bluuebunny/crossref_metadata_2025_split huggingface dataset:
0836 Chronic Pain worsens Daytime Sleepiness, Insomnia and Quality of Life in Veterans with Obstructive Sleep Apnea
Authors: Saconi Bruno , Kuna Samuel , Polomano Rosemary , Compton Peggy , Keenan Brendan , Sawyer Amy 
Published: May 2023

Abstract

Introduction
Chronic noncancer pain (CP) commonly co-occurs with obstructive sleep apnea (OSA) and may contribute to greater symptom burden. The study aim was to examine differences in sleepiness (Epworth Sleepiness Scale, ESS), insomnia symptoms (Insomnia Severity Index [ISI]), and quality of life (Short Form Health Survey 20, SF-20) in veterans with OSA with or without pre-existing CP.

Methods
An observational, cross-sectional, study of veterans with newly diagnosed, untreated OSA was conducted. Unadjusted between-group comparisons (i.e., OSA-only versus OSA + CP) were conducted using the Welch’s t-test and Pearson Chi-Square. Regression analyses were performed to determine the influence of self-reported CP on sleep-related symptoms and quality of life while controlling for potential confounders (i.e., age, sex, OSA severity, body mass index, percentage of total sleep time spent with SpO2 &lt; 90%, and presence of psychiatric/mental health comorbidities). The Hochberg (step-up) method was used to control for the family-wise error rate at 5%.

Results
The final sample included N=111 participants with complete survey responses. Compared to the group with OSA-only (n=40), veterans with comorbid OSA and CP (n=71) experienced significantly higher ESS (12.7 ± 5.5 vs 10.2 ± 5.2; p = .021) and ISI scores (18.1 ± 6.2 vs. 13.7 ± 7.4; p = .002), and worse quality of life across all SF-20 domains. Of note, clinically significant insomnia (ISI score &gt; 15) was most common among veterans with comorbid OSA and CP (68.7% vs. 45.5%, p = .010). In adjusted analyses, CP diagnosis was significantly associated with higher ESS (adjusted mean difference [95% CI] = 2.72 [0.55, 4.88], p = .014) and ISI scores (adjusted mean difference [95% CI] = 3.82 [1.27, 6.37], p =.004).

Conclusion
There is a high prevalence of CP among veterans with OSA and symptom burden is higher in patients with OSA and CP. Future investigations should address symptom response and burden to OSA treatment in comorbid OSA and CP to guide outcome expectancies and residual OSA symptom treatment plans.

Support (if any)
SRSF Small Research Grant Award: 05-SRG-20. University of Pennsylvania School of Nursing, Office of Nursing Research.
0838 Diagnosed Prevalence of Idiopathic Hypersomnia Among Adults in the United States
Authors: Saad Ragy , Black Jed , Bogan Richard , Jensen Elizabeth , Lillaney Prasheel , Prince Patricia , Estrin Adina , Whalen Marisa , Macfadden Wayne , Ni Weiyi , Plante David 
Published: May 2023

Abstract

Introduction
Idiopathic hypersomnia (IH) is a rare neurologic disorder that can cause debilitating symptoms, including excessive daytime sleepiness, severe sleep inertia, prolonged nighttime sleep, long and unrefreshing naps, and cognitive dysfunction. Research reporting the burden of IH is scant. The objective of this study was to estimate the diagnosed prevalence of IH among US adults between 2019 and 2021.

Methods
Symphony Integrated Dataverse® administrative claims between November 2015 and December 2021 were analyzed. Eligible patients were aged ≥18 years and had 1 medical or prescription claim in the calendar year of interest (2019, 2020, or 2021) and in the year prior. Diagnosed prevalence included all IH cases observed in eligible patients through the last day of the year of interest. IH cases were defined as eligible patients with ≥1 medical claim containing an IH diagnosis code in any position before or during the calendar year of interest, and no history of cataplexy. Unweighted prevalence estimates were reported per 100,000 persons with 95% confidence intervals (CIs). Age- and sex-adjusted prevalence estimates were calculated using 2019 US Census Bureau data.

