bluuebunny/crossref_metadata_2025_split huggingface dataset:
0920 Sleep Health and Cognitive Symptoms in Adults with Inflammatory Bowel Disease
Authors: Al-Saleh Stacy , Kamp Kendra , Kane Sunanda , Redeker Nancy , Conley Samantha 
Published: April 2024

Abstract

Introduction
Inflammatory bowel disease (IBD) is a chronic immune-mediated disease that includes Crohn’s disease and ulcerative colitis. People with IBD experience poor sleep health, including short and highly fragmented sleep and extraintestinal manifestations including alterations to cognitive functioning; however, the relationships between sleep health and cognitive symptoms have not been evaluated in this population. The purpose of this study was to identify the associations between sleep health and perceived cognitive impairments in adults with IBD.

Methods
We conducted a descriptive, correlational study of adults (18 to 59 years old) with IBD. We used the Pittsburgh Sleep Quality Index (PSQI) to obtain self-reported data on sleep health, the FACT-Cog Perceived Cognitive Impairments questionnaire to elicit cognitive symptoms, and the Manitoba IBD Index to describe IBD disease activity. Descriptive statistics, point-biserial correlations, and Pearson’s correlations were used to describe relationships.

Results
Of the 59 participants [Mean age 40.8 (SD 10.5), 71.2% female, 94.9% white], 67.8% (n=40) had clinically active IBD. 79.7% (n=47) had a PSQI total score &gt;5, indicating poor sleep health. The most common cognitive symptoms, occurring two or more times a week, were trouble concentrating (55.9%), walking into a room and forgetting an intended task (44.1%), and forgetting the names of people soon after being introduced (44.0%). PSQI total score was positively and significantly correlated with 12 of 13 questions on the FACT-Cog. The strongest correlations included trouble concentrating (r = .497, P&lt;.001), slower thinking (r = .450, p&lt;.001), trouble forming thoughts (r=.550, p&lt;.001), and difficulty finding the right words to express oneself (r=.546, p&lt;.001). Longer self-reported sleep latency was associated with higher frequency of 12 out of 13 cognitive symptoms, while sleep efficiency was associated with 4 and sleep duration was associated with 2. Having clinically active IBD was associated with trouble forming thoughts (r=-.261, p=.046), slower thinking (r=-.307, p=.018), and trouble concentrating (r=-.346, p=.007).

Conclusion
Cognitive symptoms are common among people with IBD, highly correlated with sleep health, and not fully explained by IBD disease activity. Future studies should include objective measures of sleep health and cognition to further elucidate these relationships.

Support (if any)
Mayo Clinic Bonner Fund
0922 Associations Between Sleep Disturbances and PTSD Symptoms in Young Adults
Authors: Schenker Maya , Cherian Darshana , Felmingham Kim , Jordan Amy 
Published: April 2024

Abstract

Introduction
Post-traumatic stress disorder (PTSD) and sleep are bi-directionally linked. Past research on the association between sleep and PTSD has largely focussed on older military populations aged 30 or above, which created a gap in understanding this relationship in younger civilian populations. In addition, individual and trauma-related factors in this demographic have been mostly overlooked. In this study, we addressed this gap by examining the association between sleep disruptions and PTSD symptoms in a young university student cohort with diverse, non-military trauma histories. In addition, we explored moderating factors such as biological sex, chronotype, and trauma chronicity and investigated the link between sleep disturbances and PTSD symptom clusters (re-experiencing, hyperarousal, avoidance, and negative mood).

Methods
A total of 634 university students (female: 491, male: 143) with a mean age of 19.83 years (SD = 4.71) completed the study. Among them, 283 students reported experiencing at least one traumatic event. Participants completed an online questionnaire to assess trauma history, PTSD symptom severity, sleep disturbances (sleep quality, insomnia, and sleepiness), chronotype, and levels of depressive and anxiety symptoms.

