bluuebunny/crossref_metadata_2025_split huggingface dataset:
P041 Audit findings of Bilevel Titrations performed in 2022 at a Public Sleep Laboratory
Authors: Doyle G , Szollosi I , Segal T , Downey C 
Published: October 2023

Abstract

Introduction
The aim of this audit was to benchmark and grade outcomes of NIV titrations for chronic hypercapnia as per the NPPV titration task force of the AASM.

Methods
All NIV studies performed in 2022 were included in the audit. Titration gradings of success were defined as per the NPPV titration task force. Each change in setting was reviewed for consistency with laboratory protocols based on task force guidelines.

Results
50 of 72 NIV titrations have been audited to date. Patients were mean age (56.4 years +/-17.6), 59% male, with the following pathophysiology leading to chronic hypoventilation. 46% OHS, 35% neuromuscular disease, 16% lung disease, 2% brain or spinal injury. 81% of all setting changes were consistent with laboratory protocols. Protocols were most often not followed when adjusting rise (86.2%), EPAP (82%), and ti max/min (62%). Titration grading outcomes were optimal (43%), good (14%), adequate (0%) and unacceptable (43%). Suboptimal titrations were attributed to; lack of supine REM sleep (24%), lack of sleep or any REM sleep (18%), persistent asynchrony (10%), uncontrolled obstruction (10%), or tcCO2/SpO2 not responding to treatment (38%).
Patients with a primary condition of a neuromuscular disease had less suboptimal titrations (36%) compared with OHS (46%), lung disease (43%) and other conditions (50%) however were not statistically significant.

Discussion
Despite local titration protocols, a high number of unacceptable titrations were identified along with a high proportion of patients not responding to treatment. Further analysis to identify reasons for titration protocol deviations and treatment non-responders is required.
P043 Comparison of sleep position classification between neck and abdominal placement in late pregnancy
Authors: Wilson D , Whenn C , Ruehland W , Barnes M , Walker S , Howard M 
Published: October 2023

Abstract

Background
Going to sleep in the supine position during pregnancy is associated with an increased risk of stillbirth, however objective sleep position data are needed to verify the mechanisms of this relationship. Sleep position measurement devices are typically worn at the neck or chest, but abdomen position is more important for assessing impact of the gravid uterus on inferior vena cava compression. This study aimed to compare sleep position measured at the neck versus the abdomen in late pregnancy.

Methods
Twenty women in the third-trimester of pregnancy wore the Night Shift Sleep Positioner with both the neck band and abdominal band for one night. Position classified as left, supine, right, prone and upright was recorded in 30-second epochs and compared across device locations.

Results
There was substantial agreement between the neck and abdomen for determination of all sleep positions with 88% concordance on an epoch-by-epoch basis (κ = .797 [SE .006], p&lt;.001). However, agreement was only fair (κ = .407 [SE .007], p &lt; .001) for supine versus non-supine positioning, with a trend for more supine sleep using the neck device compared to the abdomen (47.5 [16.3,80.5] vs 19.0 [6.8,83.8] minutes, median difference =7.3 [0.5,39.3], p=.12). The average absolute supine difference across device locations was 30.8 minutes [4.0,65.3].

Conclusion
Position measurement at the neck and abdomen has considerable concordance on an epoch-by-epoch basis, however agreement was reduced when comparing supine position only. Site of sleep position measurement in pregnancy has implications for assessing supine positioning, intervention success and stillbirth risk.
P044 Assessing Sp02 Data Reliability in a Paediatric Laboratory: A Comparative Study of Pulse Oximetry and Transcutaneous Oxygen Monitoring
Authors: Roberts C , Carballo A , Erikson N , Madden G 
Published: October 2023

Abstract

Introduction
Pulse oximetry is the primary method for measuring Sp02 in polysomnography studies to determine the presence of sleep apnoea. In paediatric studies where there is significant artefact in pulse oximetry, we investigate if transcutaneous oxygen monitoring (TcOM) can be used as a reliable alternative to measure blood oxygen concentration (Sp02).

Methods
A comparison of pulse oximetry (Nonin) and TcOM (Sentec) data was performed by a retrospective analysis of 16 diagnostic studies (Male=50%; Median age= 8±4.69SD). 6 studies were excluded due to: AHI &gt;5/hr, missing data and artefact. A comparison was made between the two sampling methods for: Oxygen desaturation index (ODI) per hour, nadir and baseline. Statistical analysis run was a paired t-test.

