bluuebunny/crossref_metadata_2025_split huggingface dataset:
0289 A PICTURE ON THE SLEEP OF THE PORTUGUESE HEALTH SYSTEM: PRELIMINARY FINDINGS OF A WORK IN PROGRESS
Authors: Beires Teresa , Borges Maria Inês , Paixão Carla , Cruz Miguel Meira e 
Published: May 2023

Abstract

Introduction
Sleep difficulties are commonly referred by health care workers that can affect quality of life and productivity, both in patients and healthy individuals. This study firstly aimed to evaluate sleep quality in distinct groups of health care workers as well as the impact of shift work and health related habits on the sleep of such professionals.

Methods
This prospective, cross sectional, observational study involved health care workers (Physicians, Residents, Nurse Staff, Psychologists and Therapeutic and Diagnostic Technicians - TDT) from the Portuguese Health System (public or private) aged from 25 and 65 years old. A General Health Survey was followed by Standard validated sleep questionnaires for assessment of sleep quality (Pittsburgh Sleep Quality Index - PSQI), insomnia (Insomnia Severity Index - ISI), risk of obstructive sleep apnea (STOP-BANG), and excessive daytime sleepiness (Epworth Sleepiness Scale - ESS).

Results
From the pretended pool of 425 health care workers to whom questionnaires where sent, 160 (131: 81.9% females) responded (37.7% of response rate). From those, 30% of those professionals were Residents, 30.6% were TDT, 21.9% Physicians, 10.6% Nurses, and 6.9% Psychologists. 46.5% assumed itself with a morning-type profile whereas 39.5% were intermedium and 14% evening-type persons. From the global sample, 62.5% had poor sleep quality with 37.5% in the insomnia threshold whereas 14.4% presented with either moderate or severe forms of insomnia. Regarding the risk for sleep disordered breathing, 6.5% where at high risk for Obstructive Sleep Apnea - OSA, and 15.6% complained from mild to moderately forms of excessive sleepiness (ESS&gt;10). In this sample, psychologists achieved the better sleep quality scores while nurses had the poorest scores for the same parameter.

Conclusion
This preliminary findings on the sleep of the portuguese health care workers, suggest that such professionals experience a poor sleep quality in general with a prevalence of major sleep disorders similar to the general population. Although the majority seemed to denie a significant degree of daytime sleepiness, those within a shift work regimen are likely to perform worse.

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0292 Development and Validation of the Sleep Conflict Scale in Couple Relationships
Authors: Novak Joshua , Miller Kaleigh , Gunn Heather , Troxel Wendy 
Published: May 2023

Abstract

Introduction
Although there is considerable sleep concordance between partners in couple relationships, less is known about sleep practices between them and if there is conflict around sleep habits, preferences, and behaviors. Past empirical work suggests that couples who share the same sleep-wake preferences (i.e., morning vs. night people) report higher marital adjustment and less relational conflict. And yet the mechanism through which this occurs is yet unknown. One such mechanism is sleep-related conflict whereby partners disagree about their partners' sleep rituals causing sleep-related conflict.

Methods
The present study utilizes two samples to validate the Sleep Conflict Scale (SCS), one in individuals in relationships and the other sample of paired partners (dyadic data). The sleep conflict scale is a 5-item measure and includes items such as "My partner and I disagree about sleep routines and habits" and "Our relationship is negatively affected by our sleep differences". In order to identify the underlying factor structure of the SCS, several criteria was assessed to determine suitability for factor analysis, including bivariate correlations, the Kaiser-Meyer-Olkin Measure of Sampling Adequacy, and Bartlett’s test of Sphericity. Composite scores were computed and internal consistency was assessed by conducting Cronbach Alpha reliability estimates. We tested convergent validity by identifying associations between the SCS and relational and psychological health measures. Finally, using the dyadic sample, we also tested a structural equation model using the SCS on both partners' sleep hygiene and sleep quality.