Results
There was a significant positive association between sleep disturbances and PTSD symptom severity, F(3, 279) = 48.68, p &lt; .001, R2 = .34 in trauma-exposed adults with and without likely PTSD. However, this relationship was not moderated by any of the hypothesised factors (p &gt;.05). Nonetheless, there was a significant positive relationship between sleep disturbances and all four PTSD symptom cluster: re-experiencing (b =0.32, p &lt;.001), hyperarousal (b =0.34, p &lt;.001), avoidance (b =0.53, p &lt;.001), and negative mood (b =0.24, p &lt;.001).

Conclusion
The association between sleep and PTSD in this young adult population with mixed-trauma exposures aligned with the previously observed findings in older military veterans. The increasing severity of sleep disturbances as a predictor for PTSD symptom severity further suggests that sleep is a potential etiological factor contributing to the onset and persistence of PTSD. These results bear significant treatment implications, emphasizing the potential to address sleep-related issues in interventions targeting PTSD.

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0923 Prospective Bidirectional Relationship Between Sleep Duration and PTSD Symptoms Following Acute Coronary Syndrome
Authors: Shechter Ari , Cornelius Talea , Abdalla Marwah , Scott Allie , Sedano Brandon Fernandez , Hiti David , Sullivan Alexandra , Schwartz Joseph , Kronish Ian , Edmondson Donald 
Published: April 2024

Abstract

Introduction
Sleep disturbance is a “hallmark” symptom of posttraumatic stress disorder (PTSD). Poor sleep (including short sleep) after combat-related trauma can also predict subsequent PTSD. Less is known about the association between sleep duration and PTSD when PTSD is induced by an acute health-related event. We examined the bidirectional relationship between sleep duration and PTSD symptoms over the year following hospital evaluation for acute coronary syndrome (ACS).

Methods
Participants were enrolled in this observational study after emergency department evaluation for ACS. Sleep duration (“During the past month, how many hours of actual sleep did you get at night?”) and PTSD symptoms related to the cardiac event/hospitalization (PTSD Checklist; PCL) were assessed at 1-, 6-, and 12 months after hospital discharge. Cross-lagged path analysis was used to model the effects of sleep duration and PTSD symptoms on each other. Covariates included age, sex, race/ethnicity, cardiac severity, baseline depression symptoms, and early acute stress disorder symptoms.

Results
The sample included 1,145 participants. Mean (SD) age was 61.4 (12.6) y and 46.5% were female. Mean sleep duration was ~6.1 hours, with ~57% of participants reporting short sleep duration (i.e., &lt; 7 hours). Mean PCL score was ~24.19, with ~16% of participants screening positive for probable PTSD related to the cardiac event/hospitalization (PCL score ≥33) at each assessment (17.2%, 16.3%, and 15.7% at 1-, 6-, and 12 months). Higher PTSD symptoms predicted shorter sleep duration at the next timepoint (i.e., 1 to 6 months and 6 to 12 months), B=-0.14 hours/10-point difference, se=0.03, p&lt;.001. Shorter sleep duration was associated with higher PTSD symptoms at the next timepoint, B=-0.25 points/hour, se=0.12, p=.04. Results were similar when insomnia and nightmare items were removed from the PCL. Higher dream-related PTSD symptoms (i.e., nightmares) had a marginally significant association with shorter sleep at the following assessment, B=-0.09 hours/point, se=0.05, p=.057. Shorter sleep was significantly associated with higher dream-related PTSD symptoms at the next timepoint, B= 0.03 points/hour, se=0.01, p=.001.

Conclusion
Short sleep duration and PTSD symptoms are mutually reinforcing across the year following ACS evaluation. Findings suggest that sleep, PTSD symptoms, and their relationship should be considered in the post-ACS period.

