bluuebunny/crossref_metadata_2025_split huggingface dataset:
P056 Improvements in Daytime Function Items of the Insomnia Severity Index Are Correlated with a Positive Impact of Treatment on the Patient Global Impression Insomnia Scale
Authors: Drake C , Gardiner F , Yardley J , Pinner K , Moline M 
Published: October 2023

Abstract

Introduction
Items 4-7 (daytime function [DF]) of the 7-item Insomnia Severity Index (ISI) can assess daytime impairment. In Study E2006-G000-303 (Study 303; NCT02952820), lemborexant (LEM), a dual-orexin receptor antagonist, was associated at 6 months (6mo) with both significant improvement in ISI-DF items and significantly more subjects reporting positive effects on sleep, as assessed by the Patient Global Impression–Insomnia version (PGI-I), versus placebo (PBO). This analysis looked at the correlation between ISI-DF improvement and patient ratings on the PGI-I.

Methods
Study 303 was a 12-month, randomized, double-blind PBO-controlled (first 6mo) phase-3 study in adults with insomnia disorder. Subjects were randomized to PBO, LEM 5mg or 10mg for 6mo (2nd 6mo not reported here). ISI items are rated from 0 (no problem) to 4 (very severe problem). ISI-DF includes sleep satisfaction, extent symptoms are noticeable to others, cause worry/distress, and interfere with daily function. On the PGI-I, subjects assess positive, neutral or negative treatment impact on falling asleep, overall benefit on sleep, and total sleep time.

Results
A total of 739 subjects completed the ISI and PGI-I and were included in these analyses. At 6mo in all treatment groups, there were significant correlations (all P&lt;0.001) between improvement in both ISI-DF items and PGI-I ratings regarding falling asleep, overall benefit on sleep, and total sleep time.

Discussion
These data suggest that the PGI-I may be a useful, quick tool to use in clinical practice, since an improvement in its score reflects improvements in daytime function.

Sponsor
Funded by Eisai Inc.
P059 Sleep and Fibromyalgia: Identifying and Managing Sleep Disorders.
Authors: Lovato N , Reynolds A , Whittle S , Watson N , Dyer K , Gill T , Adams R , Hill C 
Published: October 2023

Abstract

Introduction
Little is known about the presentation and management of sleep problems in patients with fibromyalgia [FMS]. This pilot study aims to 1) characterise sleep/wake patterns and sleep disorders in participants with FMS, and 2) assess changes in sleep and FMS symptoms with individualised sleep disorder treatment.

Methods
Women with FMS were recruited from the Rheumatology Unit at The Queen Elizabeth Hospital, South Australia. Participants recorded their sleep and activity for two-weeks using an under-mattress sleep sensor (Withings), sleep diaries and a wrist accelerometer. Questionnaires included Berlin Sleep Questionnaire (OSA); Epworth Sleepiness Scale; Flinders Fatigue Scale; Restless Legs Syndrome (RLS) Screener, Sleep Condition Indicator, and Fibromyalgia Impact Questionnaire.

Results
Preliminary data from 7 women (aged 49.3±12.8years, BMI 30.9±7.8kg/m2, average pain duration 14.1±9.4 years) were investigated. Sleep efficiency was low (65.9%±11.9). Five women were ‘high-risk’ for a sleep disorder (3 RLS, 3 OSA, 3 insomnia, 3 circadian rhythm disorders). Two were ‘high-risk’ for &gt;2 sleep disorders. Two women had delayed, and one had advanced, circadian rhythms. Average self-reported sleep time in ‘high-risk’ women was shorter than the two women not at risk (6.2±1.1 vs 7.8±0.4hours). (6.2±1.1 vs 7.8±0.4hours). Fatigue Scores exceeded those commonly observed for respondents living with a medical condition (25.2±2.4 vs. 20.4 + 6.2). Participants are currently undergoing sleep disorder treatments and preliminary results will be reported.

Conclusion
Identifying and managing sleep disorders, using cognitive behavioural therapy for insomnia and chronotherapeutic approaches may be an important therapeutic target for FMS patients to improve sleep quality, daytime functioning, and FMS symptoms.
P060 Effectiveness of current digital interventions for children and adolescents with sleep problems: a systematic review and meta-analysis
Authors: Cleary M , Richardson C , van Kins R , Heussler H , Wilson A , Downs J , Walsh J 
Published: October 2023

Abstract

Introduction
Sleep problems occur in up to 50% of typically developing children. Sleep problems include difficulty initiating sleep, frequent night waking, daytime sleepiness, or frequent nightmares, which lead to poor quality sleep. We conducted a systematic review and meta-analysis to examine the effectiveness of digital sleep interventions for children and adolescents.

