bluuebunny/crossref_metadata_2025_split huggingface dataset:
P016 Effects of Aerobic Exercise versus Inspiratory Muscle training on Apnea-Hypopnea Index in patients with Obstructive Sleep Apnea
Authors: Ittinirundorn S , Chirakalwasan N , Kline C , Tongtako W 
Published: October 2023

Abstract

Introduction
There is some evidence indicating that exercise, such as aerobic training (AT) and inspiratory muscle training (IMT), improves Obstructive Sleep Apnea (OSA) symptoms. Nonetheless, no study compares the types of exercise in OSA patients.

Objective
To compare the effects of type of exercise on Apnea-Hypopnea Index (AHI) and respiratory muscle strength in OSA patients

Methods
Twenty-nine non-obese OSA patients aged 20-50 years with mild to moderate severity (Apnea-hypopnea index 5-30 events/hour) were randomized to the AT group (n=9), the IMT group (n=10) or the control (CON) group (n=10). Participants in the AT group received 60 minutes per day, 3 times per week, for 12 weeks. For the IMT group, participants received the Powerbreathe ® device for practicing 8 cycles of 30 breaths per day, 5 times per week, for 12 weeks. Participants in the CON group did not receive any intervention. Their AHI and respiratory muscle strength were analyzed during the pre- and post-tests. Dependent variables were compared between pre- and post-tests via paired t-test, and independent variables were compared between the groups using one-way analysis of variance (ANOVA). Differences were considered significant at p&lt;0.05.

Results
AHI, maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP) changed significantly in the AT group and IMT group after 12 weeks of training. Therefore, AHI, MIP, and MEP in the AT group and the IMT group improved significantly compared to the CON group.

Conclusions
Aerobic training and inspiratory muscle training improve the apnea-hypopnea index and respiratory muscle strength in OSA patients.
P027 Insights from a 10-year Australasian consumer data registry study.
Authors: Anderson J , Yee B , Sivam S , Grunstein R , Cayanan E , Matar E , Chadwick M , Saini B , Chapman J , Tai J 
Published: October 2023

Abstract

Introduction
Idiopathic hypersomnia (IH) is a disorder of central hypersomnolence that results in excessive daytime sleepiness in the absence of another identifying cause. Case studies from sleep clinic patients have guided current knowledge but may not be a fair representation of the wider population of IH diagnoses. This study aims to better characterize patients diagnosed with IH in Australasia using online survey data.

Methods
A retrospective analysis of 686 participants from the Hypersomnolence Australia Consumer Data Registry sleep physician diagnosed with either IH (n = 554) or narcolepsy (NC) (n = 132) between January 2013 and January 2023 was performed.

Results
IH participants (98.9% had MSLT) reported additional sleep disorders such as OSA (16.4%) and restless leg syndrome (7.9%) and notable comorbidities included depression (46.2%) and anxiety (50%). Forty-two percent of IH participants were diagnosed after turning 33 years of age (compared to NC participants, 31.8%). The IH group reported more unrefreshing sleep, sleep drunkenness and the NC group reported more excessive sleepiness, hallucinations, sleep paralysis and automatic behaviour (all p values &lt; 0.001). The most frequently used medication in both groups was dexamphetamine (IH = 44.2%, NC = 47.7%) but participants from the IH group were prescribed more modafinil and less armodafinil and sodium oxybate (p values &lt; 0.001) than patients with NC. Further analyses are in preparation.

Discussion
This study demonstrates the value of consumer registries to better characterize symptomatology and co-morbidities in IH and NC and further research in these conditions.
P028 Treating Sleep Disturbances in Refugees – Preliminary Results from a randomized controlled pilot trial on the group therapy program Sleep Training Adapted for Refugees (STARS)
Authors: Dumser B , Ehring T , Koch T 
Published: October 2023