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0926 Dreaming Big: Launching a Web-Based Provider Training for Cognitive Behavioral Therapy for Nightmares
Authors: Pruiksma Kristi , Wilkerson Allison , Taylor Daniel , Dietch Jessica , Tyler Hannah , Price William , Campbell Rebecca , Davis Joanne , Wardle-Pinkston Sophie , Young-McCaughan Stacey , LoSavio Stefanie , Peterson Alan 
Published: April 2024

Abstract

Introduction
Few providers are trained to deliver Cognitive Behavioral Therapy for Nightmares (CBT-N) despite the impact of nightmares on physical and mental health. Reduced access to treatment is partially due to limited training opportunities. Web-based training resources are valuable because they are easily accessible, are cost-efficient, and can be reviewed by providers as needed. This presentation describes the development, testing, and launch of a web-based provider training for CBT-N.

Methods
Nightmare, trauma, and sleep disorder experts collaborated to develop material for the web-based CBT-N training. Next, 17 providers tested a first draft of the web-site. After feedback was integrated, 50 providers were recruited to complete the updated draft of the website and will complete feedback in January 2024. To assess learning, providers completed multiple-choice questions before and after each of the 10 training modules. Item Response Theory (IRT) analyses were used to identify items of low discrimination and difficulty for further refinement.

Results
Overall, testers had positive reactions to the training content and website. The training content was improved by adding more figures, animations, and therapy demonstration videos and integrating more cultural considerations. Usability was improved by addressing bugs and enhancing intuitive site navigation. Based on IRT analyses of multiple-choice questions, 40 (out of a total 80) items were replaced and will be re-evaluated at the conclusion of beta testing.

Conclusion
Launching in June 2024, CBTnightmares.org is a comprehensive, engaging, and accessible training after two phases of development and feedback from almost 70 licensed providers. The final phase of testing, to be conducted in April 2024, will examine the equivalence of online training compared to a live virtual workshop (Target N = 100). Providers will complete questionnaires and a mock session with a standardized patient to examine therapist proficiency and fidelity. The hypotheses are that this web-based course will be equivalent to a live virtual workshop. This project directly addresses the dissemination and implementation cliff of empirically supported treatment for nightmares.

Support (if any)
This work was supported by the Office of the Assistant Secretary of Defense for Health Affairs through the Peer Review Medical Research Program under Award No. W81XWH-21-1-0576.
0928 Sleep, Mediating the Risk of Cognitive Impairment in Post-traumatic Stress Disorder via Noradrenalin Dysregulation
Authors: Cho Yeilim , Iliff Jeffrey 
Published: April 2024

Abstract

Introduction
There is growing evidence that Post Traumatic Stress Disorder (PTSD) increases the risk of dementia, and sleep impairment in PTSD may contribute to this link. Increased cerebrospinal fluid (CSF) norepinephrine (NE) is associated with glymphatic dysfunction and poor neurocognitive outcomes. To understand the role of sleep in mediating the increased risk of dementia in PTSD, we investigated whether sleep-specific symptoms of PTSD are related to CSF NE level and cognitive function.

Methods
We analyzed a prospective study of combat Veterans with repetitive blast mild traumatic brain injury (mTBI). All underwent CSF sampling and the PTSD and DSM checklist 5 for military (PCL-M), a 17-item self-report measure reflecting DSM-IV symptoms of PTSD. We derived a sum score of each symptom cluster; Questions 1-5: “Re-Experiencing”, 6-12: “Avoidance and Negative Cognition and Mood” and 13-17: “Hypervigilance”. Among the 17 items, questions 2 and 13 are sleep-related symptoms. We calculated correlations of the sum score of each category with CSF NE level with and without sleep-specific questions (2: nightmare and 13: sleep disruption) with CSF NE levels. Trails A (attention and visual motor function) and Trail B (executive function) tests were performed.

Results
A total of 49 mTBI participants were included. A sum score of symptoms related to re-experiencing (r=0.34, p=0.001) and hyperarousal (r=0.3, p=0.03) were weakly correlated with elevated CSF NE. Excluding the sleep-specific symptom questions from these two categories attenuated the correlation (re-experiencing r=0.31, p=0.03; hyperarousal r=0.2, p=0.1). The scores of sleep-specific symptoms were separately examined, the correlation with CSF NE was (nightmare r=0.37, p=0.0009; sleep impairment r= 0.35, p=0.001). The symptom cluster related to avoidance and negative cognition and mood was not associated with NE level (r=0.15, p=0.9). Elevated CSF NE was strongly associated with lower Trials B performance (r=0.34, p=0.001). Trails A performance was not associated.

