bluuebunny/crossref_metadata_2025_split huggingface dataset:
0847 Real-World Idiopathic Hypersomnia Total Health Model (RHYTHM): Clinical Burden of Patients Diagnosed With Idiopathic Hypersomnia
Authors: Lillaney Prasheel , Saad Ragy , Profant Deb , Fuller Douglas , Alvord Trevor , Prince Patricia , Whalen Marisa , Macfadden Wayne , Ni Weiyi , Black Jed 
Published: May 2023

Abstract

Introduction
Idiopathic hypersomnia (IH) is a rare neurologic disorder that can cause debilitating symptoms, including excessive daytime sleepiness, severe sleep inertia, prolonged nighttime sleep, long and unrefreshing naps, and cognitive dysfunction. Limited research has investigated the clinical burden associated with IH. This study compared the clinical profile of patients diagnosed with IH versus matched non-IH controls.

Methods
MarketScan® administrative claims were analyzed between December 2013 and February 2020. Eligible patients were aged ≥18 years upon cohort entry and had 365 days of continuous medical coverage (gaps ≤30 days allowed) before and after cohort entry. IH cases entered the cohort upon the first medical claim containing an IH diagnosis and without history of cataplexy. Non-IH controls were matched 5:1 to patients with IH on age, sex, region, payer type, and cohort entry date. Prevalence estimates of Clinical Classification System Multilevel (CCSM) categories and comorbid conditions during the 2-year study period were compared between cohorts using logistic regression. Odds ratios (ORs) and 95% confidence intervals (CIs) were reported.

Results
The final cohorts included 11,428 and 57,138 patients with IH and non-IH controls, respectively. Approximately two-thirds of the sample was female (65.0%); median age was 45 years. Compared with non-IH controls, patients with IH experienced significantly higher prevalence of all CCSM categories. Prevalence estimates of conditions associated with sleep disorders, such as sleep apnea (OR: 26.1 [CI: 24.8, 27.6]), mood disorders (OR: 3.7 [CI: 3.6, 3.9]), and headache/migraine (OR: 2.9 [CI: 2.7, 3.0]), were higher among patients with IH. Similarly, cardiovascular conditions, including cardiovascular disease (OR: 2.2 [CI: 2.1, 2.4]), stroke (OR: 2.2 [CI: 2.0, 2.4]), major adverse cardiovascular events (OR: 2.2 [CI: 2.0, 2.4]), a composite of hypertension diagnosis or use of antihypertensive medications (OR: 2.0 [CI: 2.0, 2.1]), and heart failure (OR: 2.0 [CI: 1.8, 2.3]), were significantly more prevalent among patients with IH.

Conclusion
Patients with IH experience a significant burden of psychiatric and medical comorbidities, including acute and chronic cardiovascular illnesses. This is consistent with observations in other sleep disorders, namely, narcolepsy. Holistic treatment strategies for IH patients are needed, requiring careful consideration of patients’ overall clinical profile when selecting therapies.

Support (if any)
Jazz Pharmaceuticals.
0849 A Cross-Sectional Survey of Cannabis as a Sleep Aid in Canadian Cancer Survivors
Authors: Lee Rachel , Harris Nicholas , Donnan Jennifer , Garland Sheila 
Published: May 2023

Abstract

Introduction
Cannabis is increasingly used to manage cancer treatment-related symptoms. This study investigated the use and perceived effects of cannabis as a sleep aid in Canadian cancer survivors.

Methods
Canadian cancer survivors (N=1492) completed a self-report questionnaire about their use of cannabis as a sleep aid.

Results
Of participants, 24% (n=356) reported currently using cannabis as a sleep aid (Mage = 61; 88% white, 78% in remission). Two thirds (67%; n=238) report only starting to use cannabis for sleep after their cancer diagnosis. Reported benefits include that cannabis helps them relax (59%) and fall asleep faster (48%). Half of participants (49%) use cannabis for sleep over 4-6 times a week, meeting the criteria for regular cannabis use and 53% have been using cannabis as a sleep aid for more than 2 years. Cannabis is most commonly used in the form of edibles (58%) and oils/ sprays (45%). Only 19% have authorization from a healthcare provider and 56% obtain their cannabis from a government regulated site. There was a mix of cannabinoid content in the products used, including products that contain mostly CBD (22%), mostly THC (35%), balanced amounts of CBD and THC (32%), and 8% do not know the formulation of the cannabis they consume. The most common reasons for trying cannabis for sleep were a recommendation from family/friends (43%), their own research (35%), and that they believed it to be more natural than medication (31%). Of those who use cannabis for sleep, 31% also use it to reduce pain and 23% use it recreationally.

