bluuebunny/crossref_metadata_2025_split huggingface dataset:
0831 Sleep in Long-Term Childhood Cancer Survivors Compared to Siblings: A Report from the Childhood Cancer Survivor Study
Authors: Daniel Lauren , Wang Huiqi , Brinkman Tara , Ruble Kathy , Zhou Eric , Palesh Oxana , Stremler Robyn , Howell Rebecca , Mulrooney Daniel , Oeffinger Kevin , Neglia Joe , Yasui Yutaka , Armstrong Greg , Krull Kevin 
Published: May 2023

Abstract

Introduction
Sleep problems following treatment for childhood cancer may persist into adulthood. Because some sleep problems increase with age, it is important to understand whether cancer elevates this risk and assess associations with co-morbidities that frequently develop in long-term childhood cancer survivors. The current study compares sleep in long-term survivors to sibling controls.

Methods
Childhood cancer survivors (≥5 years from diagnosis; n=12,340; 51.5% female; mean [SD] age=39.4 [9.6] years; years since diagnosis=30.9 [7.9]; age at diagnosis=8.5 [5.8]) and siblings (n=2395; 57.1% female; age=44.6 [10.5]) participating in the Childhood Cancer Survivor Study completed the Pittsburgh Sleep Quality Index (PSQI). Binary sleep behaviors (Total Score &gt;5, Short Sleep Duration [&lt; 6 hours], Frequent Snoring [&gt;3 times/week], Frequent Sleep Medication Use [≥3 times/week]) were compared between survivors and siblings using a multivariable generalized estimating equation with Poisson error to account for intra-family correlations, adjusting for age, sex, race, and BMI. Poisson regression models evaluated treatment and chronic health conditions (CHCs) as predictors of PSQI Total Score among survivors with the same adjustment variables.

Results
Survivors were more likely to report Short Sleep Duration (12.0% vs 10.6%; adjusted prevalence ratio [aPR] 1.18, 95% confidence interval [CI] 1.04-1.34), elevated PSQI Total Score (45.1% vs 40.0%; aPR 1.17, 95%CI 1.11-1.23), Frequent Snoring (18.0% vs 17.4%; aPR 1.11, 95%CI 1.01-1.23), and Frequent Sleep Medication Use (13.2% vs 11.5%; aPR 1.28, 95% CI 1.14-1.45) compared to siblings. Among survivors, elevated PSQI Total Score was associated with female sex (aPR 1.29, 95%CI 1.21-1.37) and BMI (overweight: aPR 1.13, 95%CI 1.06-1.22; obese: aPR 1.32, 95%CI 1.23-1.42), while age at diagnosis and cancer treatment exposures (i.e., chemotherapy/radiation) were not significantly associated. Survivors with 2+ CHCs had increased prevalence of elevated PSQI Total Score (aPR 1.39, 95%CI 1.28-1.50) relative to survivors without CHCs.

Conclusion
Childhood cancer survivors exhibit elevated risk for poor sleep quality, short sleep, and snoring relative to siblings well into middle age. These sleep problems are driven by demographics and current chronic health conditions rather than prior treatment exposures. Elevated use of sleep-promoting medications suggests interest in managing sleep difficulties and an opportunity for future behavioral sleep intervention trials.

Support (if any)
NCI 5U24CA055727-26 (PI: Armstrong)
0832 ABOUT CLOCKS, SLEEP, PAIN AND THEIR INTERACTIVE ROLE IN TMJ OSTEOARTHIRIS - A CASE REPORT
Authors: Oliveira Simone , Cruz Miguel Meira e 
Published: May 2023

Abstract

Introduction
As a major cause of disability among older people, Temporomandibular Joint Osteoarthritis (OA) remain a critical issue for both geriatric medicine and public health. While etiologic foundations of this condition are still unclear, it is well known that 24h-driven biological (circadian) rhythms are basic physiological requirements for the homeostatic control of peripheral tissues, such as skeletal muscle, bone and particularly cartilage. Sleep, as the most conspicuous circadian rhythm rooling health and welbeing, is also relevant for anabolic and catabolic processes within cartilage, with nocturnal sleep regulating other factors from which depend important metabolic pathways . Pain, which is chronically coupled to OA is not only impacted by both circadian rhythms and sleep but is itself a contributor to circadian misalignment and sleep disruption which therefore increase pain propensity maintaining a deleterious vicious cycle. Hence, knowledge on such interactive structural and functional composition should be of great relevance both for preventing and successfully treating this chronic, debilitating, neurodegenerative disorder.

