bluuebunny/crossref_metadata_2025_split huggingface dataset:
1032 Association of Sleep Duration and APOE ε4 Status on Brain Regional Tau Deposition in Clinically Normal Older Adults
Authors: Murali Komal , Gills Joshua L , Briggs Anthony , Cesar Justin Oliver , Kovbasyuk Zanetta , Valkanova Elena , Mbah Alfred , Figueredo Luisa , Kam Korey , Mullins Anna , Parekh Ankit , Jean-Louis Girardin , Varga Andrew , Osorio Ricardo , Bubu Omonigho 
Published: April 2024

Abstract

Introduction
We examined interactive associations of sleep duration on regional tau-PET deposition in clinically-normal individuals, as a function of β-amyloid (Aβ), and apolipoprotein E (APOE) ε4 status.

Methods
This cross-sectional study analyzed preliminary data from 26 community-dwelling cognitively normal older-adults with baseline tau ([18F] PI2620) and Aβ ([11C] PiB) PET scans participating in NYU studies on sleep, aging and memory. Sleep duration was characterized as total sleep time (TST) using data from polysomnography (NPSG). Linear mixed effects models controlling for Aβ, age, sex, race, BMI and other sleep variables, examined a main association of TST with regional tau and a meta-region of interest, which was a composite of regions in the temporal lobe. Interactions between TST*Aβ, and TST*APOE ε4 on these regions were also examined

Results
Of the 26 subjects, 16 (61.5%) were females, 10 [38.5%] were Black/African-American, 14 [53.8%], APOE ε4 carriers, and 3 [11.5%] individuals were Aβ+. The mean (SD) age was 66.5 (4.6) years, BMI was 26.0 (10.6) kg/m**2, and education was 16.4 (2.5) years. There was no clear association of TST with cortical tau in the combined meta-region involving the entorhinal and inferior temporal lobe (meta-analytic estimate: β = −0.01[0.01]; 95% CI, −0.04 to 0.03, P =.16). However, TST by APOE ε4 interaction was significant for the combined meta-region (meta-analytic estimate: β = −0.06[0.02]; 95% CI, −0.11 to -0.01, P =.03), right inferior temporal β [right] = −0.02[0.01]; 95% CI, −0.04 to −0.00, P=.02), and bilaterally in the superior parietal β [left] = −0.20[0.08]; 95% CI, −0.37 to −0.02, P=.03), β [right] = −0.03[0.01]; 95% CI,−0.04 to −0.00, P=.04), cortical regions, suggesting a synergistic effect. TST by APOE ε4 interaction with regional tau trended in the left precuneus (β [left] = −0.01[0.01]; 95% CI, −0.02 to 0.00, P=.07) and the left inferior temporal β [left] = −0.02[0.01]; 95% CI, −0.03 to 0.00, P=.08) cortical regions. TST by Aβ interaction was not associated with regional tau.

Conclusion
APOE ε4 and sleep duration exhibited synergism in association with higher regional tau in cognitively-normal older adults. Larger studies are needed to delineate mechanisms and strata specific estimates.

Support (if any)
AASM[BS-231-20], NIAK23AG068534, R01AG082278, AARG-D- 21-848397, BrightFocus[A2022033S]
1036 Beyond Brain Fog: A Social Listening Analysis of Impaired Cognitive Functioning in Sleep Disorders
Authors: Flurie Maurice , Cline Zachary , Morse Anne Marie , Horsnell Matthew , Gudeman Jennifer , Craine Lauryn , Ortiz Luis , Ascencion Frederik , Kimmel Diana , Shah Puja , Burkoth Shannon , Neves Juliana Angelim , Mundt Jennifer , Picone Maria , DeFelice Christopher 
Published: April 2024

Abstract

Introduction
To best support a rare-disease community, it is imperative to understand the unique symptoms and challenges associated with their condition. In recent years, the experience of “brain fog” has been discussed across sleep-disorder communities, including narcolepsy and idiopathic hypersomnia (IH); however, the term “brain fog” is a vague descriptor that might represent several experiences. Here, we explored experiences with brain fog across sleep communities. The primary goal was to identify cognitive challenges associated with brain fog. Impacts on daily living were also characterized.