Conclusion
Estimates suggest that one in four Canadian cancer survivors’ regularly use cannabis to improve their sleep. Given the prevalence and potential impact, more research is needed to examine the actual efficacy of cannabis as a sleep aid.

Support (if any)
Rachel Lee is a trainee in the Cancer Research Training Program of the Beatrice Hunter Cancer Research Institute, with funds generously provided by the Canadian Cancer Society’s JD Irving, Limited – Excellence in Cancer Research Fund. Dr Garland is supported by a Canadian Cancer Society Emerging Scholar Award (Survivorship) (grant #707146).
0851 Evaluation of a new sleep focused nasal obstruction symptom evaluation (NOSE) tool
Authors: Zahir Nada , Sharma Abhay , Woodson B Tucker 
Published: May 2023

Abstract

Introduction
Nasal obstruction is a common patient complaint in the sleep clinic. The nasal obstruction symptom evaluation (NOSE) scale is a validated questionnaire to assess symptoms and quality of life. However, it has weaknesses when evaluating patients in the sleep clinic because it does not differentiate awake and sleep related nasal obstruction. Our primary goal was to compare the old NOSE scale to a new sleep NOSE scale that separates awake and sleep related nasal obstruction.

Methods
A retrospective study was completed to compare the known NOSE scale (old NOSE) with a revised clinical scale more relevant to the sleep clinic (new sleep NOSE and new awake NOSE). 169 adult participants completed the 3 scales in a sleep clinic specializing in otolaryngologic interventions. The collected data compared median scores (Wilcoxon’s signed rank test), agreement (Cohen’s kappa), and correlation (Spearman correlation). Wald’s test was also used to compare the scores between subgroups of insomnia and obstructive sleep apnea (OSA).

Results
The old NOSE scale scores were not significantly different from the sleep NOSE score (p=0.4) but was significantly different from the awake NOSE scale (p&lt; 0.001). The new sleep NOSE scores were also significantly higher than then awake NOSE scores (p&lt;.001). Patients with insomnia tended to score higher on the sleep NOSE scale than the awake NOSE scale.

Conclusion
This study suggests that in the sleep clinic setting, patients score the NOSE scale according to sleep related obstruction. In addition, insomnia patients relate more nighttime than daytime nasal obstruction. Further studies are needed to determine if the NOSE scale needs to be revised to better encompass nasal complaints related to sleep.

Support (if any)
0853 Neighborhood disorder and pain: The mediating role of sleep
Authors: Holloway Breanna , Waldstein Shari R , Quiton Raimi , Sun Shuyan , Evans Michele , Zonderman Alan , Bediako Shawn M 
Published: May 2023

Abstract

Introduction
Neighborhood factors are related to poor sleep, and sleep problems are known to have a strong relationship with pain. The underlying mechanisms for this association remain unclear. The present study evaluated whether sleep duration, sleep quality, or global sleep quality mediated the relation between perceived Neighborhood Disorder (ND) and pain intensity or interference. The study also explored whether adjusting for depressive symptoms accounted for significant mediational pathways found in Aim 1.

Methods
Participants were drawn from Wave 4 (September 2013 to September 2017) of the Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS) epidemiologic cohort study (n=1,071). Perceived ND was measured using the HANDLS Neighborhood Problems Scale, which assesses how often a particular neighborhood problem occurs. The Patient Reported Outcomes Measurement Information System Pain Intensity short form 3a was used to assess how much a person hurt in the past 7 days, and pain interference was measured by the bodily pain subdomain of the 12-item Short-Form Health Survey. The Pittsburgh Sleep Quality Index was used to assess sleep duration, subjective sleep quality, and global sleep quality.

Results
Results of the study revealed mediating effects of global sleep quality on the relation of perceived ND and pain intensity (indirect effect = .5527, SE =.1355, 95% CI [.2914, .8316]) and pain interference (indirect effect = .0579 (SE = .0143), 95% CI [.0312, .0876]) and also of subjective sleep quality on pain intensity (indirect effect = .5801, SE =.1337, 95% CI [.3206, .8468]) and pain interference (indirect effect = .0587 (SE =.0137), 95% CI [.0327, .0867]). Results revealed that mediating effects of sleep quality and global sleep on the relation of perceived ND and pain intensity and pain interference remained significant after adjustment for depressive symptoms.

