bluuebunny/crossref_metadata_2025_split huggingface dataset:
0192 Brain Circuits That Regulate Awakenings to Pain Stimulus
Authors: Lynch Nicole , Gangeddula Nishta , Spinieli Richard , Kaur Satvinder 
Published: April 2024

Abstract

Introduction
Many neurons in the external lateral PB express the calcitonin gene-related peptide [CGRP; PBelCGRP], and also receive spinal afferents carrying pain signals that are relayed to forebrain arousal promoting areas. Thus, PBelCGRP neurons form the critical relay node transmitting pain to induce cortical arousals. We tested this with genetic deletion or acute optogenetic inhibition in both inflammatory pain and opto-pain models, and found that blocking this node prevents pain-induced arousals. Our current focus is on understanding which terminal fields of the PBelCGRP neurons contribute to pain-induced wakefulness.

Methods
Using pharmacological antagonists and optogenetics, we blocked PBelCGRP neuron terminal fields located in the basal forebrain (BF), bed nucleus of stria terminalis (BNST), and central nucleus of Amygdala (CeA). For pharmacological blocking, wild type mice implanted with a guide cannula targeting one of the terminal fields received bilateral microinjections of NMDA antagonist (AP-5, 4.0 µg/200nl), or CGRP receptor antagonist (BIBN4096BS at 8 µg/200nl). For optogenetic (opto) blocking, CGRP-CreER mice injected bilaterally in the PB with AAV-Flex-Opn3-mscarlet (inhibitory opsin) and implanted with bilateral optical fibers in the terminal fields received laser light pulses for opto-inhibition. Both groups were implanted and recorded for sleep following acute inflammatory pain (AIP) of a 10 µl foot injection of 5% formalin in combination either with or without terminal field blocking.

Results
The effects on sleep-wake after pharmacological blocking or opto-inhibition were compared to saline and AIP groups. AIP induced a robust 54% decrease in sleep for 3h post-injection (F1, 17= 105; P&lt; 0.001) compared to saline. Preceding NMDA antagonist injections in the BNST and BF reversed AIP-induced sleep-loss by 95% (F4, 28= 17.1; P&lt; 0.001), followed by CeA (83% reversal). While blocking CGRP receptors (F4, 28= 12.2; P&lt; 0.001) followed the order BF&gt; BNST&gt; CeA for recovering AIP-induced sleep loss. A similar order of effect (F4, 23= 31.6; P&lt; 0.001) was produced by opto-inhibition of PBelCGRP neuron terminal fields at BF, BNST and CeA.

Conclusion
Our results show that PBelCGRP neurons likely target BF, BNST, and CeA by acting through both CGRP and NMDA receptors to promote awakenings in response to acute pain.

Support (if any)
NS112175
0196 One Less Pathway to Explain the Chronic Insufficient Sleep and Metabolism Relationship: Thyroid Regulation
Authors: Petrov Megan , Zuraikat Faris , Cheng Bin , St-Onge Marie-Pierre 
Published: April 2024

Abstract

Introduction
Chronic insufficient sleep contributes to the development of obesity and type 2 diabetes (T2D). However, the physiologic underpinnings of these effects are incompletely understood. There is some evidence that sleep restriction (SR) adversely affects thyroid hormones and growth factors involved in energy metabolism, but findings are mixed. Furthermore, no study has evaluated changes in thyrotropic axis hormones in response to a model of chronic, mildly insufficient sleep resembling real-world short sleep. Therefore, we investigated whether 6wk of 1.5 h/night SR vs. maintenance of adequate sleep (AS) impacted free thyroxine (T4), thyroid stimulating hormone (TSH), and fibroblast growth factor-21 (FGF21) in healthy adults.

Methods
Men and women with actigraphy-assessed habitual total sleep time (TST) of 7-9h/night and no cardiometabolic diseases participated in a randomized, crossover study with two 6-week phases: AS and SR. Sleep was monitored daily with actigraphy, and compliance was assessed every 1-2wk. Blood was collected following a ≥12h fast at baseline, wk 3, wk 4, and endpoint of each phase. For this investigation, circulating levels of T4, TSH, and FGF21, within an all-female subsample (n=18), were quantified from plasma. Linear mixed models tested the effect of SR on the post-baseline values of the outcomes, with models adjusted for corresponding baseline outcome values, week, and phase.

