bluuebunny/crossref_metadata_2025_split huggingface dataset:
0745 Prevalence of Sleep Disorders in Dementia Patients- a Demographic Analysis
Authors: Tallavajhula Sudha 
Published: April 2024

Abstract

Introduction
The prevalence of sleep complaints in the general population far surpasses that of sleep disorders, mainly due to under-recognition. In patients with dementia, the prevalence of sleep disorders is even more vague, despite growing interest in the association between neurodegeneration and sleep disturbances. This project aims to understand the prevalence of sleep disorders in dementia patients, overall and across demographics.

Methods
Data was analyzed from the outpatient EMR in the UTHealth Neurosciences clinic from January 1, 2022-December 18, 2023. 12,187 patients with a dementia diagnosis were selected. ICD-10 codes identified patients with concomitant sleep-related diagnoses. The cohort was analyzed by race and gender. Percentages of patients with sleep apnea and insomnia were also identified.

Results
The sample of dementia patients included 5354 white, 2846 black, 2273 other, 663 Hispanic, 489 unknown, 455 Asian, and 25 American Indian or Alaska natives. Among these, 22% white, 21% black, 20% other, 24% Hispanic, 18% unknown race, 17% Asian, and 36% American Indian or Alaska Native patients carried a sleep disorder diagnosis. We note that a comparatively small number, only 25 American Indian or Alaska Native patients were included in the analysis, which might account for the disproportionate sleep disorder prevalence in that group. Regarding gender, the patients consisted of 1069 female and 5108 male patients with dementia. Of these, 20% of female and 22% of male patients carried sleep-related diagnoses. 13.4% were given a diagnosis of insomnia and 7% of sleep apnea. 5% of female and 9 % of male patients had sleep apnea. 14% of female and 12% of male patients were diagnosed with insomnia. Other sleep disorders were not separately identified. The overall percentage of dementia patients with sleep-related diagnoses was 21%.

Conclusion
The prevalence of sleep disorders in patients with dementia was about 20%. Similar to the general population, the most common sleep disorder diagnosis was insomnia, with sleep apnea being a close second. Also, similar to the general population, insomnia was more common in female patients and sleep apnea in male patients. There were no significant differences in the frequencies of sleep-related diagnoses among dementia patients in racial and gender groups.

Support (if any)
None
0746 Rested and Connected: An Exploration of Sleep Health and Loneliness Across the Adult Lifespan
Authors: Nielson Spencer , Boyle Julia , Dzierzewski Joseph 
Published: April 2024

Abstract

Introduction
The 2023 U.S Surgeon General’s Advisory identified loneliness as a major public health concern. Growing research in this area has identified a relationship between loneliness and poor sleep outcomes in different age groups; however, few studies have explored the relationship between loneliness and sleep health. As such, the present study evaluated the association between loneliness (including social and emotional loneliness subtypes) and sleep health across the adult lifespan.

Methods
Participants included adults across the lifespan (N=2297, Mage = 44 years, 49% female) who completed an online study which included the RU-SATED sleep health questionnaire and the Gierveld Loneliness scale. Correlation and linear regression analyses were utilized to examine direct associations between sleep health, age, and loneliness. The total score and the subscales (emotional and social loneliness) of the Gierveld Loneliness scale were examined to investigate if components of loneliness were differentially associated with sleep health. Moderation analyses examined whether the link between sleep health and loneliness differed by age. Separate moderation models were constructed for each loneliness outcome (i.e., total, emotional, or social), with sleep health, age, and their interaction as predictors.

Results
Better sleep health and younger age were associated with significantly lower loneliness total and subscale scores (all p’s &lt;.05). Age significantly moderated the association between sleep health and total loneliness scores and emotional loneliness scores (b = 0.01, t = 2.63, p = .009; b = 0.04, t = 3.15, p = .002, respectively); but did not moderate the association between sleep health and social loneliness (b = 0.02, t = 1.54, p = .124). Specifically, while better sleep health was associated with lower loneliness across ages, this association was stronger at younger ages.

Conclusion
Results suggest that younger age groups may be more prone to the positive effects of better sleep health on loneliness, especially emotional loneliness, compared to older age cohorts. Promoting sleep health may be an untapped avenue to support efforts and programs that aim to reduce loneliness and increase engagement in all age groups, but especially in younger ages. Future research should consider monitoring sleep health in programs or interventions that address loneliness.