Method
Databases (MEDLINE, PubMed, PsycINFO, Scopus, EMBASE, CENTRAL and Web of Science) were searched for studies published from January 2012 to April 2023. Within-subject studies or randomised controlled trials reporting the effects of a digital sleep-based intervention were included. Random-effects meta-analyses estimated pooled standardised mean difference to assess effectiveness. Nine studies involving 484 children/adolescents were included in this review.

Results
Digital sleep interventions were effective in reducing insomnia symptoms, decreasing subjective sleep onset latency and wake after sleep onset, and increasing subjective sleep efficiency. Objective measures of SOL, WASO and SE were all unchanged following digital sleep intervention. However, objective but not subjective increases in TST were identified.

Discussion
These results suggest that digital sleep interventions are effective in improving children and adolescent’s perceptions of their sleep but are less effective at improving some objective measures of sleep. Further, uptake of current digital sleep interventions was low, therefore future interventions should aim to address this, potentially through co-design, and integrating treatment components to enhance young people’s motivation. In order to achieve a clear understanding of how digital sleep interventions compare to other behavioural interventions, additional high-quality randomised controlled trials comparing digital interventions to traditional in person modalities are needed.
P062 Validation of Unattended Polysomnography using Somte for Diagnosis of OSA in Pregnant Women during Early Gestation.
Authors: Clements F , Chung Y , Marshall N , Melehan K , Hennessy A , Makris A , Vedam H 
Published: October 2023

Abstract

Introduction
The detection of obstructive sleep apnoea (OSA) in pregnant women in early gestation using polysomnography (PSG) was logistically difficult during covid-19 lockdowns. Reliable alternates to PSG haven’t been well validated in early pregnancy. We compared the agreement between self-applied, unattended Somte and attended PSG, in pregnant women by 24 weeks gestation.

Methods
Women were recruited to undergo self-applied, unattended Somte and attended Grael PSG, by 24 weeks gestation. Tests were scored by a single experienced scorer (blinded to PSG result). An apnoea-hypopnea index (AHI) 5 or above at PSG was considered diagnostic of OSA. Diagnostic test analysis was undertaken (sensitivity, specificity, positive and negative predictive value (PPV/NPV)), by creating receiver operating characteristic (ROC) curves. The calculated AHI was compared and Bland-Altman plot used to plot agreement.

Results
Twenty-Four participants were included for analysis, median age 33.5(29.0, 37.0) years, gestation at PSG 14.1(13.4, 15.7) weeks and median BMI 31.2(26.3, 36.5). Five (20.8%) women had OSA. Median AHI were similar, 1.75 (0.50, 4.53) and 1.6 (0.58, 4.25) for Somte and PSG respectively. Somte demonstrated reasonable diagnostic test accuracy (area under the ROC curve 0.94 (95%CI 0.81-1.0)), sensitivity 80% (cut off AHI 5) and specificity 89.5%. The PPV and NPV were 80.0% and 94.7% respectively. Bland-Altman plot upper and lower confidence intervals of 6.37, -8.89, demonstrated lower and higher AHI scores slightly underestimated and overestimated, respectively.

Discussion
Somte provided reasonable accuracy compared to PSG in identifying OSA in early gestation in this sample. Larger studies will be helpful to confirm this finding.
P072 Sleep, Shift work Patterns and Work-Related Accidents in Regional/Rural versus Metropolitan Healthcare Shift Workers.
Authors: Booker L , Spong J , Hodge B , Deacon-Crouch M , Bish M , Mills J , Skinner T 
Published: October 2023

Abstract

Introduction
Sleep impairment can decline alertness and performance and increase the risk of occupational injuries such as medical errors, workplace injuries and car accidents. Australia has a shortage of healthcare shift workers, particularly in regional/rural areas. The consequence of this is that rural healthcare shift workers potentially have to work longer hours, be more on-call and/or have to commute longer distances to/from work. These factors could impact the worker's sleep and recovery. The aim was to explore the differences in sleep and shift work patterns in regional/rural and metropolitan healthcare shift workers and the risk of workplace accidents, medical error, and car accidents.

Method
An anonymous online survey was distributed targeting nurses, midwives and paramedics.

