bluuebunny/crossref_metadata_2025_split huggingface dataset:
0234 Sleep health disparity and frailty in middle aged people living with HIV in an African setting
Authors: Zheng Xi , Mosepele Mosepele , Cai Ruixue , Gao Chenlu , Ponatshego Ponego , Gao Lei , Montano Monty , Hu Kun , Li Peng 
Published: May 2023

Abstract

Introduction
The aim of this proof-of-concept study is to explore sleep health disparity and associations with frailty in middle-aged (i.e., age&lt; 65 years) people living with HIV (PLWH) in an African setting.

Methods
Data were from 98 participants (age: 56.8±4.3 [mean±SD] years; female: 49 [50%]) enrolled in Botswana, Africa, between March-December 2021. Forty-eight participants were HIV seropositive (i.e., PLWH) and on suppressive antiretroviral therapy regimens; 50 participants were confirmed uninfected (i.e., controls). PLWH and controls were matched for age and sex. Sleep health was assessed subjectively based on answers to two questions related to sleep quality, and was scored 1 (i.e., better sleep quality) if the participant answered “very much” to question “I am sleeping well” and “not at all” to question “I need to sleep during the day” or 0 (i.e., worse sleep quality) if otherwise. To assess frailty, 29 health deficits related to weight loss, obesity, physical activity, emotion, and fatigue were examined to construct a composite frailty index ranged between 0 and 1 (i.e., 0=no deficit present and 1=all deficits present). Logistic regression and linear regression models were conducted respectively to compare sleep quality (dichotomous) and the frailty index (continuous) between PLWH and controls. In addition, linear regression models were used to examine the association between frailty index and sleep quality stratified by HIV serostatus. All models were adjusted for age and sex. Statistical significance was rendered at p&lt; 0.05.

Results
PLWH displayed 2.5-fold higher odds of having worse sleep quality compared to controls (PLWH: 61.4%, controls: 38.6%; p=0.02). The frailty index did not differ significantly between PLWH (0.15±0.08 [mean±SD]; range: [0.02, 0.36]) and controls (0.14±0.10; range: [0.03, 0.56]; p=0.6). Within PLWH, having worse sleep quality was significantly associated with an increase in the frailty index (0.76 SD of the group) (p&lt; 0.001). No significant association was observed in HIV-seronegative controls (p=0.4).

Conclusion
Treated PLWH had worse self-reported sleep than controls, and worse sleep quality in PLWH is linked to an increased burden of physical frailty in Africa. Future studies are warranted to elucidate the causal direction and underlying mechanisms.

Support (if any)
Developmental Award (CFAR; P30AI060354); Pilot Grant (HIV&Aging; R33AG067069-02).
0235 Social Jetlag and Diet Quality Among US Young Adults
Authors: Lyu Xiru , Dunietz Galit , Leung Cindy , Jansen Erica 
Published: May 2023

Abstract

Introduction
Young adults are among the populations with the lowest quality diets in the US, and poor sleep could be a contributing factor. Social jetlag, the lack of consistent sleep timing from weekdays to weekends, is also more common among young adults. Our objective was to examine associations between social jetlag and diet quality among US young adults, and to evaluate effect modification by sex or race/ethnicity.

Methods
The study population included 1,308 adults aged 20-39 who participated in the 2017-2018 National Health and Nutrition Examination Survey. Social jetlag was considered as ≥2-hour difference in sleep midpoint (median of bedtime and wake time) between weekends and weekdays. Diet quality was assessed with the Healthy Eating Index (HEI)-2015, which is comprised of 13 dietary components and ranges from 0 to 100 (higher scores=better diet quality). Scores were binned into three groups based on tertile cutoffs. Ordinal logistic regression analyses were utilized to evaluate the relationship between social jetlag and HEI-2015 scores as well as the individual HEI components, adjusting for age, sex, race/ethnicity, educational attainment, recent tobacco use and physical activity. Effect modification by sex and race/ethnicity were also considered.

