bluuebunny/crossref_metadata_2025_split huggingface dataset:
0368 Vulnerability to influenza-like illness is associated with insomnia severity
Authors: Guzenko Dmytro , Winger Trevor , Chellamuthu Vidhya , Barr Shawn , DeFranco Susan , Gorski Brandon , Molina Gary Garcia 
Published: May 2023

Abstract

Introduction
Decreased immune function is associated with sleep disorders, including insomnia. Our goal was to evaluate the vulnerability to influenza-like illness (ILI) in insomnia as quantified by the insomnia severity index (ISI). To evaluate ILI vulnerability, we leveraged a published model that estimates the daily probability of ILI symptoms from a smart bed using ballistocardiograph sensors.

Methods
A longitudinal IRB-approved study was conducted with Sleep Number customers between November 2021 and April 2022 to assess the longitudinal course of insomnia. Four surveys incorporating the ISI were administered at six-week intervals. Individuals responding to at least three surveys were included in the analysis (n=3117). ISI changes were modeled using linear regression to identify respondents with quasi-constant ISI for which ILI vulnerability was quantified. For each respondent, the mean ISI (μI) was calculated and categorized into two levels: no insomnia (μI ≤ 14) and insomnia (μI &gt; 14). Bed data, including daily and restful sleep duration, sleep latency, sleep quality, heart rate, breathing rate, and motion level, were queried for 2019 (pre-COVID) and 2021 to evaluate the daily probability of experiencing ILI symptoms.

Results
Respondents with quasi-constant ISI (n=1680) included no-insomnia (1431) and insomnia (249). For 2019, the no-insomnia group had 1.23 (SD 1.82) ILI episodes on average which was significantly lower (p&lt; 0.01) than the insomnia group, 1.49 (SD 1.77). The ILI-risk odds ratio for insomnia was 1.15 (CI 0.99-1.32). The mean ILI episode duration for the no-insomnia group was 4.29 (SD 7.19) days, which was significantly lower (p&lt; 0.01) than the insomnia group 6.06 (SD 8.90) days. For 2021, similar results were obtained, with the no-insomnia group having significantly (p&lt; 0.01) lower ILI episodes 1.22 (SD 1.63) on average compared to the insomnia group 1.49 (SD 1.67). The mean ILI episode duration for the no-insomnia group, 4.98 (SD 8.22) days, was significantly lower (p&lt; 0.01) than the insomnia group, 6.14 (SD 7.93) days.

Conclusion
Insomnia may be significantly associated with more and lengthier ILI episodes per year. This was found for both 2019 and 2021 data. Additional research is needed to evaluate causality.

Support (if any)
Sleep Number Corporation funded this study.
0369 Zero-time Exercise on Physically Inactive Adults with Insomnia Disorder: A Randomized Controlled Trial
Authors: Yeung Wing Fai , Chen Shu Cheng , Lai Yuen Kwan , Lam Tai Hing 
Published: May 2023

Abstract

Introduction
Exercise is a potential treatment for insomnia. However, lack of time is a major barrier to starting and maintaining exercise. Therefore, a brief exercise training program, called Zero-time Exercise (ZTEx), was developed to relieve insomnia. ZTEx is a simple exercise that can be incorporated into habitual daily routines, requiring no extra time or equipment. This study examined the effectiveness of a ZTEx intervention program on sleep and related outcomes in inactive adults with insomnia disorder.

Methods
This randomized controlled trial (RCT) included 140 physically inactive adults (mean age: 46.7 years, SD: 14.0; 82.1% female) with insomnia disorder from the community. They were randomly assigned to ZTEx training or sleep hygiene education (SHE) group. Subjects received two 2-hour ZTEx training or SHE lessons according to their group allocation. They were told to practice ZTEx or follow sleep hygiene instructions for 24 weeks. The primary outcome measure was the Insomnia Severity Index (ISI) at weeks 8, 16, and 24. The secondary outcomes included sleep parameters by subjective sleep diaries and objective actigraphy; objective physical activity levels assessed by waist-worn accelerometers; and anxiety, depression, and fatigue levels evaluated by questionnaires.

Results
Compared with the SHE group, a significantly greater reduction of ISI was observed in the ZTEx group at week 24 (d = 0.60, P = 0.005). No significant between-group difference was observed in sleep parameters measured by sleep diary or actigraph at all study visits, except that sleep-diary-derived wake time after sleep onset was significantly lower in the ZTEx group at week 8 (d = 0.24, P = 0.035). The ZTEx group showed a significant improvement in the Multidimensional Fatigue Inventory (MFI) reduced-activity subscore (d = 0.27, P = 0.036) and reduced-motivation subscore (d = 0.33, P = 0.013) at week 8, but also a higher MFI physical fatigue (d = -0.58, P = 0.008).

