bluuebunny/crossref_metadata_2025_split huggingface dataset:
O081 “My partner just wants to sleep”: A qualitative study of the experience of living with a partner with Narcolepsy or Idiopathic Hypersomnia.
Authors: Rodriguez C , Bullock B , Buzwell S 
Published: October 2023

Abstract

Introduction
Narcolepsy and Idiopathic Hypersomnia (IH) are chronic sleep disorders that negatively impact sufferers’ Health-Related Quality of Life (HRQoL) across physical, emotional, and social functioning. Narcolepsy and IH may also impact the HRQoL of those close to the patient (i.e., partners, parents). This project explored the experiences of partners of people with Narcolepsy or IH, including how living with someone with the diagnoses had impacted their own HRQoL.

Methods
In this qualitative study, a semi-structured interview was used to collect data from 8 partners of people with Narcolepsy T1, Narcolepsy T2 and IH. The data were analyzed using Reflexive Thematic Analysis to find common themes emerging from the participants’ narratives.

Results
Five themes (and 2 sub-themes) were identified: 1) changes in dyadic identity; 2) negative impact on intimacy; 3) loneliness; 4) sacrifices to maintain the relationship, and 5) dissatisfaction at the lack of knowledge and information among (a) the general public, and (b) health professionals.

Conclusions
This novel, exploratory study identified several themes of social and emotional functioning most impacted by a partner’s sleep disorder diagnosis; themes which correspond with the areas shown to be negatively affected in patients. Psychosocial interventions for Narcolepsy and IH should include patients’ partners to reduce the impact of the diagnoses on the family system, and improve overall HRQoL.
O085 “It's Satisfying but Destructive”: A Mixed Methods approach to understanding the Impact of Bedtime Procrastination and Pre-sleep Screen time on Sleep in in new Career Starters.
Authors: Hill V , Ferguson S , Vincent G , Rebar A 
Published: October 2023

Abstract

Introduction
Bedtime procrastination, the volitional delay of going to bed, is linked to multiple indicators of inadequate sleep. Intervening to reduce bedtime procrastination may be an avenue to improve sleep outcomes, yet the phenomenon remains poorly understood in populations at-risk for bedtime procrastination. New career starters, those who are transitioning from tertiary education to full-time employment, may be susceptible to problematic bedtime procrastination and are at an opportune time for a ‘fresh start’ to change behaviour.

Methods and results
Two studies were conducted: (1) a qualitative approach to understand how bedtime procrastination is experienced by new career starters, identify barriers to behaviour change and explore themes for future interventions; and (2) a 7-day repeated-measures design to test generalisability of findings. In Study 1, data were collected through in-depth semi-structured interviews (n = 28). Inductive thematic analyses were used to find seven themes: negative feelings before and during bedtime procrastination; wanting to vs. knowing I shouldn’t; difficulty falling asleep; influence of automatic processes; consequences of bedtime procrastination; lack of self-control and technology captures late-night attention. Participants emphasised the need for me-time, self-negotiation to continue procrastinating and knowledge of the value of sleep. Study 2 aimed to quantify the relationship amongst bedtime procrastination, habit and motivation on daily pre-sleep screen use and sleep outcomes. Data collection and analyses are ongoing, preliminary findings suggest that bedtime procrastination involves both reflective and automatic cognitive processes.

Conclusion
Future interventions would benefit from a dual-process approach, using cognitive and behavioural techniques to reduce bedtime procrastination.
P002 Positive airway pressure adherence in children with sleep apnea may be similar to adults
Authors: Park D , Ryu U , Mun S 
Published: October 2023

Abstract

Introduction
Most pediatric patients with obstructive sleep apnea (OSA) are known to be treated with adenotonsillectomy (AT). However, in some of them, positive airway pressure (PAP) can be used for underlying diseases or in case of AT failure. Thus, PAP adherence and compliance were compared in pediatric OSA to adult OSA.

Methods
A retrospective study was conducted on 17 children and 167 adults who had performed polysomnography (PSG) and were prescribed PAP and followed up for more than 3 months from July 2018 to January 2023. Adherence was defined as the percentage of patients continuing to use PAP after prescription and compliance was defined as an average of more than 4 hours per night usage of 70% of the monitoring days.

