bluuebunny/crossref_metadata_2025_split huggingface dataset:
O023 Quality of Life in Central Disorders of Hypersomnolence
Authors: Kinder S , Winter S , Duce B , Ellender C 
Published: October 2023

Abstract

Background
Whilst sleep disorders are common, with up to 5.8% of Australian adults experiencing excessive daytime somnolence due to a sleep disorder, there is a relative paucity of quality-of-life data in those with central disorders of hypersomnolence. The available evidence suggests a significant impact attributable to these disorders, though it is also noted that much of this data was obtained through patient associations as opposed to sleep medicine clinics with potentially more security of diagnosis.

Methods
A retrospective, single-centre review will be undertaken of patients seen as new cases in the sleep clinic between January 2013 and December 2022 with a diagnosis of a central disorder of hypersomnolence. Quality of life at baseline will be assessed using metrics collected as standard-of-care, including the Epworth Sleepiness Scale, Short-Form 36, FOSQ, and PSQI. Demographics, comorbidity, baseline pharmacotherapy will also be analysed.

Progress to date
Planning in conjunction with co-investigators and key stakeholders has been undertaken, and a complete protocol has been drafted and submitted for ethics committee approval. Data collection is anticipated to commence and be complete by end of July 2023.

Intended outcome and impact
It is hypothesised that baseline quality of life in these patients will be poorer than in the general population. This study will improve upon the volume and quality of existing data, and serve to assist in planning for a potential subsequent investigation into the impact of cognitive behavioural therapy for hypersomnia.
O027 Patterns of nocturnal swallow frequency and related tachycardia with sleep stages and obstructive sleep apnoea severity
Authors: Lin A , Bull C , Burke P , Lewis C , Bilston L 
Published: October 2023

Abstract

Background
Swallowing is a complex activity associated with cortical arousal and tachycardia in sleep(1). Obstructive sleep apnoea (OSA) has been associated with dysfunction and altered biomechanics of swallow (2-3). This study seeks to investigate patterns of swallow frequency and associated tachycardia in relation to OSA severity.

Methods
Anthropometric and polysomnographic data for 70 subjects were analysed. Swallow index (SI; swallows per hour) and average heart rate changes from 30 seconds pre- to 10 seconds post-swallow were derived from epiglottic pressure and electrocardiogram signals respectively. This study had approval from the local district ethics committee.

Progress to date
Analysis has been completed for 34 subjects (median age 47.5, range 24-64; 24 males), most with at least moderate OSA (n=20/26). Mean SI was 3.2 in subjects without OSA (n=2), 8 in mild OSA (n=4), 5.8 in moderate OSA (n=10) and 9 in severe OSA (n=10). Mean swallow-related tachycardia was 24.3bpm in subjects without OSA, compared to 14.0bpm in those with severe OSA. Mean swallow-related tachycardia increased with progressive sleep stages (14.8bpm in wakefulness; 16.8bpm Stage 1; 16.8bpm Stage 2; 19.0bpm Stage 3; 19.4bpm in REM). A negative correlation was observed between sleep SI and magnitude of associated tachycardia (Pearson correlation r=-0.387, p=0.026).

Intended outcome and impact
Our results support existing observations that swallow-associated tachycardia is reliably conserved in sleep, and suggest possible new relationships between swallow frequency and associated tachycardia with OSA severity and sleep stage. We intend with further dataset analyses to explore relationships between sleep swallow physiology and OSA pathophysiology.
O029 Clinical features and outcomes of patients referred to a Respiratory Failure service
Authors: Moore E , Howard L , Wheatley J , Falland K , Chien J , Wu P , Kairaitis K 
Published: October 2023