Results
In the analytic sample, 31% of young adults had social jetlag. Overall, there were no associations between social jetlag and diet quality. However, interaction analysis revealed several associations were race-specific (P, interaction&lt; 0.05). Among Black adults, social jetlag was associated with lower overall diet quality (OR = 0.4, 95% CI 0.2, 0.8; i.e., less likely to be in higher diet quality tertiles) and more unfavorable scores on total vegetables (OR = 0.6, 95% CI 0.3, 1.0) and added sugar (i.e., OR = 0.6, 95% CI 0.4, 0.9). For Hispanic adults, social jetlag was associated with higher intakes of sodium (OR=0.6, 95% CI 0.4, 0.9) However, White adults with social jetlag had higher intake of greens and beans (OR = 1.9, 95% CI 1.1, 3.2).

Conclusion
Within a nationally-representative sample of US young adults, social jetlag was related to certain indicators of lower diet quality among Black and Hispanic Americans.

Support (if any)
Dr. Jansen was supported by K01HL151673.
0236 Assessing the Impact of Race and Income on Children's Sleep Habits
Authors: Hansen Devon , Sherick Courtney , Skeiky Lillian 
Published: May 2023

Abstract

Introduction
Ample research supports the need for adequate sleep to develop normal physical and mental health throughout childhood. While objective sleep monitoring is ideal, it is not always practical in real-world settings. Therefore, subjective reports provide a more realistic alternative. The validated Children’s Sleep Habits Questionnaire (CSHQ) requires parents/caregivers to retrospectively report sleep quality in school-aged children. In a nation-wide study, we compared CSHQ ratings to determine any relationship with sleep quality and demographic variables.

Methods
CSHQ and demographic questionnaires were completed for n=152 children (ages 3-12y, 63% Male, 37% female), 45% African American and 55% Caucasian. Means of CSHQ scores and demographic variables were compared using independent t-tests and chi-square test of independence.

Results
Overall, African American children had lower reported sleep quality compared to Caucasian children (t150= -3.77, p&lt; 0.001). Additionally, reported sleep quality was lower in households earning less than 100K compared to those earning more than 100K (t146= 2.69, p&lt; 0.01), with more African American families earning less than 100K compared to Caucasian families (Χ2(1) = 11.99, p &lt; 0.001).

Conclusion
Our results are consistent with previous research indicating that African American children have lower reported sleep quality than their Caucasian counterparts. While families with lower income report higher rates of sleep disturbance, this appears to be more prevalent in African American households. Although significantly different, both groups reported high levels of sleep disturbance, highlighting the need for general sleep education as well as the development of interventions tailored to different ethnic groups and demographic levels.

Support (if any)
Elson S. Floyd College of Medicine Dean’s Excellence Award Scholarship
0241 Sleep Across the Lifespan in Hispanic/Latinx Adults
Authors: Soto Pablo , Ramos Mayra , Dautovich Natalie , Corona Rosalie , Dzierzewski Joseph 
Published: May 2023

Abstract

Introduction
Studies examining racial/ethnic sleep disparities have observed that minoritized individuals are more likely to experience poor sleep compared to non-Hispanic whites. Existing research on Hispanic/Latinx (H/L) individuals further reinforces this assertion. However, to date, little attention has been paid to lifespan examinations of sleep within minoritized groups. The present study assessed sleep characteristics differences across the lifespan within a large sample of H/L adults. We hypothesized that older adults would report more concerns and symptoms associated with impaired sleep.

Methods
Participants included 1,072 (63.3% female; µ=36.43) adults who self-identified as H/L and completed an online survey assessing insomnia symptoms (Insomnia Severity Index), sleep-related daytime impairment (PROMIS Sleep-Related Impairment), sleep regularity (Sleep Regularity Questionnaire), subjective sleep quality (Pittsburgh Sleep Quality Index), and self-reported sleep duration. A One-Way ANOVA was utilized to detect mean differences in sleep markers across age groups [Young (18-25), Middle (30-50), and Late adulthood (55+)]. Significant mean differences were further analyzed with Duncan’s post hoc analysis.