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0748 Sleep Value Profiles–Which Type Are You?
Authors: Ward Levi , Sherriff Dustin , Yang Chongming , Wright Andrew , Duraccio Kara , Calvin Danika , Klingonsmith Bryce , Kay Daniel 
Published: April 2024

Abstract

Introduction
Sleep value, the worth placed on sleep, is an important dimension of sleep health. Using the Sleep Valuation Item Bank (SVIB) we have previously found associations between sleep value factors and demographic, sleep, and psychological variables. The patterns of sleep value hint that there may be distinct sleep value profiles. In a nationally representative sample of 454 participants, we sought to identify these profiles and explore whether they differ in demographic features.

Methods
Participants ages 18-85 (M = 45) completed an online Qualtrics survey that included demographic variables and the SVIB. The factor structure of the SVIB was confirmed using factor analysis. Latent profile analyses with the confirmed factors were conducted and multiple models were compared to identify the best-fitting sleep value profiles. Multiple regression was used to explore whether these profiles differed in age, gender, marital status, income, education, having dependents, and race.

Results
Five sleep value factors were confirmed: sleep wanting, liking, devaluing, prioritizing, and preferring. Latent profile analysis found evidence for 5 classes, or sleep value profiles: (1) an indifferent profile who neither valued nor devalued their sleep who made up 25% of the sample, (2) sleep prioritizers who scheduled their lives around sleep made up 27% of the sample, (3) sleep devaluers made up 26%, (4) an ambivalent profile who highly valued and devalued sleep made up 15%, and (5) on 7% were sleep valuers. Those with the indifferent profile tended to be older (p &lt; .001). Those with the ambivalent profile were more likely to be working-age adults (p &lt; .001) and male (p &lt; .05).

Conclusion
This study found distinct profiles of sleep value that differ in terms of demographics. Only 7% of our nationally representative sample had a profile suggesting they value sleep. The vast majority had an indifferent, ambivalent, or devaluing profile. Understanding how the patterns of sleep value develop and inform sleep-related behavior is an important avenue for future research. These findings may help personalize messaging for sleep health promotion.

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0750 Association Between Physical Activity and Sleep Quality in Older Adults and the Mediation of Pain
Authors: Liu Sofia , Li Mengchi , Li Qiwei , Calderon Russell , Lukkahatai Nada , Li Junxin 
Published: April 2024

Abstract

Introduction
Sleep disturbances are more prevalent in older adults. Both physical inactivity and pain have been linked to sleep disturbances in older adults, but the intricate interplay between these mechanisms is underexplored. This study investigates the associations between physical activity (PA) and sleep with both subjective and objective measures and the potential mediation of pain among community-dwelling older adults.

Methods
This cross-sectional study used baseline data of 125 community-dwelling older adults without dementia (Mean age = 70.45±6.18 years, 82.40% female, 57.60% White) who participated in a randomized controlled trial. PA and sleep were assessed objectively using ActiGraph Link and Actiwatch 2, and subjectively using Physical Activity Scale for the Elderly (PASE) and Pittsburgh Sleep Quality Index (PSQI). Pain intensity, interference, and behavior were assessed using PROMIS Pain Scales. Multiple linear regressions examined associations between PA and sleep quality, and Baron and Kenny’s approach was used to explore the mediation of pain.

Results
Adjusted for age, sex, race, and comorbidities, higher PASE correlated with lower PSQI (β = -0.169, 95% Confidence Interval [CI]: -0.284, -0.053). Pain intensity (indirect effect: -0.039, 95% CI: -0.078, -0.001), pain interference (indirect effect: -0.042, 95% CI: -0.082, -0.002), and pain behavior (indirect effect: -0.035, 95% CI: -0.071, -0.002) were significant mediators. Objective PA was associated with shorter sleep onset latency (SOL) and reduced wake after sleep onset. Specifically, the association between objective PA and SOL was partially mediated by pain intensity (indirect effect: -0.076, 95% CI: -0.173, 0.022). Pain interference and behavior mediated the relationships between objective PA and self-reported sleep quality (indirect effects: -0.022, 95% CI: -0.045, 0.001 for interference; -0.017, 95% CI: -0.037, 0.003 for behavior).

