bluuebunny/crossref_metadata_2025_split huggingface dataset:
O061 Maternal Circadian Disruption from Shift Work and the Impact on the timing of Melatonin in their Breast Milk
Authors: Booker L , Wilson D , Spong J , Deacon-Crouch M , Lenz K , Skinner T 
Published: October 2023

Abstract

Introduction
Infants are not born with a circadian rhythm. Research shows that breast milk clearly exhibits a 24-hour pattern, with melatonin concentrations high during the evening and night but barely detectable in daytime milk. The presence and timing of melatonin in breast milk suggests that this hormone may help provide sleep timing information to infants, thereby supporting the development of their own circadian cycle. Currently, it is not known if disturbances of maternal circadian rhythm, such as shift work, impact the circadian rhythmicity of breastmilk. The aim of this study was to investigate whether maternal circadian disruption, from working night shift has an impact on melatonin timing in breastmilk.

Methods
A prospective repeated measures study design was undertaken to compare melatonin levels in breastmilk across shift types (day shift/non-workdays and night shifts). Four 10ml breastmilk samples were collected by participants the same time of the day, across five consecutive days.
Results. A total of 11 mothers completed the study. Analysis is still ongoing but preliminary results show a potential difference in breastmilk melatonin between pre-night shift, night shift and post night shift, indicating a change in the circadian timing of the breastmilk.

Discussion
The findings from this study suggest that there is a potential effect from maternal circadian disruption from shift work on breast milk melatonin. This is an important first step in exploring the impact of maternal circadian misalignment disorders on breastmilk hormones and provides preliminary evidence that future research is needed in this area.
O062 Adolescents’ Mental Health Hrajectories throughout the COVID-19 Pandemic and the Protective role of Healthy Sleep Patterns
Authors: Bauducco S , Gardner L , Newton N , Gradisar M , Smout S , Chapman C , Gamble A , Teesson M , Champion K 
Published: October 2023

Abstract

Introduction
The COVID-19 pandemic has seen a rise in emotional problems among adolescents. Improving young people's mental health is a public health priority, and examining protective factors throughout the pandemic can offer insights on targets for prevention. This study aimed to investigate longitudinal trajectories of depressive and anxiety symptoms among a large sample of Australian adolescents and to examine sleep patterns in high- and low-risk trajectories.

Methods
This study utilises data from the control group of the “Health4Life” cluster RCT. We used three waves of questionnaire data collected annually (from 2019) from Year 7 students at 71 secondary schools across New South Wales, Queensland and Western Australia (N = 2,781, Mage = 12.6, SD = .51; 47% boys and 1.4% ‘prefer not to say’). Adolescents reported on their mental health (i.e., depressive and anxiety symptoms) and sleep (i.e., sleepiness, weekday sleep duration, SOL, WASO, and chronotype).

Results
We found four trajectories of depressive symptoms: low-stable (64.3%), average-increasing (19.2%), high-decreasing (7.1%), moderate-increasing (9.4%), and three anxiety symptom trajectories: low-stable (74.8%), average-increasing (11.6%), high-decreasing (13.6%). Adolescents in low-risk trajectories were more likely to be boys and to report shorter SOL and WASO, longer sleep duration, less sleepiness, and earlier chronotype. Where mental health waxed and waned, sleep patterns changed in the same direction.

Discussion
This is the first study to thoroughly examine adolescents’ sleep patterns as a protective factor for the development of emotional problems during the pandemic. Healthy sleep was clearly linked to low-risk trajectories, although this association is likely bi-directional.
O063 Objective Sleep Quality Metrics underlying next-day Sleep Quality Ratings in Adolescents
Authors: Tang C , Meredith-Jones K , Signal L , Galland B 
Published: October 2023

Abstract

Introduction
Good sleep quality is critical for good sleep health, but how sleep quality is defined remains uncertain; most defining it based solely on subjective or objective measures, and more recently, a combination of the two. PSG-derived sleep efficiency and WASO are linked to subjective sleep quality in healthy adults, but whether this is the same in adolescents (an age group notorious for not getting enough sleep), remains unknown.

