bluuebunny/crossref_metadata_2025_split huggingface dataset:
0619 Comparative analysis of different methods of assessing worker fatigue
Authors: de Mello Marco , Guerreiro Renato , Brant Valdenio , da Silva Flávia Rodrigues , Barreto Amaury , Santarelli Rodrigo , Biasibetti Isadora , Andrade Tonia Chaves , Silva Andressa 
Published: May 2023

Abstract

Introduction
Fatigue at work causes reduced functional capacity that is experienced during the workday, is associated with sleep deprivation and impairs decision making. Fatigue can be estimated in a self-reported way, through the Psychomotor Vigilance Test (PVT), postural balance and core body temperature (CBT) that correlate with performance. Interest in fatigue assessment should focus on identifying risk conditions. Thus, the objective of the study is to present comparative results of 4 different methods used to estimate fatigue.

Methods
This study was approved by Research Ethics Committee (protocol CAAE nº 97394818.6.0000.5149). The sample consisted of 47 volunteers, who worked as truck operators, in a fast reverse rotational shift (4x1) with a workload for each shift of 6 hours, including a 12-hour break between shifts. All workers were submitted to fatigue assessment by postural sway using the Sonômetro for 15 days, in addition to assessments for 5 days such as CBT monitoring, 5 minutes of PVT and karolinska sleepiness scale (KSS). The gamma distribution with the identity function was considered for data analysis through the method of generalized linear models.

Results
CBT measurements were compared from the first to the sixth hour between shifts, no significant differences were observed . Of the variables evaluated by PVT, only the 10% faster presented worse results in the night shift (00:00 to 06:00). The KSS showed no differences between the evaluated times. The result of the pairwise comparisons indicated that there are differences in postural sway by SONOMETRO, being greater at the beginning of the shift 00:00 to 06:00, in relation to the shift 12:00 to 18:00. In the middle and at the end of the shift, a difference was found between the shift 00:00 to 06:00 and all others.

Conclusion
Among the presented methods, the SONOMETER and a single variable of PVT (10% faster), identified differences in the levels of fatigue. It is up to managers to identify the method that best suits the objective of the assessment, as well as the local culture and conditions. Thus, the combined use of different risk and fatigue assessment and management methods may favor the identification and management of worker fatigue.

Support (if any)
0621 A machine learning model to predict the risk of perinatal depression from sleep data in healthy pregnant women
Authors: Garbazza Corrado , Mangili Francesca , D'Onofrio Tatiana Adele , Malpetti Daniele , D’Agostino Armando , Cicolin Alessandro , Cirignotta Fabio , Manconi Mauro 
Published: May 2023

Abstract

Introduction
Perinatal depression (PND) is a complication of pregnancy associated with serious health consequences for both mothers and their babies. Identifying predisposing factors for PND during early pregnancy is key to early detection of women who may be at greater risk of developing this condition. Machine Learning (ML) techniques have recently been applied in a few studies, mostly to predict postpartum depression. None of them, however, considered sleep data in model building, neither focused on PND.

Methods
By analyzing data from a multicenter, prospective cohort study on sleep and mood changes during the perinatal period (the “Life-ON” study), we constructed a ML model for PND risk prediction and tested it in a cross-validation setting. PND was assessed using an EPDS score &gt;12 during 9 visits from early pregnancy until 6 months postpartum. In a bivariate analysis, 47 sociodemographic, psychological, blood-based, medical/gynecological, and subjective sleep variables, collected from 439 pregnant women (33.7±4.2 yrs.) during the first trimester of gestation, as well as 33 polysomnographic (PSG) parameters, recorded from 353 women (33.6±4.2 yrs.) during the second trimester, were correlated with PND. A support vector machine (SVM) model was then trained using the 10-features with the highest permutation importance to predict the individual risk of PND for each woman.

Results
Among all variables considered, sleep quality (PSQI) and insomnia symptoms (ISI) (p&lt; 0.001), daytime sleepiness (ESS) and RLS severity (IRLS) (p&lt; 0.05), as well as the PSG parameters Apnea Index (p=0.001), number of central hypopneas and percentage of sleep stage N2 (p&lt; 0.05), were all positively correlated to PND. The PSQI and ISI scores were also selected by the SVM classifier, which achieved a mean AUROC of 0.777 and an AUPRC of 0.393, corresponding to a sensitivity of 54.3% and a specificity of 82.6% in identifying women at risk for PND.