Results
Poor test-retest reliability was observed for all parameters- mean(SD): ODI Nonin=1.13(1.24), ODI Sentec=50.74(29.13)*; Nadir Nonin=91.10(3.78), Nadir Sentec=69.10(10.62)*; Baseline Nonin=98.(0.57), baseline Sentec=99.50(0.71)*. These results strongly indicate a significant statistical difference between data groups. *indicates P=&lt;0.05

Discussion
Our analysis demonstrated inconsistent data between the two methods, and unstable Tc0M readings, which if used could lead to misdiagnosis of sleep-disordered breathing. Further comparative analysis using different Tc0M skin sites could yield more reliable data. Two reliable sources of SpO2 data would provide an in-clinic verification tool in instances of significant artefact or troubleshooting, to improve quality of studies conducted.
P047 Slow Wave Dynamics in Mild Cognitive Impairment compared with Age Matched Controls: A High Density EEG study.
Authors: Chapman J , Kao T , Teh J , Haroutonian C , Grunstein R , Naismith S , D'Rozario A 
Published: October 2023

Abstract

Introduction
Slow wave activity during non-rapid eye movement (NREM) sleep has been linked with memory consolidation in healthy older adults. To date, there has been limited research in mild cognitively impaired populations, particularly looking across the whole brain using high density EEG. We aimed to determine if the dynamics of slow wave activity (delta power) during the first NREM sleep cycle differ between patients with mild cognitive impairment (MCI) and healthy older adults.

Methods
Participants were assessed for MCI by a panel of neuropsychologists and clinicians. They underwent full polysomnography including high-density EEG (256 electrodes). We computed the delta power (0.5-4.5Hz) for each NREM cycle and slope between sleep onset and the peak of delta in the first NREM sleep cycle (rise-rate) which were compared between groups using t-tests.

Results
17 older adults with MCI and 21 older healthy controls were assessed. The mean delta power in the first NREM cycle did not differ between MCI and controls across the whole brain, but the global rise-rate (1/min) of MCI and controls was 0.0015 and 0.0032 respectively (t-value -2.35, p=0.025).

Discussion
Global slow wave dynamics in the first NREM period appear to be altered in patients with MCI compared with age-matched controls. The gentler slope of rise-rate to the first delta peak in MCI patients than in healthy controls may indicate the dysfunction of sleep homeostasis in MCI patients. Regional slow wave dynamics, ultra-low frequency delta (0.25-1Hz), and associations with sleep dependent memory consolidation will further be explored.
P054 Neurotransmitters of Sleep and Wake in Flatworms
Authors: Omond S 
Published: October 2023

Abstract

Introduction
Sleep is something that we all do, regardless of how much or how little. But why we sleep, and how sleep evolved is still something of a mystery. This research investigated how neurotransmitters and pharmaceuticals commonly seen in mammalian sleep and wake, play a role in the sleep of free-living flatworms.

Methods
Using behavioural methods, I observed the behaviour of flatworms under a 12:12 LD lighting condition. Using seven neurotransmitters and one pharmaceutical, I used a novel “yolk and soak” method – feeding the animals the neurotransmitter via hard-boiled egg yolk, as well as bathing them in the same concentration of neurotransmitter, to modulate their behaviour to either induce sleep, or wakefulness.

Results
We found that GABA, dopamine and histamine appear to be evolutionarily conserved. By dosing the flatworms with these neurotransmitters, we saw that the behaviour changed toward sleep (GABA) or wakefulness (dopamine and histamine) as it does in more recently evolved mammals. We also saw that the H1 antagonist Pyrilamine induced sleep, as it does in other animals.