Results
403 healthcare shift workers completed the survey. Those in regional/rural locations were significantly older, had more experience, worked significantly more hours per week, more night shifts and on-call shifts in the previous two weeks. However, metropolitan shift workers took significantly longer (in minutes) to travel to work, reported more feelings of sleepiness while driving to/from work, having a car accident or near accident while commuting home, and having a workplace accident in the last 12 months. There was however no differences in sleep quality between the groups but poor sleep quality was the main contributing factor related to workplace incidents, medical errors and car accidents.

Conclusion
There were differences in shift work patterns between metropolitan and regional/rural healthcare shift workers. More exploration is needed to understand the components that contribute to increased OH&S risks.
P076 Comparing Four Different Simulated Shiftwork Schedules on Higher order Cognitive Function
Authors: Guzzetti J , Marando I , Owen M , Matthews R , Yates C , Banks S 
Published: October 2023

Abstract

Introduction
Changes in cognitive performance during shiftwork due to fatigue and circadian misalignment are well-documented. However experimental evaluations of shiftwork schedules are often limited to basic tasks such as vigilance and attention. The current study evaluated several higher order cognitive functions such as memory and task switching during four simulated shiftwork schedules.

Methods
N=27 completed a 10-day laboratory shiftwork simulation. They were randomly assigned to one of four shiftwork conditions: Condition A, 4h-on/4h-off/8h-on/8h-off schedule; Condition B, 6h-on/6h-off schedule; Conditions C and D represented to different sections of a 4h-on/4h-on call/4h-off/4h-on/4h-on call/4h-off schedule. The Automated Neuropsychological Assessment Metrics (ANAM) was used to assess cognitive function. The tasks included in this analysis were Code Substitution (CDS/CDD), Pursuit Tracking (PUR), Matching to Sample (M2S), and Switching Task (SWT). Stability of performance during waking was compared between the conditions using Kruskal-Wallis tests.

Results
The analysis of cognitive performance tasks yielded mixed findings. Performance on all tasks was ranked from best to worst: Condition D (&gt;Conditions A, B, C; all p &lt; .05), Condition A (&gt;Conditions B, C; p &lt; .05 and p &lt;.001, respectively), Condition B, Condition C. Regarding stability of higher order cognitive function across the waking day, Condition A exhibited the worst stability, and was the only condition whereby performance degraded across the wake period.

Discussion
These findings highlight the variability in cognitive capacities during different shiftwork schedules. It is important to examine higher order cognitive function, and other cognitive abilities during shiftwork, when evaluating different shiftwork schedules.
P077 Associations of sex, sleep, and circadian rhythms with performance in elite Australian Rules footballers
Authors: Mascaro L , Leota J , Rajaratnam S , Drummond S , Facer-Childs E 
Published: October 2023

Abstract

Introduction
Poor sleep and circadian misalignment are associated with poorer performance. In elite Australian Rules football (ARF), both sex and professionalism could alter or exacerbate these associations. This study provides preliminary insights on how the relationships of sleep and circadian alignment with cognitive performance differ between male full-professional and female semi-professional elite ARF athletes.

Methods
Participants were 72 elite ARF athletes (42% female; M-age = 24.1±4.4 years). During pre-season, participants completed two weeks of sleep/wake monitoring via actigraphy, and a circadian phase assessment (dim light melatonin onset; DLMO) after one week. Cognitive performance testing (psychomotor vigilance task, PVT; and the balloon analogue risk task; BART) was conducted five times throughout this period.

Results
Preliminary findings suggest average total sleep time and sleep efficiency, sleep regularity, DLMO, and phase angle (interval between average sleep onset and DLMO) did not predict reaction time on the PVT, nor did sex moderate these relationships. After controlling for sex, longer sleepers demonstrated greater risk taking on the BART. Only among male athletes did larger angles predict greater risk taking.

Discussion
Elite ARF athletes, regardless of sex, sleep, or circadian alignment, have similar reaction times. Risk taking is greater among longer sleepers and in male athletes experiencing relatively delayed circadian phases. Where risk-taking has negative implications (e.g., injury and sporting errors), these findings identify at-risk groups. Few sex-specific findings may suggest that the semi-professional status of female ARF (and associated lifestyle factors such as scheduling and income) is not altering elite performance in controlled settings.
P079 Shifting the Paradigm: Implementation Science in Enhancing Sleep Health among Shiftworkers
Authors: Vincent G , Thorne H , Sophocleous R , Shriane A , Vandelanotte C , Duncan M , Sprajcer M , Gupta C , Rigney G , Hilditch C , Kolbe-Alexander T , Thomas M , Ferguson S 
Published: October 2023

Abstract

Introduction
Addressing the urgent public health concern of sleep health among shiftworkers, our study examined the application and effectiveness of a tailored sleep intervention, the Sleepfit app. We assessed reach, effectiveness, adoption, and maintenance, while identifying potential implementation barriers across diverse shiftwork industries.

