bluuebunny/crossref_metadata_2025_split huggingface dataset:
0150 Increased Prevalence of Clinical Depression in Late Teens with Sleep Complaints
Authors: Lee Ji Hyun , Cho Wonyoung , Cho Marc 
Published: May 2023

Abstract

Introduction
Adolescent mental health is becoming clinical attention since suicide is one of the leading causes of death in late teens. Depression and sleep are interconnected, since depression affects sleep, vice versa. Clinical depression with symptoms of sleep disturbance were interviewed by a board certified psychiatrist following depression inventory. Age, sex matched adolescents were also accessed by depression inventory scales.

Methods
71 adolescence aged from 16-18 ( M:F=1:1) who visited sleep disorders clinic for their complaints of daytime sleepiness, sleep initiation problems, snoring, frequent midnight awakenings. 29% of them diagnosed with narcolepsy, 21% delayed sleep phase syndrome, 19% obstructive sleep apnea syndrome, 15% of them had chronic insomnia. Some of them have multiple sleep disorders associated diagnosis like OSA + narcolepsy, OSA + insomnia, or DSPS + OSA. 21 aged, sex matched high school students were evaluated for their anxiety and depression symptoms.

Results
Patients with sleep complaints had higher level of emotional distress compared with healthy adolescents without sleep complaints. Among sleep disorders, patients with narcolepsy had higher level of depression. These explains why children or adolescents with narcolepsy are initially misdiagnosed with depression in clinical setting. Comorbid depression and narcolepsy should be differentiated in clinical field.

Conclusion
In adolescents, patients with sleep disorders especially with narcolepsy have higher level of depression. Misdiagnosis of narcolepsy as depression may delay narcolepsy diagnosis.

Support (if any)
0154 Perceived Stress Partially Mediates the Association Between Adverse Childhood Experiences and Sleep Quality in Young Adults
Authors: Flores Mark , Schwager Laura , Moon Chooza , Thomas Emily , Jenkins Nathaniel 
Published: May 2023

Abstract

Introduction
Growing evidence suggests that Adverse Childhood Experiences (ACEs) are associated with poor sleep in young adulthood. It has also been proposed that ACEs may cause stress sensitization, and perceived stress has been linked with poor sleep. We hypothesized that the relation between ACE exposure and poor sleep is mediated by perceived stress.

Methods
One-hundred and twenty-five (86% Female; mean±SD, age = 22±3 y) young adults between the ages of 18 and 30 years completed the 10-item ACE questionnaire, the Perceived Stress Scale, and the Pittsburgh Sleep Quality Index to quantify ACE exposure, perceived stress (PS), and global sleep quality (GSQ), respectively. Zero-order correlations were used to examine relations among ACE exposure, PS, and GSQ. Multiple linear regression analyses were used to examine the effect of ACE exposure on PS and GSQ after adjustment for sex, age, Race, and Ethnicity. Mediation analysis was then performed using the Bootstrapped Bias-Corrected Percentile Confidence Interval method, and the variance accounted for (VAF) was calculated as the ratio of the indirect effect to total effect β-coefficients.

Results
ACEs were highly prevalent (69% with ≥1 ACE; 30% with ≥4 ACEs) and variable (range = 0 – 10 ACEs). ACE exposure was associated with greater PS (r=0.40; p&lt; 0.0001) and worse GSQ (r=0.31; p&lt; 0.0001). Higher PS was associated with worse GSQ (r=0.31; p=0.0005). After adjustment, ACE exposure remained a significant predictor of both GSQ (β=0.29; p=0.002) and PS (β=0.39; p&lt; 0.0001). PS significantly, partially mediated the association between ACE exposure and GSQ (indirect effect standardized β-estimate = 0.035 [95% CI = 0.013 – 0.069]; VAF = 29%).

Conclusion
ACE exposure is associated with greater perceived stress and poorer sleep quality among young adults. Perceived stress partially mediated the association of ACE exposure with sleep quality. Studies confirming the directionality and causality of these associations (including longitudinal mediation), and subsequently whether stress reduction interventions can promote improvements in sleep among individuals with ACEs are needed.