Abstract
Sleep disturbances are both highly prevalent and often persistent even after otherwise successful treatment in traumatized refugees. The need for scalable, adaptable, and easily disseminated interventions has been highlighted. Existing evidence-based treatments do not sufficiently account for the special needs of refugees and asylum seekers. The group therapy program STARS expands and complements evidence-based treatment approaches (e.g., CBT-I, IRT) with a culturally and context-sensitive approach.
The aim of this study was to examine the feasibility, acceptability, and effectiveness of the intervention.
A randomized-controlled study using a parallel group design (STARS vs. waitlist) with 47 young male Afghan refugees was conducted in a routine clinical setting (DRKS-ID: DRKS00024419) comparing pre- to post and a 3-month follow-up assessment. Insomnia symptoms (ISI) were defined as the primary outcome. Secondary outcomes included PCL-5, HSCL-25, NDI, FOSI-SF and EUROHIS-QOL. Acceptability was measured via client satisfaction and treatment adherence. The data are analyzed using mixed models.
Preliminary results indicate that dropout (18%) was comparable to other interventions with refugees. Participants who completed the intervention attended M = 7.93 out of 10 sessions (SD = 1.88). Results on the effectiveness are still pending.
STARS seems to be a feasible intervention for sleep disturbances in traumatized refugees in a routine clinical setting. Depending on its effectiveness it might be a promising intervention to enhance scalable treatment both as a low-threshold primary care intervention as well as a potential add-on to PTSD-focused treatment. To draw final conclusions replication in large-scale studies with active control groups will be necessary.
P033 Assessment of Upper Airway Dilator Muscle Function and Collapsibility in People with Multiple Sclerosis with Versus without Sleep Apnea
Authors: Thomas E , Osman A , Calonzo L , Hall L , Agzarian M , Slee M 
Published: October 2023

Abstract

Introduction
Upper airway reflex responses to negative pressure are important to prevent upper airway narrowing and closure. Recent evidence indicates ~30% of people with multiple sclerosis (MS) have an impaired upper airway dilator reflex response. Thus, the aims of this study were to compare genioglossus muscle reflex responses and upper airway collapsibility in non-obese people with MS, with and without OSA.

Methods
Non-obese adults with MS and OSA vs MS without OSA were instrumented with pressure sensors at the choanae and epiglottis. Bipolar fine wires were inserted into the genioglossus. A nasal mask and pneumotachograph were attached to a breathing circuit to deliver brief (~250ms) suction pressure (~-12cmH2O) during early inspiration every 2-10 breaths while awake. Genioglossus reflex onset latency, peak latency and peak amplitude were quantified. The upper airway collapsibility index was the percent difference between choanal and epiglottic airway pressures during negative pressure.

Results
15 people with MS (6 males), aged 48±13years, BMI=25±3kg/m-2 and AHI=13±17events/h (mean±SD) were studied. 47% had OSA (AHI&gt;10events/h). Genioglossus reflex excitation onset latency (22±2 vs. 24±19ms), peak excitation latency (37±11 vs. 38±23ms) and peak amplitude (258±125 vs. 205±95%) were not different between OSA vs. non-OSA. The upper airway was more collapsible in people with OSA (49±32 vs. 17±16%, p=0.04).

Conclusions
There is a high prevalence of OSA among non-obese people with MS. There was no systematic difference in upper airway dilator muscle function. However, the upper airway is ~65% more collapsible in people with MS and OSA despite absence of obesity.
P036 A novel approach to nurture sleep education in a crowded curriculum
Authors: Falloon K , Campos C , Nakatsuji M , Moir F , Wearn A , Bhoopatkar H 
Published: October 2023

Abstract

Aims
To explore Year 6 medical students’ perceptions of sleep education during medical school to inform the development of a sleep curriculum.

Methods
Year 6 medical students on their final general practice (GP) placement in 2020 (71/254 of the Year 6 cohort) were invited to complete an online survey regarding sleep education recalled during the medical programme.

Results
Sleep education survey responses were received from 51/71 of students in the final GP cohort (72%). Three areas were more frequently recalled - 83% recalled learning about sleep apnoea, 71% about sleep physiology, and 69% about snoring. Only 50% recalled learning about assessing sleep and 42% recalled receiving education about insomnia. More than 80% of students reported they received no education regarding preparing for, coping with, or recovering from night shifts. Students identified common sleep disorders, sleep assessment, and shift work as priority topics.