Results
Over 158, 168, and 187 million adults were eligible for assessment of diagnosed prevalence of IH in 2019, 2020, and 2021, respectively. The unweighted diagnosed prevalence of IH was 32.12 per 100,000 persons (CI: 31.84, 32.40), 35.71 per 100,000 persons (CI: 35.43, 36.00), and 37.03 per 100,000 persons (CI: 36.75, 37.30) in 2019, 2020, and 2021, respectively. The estimated standardized numbers of US adults diagnosed with IH were 80,603 (CI: 80,048, 81,161), 89,539 (CI: 88,954, 90,127), and 92,139 (CI: 91,545, 92,736) in 2019, 2020, and 2021, respectively.

Conclusion
To our knowledge, this is the most recent study to estimate diagnosed prevalence of IH in US adults. It is uncertain what proportion of IH cases remain undiagnosed considering the under-recognition of this condition, low utilization of sleep testing, and concerns over the reliability of multiple sleep latency testing. Furthermore, recent studies suggest only a subset of patients with IH actively seek medical care for their condition. Given its impact on patients’ lives, further research to improve surveillance of IH symptoms is needed.

Support (if any)
Jazz Pharmaceuticals.
0839 Does CBT-I Dose Improve Depression and Anxiety in Patients Diagnosed with Breast and Prostate Cancer?
Authors: Jayaraman Nirmala , Muench Alexandria , Posner Donn , Seewald Mark , Boyle Julia , Vargas Ivan , Thompson Michelle , Grandner Michael , Perlis Michael 
Published: May 2023

Abstract

Introduction
It has been widely reported in the literature that insomnia, depression, and anxiety are reciprocally related, and that CBT-I not only improves insomnia but also symptoms of depression and anxiety. With respect to cancer, patients of-ten report high co-morbidity of insomnia, fatigue, depression, and anxiety, with fatigue occurring in almost all patients diagnosed with cancer (irrespective of diagnoses and staging) and extending well into survivorship. The underlying mechanisms of fatigue are not well understood and, as such, there could be many contributing factors (e.g., insomnia and mood disturbance). The present analysis is based on a pilot study evaluating whether sleep continuity and CRF is improved by CBT-I dose (4 & 8 [Low dose] vs 10 & 12 [High dose] sessions). The present analysis evaluates whether dose of CBT-I effects depression and anxiety in patients diagnosed with breast and prostate cancer.

Methods
This descriptive analysis (percent change from pre to post treatment) includes 12 adult subjects (83.3% female, Mage 58.4±7.5yrs.; [Low dose, n=6], [High dose, n=6]). CBT-I was provided by a master therapist via video conferencing (telehealth CBT-I). Subjects were asked to complete sleep diaries and weekly measures of fatigue (FACIT), insomnia severity (ISI), depression (PHQ-9), and anxiety (GAD-7).

Results
On the PHQ-9, subjects in the Low dose group exhibited a 57% improvement and subjects in the High dose group had a 52% improvement. On the GAD-7, this corresponded to a 26% improvement (High dose group) and 25% improvement.

Conclusion
As increasingly reported in the literature, CBT-I produced robust effects on depression as assessed by the PHQ-9. The effects on anxiety appear to be less robust. This may be the case because CBT-I’s effects on fatigue are likely to impact a variety of depressive symptoms, where this is less the case for anxiety. Analyses are ongoing, where the relative effects will be adjusted for insomnia-related items and rendered in terms of effect sizes.

Support (if any)
5T32HL00795320;K24AG055602
0848 Total sleep time, wake after sleep onset, and inflammation predict obesity in young adult African Americans
Authors: Boyd Kevin , Bell Kimberly , Chen Yuanxui , Mellman Thomas 
Published: May 2023

Abstract

Introduction
Sleep is vital to maintaining psychological and physiological health. Poor sleep is associated with adverse health outcomes, including obesity. Studies have shown that African Americans disproportionately suffer from poor sleep and the adverse health outcome associated with obesity. We aimed to determine if sleep quality and peripheral inflammation are significant predictors of obesity in a young adult African American sample.

Methods
Participants were healthy adults with a body mass index of less than 40 between 18- 35 who self-identified as Black or African American and completed a protocol consisting of in-lab polysomnography, ambulatory monitoring and a morning blood draw. Height and weight were collected to derive body mass index (BMI). Total sleep time (TST), wake after sleep onset (WASO), sleep onset latency (SOL), and sleep efficiency (SE) were derived from in-home actigraphy. Venipuncture was used to collect blood samples within 15 minutes of awakening. Once samples were processed, interleukin-6 (IL-6) levels were detected and quantified using enzyme-linked immunosorbent assays (ELISA).