Results
The One-Way ANOVA revealed significant mean differences across all sleep markers analyzed: insomnia symptoms, F(2, 1069)=67.459, p&lt;.001; sleep-related daytime impairment, F(2, 1069)=77.465, p&lt;.001; sleep regularity, F(2, 1069)=74.091, p&lt;.001; sleep quality, F(2, 1069)=29.300, p&lt;.001; and total sleep duration, F(2, 1069)=5.898, p=.003. Post hoc analyses revealed significantly more insomnia symptoms (µ=14.325) and poorer sleep quality (µ=1.623) in late adulthood compared to younger (µ=8.270; 1.092) and middle-aged (µ=10.186; 1.345). As well as significant elevations in sleep-related daytime impairment (µMiddle=22.314; µLate=23.508) and poorer sleep regularity (µMiddle=16.556; µLate=16.704) in middle and late adulthood compared to younger adults (µ=16.056; 13.054). Lasty, young adults slept (µ=6.756) significantly less than middle and late adulthood (µMiddle=7.025; µLate=7.162).

Conclusion
Results suggest that age is important factor in the consideration of sleep among H/L adults. These findings generally point to an increase in poor sleep as age increases. It’s important to consider this trend when working with minoritized individuals due to the disproportionate burden of sleep factors being potentially compounded by age.

Support (if any)
This work was supported by the National Institute on Aging (K23AG049955, PI: Dzierzewski).
0243 SLEEP REGULARITY AND MENTAL HEALTH DURING EXTENDED ANTARCTIC RESIDENCE
Authors: Cifre Anthony , Mi Qi , Ahamed Nizam , Bower Joanne , Connaboy Christopher , Simpson Richard , Alfano Candice 
Published: May 2023

Abstract

Introduction
As humans’ advance towards a Mars mission, ensuring astronaut safety, well-being, and performance becomes increasingly critical. Long-duration space exploration presents several challenges for human sleep, including altered photoperiods, prolonged confinement, and monotony. Antarctica provides an ideal analog for understanding how these and other stressors impact sleep over time. Prior studies among Antarctic cohorts have found reduced total sleep, increased sleep onset, and circadian phase delay. However, day-to-day regularity of sleep-wake patterns in the Antarctic over prolonged periods has not been studied.

Methods
Crew members (N= 110) at a coastal (McMurdo: MM, n = 88) and an inland Antarctic station (South Pole: SP, n = 22) were studied longitudinally for up to 9-months. Sleep was monitored continuously with actigraphy (Actiwatch Spectrum, Philips Respironics) and examined in relation to cumulative time on station and calendar month (photoperiod). Self-reported mental health symptoms were also examined monthly using The Mental Health Checklist (MHCL). The Sleep Regularity Index (SRI; Phillips et al., 2017) which calculates the percentage probability of an individual being in the same state (sleep vs. wake) at any two time-points 24 hours apart was calculated to examine sleep regularity over time.

Results
Controlling for time on station prior to participation, we observed no significant changes in monthly SRI over a 6-month period at MM where photoperiod alterations are less extreme. At SP, SRI remained very stable during months of total daylight but declined during winter months in the absence of sunlight. SRI scores were significantly different between month-8 and month-9 and with large effect sizes across month-7, month-8, and month-9. Participants with lower month-7 SRI scores had significantly higher MHCL poor self-regulation scores at the end of the mission.

Conclusion
Day-to-day variability in sleep–wake patterns is an important predictor of health and safety. Our findings show reductions in sleep regularity during prolonged Antarctic residence particularly at the SP station, where sunlight is absent for 6 months of the year. Less sleep regularity predicted worse mental health functioning. These findings suggest that mitigation the impact of altered light-dark cycles on sleep is critical for a Mars mission.

Support (if any)
NASA award #NNX15AC13G S014 to the last author.
0246 Current shift work and frailty: findings from the UK Biobank
Authors: Cai Ruixue , Zheng Xi , Gao Lei , Hu Kun , Li Peng 
Published: May 2023

Abstract

Introduction
Shift work may disrupt sleep and circadian rhythms, leading to adverse health outcomes. The objective of this study is to examine whether performing shift work is associated with frailty in middle- to older-aged adults.

Methods
We examined current shift work exposure and frailty risk in 242,126 UK Biobank participants (38-71 years old; 128,595 females). Using the baseline self-reported employment information, participants were categorized as shift workers (with ‘work schedule that falls outside of the normal daytime working hours of 9am-5pm’) or day workers if no shift work schedule. Based on a previously validated approach, frailty phenotype was identified when three or more of the following five criteria were fulfilled: self-reported weight loss, exhaustion, low physical activity, slow walking pace, and measured low grip strength. Multivariate logistic regression models were used to assess the association between shift work and frailty.