Results
There were 11 males (64.7%) in pediatric and 141 males (84.4%) in adult patients. The mean age was 8.0 years (6.50-12.50) in pediatric and 50.0 years (41.00-58.00) in adult patients. The mean apnea hypopnea index (AHI) (37.0 vs 50.7) and Lowest O2 saturation (79.4% vs 75.5%) did not show any differences in the 2 groups. Longest apnea showed considerable differences (25.9 sec vs 50.8 sec) (p=0.000). After 18 months of PAP usage, AHI dropped from 37.0 to 5.1 vs 50.7 to 2.6, adherence decreased from 94.1% to 41.2% vs 90.4% to 38.9% (p=0.944), compliance reduced from 64.7% to 28.9% vs 67.0% vs 29.3% (p=0.268) in pediatric and adults groups.

Conclusions
There were no significant differences in adherence and compliance with PAP in children compared to adults.
P014 Go to bed! A Systematic Review and Meta-analysis of Bedtime Procrastination Correlates and Sleep Outcomes
Authors: Hill V , Rebar A , Ferguson S , Vincent G 
Published: October 2023

Abstract

Introduction
Bedtime procrastination is defined as the volitional delay of going to bed, without any external circumstances causing the delay, and is associated with inadequate sleep. Alleviating bedtime procrastination may be an important target for interventions promoting adequate sleep, yet the correlates of bedtime procrastination are poorly understood. This study examined (1) correlates of bedtime procrastination, and (2) strength and direction of the association between bedtime procrastination and sleep outcomes.

Methods
Six databases (CINAHL, EMBASE, PsychINFO, PubMed, Scopus, Web of Science) were searched from inception to September 2021 against pre-determined eligibility criteria.

Results
Forty-three studies were included (GRADE = low). Meta-analysis revealed that bedtime procrastination had a moderate negative association with self-control (z = -0.39; CI: -0.45, -0.29) and a moderate positive association with evening chronotype (z = 0.43; CI: 0.32, 0.48). Furthermore, bedtime procrastination was moderately negatively associated with sleep duration (z = -0.31; CI: -0.37, -0.24), sleep quality (z = -0.35; CI: -0.42, -0.27) and moderately positively associated with daytime fatigue (z = 0.32; CI: 0.25, 0.38).

Conclusion
Further high-quality studies are needed to identify causal relationships between bedtime procrastination and correlates, as well as bedtime procrastination and sleep. Future work will guide the development of interventions targeting bedtime procrastination for improved sleep outcomes.
P021 Daily association between post-traumatic stress symptoms and sleep in trauma-exposed young adults
Authors: Schenker M , Theoswin P , Qian H , Jordan A , Nicholas C , Felmingham K 
Published: October 2023

Abstract
Sleep disruptions and post-traumatic stress disorder (PTSD) are bi-directionally linked and have been found to mutually reinforce each other on a daily basis. However, most of the previous research has focused on subjective sleep measures only. In this study, we investigated the temporal relationship between sleep and PTSD symptoms using both subjective (sleep diary) and objective sleep measures (actigraphy) in 41 non-treatment seeking, trauma-exposed young adults (age M=24.68, SD=8.15) with a range of PTSD symptom severities (PTSS, 0-53 on PCL-5). Participants reported daily PTSS and number of intrusions as well as nightly sleep, while wearing an actigraphy watch over four weeks. Linear mixed models showed that subjectively reported sleep disruptions were associated with elevated next-day PTSS and more intrusions both within and between participants. Similar effects were found for PTSD symptoms influencing subsequent subjective sleep. However, these associations were not found in the objective sleep data. Exploratory moderator analyses including sex (male vs. female) suggested sex-specificity in these associations. While subjective sleep results were in line with previous research, objective sleep results differed. Several factors may underly the divergent findings, such as the COVID-19 pandemic and/ or sleep-wake state discrepancy. Although further research is required, these data suggest the relationship between sleep and PTSD symptoms differs between objective and subjective sleep measures and depending on sex.
P022 Sleep Biomarker Phenotyping of Neurodegenerative Disorders Using Artificial Intelligence – A Pilot Study
Authors: Levendowski D , Tsuang D , Neylan T , Walsh C , Lee-Iannotti J , Berka C , Mazeika G , Boeve B , St. Louis E 
Published: October 2023

Abstract

Introduction
In this pilot study, we explored sleep biomarker risk probabilities for different neurodegenerative disorder (NDD) phenotypes across a spectrum of NDD patients, compared with controls.