Aims
To investigate which objective measures of sleep correlate with next-day ratings of sleep quality (primary outcome), sleep sufficiency, morning and daytime sleepiness, mood and concentration.

Methods
Seventy-one 16-17 y-olds (50% female) without anxiety/depression symptoms, completed a week of actigraphy and daily ratings of the subjective elements described above (469 days analysed). Statistical analyses used generalised estimating equation models.

Results
In unadjusted models, sleep quality showed significant within- and between-subject relationships with variables of sleep timing, amount, efficiency and variability. However after adjustment, total sleep time (TST) was the only metric that remained significant; for every 1 h less TST/night, teens were 1.56 (95%CI: 1.29, 1.88) times more likely to rate their sleep quality as poor rather than good. TST also correlated with daily mood ratings, and awakenings with morning sleepiness. No other significant relationships were found.

Discussion
The key sleep metric contributing to perceptions of sleep quality in adolescents was in fact one related to sleep quantity. Surprisingly, none of the sleep quality metrics used in sleep quality guidelines, linked to subjective ratings of sleep quality in this age group.
O071 MOEMOEĀ: The Development of an Indigenous Sleep and Well-being Intervention in Aotearoa WHĀNAU (New Zealand families)
Authors: Russell-Camp T 
Published: October 2023

Abstract

Introduction
The creation of culturally relevant interventions is essential to improving access and outcomes for Māori. Moemoeā is a Māori-led, tikaka ritual-based, Multiphase Optimisation Strategy (MOST) sleep intervention. This presentation will outline the creation of three pou (components) which aimed to increase connection to Māori language, culture, and well-being as well as sleep.

Methods
Māori members of our team co-designed with whānau (families) and experts in mātauraka Māori (knowledge) using kaupapa Māori methods. The team undertook semi-structured interviews with experts and structured interviews with whānau using kaupapa Māori principles of: taonga tuku (passed down knowledge), ako (learning), utu (reciprocity) and aroha ki te takata (respect).

Results
Three pou (Rongo time, Uru time, whanau support) were created and are currently being tested in a MOST factorial trial in 500 whānau across Aotearoa. Qualitative feedback to date shows that use of ritual rather than routine works in varied whānau contexts, and that our pou create a better sense of connection to living as Māori. This connection is a significant driver of good outcomes and removes the shame that whānau often experience as research participants in Western projects.

Discussion
Whānau who have a strong sense of (honoka) connection felt validated in their use of ritual and mātauraka, while those who were less connected appreciated being able to grow their connection to the Māori world. Use of the western MOST trial design posed challenges as everything is interconnected in Māori culture, but our decolonizing tools and measures were able to overcome much of this.
O073 The Relationship between Circadian type and Physical Activity on Cognitive Performance during Simulated Nightshifts: A Randomised Controlled Trial.
Authors: Easton D , Gupta C , Vincent G , Ferguson S 
Published: October 2023

Abstract

Introduction
Physical activity might be a nonphotic strategy which could improve cognitive performance for nightshift workers. Innate characteristics like circadian type may also influence individual performance. Thus, this study explores the relationship between circadian type and physical activity on cognition over consecutive nightshifts.

Methods
Thirty-two healthy adults (age M±SD: 24.3±4.6 years; 19 females) participated in a 7-day laboratory study, with 5 nightshifts (2200-0600). Participants were randomised into the Breaking up sitting (BUS; n=19) or Sedentary (SED; n=13) condition. Overnight, BUS participants completed 3-min bouts of light-intensity walking every 30-min, while SED participants remained seated. At 2200, 0000, 0200, 0400 and 0600, participants completed the 10-min Psychomotor Vigilance Task (mean RRT). Participants completed the 11-item revised Circadian Type Inventory (factor 1: rigid/flexible; factor 2: languid/vigorous), resulting in four-subgroups (rigid; n= 12, flexible; n= 11, and languid; n= 11, vigorous; n= 13). Participants may only be one type from either factor (i.e. rigid and vigorous).

Results
Linear mixed models showed a significant 3-way interaction between nightshift (1-5), condition (BUS, SED), and circadian type (rigid/flexible) for mean RRT (p=0.03), such that flexible types in the Breaking up sitting condition outperformed Sedentary flexible types and Breaking up sitting rigid types, with performance worse on the first nightshift. There were no significant interactions between nightshift, condition and circadian type (languid/vigorous).