Abstract
Non-invasive ventilation (NIV) improves quality of life and mortality in patients with hypercapnic respiratory failure. We reviewed the last decade of long-term home NIV provision in a single centre via an observational retrospective study.
Data were prospectively collected in a database. Anthropometric and demographic data were expressed as mean±SD. Indications for chronic home NIV were categorised into: neuromuscular diseases (NMD) [including motor neuron disease (MND)]; obstructive sleep apnoea/obesity hypoventilation (OSA/OHS); pulmonary disease; and others. Linear regression analysis was performed for the annual incidence by indication, and multivariate Cox regression performed compares MND mortality with other causes.
541 new patients (Age 60.8 ±17.1 years; 273 Female; BMI 33.4±13.9 kg/m2 (n=380)) were commenced on NIV between 2012-2022. Patient numbers increased by 2.3 (0.4-4.1) per year (slope, (95% confidence intervals); p&lt;0.02). Indications for treatment included: 52% NMD (29% MND); 19% OSA/OHS; 19% pulmonary disease; and 10 % other causes. Average referral age, BMI and gender composition were stable over the time period. There was an increase in patients with pulmonary disease commenced on NIV of 0.6 (0.7-3.5)% per year (p&lt;0.008), other indications for treatment were unchanged. 31.4% patients died (16.8% MND). Multivariate Cox regression analysis showed that a diagnosis of MND was associated with an increased likelihood of death (HR 11.42, p&lt;0.0001).
In the last decade, there’s been a gradual increase in patient numbers treated with chronic home NIV, with an increasing percentage of patients with pulmonary disease commenced on treatment. Mortality in MND patients on NIV is higher compared with other indications.
O032 It's OK to Lose your Head!
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 looks at a novel attribute of flatworms – the ability to regenerate whole body structure, and how neural regeneration may impact sleep.

Methods
Using behavioural methods, I observed the behaviour of flatworms under a 12:12 LD lighting condition. Once the baseline was established, I used a small razor to cut the head off each individual. Recordings took place every two weeks, for baseline, post-decapitation, and then at full regeneration.

Results
Animals that were re-growing their brains moved a lot less than their original intact data showed, a small circadian rhythm was still present. Once the animal had regained its eyespots, and thus regenerated, this rhythm was more prominent and on its way to returning to intact levels. Animals that were re-growing their bodies also showed a persistent circadian rhythm in their activity throughout the regeneration process.

Discussion
This research is very exciting for several reasons. It shows that flatworms themselves rely on more than just their brain and eyespots to sense the light and environment around them. It also suggests that circadian rhythms are deeply engrained and that behaviours that arise from this, such as locomotion can still be influenced even without the presence of a brain – the neurons in the ventral nerve cords, and other body systems may be equally as important.
O037 Diagnostic Accuracy of OSA Screening Tools for Acute Coronary Syndrome
Authors: Tong B , Dissanayake H , Patel S , Skilton M , McClintock S , Sutherland K , Ucak S , Yee B , Sarkissian N , Cistulli P 
Published: October 2023

Abstract
Obstructive sleep apnoea(OSA) is associated with cardiovascular diseases including acute coronary syndrome(ACS). Current estimates suggest some 70% of patients with ACS have OSA. OSA in this population remains under-recognised. This high prevalence calls for effective OSA screening tools for this high-risk population. We aimed to assess the diagnostic accuracy of the Epworth Sleepiness Scale (ESS), Berlin and STOP-BANG questionnaire in screening for OSA in patients with ACS.
70 patients with ACS (age IQR: 58[52,63] years, BMI: 27[24,30]kg/m2) were recruited from the cardiology department following an admission for ACS. Patients were administered with the ESS, Berlin and STOP-BANG questionnaires within 6 months of ACS admission. A level 2 polysomnogram was conducted to confirm the presence and severity of OSA (AHI≥5). The diagnostic accuracy of ESS&gt;10, Berlin questionnaire (high-risk category), STOP-BANG score ≥3 (intermediate-high risk) and STOP-BANG score ≥5 (high-risk) was compared to a level 2 polysomnogram for different OSA severity.
OSA (AHI≥5 events/h) was diagnosed in 94% of patients with ACS. 67% of patients had moderate-severe OSA (AHI≥15 events/h). ESS, Berlin and STOP-BANG questionnaires have poor diagnostic accuracy across all severity of OSA (ESS&gt;10, AUC:0.60 (95%CI: 0.42-0.79); Berlin, high risk, AUC:0.54 (95%CI: 0.39-0.68); STOP-BANG ≥3, AUC:0.69 (95%CI: 0.56-0.82); STOP-BANG ≥5, AUC: 0.66 (95%CI: 0.53-0.79)).
This study confirms a very high prevalence of OSA in patients with ACS. The Berlin and STOP-BANG questionnaires alone are inadequate to identify OSA in this high-risk cohort. Simplified objective measures to screen for OSA may be better suited for this patient population.
O042 Healthy lifestyle is Associated with Reduced Cardiovascular Disease, Depression and Mortality in People at Elevated risk of Sleep Apnea
Authors: Melaku Y , Appleton S , Reynolds A , Milne R , Lynch B , Eckert D , Adams R 
Published: October 2023