Methods
We analyzed a cohort of patients with different NDD phenotypes who underwent in-home recordings with Sleep Profiler, including Lewy body disease (LBD=20), Alzheimer’s disease dementia (AD=29), and isolated REM sleep behavior disorder (iRBD=19). Controls with an MMSE&gt;28 (CG=61) and patients with Parkinson disease (PD=16) and mild-cognitive-impairment (MCI=41) also participated.
We developed a machine-learning classifier that assigned NDD probabilities for LBD, AD, iRBD, and CG. The input variables included: time-REM, non-REM hypertonia, autonomic-activation index, spindle-duration, atypical-N3, time-supine, sleep-efficiency, relative-theta, and theta/alpha. Probabilities &gt;50% were assigned “likely”, and for CG&gt;=50% and a NDD group probability 20-50%, the assignment was normal “plus”. Probability assignments were then made for the NDD and CG groups, then further applied to the PD and MCI patient groups.

Results
The CG group participants were assigned Normal-Likely=74%, Normal+AD=11%, Normal+iRBD=5%, iRBD-Likely=5%, and AD-Likely=5%.
LBD patient distributions were LBD-Likely=70%, iRBD-Likely=5%, AD-Likely=5%, Normal+LBD=5%, Normal+iRBD=5%, Normal+AD=5%, and Normal-Likely=5%.
AD group distributions were AD-Likely=71%, LBD-Likely=4%, Normal+AD=14%, Normal+iRBD=4%, Normal-Likely=7%.
iRBD patients were characterized with iRBD-Likely=37%, LBD-Likely=5%, AD-Likely=5%, Normal+iRBD=27%, Normal-Likely=26%.
PD patients were assigned iRBD-Likely=29%, LBD-likely=14%, AD-Likely=14%, Normal+iRBD=21%, Normal+AD=7%, Normal-Likely=14%.
MCI distributions were AD-Likely=45%, LBD-Likely=8%, iRBD-Likely=5%, Normal+AD=21%, Normal-Likely=13%.

Conclusions
For LBD, AD and CG groups, correct risk assignments were &gt;70% while gross misclassifications were &lt;10%. Classification patterns for PD, MCI and iRBD were disbursed in a manner consistent with the range of severities expected in each group.
P026 Should we consider new mothers an at-risk group for fatigued driving?
Authors: Sprajcer M , Thorne H , Newman L , Gupta C 
Published: October 2023

Abstract

Introduction
New mothers typically experience a high level of sleep disruption during the first year of their child’s life. Other populations who are likely to experience sleep disruption (e.g., shift workers) are considered at-risk for fatigued driving. As a result, significant educational resources and support are available to minimise risks for these groups. However, no similar resources are available for new mothers as it is unclear whether they should be considered an at-risk population. This study therefore aimed to identify the frequency of fatigued driving and fatigue-related near misses / vehicle crashes in new mothers.

Methods
A cross-sectional survey was undertaken with a sample of 187 Australian mothers who had a child aged under one year. Participants completed the Pittsburgh Sleep Quality Index and a series of questions addressing their driving behaviour and experiences of fatigued driving.

Results
Over 50% of participants who drove regularly did so while fatigued at least a few times per month. Of the participants who reported experiencing near misses while driving, &gt;70% indicated that at least some were caused by fatigue. Furthermore, &gt;55% of participants who had experienced a vehicle crash since the birth of their child reported that the crash was caused by fatigue.

Discussion
The reported rates of fatigued driving suggest that new mothers experience a similar degree of fatigue-related driving risk as other at-risk populations and are likely at greater risk than the general population. It may therefore be appropriate to provide targeted educational resources and/or fatigue management strategies for new mothers.
P029 Comparing the Impact of General Strength Conditioning and Motor Control Manual Therapy on Sleep Quality in Adults with Chronic Low Back Pain: A Randomised Controlled Trial
Authors: Vincent G , Craige E , Belavy D , Ford J , Miller C , Main L , Hahne A , Ferguson S , Owen P 
Published: October 2023

Abstract

Introduction
There is strong evidence indicating interactions between sleep and chronic low back pain (CLBP). However, evidence on the effect of exercise training (first-line treatment for CLBP), especially of specific modes of exercise training, on sleep is limited. This study aimed to investigate the effect of two exercise-based interventions (general strength and conditioning [GSC] and motor control and manual therapy [MCMT]) on sleep quality in adults with CLBP.