Results
Data were available from 30 participants (20 women, 39.0±14.0y, BMI: 26.7±3.6; 10 men, 29.4±5.2y, BMI: 26.6±2.2). T4, TSH, and FGF21 concentrations at the baselines of each phase ranged from 0.27-2.55 ng/dL (M±SD: 0.87±0.47), 0.86-1.66 μIU/ml (M±SD: 1.24±0.19) and 17.5-383.3 pg/mL (M±SD: 140.2±97.6), respectively. In the full sample free T4 (β=-0.02, p=0.64) and TSH (β=0.02, p=0.67), and in the subsample, FGF21 (β=-1.57, p=0.83) were not significantly different between study arms. In analyses of T4 and TSH stratified by sex, there were no differences between study arm.

Conclusion
In a sample of healthy adults, prolonged mild sleep restriction did not cause alterations in thyroid hormones and FGF21. These findings suggest that adverse endocrine and metabolic consequences commonly observed with chronic short sleep are not owed to disruptions in the thyroid axis endocrine pathway.

Support (if any)
American Heart Association 16SFRN27950012 and NIH/NHLBI R01HL128226 and R35HL155670 and in part by UL1TR001873
0214 Pre- and Post-Pandemic Adolescent Physical Activity and Potential Impacts on Sleep
Authors: Anderson Abrianna , Shoval Noa , Sheppard Kennedy , Shah Saira , Price Garrett , Garrison Michelle 
Published: April 2024

Abstract

Introduction
Research suggests that up to 70% of U.S. adolescents get less than 8 hours of sleep per night regularly and less than 25% of children ages 6-17 years old meet the CDC recommendation of 60 minutes of daily physical activity. We hypothesize that decreased physical activity was associated with worse sleep among adolescents across 2017 to 2021, and that the magnitude of the association may have changed during and after the COVID-19 pandemic.

Methods
We utilized the Youth Risk Behavior Surveillance System (YRBS) for our analyses. All participants of the 2017, 2019, and 2021 national YRBS surveys were eligible for inclusion. The main outcome of interest was school-night sleep duration (ordinal variable: &lt;= 5 hours, 6-7 hours, 8+ hours), and the primary predictor was days per week of 60+ minutes of moderate to vigorous physical activity. We conducted survey weighted ordinal logistic regressions to explore the association between physical activity and sleep.

Results
The analytic sample included 38,531 adolescents; ages 12 to 18 years old. Across all three years of the data, each additional day of physical activity was associated with a similar increase in the odds of receiving more sleep: in 2021 OR = 1.11 95%CI 1.08 – 1.15, in 2019: 1.09, 95%CI 1.07 – 1.12, and in 2017: 1.08 95%CI 1.05 – 1.11.

Conclusion
As hypothesized, increased physical activity was significantly associated with increased sleep. Although the effect size increased somewhat across the three years sequentially, this change was not statistically significant. 2023 YRBSS data will be available in January 2024. We plan to run additional analyses to expand on initial findings at that time, in addition to identifying potential effect modifiers of the relationship.

Support (if any)
0224 Sleep Deprivation and Recovery Sleep Impact Serum Biomarkers of Alzheimer's Disease in Retired Adults
Authors: Lehrer Matthew , Zeng Xuemei , Krafty Robert , Wilkens Kristine , Buysse Daniel , Karikari Thomas 
Published: April 2024

Abstract

Introduction
Short sleep increases Alzheimer’s disease (AD) risk, and sleep facilitates clearance of AD-related metabolites. Blood-based AD biomarkers (e.g., beta amyloid [Aβ] 42/40 ratio, phosphorylated tau181 [p-Tau181], neurofilament light chain [NfL], glial fibrillary acidic protein [GFAP]) are validated and increasingly used clinically. However, the impact of sleep deprivation and recovery sleep on these markers is unclear. This study determined the effects of sleep deprivation and recovery sleep on serum AD biomarkers in retired adults and explored: 1) whether changes in EEG slow-wave activity (SWA) from baseline to recovery sleep were associated with serum AD biomarker changes, and 2) whether findings differed between retired night shift and day workers.