Conclusion
In our data-driven ML model to predict the risk of PND during early pregnancy, subjective poor sleep quality and insomnia symptoms identified women at greater risk of developing PND, while none of the PSG variables improved model performance.

Support (if any)
Swiss National Science Foundation (grant: 320030_160250/1). The Italian Ministry of Health and Emilia-Romagna Region (grant: PE-2011-02348727).
0625 Sleep when the baby sleeps? The effect of daytime nap behaviors on postpartum depression severity: a stress buffering hypothesis
Authors: Dhaliwal Sammy , Gehrman Philip , Le Huynh-Nhu (Mimi) , Keller Jennifer , Sharkey Katherine 
Published: May 2023

Abstract

Introduction
The early postpartum is a time of expected maternal sleep loss, normalized as part of infant care. While short duration and disrupted nocturnal sleep are posited risk factors for postpartum depression (PPD), the role of daytime sleep remains less understood, despite the widespread recommendation that mothers sleep when their baby is sleeping. This study examined associations between napping, stress, and longitudinal PPD in a sample of in a sample of healthy first-time mothers, using a prospective ambulatory field study design.

Methods
Fifty primiparous women (62% non-White; mean age=32 years) without a history of sleep disorders or psychopathology completed 10-days (9-nights) of actigraphy and sleep diaries at postpartum week 6. Sleep variables included nighttime duration and efficiency, and daytime nap frequency, timing and duration. Participants completed 3-days of superimposed ecological momentary assessment (EMA) rating naturalistic infant-related stressors (task demand; effort-reward-imbalance) at four daily intervals. Hierarchical mixed models tested whether daytime sleep characteristics predicted lower depression levels (via Edinburgh Postnatal-Depression Scale - EPDS) at 6-weeks, 8-weeks, and 3-months postpartum. Time-varying within-person covariates included time-of-day, baseline depression and anxiety (via Generalized-Anxiety-Disorder-7 scores), and previous night sleep. To test the putative stress-protective role of napping, we examined pre-post nap differences in EMA ratings.

Results
Sixty percent (n = 30/47) of women napped regularly (&gt;3x/1 week, between 1-5 PM, &lt; 90 min by both diary and actigraphy), rating 80% of these naps “intentional.” Women with greater nap regularity at 6-weeks had lower depression levels at all timepoints (Betas = -2.4(1.6); -1.4(.5), -.5(.01) ps&lt;.001, respectively), and less of an increase in depression symptoms at 3-months postpartum, compared to non-nappers [Beta(SE)=-1.2 (.5); R^2=.21; p&lt;.001]. At 6-weeks, regular nappers reported lower stress post-nap (effort-reward-imbalance; demand) [Beta(SE)=-6.3(1.4); 1.2(.12,), R^2=.27, .32, respectively; ps&lt;.01].

Conclusion
This study demonstrates a contemporaneous mood-protective role of daytime sleep in a perinatal sample, using 24-hr objective sleep assessment coupled with daily assessments of naturalistic stressors. Moreover, these results provide support for the protective role of regular daytime sleep on development of PPD over time. Among new mothers who regularly nap, lowered post-nap stress may be one pathway through which daytime sleep buffers against PPD severity.

Support (if any)
NIMH-1R36MH118000-01, CTSI89431, T32-HL007713
0627 Postpartum Insomnia and Poor Sleep Quality are Uniquely Predictive of Postpartum Mood Disorders
Authors: Okun Michele , Lac Andrew 
Published: May 2023

Abstract

Introduction
Many postpartum women experience symptoms of depression (PPD) and anxiety (PPA). Insomnia and poor sleep quality are frequently reported by postpartum women and are risk factors for postpartum mood disorders. This longitudinal study sought to assess whether perinatal insomnia or sleep quality predicted depression and anxiety across each month of the first 6 months postpartum in women with a history of depression.

Methods
Pregnant women (N = 178) aged 18-45 years with a self-reported prior history of depression were recruited from social media in late pregnancy. None of the women were depressed at enrollment. In late pregnancy and for up to six months postpartum, women completed monthly online questionnaires including the ISQ, PSQI, EPDS, and GAD-7. Repeated-measures multilevel models were performed using the generalized linear mixed model command in the software IBM SPSS 28 to determine predictive associations across the postpartum. Demographics (age, education, race, and sex of baby) were statistically controlled for in these models.