Conclusion
PTSD-associated sleep symptoms of nightmares and sleep disruption are most strongly associated with CSF NE. CSF NE is associated with worsening executive function measured by Trails B. Sleep symptoms may be the driver of the poor neurocognitive outcomes in patients with PTSD. Traditional symptom clusters of PTSD may not accurately reflect the risk of cognitive function.

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0930 Trauma-Specific and Nonspecific Predictors of Sleep-State Misperception Among Trauma-exposed Women
Authors: So Christine , Harmouch Sirine , Alfano Candice 
Published: April 2024

Abstract

Introduction
Sleep disturbances are highly prevalent following trauma exposure but tend to persist following trauma-focused treatment, which brings into question the relevance of trauma-specific factors in these sleep problems. Sleep assessment can include subjective methods, like sleep diaries, and/or objective methods, like actigraphy. However, these methods tend to result in low-moderate concordance, and it has been hypothesized that clinical samples report greater sleep disturbance than objective methods record (i.e., sleep-state misperception). This may be due to greater overall distress or bias from experiencing clinical symptoms. This study examined trauma-specific and nonspecific predictors of sleep-state misperception in trauma-exposed women.

Methods
N=55 cis-gendered women with a self-reported history of sexual abuse in childhood (between ages 6-11) completed baseline surveys assessing sleep and mental health, and one week of sleep monitoring via actigraphy and sleep diaries as part of a larger study. Cohen’s d was calculated to estimate the degree of sleep-state misperception between sleep diary and actigraphy.

Results
Participants tended to overestimate total sleep times (TST) and sleep onset latencies (SOL) when reported on sleep diary compared to actigraphy. In contrast, participants underestimated wake after sleep onset (WASO) via sleep diary compared to actigraphy. In examining clinical correlates of sleep-state misperception, we found that TST Cohen’s d was significantly correlated with baseline depressive symptoms (r=.295, p=.029) and pre-sleep cognitive arousal (r=.269, p=.047). PTSD hyperarousal symptoms (minus the sleep item) were positively correlated with TST Cohen’s d (r=.358, p=.007) but negatively correlated with SOL Cohen’s d (-.279, p=.039).

Conclusion
While we observed both trauma-specific (i.e., hyperarousal) and nonspecific (i.e., depression, cognitive arousal) to be associated with sleep-state misperception, it is possible that these variables have similar underlying transdiagnostic factors. For example, rumination (a form of perseverative cognition focused on negative content) underlies both depression and PTSD. Future work should further probe contributing factors to sleep-state misperception to better understand this phenomenon.

Support (if any)
This study was funded by the University of Houston Small Grants Program (PI: CAA). CJS was supported by the Department of Veterans Affairs, Office of Academic Affiliations, Advanced Fellowship in Mental Illness Research and Treatment, and the University of Houston Dissertation Completion Fellowship.
0931 COMISA-MARES: Comorbid Insomnia and Obstructive Sleep Apnea with and Without Nightmares in US Military Personnel
Authors: Bolstad Courtney , Pruiksma Kristi , Mysliwiec Vincent , Li Xueying , Gerwell Kelsi , Young-McCaughan Stacey , Peterson Alan , Straud Casey , Brock Matthew 
Published: April 2024

Abstract

Introduction
Comorbid insomnia and obstructive sleep apnea (OSA), also called COMISA, has deleterious effects on mental and physical health. Limited research has examined the occurrence of nightmares in patients with COMISA. In a sample of service members seen in a US military sleep disorders clinic, this study examined the impact of nightmares among participants with insomnia, OSA, and COMISA and how sleep and mental health symptoms differed by sleep disorder (i.e., insomnia only, OSA only, COMISA) among those with nightmares.