Methods
Authors are reporting an interesting case of a patient in which circadian disruption, impaired sleep and exacerbated persistent pain co-ocur within OA. Sleep questionnaires (Insomnia Severity Index - ISI, STOP-BANG

Results
NA

Conclusion
From this singular case, a chronobiological approach (phototherapy) directed to circadian alignment and sleep improvement showed to be effective both for general clinical improvement and for its long-term prognosis associated to OA.

Support (if any)
0835 Cancer Patient-Caregiver Dyad Reports of Insomnia, Depression, Anxiety, Symptom Management and Healthcare Utilization
Authors: Carter Patricia , Dorsey Leah , Acker Kristi , Welch Teresa 
Published: May 2023

Abstract

Introduction
More than 1.9 million new cases of cancer were diagnosed in 2022; 30,210 of those were in Alabama. Both caregivers and patients report high levels of insomnia, depression, anxiety and stress that can be linked to a cancer diagnosis, cancer therapies, and the stressful cancer journey. Insomnia, depression, and anxiety may lead to poor symptom management at home and inappropriate (over or under) utilization of healthcare resources. However, these relationships in cancer patients and family caregivers need further exploration. This cross-sectional study is using a community-engaged research approach to gather data to support the development and testing of a model of these relationships and targeted interventions.

Methods
Caregiver-patient dyads are being recruited at a rural oncology clinic. Each dyad completes a role specific survey one-time during a clinic visit. Sleep is assessed with PSQI and ISI, Depression with PHQ-9, Anxiety with GAD-7, and Stress with PSS. Healthcare resource utilization is captured by self-report. Caregivers report patient symptoms and level of confidence with home symptom management. Patients report quality of life with FACT-G. Target enrollment is 50 dyads for the full study.

Results
To date we have enrolled 33 patient-caregiver dyads (66% of target). Sleep quality (PSQI) and insomnia levels (ISI) ranged from no difficulties to significant difficulties for both groups. Similar variances in depression (PHQ-9), anxiety (GAD-7), and perceived stress (PSS) have been reported. On these measures, some dyad members appeared to mirror each other, whereas others reported vast differences. Caregivers who reported a greater number of patient symptoms tended to report lower levels of confidence in home symptom management. Approximately 50% of the participants have reported healthcare resource utilization, with a majority reporting little to no use of healthcare services. Indicating possible underutilization.

Conclusion
The cancer journey impacts both patients and caregivers. However, the impact is reflected differently in each member of the dyad. More research is needed to explore the individual and dyadic experiences along the cancer journey and to model the relationships to develop effective interventions for both the cancer patient and family caregiver.

Support (if any)
Project funding- Office of Research & Economic Development, University of Alabama.
0837 Could sleep quality and excessive sleepiness be associated with knee pain? A cross-sectional study
Authors: Kakazu Viviane , Pinto Rafael , Dokkedal-Silva Vinicius , Fernandes Guilherme , Gobbi Cynthia , Pires Gabriel , Dias Tayna , Andersen Monica , Tufik Sergio , Morelhão Priscila 
Published: May 2023

Abstract

Introduction
Osteoarthritis (OA) is common among the older population, and sleep deprivation and depression appear to be associated with worse OA pain. The scientific literature is inconsistent in respect of overall sleep quality and daytime sleepiness in studies that consider knee pain specifically. To examine the association between sleep quality, daytime sleepiness and knee pain in older adults.

Methods
This was a cross-sectional study. The sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI) and sleepiness was evaluated by Epworth Sleepiness Scale. Older adults with knee pain classified as having OA according to the National Institute for Health and Care Excellence (NICE) guidelines. Eligibility criteria were preserved cognitive functions and being over 60 years old. Logistic regression analyses, adjusted for potential covariates (age, body mass index and sex), were performed to assess potential associations between sleep parameters and knee pain.

Results
The total sample was 451 older adults. Poor sleepers were associated with knee pain (OR=1.93, 95%Confidence interval [CI]: 1.26 to 299). Participants with daytime sleepiness were related with knee pain (OR=1.68, 95%CI: 1.100 to 2.80).

Conclusion
Sleep quality and daytime sleepiness were correlated with knee pain in the older adults. Social sleep education strategies for patients with knee pain may be important for pain control. Therefore, these variables are important in the management of patients with knee pain. Future studies should investigate whether there is a prognostic relationship between sleep quality and knee pain in the older population.