Results
The rate of depression averaged (15.7%) and anxiety averaged (17.0%) across the postpartum. The prevalence of insomnia was 20.4%, and the prevalence of poor sleep quality was 67.8% across the first 6 months postpartum. Insomnia in the postpartum predicted greater depressive and anxiety symptoms, even after controlling for prenatal insomnia. Likewise, poor sleep quality in the postpartum predicted greater depressive and anxiety symptoms after controlling for prenatal poor sleep quality scores. When considering clinical cutoffs of the EPDS ≥ 12 and GAD ≥ 10, postpartum insomnia and sleep quality uniquely predicted postpartum depression (OR = 5.69, 95% CI 3.33-9.74 and OR = 3.13, 95% CI 1.70 -5.77). Insomnia predicted postpartum anxiety (OR = 11.15, 95% CI 5.99-20.78), with sleep quality trending (OR = 1.76, 95% CI 0.99 -3.12). None of the demographic variables significantly contributed (P’s &gt; 05).

Conclusion
Both postpartum insomnia and poor sleep quality contributed to clinical postpartum mood. The chronic sleep deprivation of insomnia and the subjective experience of poor sleep quality are uniquely relevant to risk for postpartum mood. The consideration and treatment of both is important as they are uniquely associated with adverse outcomes for mother and child.

Support (if any)
Happiest Baby, Inc
0630 For Whom the Bell Tolls: Empirical Clustering of Insomnia and Suicidal Ideation
Authors: Tubbs Andrew , Karp Jordan , Perlis Michael , Grandner Michael , Fernandez Fabian-Xosé , Killgore William 
Published: May 2023

Abstract

Introduction
Insomnia is associated with risk for suicidal thoughts and behaviors. It is unclear if insomnia drives risk equivalently across all individuals, or whether there are subgroups of high-risk individuals for whom insomnia is more relevant. This exploratory archival analysis examined the relationship between insomnia and current suicidal ideation among subgroups of individuals with lifetime suicidal ideation.

Methods
Data were acquired from the Military Suicide Research Consortium on 2,617 individuals without missingness on measures of suicidal thoughts and behaviors, anxiety, insomnia, thwarted belongingness, traumatic brain injury, risky alcohol use, and symptoms of post-traumatic stress. Medoid (k-means) clustering algorithms identified subgroups. Robust Poisson models tested interactions between insomnia and cluster identity in association with current suicidal ideation. Models were unadjusted, adjusted for demographic factors, and adjusted for clinical characteristics.

Results
Clustering identified two subgroups: Cluster 1 (N=1,141) and Cluster 2 (N=1,494). Cluster 1 had fewer individuals with current suicidal ideation (29.2% vs. 66.6%) and in general had less severe symptoms of anxiety, PTSD, insomnia, traumatic brain injury, and suicidal thoughts and behaviors. Across clusters, insomnia severity was associated with risk for current suicidal ideation (PRR: 1.09 [1.03-1.14]). Although individuals in Cluster 1 were less likely to have current suicidal ideation (PRR 0.51 [0.44-0.58]), greater severity of insomnia was associated with greater risk (PRR: 1.11 [1.04-1.18]). By contrast, individuals in Cluster 2 had a greater risk of current suicidal ideation (PRR: 1.68 [1.51-1.88]) and greater severity of insomnia was associated with a diminished risk of current ideation (PRR 0.92 [0.88-0.97]).

Conclusion
In this exploratory study, individuals with less severe psychopathology were more likely to report current suicidal ideation with worsening insomnia, while those with severe psychopathology were less likely to report suicidal ideation with worsening insomnia. Insomnia may disproportionately increase suicide risk among lower risk individuals.

Support (if any)
This work was in part supported by the Military Suicide Research Consortium (MSRC), an effort supported by the Office of the Assistant Secretary of Defense for Health Affairs under Award No. (W81XWH-16-2-0003). Opinions, interpretations, conclusions, and recommendations are those of the author and are not endorsed by the MSRC or the Department of Defense.
0632 The relationship of shift work disorder with depression, anxiety, and stress
Authors: Chang Melinda , Mendieta Miguel , Vidafar Parisa , Birk Jeffrey , Shechter Ari 
Published: May 2023

Abstract

Introduction
Shift work-related circadian misalignment can adversely impact health and well-being. Shift workers often experience disturbances in mood and impairments in waking vigilance and cognitive performance. Shift workers also commonly experience disturbed sleep. Shift work disorder (SWD) is a circadian rhythm sleep disorder characterized by insomnia symptoms during the sleep episode and sleepiness during the wake episode, temporally associated with shift schedules. Here, we examined the association between SWD and mental health.