Methods
We conducted a two-group parallel (1:1), randomised controlled trial. Forty adults (mean age [SD]: 34.7 [6.1] years) with CLBP were randomised to receive either GSC (n=20) or MCMT (n=20) for 6 months. Sleep quality and its sub-components (e.g., sleep disturbance, sleep duration) were measured by the Pittsburgh Sleep Quality Index (PSQI). Analysis employed an intention-to-treat approach and group-by-time effects were assessed with mixed linear effect models.

Results
Both GSC (PSQI mean change [95%CI]: -1.58 [-2.70, -0.46] points) and MCMT (-1.61 [ 2.79, -0.43]) improved sleep quality at 6 months, but no group-by-time effect was detected (β [95%CI]: 0.03 [-1.60, 1.65]). For sleep quality sub-components, GSC improved daytime dysfunction (-0.33 [-0.65, -.0.01]), but led to a small decline in sleep efficiency (0.06 [0.01, 0.10]). MCMT improved sleep disturbance ( 0.31 [-0.55, -0.07]).

Conclusion
Both GSC and MCMT improved sleep quality, although neither intervention appeared superior. Sleep disturbance was improved in the MCMT group and daytime dysfunction was improved in the GSC group. Future studies would benefit from including a true control, objective sleep measures, and investigation of potential mediators.
P030 Understanding the relationships between sleep quality, and depression and anxiety in neurotrauma: A scoping review.
Authors: Saravanan K , Downey L , Sawyer A , Jackson M , Berlowitz D , Graco M 
Published: October 2023

Abstract

Introduction
Sleep problems, depression, and anxiety are highly prevalent following a spinal cord injury (SCI) and traumatic brain injury (TBI) and may worsen functional outcomes and quality of life. This scoping review examined the existing literature to understand the relationships between sleep quality, depression, and anxiety in people with SCI and TBI, and to identify gaps in the literature.

Methods
A systematic search of seven databases was conducted. The findings of 30 eligible studies reporting associations between sleep quality and depression and/or anxiety following SCI or TBI were synthesised.

Results
The included studies were mostly cross-sectional and employed a range of subjective and objective measures of sleep quality. Poor subjective sleep quality and insomnia tended to be significantly associated with increased levels of depression and/or anxiety, but no such associations were reported when sleep quality was measured objectively. Two longitudinal studies observed worsening depressive symptoms over time were related to insomnia and persistent sleep complaints. Two interventional studies found that treating sleep problems improved symptoms of depression and anxiety.

Discussion
The findings of this review suggest that sleep and psychopathology are related in people with neurotraumatic injuries. This has important therapeutic implications, as individuals may benefit from therapy targeting both sleep and psychological issues. More longitudinal and interventional studies are warranted to further understand the direction and strength of the relationships, and how they impact patient outcomes.
P032 Prospective Crossover Trial of Positional and Continuous Positive Airway Pressure Therapy (PaCT) for the Treatment of Mild-to-Moderate Positional Obstructive Sleep Apnoea
Authors: Kinder S , Ryan A , Carroll R , Duce B , Ellender C , Wilson M 
Published: October 2023

Abstract

Introduction
Positional obstructive sleep apnoea (pOSA), defined by a supine-to-non-supine AHI ratio ≥2, is a phenotype present in a significant subset of patients with sleep-disordered breathing. CPAP has been the gold standard for OSA treatment since its first description in clinical use, although various practical and patient factors may preclude its use. Positional therapy (PT) provides an alternative for pOSA – shown to be effective in restricting supine sleep, thereby reducing the frequency of events and improving outcomes.

Methods
Prospective, single-centre crossover trial of consecutive, treatment-naïve participants with symptomatic, mild-to-moderate pOSA on diagnostic polysomnogram. Eligible participants were randomised to undergo paired treatment CPAP and PT polysomnography to assess efficacy. Participants thereafter received a two-month trial of each, according to randomisation. Adherence, symptom, quality of life (QoL) measures, and patient preference were assessed.