Conclusion
Our findings reinforce the association between PA and better sleep quality using both self-reported and objective measures and validate the mediation role of pain measures. These results suggested a critical role of pain in shaping the dynamics links between PA and sleep quality. Given the cross-sectional nature of our data, future longitudinal studies are necessary to further explore these findings.

Support (if any)
R00NR016484
0754 Sleep Sightlines and Soundwaves: Exploring Sex Differences in Sleep-Related Attentional Bias in Older Adults
Authors: Curtis Ashley , Costa Amy , Musich Madison , Nowakowski Lauren , Young Kobe , Rzeppa Chloe , McCrae Christina 
Published: April 2024

Abstract

Introduction
Insomnia disorder affects 12-20% of older adults, with 2x higher prevalence in women than men. Persistent insomnia symptoms may be influenced by excessive sleep pre-occupation and biases toward sleep-related stimuli (“sleep-related attentional bias”). Whether this bias is sex- and/or modality-specific remains unexplored. This study examined whether there are sex differences in visual/auditory sleep-related attentional bias in older adults.

Methods
Older adults (Mage=68.2±5.9) with (n=31; Women:20/Men:11) and without (n=50; Women:28/Men:22) insomnia (DSM-5 criteria plus reported 6+nights/14 of &gt;30 mins sleep onset latency or wake after sleep onset) completed modified Posner Cueing tasks. Cues included sleep-related auditory (e.g., alarms, snoring), visual (e.g., clocks set to bedtimes, person awake in bed) and non-sleep (auditory: pure tones; visual: neutral International Affective Picture system images) stimuli. Valid [non-cued reaction time (RT) minus validly-cued RT] and invalid (non-cued RT minus invalidly-cued RT) sleep/non-sleep visual/auditory cueing effects were calculated. Two-way ANOVAs examined whether insomnia status interacts with sex it its impact on mean cueing effects.

Results
For visual valid (F=4.39, p=.039) and invalid (F=4.78, p=.03) sleep-related cueing effects, there were significant interactions between insomnia status and sex. Pairwise comparisons revealed insomnia men had larger (trending/p=.06) valid sleep-related cueing effects (122.0±20.0ms) than non-insomnia men (71.0±10.0ms). Invalid sleep-related cueing effects for insomnia men (123.0±23.0ms) were larger (p=.02) than insomnia women (56.0±16.0ms) and larger (p=.02) than non-insomnia men (57.0±15.0ms). For auditory valid cueing effects, there were main effects of insomnia status for sleep-related (F=4.39, p=.04) and non-sleep-related (F=6.32, p=.003) stimuli. Larger effects were observed in insomnia for valid sleep-related cues (insomnia:145.0±18.0ms; non-insomnia:89.0±12.0ms; p=.009) and valid non-sleep-related cues (insomnia:152.0±19.0ms; non-insomnia:81.0±13.0ms; p=.003) cues.

Conclusion
Visual sleep-related attention bias in older adults with insomnia may be sex-dependent, with men more likely to experience this phenomenon. Possible underlying sex-specific mechanisms include contributions of circulating testosterone to spatial attention and sleep-stimuli valence and/or threat detection. Visual stimulus desensitization towards insomnia triggers may be particularly beneficial in older men to facilitate sleep. Auditory attentional bias in insomnia may not be sex-dependent and reflect general auditory cortex hypervigilance.

Support (if any)
This research was made possible by an award (PI:Curtis) from the American Academy of Sleep Medicine Foundation.
0757 Association of Insomnia with Objective Short Sleep Duration and Other Phenotypes with Mortality in Older Persons
Authors: Miner Brienne , Pan Yulu , Cho Gawon , Knauert Melissa , Yaggi Henry , Gill Thomas , Stone Katie , Ensrud Kristine , Zeitzer Jamie , Yaffe Kristine , Doyle Margaret 
Published: April 2024

Abstract

Introduction
The association of insomnia with objective short sleep duration (ISSD) and mortality has not been studied in older persons.