Discussion
Breaking up sitting improved performance for flexible types over rigid types. These findings have significant implications for nightshift rostering, suggesting that incorporating breaking up sitting may optimise cognitive performance, and therefore work efficiency.
O074 Does Sleep Duration, Shift work or Sleep Disorder Status Predict Perceived work Performance and Quality of Life in Young Adults?
Authors: Sansom K , Eastwood P , Brown B , Crowther M , Wanstall S , McArdle N , Adams R , Reynolds A 
Published: October 2023

Abstract
Young adults are vulnerable to the consequences of disturbed sleep from insufficient sleep, shift work and sleep disorders. The impact of these causes of disturbed sleep on perceived work performance and quality of life (QOL) in young adults is unclear. This study sought to investigate these associations in a community sample of 22-year-old adults. Participants studied (n=565, 53% female) were a subset of the Raine Study. All were employed and provided information on sleep disorders (obstructive sleep apnoea by polysomnography and insomnia and restless legs syndrome symptoms by validated questionnaires), shift work status, habitual sleep duration, QOL (Short Form (SF) 12) and perceived work performance (categorical response: perform better, same or worse than most workers). Multinomial and linear regression models adjusted for sex, comorbidities and work hours were used to examine the associations between disturbed sleep with work performance and QOL, respectively. In total 25% of participants had a sleep disorder, 29% were shift workers, and 31% had insufficient sleep (&lt;6 hours). Presence of a sleep disorder was associated with poorer perceived work performance (OR, 2.27; 95%CI, 1.3 – 4.1). Sleep disorders were also associated with significantly lower SF-12 mental (β, -4.19; 95%CI, -5.92 to -2.45, p&lt;0.001) and physical (β, -1.56; 95%CI, -2.70 to -0.42, p&lt;0.008) component scores. Shift work and insufficient sleep were not associated with either perceived work performance or QOL. Identifying and treating sleep disorders in young adults may be important given its negative association with perceived work performance and QOL.
O076 Changes in Sleep and Perceived Health risk in early Career Paramedics
Authors: Crowther M , Ferguson S , Adams R , Reynolds A 
Published: October 2023

Abstract
Shift work is associated with increased chronic disease risk and suboptimal health behaviours. However, our understanding of the impact of shift work on health behaviours is impacted by a lack of longitudinal studies that examine health behaviours in shift workers relative to behaviours prior to shift work commencement. To address this limitation, we examined sleep changes and perceived health risk (i.e., individual’s perception of risk to their health) in intern paramedics during the first 12 months of shift work.
The current study examined self-report sleep quality and duration in 21 interns (15 Female, 6 Male, aged 23.0 [20.0, 36.0]) from one Australian Ambulance service. Data were collected quarterly for a year (pre-shift work, and then 3, 6, 9 and 12 months post recruitment training).
Linear mixed models, controlling for chronotype and baseline perceived health risk, showed that the first 12 months of shift work were associated with a significant decline in sleep quality (p=0.021) but no change in sleep duration (p=0.76). Linear mixed models also showed that perceived health risk significantly increased (p=0.036). Substantial between-subjects differences were observed, highlighting individual differences in response to shift work onset on sleep and perceived health risk.
This study demonstrates that commencement of shift work is associated with a decline in sleep quality and increase in perceived health risk in early career paramedics. The considerable individual differences observed in this study highlight a need for larger studies with more participants, and a focus on personalised strategies for workers commencing shift work.
O082 A Survey to explore the Knowledge and Education needs of Perinatal Health Professionals to support the Provision of Inclusive Care to Transgender people in Aotearoa New Zealand
Authors: Baddock S , Miller S , Ker A , Kerikeri E , Veale J , Parker G 
Published: October 2023

Abstract

Background
International literature shows that transgender teens and young adults are more likely to report insomnia compared to cis-gendered individuals of the same age – often linked with discrimination or minority stress. Trans people often encounter health providers with limited knowledge of gender diversity.