Methods
We analyzed conversations in 2 online sleep disorder communities: narcolepsy (a private Facebook group, PWN4PWN; and a public subreddit, r/narcolepsy) and IH (a public subreddit, r/idiopathichypersomnia). Posts/comments were explored using a natural language processing (NLP) engine designed to recognize and categorize clinical language on social media. Conversations mentioning brain fog across communities were isolated for analysis. Odds ratios were calculated to identify clinical concepts associated with brain fog conversations (vs other conversations). Last, conversations were subjected to topic modeling, a process which reveals common conversational themes in community discussions.

Results
Narcolepsy and IH communities contributed 355,028 posts/comments from 2011-2023. The NLP engine extracted concept mentions across communities. Brain fog mentions experienced the largest increase from 2014-2017. The concept most associated with brain fog was “memory impairment”. Another strongly associated cognitive concept included “inattention”. Sleep-related concepts (e.g., “difficulty sleeping”) were also associated with brain fog. Topic analysis showed converging support for these findings by identifying topics such as “memory issues” and “ADHD”. Topics related to daily living included “school” and “workplace”.

Conclusion
The experience of brain fog is shared across multiple sleep communities. In both narcolepsy and IH groups, brain fog experiences preceded the COVID-19 pandemic, with a substantial increase in mentions before 2020. Brain fog conversations were significantly associated with memory and attention difficulties, similar to other disorders. The association with sleep-related concepts appears to be unique in this patient group. These findings suggest brain fog may impact certain mental processes more than others and may be exacerbated by poor sleep quality. The daily impact of brain fog was illustrated by conversations centering around school and workplace experiences.

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1037 Comorbid Insomnia and Sleep Apnea in Epilepsy Patients
Authors: Deepak Vishal , Grayson Kammi , Scott Rebecca , Rodriguez Alcibiades 
Published: April 2024

Abstract

Introduction
Obstructive Sleep Apnea (OSA) is very common in patients with epilepsy disorders, especially in refractory cases. Both epilepsy patients and OSA patients can have complaints of insomnia as a prevalent symptom. Additionally, about 30% of patients with chronic insomnia have OSA, and nearly 40% of people with OSA also have insomnia symptoms. This is known as Comorbid Insomnia and Sleep Apnea (COMISA). The objective of this study was to describe COMISA in patients with epilepsy.

Methods
We performed a retrospective observational study of adult patients with epilepsy with a concomitant diagnosis of OSA who presented for clinical visits between 10/01/2022 and 09/30/2023 at a sleep center. 57 patients were identified with either seizures or an epilepsy disorder. Among those patients, 9 patients were found to have concurrent OSA and met study criteria. Electronic medical records were reviewed to identify those with insomnia complaints.

Results
Preliminary results of the study are presented. Most patients were female (n=6, 66.7%%), with a mean age of 36.33 + 0.7 years. On review of the patients’ polysomnography, the mean apnea hypopnea index (AHI) was 15.63 + 10.74/hour, total sleep time (TST) was 342.05 + 104 minutes, and sleep efficiency was 64.92 + 0.21%. Four patients (44.4%) had COMISA. Among the patients with COMISA, the mean AHI was 16.65 + 10.74%. The mean TST (239 + 104.65 minutes) and mean sleep efficiency (45.78 + 21.6%) were significantly reduced and mean sleep latency was high (37.65 + 0.42 minutes).

Conclusion
Based on our retrospective screening, the prevalence of insomnia in patients with OSA and seizure disorders is quite high. Further large retrospective and longitudinal studies are required to identify the patients at risk of COMISA in epilepsy with the help of clinical and polysomnographic evaluation.