Methods
In 3,601 men from the Osteoporotic Fractures in Men Sleep Study (average age 76±6 years) and 3,295 women from the Study of Osteoporotic Fractures (average age 84±4 years), we used Cox proportional hazards models to examine the association of ISSD (trouble getting to sleep within 30 minutes, waking up in the middle of the night or early morning, and/or taking a medication to help with sleep ≥3 times/week and actigraphy-estimated sleep duration&lt; 6h) with mortality. We also examined whether other sleep phenotypes (insomnia with normal sleep duration [INSD; insomnia and sleep duration 6-9h], asymptomatic short sleep [AS; no insomnia and sleep duration&lt; 6h], long sleep [LS; self-reported or actigraphic sleep duration&gt;9h]) were associated with mortality. Persons with normal sleep (no insomnia and actigraphic sleep duration 6-9h) served as the reference group. Follow-up times were 6,538 and 2,953 days in men and women, respectively. Adjusted models included age, race, education, obesity, depression, diabetes, COPD, stroke, hypertension, myocardial infarction, and heart failure. In analyses for men, we also adjusted for severe sleep disordered breathing (apnea-hypopnea index &gt;=30).

Results
Prevalence rates in men/women for ISSD, INSD, AS, and LS were 19.9%/11.5%, 41%/34.8%, 10.6%/10.4%, and 7.7%/17.9%, respectively. Mortality rates for men and women were 65.2% and 35.7%. Compared to men with normal sleep, ISSD (OR 1.32 [1.16, 1.52]) and LS (OR 2.22 [1.58, 3.12]) in men were associated with increased mortality risk in unadjusted models. In adjusted models, only LS vs. normal sleep conferred higher mortality risk (adjOR 1.49 [1.03, 2.14]). Similarly, ISSD (OR 1.32 [1.07, 1.62]) and LS (OR 4.65 [3.49, 6.19]) in women were associated with increased mortality risk in unadjusted analyses, but only women with LS had a higher mortality risk in adjusted models (adjOR 2.30 [1.60, 3.31]). Compared to normal sleepers, neither INSD nor AS in older men or women were related to mortality risk.

Conclusion
ISSD and LS represent high risk phenotypes in older persons. Future work should examine causal pathways and determine whether sleep improvements decrease mortality risk.

Support (if any)
AASM Foundation, NIA
0758 Associations Between Actigraphy-Assessed Step Activity and Sleep in Older Adults Following Acute Hospitalization
Authors: Arentson-Lantz Emily , Deer Rachel , Kokonda Manasa , Meers Jessica , Carreon Samantha , Boyle Julia , Fisher Steve , Hommel Erin , Baillargeon Jacques , Volpi Elena , Nowakowski Sara 
Published: April 2024

Abstract

Introduction
Three out of 10 older adults are admitted for acute care in U.S. hospitals where they are at risk for a rapid decline in physical function due to deconditioning. Clarifying the relationship between sleep and the recovery of physical functioning is a key step in facilitating independence following hospital discharge. Thus, this study aimed to examine the association between step activity and sleep parameters after an acute hospitalization in community dwelling older adults.

Methods
Patients (n=52; age 71.3 ± 6.8y, 75% female, 94.2% white), were recruited during an acute hospitalization. Participants completed sleep questionnaires including PROMIS Sleep-Related Impairment and Sleep Disturbance during acute hospitalization (baseline) and at 4-weeks post-discharge (follow-up). Participants were also given an ankle-worn accelerometer (Modus Stepwatch®) to continuously record the steps and active minutes in the hospital and the 4-week period following discharge. A subset of participants (n=26) also received an actigraphy device (Philips Actiwatch-2®) to measure number of awakenings and wake after sleep onset (WASO). Separate multivariate regression analyses were performed to determine whether steps activity predicted sleep parameters.

Results
An increase in active minutes was inversely associated with number of awakenings (-0.09±0.04, p=0.04), although the association with WASO was not significant. The average number of active minutes was inversely associated with PROMIS Sleep Disturbance score at follow-up (-0.12±0.06, p=0.04) and change in PROMIS Sleep-Related Impairment score (-0.12±0.05, p=0.03) from baseline to follow-up.

Conclusion
Together, these results demonstrated that increase in the number of minutes when steps are taken following hospitalization decreased the number of awakenings, sleep disturbance and sleep-related impairment.