Conclusion
These findings provide preliminary evidence to support the notion that select sleep dimensions, particularly sleep quality, is a pathway by which subjective neighborhood factors may impact pain intensity and pain interference. More research is needed to understand potential pathways underlying the perceived ND and pain relation.

Support (if any)
NIH Intramural Research Program Inter-laboratory proposal provided by the National Institute on Aging Intramural Research Program
0854 Observation-based Diurnal Sleepiness Inventory (ODSI) is associated with Objective Sleepiness via Psychomotor Vigilance Task
Authors: Pak Victoria , Russell Kate , Gooneratne Nalaka , Cox John , Servaes Stijn , Lee Taekyu , Onen Hakki , Onen Fannie 
Published: May 2023

Abstract

Introduction
The Epworth Sleepiness Scale (ESS) is commonly used to assess excessive daytime sleepiness, but its accuracy is limited. In this study, we aim to compare the ESS with the Observation-based Diurnal Sleepiness Inventory (ODSI), a subjective measure of sleepiness that has been validated using the ESS in older adults, to objective measures of sleepiness obtained through the Psychomotor Vigilance Task (PVT). Despite being validated with the ESS, the ODSI has not yet been tested with objective measures of sleepiness. By comparing subjective measures of sleepiness (ODSI and ESS) to objective measures (PVT), we aim to expand the usage of ODSI to other populations.

Methods
91 persons with newly diagnosed obstructive sleep apnea and not yet treated on continuous positive airway pressure (CPAP) were administered the ESS, ODSI, and PVT sleepiness tests, and the results were analyzed for correlations using linear regression. The average age was 50.48 ± 12.74, the mean body mass index (BMI) was 35.9 ± 9.3, the mean apnea hypopnea index was 30.9 ± 23.7, and 53.5% were male. The ESS and ODSI scores were run against PVT lapses and transformed average reaction time, which are the two primary outcomes of PVT.

Results
PVT lapses were significantly different between sleepy and non-sleepy individuals as defined by both ESS and ODSI categorization. Both the ODSI and the ESS were significantly correlated to the transformed average reaction time. The second question on the ODSI was also significantly correlated to PVT lapses as well as the transformed average reaction time.

Conclusion
The ODSI and ESS correlated well with objective measures of sleepiness through the PVT. The ODSI is a suitable measure of sleepiness appropriate for usage in middle-aged adults with obstructive sleep apnea.

Support (if any)
R00NR014675-05 (PI: Pak)
0855 Patient-reported sleep symptoms across four cycles of chemotherapy among adults with lymphoma: A pilot study
Authors: Fox Rina , Kalam Faiza , Gaumond Julia , Crawford Abigail , Karmali Reem , Morelli Whitney , Hibler Elizabeth , Knutson Kristen 
Published: May 2023

Abstract

Introduction
Sleep disturbance is one of the primary symptoms reported by cancer survivors before, during, and after treatment. To better understand trajectories of sleep disturbance over the course of chemotherapy, we evaluated patient-reported symptoms among adults being treated for lymphoma.

Methods
Participants were 18-74 years old, English-speaking, and scheduled to be treated with a full course of anthracycline-based chemotherapy. Among other assessments, participants completed a battery of patient-reported outcome measures prior to the first cycle of chemotherapy (T1) and on the final days of the second (T2) and fourth (T3) cycles. Sleep symptoms were assessed with the Insomnia Severity Index (ISI), PROMIS Sleep Disturbance (PROMIS-SD), and PROMIS Sleep-Related Impairment (PROMIS-SRI) measures. Given the small sample size, descriptives and effect sizes were calculated rather than conducting inferential analyses.