Support (if any)
Research reported in this publication was supported in part by the NCATS of the NIH (UL1TR002537) and by the Injury Prevention Research Center through the CDC (R49 CE003095).
0156 Personality traits and chronicity of insomnia among soldiers
Authors: Barilla Holly , Miller Katherine , Gehrman Philip 
Published: May 2023

Abstract

Introduction
Within the behavioral model of insomnia, predisposing factors can increase vulnerability to developing problems sleep. One predisposing factor is personality characteristics and past research has identified associations between traits such as rumination/worry and perfectionism with insomnia. Past studies have not considered the chronicity of insomnia and its association with personality characteristics. The goal of this study was to examine the association between chronicity of insomnia and a wide range of personality traits to identify a risk profile for chronic sleep disturbance.

Methods
Data were acquired from the New Soldier Study(NSS) components of the Army Study to Assess Risk and Resilience in Service members(Army STARRS), which collected survey data from soldiers newly recruited to the military(N=38,348; 20.9 (3.5) years old; 82.8% male). The data captures information regarding soldiers sleep, personal characteristics and mental health symptoms. Participants reported on lifetime history of insomnia with a frequency of at least 3 nights/week as well as the number of years they have experienced insomnia. Items also assessed a range of personality traits. A stepwise selection model was used to identify a profile of personality traits associated with chronicity of insomnia.

Results
Lifetime history of insomnia was very high at 88.7%, with a mean(SD) duration of insomnia mean (SD)=3.0(2.4) years. The selection model identified three personality traits significantly associated with duration of insomnia: feeling empty inside, the need to rely more heavily on friends for emotional support, and being scared of things most people are (all p&lt; 0.05).

Conclusion
These results demonstrate that, among new Army soldiers, those who have experienced chronic problems with insomnia endorse feeling empty inside leading to them stating either they are not scared of most things (increase in risk taking) or need to rely heavily on others for emotional support. Consistent with previous research, these data suggest that emotional instability is linked to poorer sleep quality.

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. KEM’s time was supported by the U.S Department of Veterans Affairs, Veterans Health Administration (Clinical Science Research and Development Service – IK2 CX001874).
0157 Physiological responses to acute psychosocial stress in adolescents with insomnia
Authors: Yuksel Dilara , Khajehpiri Boshra , Forouzanfar Mohamad , Kiss Orsolya , Prouty Devin , Arra Nicole , Volpe Laila , Baker Fiona C , de Zambotti Massimiliano 
Published: May 2023

Abstract

Introduction
Insomnia often develops during adolescence, with girls being at greater risk than boys. Alterations in response to psychosocial stress have been linked to the etiology of the disorder, but it remains unclear whether the reactivity of the major stress systems (hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system (ANS)) in response to stress is altered in adolescents with insomnia.

Methods
Forty-seven post-pubertal adolescents (age range: 16-20 years, 28 female) with (N=16; insomnia group) and without (N=31; control group) insomnia symptomatology underwent two randomized nights of polysomnographic (PSG) laboratory recordings. Participants underwent an experimental pre-bedtime stress anticipation protocol (stress night) and a control night during which they engaged in neutral activities before bedtime. The morning after the stress night, participants underwent the Trier Social Stress Test (TSST), a standardized protocol that requires participants to complete verbal and arithmetic tasks in front of observers. On both nights, heart rate (HR) was measured across the night and cortisol was collected upon awakening and 30 minutes later to calculate cortisol awakening responses (CAR). Stress perception, salivary cortisol (HPA activity), and HR were measured during the TSST.

Results
There were no differences in nocturnal HR recovery or in the CAR on the stress night compared with the control night in either group. Morning pre-TSST stress levels did not differ between groups. Both groups exhibited significant increases in HR in response to the TSST (p&lt; 0.05). HR was higher in girls compared to boys in the control group at baseline (p&lt; 0.05). Potential group differences in HPA responses to the TSST were inconclusive due to the apparent confounding effect of the CAR on cortisol responses to stress: many participants did not show a cortisol response to the task and larger CARs were associated with an attenuated cortisol response.

Conclusion
There were no significant differences in HR responses to anticipation of experimental stress during the night or in response to the morning TSST between adolescents with and without insomnia. Further work is needed to examine whether altered responses to stress may emerge if insomnia becomes chronic.