Support (if any)
n/a
1039 Diffusion Imaging Markers of Glymphatic Function in Veterans with Sleep Dysfunction and Mild Traumatic Brain Injury
Authors: Bhatti Gursimrat , Robinson Meghan , Li Ruosha , Jones Melissa , Jorge Ricardo 
Published: April 2024

Abstract

Introduction
We investigated the impact of sleep disturbances and past mild traumatic brain injuries on the glymphatic system (GS), an essential cerebral network responsible for fluid exchange and solute balance, by employing a novel, non-invasive imaging technique, Diffusion Tensor Imaging Along Perivascular Spaces (DTI-ALPS).

Methods
Participants were 148 Veterans of post-911 conflicts enrolled in the Houston Translational Research Center for TBI and Stress Disorders (TRACTS) who completed MRIs, the Pittsburgh Sleep Quality Index, Boston Assessment of TBI-Lifetime, and Clinician-Administered PTSD scale for DSM-5. Individuals with moderate or severe TBI were excluded. We analyzed potential relationships between the DTI-ALPS index, a ratio of diffusion measures at a priori regions of interest, and sleep parameters derived from the PSQI, concussion severity (grades I-III), demographic factors, and PTSD severity.

Results
Participants were aged 36.5±7.4 years, 8.6% were females, 55% were white, and 82.1% had mild TBI. DTI-ALPS negatively correlated with age (r=-0.189, p=0.021); correlations with PSQI global score, sleep efficiency, and total hours asleep were not significant. DTI-ALPS was significantly associated with concussion severity (p=0.042) and time to bed after 12:30 AM (p=0.038). After adjusting for age, grade III concussion severity and time to bed after 12:30 AM remained significant, but the interaction between them was not. There were no significant associations with components of the PSQI, PTSD, and other demographic variables.

Conclusion
Glymphatic flow is known to be affected by sleep, however, we found relatively modest effects of sleep on DTI-ALPS, which may mean that it may not be sensitive to detect cross-sectional measures of subjective sleep quality in awake participants. We observed both brain injury and time to bed to influence DTI-ALPs. Although brain injury is often associated with impaired sleep, these appear to be independent predictors of GS function in our cohort. Large-scale studies focusing on diurnal fluctuations of GS may advance our understanding of its role in long-term brain health.

Support (if any)
This work was funded by the Translational Research Center for TBI and Stress Disorders (B9268-X) from VA RR&D; Career Development Award # IK2CX002363-01A1 from VA CSR&D (MJ); MR is now a full-time employee of KBR, Inc.
1042 Influence of OSA Severity on the Association of Global Amyloid and Regional Tau-PET Burden
Authors: Bubu Omonigho , Gills Joshua L , Cesar Justin Oliver , Kovbasyuk Zanetta , Dharmapuri Anhiti , McBride Julian , Valkanova Elena , Mbah Alfred , Dominguez Joanna , Browne Laurel , Figueredo Luisa , Kam Korey , Mullins Anna , Parekh Ankit , Jean-Louis Girardin , Varga Andrew , Osorio Ricardo 
Published: April 2024

Abstract

Introduction
We examined the association of OSA severity with regional tau-PET deposition in clinically normal individuals, as a function of β-amyloid (Aβ), race and apolipoprotein E (APOE) ε4 status.

Methods
Cross-sectional analysis of preliminary data from 26 (16 Whites and 10 Blacks matched on AHI4%, age, BMI and educational level) community-dwelling cognitively normal older-adults with baseline tau ([18F] PI2620) and Aβ ([11C] PiB) PET scans. OSA severity was characterized using AHI4%. Linear mixed effects models controlling for Aβ, age, sex, race, BMI and other sleep variables, examined a main association of OSA with regional tau and a meta-region of interest, which was a composite of regions in the temporal lobe. Interactions between OSA*Aβ, OSA*Race, and OSA*APOE ε4 on these regions were also examined.