Objective
to understand the education needs, knowledge, and attitudes of the perinatal health workforce in New Zealand when providing care for trans people.

Methods
Interviews with trans people who had engaged with perinatal services, informed the development of a workforce survey, alongside extensive consultation with Māori, health professionals and trans community groups. The survey was shared with perinatal care providers via their professional organisations and social media. It included questions about strategies utilised in their clinical practice towards trans inclusion, previous education opportunities and current needs, as well as attitudes towards gender diversity.

Results
Survey participants (n=476) reported using multiple strategies when providing inclusive practice for trans people. Gaps in knowledge to support inclusive practice were identified, along with support needs to ensure perinatal care providers are resourced to provide culturally safe and affirming care for trans people and whānau/families. Most respondents had not received education on gender-inclusive care but three quarters of them reported they would access this if available.

Conclusions
Survey results identified strategies for inclusive care as well as knowledge gaps, in relation to meeting trans people’s perinatal care needs. Findings led to recommendations for education, practice and policy which could readily apply to those supporting trans people to improve their sleep health.
O083 Myopic, or Short-sighted, Children show Delayed Melatonin Circadian Timing, Lower Melatonin Output and Sleep Disruptions
Authors: Chakraborty R , Scott H , Seby C , Tang V , Lovato N , Lack L , Kemps E , Anstice N , Juers E 
Published: October 2023

Abstract

Introduction
Recent studies have reported poor and reduced sleep in myopic, or short-sighted, individuals. Here, we investigated differences in melatonin secretion timing and output and actigraphy-derived sleep in myopic and non-myopic (or emmetropic) children, aged 8-15 years.

Methods
26 myopes [refractive error (mean ± standard error mean) -2.06 ± 0.23 dioptres] and 19 emmetropes (-0.06 ± 0.04 dioptres), aged 11.74 ± 2.31 years were recruited. Melatonin timing was assessed using salivary dim light melatonin onset (DLMO), collected half-hourly for 7 hours in a sleep laboratory, beginning 5 hours before and finishing 2 hours after habitual bedtime for the past week. Total melatonin production was assessed via aMT6s levels from urine voids collected from 05:30 pm and until 08:00 am the following morning. Actigraphy-derived sleep was acquired for one week prior to the sleep laboratory visit.

Results
Myopic children (21:07 ± 0.2 hrs) had a DLMO time 1.1 hrs later compared to emmetropes (19:59 ± 0.2 hrs), p=0.002. aMT6s melatonin levels were significantly lower among myopes (18.70 ± 2.38) than emmetropes (32.35 ± 6.93, p=0.001). Myopes also exhibited significantly delayed sleep onset (21:42 ± 0.2 vs 23:00 ± 0.2 hrs), delayed wake-up time (06:38 ± 0.2 vs 07:29 ± 0.1 hrs), shorter sleep duration (8.1 ± 0.2 vs 7.6 ± 0.1 hrs), and more evening-type diurnal preference than emmetropes (all p&lt;0.05).

Discussion
These findings suggest a potential association between circadian rhythm dysfunction and myopia in children, supporting towards a shared mechanism of myopia and delayed sleep-wake phased disorder development during adolescence.
P006 The Impact of Growth Hormone Treatment on Cardiovascular Control in Children with Prader-Willi syndrome
Authors: Patoglu O , Walter L , Davey M , Nixon G , Edwards B , Horne R 
Published: October 2023

Abstract

Background
Many children with Prader-Willi syndrome (PWS) are treated with growth hormone (GH), which may increase the risk of obstructive sleep apnoea. Children with PWS also have impaired cardiac autonomic control due to reduced parasympathetic activity, which may increase cardiovascular risk, however the impact of GH on autonomic control is yet to be elucidated.

Methods
Pre- and post-GH polysomnographic data in 38 children (aged 0-18 years) were retrospectively collected. Spectral analysis of heart rate variability (HRV) was used to determine total, low frequency (LF, sympathetic and parasympathetic activity), high frequency (HF, parasympathetic activity) power and LF/HF (sympathovagal balance). Data were compared with Wilcoxon Signed Rank Test and Spearman Rank Order Correlation analysis and are presented as median [interquartile range].