Results
Results revealed that the SCS fit a one factor solution of five items and that a summed or mean score can be used. The SCS demonstrated excellent internal reliability and external validity when compared to other relational and psychological measures. Finally, higher sleep conflict was associated with worse sleep hygiene and poorer sleep quality for both partners.

Conclusion
The analyses provided support that the SCS scale is a psychometrically sound measure, in that it demonstrates a single factor structure, is highly reliability, and is qualitatively different than other couple or sleep-related measures. The SCS can be used in both primary and secondary care settings to identify couples who would benefit from relational intervention especially when sleep adherence is low.

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0293 Sleep Health in America: Update from the National Sleep Foundation’s 2022 Sleep Health Index®
Authors: Dzierzewski Joseph , Hendren Lindsey , Langer Gary 
Published: May 2023

Abstract

Introduction
Sleep is a crucial measure of health and wellbeing. Individuals with good sleep health tend to have better physical, emotional, cognitive, and social functioning than individuals with poor sleep health. The National Sleep Foundation developed the Sleep Health Index® (SHI) in 2016 as a means to monitor the sleep health of the general population. Since its inception, the National Sleep Foundation has administered the SHI annually to a representative sample of the US population. This study reports on the 2022 SHI and examines US population trends in sleep health from 2019 through 2022.

Methods
The SHI is a valid, reliable measure consisting of 16 questions related to the three discrete constructs of sleep duration, sleep quality, and disordered sleep. In 2022, the SHI was administered to a nationally representative, random sample of 1,042 Americans via the probability-based Ipsos KnowledgePanel®, in which panelists complete surveys online in English or Spanish. Results have a margin of sampling error of 3.2 points. We examined sleep health trends from 2019 through 2022 and examined whether sleep health in 2022 differed from previous years. Group differences in sleep health were also investigated.

Results
Americans’ average SHI score in 2022 was 75 (on a 0–100 scale), which is consistent with SHI scores observed in previous years. The SHI total score was statistically highest among college graduates, Hispanic adults, and people with household incomes of $100,000+ a year and statistically lowest among those with household incomes less than $50,000. Despite stable SHI total scores, there were statistically significant declines in both average weekday sleep scores (76 in 2021 to 71 in 2022) and in sleep deficit scores (86 in 2021 to 82 in 2022), which are based on the difference between weekday sleep and the amount of sleep respondents say they need to be well-rested and feel their best.

Conclusion
While overall sleep health remained stable, weekday sleep duration and sleep deficit worsened considerably as pandemic-related restrictions came to an end. The sociocultural and political contexts in which sleep health occurs, as well as associated features, like mental and physical health, deserve further consideration.

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0298 Romantic Relationships and Insomnia in Military Soldiers
Authors: Cruz Nayeli Nunez , So Christine , Miller Katherine , Gehrman Philip 
Published: May 2023

Abstract

Introduction
Intimate relationships may impact insomnia symptoms. In particular, marriage may serve as a protective factor against the development of insomnia, particularly for men. However, little research has studied how relationship quality may contribute to insomnia, particularly in military populations where social support may be particularly important. Therefore, this study will examine the associations between indices of relationship quality and insomnia in a sample of Army Soldiers.

Methods
Data were acquired from the All Army Study of the Army Study to Assess Risk and Resilience in Servicemembers (STARRS; N=21,449; mean age= 28.6; 88.24% male). Participants completed a survey that included questions about insomnia symptoms and their social networks. Items assessed marital status, duration of marriage, frequency of disagreements, and relationship quality and happiness. Chi-squared analyses were used to examine the associations between probable insomnia from the past 30 days and relationship items.

Results
Approximately 38.2% of this sample experienced past month insomnia symptoms. Insomnia was more prevalent in divorced or separated individuals. Among partnered individuals, Soldiers who reported that they talked more about ending the relationship and had more disagreements with their partners were more likely to have insomnia symptoms. Conversely, those reporting that their relationships were going well or satisfied in their relationship were more likely to not have insomnia.