Support (if any)
Our studies are supported by grants from the Associacão Fundo de Incentivo à Pesquisa (AFIP) and the Sao Paulo Research Foundation (FAPESP 2022/00328-5 to VAK). CG and PKM are supported by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-Brazil (CAPES)-Finance Code 001). GLF is supported by the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq—#141445/2021-1). MLA, ST and RZP are Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) fellowship recipientes.
0843 Identifying the Minimum Number of Ambulatory Blood Pressure Measurements to Classify a Reliable Blood Pressure Dipping Status
Authors: Brito Leandro , Bowles Nicole , Butler Matthew , McHill Andrew , Rice Sean , Emens Jonathan , Shea Steven , Thosar Saurabh 
Published: May 2023

Abstract

Introduction
Ambulatory blood pressure monitoring (ABPM) is recommended over office BP assessment as it enables quantification of the degree of nocturnal BP dipping (classifications: “dipping” = nighttime/daytime BP of &lt; 0.9; “non-dipping” = ≥0.9), a robust predictor of future adverse events. However, ABPM can cause discomfort jeopardizing adherence to the 24-hour assessment. Current guidelines recommend at least 20/7 daytime/nighttime BP measurements for reliable classification of nocturnal dipping status, but recent reports suggest 8/4 daytime/nighttime measurements may be sufficient. This threshold for classification can reduce patient burden and potentially enhance clinical practice. We aimed to identify the minimum number of ambulatory BP measurements to determine a reliable dipping status.

Methods
Forty-three ostensibly healthy participants (50±10 years [mean±SD]) wore an ambulatory BP monitor for 24 hours with measurements every 20/30 minutes during the daytime/nighttime, respectively (maximum 48/16 daytime/nighttime measurements). We calculated each participant's dipping status using all available systolic BP measurements. We randomly selected 20-daytime plus 8-nighttime measurements, identified dipper statuses from all possibilities of 1-20 daytime and 1-8 nighttime measurements separately, and calculated the proportion of participants whose dipping status remained unchanged. We then evaluated all possible combinations starting with a minimum of 8 daytime/5 nighttime for consistency with participants’ full data set using a second random selection of 20/8 measurements

Results
We found that using 8-daytime (plus all available nighttime) measurements was sufficient for unchanged dipper status in 90% of possible combinations, and using 5-nighttime (plus all available daytime) measurements was sufficient for unchanged dipper status in 92% of possible combinations. Confirmatory analyses revealed that 8/5 daytime/nighttime combinations correctly identified dipper status in 84% of the &gt;7 million combinations. 10/8 daytime/nighttime combination improved this to 86%, similar to 87% returned from the guidelines’ recommended combination of 20/7 daytime/nighttime measurements.

Conclusion
In ostensibly healthy people, current thresholds for ambulatory BP monitoring recommendation could result in ~13% misclassifications of dipping status compared to full datasets. However, considering that this measurement can cause discomfort and that dipping statuses can be unstable in 30% of individuals, 10/8 daytime/nighttime measurements may be a reliable alternative.

Support (if any)
NIH F32HL131308, R01HL163232, R01HL125893, R35HL155681, OHSU MRF and OFDIR.
0845 Individuals with Persistent Low Back Pain Have Less Time in Deep Sleep Stage than Asymptomatic Controls
Authors: Wang Xuewen , Kishman Erin , Gilliam John , Vendemia Jennifer , Silfies Sheri 
Published: May 2023

Abstract

Introduction
Sleep consists of stages of light sleep, deep sleep, and rapid eye movement (REM), which have different characteristics. These stages are thought to be associated with different physiological and psychological processes. Pain is an unpleasant sensory and emotional experience generated by neural activity that potentially impacts several networks in the brain. There is limited information regarding the potential association between objectively determined sleep characteristics and persistent low back pain (pLBP). The purpose of this study was to examine whether sleep characteristics differ between individuals with pLBP and asymptomatic controls.

Methods
Individuals in a current episode of back pain with symptoms impacting function and persisting greater than 3 months (pLBP group, n=20) and asymptomatic individuals (control group, n=16) participated in the study. They wore a home sleep test device (Zmachine® Insight+, General Sleep Corporation) for three nights.