Methods
Participants were 58 cognitively normal retired shift workers (n = 28) and retired day workers (n = 30). All completed a 60-hour laboratory study including a baseline night of EEG sleep recording, one night of total sleep deprivation, and one night of recovery sleep. EEG SWA (0.5-1Hz) was assessed during baseline and recovery sleep. Blood was collected the morning after each night. Serum samples were analyzed for Aβ40, Aβ42, p-Tau181, NfL, and GFAP using ultra-sensitive immunoassay. Linear mixed models determined the effects of sleep deprivation and recovery sleep on biomarker levels adjusted for age, sex, race/ethnicity, and education.

Results
Mean participant age was 67.8 +/- 5.5 years, 52% were female, 86% were White, and mean education was 16.0 +/- 1.9 years. Serum Aβ42/40 ratio, NfL, and GFAP decreased following one night of sleep deprivation. Following recovery sleep, the Aβ42/40 ratio remained below baseline, while NfL and GFAP increased to baseline levels. Serum pTau-181 did not change following sleep deprivation or recovery sleep. Greater SWA increase from baseline to recovery sleep was associated with smaller Aβ42/40 ratio decrease. Findings did not differ between shift and day work groups.

Conclusion
In retired adults, acute sleep deprivation and recovery sleep impacted serum AD biomarker levels. Sleep characteristics may therefore affect the diagnostic accuracy of these tests. Former night shift work exposure did not influence serum biomarker responses, suggesting no effect of long-term shift work exposure over time. SWA may aid Aβ clearance during sleep.

Support (if any)
K01AG075171, R01AG047139, R01GM140476, R01GM113243
0227 Association Between Sleep Quality and Sleep Duration and Physical Frailty Among Older Adults in India
Authors: Thalil Muhammad , Lee Soomi , Pai Manacy 
Published: April 2024

Abstract

Introduction
Considering the significant growth in India's aging population, it is imperative to identify risk factors associated with frailty among older Indians. However, there is limited studies that assessed the linkage between sleep and frailty in this population and it is focused on sleep disorder. The purpose of this study was to examine the association between sleep quality, sleep duration, and physical frailty among older Indian adults.

Methods
Data come from the World Health Organization’s Study on global AGEing and adult health (WHO-SAGE), India wave-2 (2013-14). The sample size comprised 6,512 older adults aged 50 years and above. Pre-frailty and frailty were assessed using the modified version of the frailty phenotype proposed by Fried and colleagues. Sleep was assessed by self-reported quality and duration. Multinomial logistic regression analysis was employed to examine the associations of sleep quality and duration with pre-frailty and frailty.

Results
A total of 66.7%, and 25.3% of older adults in our sample were pre-frail and frail, respectively. A higher prevalence of frailty was found among those with poor sleep quality (44.8%) and with short sleep duration (&lt; 7 hours/night; 32.2%). Relative to peers with good sleep quality, the odds of frailty were significantly higher among older adults with poor sleep quality [AOR: 2.79; CI: 1.37–5.66]. And, notably, compared to those who enjoyed the recommended age-appropriate amount of sleep (7-8 hours), older adults with long sleep duration (≥ 9 hours) reported a significantly lower likelihood of both, pre-frailty [AOR: 0.73; CI: 0.57-0.93] and frailty [AOR: 0.68; CI: 0.51-0.91].

Conclusion
Our study found both sleep quality and quantity to be associated with pre-frailty and frailty among older Indians. Poor sleep quality may increase risk for frailty, yet long sleep duration may be a protective factor independent of the quality of sleep.

Support (if any)
0238 Disparities in Sleep, Asthma, and the Sleep Context in Urban Children
Authors: Koinis-Mitchell Daphne , Kopel Sheryl J , Dunsiger Shira , Guzman Luis , Mattice Carly , Kirchhof Sidney , Gredvig-Ardito Caroline , Carskadon Mary 
Published: April 2024

Abstract

Introduction
Children who have asthma and live in urban settings experience challenges that can complicate asthma management and compromise sleep outcomes. The goals of this presentation are to 1) describe environmental factors in children’s homes impacting asthma and sleep, 2) examine associations between asthma and sleep outcomes in urban children, and 3) examine the moderating role of environmental and behavioral factors in the association between asthma and sleep outcomes.

Methods
140 children 7-9 years old with persistent asthma and their primary caregivers completed a 16-day observational protocol. Asthma and sleep outcomes were evaluated via self/caregiver report (Asthma Control, Sleep Hygiene) and objective (portable handheld spirometer, actigraphy) methods. Home sleep and asthma environment was assessed with a structured interview.