Methods
In this observational study, 372 participants completed video-polysomnography and received a primary sleep disorder diagnosis (i.e., insomnia, OSA, COMISA). Participants with nightmares 1 ≥ week that woke them up at least “sometimes” were counted as having nightmares. Participants also completed measures of insomnia, anxiety, depression, and posttraumatic stress disorder (PTSD). General linear and mixed effects models were used to test our research questions.

Results
Nightmares were endorsed by 30% (n = 111) and were significantly more likely to be reported by those in the insomnia (36%, n = 42) and COMISA (38%, n = 52) groups than in the OSA group (14%, n = 17; p &lt;.0001). Among the sleep diagnostic groups (i.e., insomnia, OSA and COMISA), participants with nightmares had significantly increased insomnia, anxiety, depression and PTSD symptoms compared to those without nightmares. Participants with COMISA and nightmares (i.e., COMISA-MARES) had the worst overall symptoms.

Conclusion
We propose COMISA-MARES as the combination of three sleep disorders that manifests with the worst overall sleep and mental health symptoms in military personnel. Given the high diagnostic rate, military and veteran sleep clinics should incorporate insomnia and nightmare assessments in efforts to better characterize this disorder. COMISA is significantly more burdensome than OSA alone and insomnia alone, and nightmares pose an even greater additive element of burden. Research is needed to guide treatment.

Support (if any)
This work was supported by the Defense Health Agency, Defense Medical Research and Development Program, Clinical Research Intramural Initiative for Military Women’s Health (DM170708; Mysliwiec) and the US Air Force (USAF) Air Force Materiel Command (AFMC), Wright Patterson Air Force Base, Ohio (FA8650-18-2-6953; Peterson).
0934 Self-Compassion, Bedtime Procrastination, Sleep, and Mental Health in Individuals Exposed to Trauma
Authors: Bistricky Steven , Kenigsberg Zara , Klein Paige , Feliciano Leilani 
Published: April 2024

Abstract

Introduction
Though it is increasingly evident that bedtime procrastination (delaying going to bed after one’s intended bedtime) significantly interferes with health-promoting sleep, effects of bedtime procrastination have scarcely been studied in relation to trauma. Because sleep can be persistently problematic following trauma, even after completion of trauma-focused therapies, understanding and intervening with relevant malleable factors might improve trauma survivors’ sleep and mental health. Although adherence to sleep hygiene practices has long been indicated for insomnia and downstream psychological effects, accumulating research is suggesting that sleep behaviors and other health behaviors can be further improved through self-compassion practice amidst personal shortcomings, struggles, and failures. Self-compassion can be conceptualized as an orientation toward increased awareness and acceptance of one’s experiences—positive or negative, extending self-kindness during times of suffering, and feeling connection with the common human experience of life challenges. Functionally, self-compassion may promote effective self-regulation and curb emotional or behavior dysregulation, such as impulsivity or procrastination.

Methods
In this presentation, we discuss our cross-sectional and intervention studies (2 completed, 2 ongoing; respective N’s = 25, 74, 235+, collecting) examining circadian rhythm and psychological factors linked to bedtime procrastination and potential mechanisms of reducing bedtime procrastination, improving sleep, and reducing PTSD symptom severity, such as emotion regulation and procrastinatory cognition. We review promising effects of a brief virtual group psychosocial intervention focusing on self-compassion and expanded sleep hygiene on bedtime procrastination, sleep, and mental health, and we describe how this intervention has been tailored to address the common daily and nightly experiences of trauma-exposed individuals (e.g., nightmares). Correlation analysis as well as moderation and mediation analyses are presented.

Results
Our findings with trauma survivors indicate that the relation between self-compassion and healthier sleep can be mediated through bedtime procrastination and sleep self-efficacy, one’s belief that they can get healthy sleep. Further, we have found that the positive association between self-compassion and sleep self-efficacy is strengthened by sleep hygiene adherence.

Conclusion
In sum, bedtime procrastination appears salient to the sleep, emotional health and well-being of trauma-exposed individuals, and it can be reduced through intervention. Limitations, future directions for research, and scalable intervention development will be discussed.

Support (if any)
N/A