Support (if any)
This study was supported by the National Heart, Lung and Blood Institute (NHLBI) grant R01HL139652(MdZ).
0159 Sleep Disturbance, Media Consumption, and Post Traumatic Stress following Hurricane Harvey
Authors: Kim Jinu , Vieira Alyssa , Myers Annika , Alfano Candice 
Published: May 2023

Abstract

Introduction
Experiencing one-time traumatic events such as a hurricane is known to produce sleep disturbances that may contribute to the development and maintenance of PTSD symptoms (Mellman, 2019). Additionally, greater exposure to media coverage during and following such events has been shown to contribute to elevated post-traumatic stress (PTS; Shin & Sommers, 2021). However, whether media consumption might moderate the relationship between sleep disturbances and PTS symptoms has not been examined. We examined these relationships in a sample of college students following Hurricane Harvey, an epic storm that hit Texas in 2017 and received non-stop media coverage for an extended period after the storm.

Methods
Participants were undergraduate students (N=260, M age=21.32) at the University of Houston during Hurricane Harvey. Students answered online surveys 6-8 months following the hurricane that measured sleep quality and PTS symptoms over the last month, and media use both during and immediately following the hurricane. Sleep was assessed using the Pittsburg Sleep Quality Index (PSQI) and PTS symptoms were assessed using the PTSD Checklist for DSM-5 with sleep questions removed.

Results
Results indicated that active media consumption post hurricane was significantly correlated with PTS symptoms (r=.21, p&lt;.001). Regression analyses showed sleep quality significantly predicted PTS symptoms (R2 change=.133, p&lt;.001). However, contrary to expectation, this relationship was not moderated by active media consumption after Hurricane Harvey (R2 change=.19, p=.495).

Conclusion
Previous research has found both sleep disturbance and greater exposure to media coverage of traumatic events are associated with greater symptoms of PTS. Although media exposure to trauma may impact sleep quality, our findings suggest these factors to exert independent effects on PTS symptoms. Better understanding of the role of media consumption in the aftermath of trauma is needed to understand these relationships.

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0160 Sleep quality affects the heart rate signal when facing the different stress sources
Authors: Chiu Amy , Tou Shao Wen , Liu Yu Ting , Chang Ya Ju 
Published: May 2023

Abstract

Introduction
Stressful conditions can impact our judgement and increase the risk of adverse events such as workplace accidents, falls, and automobile collisions, among others. Sleep quality has also been shown to influence stress responses and heart rate variability (HRV) has proved to be a useful indicator of stress in a variety of scenarios. Therefore, wearable devices such as heart rate monitors may be able to reduce adverse events by measuring stress responses. Among subjects reporting different sleep quality, we measured heart rate variability (HRV) before and after different stressors to understand whether these stressful events could be detected by a wearable device.

Methods
Twenty-four subjects (male = 10; female = 14) with no known health conditions participated in this study. Subjects were divided into good sleep quality (N = 12) and bad sleep quality (N = 12) groups based on their Pittsburgh Sleep Quality Index (PSQI) score. Each subject engaged in a physical stress and mental stress on separate days and HRV was assessed before and after each stress intervention. T-tests were used to assess the change in HRV from pre- to post stress condition for each group.

Results
In the good sleep quality group we found several statistically significant differences across several HRV frequency-domains before and after physical stress (Low frequency: p = 0.0292; High frequency: p = 0.0287; Low frequency/ High frequency ratio: p = 0.0245) and mental stress (Low frequency: p = 0.0394; High frequency: p = 0.0387; Low frequency/ High frequency ratio: p = 0.0373).

Conclusion
Our findings indicate that sleep quality may influence the HRV response to different stressors. This suggests that HRV measured via wearable device may be used to provide warning under stressful conditions that could help prevent accidents and other adverse events.

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0166 Effects of Evening Pre-Sleep Alcohol on Next-Day Psychomotor Vigilance (PVT) Performance
Authors: Carskadon Mary , Gredvig-Ardito Caroline , Barker David H , Coston Cosette , McGeary John 
Published: May 2023

Abstract

Introduction
Few reports have examined how pre-sleep alcohol affects performance on the next day given adequate sleep opportunity on a preferred schedule. Our goal is to identify whether alcohol intake targeting .08g% 1 hr before sleep of ~8 h will affect PVT performance on subsequent days, with the hypothesis that morning performance will be negatively affected.

