

Support (if any)
0734 Early Life Trauma Impacts Adult’s Sleep Valuation in a Sample of African American Couples
Authors: Kay Daniel , Decker Andrea , Marquez Francisco , Cribbet Matthew , Nielson Spencer 
Published: April 2024

Abstract

Introduction
Sleep value is the worth placed on sleep. The Sleep Valuation Item Bank (SVIB) is a novel questionnaire designed to capture the basic dimensions of sleep. The latent structure of sleep value has been tested in several nationally representative samples and college students. Distinct patterns have emerged across demographic and sleep variables. This study sought to outline the factor structure of the updated SVIB in African American couples (97% married) and explore how early life trauma impacts sleep value in adulthood.

Methods
Participants (30+/-4 years of age) in a committed relationship (6.6+/-3 years in a relationship) completed an online survey that included demographic variables, the SVIB, and the Childhood Trauma Questionnaire (CTQ). The factor structure of the SVIB was determined using principal axis factoring with a Promax solution. Factors scores were extracted using the Barlett method and correlated with CTQ subscores: emotional, physical, and sexual abuse and emotional and physical neglect.

Results
The scree plot method, eigenvalues greater than 1, model fit indices (BIC=-2667, χ2=&lt;.001, CVE=.44, TLI=.84, and RMSEA=.054), and conceptual considerations of item fit suggested the presence of 5 factors: sleep devaluing, wanting, prioritizing, preferring, and enjoyment/liking. With the exception of emotional abuse, early life trauma was related to an ambivalent sleep value pattern characterized by lower sleep devaluing (r=-.69), greater sleep wanting (r=.24), and preferring to go to sleep when sleepy at night (r=.22) on the one hand, while enjoying sleep less (r=-.33) on the other (p&lt;.05, for all). Emotional abuse was unique in that they tended to prioritize sleep less (r=-.15) and had the highest negative correlation with sleep enjoyment (r=-.44, p&lt;.05 and .01, respectively).

Conclusion
Our results generally support previous analyses in other samples suggesting the SVIB captures a 5-factor structure of sleep value. This study extends those findings to African American couples. These findings suggest that early life trauma has a highly significant impact on sleep value in adulthood making it more desirable but less enjoyable. Emotional abuse in particular may lead to less prioritizing of sleep and more negative experiences with sleep.

Support (if any)
0736 Association of Excessive Sleepiness with All-cause Mortality Among Older Adult US Veterans
Authors: Maghsoudi Arash , Ramezani Amin , Sharafkhaneh Amir , Razjouyan Javad 
Published: April 2024

Abstract

Introduction
The association between excessive daytime sleepiness (EDS) and all-cause mortality remains uncertain. We investigated the relationship between EDS and all-cause mortality along with other factors including comorbid conditions.

Methods
We included patients who had visited the Veterans Health Administration (VHA) between FY 1999 and the end of 2022; and those who had been assigned ICD codes 9/10 of any sleep disorders or CPT codes of sleep studies. We developed and validated a Natural Language Processing (NLP) algorithm to extract Epworth sleepiness scale (ESS) from unstructured free-form text from physician notes. We assessed the NLP pipeline's performance using 470 patient notes that were manually annotated. We defined EDS as an ESS≥11. We categorized the patients into two groups: normal (ESS ≤10) and sleepy (ESS &gt;10). Control factors were the most important variables determined through a machine learning algorithm. We reported adjusted odds ratios (aOR) and 95% confidence intervals (95%CI) from logistic regression models using most important factors. The process was separately applied to two distinct groups of veterans: those younger than 50 years and those aged 65 years or older.

Results
Out of 423,087 unique patients with ESS, 116,581 (27.6%) were older adults where 71,913 were grouped as normal and 44,668 as sleepy. Among young adults, only depression considered as the most important factor for all-cause mortality and all-cause mortality rates did not differ between normal and sleepy groups. For older adults, 33 factors including ESS were considered as the most important variables. The aOR of all-cause mortality was 21% higher in Sleepy compared Normal (aOR,1.21;95%CI:1.17,1.24). Among the comorbid conditions, the prevalence of diabetes, depression, heart failure, renal disease, PTSD, and cerebrovascular disease were higher in Sleepy compared to the Normal.

Conclusion
In sharp contrast to younger adults, excessive daytime sleepiness, as measured by ESS, predicted higher mortality in older adults. The presence of important comorbid conditions in older adults most likely plays a causal role. Chronic comorbid conditions may disturb sleep and result in excessive daytime sleepiness.