Abstract

Background
We evaluated 1) the independent and combined influence of obstructive sleep apnea (OSA) risk and a healthy lifestyle on typical OSA outcomes [excessive daytime sleepiness (EDS), depression, cardiovascular disease (CVD), and stroke]; and 2) the impact of a healthy lifestyle on survival in individuals presenting a heightened risk of OSA.

Method
We utilized data from 13,694 adults (median age 46 years; 50% men) for both cross-sectional and longitudinal analyses (15 years). A healthy lifestyle score ranging from 0 (most unhealthy) to 5 (most healthy) was computed based on diet, alcohol consumption, physical activity levels, smoking habits, and body mass index.

Results
A dose-response relationship was found between OSA risk and all examined chronic conditions and EDS (p for trend &lt; 0.001). A healthy lifestyle was found to be inversely related to all chronic conditions (p for trend &lt; 0.001), except EDS (p for trend = 0.379). A higher healthy lifestyle score correlated with lower odds of depression and CVD. An inverse relationship was found between healthy lifestyle score and depression (P for trend &lt; 0.001), CVD (P for trend = 0.003), and stroke (P for trend = 0.025) in those with high OSA risk. An inverse relationship was observed between a healthy lifestyle and all-cause mortality in general, and in the moderate/high and high OSA risk groups (p for trend &lt; 0.001).

Discussion
This study highlights the role of a healthy lifestyle in reducing chronic conditions and in enhancing survival rates in individuals with a heightened risk of OSA.
O057 The Impact of Surgical Weight Loss on the Physiological Endotypes causing Obstructive Sleep Apnea
Authors: Beatty C , Wong A , Landry S , Thomson L , Collet J , Joosten S , Playfair J , Brown W , Kee K , Naughton M , Sutherland K , Cistulli P , Patel S , Hamilton G , Edwards B 
Published: October 2023

Abstract

Background
Weight loss improves upper airway collapsibility in people with obstructive sleep apnoea (OSA). However, it’s unclear how weight loss affects the other endotypes responsible for OSA (loop gain, arousal threshold and muscle compensation). We investigated the effect surgical weight loss has on the OSA endotypes and whether the baseline endotypes predict response to surgery.

Methods
Endotypes were measured using non-invasive methods in 43 OSA patients who had a clinical polysomnogram before and after (~6-18 months) receiving weight loss surgery. Linear regression was used to assess whether the baseline endotypes predicted improvement in OSA severity defined by the apnoea-hypopnoea index (AHI).

Results
Weight loss surgery was associated with significant improvements in AHI (43.4[28.6-64.8]events/hr vs. 16.9[11.6-33.3]events/hr, p&lt;0.001), body mass index (42.1 ±5.5kg/m2 vs. 32.8 ±4.5kg/m2, p&lt;0.001), upper airway collapsibility (73.8[65.2-78.5]%eupnea vs. 77.1[71.7-81.3]%eupnea, p=0.034) and loop gain (0.62[0.53-0.71] vs. 0.54[0.44-0.72], p=0.012). Weight loss surgery was also associated with a reduced arousal threshold (144.5[130.1-160.5] vs.136.9[121.9-156.4], p=0.007). A greater reduction in OSA severity was associated with greater improvements in upper airway collapsibility (p=0.001, r2 =0.23) and reductions in the arousal threshold (p&lt;0.001, r2=0.27). Poor upper airway collapsibility at baseline was weakly predictive of a greater improvement in OSA severity (p=0.018, r2 =0.13). No other endotype was predictive of OSA improvement.