Results
Participants were 9 adults with Hodgkin’s (n=5) or Non-Hodgkin’s (n=4) lymphoma, mean age 41 years (SD=13.9), mostly male (89%), White (78%), and non-Hispanic (89%). The majority had higher scores on the ISI (85.7%), PROMIS-SD (71.4%), and PROMIS-SRI (71.4%) at T2 than T1, demonstrating more sleep disturbance mid-chemotherapy than prior to chemotherapy. Conversely, the majority had lower scores at T3 than T2 (ISI: 80.0%, PROMIS-SD: 80.0%, PROMIS-SRI: 100.0%), demonstrating less sleep disturbance at late-chemotherapy than mid-chemotherapy. For most participants scores remained higher at T3 than T1 (all 3 measures: 75.0%), indicating more sleep disturbance at late-chemotherapy than pre-chemotherapy. Averaged across participants, differences in scores from T1 to T2 were small-to-medium (ISI: Hedges’ g=0.42, PROMIS-SD: g=0.44, PROMIS-SRI: g=0.62), from T1 to T3 were small (ISI: g=0.26, PROMIS-SD: g=0.26, PROMIS-SRI: g=0.23), and from T2 to T3 were medium-to-large (ISI: g=0.98, PROMIS-SD: g=0.73, PROMIS-SRI: g=0.53).

Conclusion
Patient-reported sleep symptoms worsened over the first two cycles of anthracycline-based chemotherapy. Symptoms improved over the subsequent two cycles; however, for most participants they remained worse than baseline levels. Pending replication in a larger sample, intervening before initiating chemotherapy or during the early cycles thereof may be beneficial to diminish sleep disturbance among patients with lymphoma.

Support (if any)
The project described was supported by the Robert H. Lurie Comprehensive Cancer Center. RSF was supported by NCI grant #K08CA247973. EH was supported by NHLBI grant #K01HL152009.
0857 Associations between Functional Vision and Sleep Performance
Authors: Joyce Daniel , Fernandez Kaitlin , Ricketts Emily 
Published: May 2023

Abstract

Introduction
Conserved early visual pathways set visual perception and sleep consolidation and timing, but the associations between functional vision and sleep are not well established. Here, we determine these associations in a nationally-recruited adult cohort and contrast them with health outcome covariates.

Methods
Data were drawn from 5973 adults aged 20 to 85 years (M=41.32, SD=21.82), obtained from the US National Health and Nutrition Examination Survey (NHANES) 2005-2006 and 2007-2008 cohorts. Adults reported demographics, sleep duration, vision, body size (body mass index; BMI), depression (Patient Health Questionnaire-9), and social support information. Spearman’s rank correlations were performed to determine the association between self-reported measures of functional vision and self-reported typical nightly sleep duration. To determine the influence of covariates thought to moderate health outcomes on this association, ordinal logistic regression was performed with sleep as the predictor and ‘general eyesight condition’ or ‘vision limiting activities’ as the dependent variables; and age, BMI, depression, and emotional support as covariates.

Results
Typical nightly sleep duration correlated very weakly with general eyesight condition (r=-.07, p&lt;.001), vision limiting activities (r=-.03, p=.001), eyesight worry (r=-.09, p&lt;.001), difficulty reading newsprint (r=-.06, p&lt;.001), and difficulty discriminating objects (r=-.03, p=.007). For general eyesight condition, (exponentiated) odds ratios were minorly improved with increasing typical nightly sleep duration (B=.93, p&lt;.001), but these effects were eclipsed by psychosocial factors such as PHQ-9 depression score (B=1.11, p&lt;.001) and emotional support availability (B=.71, p&lt;.001), while ageing had a minor effect (B=1.02, p&lt;.001) and BMI did not associate (p=.29). For vision limiting activities; odds ratios were not influenced by typical nightly sleep duration (p=.086), psychosocial factors such as PHQ-9 depression score (B=1.13, p&lt;.001) and emotional support availability (B=0.63, p&lt;.001) meaningfully enhanced odds ratios, while ageing (B=1.03, p&lt;.001) and BMI had minor effects (B=1.01, p=.009).

Conclusion
Despite shared sensory pathways, the neuroprotective effects of sleep on functional vision appear limited. Unlike for many disorders, BMI and ageing did not meaningfully associate with functional vision deficits. Psychosocial support mechanisms had the strongest beneficial association with functional vision, and such mechanisms should be given more consideration during optometric care.