Results
Significant correlations were found between BMI, WASO, TST, SE, and IL-6. A forward stepwise linear regression was used to identify possible predictors of BMI out of the following candidate variables: TST, SE, WASO, and IL-6. At each step, variables were chosen according to their contribution to the model's R^2. The p-value threshold of 0.05 was used to set a limit on the total number of variables included in the final model. TST, WASO, and IL6 were the significant predictors in the final model that accounted for 26% of the variance in BMI (∆R2 = .260, p&lt;.001). Regression coefficients suggest that IL-6 (β =.388), TST (β= -.234), and WASO (β=.205) predict obesity.

Conclusion
Total sleep time and wake after sleep onset are modifiable protective and risk factors that appear to be significant contributors to obesity in urban-residing young African Americans.

Support (if any)
This research was supported by the NIHLB grants R01HL087995 and R01HL136626 and to Dr. Thomas A. Mellman and NCATS grant for a Clinical Translational Science Award UL1-TR001409.
0852 Insomnia with Objective, but not Subjective, Short Sleep Duration is Associated with Increased Risk of Incident Hypertension
Authors: Li Yun , Dai Yanyuan , Chen Baixin , Chen Le , Fernandez-Mendoza Julio , Karataraki Maria , Tang Xiangdong , Vgontzas Alexandros 
Published: May 2023

Abstract

Introduction
Insomnia with objective short sleep duration (ISSD) has been associated with higher risk of cardiometabolic morbidity. In this study, we examined the association between ISSD, also based on subjective sleep duration, with incident hypertension in the Sleep Heart Health Study (SHHS).

Methods
We analyzed data from 1413 participants free of hypertension or sleep apnea at baseline from the SHHS with a median follow-up duration of 5.1 years. Insomnia symptoms were defined based on difficulty falling asleep, difficulty returning to sleep, early morning awakening, or sleeping pill use more than half days in a month. Objective short sleep duration was defined as polysomnography-measured total sleep time &lt; 6 hours. Incident hypertension was defined based on blood pressure measures and/or use of antihypertensive medications at follow-up.

Results
Insomnia subjects who slept objectively &lt; 6 hours had significantly higher odds of incident hypertension compared to normal sleeping subjects who slept ≥6 hours (OR=2.00, 95% CI=1.09-3.65) or &lt; 6 hours (OR=2.00, 95%CI=1.06-3.79) or insomnia subjects who slept ≥6 hours (OR=2.79, 95%CI= 1.24-6.30). Insomnia subjects who slept ≥6 hours or normal sleepers who slept &lt; 6 hours were not associated with increased risk of incident hypertension compared to normal sleepers who slept ≥6 hours. Finally, insomnia subjects who self-reported sleeping &lt; 6 hours were not associated with significantly increased odds of incident hypertension.

Conclusion
These data further support that the ISSD phenotype based on objective, but not subjective measures is, similar to sleep apnea.

Support (if any)
The Sleep Heart Health Study (SHHS) was supported by National Heart, Lung, and Blood Institute cooperative agreements U01HL53916 (University of California, Davis), U01HL53931 (New York University), U01HL53934 (University of Minnesota), U01HL53937 and U01HL64360 (Johns Hopkins University), U01HL53938 (University of Arizona), U01HL53940 (University of Washington), U01HL53941 (Boston University), and U01HL63463 (Case Western Reserve University). The National Sleep Research Resource was supported by the National Heart, Lung, and Blood Institute (R24 HL114473, 75N92019R002).
0856 Are African-Americans/Blacks with Asthma getting the recommended amount of sleep?
Authors: Hollimon Laronda , Moore Jesse , Rogers April , Nunes Joao , Casimir Georges , Jean-Louis Girardin , Seixas Azizi 
Published: May 2023

Abstract

Introduction
Asthma is one of the leading respiratory illnesses in the United States. African Americans/Blacks are particularly vulnerable to the long-term effects of this condition. In addition to general healthcare inequities, African Americans/Blacks may also have an increased vulnerability to the deleterious effects asthma may enact on health behaviors such as sleep. Comparison between races for how much asthma affects sleep health would be useful to address these vulnerabilities.