Discussion
Understanding how neurotransmitters involved in sleep and wake in humans, and other mammals, may work in animals that are neurologically simple, and older in evolution can lead to many opportunities. We now know that GABA, dopamine and histamine promote sleep and wake in animals that have lost most of their complex systems through secondary simplification, suggesting that these neurotransmitters might be key to the origin of sleep, and may help to understand sleep disorders in humans.
P058 Dissecting Sleep Restriction: Defining and Empirically testing a two-stage Build-Maintain model of Sleep Restriction Therapy for Insomnia
Authors: Drummond S , Bei B 
Published: October 2023

Abstract

Introduction
Sleep Restriction Therapy (SRT) is one of the core components of CBT for Insomnia (CBT-I). However, there is little empirical evidence regarding how SRT implementation evolves over the course of therapy. Here, we propose a conceptual model for defining stages of SRT and assess the applicability of the model in a recently completed clinical trial.

Methods
Our proposed two-stage Build-Maintain model of SRT is: 1) The Build stage starts with SRT implementation. The primary goal is building homeostatic pressure until average weekly sleep efficiency (SE) is high enough to increase time-in-bed (e.g., 85% or 90%). 2) The Maintain stage starts with the first increase of time-in-bed after the target SE is reached. The goal is to maintain sleep pressure sufficiently high that one can maintain SE in the desired range.
We assessed the model in 83 adults (age=48.3±14.8 years; 50F) undergoing CBT-I in a RCT. SRT was introduced in week 2. We explored the extent to which age, sex, psychiatric comorbidities, use of hypnotics, and baseline insomnia severity predicted progression through the SRT stages.

Results
Participants were in the Build stage 2.1±1.3 weeks (41.8% were in Build for only one week; 84% for ≤3 weeks). Higher baseline ISI (r=.238,p=.036) and lower baseline SE (r=-.365,p=.001) predicted spending more weeks in the Build stage before transitioning to the Maintain stage.

Discussion
The two-stage Build-Maintain model of SRT may inform: a) setting empirically-based expectations for client progress; b) examining adherence to CBT-I; c) evaluating shortened versions of CBT-I.
P067 Patient perceived sleep quality at CPAP titration study as an early indication of short and long-term adherence to CPAP therapy.
Authors: Riddles T , Hollamby M , Henderson D , Curtin D , Szollosi I 
Published: October 2023

Abstract

Background
Untreated obstructive sleep apnoea is associated with morbidity and diminished quality of life. Despite this, adherence to continuous positive airway pressure (CPAP) remains poor. Few studies have examined which factors from CPAP titration study affect adherence, with a paucity that evaluated perceived sleep quality and adherence.

Methods
We hypothesise that patients with better perceived sleep quality, at the time of their CPAP titration study will have greater uptake and adherence to CPAP. We aim to:
1. Compare the change in patients’ perceived sleep quality between diagnostic and CPAP titration studies, and future CPAP adherence at 3 and 12 months.
2. Evaluate the association between patients’ perceived sleep quality at the time of their CPAP titration study with future CPAP adherence at 3 and 12 months.
3. Evaluate factors relating to sleep architecture, and sleep disturbance that affect patients’ perceived sleep quality.
Sleep studies were obtained prospectively between 2018 and 2019. Patients completed two questionnaires grading sleep quality post study.

Progress to Date
This study was approved as a quality activity through the Metro North Quality and Safety Unit (ID 3929). Sleep study and questionnaire data were collated and merged with adherence data. Analysis will begin shortly.

Intended Outcome and Impact
We intend to publish the results of this study in an international sleep journal. Positive findings may improve management of those at risk of poor adherence. Subsequent studies may evaluate the effect of early patient follow up or early motivational interviewing on uptake and adherence to CPAP.
P081 Experiences of men who have had bariatric surgery in New Zealand
Authors: Besley E 
Published: October 2023

Abstract

Introduction
Bariatric or weight loss surgery is currently the most effective method of long-term weight loss, and as obesity is a major risk factor for obstructive sleep apnoea, a potential treatment option. Approximately 80% of people who have bariatric surgery are women, however there is limited research regarding men, and none from New Zealand. This project aimed to investigate the experiences of men who have had bariatric surgery in New Zealand.

Methods
This study took a constructivist qualitative approach, collecting data using semi-structured interviews with six men who had bariatric surgery in New Zealand. Interviews were conducted in person and over Zoom. Interviews were transcribed, then thematic analysis used to develop themes.

Results
Participants were aged between 31 and 63 when they had surgery, with half having surgery in the public, and half in the private sector. Five identified as New Zealand European/Pākehā, and one as Māori. The main themes developed from the data were: attaining control of their weight, and surgery as life changing. A significant sub-theme was support, with that of health care professionals vital.