Results
Among 242,126 participants, 201,489 (83.2%) were day workers and 40,637 (16.8%) shift workers. Frailty was identified in 4,308 participants (1.8%), including 3,312 day workers (1.6%) and 996 shift workers (2.5%). Compared with day workers, shift workers were at higher risk for frailty after adjusting age, sex, and ethnicity, i.e., odds ratio (OR) =1.58 [95% CI, 1.47-1.70] (p &lt; 0.0001). The effect of shift work appeared to be more pronounced in 5,659 permanent night shift workers (OR = 1.98 [95% CI, 1.68-2.32], p &lt; 0.0001). The differences between day workers and shift workers persisted even after further adjusting for social economic status, sleep duration, and chronotype (OR = 1.38 [95% CI, 1.28-1.48] for all shift workers; OR = 1.53 [95% CI, 1.30-1.80] for permanent night shift workers, both p values &lt; 0.0001).

Conclusion
Middle- to older-aged adults who were currently performing shift work, especially those permanent night shift workers, were more likely to be frail. Longitudinal and interventional studies are warranted to elucidate the causal relationship between shift work and the risk of frailty.

Support (if any)
BrightFocus Foundation (A2020886S), NIH (RF1AG059867, RF1AG064312)
0247 Developing and Implementing Sleep Health Education for Foster Care Personnel: A Qualitative Analysis
Authors: Hope Peter , Nogales Josephina Munoz , Endlein Morgan , Wolfson Amy , McGlinchey Eleanor , Alfano Candice , Ripple Carol 
Published: May 2023

Abstract

Introduction
Sleep during childhood has a major impact on physiological, psychological, and cognitive development, yet sleep health is a neglected part of training/education for foster parents and agency staff. This study examined foster care agency staff perceptions of child sleep problems encountered by foster caregivers in order to inform the development of a sleep health training program for foster care agency staff and caregivers.

Methods
N=36 staff members from public and private foster care agencies in Texas, New York, New Jersey, and Maryland were interviewed remotely. Questions included knowledge of sleep policies, concerns surrounding sleep, methods for addressing sleep concerns, and sleep training recommendations. Two members of the research team coded the interviews using the Atlas.ti program. Coders first independently reviewed and coded transcriptions for thematic key words without formal concepts before reviewing and refining themes/codes with the full research team for consensus.

Results
Eight interviews were coded for this preliminary analysis, focused on response to the question, “What kinds of questions/concerns/requests have you received from foster caregivers regarding children’s sleep?” Across the 8 transcripts, the code Fear/trauma associated with bed/sleeping (n = 22 occurrences) and Difficulty Sleeping (initiating, maintaining sleep) (n = 18 occurrences) were the most frequently reported concerns. Other codes included: Behavioral issues affecting issues fall asleep (n=11), Placement adjustment impacting sleep (n = 10); Lack of bedtime routine (n = 9); Concerns surrounding medication (n = 7); and Insufficient sleep impacting daytime functioning (n = 5).

Conclusion
Preliminary findings suggest that sleep training approaches and programs should focus on addressing fear and trauma associated with bedtime and sleeping, as well as establishing a healthy, consistent bedtime routine. Additionally, difficulties with the use of medications, placement adjustment, and behavioral issues manifesting around bedtime should be addressed.

Support (if any)
This research was funded by the AASMF grant: 266-CS-22.
0248 Disparities in Bed and Wake Times in the US Population
Authors: Mendoza Javier , Valencia Dora , Jean-Louis Girardin , Armenta M Denisse , Killgore William D S , Grandner Michael 
Published: May 2023

Abstract

Introduction
Although quality sleep is crucial for good health, well-being, and cognitive function, racial and ethnic minority populations are at an increased risk of having shorter sleep duration and poorer sleep quality in comparison to other groups. This study, which is nationally representative, intends to show differences in population-level sleep time. Population-level differences in timing have significant public health ramifications because of the important contribution that circadian rhythms play to health.