Results
HRV data were significantly correlated with age so children were grouped into those &lt;2 years (n=22) and &gt;2 years (n=16). There were no significant differences in the obstructive or central apnoea-hypopnoea indexes between pre- and post-GH studies in either group. In children &lt;2 years, there were no significant differences in total power, LF, HF and LF/HF between studies. In children &gt;2 years, total power (1912.2 ms2, [920.2, 4916.1] vs 1010.2 ms2 [416.0, 2828.7), LF (434.0 ms2 [247.0, 1340.7] vs 278.9 ms2 [83.4, 676.0]) and HF (986.0 ms2 [321.8, 2400.6] vs 414.4 ms2 [146.2, 1152.7]) were lower (p&lt; 0.01 for all) post-GH.

Conclusions
Our results demonstrate that GH decreases both sympathetic and parasympathetic activity during sleep in children &gt;2 years, which could further increase cardiovascular risk.
P009 Time spent with SpO2 below 90% during Sleep is Greater in Children with Down syndrome and OSA than in Typically Developing Children
Authors: Walter L , Bhatnagar D , Ong M , Davey M , Nixon G , Horne R 
Published: October 2023

Abstract

Background
Children with Down syndrome (DS) have a higher predisposition to obstructive sleep apnoea (OSA) compared to typically developing (TD) children. Children with DS have more frequent dips &lt;90% compared with TD children matched for age, sex and OSA severity. Intermittent hypoxia with repeated desaturations and resaturations is associated with cognitive impairment in children. New methods which calculate the time spent with SpO2 &lt;90% have identified an association with cardiac dysfunction in adults with OSA. We aimed to determine if children with DS and OSA spent longer with SpO2 &lt;90% during sleep compared with TD children.

Methods
44 children with DS (3-19 y) and age, sex and OSA severity matched TD children underwent overnight polysomnography. Time spent with SpO2 &lt;90% as a percentage of total sleep time (%TST) was calculated. SpO2 nadir when &lt;90% was recorded.

Results
SpO2 fell &lt;90% in 32 (73%) children with DS and 15 (34%) TD children. The %TST spent with SpO2 &lt;90% was higher in the DS group (median [IQR] 0.029% [0.004, 0.114]) compared with the TD group (0.000% [0.000, 0.020]; p&lt;0.001). There was no difference in SpO2 nadir between the groups (DS mean±sem 84%±1.1%; TD 85%±1.1) when the SpO2 fell &lt;90%.

Conclusion
Twice as many children with DS experienced periods of oxygen desaturation below 90% as did TD children matched for age, sex and OSA severity. Although as a %TST, the time spent &lt;90% was small, different physiologically-based metrics to characterise OSA severity and the consequences of recurrent hypoxia in children may be merited.
P010 Delivery of volume assured pressure support (VAPS) through tracheostomy in paediatric patients
Authors: O'Connor A , Saddi V , Thambipillay G , Teng A 
Published: October 2023

Abstract

INTRODUCTION
Volume assured pressure support (VAPS) allows the ventilator to deliver a constant pre-set tidal volume or alveolar ventilation by automatically adjusting the inspiratory pressures within a set range, providing targeted pressure support. Data on its use in children are limited. We describe a series of four children effectively and safely ventilated using VAPS mode through tracheostomy.

METHODS
Retrospective review of patient notes.

PROGRESS TO DATE
Four paediatric patients were identified in our cohort who were successfully and safely ventilated using the VAPS mode through tracheostomy. The patients were between 6-14 years of age inclusive, with four differing underlying disease processes – Prader-Willi syndrome, congenital central hypoventilation syndrome, Guillain-Barré syndrome and Moebius-type syndrome.

INTENDED OUTCOME AND IMPACT
Whilst there have been previous paediatric case reports and case series which have demonstrated efficacy of VAPS mode used non-invasively, the use of VAPS mode to provide effective and safe ventilation through tracheostomy in children has been described in only one recent case series. The advantages of its use over conventional bilevel positive airway pressure support include its ability to compensate for changes in tidal volume, which can occur with changes in lung compliance and during different stages of sleep. This case series highlights safe and effective use of VAPS mode in children with tracheostomy.