Support (if any)
This work is supported by NIH Grant #s R01NR018342 (PI: Nowakowski), P30AG024832, UTMB Pepper OAIC, (PI: Volpi), UL1TR001439, (UTMB ITS); and the National Dairy Council (1229, PI: Volpi). Additional support was provided by the Center for Innovations in Quality, Effectiveness and Safety (CIN 13-413).
0761 The Influence of Sex on Sleep Characteristics in the Older Adult Population: Findings from the EPISONO Sleep Study
Authors: Silva Mayra , Tempaku Priscila , Andersen Monica , Tufik Sergio , Poyares Dalva 
Published: April 2024

Abstract

Introduction
Sleep plays an important role in the prevention and development of several chronic diseases. However, there are significant differences between female and male sleep characteristics, some of which can be lifelong. Thus, the objective of this study was to analyze, according to sex, the polysomnographic findings of adults and older adults who participated in 2 editions (2007 and 2015) of EPISONO, an ongoing Brazilian, population-based sleep study.

Methods
The baseline randomized sample included 1,042 volunteers in 2007, of these 688 were reassessed in 2015. There were 574 women and 468 men in 2007, and 380 women and 308 men in 2015. All examinations and tests were undertaken using the same protocols at both times. All participants completed an institutional questionnaire to collect socioeconomic data, and a range of other questionnaires on health and sleep parameters, and underwent full-night polysomnography (PSG) and peripheral blood collection for biochemical and hematological measurements. In both editions (2007 and 2015) physical and anthropometric assessments were made. The exclusion criteria were: pregnant and nursing women, individuals with self-care limitations (physical or mental), and shift workers.

Results
We observed that adult (p=0.003) and older adult women(p=0.001) spent more time in N3 than men, with a greater number of awakenings (p=0.001), and an increased periodic leg movement index in older adult women (0.012), but only adult women in the follow-up presented greater sleep efficiency (p=0.047). Men (adults and older adults) remained longer in N1 and adult men (p=0.001) had a higher apnea-hypopnea index (p=0.001).

Conclusion
This study prospectively evaluated with full-night PSG the sleep of the general population and reported significant findings according to sex and age, suggesting that some aspects of sleep change differ with age and according to sex.

Support (if any)
acknowledgments: This work was supported by grants from the Associação Fundo de Incentivo à Pesquisa (AFIP), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPQ) and and São Paulo Research Foundation (FAPESP, #20/13467-8 to MLA)
0762 Assessing Sleep Health Literacy in Older Adults: Dysfunctional Beliefs About Napping
Authors: Berkley Amy 
Published: April 2024

Abstract

Introduction
Many older adults have false, or inaccurate beliefs about sleep and insomnia that lead them to adopt coping strategies that are frequently counter-productive. People who are sleep-deprived frequently take naps to compensate for fatigue, and ‘power naps’ are frequently recommended for stress reduction. Research has shown some correlations between older adults’ napping habits and increased medical comorbidities and risks of dementia, but it has also shown that napping enhances memory consolidation and broader aspects of cognition in younger adults. Guidance against napping has centered around the possibility of detrimental effects on nighttime sleep duration and quality, and/or possible links to cognitive impairment. But much previous research has neglected to differentiate between daytime sleepiness, a complex phenomenon associated with medical comorbidities, and to regulate nap timing and duration. With greater sleep-oriented health literacy, older adults, their families, and caregivers could overcome many of these dysfunctional beliefs and learn to use intentional napping as effective compensation for a poor night’s sleep.

Methods
Semi-structured, audio-recorded interviews were conducted with residents of 2 senior living communities in the Midwest who self-reported sleep problems. The interviews were supplemented by self-report instruments, including the PSQI, along with the Dysfunctional Beliefs About Sleep Scale (DBAS) and a questionnaire about napping and daytime sleep. In the second phase, a subset of participants took part in a sleep health literacy educational intervention, in which they practiced intentional napping under recommended guidelines.

Results
Insomnia symptoms ranged from 6 months - 20+ years in duration. Mean PSQI score = 9 (5+ is considered indicative of sleep problem). 5 participants reported napping in qualitative interviews but denied daytime sleep on standard sleep assessments. Others expressed dread of napping because of perceived links to functional and cognitive decline.

Conclusion
Participants expressed optimism and relief upon learning that napping could be beneficial to their sleep.More research is needed into the ways napping can improve physical and cognitive function, and more education is needed for older adults, their families and caregivers, and long-term care staff about the importance of sleep for older adults.

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