Conclusion
In this sample of Soldiers, marriage only served as a protective factor when individuals had a positive outlook in their relationship. These results also suggest that healthier relationships are generally associated with better sleep. These findings underline the importance of relationship quality and its effects on insomnia.

Support (if any)
This publication is based on public use data from Army STARRS (Inter-university Consortium for Political and Social Research, University of Michigan-http://doi.org/10.3886/ICPSR35197-v1), funded by U.S. NIMH-U01MH087981. CJS’s time was supported by the Department of Veterans Affairs Office of Academic Affiliations Advanced Fellowship in Mental Illness Research and Treatment. KEM’s time was supported by the U.S Department of Veterans Affairs, Veterans Health Administration (Clinical Science Research and Development Service – IK2 CX001874).
0300 A prospective follow-up study of Covid’s effects on Sleep and Cognition in post-acute period in a primarily minority population
Authors: Ibrahim Malika , Nanduri Sumant , Singh Gagan , Batta Yashvardhan , Kim Rachel , Smith Tori , Kolawole Oluwapelumi , Ogwo Valarie , Shayegh Nader , Challa Suryanarayana , Ashktorab Hassan , Brim Hassan , Oskrochi Gholamreza , Martirosyan Zara 
Published: May 2023

Abstract

Introduction
Long Covid, the post-acute sequelae of COVID-19, has evolved in recent months into a recognized spectrum of manifestations that persist after acute Covid-19 illness. Despite over 2 years of information since the start of the pandemic, data remains limited on the effect Long Covid may have on sleep and cognition. This study aims to assess the association between COVID-19 infection and sleep impairment in the post-acute period.

Methods
A total of 747 patients were identified from hospitalized COVID-19 patient records at Howard University Hospital between Feb 2020 and May 2021. 285 of these patients were interviewed by the research team 6-12 months after their initial infection. Sleep symptoms were collected via a questionnaire from 125 patients (64% African American, 34% Hispanic) to include the following four data points: difficulty falling asleep, worsened sleep quality, daytime somnolence (since COVID-19 occurrence) and the number of hours of sleep in 24 hours. In addition, a cognitive assessment was also conducted via a Mini-MOCA questionnaire(n=103 patients, 59% African American, 35% Hispanic). Of note, all sleep questionnaire participants did not report pre-COVID-19 sleep issues concerns. We looked for any associations between multiple clinical variables, sleep disturbance, and abnormal MOCA scores using proper statistical methods such as t-tests, chi-square tests, univariate and multivariable logistic regression.

Results
Out of the 285 respondents to the interview, 28 of 125 completing sleep assessments declared sleep disturbance symptoms, and 79 of 103 completing Mini-Moca assessments had an abnormal Mini-MOCA score. Patients with sleep disturbance symptoms were further analyzed and a significant association was identified between sleep disturbance and the following variables: increase in age (p=0.046), Diabetes Miletus diagnosis (p=0.009), elevated troponin level on admission (p&lt; 0.05), ARB use during hospitalization (p=0.006), ICU admission during hospitalization (p&lt; 0.05), and exposure to ECMO (p=0.011). Not surprisingly, sleep disturbance had a significant association with reduced total sleeping hours in 24 hr period (p&lt; 0.0001).

Conclusion
Preliminary findings indicate the presence of sleep disturbance on longitudinal follow-up of patients previously infected with SARS-CoV-2. Additionally, we found a significant association between sleep disturbance in COVID-19 patients with many variables. Larger studies are required to further analyze these associations.

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0302 Impact of the COVID-19 pandemic on the sleep pattern of a Brazilian population sample
Authors: Porcacchia Allan , Tufik Sergio , Pires Gabriel , Bezerra Andréia , Tufik Sergio , Andersen Monica 
Published: May 2023

Abstract

Introduction
As of late 2019, a new viral variant that causes respiratory infection has concerned humanity: SARS-CoV-2. The following year, the COVID-19 pandemic was declared by the World Health Organization. The spread of the virus across country borders led to the implementation of security measures to contain new infections. The confinement during the pandemic helped to minimize new infections, but it affected people's mental health, including sleep parameters. This study evaluated the impact of the pandemic and social isolation on sleep parameters, including sleep quality and hygiene, in a sample of the Brazilian population.