Results
The most prevalent environmental risk factors for asthma and sleep were tobacco smoke (25% of sample), pets (42%), and pests (e.g., rodents, roaches, etc.; 34%). Sleep hygiene/environmental factors reported by families as challenging included child routinely falling asleep (48% of sample) or sleeping all night (48%) in a room not intended as their sleep space. Shared sleep space (40%) and lack of protective allergy bedding (40%) were also common challenges. Numerous factors causing objectively measured nighttime awakenings and sleep disruption were also reported. On average, children with well-controlled asthma reported more optimal sleep hygiene behaviors (rho = .91, p&lt;.05) relative to those with poorly controlled asthma. Better day-to-day lung function (via spirometry) was related to fewer nighttime awakenings, measured with actigraphy (rho = .20; p’s &lt;.05). Children with poorly controlled asthma tended to have more night awakenings and lower levels of sleep efficiency than those with well controlled asthma. Analyses testing a moderating role of environmental/behavioral processes are underway.

Conclusion
Urban children's sleep environment contains asthma and sleep-related factors that make it challenging to fall and stay asleep. These disruptors affect both asthma activity and sleep and are areas to target in future multi-component asthma and sleep interventions.

Support (if any)
NHLBI R01HL142058 (Koinis Mitchell and Carskadon); NIGMS 5P20GM139743 (Carskadon)
0240 Associations Between Parental Education Level and Subjective Sleep Parameters in Chilean School-aged Children
Authors: Ramírez-Contreras Catalina , San Martín Carla Ortiz , Romero Javiera Vásquez , Venegas María Fernanda Vejar 
Published: April 2024

Abstract

Introduction
Healthy sleep is crucial for children's development. The literature suggests that higher parental education is associated with longer child sleep duration. However, little is known about how family education level affects children’s sleep patterns in Chile. We aimed to investigate the relationship between parental education level and sleep patterns and sleep duration during the week and on weekends.

Methods
Two hundred and fifty-eight participants (6-13 years; 50% girls) were included in this cross-sectional study. Data collected were parent-reported and included: educational level of the household head, categorized as no schooling or primary school, secondary school, technical or higher (graduate) college degree, bedtime, midpoint of sleep and sleep duration on weekdays and weekends. General linear models were tested to calculate adjusted differences between parental education level categories, adjusted for age and gender, followed by a Tukey post hoc test.

Results
We found that higher parental education level was significantly associated with advancing children’s bedtime on weekends (P = 0.007). Participants whose parents had a secondary school degree postponed their weekend bedtime by 0.36 hours (95% CI: 0.11, 0.61) compared to those whose parents had a technical or higher college degree. We also found that higher parental education level was significantly associated with advancing children’s weekend midpoint of sleep (P = 0.044). Specifically, the weekend midpoint of sleep was earlier (−0.29 h; 95% CI: −0.06, −0.53) for participants whose parents had a technical or higher college degree than for parents with a secondary school degree. Surprisingly, we found that lower parental education was associated with children sleeping longer on weekends (P = 0.026). In detail, participants whose parents had no schooling or primary education had 0.45 h longer weekend sleep duration (95% CI: 0.04, 0.87) compared to those whose parents had secondary school level.

Conclusion
Higher parental education level was associated with earlier weekend sleep patterns in children. However, lower parental education levels were associated with children sleeping longer on weekends. These results could be useful for the development of parenting programs targeting different levels of education to promote optimal sleep duration and time, as well as the well-being of Chilean children.

Support (if any)
0241 Racial/Ethnic and Socioeconomic Disparities in Circadian Misalignment in Adolescents
Authors: Morales-Ghinaglia Natasha , Calhoun Susan , Liao Jason , Vgontzas Alexandros , Liao Duanping , Bixler Edward , Fernandez-Mendoza Julio 
Published: April 2024

Abstract

Introduction
Prior research has shown sleep health disparities as a function of race/ethnicity and socioeconomic status (SES). However, most studies focused on habitual sleep duration and its night-to-night variability. Few studies have examined the association of these social determinants with circadian misalignment metrics, such as sleep midpoint (SM), sleep irregularity (SI), and social jetlag (SJL). We hypothesize that adolescents who identify as a racial/ethnic minority or from low SES households have greater circadian misalignment as compared to non-Hispanic whites or those from high SES households.