Conclusions
Whilst the majority of students recalled receiving education on select topics, most had no awareness of education relating to sleep assessment, insomnia, or shift work. Sleep education in the curriculum needs more emphasis and reinforcement given its relevance across many domains of health and morbidity. We propose that an identifiable sleep curriculum is necessary and useful to ensure medical students have the necessary core education regarding sleep and sleep disorders both for patients and themselves. Further, we believe this is possible to achieve within the constraints of the undergraduate curriculum and propose some creative solutions.
P057 Exploring the ‘Pharmacist Role’ in Insomnia Management and Care Provision: A Scoping Review
Authors: Basheti M , Grunstein R , Gordon C , Saini B 
Published: October 2023

Abstract

Background
Insomnia is a highly burdensome sleep disorder, with a global prevalence of approximately thirty percent in adults. Given its impact on daily functioning and the role it plays in the development/progression of comorbid mental/physical disease, appropriate and timely management is essential. Pharmacists are at the forefront of the primary care workforce and given their expanding roles in healthcare, could aid in alleviating the burden of insomnia in the community by delivering adequate care.

Objectives
To describe the current and potential roles of pharmacists in insomnia care.

Methods
An extensive search of five databases (MEDLINE, EMBASE, SCOPUS, IPA, CINAHL) was conducted. Titles, abstracts, and full text articles were screened to identify relevant studies for review inclusion. Articles were reviewed and data extracted, analysed, and grouped categorically based on nature of care provided.

Results
Thirty studies met inclusion criteria. Insomnia management provision across these studies was divided categorically into 1) Screening/Assessment, 2) Pharmacological and non-pharmacological management provision, and 3) Deprescribing services. Regarding treatment provision, it was evident that pharmacological approaches remain the most common treatment modality adopted despite guidelines recommending behavioural therapy as first line. Overall, the results highlighted that provided with the adequate training and education, pharmacists have the potential to engage in insomnia screening, behavioural therapy and deprescribing services, improving overall insomnia management in primary care.

Conclusion
The outcomes of this review highlight a current gap in insomnia management practices carried out by pharmacists and provide evidence for improved roles when pharmacists are upskilled with specialised insomnia management education/training.
P061 CPAP Investigation Results: Physician vs Scientist delivered. Is there a difference in CPAP compliance and uptake?
Authors: Doyle G , Szollosi I , Segal T 
Published: October 2023

Abstract

Introduction
As standard practice in a tertiary public hospital, CPAP titration outcomes and recommendations are provided to patients by Sleep Physicians in a follow up consultation. To free up physician time, a new model of care was introduced where senior scientific staff would provide the results and recommendations after Sleep Physician reporting. The aim of this retrospective review was to determine if there were any differences in CPAP uptake and compliance between results and recommendations provided by Scientists, or Sleep Physicians.

Method
Retrospective review of uncomplicated CPAP naïve patients attending CPAP titration between 1/07/20 to 30/06/21. CPAP uptake, compliance, and Epworth at 2 and 12 months were compared between the groups receiving physician or scientist recommendations, using Student’s T-Tests for continuous or Chi-Square tests for categorical variables.

Results
446 patients (55% Male) received titration outcomes and recommendations, 57% from Scientists and 43% from Physicians. Mean age was 57.6+/-14.5 years, BMI=37.6+/-8.8 kg/m2, Baseline Epworth=10.5+/-5.9 and AHI=37.6+/-26.8 events/hr with no significant differences between groups. CPAP uptake for Scientists=72% and Physician=68% (p=0.403). There was also no difference in either compliance or ESS at 2 month and 12 month follow up.

Discussion
In this retrospective audit, no differences in CPAP uptake, compliance or ESS were observed between CPAP titration results and recommendations provided by Scientist compared to Sleep Physicians. However patient selection was not randomised and may have influenced results. More robust evidence requires a randomised controlled trial design to confirm findings.
P065 A Comparison of Two Obesity Related Hypoventilation Disorders – Impact on Sleep, Quality of Life and Neurocognitive Outcomes and the Effects of PAP Therapy
Authors: Zheng Y , Yee B , Wong K , Grunstein R , Piper A 
Published: October 2023

Abstract

Introduction
Symptom burden and neurocognitive function have not been previous compared between patients with obesity-associated hypoventilation disorders (obesity hypoventilation syndrome, OHS), and hypoventilation in the setting of obesity and obstructive airways disease (OHAD). The aim of this study is to compare baseline sleep-related symptoms, health-related quality of life and neurocognitive function between OHS and OHAD and the impact of PAP therapy on these outcomes.

Methods
ESS, PSQI, SF36, and various neurocognitive tests, in addition to anthropometric, polysomnography, lung function and blood gas data from 45 patients with OHS and 32 patients with OHAD, were included in the analysis. Between groups (OHS vs OHAD), pre- and post-treatment (with 3 months of positive airway pressure) comparisons were made using linear mixed modelling.