Results
53 participants completed treatment and follow-up. Mean age was 55.1±12.7 years. 30 participants were male (56.6%). Median BMI was 30.1kg/m2 (27–34). Median baseline AHI was 14.4 (9.9–20.2). Median baseline Epworth Sleepiness Scale (ESS) was 12 (10–14) and improved after treatment with positional [8 (6–11); p=0.001] and CPAP [8 (6-11); p&lt;0.001] therapies. There was no difference in ESS reduction between treatment groups (p=0.691). There was no significant difference in usage between therapies (p=0.877). QoL measures were also assessed.

Discussion
In this cohort with symptomatic mild-to-moderate pOSA, treatment with both PT and CPAP resulted in comparable, clinically significant symptomatic improvement with similar usage. Our findings suggest either therapy can be considered effective in appropriately selected patients.
P038 Characterising Pulse Wave Amplitude Drops in Patients with Acute Coronary Syndrome
Authors: Tong B , McClintock S , He S , De Chazal P , Yee B , Cistulli P 
Published: October 2023

Abstract
Pulse wave amplitude derived from photoplethysmography signals is a surrogate measure of autonomic function and vascular response. Recent studies have demonstrated low pulse wave amplitude drop(PWAD) index to be associated with increased cardiovascular risk in obstructive sleep apnoea(OSA). The nature of PWAD in patients with cardiovascular disease remains unknown. We aimed to characterize PWAD in patients with acute coronary syndrome(ACS) diagnosed with OSA in terms of cardiovascular measures.
We studied 70 patients with ACS (age:58[52,63]years, BMI:27[24,30]kg/m2). A level 2 polysomnogram was conducted to confirm OSA diagnosis within 6 months after discharge. Cardiovascular measures of heart rate variability(HRV), baroreflex sensitivity, pulse wave velocity (PWV) and endothelial function(FMD) were measured. PWAD was analysed using a validated algorithm. PWAD with an amplitude reduction of &gt;30% from baseline and a duration &gt;4 heartbeats were identified. PWAD frequency, duration, amplitude, area under the curve(AUC), descending and ascending slopes were calculated.
There was no relationship between PWAD frequency and AHI (r=0.057, p=0.642). PWAD amplitude (rs= 0.308, p=0.031) and duration (rs= -0.319, p= 0.025) correlated with baroreflex effectiveness index. After controlling for age, gender and BMI, baroreflex effectiveness index was associated with PWAD duration (β±SE: -0.009±0.003, p=0.009). Aortic augmentation index correlated with PWAD duration (rs= 0.3565, p=0.0041). HRV parameters, FMD and PWV did not correlate with PWAD parameters (data not shown).
These preliminary findings suggest PWAD duration and amplitude are not associated with OSA severity in patients with ACS. However PWAD may be appropriate markers of vascular and autonomic nervous system response in patients with cardiovascular disease.
P034 An economic evaluation comparing the provision of sleep disorder services via a regional hub-and-spoke model of care to standard care in a metropolitan tertiary hospital
Authors: Szollosi I , Worley S , Curtin D 
Published: October 2023

Abstract

Introduction
A new hub-and-spoke model of care (New-MOC) was introduced in a very remote Queensland region for the management of Obstructive Sleep Apnoea. Standard Care required travel and admission to a major metropolitan hospital. The aims were to increase access to services and ensure the New-MOC was cost-effective for sustainability.

Method
A cost-utility evaluation was performed from the health service perspective. Administrative and clinical data was collected in the 2-years prior and 1-year post implementation of the New-MOC to compare costs and outcomes. Base-case was modelled using decision tree analysis for a hypothetical cohort of 100 patients over a time horizon that captured 12-months of treatment. One-way sensitivity analyses were performed to evaluate uncertainty of inputs in which a) all costs were adjusted to upper bound b) set up costs were added and c) QALYs were reduced in the New-MOC.

Results
Under base-case the New-MOC was dominant and projected to save $226,511 of health service costs over 1.2 years and result 0.488 QALYs gained compared Standard Care. The New-MOC remained cost effective under all scenarios modelled.

Discussion
Whilst the New-MOC was cost effective, primary source data was only available up to diagnosis and therefore modelling relied on assumption around outcomes. Follow-up of patients in relation to treatment compliance would improve the accuracy of the model as would applying a lifetime horizon to capture all outcomes for a chronic condition. However, sufficient evidence exists to support the New-MOC as cost saving and cost-effective.

Acknowledgement
supported by a Metro North LINK Grant