Methods
The two-phase study commenced with the Sleepfit app's optimisation, originally developed for day workers, by integrating sleep improvement strategies specifically for shiftworkers. The feasibility of large-scale implementation was then evaluated based on the RE-AIM framework, considering reach, effectiveness, adoption, implementation, and maintenance. The study involved existing shiftworkers (current sample, n=29; anticipated final sample n=90). Validated sleep health measures and RE-AIM metrics were used, with data analysed through a mixed-methods approach.

Results
Preliminary results indicate significant improvement in sleep satisfaction and reduction in insomnia severity, indicating the potential of the intervention in enhancing sleep outcomes. We also observed increased engagement with healthy sleep practices, demonstrated by a significant decrease in poor sleep behaviours. Interestingly, our preliminary findings propose specific benefits for younger shiftworkers who typically engage in problematic sleep practices. Preliminary data suggests 71% of shiftworkers engaged with the app at 2-weeks post intervention, with 23% continuing to use the app during long-term maintenance evaluation. As data collection is ongoing, a detailed analysis incorporating feasibility and all RE-AIM dimensions will be subsequently presented.

Conclusion
Preliminary findings suggest the Sleepfit app may serve as an effective sleep health intervention among shiftworkers, with further analyses needed to fully understand its feasibility and long-term adoption.
P080 Using your Mobile/Tablet Device at Bedtime for Work: Implications for Adult Sleep and Job Performance
Authors: Lushington K , Markobotsaris M , Dollard M , Parkin A , Potter R , Zadow A , Pignata S , Afsharian A , Owen M , Bakker A 
Published: October 2023

Abstract

Introduction
A substantial number of workers post-COVID-19 now work at home. Remote work allows for greater flexibility in work timing including the preference to work at bedtime. Thus, increasing the likelihood of digital device use at bedtime with possible negative consequences for sleep, job recovery and, in turn, job performance. This interplay remains to be tested.

Methods
202 university workers (54M, 144F; mean age (SD) = 48.38 ± 10.23y) completed a 10 day diary over two working weeks (Oct/Nov 2021) assessing digital device use, sleep, workload, worksite location, job recovery in the evening and job performance.

Results
Linear mixed model analyses revealed when comparing between individuals that greater digital device at bedtime was associated with greater wakefulness after sleep onset and shorter sleep and, in particular, if they worked from home compared to the office. By contrast, when comparing within individuals it was not the case if an individual used their digital device more on one night than another that this was associated with worse sleep nor was sleep worse on those nights when an individual had worked at home rather than the office. Analyses examining job recovery and job performance are currently under review.

Discussion
The present findings suggest that individuals who habitually use their digital device at bedtime are at a greater risk for poor sleep and supports the need for workplace implementations to discourage workers taking work to bed.
P083 Evaluation of OSA in children: Defining the scope of a paediatric sleep service
Authors: Carballo A , Madden G 
Published: October 2023

Abstract

Introduction
The sleep unit runs as a diagnostic paediatric service, and does not provide titrations as part of its scope. This study evaluates the requirement for titration studies for our patient cohort to better understand the scope of service. Obstructive sleep apnoea (OSA) affects 0.7%-13% of the general paediatric population, where a normal AHI is &lt;1, mild &gt;1-4.99, moderate &gt;5-9.9 and severe OSA &gt;10.

Method
A retrospective audit was undertaken of patients who attended between January and April 2022. Patients &lt;2 years old and oxygen titration studies were excluded. Data was obtained by collating information from electronic medical records and physician reports. Parameters analysed: study indication, gender, AHI, desaturations, and BMI percentile.

Results
Preliminary data (n=101) (males 59.6%, age 8.6 ±4.3SD) shows that 12.9% (Male n=7; age 8.9 ±4.9SD) of our paediatric patients have OSA. 61.5% were mild, 7.7% were moderate and 30.8% of those had severe OSA. Patients had an average oximetry of 96% (±1.3SD) at baseline and an average Nadir of 83% (±10.1SD). It was also found that 53.8% of patients with OSA had a BMI percentile well above the healthy range. Other preliminary findings show 58% of the patients were snorers, and 8.9% of the patients were diagnosed with periodic limb movements.