Support (if any)
Supported by NIH-NHLBI-K25 funding (#1K25HL152006-01 [J.R.]); seed funding by AHBPCE (#FY2024-002 [J.R.]); and Center for Innovations in Quality, Effectiveness, and Safety (CIN 13-413), MEDVAMC.
0737 Retirement, Health-Related Quality of Life, and Sleep in Older Adult Veterans
Authors: Erickson Alexander , Kelly Monica , Fung Constance H , Stepnowsky Carl , Zeidler Michelle , Song Yeonsu , Dzierzewski Joseph , Mitchell Michael , Barretto Bronson , Partch Lisa , Rodriguez Ariana , Pearson Lori , Josephson Karen , Martin Jennifer , Alessi Cathy 
Published: April 2024

Abstract

Introduction
Retirement is a major life transition. Prior evidence suggests that retired individuals have better sleep quality than working individuals, though may also exhibit worse physical and mental health-related quality of life (HRQOL). Few studies have examined how retirement can impact the relationship between sleep and HRQOL, particularly among veterans who often face greater impairments in sleep and health.

Methods
Secondary analyses were conducted in a sample of 346 older veterans (mage=64, 47% white) with suspected co-morbid sleep apnea and insomnia. Measures included retirement status (retired/not retired), the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and Short-Form Health Survey (SF-12) encompassing both physical (SF-P) and mental health-related (SF-M) quality of life. Multiple regression analyses were conducted, with each model containing one sleep variable (ex. ISI), retirement status, and statistical interactions predicting SF-M or SF-P.

Results
All models were statistically significant. Retirement status was a significant predictor of SF-P across models (-4.52&lt; b&lt;-4.22, p≤.001), but was not a predictor of SF-M. When coupled with PSQI, the relationship between PSQI and SF-P was moderated by retirement status (b=-.68, p=.02), with retired individuals endorsing lower SF-P with poorer sleep quality compared to non-retired individuals. PSQI was also a significant predictor of SF-M (b=-1.27, p&lt;.001). ISI was a significant predictor of both SF-P (b=-.41, p=.01) and SF-M (b=-.9, p&lt;.001).

Conclusion
Poor sleep and being retired are associated with poor physical HRQOL, with physical HRQOL being particularly impacted by sleep quality in veterans who are retired. In contrast, only poor sleep functioning appeared to impact mental HRQOL. Findings from this study highlight the importance of sleep-related factors in maintaining HRQOL as well as the role retirement can play in physical HRQOL.

Support (if any)
Support: Support provided by the Veterans Administration (VA) HSR&D (Award #: HX003221), VA Greater Los Angeles GRECC, and the National Heart, Lung and Blood Institute (NHLBI)
0738 Differences in Perception in Sleep in Individuals with Dementia and Cognitive Impairment
Authors: Singh Jasmin , Vaughn Brad , Fan Zheng , Roth Heidi 
Published: April 2024

Abstract

Introduction
Normal aging is associated with changes in an individual’s sleep. Individuals with dementia and cognitive impairment have greater dysregulated sleep. These patients may have difficulty reporting sleep problems reliably or may have a distorted perception of their sleep quality. In this study, we examined how older patients with and without cognitive impairment compared with respect to objective and subjective measures of sleep, with a focus on perception of sleep onset latency (SOL) and total sleep time (TST).

Methods
We performed a retrospective review of diagnostic and PAP Titration polysomnograms from 2022 that were performed for patients ages 60-95 with a diagnosis of dementia or cognitive impairment (impaired group). An age-matched control group was also found in this fashion (control group). These polysomnograms were performed and scored in accordance with the AASM guidelines. Data regarding sleep time, SOL, Apnea-Hypopnea Index (AHI) and perceptions on TST and SOL were collected. A student T-test was used to compare measures in these groups.

Results
We identified 35 patients who were in the cognitively impaired group (mean age = 73) and 35 age-matched controls (mean age = 71). The average objective sleep latency for the impaired and control groups did not differ (26 minutes and 24 minutes, p=0.73), neither the average total sleep time (312 minutes and 309 minutes, p=0.86) nor the average AHI (12.9 and 17.5, p=0.34). The impaired group more frequently overestimated their perceived sleep latency (+62 minutes versus +22 minutes, p=0.02); however, the groups did not differ in their estimation of TST (p=0.16).

Conclusion
Our study found that patients with cognitive impairment overestimate how long it takes them to fall asleep compared to objective measures and their age match controls. Although many factors may contribute to this discrepancy, these findings suggest more thorough screening of sleep problems should be considered prior to initiation of interventions in individuals with cognitive impairment.

Support (if any)
0742 Sleep and Cognition in Older Adults: The Role of Subjective Cognitive Beliefs
Authors: Nielson Spencer , Dzierzewski Joseph 
Published: April 2024

Abstract

Introduction
Sleep is vital for an individual’s cognitive functioning and changes in sleep and cognition are common as individuals age. In older adults, subjective cognitive beliefs are a robust predictor of subsequent objective cognitive decline. Although sleep is consistently associated with subjective cognitive beliefs, its association with objective cognitive functioning is less well defined. This study aimed to examine whether sleep may be associated with objective cognitive functioning through its association with subjective cognitive beliefs in community-dwelling older adults.