Methods
An online questionnaire on the Google Docs platform was sent to all participants who agreed to contribute to the study, constituting a convenience sample. The questionnaire consisted of 8 parts: written consent; socio-demographic characteristics; assessment of quarantine status, COVID-19 infection, and other health complaints; general sleep evaluation; Pittsburgh Sleep Quality Index (PSQI); Insomnia Severity Index (ISI); Sleep Hygiene Index (SHI); closing remarks. All questions were presented in Portuguese and participants had to answer them considering 2 different contexts: before and during the pandemic. PSQI and ISI categorical data from the two periods were evaluated using the McNemar-Bowker test. To evaluate the effects of the pandemic on questionnaire scores, sleep efficiency and total sleep duration (TSD), generalized estimating equations models were used. Age and quarantine time were covariates in the model.

Results
The final sample comprised 1,109 individuals. During the pandemic, it was observed an increase in sleep efficiency (β=3.537; p=0.002) and in the TSD (β=29.212; p=0.002). Yet, during the pandemic there was an elevation in the PSQI score (β=4.196; p&lt; 0.001) and in the ISI score (β=–6.952; p&lt; 0.001). For this last, there was a statistical significance when considering the interaction between life context and gender, in which women during the pandemic had higher ISI scores than men before the pandemic (β=–1.877; p&lt; 0.001). A decrease in the SHI score was reported during the pandemic (β=–6.768; p&lt; 0.001).

Conclusion
An increase in sleep efficiency, total sleep time and SHI score was reported in the sample during the pandemic, although insomnia symptoms and sleep quality worsened.

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0306 Circadian Disrupting Light Exposure within Pediatric Hospital Rooms
Authors: Fidler Andrea , Waitt Julie , Lehmann Leslie , Solet Jo , Duffy Jeanne , Gonzalez Brian , Beebe Dean , Fedele David , Zhou Eric 
Published: May 2023

Abstract

Introduction
Pediatric patients undergoing stem cell transplant (SCT) often experience extended hospitalizations. Inappropriate lighting during admissions is known to disrupt sleep and circadian health, which can result in worse health outcomes. This study aimed to describe patterns of light across 24-hour periods in two inpatient rooms of children undergoing SCT.

Methods
Wall-mounted light meters (Extech SDL400) continuously tracked noise and light levels at one-minute intervals in two patient rooms over six months. We determined the percent of time that patients were exposed to non-optimal light levels (&lt; 448 lux during the daytime, &gt;18 lux in the evening, &gt;2 lux at night); thresholds were based on converting recent consensus-based melanopic equivalent daylight illuminance guidelines to vertically measured illuminance thresholds. We assessed the frequency that light exceeded thresholds associated with night wakings (&gt;150 lux). Wilcoxon rank-sum tests compared light levels between the two rooms. Room A had a single northwest-facing window overlooking a narrow courtyard. Room B had an unobstructed window facing north.

Results
On average, hospitalized pediatric SCT patients spent 50% of their time in inappropriate light conditions. They were exposed to light spikes &gt;150 lux on 2% of nights, with overnight light peaking at 513 lux. When comparing average daytime and nighttime light levels between the two rooms, Room A was significantly dimmer than Room B, p &lt;.001. In the dimmer room, light levels never reached the recommended threshold during the daytime, and the light was too bright for 19% of the evening and 17% of the nighttime. In the brighter room, light levels were too dim during 97% of the daytime and too bright during 59% of the evening and 30% of the nighttime.

Conclusion
During the day, pediatric SCT patients are rarely exposed to light bright enough to preserve a healthy circadian rhythm. Hospitals have an opportunity to significantly improve the sleep and circadian health for children already at elevated risk for health morbidities during transplant.