Methods
Analysis was performed on the 2020 National Health Interview Survey, the most recently collected data (n=31,568.) The sample was stratified to include only asthmatics using the survey variable that asked “Have you ever been diagnosed with asthma?” 8.6% of the sample reported having asthma (n=2123). Adjusted binary logistic regression was performed to determine how race predicts sleep health in this population. Covariates included age, sex, education, household income, and physical activity. “Healthy Sleep” was coded as self-reported 7-8 hours of sleep, and “Unhealthy Sleep” was coded as either less than 6 hours or more than 9 hours, as literature establishes short and long sleep have deleterious effects on health. “Race” was coded as White, Black, American Indian/Alaskan, or Asian. In the regression, White was used as the reference category.

Results
In the adjusted model for race predicting healthy sleep, only African-Americans/Blacks showed significance compared to other races. The model showed that Blacks who are asthmatic are 54% (p&lt;.01) less likely to sleep for 7-8 hours per day. Asian asthmatics (p=.815), and American Indian asthmatics (p=.761) did not demonstrate significance in the model predicting healthy sleep.

Conclusion
These analyses show a pronounced connection between black racial status and unhealthy sleep amongst asthmatics. The results are in line with literature that demonstrates blacks sleep less in general and are more commonly afflicted with sleep conditions such as OSA, but there is a dearth of research examining how asthma affects sleep in this population. Further studies are needed to examine the underlying factors that may drive these vulnerabilities.

Support (if any)
K01HL135452, K07AG052685, R01AG072644, R01HL152453, R01MD007716, R01HL142066, R01AG067523, R01AG056031, and R01AG075007
0877 SLEEP AND PARKINSON’S DISEASE: PREVALENCE IN AN OUTPATIENT MEXICAN CLINIC
Authors: Torrecillas-Gordillo Meliza J , Ferrari-Aquino Anaké L , De la Graza-Manrique Paula M , Marichalar José Garza , Chávez Luévanos Beatriz E 
Published: May 2023

Abstract

Introduction
Sleep disturbance in patients with Parkinson's disease (PD) is highly prevalent. PD is the second most common progressive neurodegenerative disease, affecting about 1% of people over 60 years. Little it's said about the sleep disorders in this disease, which are very frequent and frequently underdiagnosed. In Mexico, there are not a lot of studies on PD and sleep disorders in their population. University Hospital Dr. José E. González having the only Parkinsons' clinic in the northeast of Mexico for the population without medical coverage, has recognized the importance of unreported sleep disorders in their broad patient population.

Methods
Patients of the outpatient clinic whom their medical query wasn’t about sleeping disorder were screened using the following clinical tools: the Pittsburgh Sleep Quality Index (PSQI), the Patient Health Questionnaire (PHQ-9), the STOP-BANG Questionnaire, and the Epworth Scale. A full clinical history was also taken, focusing on sleep habits and risk factors that could contribute to sleep difficulties.

Results
A total of 65 patients (26 females, 39 males) that attended the outpatient Parkinson’s clinic were screened for sleep disorders. Fifty-nine patients (90.7%) were identified with at least 3 risk factors for obstructive sleep apnoea with the STOP-BANG questionnaire and were ordered polysomnography. Using the PSQI we identified 56 patients (86.1%) with low-quality sleep (defined as a score of 5 or higher). With the PHQ-9 we identified 41 patients (63%) with a high risk of depression, none of them were receiving treatment. And the Epworth Scale helped us identify 33 patients (50%) with a possible pathological excessive daytime sleepiness, none of them diagnosed.

Conclusion
PD is associated with multiple sleep disorders, which commonly impair quality of life. Routine inquiry about sleep problems from healthcare providers can increase its detection in a clinical setting outside of a sleep clinic and better management. Further research should focus on improving screening and diagnostic tools in the PD population. With this initiative, we present our experience and results incorporating routine screening for these disorders, future exploration toward this direction may hopefully shed light on developing effective, mechanisms-driven treatment options.