Results
Of the 26 subjects, 16 (61.5%) were females, 14 APOE ε4 carriers [53.8%], and 3 individuals [11.5%] were Aβ+. The mean (SD) age was 66.5 (4.6) years, BMI was 26.0 (10.6) kg/m**2, and education was 16.4 (2.5) years. OSA severity was associated with cortical tau in the combined meta-region involving the entorhinal and inferior temporal lobe (meta-analytic estimate: β = −0.12[0.05]; 95% CI,−0.23 to −0.00), and regional tau in the superior parietal (β [left] = −0.05[0.02]; 95% CI,−0.10 to −0.01; β [right] = −0.05[0.02]; 95% CI,−0.09 to −0.00), left parahippocampal (β = −0.05[0.02]; 95% CI,−0.09 to −0.00), and right precuneus (β = −0.04[0.01]; 95% CI,−0.06 to −0.01) cortical regions, P &lt;= .04 for all. A race by OSA severity interaction was significant for the left superior parietal (β [White, AHI4%] = −0.06[0.01]; 95% CI,−0.12 to −0.00), and left parahippocampal (β [White, AHI4%] = −0.01[0.03]; 95% CI, −0.03 to −0.00) and (β [Black, AHI4%] = −0.04[0.01]; 95% CI,−0.06 to −0.00) regions, P &lt;= .05 for all. OSA severity by APOE ε4 interaction was not associated with regional tau.

Conclusion
OSA severity is associated with regional tau-PET deposition in clinically normal individuals, regardless of APOE ε4 status, and this association differed by race in certain brain regions. These findings highlight OSA as a unique disease model for examining racial differences in Alzheimer disease risk.

Support (if any)
AASM[BS-231-20], NIAK23AG068534, L30-AG064670, R01AG082278, RF1AG083975, AARG-D- 21-848397, BrightFocus[A2022033S]
1043 Prevalence of Sleep Paralysis in Medical Students Across India- a Cross Sectional Study
Authors: Shah Urmil , Abhishek Kumar , Shukla Rushikesh , Kumar Pratyush , Srikumar Shabarini , Panchawagh Suhrud , Sheth Aryan , Singh Shailja , Acharya Sourya 
Published: April 2024

Abstract

Introduction
Sleep paralysis is a condition that has been on the rise in recent years, occurring during the pre or post sleep stages. While there is no known direct cause of sleep paralysis, studies have shown a number of potential causes, including poor quality of sleep, alcohol use, exposure to stressful events, anxiety disorders, and a family history of the illness. The purpose of this study was to assess the prevalence of sleep paralysis among medical college students in India and identify factors associated with the condition.

Methods
A cross-sectional study involving 155 medical students was done involving the students to fill the questionnaire anonymously. The questionnaire was made using data from the Unusual Sleep Experiences Questionnaire (USEQ) and distributed nation-wide among medical students using an online Google Form. Power analysis is done using CDC EpiInfo software, Version 7.2.5. Statistical analysis is done using StataCorp. 2021. Stata Statistical Software: Release 17. College Station, TX: StataCorp LLC.

Results
Out of 155 students, 145 students (93.55%) participants consented to participate in the study. 76 medical students (52.4 %) reported having an episode of sleep paralysis in their lifetime. Out of those students, 39 (51.3%) were males, while 37 (48.6%) were females. A statistically significant association between medical students suffering from psychological illness and sleep paralysis was established, with 32.4 % of students suffering from anxiety and 22.1 % of individuals reporting concurrent depression. 46% of the individuals had only one or two episodes of sleep paralysis episodes in their lifetime while 54% had recurrent episodes of sleep paralysis. Majority (76%) of the participants do not indulge in recreational drug usage. Terror (56%) and Paralysis (54%) were the most commonly reported sensations by the individuals.

Conclusion
This study divulges that more than half of the medical students have suffered from sleep paralysis. In addition to it, students suffering from psychological illnesses were at increased risk of having sleep paralysis. In conclusion, this study highlights the need for increased awareness and education about sleep paralysis, especially among medical students. It also emphasizes the importance of addressing psychological issues and sleep-related disorders to reduce the risk of sleep paralysis.