Discussion
Only patients with severe OSA were referred externally for bi-level studies. Of the remaining OSA positive patients, adenotonsillectomy was recommended for three subjects, and the rest received no bi-level intervention. The data suggests a diagnostic only laboratory is sufficient to service our paediatric population.
P087 Exploring Associations between, and Temporal Changes in, the Sleep, Psychological Affect, and Exercise Performance of Elite Cyclists during a period containing the Tour de France
Authors: Fitton J , Manners J , Lechat B , Loffler K , Altree T , Catcheside P , Reynolds A , Eckert D 
Published: October 2023

Abstract
The effects of partial sleep restriction and minimal sleep impediment on endurance exercise performance remain incompletely understood. Moreover, the suggested role of psychological factors in the relationship, or lack thereof, between sleep and endurance performance is yet to be rigorously investigated in naturalistic settings. This study investigates the relationships between sleep, psychological affect, and exercise performance in elite cyclists during the Tour de France (TDF).
Data from eight male professional cyclists were collected over a 6-week period, including the 3-week TDF. Sleep, exercise performance, and affect (e.g., motivation) data were collected through smartwatches, bicycle-based instruments, and smartphone-administered questionnaires. Relationships between, and temporal changes in, sleep, affect, and performance metrics were explored through correlation and ANOVA analyses.
Participants were ~30±4 years old. Over the 6-weeks, average sleep duration was 08:11±00:58, with mean sleep onset and wakeup times of 23:46±00:44 and 07:57±00:52, respectively. Wakeup time (r = -0.40) and sleep quality (r = -0.32) were negatively associated with Performance Index. Compared to pre-race, sleep onset and wakeup time were delayed, sleep duration increased, and sleep quality and subjective mood declined, during the race (00:26±00:14[95%CI]; 00:48±00:16; 00:22±00:20; -6.4±5.2, -9.5%; -5.7±4.4, -9.1%, respectively). All p &lt;.05.
Findings suggest temporal change in, and inter-relationships between, sleep, affect, and performance during real-world endurance competition. Increased psychophysiological strain and event-related factors (e.g., travel) likely explain the greater sleep duration, delayed sleep timing, and reduced sleep quality observed during the race. Further research into the temporal interplay between sleep, psychological affect, and performance during real-world competition is necessary.
P089 The Predictive Value of an Omegoid Epiglottis in Upper Airway Reconstruction Surgery for Obstructive Sleep Apnea
Authors: Gunasekera D , Lightfoot E , Ekanayake M , Foreman A , Krishnan S , Hodge J 
Published: October 2023

Abstract

Background
Obstructive sleep apnea is a serious medical issue with significant cardiovascular health associated complications. Surgical intervention is indicated for patients who are refractory to medical management. It’s efficacy was demonstrated in SAMS Trial in 2019. Surgery in this trial predominantly widened the airway in an anterior-posterior plane. An omegoid epiglottis has been hypothesized to be indicative of chronic lateral airway collapse, which hypothetically would be less responsive to the surgical protocol used in SAMS trial.. Our aim is to determine whether an omegoid epiglottis is therefore a poor predictor of surgical success.

Method
Following ethics approval, 53 OSA patients MRI images, Apnoea-hypopnea index’s (AHI) and Epworth sleepiness scale’s (ESS) who fell into the surgical arm of the SAMS trial were de-identified and retrospectively analyzed. Two independent researchers measured the width: depth ratio and alpha angle of patient epiglottises on MRI and used this data to separate patients into omegoid and non-omegoid epiglottis cohorts. The difference between pre-operative and post-operative AHI and ESS scores were tabulated and statistically analyzed between the 2 cohorts to determine the effectiveness of surgery. Intra-rater measurement assessments were undertaken to ensure reliability of data-collection.
Result: Epiglottis shape will be correlated with the effectiveness of multilevel OSA surgery based on qualitative, Epworth Sleepiness Scale (ESS), and quantitative, apnoea-hypoapnoea index (AHI) data collection prior and post-surgery (On going).

Conclusions
This study aims to determine whether an omegoid epiglottis acts as a predictor of poor outcome following SAM trial soft tissue reconstructive protocol.