Discussion
Weight loss surgery is associated with improvements in weight, OSA severity, upper airway collapsibility and loop gain. There was a paradoxical worsening of arousal threshold. Furthermore, weight loss surgery may be particularly effective in improving OSA in those with poor upper airway collapsibility.
O065 Autonomic Dysregulation During Sleep in Parkinsonian Spectrum Disorders
Authors: Levendowski D , Cho Y , Walsh C , Tsuang D , Lee-Iannotti J , Berka C , Mazieka G , Boeve B , Neylan T , St. Louis E 
Published: October 2023

Abstract

Introduction
Symptoms associated with autonomic nervous system dysfunction are common to patients with neurodegenerative disorders (NDD) resulting from the accumulation of α-synuclein in the neurons and glial cells. In this study we investigate whether a novel biomarker, the autonomic activation index, can discriminate these potentially affected NDD groups.

Methods
After ethics review and with informed consent, patients with Lewy body disease (DLB/PDD: n=20%), Alzheimer’s disease dementia (AD: n=27), Parkinson disease (PD: n=14), mild cognitive impairment (MCI: n=37), isolated REM sleep behavior disorder (iRBD: n=15) and a control group (CG: n=58) were studied with the Sleep Profiler. AAI was based on a 6 BPM increase in pulse rate compared to the previous/subsequent 10th second. Between-group comparisons were assessed with Mann-Whitney U and Chi-square tests.

Results
The AAI values for the DLB/PDD patients were decreased compared to the AD, MCI (both p&lt;0.03), and CG (p&lt;0.0005), while the PD was less than AD and MCI (both &lt; 0.05) and CG (p&lt;0.002). The proportions of cases with abnormal AAI values (&lt;10 events/h) was greatest in DLB/PDD patients, and greater than in ADem (p&lt;0.02), MCI (p&lt;0.02) and CG (p&lt;0.0001), while AAI in PD and iRBD was greater than in CG (p&lt;0.007 and 0.05 respectively).

Conclusions
These findings suggest that the AAI can be used to objectively confirm subjective complaints of autonomic dysfunction symptoms in patients with synucleinopathies. Longitudinal studies are needed determine factors that influence changes in the AAI.
O075 Improving Sleep Health in Paramedics through an App-based Intervention: A Randomised Waitlist Control Trial
Authors: Shriane A , Vincent G , Ferguson S , Rebar A , Kolbe-Alexander T , Rigney G 
Published: October 2023

Abstract

Introduction
Paramedics engaging in shiftwork arrangements face unique challenges that impact their sleep health, potentially compromising performance and wellbeing. This study investigated whether tailored sleep health advice delivered through the Sleepfit mobile application improved sleep health in paramedics.

Methods
We conducted a two-group randomised waitlist-controlled trial. Fifty-eight paramedics were randomised to the intervention group (n = 29) or the waitlist group (n = 29). Intervention group participants trialled Sleepfit for 14 days, during which waitlist control participants continued as usual, before being provided with Sleepfit for 14 days. During the 14-day intervention period, Sleepfit provided tailored sleep health education for shift workers, relaxation exercises, and a sleep diary to track sleep quantity and quality. Measures of sleep health (e.g., ISI, FSS, ESS, SHI) were completed at baseline, 14 days following, and 3-month follow-up. Multiple linear regression models were conducted to test the impact of the intervention on sleep health outcomes.

Results
Participants reported an average two-point reduction in both ISI (p = 0.01) and SHI (p = 0.01) scores, as well as a significant improvement in sleep satisfaction (p = 0.01) at post-intervention measurement. All other measures remained unchanged. This may be due to limited intervention impact, insufficient participant numbers, a short intervention period, or a ceiling effect.

Conclusion
This study provides preliminary evidence supporting the use of Sleepfit as an intervention in improving measures of sleep health in some shiftworkers. Further investigations, including objective assessments of sleep, are needed to validate these self-report measures in larger cohorts of shiftworkers.
O079 Investigating Hypersomnolence Disorders in South Australia: A Retrospective Audit of Multiple Sleep Latency tests
Authors: O'Reilly M , Mukherjee S , Chai Coetzer C , Mercer J , Ullah S , Naik G , Catcheside P , Walker A 
Published: October 2023

Abstract

Introduction
This study aims to evaluate the characteristics of patients with Narcolepsy Type 1 (NT1), Narcolepsy Type 2 (NT2), and Idiopathic Hypersomnolence (IH) along with diagnostic outcomes in patients referred for a multiple sleep latency test (MSLT) at an Australian hospital.