Results
The pLBP and control groups had similar age (24.8 ± 5.8 and 25.4 ± 4.3 years, respectively; mean ± SD), height, weight, and waist and hip circumferences. The two groups also had similar total sleep time (6.0 ± 1.2 and 6.6 ± 1.0 hours, for pLBP and control groups, respectively), sleep efficiency (82.8 ± 8.8% and 84.9 ± 5.7%), and wake time after sleep onset (35.8 ±27.4 and 31.5 ±18.1 minutes). The duration in REM (1.5 ± 0.5 and 1.5 ± 0.6 hours) and light sleep (3.1 ± 0.7 and 3.4 ± 0.9 hours) stages were also similar. However, the pLBP group had less deep sleep time (1.4 ± 0.4 hours) than the control group (1.7 ± 0.3 hours) (p = 0.029).

Conclusion
Individuals with pLBP had less deep sleep time than asymptomatic controls, although other objectively determined sleep characteristics appear to be similar. These results suggest an association between the deep sleep stage and persistent low back pain that requires further investigation.

Support (if any)
National Institutes of Health R01HD095959 and University of South Carolina ASPIRE 80004373.
0846 Prevalence of Obstructive Sleep Apnea Among Medical ICU Patients
Authors: Ehrenberg Madeline , Kongpakpaisarn Kullatham , Intihar Taylor , Doyle Margaret , Knauert Melissa 
Published: May 2023

Abstract

Introduction
The prevalence of Obstructive Sleep Apnea (OSA) among medical intensive care unit (MICU) patients is unknown. However, OSA prevalence in the general population and in conditions that are frequently comorbid in ICU populations (e.g., diabetes and cardiovascular disease) suggests that OSA may be common among MICU patients. Our objective is to prospectively examine the prevalence and severity of OSA in patients admitted to a tertiary academic MICU.

Methods
This was a prospective observational study that included patients admitted to the MICU from July to December 2022. Patient charts were reviewed for patient demographics, clinical characteristics, and evidence of pre-existing OSA. Pre-existing OSA was assessed via in depth review of the electronic medical record and included data fields such as the past medical history, documentation of OSA treatment, description of OSA diagnosis in outpatient provider notes, and/or sleep study records. Based on chart review, we also assigned confidence ratings for the OSA diagnosis (high versus low) and noted patients for whom outpatient providers had a high clinical suspicion for OSA in the absence of definitive sleep evaluation.

Results
Herein, we present preliminary analysis of 345 MICU patients. Mean age (SD) was 64 (18) years; 49% were female, 23% were Black, and 67% were White. Acute respiratory failure (36%) and septic shock (24%) were the leading reasons for admission. Mean (SD) APACHE II severity of illness score was 19.6 (8.8) and body mass index was 27.5 (8.5). Pre-existing OSA was identified in 19% of patients; 63% of pre-existing OSA patients were characterized as “high confidence” in OSA diagnosis. An additional 6% of patients had high clinical suspicion of OSA. Severity data was sparse in the chart with only 17% of OSA patients having severity data available; OSA severity distribution was as follows: mild 9%, moderate 27%, and severe 64%.

Conclusion
Our preliminary analysis indicates that OSA is notably prevalent among MICU patients. We hypothesize that OSA is under-recognized and consequently undertreated in MICU patients. With this in mind, future directions include investigation of the recognition, treatment, and outcomes related to pre-existing OSA in critically ill patients.

Support (if any)
NHLBI, NIH T35HL007649
0850 Association of Actigraphy-Assessed Sleep Parameters and Physical Functioning following Acute Hospitalization in Older Adults
Authors: Arentson-Lantz Emily , Deer Rachel , Kokonda Manasa , Meers Jessica , Carreon Samantha , Shetty Sharonya , Boyle Julia , Taffet George , Vahidy Farhaan , Agarwal Kathryn , Volpi Elena , Nowakowski Sara 
Published: May 2023

Abstract

Introduction
Three out of 10 older adults are admitted for acute care in U.S. hospitals where they are at risk for a rapid decline in physical function due to deconditioning. Identifying factors, such as sleep continuity, that may be related to recovery of physical functioning is a key step in facilitating independence following hospital discharge. Thus, this study aimed to examine the association between actigraphy-assessed sleep parameters and physical functioning after an acute hospitalization in community dwelling older adults.