Results
Both OHS and OHAD had similar baseline ESS (14(5.6) vs. 12(5.4)), Global PSQI (10(3.2) vs 11(4.8)), SF36 and neurocognitive test performances (other than OHAD had lower digit symbol substitution test performance). Treatment with PAP therapy resulted in similar improvements in ESS, Global PSQI, and SF36 in both groups. Neurocognitive performance did not significantly improve after PAP therapy in either group.

Discussion
The symptom burden between two separate hypoventilation disorders (OHS and OHAD), in terms of sleepiness, sleep quality, quality of life and cognitive function, were similar. OHS and OHAD had similar treatment responses in these parameters after 3 months of PAP therapy.
P073 Examining the Complex Relationships Among Insomnia, PTSD, Psychological Distress, and Suicidal Ideation in Firefighters.
Authors: Ferguson S , Canney A , Rebar A , Paterson J , Bowen-Salter H , Van Hooff M , McFarlane A , Marcus A , Vincent G 
Published: October 2023

Abstract

Introduction
Firefighters endure sleep disruption and exposure to traumatic events - inherent occupational stressors that may contribute to insomnia, psychological distress, and PTSD. These factors are interrelated, with around 70% of individuals with PTSD experiencing co-occurring sleep problems but it remains unclear if insomnia has a unique effect on the risk of suicidality. The aim of this study was to investigate if there was an association between insomnia and suicidal ideation, above and beyond PTSD symptom severity and psychological distress.

Methods
Firefighters (n=578) self-reported their sleep problems, PTSD symptom severity, psychological distress, and suicidal ideation and attempts. Logistic regression was used to estimate the association between insomnia and suicidality and whether insomnia was associated with suicidality, above and beyond PTSD symptom severity and psychological distress.

Results
Insomnia was positively associated with suicidal ideation; with every one unit increase in insomnia, the odds of suicidal ideation increased by 1.42. However, the significance of the association between insomnia and suicidal ideation did not remain when accounting for PTSD symptom severity and psychological distress.

Conclusion
These findings suggest an association between insomnia and suicidal ideation in firefighters, as part of the impact of PTSD and psychological distress, rather than unique to these risk factors. Although interventions to target sleep problems in firefighters may have benefits for reducing risk of suicidality, our findings suggest a more holistic mental health approach may be more successful.
P078 “It’s very good but it needs to be better”: Usability and Acceptance of Fatigue Detection Technology in Australia.
Authors: Sprajcer M , Ferguson S , Irwin S , Naweed A 
Published: October 2023

Abstract

Introduction
Fatigue detection technology (FDT) is commonly used in the Australian road transport industry to monitor and/or detect driver fatigue. These devices typically provide alerts to drivers and their organisation if fatigue is detected and aim to reduce incidences of fatigue-related vehicle crashes and/or improve driver behaviour. The rise of these technologies is generating debate about how their relative design and merit might be evaluated. However, little is known about the experiences of individuals who use FDTs, including perceptions of use, acceptance, and effects on driver behaviour. The Australian Automobile Association funded the research into FDTs from which this presentation draws.

Methods
Semi-structured interviews were conducted with a range of existing users of FDT (n = 28) between November 2022 and June 2023. Participant groups included drivers (n = 17), middle managers and data users (n = 7), and executives (n = 4) from different commercial organisations that were trialling or had adopted FDT.

Results
Preliminary thematic analysis has identified a range of factors underlying driver and organisational acceptance of FDTs. These include: data privacy, vendor support, technical merit, training load, intrusiveness, and cost. Drivers perceived their behaviour to be moderately impacted by FDT in positive and negative ways. This included impacts on sleep/wake behaviour, in-cab activities, and driving performance. Certain types of FDT were considered highly contentious by all existing user groups.

Discussion
FDT adds further complexity to the contentious topic of fatigue management for professional drivers. Findings highlight a range of implications for FDT adoption and effective evaluation.
P084 Characteristics of sleep hypoventilation during polysomnography in a large Australian clinical sleep laboratory cohort.
Authors: Chew C , Ruehland W , Berlowitz D , Howard M 
Published: October 2023

Abstract

BACKGROUND
Sleep hypoventilation complicates a range of neurological and respiratory conditions. However, robust definitions are based mainly on expert consensus, and clinically significant thresholds remain unclear. This study thus aims to provide a descriptive analysis of capnography results in a large clinical cohort of patients referred for overnight polysomnography (PSG).