Discussion
Participants had regular interactions with health care professionals due to multiple comorbidities, including sleep apnoea, however, the topic of surgery was rarely broached. All the men were satisfied with their decision to have surgery, with an improved quality of life and most comorbidities resolved. With a high number of sleep apnoea patients also morbidly obese, sleep professionals are well placed to encourage or to refer their morbidly obese patients for bariatric surgery.
P086 Measurement of Environmental Factors affecting Sleep within Rehabilitation Wards, Sub-acute Care Wards, and Aged Care Facilities: A Scoping Review
Authors: Dunstan O , Shafiee Hanjani L , Young A , Ellender C , Hoang T , Hubbard R 
Published: October 2023

Abstract

Introduction
Unfamiliar environments are often poorly conducive to adequate sleep, especially for patients within different care settings, where proper sleep is vital for recovery and overall health. This scoping review thus aims to synthesise the evidence around which aspects of the sleep environment are measured within rehabilitation, sub-acute and aged care settings, how they are being measured, and to identify if there are any ‘gold standards’ against which the environmental factor measurements are compared.

Method
A search was conducted from inception to May 2023 within PubMed, EMBASE, Cochrane Library, Cumulated Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, and Web of Science. Eligibility criteria included full length original studies of any design reporting on the measurement properties of environmental factors affecting sleep of adult patients admitted to rehabilitation/sub-acute wards and aged care facilities.

Results
This scoping review identified 2185 studies after duplicate removal, of which 82 studies have been admitted for data extraction following review from two authors. Data will be sought for the following variables: publication year, country, study aim, study design, care setting, population characteristics, environmental factors studied, unit of measurement, specific measure, measurement method, gold standard comparators (if any).

Discussion
It is anticipated that this review will be completed by August 2023 and will identify the most common methods used to measure environmental factors affecting sleep outcomes within the literature. This study will thereby inform and aid researchers and clinicians with developing future environmental interventions and measuring their impact within rehabilitation, subacute and aged care settings.
P088 The Relationship between Screen time, Sleep, and Language Development in Pre-school Aged Children
Authors: Gale M , Axelsson E , Eidels A , Robson A , Mace J 
Published: October 2023

Abstract
An increasingly prevalent factor in the preschool years is screen time, with possible implications for sleep and development. Few studies have simultaneously assessed screen time, sleep, and development. I aim to investigate preschoolers’ screen time, sleep, and language development, alongside predictors of screen time, social behaviours, and how sleep supports long-term memory for new words.
Screen time durations for educational, entertaining, and relaxing content types, will be recorded over three days. This is to assess whether content types have differing relationships with sleep. If sleep quality and duration are impeded, this may create a cyclical pattern between sedentary behaviour, sleep, and screen time. I will also measure screen times at differing times of the day, and the percentage of time spent interacting with another person or the screen content. Children will be exposed to new words at the beginning of the study and their memory will be tested after three nights. Importantly, assessing the interaction between screen time and sleep, in relation to children’s memory for the new words. Sleep will be measured using actigraphy watches and a sleep diary. Standardised measures of vocabulary and communication will be used to assess children’s language development.
As language development is a multifaceted process, assessing predictors, social behaviours, and memory for new words, allows assessment of factors that may benefit or hinder sleep and language development. This comprehensive study will contribute to the understanding of the relationships between screen time, sleep, and language development, and the nuanced factors that relate to its success.
P098 Risk stratification tool for gastrostomy insertion in Motor Neurone Disease
Authors: Parker J , Banks J , Lau H 
Published: October 2023

Abstract

Introduction
An FVC&lt;50% has traditionally been used to quantify the risk of respiratory compromise in patients with motor neurone disease(MND) undergoing gastrostomy insertion. More recently, a Risk Stratifying Tool(RST) has been developed to better identify those patients who might be at higher risk for the procedure. We set out to evaluate whether there were any differences in the outcomes of high-risk MND patients undergoing gastrostomy insertion as determined by the FVC or RST.

Methods
A retrospective review of MND patients undergoing gastrostomy insertion was performed between June 2018 and June 2023. Data was collected on demographics, RST variables (orthopnoea, elevated serum bicarbonate or pCO2, or use of NIV), complications, and mortality.