Methods
Participants (n=24; age 68.9±5.5y, 71% female, 96% white), were recruited during an acute hospitalization. Participants completed physical performance testing using the Short Physical Performance Battery (SPPB) during acute hospitalization (baseline) and at 4-weeks post-discharge (follow-up). At the time of discharge, participants were given Philips Actiwatch-2® device to record sleep continuity for four weeks following hospital discharge. Actigraphy parameters included total sleep time (TST), sleep efficiency (SE), sleep onset latency (SOL) and wake after sleep onset (WASO). We conducted multivariate regression analyses using Poisson distribution to determine whether actigraphy-derived sleep parameters predicted of physical function.

Results
Increase in actigraphy-derived SE was associated with greater SPPB Balance (0.05±0.02, p=0.04) at the 4-week follow-up assessment. Increased TST was associated with improvements in SPPB total score (0.004±0.002, p=0.05) change score from baseline to 4-week follow-up. SE (0.11±0.04, p=0.01) and TST (0.004±0.002, p=0.005) were positively associated, whereas WASO (0.03±0.01, p=0.05) and SOL (0.15±0.07, p=0.03) were inversely associated with improvement in SPPB Balance change score from baseline to 4-week follow-up.

Conclusion
Together, these results demonstrated that improvements in actigraphy-derived sleep parameters (increased sleep efficiency and total sleep time; and decreased wake after sleep onset and sleep onset latency) were associated with improvements in physical functioning from hospital to 4-week follow up. Improving sleep during hospitalization may reduce hospital deconditioning and improve functional recovery.

Support (if any)
This work is supported by NIH Grant #s R01NR018342 (PI: Nowakowski), P30AG024832, UTMB Pepper OAIC, (PI: Volpi), UL1TR001439, (UTMB ITS); and the National Dairy Council (1229, PI: Volpi) Additional support was provided by the Center for Innovations in Quality, Effectiveness and Safety (CIN 13-413).
0858 Associations between Sleep Duration and Cholesterol Levels among Hispanics: Findings from the National Health Interview Survey
Authors: Carrasco Mary , Moore Jesse , Locklear Clarence , Blanc Judite , Chung Debbie , Rogers April , Zizi Freddy , Jean-Louis Girardin , Seixas Azizi 
Published: May 2023

Abstract

Introduction
Short sleep (&lt; 7 hours of sleep/24 hr. period) duration is associated with unhealthy cholesterol levels, a significant cardiovascular risk marker. Precious epidemiological studies indicate that Hispanics are at increased risk for hypercholesteremia. However, little is known about whether sleep duration contributes to high cholesterol levels, among Hispanics. We sought to investigate the following: 1) Examine whether sleep duration predicts cholesterol levels; 2) Examine whether this relationship differs in Hispanics in comparison to non-Hispanics.

Methods
This study was based on the 2020 National Health Interview Survey. Cholesterol, the outcome, is defined as whether an individual had high cholesterol during the last 12 months. Sleep quantity was categorized as follows: short sleep (&lt; 7 hours), healthy sleep (7-8 hours), and long sleep (≥9 hours). For stratified analyses, we investigated whether the relationship between sleep duration and cholesterol differed between Hispanics and non-Hispanics. We performed unadjusted and fully adjusted binary logistic regression analyses, with age, sex, education, income, and BMI as covariates.

Results
In our unadjusted models, Hispanic short sleepers had increased odds of high cholesterol (OR: 1.39 p&lt;.01 ), while long sleepers (OR: 1.25, n.s. p=.129) did not, compared to individuals who slept 7-8 hours. Non-Hispanic short (OR: 1.14 p&lt;.01) and long (OR: 1.47, p&lt; .01) sleepers had greater odds of high cholesterol, compared to individuals who slept 7-8 hours. For our fully adjusted models, Hispanic short sleepers had increased odds of high cholesterol (OR: 1.29, p&lt;.05), while long sleepers did not (OR: 1.15, n.s. p=.55), compared to individuals who slept 7-8 hours. Non-Hispanics short sleepers had greater odds of high cholesterol (OR: 1.13 p&lt;.01), while among long sleepers, no significant relationship was observed (OR: 1.05, p=.46), compared to individuals who slept 7-8 hours. Overall, Hispanic short sleepers had greater odds of high cholesterol compared to their non-Hispanic counterparts.

Conclusion
Hispanic short sleepers have an increased risk for high cholesterol. Further studies are needed to elucidate the pathophysiological mechanisms that affect the relationship between short sleep and cholesterol levels among Hispanics. This will enable tailored risk and protective profiling of Hispanic individuals to reduce their risk for high cholesterol.

Support (if any)
K01HL135452, K07AG052685, R01AG072644, and R01HL152453