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1046 Sleep Problems Predict Pain One Month After Diagnosis and Twelve Months Later Among People with Multiple Sclerosis
Authors: Whibley Daniel , Abou Libak , Kratz Anna , Ehde Dawn , Fritz Nora , Alschuler Kevin 
Published: April 2024

Abstract

Introduction
Sleep problems and pain are commonly experienced by people with multiple sclerosis (PwMS). This study aimed to determine whether sleep problems assessed one month after receiving an MS diagnosis associated with pain intensity and/or pain interference at this time or predicted these pain outcomes 12 months after diagnosis.

Methods
This secondary analysis used data from the prospective observational LAND (‘Life After New Diagnosis’) study and was restricted to those with an MS diagnosis who provided complete Medical Outcomes Study (MOS) Sleep Scale questionnaire data. Linear regression was used to quantify associations between sleep variables (MOS-Sleep problems index and dimension scores ‘sleep disturbance’, ‘sleep adequacy’, and ‘awaken short of breath or headache’) and pain intensity (past-week average, 0-10 Numeric Rating Scale) and pain interference (PROMIS Short Form 6a), adjusted for age, sex, number of years of education, comorbidities, and, in longitudinal models, baseline level of the outcome (pain intensity or pain interference). A p value &lt; 0.05 was used to determine statistical significance.

Results
The sample (N=174) was predominantly female (69.5%) and white (86.2%), with a mean age of 39.8 years (standard deviation 11.2). The most common MS disease course was relapsing/remitting (52.3%); 35.6% were yet to be categorized. One month after diagnosis, there was a significant, cross-sectional association between MOS-Sleep problems index score and pain intensity (B=0.04, 95% confidence interval (CI): 0.02-0.05, p&lt; 0.001) and pain interference (B=0.17, 95% CI: 0.11-0.24, p&lt; 0.001). Dimension scores for ‘sleep disturbance’, ‘sleep adequacy’, and ‘awaken short of breath or headache’ were also significantly associated with the pain outcomes at this time. In longitudinal analyses, MOS-Sleep problems index score one month after diagnosis predicted pain intensity (B=0.02, 95 %CI: 0.007-0.04, p=0.003) and pain interference (B=0.11, 95% CI: 0.05-0.17, p&lt; 0.001) 12 months after diagnosis. Higher scores for ‘sleep disturbance’ and ‘sleep adequacy’ one month after diagnosis also predicted both pain outcomes 12 months after diagnosis.

Conclusion
As a modifiable factor, sleep presents a viable constituent of multicomponent pain management for PwMS. Research is needed to determine whether improving sleep reduces pain in this population.

Support (if any)
The LAND study was funded by the National Multiple Sclerosis Society (RG4986A1/1).
1047 Sleep Fragmentation Predicts Diminished Processing Speed in Non-demented Elderly from the Cretan Aging Cohort
Authors: Skourti Eleni , Basta Maria , Simos Panagiotis , Zampetakis Alexandros , Alexopoulou Christina , Aligizaki Marina , Ganiaris Andronikos , Zaganas Ioannis , Vgontzas Alexandros 
Published: April 2024

Abstract

Introduction
Processing speed is an early index of cognitive decline in elderly. Also, sleep quality predicts memory deficits in this age group. However, the relationship between sleep fragmentation and processing speed remains controversial. Our aim was examine the longitudinal associations between sleep quality and processing speed in non-demented community dwelling elderly.

Methods
A sub-sample of 148 participants diagnosed with Mild Cognitive Impairment (MCI;n=79) or cognitively non-impaired (CNI;n=69) from the Cretan Aging Cohort, a large population-based cohort of 3,140 older adults (&gt;60 years; baseline) were followed-up 8 years later (follow-up). Mean age at baseline was 74.9±6.33 and 70.4 ±6.24 years for MCI and CNI persons. Processing speed was assessed based on age and education adjusted z-scores of the Symbol Digit Modality Test. Sleep fragmentation (wake after sleep onset; WASO) was assessed using a 3-day actigraphy at baseline and follow-up. Change between the two time points was calculated using paired sample t-tests. The direct and indirect effects of baseline WASO on subsequent processing speed after controlling for sociodemographic covariates were estimated using panel models in AMOS.