Results
42 patients were referred for gastrostomy insertion, only 1 procedure was unsuccessful due to anatomical difficulties. 17 patients (n=8 PEG,n=9 RIG) were classified as high-risk based on FVC&lt;50%, while 30 patients (n=17 PEG,n=13 RIG) were classified as high-risk using the RST. No direct procedure-related complications were recorded in either group. Length of stay(3 vs 3.04 days), 30-day morbidity(23.5% vs 30%), 30-day mortality(0% vs 0%), 6-month mortality(23.5% vs 20%), and median survival(271 days vs 309 day) were comparable between the FVC and RST groups respectively. The RST was more sensitive at identifying patient mortality at 6 months (4/6 vs 6/6 patients).

Conclusion
Gastrostomy insertion was safe in this cohort of high-risk MND patients, independent of the tool used. Similar morbidity, mortality and length of stay were observed between the two groups. RST was more sensitive for identifying 6-month mortality.
P111 Validity and Reliability of Sleep Questionnaires in Adults: A Systematic Review
Authors: Way J , Cistulli P , Bin Y 
Published: October 2023

Abstract

Introduction
Sleep plays an important role in maintaining overall health and well-being. It has been well-established that poor sleep is linked to several negative health consequences. Therefore, the use of appropriate sleep measures in national surveillance systems is essential to understand the impact that poor sleep has on population health. The aim of this systematic review is to evaluate the validity and reliability of self-reported sleep questionnaires.

Method
Electronic database searches were performed on PubMed, EMBASE, and PsycINFO, focusing on studies of adults aged 18 and above that validated sleep questionnaires against objective sleep measurements or compared them with other subjective sleep instruments. Search terms were grouped into three categories: sleep health, assessment instrument type, and psychometric properties.

Progress to Date
A total of 5,071 abstracts across the three electronic databases were retrieved from the general search and screening is currently being undertaken. Relevant studies meeting the inclusion criteria will be analysed, and data will be extracted using a predefined form, which includes study characteristics, sleep measures, validated objective and/or subjective instruments, and psychometric properties.

Intended Outcome and Impact
The systematic review is expected to provide a summary of the psychometric properties of sleep questionnaires that have potential use in population health surveys as part of routine health monitoring. The findings will contribute to the identification of any gaps in the current sleep questionnaires to help enable more comprehensive monitoring and understanding of population sleep habits and associated health outcomes.
Can virtual reality enhance the patient experience during awake invasive procedures? A systematic review of randomized controlled trials
Authors: Boyce Louis , Jordan Chloe , Egan Timothy , Sivaprakasam Rajesh 
Published: October 2023

Abstract
Procedural anxiety and pain negatively affect surgical outcomes and the patient experience during awake, invasive procedures (AIPs). This systematic review aims to evaluate the effect of using virtual reality (VR) to enhance the intraprocedural patient experience during AIPs. PRISMA, Cochrane, and SWiM Reporting Items guidelines were followed. PubMed, EMBASE, CENTRAL, and medRxiv databases were systematically searched for randomised controlled trials (RCTs) investigating the use of immersive VR headsets to enhance the patient experience in adults undergoing AIPs. Sixteen studies were included. The VR and control groups comprised 685 and 677 patients, respectively. Patients underwent endoscopic procedures in 9 studies (“endoscopic”) and interventions that involved a skin incision in 7 studies (“incision”). Eleven (of 13) studies demonstrated a favourable effect on procedural anxiety with VR use compared with standard intraprocedural care (85% [95% CI: 46%-100%], P = 0.011). Ten (of 13) studies demonstrated a favourable effect on pain with VR use (77% [95% CI: 38%-100%], P = 0.046). Seven (of 9) studies demonstrated a favourable VR effect on patient satisfaction (78% (95% CI: 44%-100%), P = 0.070). The effect of VR on physiological markers of anxiety and pain and requirements for additional pro re nata (PRN) analgesia and sedation were not clear. No significant differences in patient experience were identified between the “incision” and “endoscopic” subgroups. This review demonstrates that VR can feasibly be used to enhance the patient experience during AIPs by attenuating subjective perceptions of procedural anxiety and pain. However, further RCTs are required to elucidate the effect of VR on more objective measures of the patient experience.