Methods
A retrospective audit was performed of all patients who completed an MSLT between January 2018 to January 2023.

Results
431 participants (62.4% female; mean±SD age 40.2±16.4 years; BMI 28.6±7.4 kg/m²) who completed MSLTs were included. 95 participants (22%) had a positive MSLT of ≤ 8 minutes, of which 87% (n=83) had a prior night total sleep time on polysomnography of &gt; 6 hours. Gender, age, and BMI did not vary significantly between participants with a mean sleep latency (MSL) ≤ 8 versus &gt;8 minutes (p=0.9, p&gt;0.9, p=0.1 0, respectively). Participants with an MSL ≤ 8 minutes had higher Epworth Sleepiness Scale scores 14.6 ± 5.1 vs 12.5 ± 5.0 (p &lt; 0.001), with more sleep onset REM periods (SOMREPs) 0.82 ± 1.35 vs 0.14 ± 0.49 compared to those with MSL &gt;8 minutes. Further data collection is in progress, but to date, diagnoses were available for 34 participants with MSL ≤ 8 minutes (6 NT1, 8 NT2, 8 IH, 12 Other [i.e., shiftwork disorder, sleep restriction, medication-induced]).

Discussion
This study seeks to estimate diagnostic frequency and characteristics of patients presenting for evaluation of hypersomnolence. The prevalence of MSL &lt; 8 minutes (22.0%) is consistent with prior studies1,2. Analysis of diagnostic outcomes is pending further data collection in progress.
O080 The Associations Between Sleep Environment Factors and Sleep Health in Individuals Living with Neurological Conditions
Authors: Cruickshank T , Turner M , Laws M , Beranek P , Griffiths M 
Published: October 2023

Abstract

Introduction
Accumulating evidence indicates that sleep health is worse in individuals living with a neurological condition and may hasten neurodegeneration. The extent to which the sleeping environment, particularly air temperature and light, influence sleep health has not been investigated in individuals living with a neurological condition. This research aimed to explore, for the first time, associations between air temperature and light in the sleeping environment and sleep health in individuals living with a neurological condition.

Methods
The sleep health, including the domains of sleep quality, duration, and disorders, of 46 individuals with a neurological condition was measured using the Sleep Health Index. Air temperature and light data were captured across seven days using a light/temperature data logger positioned next to the participant's bed. Data recorded during the participants' sleeping periods (determined using a sleep diary) were analysed. Linear regression models were used to assess the associations between air temperature and light and sleep health (including domains).

Results
This study showed that for every additional minute of low (10 to 50 lux) light exposure during sleep periods, sleep quality decreased by 9%.

Discussion
Our findings suggest that low light exposure during sleep periods may be detrimental to the sleep quality of individuals with neurological conditions.
O001 Remote Monitoring Paediatric Non-invasive Ventilation Adherence: Utilising Airview to Support Paediatric Patients and Clinicians
Authors: Angliss M , Leclerc M , Hartnett C 
Published: October 2023

Abstract

Aim
To determine if starting a remote non-invasive ventilation service improves adherence and process efficiency.

Method
Three time points were considered for comparison of the service for patients on NIV initiation:- pre-covid-19 (N-9,2019), during covid-19 (N=9,2021) and post-Airview implementation (N=7,2023). A comparison of the time from NIV initiation to first download, download adherence, percentage of patients from rural/remote areas, number and type of download. Anova test was used for statistical significance.

Results
Pre and post covid had longer time to download with mean 53 (std 49) and 63 days (std 51), respectively, compared to Airview downloads 21.5 days (std 8), though not significant. 44% of the pre-covid group had mean adherence &gt;= 6hours by first download, 12.5% in covid group and 50% in Airview group. The percentage of the group in rural/remote were 40% (pre-covid), 55.5% (covid) and 50% (Airview). None of the pre-covid or Airview group sent data by post, only 55% of the covid group. For non-adherent patients within the first three months of use, the Airview group had median 2.5 downloads post first download, with the other groups only achieving median of one.

Discussion
The covid group of patients had the lowest adherence, possibly due to telehealth and lack of download data as the mean time to download was the longest. Implementing a remote NIV download service with Airview showed significant improvements in availability of adherence data earlier and identify patients with low adherence. Supporting patients with low adherence remains a priority for patients and clinicians.