Conclusion
The ZTEx training program improves physically inactive individuals’ insomnia severity and daytime impairment.

Support (if any)
The study was supported by the Research Grants Council, General Research Fund, Hong Kong SAR (Project no.: 15100419)
0378 A Randomized, Sham-Controlled Pilot Trial of a Novel Near-Infrared Phototherapy Device on Sleep and Daytime Function
Authors: Kennedy Kathryn E R , Wills Chloe C A , Holt Catie , Grandner Michael 
Published: May 2023

Abstract

Introduction
Near-infrared (NIR) light delivered transdermally exhibits several therapeutic properties, likely through stimulation of parasympathetic activity. This may aid in relaxation. However, little is known about the benefits to sleep and next-day daytime function. The purpose of this study was to investigate the effects of NIR exposure before bed on sleep and next-day function.

Methods
Thirty adults (30-60 y) with a self-reported sleep complaint but without a sleep disorder participated in a randomized, sham-controlled study for a duration of five weeks. After a two-week baseline period, participants wore a cervical NIR-emitting collar (combined 660nm, 740nm, 810nm, and 870nm) every other night before bed for three weeks. Physical symptoms (including sleep-related experiences) were assessed with the Systematic Assessment of Treatment Emergent Effects (SAFTEE). Insomnia Severity Index (ISI), daily sleep diaries, Oura rings (v2), daily ratings of overall sleep quality and feeling refreshed, and general ratings (0-100) of perceived changes to sleep, relaxation, daytime function, overall performance, and energy levels were also used to examine group differences.

Results
Significant group differences in change scores were seen for SAFTEE total score (-9.4 vs +13.8, p=0.036), SAFTEE sleep-related symptoms (-2.9 vs +4.1, p=0.005). No differences were seen in ISI scores. No differences were seen for Oura recordings or sleep diary data. Upon examining within-group changes, most instances were consistent (change or no change), with some exceptions: The active group showed decreased sleep latency (-6mins, p=0.001), decreased REM% (-0.9%, p=0.034), increased average sleep quality (+0.6pts, p=0.003) and feeling refreshed (+0.7pts, p&lt; 0.0005), and a perceived increase in relaxation (17.5pts, p=0.003) and daytime function (17.5pts, p=0.003), while the sham group did not. The sham group reported decreases in perceived overall performance (18.7pts, p=0.047) and energy level (26.0pts, p=0.023), while the active group did not.

Conclusion
NIR exposure to the head and neck before bed may offer potential therapeutic benefits to sleep and daytime function, but further work needs to be done to determine optimal dose parameters, wavelengths, and power level.

Support (if any)
0380 Adults with and without Mild Cognitive Impairment Show Similar Treatment Adherence and Sleep Improvement after Insomnia Therapy
Authors: Morehouse Allison , O’Hora Kathleen , Hernandez Beatriz , Lazzeroni Laura , Zeitzer Jamie , Friedman Leah , Posner Donn , Kushida Clete , Yesavage Jerome , Goldstein-Piekarski Andrea 
Published: May 2023

Abstract

Introduction
Non-pharmacological Insomnia Therapies are robustly effective in improving sleep in cognitively intact (CI) older adults. However, it remains unknown whether older adults with mild cognitive impairment (MCI) can engage in insomnia therapy to experience similar sleep improvements.

Methods
We leveraged an existing dataset derived from a randomized clinical trial (NCT02117388) in older adults with and without MCI to examine differences in treatment adherence and sleep improvements after completing six sessions of insomnia therapy. Healthy older adults with insomnia (n=127, Mage= 69.18, 34.4% male, MCI: n=38 determined by Montreal Cognitive Assessment score&lt; 26) completed a one-week sleep diary at pre-treatment (BL), post-treatment (ET), and six-months post-treatment (6M). Wake after sleep onset (WASO), total sleep time (TST), sleep efficiency (SE), and sleep onset latency (SOL) were calculated from sleep diaries. Treatment consisted of either the behavioral, cognitive, or combined components of Cognitive Behavioral Therapy for Insomnia (CBT-I). Participants rated their treatment adherence at the final treatment session. Linear mixed effects models were used to determine the effect of MCI status, time, and an MCI status-by-time interaction on each sleep outcome while covarying for age and sex. A Benjamini-Hochberg correction was applied to correct for multiple comparisons. Linear regression models controlling for age and sex were used to test group differences in treatment adherence scores.

Results
Both groups showed significant improvements in all sleep measures from BL to ET and sustained these improvements at 6M (padj’s&lt; 0.016). There were no significant MCI status-by-time interactions for any sleep measure (padj’s &gt; 0.29), suggesting individuals with and without MCI similarly improved their sleep. Further, there were no differences in treatment adherence scores between the CI and MCI groups (b=0.131, p=0.432), suggesting the MCI group engaged in therapy similarly to the CI group.

Conclusion
These preliminary findings suggest older adults with MCI may be capable of engaging in insomnia therapy to improve their sleep to the same degree as CI older adults. These findings also highlight the need of future research investigating the efficacy of non-pharmacological insomnia therapy on sleep and cognitive outcomes in older adults with MCI.

Support (if any)
NIMHR01MH101468-01; Mental Illness Research, Education, and Clinical Center (MIRECC) at VAPAHCS
0382 Age at Onset in Adults with Insomnia: A Latent Profile Analysis
Authors: Ricketts Emily , Kircanski Katharina , Rissman Ariel , Joyce Daniel , Ottenberg Juliet , Soehner Adriane 
Published: May 2023

Abstract

Introduction
Research has sought to understand insomnia through identification of subtypes, yet age at onset (AAO) has received limited empirical attention. Across psychiatric disorders, early AAO is associated with higher clinical severity and burden, more persistent course, and greater familiality, whereas late AAO is associated with comorbid psychiatric and physical illness. We sought to detect clinically distinct AAO subgroups in adults with insomnia utilizing latent profile analysis (LPA).

Methods
Participants were 618 adults aged 18 to 71 years (M=28.94, SD=11.06) with insomnia, recruited through Prolific Academic. Participants completed an internet survey of demographics, medical/psychiatric history, family history, insomnia onset acuity, and course, causal attributions surrounding insomnia onset, and current insomnia severity and sleep-related impairment. LPA was performed on AAO of clinically significant insomnia (i.e., causing distress or daytime impairment and occurring 3 days per week for at least 3 months). Independent samples t-test and chi-squared test of independence were performed to compare resulting AAO subgroups on clinical outcomes.

Results
A two-class model (Class 1: n=547, 88.5%, Monset=19.2 years; Class 2: n=71, 11.5%, Monset=43.5 years) was optimal for forming insomnia AAO subgroups. The late onset group had higher relative insomnia severity, t=-2.78, p=.006, and sleep-related impairment, t=-3.75, p&lt;.001. There were no group differences in lifetime prescription sleep medication, p=.569, lifetime diagnosis of psychiatric disorder(s), p=.189, family history of insomnia, p=.159, or insomnia onset acuity (i.e., sudden vs. gradual), p=.140. Late onset was associated with higher relative endorsement of hormonal factors, Χ2=12.81, p&lt;.001, bodily arousal, Χ2=8.57, p=.003, scheduling, Χ2=9.08, p=.003, and childhood experiences and traumatic events, Χ2=5.67, p=.017). There were group differences in insomnia course, Χ2=16.35, p&lt;.001, such that early onset was associated with higher relative endorsement of persistent insomnia and late onset was associated with higher relative endorsement of seasonal insomnia.

Conclusion
Findings suggest the presence of an early onset group with higher persistence, but not increased severity and impairment as anticipated, and a late onset group with more seasonal course, numerous causal attributions, and higher insomnia severity and impairment. Future replication is needed to determine the validity and treatment applications of these subgroups.

Support (if any)
NIMH K23MH113884
0383 Amygdala Resting State Functional Connectivity Change Correlates with Sleep EEG Beta Power in Chronic Insomnia Disorder Patients
Authors: Kweon Woojin , Lee Kyung Hwa , Choi Sang Ho , Shin Jiyoon , Seo Min Cheol , Jeon Jeong Eun , Lee Ha Young , Park Cho Won , Kim Sun-Young , Lee Yu Jin 
Published: May 2023

Abstract

Introduction
Physiological hyperarousal is suggested as a core feature of insomnia and resting-state functional magnetic resonance imaging (rs-fMRI) studies have examined the neurobiological basis of the hyperarousal theory. However, few have investigated the associations between rs-fMRI and the biomarkers of physiological hyperarousal. We aimed to investigate (1) the differences in the resting-state functional connectivity (RSFC) between chronic insomnia disorder (CID) patients and good sleepers (GS), and (2) the relationships between altered RSFC and the hyperarousal biomarkers including electroencephalogram (EEG) and heart rate variability (HRV).

Methods
Fifty CID patients (37 females, 45.8±12.7 years old) and 52 GS (32 females, 37.0±13.2 years old) completed self-report questionnaires, and underwent nocturnal polysomnography and rs-fMRI. We analyzed RSFC in the amygdala (AMYG) and anterior insula (AI), which were core regions of the salience network probably associated with hyperarousal. We also analyzed EEG relative beta power at central derivations and frequency domain HRV parameters (e.g., low frequency and high frequency) in ECG lead ll during sleep. We then tested differences in the RSFC between CID and GS and examined the correlations between RSFC, EEG beta power, and HRV.

Results
Compared with GS, CID showed more negative RSFC between the right AMYG and left supramarginal gyrus (SMG), but less positive RSFC between the left AI and bilateral lateral prefrontal cortex (LPFC). The right AMYG-left SMG RSFC was positively correlated with EEG beta power in non-rapid eye movement (NREM) stage 3 sleep measured on central regions (C3: r=-0.336, p=0.012; C4: r=-0.314, p=0.024). We did not find any significant correlations between RSFC and HRV parameters.

Conclusion
Decreased RSFC between the AMYG and SMG in insomnia patients may reflect a difficulty in the cortical top-down regulation of the amygdala, indicating hyperarousal during daytime. We also found a significant correlation between the AMYG-SMG RSFC and EEG beta power. This result suggests that altered AMYG connectivity during daytime is associated with cortical hyperarousal during sleep. Overall, our study may provide neurobiological evidence for the 24-hour hyperarousal theory of insomnia.

Support (if any)
The Korea Institute for Advancement of Technology funded by the Ministry of Trade, Industry and Energy (study no.: P0014279, 20009210).
0386 Brief cognitive-behavioral therapy for insomnia among Japanese university students with sleep disturbances
Authors: Kawakatsu Yuki , Takahata Miki , Satake Shinji , Sato Toshiaki , Eakman Aaron 
Published: May 2023

Abstract

Introduction
Sleep disturbances among Japanese university students negatively affect their academic performance and mental health. Student habits, such as naps and using smartphones in bed, may lead to sleep problems. We hypothesized the Sleep Health through University Student Habits (SHUSH) program, a four-week cognitive-behavioral therapy for insomnia intervention, would improve sleep disturbances in university students.

Methods
We used a pretest-posttest, single arm pilot study design and evaluated the feasibility and preliminary efficacy of SHUSH. Occupational therapy and physical therapy students (N = 18) in a university with self-reported sleep disturbances (Insomnia Severity Index; ISI score ≥ 9) were offered 90-minutes of sleep education (e.g., two-process model of sleep regulation, stimulus control, and sleep hygiene) then prescribed personalized sleep restriction therapy (SRT) and stimulus control therapy (SCT) goals based upon 10-days of sleep diary data. This was followed by weekly 15-minute individualized meetings for three consecutive weeks; SRT and SCT goals were titrated based upon sleep diaries, and occupational therapists supported treatment adherence. Assessments included validated Japanese versions of sleep-related (e.g., sleep disturbance), mental health-related (e.g., depression) and sleep diary (e.g., sleep efficiency) variables. Dependent t-tests (d) and Wilcoxon rank sum tests (r) were used to test differences between baseline and posttest assessments.

Results
There were 15 students who completed SHUSH with a mean age of 19.7 years; 9 were women. Improvements were found in sleep disturbance (r = 0.843), sleep quality (r = 0.851), daytime sleepiness (d = 0.762), sleep hygiene practice (d = 1.216) and change from an eveningness towards a morningness circadian preference (d = 0.990). Anxiety (d = 0.604) and depression (d = 0.729) improved. Sleep onset latency (r = 0.851), nighttime awakening (r = 0.514), and sleep efficiency (r = 0.880) also improved. Participants were satisfied with the SHUSH group-based education, one-on-one therapist meetings, and program brevity; there were no adverse events.

Conclusion
SHUSH is a feasible and preliminarily effective sleep improvement program for reducing sleep disturbances among Japanese university students. Improved sleep was associated with improved mental health and sleep-promoting behaviors. A randomized controlled trial of SHUSH is recommended.