Methods
We analyzed 377 adolescents from the Penn State Child Cohort (median 16y; 46% female; 22% racial/ethnic minority, of which 58% were Black/African American and 28% Hispanic) who had at least 3 nights of actigraphy. SM was defined as the intra-individual midpoint of the sleep period, SI as the intra-individual standard deviation of the SM across nights, and SJL as the absolute difference between SM on weekdays vs. weekends. SES variables included parent’s professional status, student working status and zip-code level median household income and 5-year average percentage of high school/college graduates. Multivariate general linear models adjusted for sex, age, sleep duration, and sleep variability as well as a composite score of SES variables.

Results
Adolescents identifying as a racial/ethnic minority, working part-time, belonging to a household of lower professional status, lower median income or with less high-school or college graduates had a significantly delayed SM (p=0.011, p=0.005, p=0.049, p=0.047, p=0.009 and p=0.004, respectively). Adolescents identifying as a racial/ethnic minority and belonging to a household of lower professional status had significantly increased SI (p=0.009 and p=0.028, respectively). Race/ethnicity or SES were not associated with SJL (p≥0.203). The association of race/ethnicity with a delayed SM and increased SI remained significant after adjusting for all covariates, including SES (p=0.009 and p=0.029, respectively).

Conclusion
Racial/ethnic disparities in the circadian timing of sleep are not fully explained by socioeconomic factors in adolescents. Beyond insufficient sleep, circadian misalignment and its upstream social determinants should also be a target of strategies to prevent sleep health inequalities in historically minoritized racial/ethnic groups.

Support (if any)
AHA (23PRE1011962), NIH (R01HL136587,R01MH118308,UL1TR000127)
0246 Testing for Obstructive Sleep Apnea by Area Socioeconomic Deprivation in Six Million Adults
Authors: Greider Montana , Fernandez Chris , Rusk Sam , Nygate Yoav , Richardson Dana , Hutchinson Brian , Bartholow Tim , Watson Nathaniel , Wickwire Emerson 
Published: April 2024

Abstract

Introduction
Area socioeconomic deprivation, as measured by the Area Deprivation Index (ADI), is associated with numerous adverse health and economic outcomes (cardiovascular, readmissions, Alzheimer’s). This composite score is based on 17 health disparities indicators (income, education, employment, housing) used to rank relative disadvantage across communities, and is a widely utilized key social determinant of health and a validated marker of health risk. The purpose of this study was to determine the association between the ADI and OSA testing and diagnosis.

Methods
Our data source was the All-Payer Claims Database (APCD) for the Wisconsin Health Information Organization from 2017-2022 and linked to the publicly available ADI. Sociodemographic variables were extracted from APCD including race, gender, and age. Inclusion criteria included continuous enrollment coverage for a minimum of 12-months prior to the date of OSA diagnosis (defined by ICD code G47.33) and a diagnostic sleep test (defined by CPT codes for PSGs and HSATs). ADI was measured at state and national levels. Rates of OSA testing and diagnosis were compared between individuals with OSA across the entire range of ADI scores using ordinary least squares (OLS) regression analysis.

Results
Of N=6,026,463 participants, n=1,310,286 were linked and included in the final sample: 53% women, Mean age=46.75[SD=22.2], National ADI=52.4[SD=20.2], ethnoracial demographic group affiliation: 22 self-identified categories), n=154,821 underwent OSA diagnostic testing, and n=43,601 were subsequently diagnosed with OSA (45% women, age=56.24[SD=16.2], National ADI=55.95[SD=20.88]). Diagnostic testing for OSA was significantly, positively associated with socioeconomic deprivation based on National ADI (slope: 0.0002, p&lt; 0.005) and State ADI (slope: 0.0003, p&lt; 0.005). The highest rates of OSA testing were observed in areas of socioeconomic disadvantage (&gt;4.5%: ADI-decile 90-10). Conversely, the lowest OSA testing rates were observed in areas of socioeconomic advantage (&lt; 2%: ADI-decile 0-10). Relative to individuals in socioeconomically advantaged areas (low-ADI), individuals in disadvantaged areas (high-ADI) were approximately 3% more likely to be tested for OSA.

Conclusion
Area socioeconomic deprivation measured by ADI is associated with a small but significant increase in OSA testing. Future research should seek to increase access to OSA care in areas of socioeconomic disadvantage to improve sleep health equity and reduce global health disparities.

Support (if any)