Methods
25 adults (13F; age range 22-57 y) completed the full study, including at-home sleep on a fixed schedule of 8-9 hr and two 3-night in-lab PSG sessions spaced ≥3 days apart. Sessions were counterbalanced for alcoholic or nonalcoholic control beverage administered in 3 drinks over 45 minutes ending 1 hr before bedtime. Alcohol was targeted to .08g%. The 10-min PVT (Ambulatory Monitoring, Inc.) was given each night (PM-Lab) 1.5 hr before drinking and in the morning after a light breakfast (AM-Lab) 50 min after waking. PVT was performed at home/work twice each day within 1.5-h windows starting 3h after waking (AM-Home) and 7.5h after waking (PM-Home). Two reaction time (RT) variables were assessed: RRT (1/RT), FRT (10% fastest RT). Linear mixed effects models were used to account for nesting of assessments within alcohol/control condition and days.

Results
RRTs showed slowed RT (meanRT±SE) following alcohol: AM-Lab F=7.234, p=.008, alcohol RT=246±9.6 msec, control RT=234±9.6 msec; AM-Home F=17.936, p&lt;.001, alcohol RT=254±9.5 msec, control RT=242±9.6 msec; but not PM-Home or PM-Lab tests. FRT slowed for AM-Lab F=9.391, p=.003, alcohol FRT=195±4.3 msec, control FRT=201±4.3 msec; AM-Home F=17.251, p=.001, alcohol FRT= 202±4.4 msec, control FRT=194±4.4 msec; PM-Home F=3.379, p=.068 (trend), alcohol FR=200±4.8 msec, control FRT=196±4.8 msec, but not for PM-Lab PVTs. PM-Home FRT also had a significant day order effect: F=3.087, p=.0496, Day 1 FRT=197±5.0 msec, Day 2 FRT=202±5.0 msec, Day 3 FRT=195±5.0 msec.

Conclusion
We found statistically significant slowing of psychomotor vigilance RT on days after pre-sleep alcohol lasting up to 3-4.5h after waking in the morning (with a trend up to 7.5-9h post waking). PVT lapses (not shown) were similarly affected by alcohol. Thus, even with sufficient sleep opportunity, RT is impaired following 3 consecutive nights of alcohol drinking.

Support (if any)
R01AA025593
0170 When to Sleep and Work to Optimize Alertness
Authors: Reifman Jaques , Vital-Lopez Francisco , Doty Tracy Jill 
Published: May 2023

Abstract

Introduction
Currently, millions of individuals work outside of the conventional 9-to-5 work shift and are often required to sleep at times that are not conducive to maximizing restorative sleep. This insufficient sleep leads to health and cognitive performance impairments that compromise workers’ safety and productivity. This can be mitigated by sleeping at the time of day that maximizes the restorative benefits of sleep and working at favorable hours, within their particular opportunity windows. Here, we present an optimization algorithm to identify sleep and work schedules that maximize alertness during work hours, while reducing impairment during non-working hours to the greatest extent possible.

Methods
We developed an optimization algorithm that searches through a large number of possible sleep and work schedules to identify the one that maximizes alertness during work times, while meeting user-provided constraints, such as the periods during which the user has flexible opportunities to sleep and work. To generate the possible sleep and work schedules, we used the well-validated Unified Model of Performance (UMP), including its ability to predict sleep latency and sleep duration. To assess the algorithm, we simulated four experimental studies, where we compared the effectiveness of the sleep schedules obtained by the algorithm against those of the sleep schedules used in the studies. In addition, we tested the algorithm’s ability to simultaneously optimize sleep and work schedules in one of the studies.

Results
Using the same amount of sleep as in the studies, the algorithm proposed sleep schedules that optimally allocated sleep, reducing alertness impairment during work hours by an average of 29%. Similarly, by simultaneously optimizing sleep and work schedules during a recovery period following a chronic sleep-restriction challenge, the algorithm’s solutions resulted in recovery to baseline alertness levels two days earlier than the conventional 9-to-5 work schedule.

Conclusion
Our work provides the first quantitative tool to optimize sleep and work schedules and complements other existing fatigue-management tools to provide a more comprehensive set of countermeasure strategies to mitigate alertness impairment due to limited sleep.

