bluuebunny/crossref_metadata_2025_split huggingface dataset:
0665 Ibogaine treatment in combat Veterans significantly improves sleep, beyond alleviating Posttraumatic Stress Disorder symptoms
Authors: Faerman Afik , Anker Lauren , Cherian Kirsten , