bluuebunny/crossref_metadata_2025_split huggingface dataset:
0864 Evolution of Sleep Symptoms over Time Among Youth with Craniopharyngioma
Authors: Hopper Kayce , Mandrell Belinda , Caples Mary , Hancock Donna , Merchant Thomas , Wise Merrill , Crabtree Valerie 
Published: May 2023

Abstract

Introduction
Craniopharyngioma is a non-malignant tumor that arises in the suprasellar region of the intracranial compartment. Hypothalamic dysfunction is common and associated with diabetes insipidus, hormone deficiencies, neurocognitive impairment, sleep disturbance, obesity, and decreased health-related quality of life. Patients with craniopharyngioma commonly have excessive daytime sleepiness, and are often diagnosed with narcolepsy without cataplexy and even obstructive sleep apnea (OSA). This study examined the change in apnea/hypopnea index (AHI) and prevalence of disorders of hypersomnia among pediatric patients with craniopharyngioma, from the time of diagnosis to 3 years after the completion of proton therapy.

Methods
A total of 110 pediatric patients diagnosed with craniopharyngioma were prospectively evaluated on a protocol of limited surgery and proton therapy or observation. Prior to proton therapy , patients age ≥4 years completed a baseline overnight polysomnography (PSG) and the next day multiple sleep latency test (MSLT) when age ≥7 years. Follow-up PSG and MSLT were repeated 3 years later. Patients were excluded from the analysis if they did not complete the sleep study at either time points.

Results
71 completed the baseline and 3-year PSG/MSLT. A paired samples t-test determined the change between time points. When compared to baseline (M=1.30, SE=.22) the AHI significantly increased at the 3-year evaluation (M=3.00, SE=.60), with a difference of t=-1.69, (p=.002). Fifty-one patients completed the baseline and 3-year MSLT. At baseline, 8 patients did not exhibit a hypersomnolence disorder, 30 were diagnosed with hypersomnia due to medical disorder and 13 were diagnosed with narcolepsy due to medical disorder. At the 3-year MSLT, 2 of the 51 did not exhibit a hypersomnolence disorder, 30 were diagnosed with hypersomnia due to medical condition and 19 were diagnosed with narcolepsy due to medical condition.

Conclusion
Pediatric patients with craniopharyngioma have disorders of hyposomnolence at diagnosis. The number impacted by hypersomnia increase with time, with the added burden of hypothalamic obesity and OSA. Interventions should be initiated early after diagnosis for promotion of wakefulness and prevention of obesity to deter the onset of OSA.

Support (if any)
This work was supported by the Cancer Center Support Grant (CA21765) from the National Cancer Institute and ALSAC.
0865 Feasibility of a Disposable Home Sleep Test Device in a Chronic Pain Population Prescribed Opioids
Authors: Finlay Myles , Bindler Ross , Wilson Marian 
Published: May 2023

Abstract

Introduction
Opioids are a common pain treatment in the United States with approximately 143 million prescriptions dispensed in 2020. Long-term opioids for chronic pain increase risk of misuse and overdose. Opioids can also disrupt sleep and cause respiratory depression while poor sleep can exacerbate pain. In-lab polysomnography is the standard for diagnosing sleep disorders. However, polysomnography is less effective for observing patterns over multiple days and is not always representative of at-home sleep. This study investigates the feasibility of using a disposable home sleep test device with adults prescribed opioids for chronic pain and its ability to screen for sleep disorders and overnight oxygenation.

Methods
Participants were recruited from clinics and public advertisements. Key inclusion criteria were: ≥18 years of age, moderate daily level of pain (≥5 on the 0-10 Numeric Pain Scale [NPS]), prescribed opioids, and internet access. The NightOwl mini disposable home sleep test (Ectosence, Leuven, Belgium) was used to record total sleep time (TST), time in bed (TIB), sleep efficiency (SE), oxygen saturation (SaO2) and apnea-hypopnea index (AHI) for 5 consecutive nights.

Results
All enrolled participants (N=9) completed 5 days with no missing data. The sample was 66% female with an average age of 60±12 (Mean ± SD). Mean NPS scores indicated moderate pain intensity (6.3±1.9). Participants spent an average of 8.0±1.4h TIB and slept for 5.4+/-1.3h TST resulting in a SE of 68.5±17.9%. On average, AHI was 7.3±7.7 (mild range for sleep apnea). 56% of participants displayed a SaO2 nadir below 88%, the recommended threshold for supplemental oxygen. All individuals agreed that they were at least somewhat satisfied with the ease and amount of time participating in the study. All agreed or strongly agreed that they felt comfortable participating.

Conclusion
Participants used the disposable sleep test device at home with relative ease as indicted by complete data recording, values within expected norms, and satisfaction survey responses. The device could be an acceptable screening tool for sleep disorders and respiratory events that may otherwise go undetected in this population prescribed opioids and at risk for apnea and respiratory depression.

Support (if any)
NCATS/NIH # Ul1 TR002319 and The Rayce Rudeen Foundation
0867 Lower Bedtime HRV is Associated with Higher WASO in Middle-Aged Adults with Chronic Insomnia
Authors: Huskey Alisa , Taylor Daniel , Emert Sarah , Kim Kelly , Nagy Sam , Leete Jackie , Olson Ethan , Lopez Nicole 
Published: May 2023

Abstract

Introduction
Short sleepers (&lt; 6 hours per night) represent a unique phenotype of insomnia associated with more severe biological implications compared to insomnia with normal sleep duration. A primary contributor to shorter sleep duration is more time spent awake after sleep onset (i.e., WASO), which has deleterious effects on long-term cardiac physiology. For instance, short sleepers with higher WASO have lower parasympathetic activity at sleep onset compared to those with lower WASO or greater sleep duration.

Methods
Results presented here are derived from baseline assessments collected as a part of a clinical trial comparing three modalities of cognitive behavioral therapy for insomnia in middle-aged adults (50-65yrs) with chronic insomnia (N = 23). During their baseline assessment, individuals first completed one night of in-home polysomnography. Total sleep time was PSG derived. The following night, they wore an Equivital Harness equipped with an electrocardiogram (ECG) for 24 hours. In this investigation, inter-beat intervals were derived from ECG in 10-minute segments just before and just after bedtime (i.e., when the individual tried to sleep). WASO was calculated using sleep diaries during the night they wore the Harness and the following week.

Results
Preliminary data N = 23) show that high frequency (0.15-0.4Hz) heart rate variability (HRV; i.e., parasympathetic activity) at bedtime is not associated with WASO that night or WASO averaged across the following week. However, when the sample was narrowed to short sleepers only (□6hours; n = 7), lower levels of bedtime HRV (B = -.81, p = .028) is associated with greater WASO during the following week. In short sleepers, mean score of both before and after bedtime HRV predicted 65% of variance in WASO averaged across the next seven nights (R2 = .653, F (1, 5) = 9.41, B = -0.81, p = .28). These effects were not significant in individuals with sleep durations longer than 6 hours.

Conclusion
In this small sample, short sleepers display a unique, inverse relationship between cardiac vagal activity and sleep continuity, replicating similar findings regarding parasympathetic activity at sleep onset and subsequent WASO.

Support (if any)
This project is supported by the Psychology Department at the University of Arizona.
0883 Understanding how naps may modulate tinnitus
Authors: Guillard Robin , Philippe Vincent , Hessas Adam , Faraut Brice , Léger Damien , Londero Alain 
Published: May 2023

Abstract

Introduction
Tinnitus is a debilitating auditory symptom that globally impacts the quality of life of patients. Sound exposure, stress, and somatosensory stimuli (e.g. neck and jaw movements) are tinnitus modulators that have been commonly described and studied. Napping may also increase tinnitus loudness upon awakening in a minority of subjects. To our best knowledge this modulation and its potential pathophysiological mechanisms has never been systematically assessed.

Methods
For this observational prospective study, we studied 37 tinnitus subjects complaining of significant naps-related tinnitus modulations. All subjects performed 6 naps attempts under polysomnography over 2 days. Audiological, electrophysiological as well as jaw and neck muscles mobility and sensitivity assessments were completed before and after each nap. In addition, subjects filled a screening questionnaire and underwent a tinnitus pitch-matching procedure.

Results
197 naps attempts were collected. It was confirmed that overall naps were increasing tinnitus loudness (p&lt; 0.001). First naps of the day yielded more important tinnitus modulations than second (p&lt; 0.05) and third naps (p&lt; 0.01) suggesting a saturation effect. Analyses conducted so far highlight that nap sleep duration correlates with observed tinnitus modulation (p&lt; 0.05) and that audiometric thresholds at tinnitus closest frequency do not seem to be affected by tinnitus modulation. Neither jaw mobility nor sensitivity were correlated with tinnitus modulation. Analyses to come will assess if sleep apnea, sleep bruxism, cervical mobility or sleep position may correlate with tinnitus nap modulations.

Conclusion
This study demonstrated that in a subgroup of tinnitus patients naps may modulate tinnitus. Nap sleep duration more than jaw muscles sensitivity seem to be correlated with these modulations.

Support (if any)
This study was supported by Felicia and Jean-Jacques Lopez-Loreta Foundation, Robin Guillard EIRL and Université Paris Cité VIFASOM
0884 User Needs and Preferences for a Smartphone App to Treat Insomnia in Cancer Survivors
Authors: Kutana Samlau , Garland Sheila 
Published: May 2023

Abstract

Introduction
Cancer patients with insomnia have unique needs and require tailored healthcare interventions. iCANSleep is a mobile health intervention aimed at providing evidence-based insomnia treatment via a smartphone app. As part of a user-centered development process, virtual needs assessment interviews were conducted with cancer survivors who report insomnia to determine the needs and preferences of this patient group for insomnia treatment.

Methods
22 cancer survivors from 5 Canadian provinces completed an online survey and participated in a needs assessment interview. Surveys were analyzed using descriptive statistics, while interviews were transcribed and analyzed using thematic analysis.

Results
81.8% (18/22) of cancer survivors report that their insomnia started or was exacerbated during the time of their cancer diagnosis and treatment. Of the participants who discussed insomnia with a medical provider, hypnotic medications were prescribed in 64.3% (9/14) of cases. With some exceptions, participants reported strong familiarity with smartphone technology, had experience using apps for health management, and found an insomnia treatment app highly acceptable. Participant-identified facilitators of app use included ease of access, lack of cost, anonymity, empirical basis, and recommendation by local care teams. Smartphone ownership, cumbersome user interface, and limited access to internet were raised as potential challenges of implementation. Additional functionality identified by participants included options to link consumer wearable devices, additional modules to address comorbid conditions such as pain and anxiety, and an anonymous peer support forum.

Conclusion
Mobile apps hold promise as an avenue for the effective delivery of insomnia treatment; however, treatments must be evidence-based, and apps must be designed for maximum ease of use. Findings provide novel insight into how to best promote uptake and sustained use of mobile health interventions in cancer survivors and will be used to develop functional guidelines.

Support (if any)
Samlau Kutana is a trainee in the Cancer Research Training Program of the Beatrice Hunter Cancer Research Institute, with funds provided by the Canadian Cancer Society’s JD Irving, Limited – Excellence in Cancer Research Fund. Dr. Sheila Garland is supported by a Canadian Cancer Society Emerging Scholar Award (Survivorship) (grant #707146).
0885 Alzheimer’s disease progression risk in Cognitive Normal Older Adults with Obstructive Sleep Apnea using NIA-AA Research Framework
Authors: White Payton , Azad Dishari , Cesar Oliver , Kovbasyuk Zanatta , Wahab Ariana , Jacobs Tovia , Kam Korey , Mullins Anna , Parekh Ankit , Rapoport David , Ayappa Indu , Jean-Louis Girardin , Varga Andrew , Osorio Ricardo , Bubu Omonigho 
Published: May 2023

Abstract

Introduction
We determined risk profiles of strata-specific cognitive-normal (NL) older-adults with obstructive sleep apnea (OSA) characterized by their Aβ, P-Tau & T-tau (ATN) burden, on prospective AD stage-transition

Methods
Longitudinal study utilizing data from 167 community-dwelling NL older-adults participating in NYU studies on memory, sleep and aging. Subjects had baseline CSF AD-biomarker data and at least two follow-up clinical and neuropsychological data. OSA was defined using AHI4%. Using the NIA-AA Research Framework, data-driven, clinically relevant thresholds for CSF-Aβ42 (≤375pg/ml), P-tau (≥53.7pg/ml) and T-tau (≥367 pg/ml) indicated ATN status respectively. Twenty-four participants with suspected non-AD pathologic change defined as A-T+ were excluded leaving 143 for the analysis. Main outcome was AD stage-transition (i.e., change from Global Deterioration Scale (GDS) 1 or 2 [NL] at baseline to ≥3 [≥ MCI] during follow-up). Logistic mixed-effects models with random intercept and slope were used to assess associations between ATN characterized OSA subjects, and longitudinal AD stage transition, controlling for age-at-baseline, sex, APOE4-status, years-of-education, and their interactions with time.

Results
Of the 143 participants, 91 (63.8%) were women. The mean (SD) age was 69.6 (7.3) years and follow-up time was 4.73 (3.45) years. Sixteen (11.2%) were OSA+/A+/TN-, and 21 (14.7%) were OSA-/A+/TN-. Ninety-two (64.3%) had normal AD biomarkers (OSA+/A-/T- [n=45] and OSA-/A-/T- [N=47]). To generate strata-specific risks, subjects were combined into groups: (i) OSA subjects with AD pathologic change OSA+/A+/TN [n=25] consisting of OSA+/A+/TN+ [n=9] plus OSA+/A+/TN- [n=16] (ii) non-OSA subjects with AD pathologic change OSA-/A+/TN [n=26]) consisting of OSA-/A+/TN+ [n=5] and OSA-/A+/TN- [n=21] Fourteen subjects (9.8%) transitioned from NL to MCI (i.e., OSA+/A+/TN [6/25], OSA-/A+/TN [3/26], OSA+/A-/TN- [4/45] and OSA-/A-/TN- [3/47]). OSA+/A+/TN subjects were at higher risk of AD stage-transition relative to OSA-/A-/TN- (β = 1.31, 95%CI, 1.02, 1.62); OSA+/A-/TN- (β = 0.89, 95%CI, 0.42, 1.37); and OSA-/A+/TN subjects, (β = 0.71, 95%CI, 0.38, 1.04); P &lt; .01 for all. OSA+/A-/T- vs. OSA-/A-/T- participants did not show differences in cognitive change over time (β = 0.22, 95%CI, -0.15, 0.39, P =.17).

Conclusion
Among ATN characterized NL older-adults with OSA, those with evidence of AD pathologic change have the greatest risk of developing AD.

Support (if any)
AASMBTS#231-BS-20, NIAK23AG068534A, AARG-D- 21-848397, BFFA2022033S
0886 Daytime Sleepiness in the Development of Alzheimer's Disease
Authors: Espejo Kimberly , Holloway Breanna M , DeYoung Pamela , Bosompra Naa-Oye , Ancoli-Israel Sonia , Malhotra Atul 
Published: May 2023

Abstract

Introduction
Obstructive sleep apnea (OSA) is common in older adults and has recently been implicated in pathogenesis of Alzheimer’s disease (AD). Sleep disruption is a possible reversible cause of memory impairment. Furthermore, quality of sleep has been determined to be one of the most important variables affecting overnight memory consolidation. Men and women differ in frequency and type of sleep complaints. As part of a larger study, data are presented on sex-stratified correlations between sleepiness and sleep-dependent memory consolidation in cognitively normal older adults with OSA.

Methods
Forty-Three participants (age 65 to 81 years; M=70.5 years, SD=4.3) deemed cognitively normal based on a Montreal Cognitive Assessment [MOCA] score of &gt;26 were analyzed. The sample was 48.9% women; 86% White; 90.7% Non-Hispanic; and 73.8% with a bachelor's degree or higher. The Epworth Sleepiness Scale (ESS) was used to assess general daytime sleepiness. Sleep-dependent memory consolidation was assessed using the Word-pairs Association (WPA) task. The WPA task shows a word pair for 5 seconds for the participant to learn and the next morning, post-sleep, the delayed recognition test is performed.

Results
Preliminary descriptive analyses revealed women had an average ESS of 5.4 (SD=3.0) and WPA score of 29.6 (SD=4.3); while men had an average ESS of 6.9 (SD=2.99) and WPA of 29.5 (SD=7.4). Non-parametric correlations, assessed to examine the association between ESS sum scores and WPA scores, revealed a significant negative correlation between ESS and WPA for female sex, but not for male sex. That is, in women, greater daytime sleepiness scores were associated with worse sleep-dependent memory consolidation (r=-.66, p= .01).

Conclusion
Preliminary findings of the ongoing study provide support for a sex specific association between daytime sleepiness and sleep-dependent memory consolidation. Further research on this topic is needed to determine optimal preventative strategies for older adults at risk of cognitive decline.

Support (if any)
1R01AG063925-01A1 provided by National Institute on Aging
0888 Individuals with REM sleep behavior disorder show increased parkinsonism with comorbid neurotrauma: A NAPS Consortium substudy
Authors: Elliott Jonathan , Ligman Brittany , Bryant-Ekstrand Mohini , Keil Allison , Powers Katherine , Olivo Cosette , Neilson Lee , Postuma Ronald , Boeve Bradley , Ju Yo-El , Lim Miranda ,   NAPS Consortium
Published: May 2023

Abstract

Introduction
Introduction: Rapid eye movement (REM) sleep behavior disorder (RBD) is strongly associated with progressive phenoconversion to an overt synucleinopathy (e.g., parkinsonism). Neurotrauma [i.e., traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD)], increases the odds of RBD diagnosis by ~2.5-fold and is associated with an increased later diagnosis of Parkinson’s Disease (PD), a service-connected illness in Veterans. Thus, RBD and neurotrauma are both independently associated with parkinsonism; however, it is unclear how neurotrauma influences neurological symptoms and exam findings in patients with RBD.

Methods
Methods: Participants ≥18 years of age with overnight polysomnogram-confirmed RBD were enrolled between 8/2018 to 4/2021 as part of the North American Prodromal Synucleinopathy (NAPS) Consortium. Standardized assessments for RBD, TBI, and PTSD history, as well as cognitive, motor, sensory and autonomic function were completed. This sub-study applied a cross-sectional, case-control (1:4 ratio) analysis comparing cases (n=24; RBD+TBI+PTSD) to controls (n=96; RBD) matched for age (±2 years), sex, and years of education (±2 years).

Results
Results: Participants with neurotrauma reported an earlier age of RBD symptom onset and more severe RBD phenotype, more severe anxiety and depression, greater frequency of hypertension, and significantly worse cognitive, motor, and autonomic function compared to participants without neurotrauma.

Conclusion
Conclusion: This cross-sectional, matched case:control study showed that individuals with comorbid neurotrauma and RBD have significantly worse neurological outcomes related to common features of early parkinsonism. Although confirmatory longitudinal studies are still ongoing, these results may be a sign of further/faster progression of synucleinopathy in those with comorbid neurotrauma and RBD.

Support (if any)
Support: NIH R34 AG056639, NIH U19 AG071754, VA RRD 1K2 RX002947, Parkinsons Center of Oregon
0893 Long objective sleep duration is a marker of cognitive impairment among older elderly: findings from the Cretan Aging Cohort
Authors: Basta Maria , Skourti Eleni , Zampetakis Alexandros , Alexopoulou Christina , Ganiaris Andronikos , Aligizaki Marina , Zaganas Ioannis , Simos Panagiotis , Vgontzas Alexandros 
Published: May 2023

Abstract

Introduction
We have previously shown that although sleep duration is similar between cognitively non-impaired (CNI) elders and patients with Mild Cognitive Impairment (MCI), long sleep duration is associated with disease severity in patients with multi-domain MCI and Dementia. Our aim was to examine the associations between sleep duration and cognitive status in subjects with CNI and MCI followed 8 years later.

Methods
A sub-sample of 110 participants (77.3% females) were recruited from a large population-based cohort in Crete, Greece of 3,140 older adults (&gt;60 years). Participants with an initial diagnosis of CNI (n=57) and MCI (n=53) (mean age at baseline=72.7 years [SD=6.8]) were followed-up 8 years later (mean age at follow up=80.5 years [SD=6.7]). All participants underwent neuropsychiatric/neuropsychological evaluation (baseline & follow-up) and a 7-day 24h actigraphy (follow-up). Sleep duration measured as night Total Sleep Time (TST) at follow-up was compared between the diagnostic groups using ANCOVA controlling for age, gender, depression symptom severity, psychotropic medication. Long sleep duration was defined by values &gt;75% percentile of the total sample distribution on each sleep index.

Results
At follow up 62.7% of participants have deteriorated cognitively with 29 being diagnosed with CNI, 49 with MCI and 32 with dementia. Patients with dementia had significantly longer night TST (mean=493, SD=106 min) than persons with MCI (mean=453, SD=68 min, p=0.05) who in turn had longer night TST than CNI participants (mean=409, SD=58 min, p=0.02). Also, long night sleep duration was significantly more prevalent among dementia patients and MCI compared to CNI individuals [67.7% vs. 36.7% vs. 10.3%, respectively; all p&lt; 0.02)].

Conclusion
Our study confirms and expands previous findings that objective long sleep duration is a marker of worse cognitive status in elderly with MCI or Dementia and that this association is even stronger in old-old individuals.

Support (if any)
National Strategic Reference Framework (NSRF)-Research Funding Program: THALES entitled “UOC-Multidisciplinary network for the study of Alzheimer’s Disease” Grant Cod: MIS 377299 HELLENIC FOUNDATION FOR REASEARCH AND INNOVATION (HFRI)- Research Funding Program: ELIDEK entitled “Sleep Apnea (OSA) and poor sleep as Risk Factors for decreased cognitive performance in patients with Mild Cognitive Impairment: the Cretan Aging Cohort (CAC)”, Grant Cod: HFR1-FM17-4397