Support (if any)
BBRF NARSAD (#28056). KTEF Career Starter (#NNO). NAM Catalyst (#2000012740).
0859 Characterizing Comorbid Chronic Pain in Veterans with Obstructive Sleep Apnea
Authors: Saconi Bruno , Polomano Rosemary , Compton Peggy , Keenan Brendan , Kuna Samuel , Sawyer Amy 
Published: May 2023

Abstract

Introduction
Evidence suggests that chronic noncancer pain (CP) and obstructive sleep apnea (OSA) are highly prevalent in the adult civilian population. As military veterans are disproportionally affected by both CP and OSA, greater understanding of the frequency and characteristics of CP that most commonly affect veterans with OSA is needed. Thus, this study characterized CP among veterans with OSA in terms of frequency, location, duration, severity, interference on daily activities, and etiology (neuropathic versus not).

Methods
A descriptive, observational, cross-sectional survey of veterans with newly diagnosed, untreated OSA and reporting pre-existing CP (N=107). Descriptive statistics characterized the sample and comorbid CP outcomes.

Results
In total, 69.5% (107/154) of participants with OSA who consented for the study had CP. Among participants with CP completing the survey (66.4% [71/107]), CP symptoms persisted for 15 years (IQR = 10-26.5). On average, Brief Pain Inventory – Short Form scores (0-10 scale) indicate moderate pain severity (5.2 ± 2.0) and interference on daily activities (5.7 ± 2.3). Greater pain interference was with sleep (6.3 ± 3.1) and enjoyment of life (6.0 ± 2.5). Pain affected multiple body regions and symptoms of predominantly neuropathic origin (defined as Self-completed Leeds Assessment of Neuropathic Symptoms and Signs scores ≥ 12) were reported by 49.3% of the sample.

Conclusion
CP is commonly comorbid with OSA. Primary care, pain management, and sleep medicine providers should prioritize CP screening, OSA screening, and management among patients with OSA. Future investigations of CP and OSA should focus on their association and how the effective treatment of one affects the severity of the other.

Support (if any)
SRSF Small Research Grant Award: 05-SRG-20. University of Pennsylvania School of Nursing, Office of Nursing Research.
0860 Comparative description of sleep, thyroid-stimulating hormone and calcium metabolism in 5 vitiligo patients under phototherapy
Authors: Xerfan Ellen , Facina Anamaria , Tomimori Jane , Tufik Sergio , Andersen Monica 
Published: May 2023

Abstract

Introduction
Vitiligo is an autoimmune skin disease represented by melanocytes destruction. Clinically, it evolves with spots that are lighter than normal skin color. Periodical evaluation of patients is recommended, including thyroid function. Phototherapy is its gold standard treatment, consisting in specific range of ultraviolet B (UVB) light sections. Sleep may play an immunological role, and should be investigated in vitiligo. The study aimed to compare results of thyroid-stimulating hormone (TSH), parathyroid hormone (PTH), serum calcium and vitamin D 1.25(OH)2D and 25(OH)D; and Pittsburgh Sleep Quality Index (PSQI) scores of vitiligo patients before and after phototherapy period.

Methods
Five individuals with vitiligo were evaluated at a University Dermatology Service, following ethical guidelines. Blood collection and PSQI application were performed before and after phototherapy. Laboratory elements were those related to calcium metabolism (PTH, calcium and vitamin D) and TSH.

Results
The sample included 4 female individuals with 21, 46, 65 and 70 years old; and a 57 years old male. Three of them had large skin involvement and 2 had localized vitiligo. After 6 months under phototherapy, patients returned for reassessment. All showed skin lesions improvement. Quantitative increase in TSH, PTH, 1.25(OH)2D and 25(OH)D was observed; serum calcium varied among the sample. Regarding PSQI before phototherapy, all 5 scores were &gt;5 (1 score&gt;10). The PSQI was reapplied only in 3 of the 5 volunteers after phototherapy; 2 scores reduced, and 1 score increased. This results, although from few individuals, alert to the possible role of UVB phototherapy on TSH and calcium metabolism substrates. Vitamin D increase may be associated to improvement of subjective sleep of 2 individuals. It was described that vitamin D in sufficient concentration could be related to better sleep quality. Phototherapy, by acting on clinical improvement of vitiligo, may influence subjective sleep, as reported in PSQI; and it could influence on melatonin and circadian rhythm.

Conclusion
The interaction between vitiligo/autoimmunity, phototherapy, vitamin D and sleep is complex and may have interrelated pathways. A better understanding of this pathophysiology through larger studies is worthy for benefiting clinical management of vitiligo and associated sleep disorders.

Support (if any)
AFIP, CAPES and CNPq.