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0173 Improving Well-being by Changing the Shiftwork Schedules at U.S. Navy Watchfloors
Authors: Lawrence-Sidebottom Darian , Dotson Elizabeth , Matsangas Panagiotis , Shattuck Nita 
Published: May 2023

Abstract

Introduction
Watchfloors provide around-the-clock information, intelligence, and technical support to the U.S. military. Active-duty service members (ADSMs) working on these 24/7 watchfloors stand watches to include night shifts and/or frequent shift rotations. Tailoring shiftwork schedules to optimize individual sleep patterns may reduce the negative effects of shiftwork. The purpose of this study was to test whether a new shiftwork schedule would improve ADSM well-being and sleep.

Methods
ADSMs (N=79; 83.5% males, 91.2% enlisted, 19 to 54 years of age) participated in a two-phase quasi-experimental longitudinal study to assess well-being and sleep before and after the implementation of a new shiftwork schedule. Both schedules involved three rotating shifts: day shift (0730-1530), evening shift (1320-2330), and night shift (2330-0730). The old schedule had 5 successive days on-shift (5-on/4-off) and the new schedule had 4 successive days on-shift (4-on/4-off). Shifts rotated after every off period. Standardized questionnaires were administered while participants were on the old schedule (study start) and ~5 months after switching to the new schedule. The questionnaires included the Pittsburg Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), the Epworth Sleepiness Scale (ESS), and the Profile of Mood States (POMS). Sleep was monitored using wearable devices (ŌURA rings).

Results
POMS total mood disturbance scores were lower (i.e., better) on the new schedule (p&lt; 0.001), as were several POMS sub-scale scores including tension (p&lt; 0.001), depression (p&lt; 0.001), anger (p=0.014), confusion (p&lt; 0.001), and vigor (p=0.029). There was a statistical trend for a decrease in ISI scores from the old schedule to the new schedule (p=0.067). Sleep duration, PSQI, and ESS scores did not differ between schedules (all p&gt;0.05).

Conclusion
Implementation of a new shiftwork schedule that was tailored to worker sleep patterns was associated with decreased mood disturbance, improvement in negative mood states (e.g., depression and tension), and reduced insomnia symptom severity. Also, the research team received several anecdotal reports of high levels of worker satisfaction with the new schedule. This study demonstrates the positive real-world effects of using basic sleep and circadian methods to tailor shiftwork schedules to improve the well-being of military personnel.

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0178 2B-Alert App: Personalized Caffeine Recommendations for Optimal Alertness
Authors: Reifman Jaques , Doty Tracy Jill , Anlap Ian , Killgore William , Vital-Lopez Francisco 
Published: May 2023

Abstract

Introduction
Sleep loss causes millions of individuals around the world to carry out daily activities with impaired alertness, affecting injury risk and productivity. If properly consumed, caffeine can safely and effectively mitigate the effects of sleep loss on alertness. However, to be effective, caffeine should be consumed at the right time and in the correct amount, depending on sleep history, work schedule and, importantly, sensitivity to sleep loss. Here, we present the 2B-Alert app, a unique smartphone application with capabilities to learn an individual’s trait-like response to sleep loss and to provide personalized caffeine recommendations to optimize alertness.

Methods
We conducted a prospective 62-h total sleep deprivation study to validate the capabilities of 2B-Alert. Throughout the challenge, 21 participants used the app to measure their alertness via the psychomotor vigilance test (PVT). The app used the PVT data collected during the first 36 h of wakefulness to learn each participant’s sleep-loss response and provided on-the-fly personalized caffeine recommendations (from 0 to 800 mg), so that each participant would sustain alertness at a pre-specified target level (mean PVT response time of 270 ms) during a 6-h period starting at 44 h into the challenge. To assess the effectiveness of the personalized recommendations, we computed the amount of PVT data during the 6-h period that fell within the target alertness level +/-2 times the within-subject variability of alertness impairment (i.e., +/-60 ms).

Results
We observed a wide range of responses to sleep loss, with some participants displaying high levels of resilience and others high levels of vulnerability. Accordingly, 2B-Alert recommended no caffeine to five participants, 100-400 mg to 11 participants, and 500-800 mg to five participants. Regardless of their sleep-loss response and the consumed amount of caffeine, participants sustained the target alertness level ~80% of the time during the 6-h period.

Conclusion
2B-Alert automatically learns an individual’s trait-like response to sleep loss and provides personalized caffeine recommendations in real time so that individuals achieve a desired alertness level regardless of their susceptibility to sleep loss.

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