Support (if any)
Fulbright U.S. Scholar Award to Japan
0388 Comparison of objective and subjective sleep evaluations based on with or without insomnia symptoms among Japanese city employees
Authors: Omichi Chie , Kadotani Hiroshi , Sumi Yukiyoshi , Ubara Ayaka , Nishikawa Kohei , Matsuda Arichika , Tsovoosed Uyanga , Ozeki Yuji 
Published: May 2023

Abstract

Introduction
Discrepancies between subjective and objective assessments of sleep duration and onset latency have been reported among insomnia patients. However, such discrepancies have not been well studied in the general population or working populations with sleep EEG measurements. The aim of this study was to compare subjective and objective assessments of sleep at home in a working population.

Methods
Between 2017 and 2019, a questionnaire survey including the Athens Insomnia Scale (AIS) and home 1-Ch electroencephalograph (EEG) measurements were conducted among municipal employees in Koka, Shiga Prefecture, Japan (NinJaSleep study). Sleep duration and sleep onset latency (SL) on weekdays answered in the questionnaire were used as the subjective evaluation. Sleep duration and SL determined with 1-Ch EEG were used as the objective evaluation. AIS≥6 was defined as having insomnia. The study protocol was approved by the Ethics Committee of the Shiga University of Medical Science.

Results
646 employees (44.7 ± 11.5 years, AIS: 5.4 ± 3.6 points) participated in the study. In the with-insomnia group (AIS≥6, n=274), no significant difference was found between subjective and objective sleep duration (347.1±75.8 min vs. 355.1±78.9 min, p=0.153), and subjective SL was longer than objective SL (24.5±20.2 min vs. 19.5±18.8 min, p=0.002). In the without-insomnia group (AIS&lt; 6, n=372), no significant differences were found between subjective and objective evaluations in both sleep duration (372.3±64.6 min vs. 369.9±78.6 min, p=0.597) and SL (18.9±15.8 min vs. 16.9±12.3 min, p=0.259).

Conclusion
In the with-insomnia group, subjective SL was perceived longer than the objective SL. No differences were found between subjective and objective sleep duration both in with and without insomnia groups, which may come from the study performed in a working population.

Support (if any)
Investigator-Initiated Studies Program of Merck Sharp & Dohme Corp. / MSD K.K. The funders had no role in the study design, data collection, analyses, interpretation, writing of the manuscript, or in the decision to publish the results.
0389 Co-sleeping with pets does not worsen insomnia symptoms among US veterans with sleep disorders
Authors: Gohari Ellaheh , Wohlgemuth William , Wallace Douglas 
Published: May 2023

Abstract

Introduction
Little is known about the association of pets and insomnia symptoms among US veterans. The aim of this study was to examine the association between pets sleeping in the bedroom environment and insomnia symptoms in a sleep clinic cohort of US veterans.

Methods
The sample consisted of US veterans at risk for sleep apnea (SA) evaluated at the Miami VA Sleep Center between 9/2019 and 10/2020. Veterans completed home polysomnography and questionnaires which queried demographics, pet characteristics, insomnia (insomnia severity index [ISI]), and mental health symptoms (PROMIS-29 anxiety and depression). Three linear regression models were constructed evaluating the associations between pet ownership (pet sleeping in bedroom or bed vs no pet) and a) total ISI score, b) nocturnal symptoms only (first 3 ISI items), c) daytime impairment symptoms (last 4 ISI items). Models were adjusted for relevant covariates (age, gender, race, apnea-hypopnea index, depression, anxiety, during or before COVID).

Results
The sample consisted of 411 veterans (age 51 ±14, BMI 32 ± 6 Kg/m2, 41% black, 87% male). Sixty-seven veterans (16%) reported sleeping with a pet in the bedroom (57% co-sleeping with their pet). Of these, 19% sleep with a cat, 76% sleep with a dog, 6% sleep with both, and 31% sleep with multiple pets. The mean ISI was 18 ± 7 while the mean AHI 21 ±19 events / hour, and 81% of the sample had SA. In adjusted analyses, relative to veterans without pets, sleeping with a pet in the bedroom (outside of the bed) was not associated with any insomnia symptoms. However, co-sleeping with a pet in bed was associated with a lower total ISI (β = -2.1, p = 0.032) and less daytime impairments (β = -1.5, p = 0.016), but co-sleeping with a pet was not associated with nocturnal insomnia symptoms.

Conclusion
Among veterans with a high prevalence of SA, co-sleeping with pets in bed mitigated daytime impairments and did not worsen nocturnal insomnia symptoms. Further studies are needed to clarify the mechanisms of why co-sleeping with pets may lessen daytime impairments among veterans with SA and insomnia complaints.

Support (if any)
None