METHODS
Retrospective clinical audit of overnight in-lab PSGs, between Jan 2015 and June 2023, at a tertiary hospital housing the State-wide referral centre for chronic domiciliary ventilation. Diagnostic PSGs with transcutaneous CO2 (PTcCO2) monitoring and without supplemental oxygen were included.
The following data will be extracted from each PSG:
Patient demographics:
-Primary and secondary clinical diagnoses
-PTcCO2 values (e.g. Mean, Minimum and Maximum PTcCO2 in Wake, Sleep, NREM and REM)
-Sleep fragmentation measures
-Sleep macro-architecture measures
-AHI
-SpO2 values
Data analysis will be performed with IBM SPSS Statistics software, version 26 (Armonk, NY: IBM Corp)

PROGRESS TO DATE
525 PSGs meeting initial criteria have been identified. Currently processing PSG data files to extract parameters and complete exploratory data cleaning and analysis.

INTENDED OUTCOME AND IMPACT
We aim to explore and clarify:
-Differences in patterns of hypoventilation between different diagnostic groups.
-Relationships between awake hypoventilation, sleep hypoventilation and REM-isolated hypoventilation.
-Effects of applying differing criteria for hypoventilation available in the literature.
-Relationships between measures of sleep fragmentation, AHI, SpO2 and hypoventilation parameters.
The results of this study will also support and inform future research into associations between severity, duration and patterns of hypoventilation and clinically significant outcomes including morbidity and mortality.
P092 Automation in Equipment Asset Management for Laboratory Efficiencies
Authors: Hartnett C , Kevat A , Williams G 
Published: October 2023

Abstract

Introduction
Asset management of laboratory equipment is essential to patient safety. Traceability enables any patient affected by equipment that has been recalled, or subsequently been found faulty, to be retested. Sleep equipment in home, ward or laboratory needs to be clearly documented but this paperwork is tedious and manual.

Methods
A portable barcode scanner with software was added to the laboratory asset management and the time efficiencies were evaluated.

Results
The time reduction of using a barcode scanner to manual data entry was found to decrease time approximately fourfold, from 8 mins (std 1.5mins) to 2.2 mins (std 0.5mins). This is for each sleep laboratory testing bed and can equate to 35 minutes in a six-bed sleep laboratory. Accuracy of data is assured with a barcode scanner, compared to manual input.

Discussion
Using automation to replace manual tasks in a sleep laboratory saves time and ensures data accuracy. Further advances in automation for tagging medical devices would improve this in areas with high use of home or ward devices.
P096 The Effect of Moderate-Intensity Exercise on Sleep Quality and Quantity in Healthy Adult Males
Authors: Morrison M , Weakley J , Roach G , Sargent C , Miller D , Gardiner C , Halson S 
Published: October 2023

Abstract

Introduction
Acute exercise may have the ability to disrupt sleep in healthy adults. Given the popularity of afternoon exercise, it is important to determine how this affects sleep. Therefore, the aim of this study was to investigate the effect of afternoon moderate-intensity cycling exercise on objective and subjective sleep in healthy adult males.

Methods
To assess the effect of moderate-intensity afternoon exercise on sleep quality and quantity, 12 healthy adult males who were identified as good sleepers completed a repeated-measures, counter-balanced, crossover study design with two conditions (moderate-intensity aerobic exercise or no exercise). The exercise task involved cycling for 40 minutes at 70%HRmax and was completed ~15:30h. Polysomnography was used to measure sleep during a 9-h sleep opportunity (23:00h to 08:00h).

Results
There were no statistically significant differences in objective or subjective sleep between conditions. Exercise had a medium-sized effect on reducing total sleep time (mean ± SD; control 493.71 ± 12.59 mins vs exercise: 471.46 ± 55.19 mins; Cohen’s d: 0.56), sleep efficiency (mean ± SD; control 91.43 ± 2.33 % vs exercise: 87.31 ± 10.22 %; Cohen’s d: 0.56), and increasing REM onset latency (mean ± SD; control: 76.13 ± 45.10 mins vs exercise: 102.75 ± 46.85 mins; r: -0.33) (all p &gt; 0.05).

Discussion
Healthy adult males can complete afternoon moderate-intensity exercise without compromising subsequent sleep. Individual responses in objective sleep outcomes may vary after exercise.