Results
Average WASO among MCI and CNI participants was 80.6±41min and 72.3±31.2min; p=0.1 and 75.7±34.8min and 59.3±20.6min; p&lt; 0.001 at baseline and follow-up, respectively. Average processing speed decreased between the two measurement points (CNI: 0.23±0.97 and -0.40±1.04; p&lt; 0.001 and MCI: -0.75±0.60 and -1.09±0.72; p&lt; 0.001 at baseline and follow-up, respectively). Baseline WASO directly predicted processing speed (β=-0.201; p=0.04) among MCI persons, while WASO at follow-up fully mediated the relationship between baseline WASO and subsequent processing speed (β=-0.098; p=0.004) in the CNI group.

Conclusion
Sleep fragmentation predicts diminished processing speed among non-demented elderly. Given the significance of processing speed on cognitive function, interventions improving sleep quality in elderly may prevent/delay cognitive decline.

Support (if any)
National Strategic Reference Framework (NSRF) - Research Funding Program: THALES entitled “UOC-Multidisciplinary network for the study of Alzheimer’s Disease” Grant Cod: MIS 377299 HELLENIC FOUNDATION FOR REASEARCH AND INNOVATION (HFRI)- Research Funding Program: ELIDEK entitled “Sleep Apnea (OSA) and poor sleep as Risk Factors for decreased cognitive performance in patients with Mild Cognitive Impairment: the Cretan Aging Cohort (CAC)”, Grant Cod: HFRI-FM17-4397
1052 Impact of CPAP Adherence on Hospitalized Patients Diagnosed with OSA on Healthcare Utilization in Rural Settings
Authors: Srinivasan Priyanka , Rojas Edward , Olgers Kassandra , Knollinger Scott , Seol Calvin , Stansbury Robert , Sharma Sunil 
Published: April 2024

Abstract

Introduction
Obstructive Sleep Apnea (OSA) is an increasingly prevalent condition with significant implications for cardiopulmonary health. Data suggests that early detection of OSA in hospitalized patients may improve outcomes. However, the effects of CPAP therapy have not been studied for hospitalized patients in a rural population. The primary purpose of this study is to examine the 1-year readmission, ED visit rate, and associated healthcare costs in hospitalized patients screened as high-risk for OSA, diagnosed, and started on CPAP therapy.

Methods
Through a retrospective review of 2042 patients from 08/2019 to 06/2023 in a registry of a hospital-based sleep medicine program, 786 patients were determined as high risk based on their results from apnea link. From there, 341 patients were selected based on their completion of an outpatient polysomnography (PSG), of which 293 were assessed for adherence of CPAP therapy. Composite end point of combined number of hospitalization and emergency department (ED) visits for 1-year were recorded, further separating the outcomes that were cardiopulmonary in nature due to the CPAP’s focus on those organs. Moreover, cost analysis was performed.

Results
Of the 293 assessed for adherence of CPAP therapy, 108 patients were adherent, while 185 were non-adherent. The mean age of patients evaluated was 58 years (12.82) and 57% were males. The average BMI of these patients was 39.7 (10.7). The mean AHI was 25.49 (26). Analyses showed that 1-year composite end point of hospital readmissions and ED visits were significantly higher in non-adherent patients compared to adherent patients. The hazard ratio was determined to be 1.24 with 95%CI 1-1.54(p=0.03). In the multivariate Cox model, adjusting for age and gender, the adjusted HR was 1.27 with 95%CI: 1.02 – 1.58 (p = 0.033). The one-year total cost of healthcare was significantly higher among non-adherent patients (p&lt; 0.001).

Conclusion
Early detection of OSA in hospitalized patients in Appalachia and successful treatment may significantly lower healthcare utilization. These may have practical impact on quality of life and cost of healthcare delivery in rural hospitals.

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