Methods
Data were obtained from adults who participated in the National Health And Nutrition Examination Survey (NHANES), overseen by the CDC, for the 2017-2018 and 2019-2020 (March, pre-pandemic) waves. These data were combined and weighted using NHANES sample weights. Habitual sleep timing was assessed as self-reported typical bedtime and wake time, which was converted to minutes from midnight. Race/ethnicity was self-reported as non-Hispanic White, Black/African-American, Mexican-American, Other Latinx, Asian, or Multiracial/Other. Covariates included demographics (age, sex), socioeconomics (education, income-poverty ratio), health (body mass index, overall health rating), mental health (depressed mood), and sleep health (sleep disturbance, daytime tiredness).

Results
In the fully-adjusted model, compared to non-Hispanic Whites, Blacks/African-Americans went to bed 17.8 minutes later (95%CI [6.011, 29.497], P=0.003) but did not differ regarding wake time. Asians went to bed 17.8 minutes later (95%CI [6.255, 29.365], p=0.003) and woke up 18.9 minutes later (95%CI [5.222, 32.626], p=0.007). Mexican-Americans went to bed 18.0 minutes earlier (95%CI [-30.722, -5.233], p=0.006) and woke up 33.9 minutes earlier (95%CI [-47.737, -20.112], p&lt; 0.0005). The other groups did not significantly differ from non-Hispanic Whites. As a post-hoc analysis, habitual sleep duration was entered as an additional covariate, and bedtime differences between non-Hispanic Whites and Blacks/African-Americans were no longer significant.

Conclusion
Even after accounting for other elements of sleep, Blacks/African-Americans, and Asians still exhibit delayed sleep. This timing difference may reflect underlying circadian factors, or social ones that may influence timing of sleep. Future work should explore the possibility that circadian disparities exist as well, and may be related to health disparities since circadian rhythms play so many roles in health.

Support (if any)
0250 In-laboratory and at-home sleep assessments using wrist actigraphy in healthy individuals
Authors: Ishihara Asuka , Brychta Robert , LaMunion Samuel , Walitt Brian , Nath Avindra , Chen Kong 
Published: May 2023

Abstract

Introduction
Whole-room indirect calorimetry is the gold standard to measure metabolism during sleep. However, it is unknown whether sleep in a room calorimeter is reflective of a person’s natural sleep pattern or whether it suffers from limitations common to other in-laboratory assessments, such as the “first night effect”. To address this knowledge gap, we compared actigraphy-assessed sleep parameters measured in a room calorimeter with those measured at home to examine how research environments may alter natural sleep quality and patterns.

Methods
Ten healthy individuals (4 females; 41.5 ± 14.5 years old; 25.4 ± 4.2kg/m2) participated in the study (NCT02669212). Participants had no major sleep disturbances (Pittsburgh Sleep Quality Index; PSQI &lt; 5) with minimal anxiety (0-7), assessed using the Beck Anxiety Index. The in-laboratory portion of the study was conducted in a whole-room indirect calorimeter with controlled diets and ambient temperatures. The out-patient, at home study was conducted for seven consecutive nights, further divided into weekday and weekend sleep for analysis. Sleep was measured with an ActiGraph wGT3X-BT accelerometer on the non-dominant wrist throughout the study.

Results
The in-laboratory total sleep time (TST) was 399.7 ± 85.7min, comparable to weekend sleep at home, which was 399.8 ± 57.6min (p=0.998). In-laboratory TST was slightly longer than weekday sleep at home (359.7 ± 69.3min), but was not significantly different (p=0.34). Sleep efficiency in all three conditions was similar for baseline (90.6 ± 6.3%), weekday (91.4 ± 4.5%), and weekend sleep at home (91.1 ± 4.9%). These results suggest that despite being in the laboratory, sleep in healthy individuals was not significantly affected by sleeping in the calorimeter. As expected, seven consecutive nights of sleep at home revealed a tendency for shorter total sleep time during the week (359.7 ± 69.3min) compared to the weekend (399.8 ± 57.6min) (p=0.095), suggesting the presence of social jetlag and circadian misalignment throughout the week.

Conclusion
The present study showed that actigraphy-measured sleep was not affected by sleeping in the whole-room indirect calorimeter in healthy individuals. Further studies would be crucial to address whether this trend holds for other study populations.

Support (if any)