Methods
Participants were adults (18 y+) who engaged in non-standard work shifts (morning, evening, night, rotating, other). Data were collected via online survey, and included questions about demographics, job details, sleep, and mental health. Participants completed the validated SWD Questionnaire, assessing the presence and severity of symptoms, categorizing individuals as high or low risk for SWD based on International Classification of Sleep Disorders criteria. Participants completed the Depression, Anxiety, and Stress Scale-21 (DASS-21). Higher scores on each DASS-21 subscale indicate higher symptom severity. Linear regression was used to determine the relationship between the presence of SWD and depression, anxiety, and stress symptom scores, adjusting for age, gender, shift work type, self-reported work-day sleep duration, and alcohol use frequency.

Results
Sixty participants were included (60% female, mean age: 37 [SD: 12.2] y). High risk for SWD was seen in 55% of participants. Sleep duration was on average ~40 minutes shorter in those with vs. without SWD (5.61 [1.24] h vs. 6.31 [1.31] h, p=.037). Participants with SWD reported significantly higher depressive symptoms than those without (B=3.59, SE=1.52, 95% CI [0.54, 6.65], p=.022). SWD was not associated with anxiety, and was marginally associated with stress (B=2.48, SE=1.26, 95% CI [-0.06, 5.02], p=.055). Age was significantly associated with lower stress symptoms (B=-0.11, SE=0.05, 95% CI [-0.22, -0.01], p=.029). No other covariates were significantly associated with depression, anxiety, or stress (all other ps ≥.10).

Conclusion
SWD was common. Its presence was associated with higher severity of depression symptoms. Intervention approaches targeting underlying causes of SWD (e.g., strategic light-dark exposure and cognitive behavioral therapy for insomnia that is adapted for shift work) should be tested as methods to protect shift workers’ mental health.

Support (if any)
0633 Age matters: Association between age and depression severity at the time of OSA diagnosis, and PAP adherence in adult patients
Authors: Niraula Rijesh , Singh Amitoj , DelRosso Lourdes , Meghpara Sanket , Keenan Lynn , Van Gundy Karl 
Published: May 2023

Abstract

Introduction
Numerous studies have shown association and symptom overlaps between Obstructive Sleep Apnea (OSA) and depression. However, data is limited on association between age, severity of depression at time of OSA diagnosis, and its impact on PAP adherence. Patient Health Questionnaire-9 (PHQ-9) is a validated depression screening and severity scoring tool recommended by DSM-V. In this retrospective observational study, we will evaluate the interrelationship between age at OSA diagnosis, depression severity and positive airway pressure (PAP) adherence.

Methods
Patients were seen at the University of California, San Francisco Fresno sleep center. PHQ-9 scores for depression severity uses a 1-5 scale (1 = none, 2 = mild, 3 = moderate, 4 moderately severe, 5 = severe). PHQ-9 was administered at diagnosis of OSA and follow up, and average daily PAP usage was obtained from PAP devices after 1 month of therapy initiation. IBM SPSS version 29.0.0 was used to calculate descriptive statistics, Pearson correlation and Mann Whitney test.

Results
Twenty-six participants were included with mean age 53.04 years and standard deviation (SD) 17.97. PHQ-9 scores ranged 4-27 with mean 10.6, SD 5.9, 40% with mild and 66.3% with moderate to severe scores. 53.8% were 50 years or older (“older”) while 46.2% were 49 years or younger (“younger”). Pearson correlation between average CPAP use and PHQ-9 scores was 0.181. Age did not affect PAP adherence (Pearson correlation -0.046). Moderate correlation was noted between age and PHQ-9 scores (-0.4390) with younger patients showing more severe depression scores. Comparison between “older” and “younger” patients showed significant difference in PHQ-9 scores (p=0.020).

Conclusion
This study showed that PHQ-9 scores at the time of OSA diagnosis are moderately correlated with younger age, with those patients younger than 50 years old having more moderate to severe PHQ-9 scores than patients 50 years or older. We did not find correlation between age and PAP adherence or between PHQ-9 scores and PAP adherence. Our findings can help identify depression early on in the diagnosis of obstructive sleep apnea and bring awareness that the young adult population can be particularly vulnerable.