Methods
Participants (N=365) were middle-aged and older adults (Mage=62.8, 59.7% female) who participated in an online study including questionnaires (Insomnia Severity Index, RU-SATED sleep health questionnaire, Karolinska Sleepiness Scale, and the Everyday Cognition Scale) and objective cognitive testing assessing the following domains: impulsivity, executive function, memory, and attention. Bivariate correlations and linear regression analyses examined direct associations between variables. Mediation was examined via SPSS PROCESS macro to determine whether subjective cognitive beliefs mediated the associations among sleep characteristics and objective cognitive functioning.

Results
Better sleep (i.e., less insomnia symptoms and sleepiness, better sleep health) was associated with more positive subjective cognitive beliefs (all p’s&lt;.05). Additionally, less insomnia symptoms (impulsivity, executive functioning, memory), less sleepiness (impulsivity, executive functioning, memory, attention), and better sleep health (executive functioning, memory) were associated with better objective cognitive functioning (all p’s&lt;.05). Mediation analyses revealed that subjective cognitive beliefs fully mediated the associations between the following: (1) Insomnia and impulsivity and memory (2) Sleepiness and impulsivity, memory, and executive functioning (3) Sleep health and memory and executive functioning. Subjective cognitive beliefs only partially mediated the associations between the following: (1) Insomnia and executive functioning and (2) Sleepiness and attention.

Conclusion
Subjective cognitive beliefs play an important role in linking sleep behaviors to objective cognitive functioning in older adults. In fact, many of the sleep—cognitive functioning associations were found to be fully mediated by subjective cognitive beliefs. As beliefs about cognitive functioning are an important predictor of pathological cognitive aging, interventions aimed at improving both sleep and cognitive functioning that utilize social learning principles, such as self-efficacy, may be particularly efficacious.

Support (if any)
0743 Association of Circadian Timing with Incident Dementia: The Korean Genome and Epidemiology Study
Authors: Kim Soriul , Kim Hyeon Jin , Lee Seung-Ku , Kim Hyun , Siddiquee Ali , Lee Min-Hee , Hwang Yoon Ho , Thomas Robert , Westover M Brandon , Shin Chol 
Published: April 2024

Abstract

Introduction
Circadian rhythm disruption is common in neurodegenerative disorders such as dementia. Especially, preference for circadian timing (e.g., chronotype) mainly affects cognitive and memory function. Previous studies reported that individuals with earlier chronotype may be useful predictor of poor neurocognitive outcomes and accelerated brain aging, but there is still not adequate strong evidence regarding the relationship between chronotype and dementia. The aim of the present study is to examine the associations between different chronotype and incident dementia through middle-aged to older general population.

Methods
A total 9541 participants of the Korean Genome and Epidemiology Study – Ansan and Ansung (mean age, 52.2±8.9), who have been linked to the Health Insurance Review and Assessment Service national database to assess incident all-cause and sub-type of dementia were analyzed. The mid-point sleep (MST) was defined as the midpoint between bedtime and wake time and used to categorize the participants into three groups (earlier-, intermediate-, and later-type). In multivariate Cox regression analysis, we adjusted for age, sex, area, marital status, education level, body mass index, smoking and drinking status, regular exercise, hypertension, diabetes, depression, hyperlipidemia, heart, and cerebrovascular disease at baseline.

Results
During the mean follow-up of 17.7 years, dementia was diagnosed in 1236 participants (588 with Alzheimer's disease (AD)). Among total participants at baseline, 13.0% were 65-69 years of age and 52.9% were women. Compared to the intermediate-type (-1SD (1.3 h) ≤ MST ≤ +1SD (3.6 h)), adjusted hazard ratio (HR) of all-cause dementia were 1.19 (95% CI, 1.04-1.36) in the earlier-type (&lt;-1SD). In addition, earlier-type was associated with greater risk of AD (HR = 1.22; 95% CI, 1.02-1.47). However, these associations were not shown in later chronotype (&gt;+1SD).

Conclusion
Our findings suggest that early mid-point of sleep was prospectively associated with an increased risk of all-cause dementia and Alzheimer’s disease among middle-aged or older adults.

Support (if any)
This study was supported by the Korea Centers for Disease Control and Prevention (2001-347-6111-221, 2002-347-6111-221); Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Education (NRF-2020R1I1A1A01071011 and NRF-2022R1I1A1A01065700); National Institutes of Health (NIH) (RF1NS120947); Health Insurance Review and Assessment Service research data (NHIS-2023-1-600).