Support (if any)
0900 A Community-based Survey of Personal Perspectives Regarding Prodromal Sleep Screening for Neurodegenerative Disorders
Authors: Levendowski Daniel , Berka Chris , Neylan Thomas C , Mazeika Gandis , Walsh Christine , Boeve Bradley , St. Louis Erik 
Published: May 2023

Abstract

Introduction
Sleep markers can assess prodromal risk for neurodegenerative disorders (NDD). In a recent study conducted by the Mayo Clinic, most isolated REM sleep behavior disorder patients preferred knowing about their risk for parkinsonism or dementia. In their email survey, patients indicated a strong preference for disclosure of prognostic NDD risk in order to spur family discussions and plan for the future. For this pilot study, the Mayo questions were modified in order to investigate the perspectives and preferences of community-based adults about potentially being at-risk of a NDD and how it might impact their lives.

Methods
A brief survey was administered to Rotary Club attendees prior to a presentation on sleep and neurodegenerative disease. Each question offered five responses: strongly disagree, disagree, neutral, agree, or strongly agree. Personal identifiers were not obtained. Thirty-four surveys were completed from approximately equal numbers of older men and women with estimated ages above 50 years. Personal information were not obtained (e.g., age and sex).

Results
When asked whether it was important to know their NDD risk given the fact that there are no known methods to prevent or cure the disease, most (83%) strongly agreed or agreed, while only 18% preferred not to know their NDD risk. The majority felt they would be more pessimistic about their future if identified as being at risk of NDD the (62% strongly agreed/agreed). Most believed their priorities and plans for living life would change (68% strongly agreed/agreed). Further, the vast majority felt that knowing NDD risk would help them plan for the future (89% strongly agreed/agreed), including planning for health resources and support (88% strongly agreed/agreed).

Conclusion
Eighty-three percent of those surveyed reported they would benefit from knowing if they were at risk of NDD, even though the majority would feel more pessimistic about their future. The vast majority (89%) responded that knowing their NDD risk would help them plan for the future. These results suggest that most community adults might be receptive to future sleep screening for NDD with results. Investigations are underway to confirm these findings in a broader community-based study.

Support (if any)
NIA-R44AG050326
0902 Comparative Analysis of Sleep Apnea Patients Selected from the Stroke Unit vs Outpatient Clinic
Authors: Seo Jun Hyeok , Yang Tae-Won , Kim Seung Hwan , Kim Mi-Ji , Ko Nak Gyeong , Jeon Byeong Gu , Kim Ji Yoon , Lee Jin Gyeong , Kwon Oh-Young , Kim Young-Soo , Kim Do-Hyung 
Published: May 2023

Abstract

Introduction
To our knowledge, there have been studies actively looking for patients with suspected SA in the Stroke Unit (SU), but most of them were conducted using a portable polysomnography (PSG), and no study has performed Level 1 PSG (L1PSG) to date. We conducted L1PSG to the acute stroke patients selected in the SU, and conducted L1PSG to patients who visited the Neurology Outpatient Clinic (NOC) with subjective SA symptoms at the same time. By comparison, we tried to find out the SA characteristics of acute stroke patients.

Methods
This study was conducted on patients admitted to SU from April 1, 2021 to October 31, 2022, and patients who visited NOC during the same period and underwent L1PSG. Among patients admitted to the SU, trained night shift nurses selected patients with SA symptoms with a modified mallampati score of 3 or higher. Cases under intracranial pressure control or other interventions were excluded. Outpatients were enrolled in patients who underwent L1PSG by visiting the NOC to examine only SA. The results of the pre-sleep questionnaire and L1PSG were compared.

Results
Of a total of 829 stroke patients admitted to SU, 31 SU patients received L1PSG, and during the same period, 74 patients received L1PSG for SA testing at NOC. The average age of SU and NOC was 56 and 57 years, and the median BMI was 26.9 and 26.4. In the survey, the ISI (7 vs 12, p=0.04) and PSQI (5 vs 7, p=0.021) scores were statistically significantly higher in NOC patients. As a result of the L1PSG, AHI (38.8 vs 23.1, p=0.027), AHI in Supine (59.3 vs 25.6, p=0.004) and NonREM AHI (36.3 vs 20.9, p=0.027) were statistically significantly higher in SU patients.

Conclusion
Patients screened SA at SU overlooked their symptom and thought their sleep quality was better than that of NOC patients, but the actual AHI was higher. In particular, acute stroke patients show a large difference in AHI in supine compared to NOC, so lateral position can be recommended when absolute bed rest is needed in situations where SA is suspected in SU. More follow-up studies will be needed.

Support (if any)