Support (if any)
0635 Associations Between Ambient Light Exposure and Development of Depressive Symptoms in Women at Risk for Postpartum Depression
Authors: Sharkey Katherine , St. Hilaire Melissa 
Published: May 2023

Abstract

Introduction
There is increasing recognition that ambient light exposure plays a critical role in daytime functioning, including mood regulation. In this analysis, we examined associations between 24-hour light exposure patterns and mood in women at risk of developing postpartum depression.

Methods
Perinatal women ages 18-40 with a history of major depressive disorder or bipolar disorder who did not meet criteria for depression at study enrollment during 3rd trimester wore wrist actigraphs that recorded ambient light levels for one week at 3rd trimester (~33 weeks’ gestation) and again during postpartum weeks 2, 6, and 16. Depressive symptoms were assessed with the Hamilton Depression Rating Scale (HAM-D-17) at the end of each recording week. To summarize the light data, we calculated the arithmetic mean of the log-light levels in twenty-four 60-minute bins across each day and then aggregated each hour across each recording week. We used nonlinear model fitting (cosinor) to calculate area under the curve (AUC) and compared 24-hour and morning (8:00 am to 12:00 pm) light exposure patterns between women with elevated depression symptoms at week 16 (HAM-D-17 &gt; 7) and women with low depression symptoms at study entry and week 16 (HAM-D-17 &lt;=7) using Mann-Whitney U-tests.

Results
Compared with women who did not become depressed (n=15), those who ultimately developed depression (n=8) had significantly lower morning light exposure at 3rd trimester and at postpartum week 6, but not at postpartum week 16. Effect sizes were moderate at 3rd trimester (eta-squared=0.30) and small at Week 6 (eta squared=0.24). There were no significant differences in the overall 24-hour AUC of light exposure between participants who developed significant depressive symptoms at postpartum week 16 and non-depressed women at any time point [3rd trimester: p=0.35; postpartum week 6: p=0.92; postpartum week 16: p=0.35].

Conclusion
In this sample of perinatal women at risk for postpartum depression, new mothers who developed clinically-significant depressive symptoms at postpartum week 16 had lower levels of morning light exposure during 3rd trimester and at 6 weeks postpartum. Lower peripartum morning light exposure may predict the development of postpartum depression.

Support (if any)
MH086689 to KMS
0637 Associations Between Sleep Quality and Child Behavioral Problems, a Longitudinal Analysis
Authors: Tussey Emma , Wong Maria 
Published: May 2023

Abstract

Introduction
Internalizing and externalizing behaviors are important mental health outcomes in children. Internalizing symptoms are characterized by a disturbance in mood or emotion. Symptoms include loneliness, sadness, anxiety, rumination, and depression. Externalizing symptoms are behaviors that are aversive to others and experienced by other people. Symptoms include aggression, hyperactivity, property destruction, and losing one’s temper. This longitudinal analysis examined how children’s sleep quality related to their internalizing and externalizing behaviors.

Methods
246 Children (n = 246 at T1, n = 196 at T2, n = 151 at T3), with a mean age of 9.9 (SD = 1.4) at time one, participated in a longitudinal study on sleep and substance use. Sleep quality was measured with the Adolescent Sleep Wake Scale (range 1-6); higher scores represent better sleep quality. Child internalizing and externalizing behavior problems were measured using the Childhood Behavior Checklist; higher scores indicate higher levels of behavioral problems. The associations between sleep quality, and internalizing and externalizing behavior at T1, T2, and T3 were examined. One year separated each time-point. Data were analyzed by structural equation modeling. Latent variables of sleep quality, internalizing, and externalizing were created from the observed measurements at the three time-points. Latent variables of internalizing and externalizing were regressed on sleep quality.

Results
The model indicated an excellent fit with the data (χ2 = 21.94, p = 0.46; CFI = 1.00; TLI = 1.00; RMSEA = 0.00). All observed variables loaded significantly onto their respective latent variables, internalizing, externalizing, and sleep quality (p &lt; 0.001). Results indicated that the latent variable of sleep quality predicted both the latent variables of internalizing (b = -0.34, se = 0.09, p &lt; 0.001) and latent externalizing behaviors (b = -0.31, se = 0.08, p &lt; 0.001).

Conclusion
These results indicate children with better sleep quality have fewer internalizing and externalizing behavioral problems. This suggests that improving sleep quality could improve behavioral problems in children. Alternatively, improving behavioral problems may improve sleep quality. Future research should examine the directionality of this relationship. Future research should also test if sleep or behavioral interventions improve sleep quality and child behavioral problems.

Support (if any)
NIH Grant R01 AA020364