Support (if any)
This research was generously supported by grant funding from Pedals for Pediatrics (PI: Zhou) and an institutional research training grant (T32DK063929).
0307 Day and night light exposure are associated with psychiatric disorders: An objective light study in &gt;80,000 people
Authors: Burns Angus , Windred Daniel , Rutter Martin , Olivier Patrick , Vetter Celine , Saxena Richa , Lane Jacqueline , Phillips Andrew , Cain Sean 
Published: May 2023

Abstract

Introduction
Circadian rhythm disturbance is a common feature of many psychiatric disorders. Light is the primary input to the circadian clock, with daytime light strengthening rhythms and night light disrupting them. Therefore, habitual light exposure may represent an environmental risk factor for susceptibility to psychiatric disorders.

Methods
We performed the largest to-date cross-sectional analysis of light, sleep, physical activity, and mental health in participants from the UK Biobank actigraphy cohort (n = 86,772 adults; aged 62.4 ± 7.4 years; 57% women). We examined the independent association of day and night light exposure intensity with covariate-adjusted risk for psychiatric disorders and self-harm.

Results
Greater night light exposure was associated with increased risk for major depressive disorder, generalized anxiety disorder, PTSD, psychosis, bipolar disorder, and self-harm. Independent of night light, greater day light exposure was associated with reduced risk for major depressive disorder, PTSD, psychosis, and self-harm. These findings were robust to adjustment for sociodemographics, photoperiod, physical activity, and sleep quality.

Conclusion
Our findings demonstrate that low day light and bright night light exposure are associated with a wide range of psychiatric outcomes. Avoiding light at night and seeking light during the day may be a simple and effective, non-pharmacological means of broadly improving mental health.

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0308 Impact of Customized Lighting on Sleep in Hospitalized Patients
Authors: Adawi Ayham , Parekh Ankit , Weinberg Alan , Khan Rabia , Perez Octavio , Rabin Barbara , Condrat Lindsay , Fraser Allison , Loor Marjorie Zambrao , Rajda Geetanjali , Varga Andrew , Vincent Richard , Dunn Andrew 
Published: May 2023

Abstract

Introduction
Inpatient sleep may be disrupted for myriad reasons, including lighting exposure that is typically fixed at constant intensity and spectra. In this study we employed customized lighting that promotes circadian entrainment by exposing patients to blue-augmented lighting during the morning and blue-suppressed lighting evening to improve sleep timing and duration.

Methods
Two Mount Sinai hospital rooms (with 2 beds each) were outfitted with Eight Mattress sensors that use a combination of movement, breathing, heart rate, and temperature variables to estimate wake and sleep vigilance states in 30-second epochs. One room contained customized lighting between 7 am and 11 pm, while the other room contained standard hospital lighting. The current analysis includes 60 participants (30 in the control room and 30 in the custom lighting room), who were matched for time-of-year hospital admission date. We first analyzed the probability of sleep during any given 30-second epoch across each subject’s admission and compared the distributions of sleep probability across the 24-hour cycle for all subjects in the lighting vs control conditions. We additionally evaluated total nocturnal sleep duration(11 PM – 7 AM) by 1) summating all sleep epochs on nights containing at least 50% valid data and 2) normalizing all measured sleep epochs to all valid sleep/wake outputs (excluding indeterminate epochs).

Results
The distribution of sleep probability was significantly different in the lighting vs control condition (p &lt; 0.001) with most apparent diversion of the distributions between 9 pm and 9 am. The average raw nocturnal sleep duration was significantly higher in lighting condition (270.0 ± 23 minutes vs 201 ± 23 min in control, p = 0.037), as was the average minutes of sleep per hour of valid recording (36.9 ± 15 minutes vs 28.4 ± 13 in control, p = 0.022). There were no significant differences in the number of nocturnal wake or indeterminate epochs between conditions.

Conclusion
Custom lighting appears to promote sleep in hospitalized patients, but the interpretation is tempered by absence of full validation of the mattress sensor against polysomnography. Future work will evaluate differences in sleep timing and continuity between conditions.

Support (if any)
McClung Foundation, R01 AG066870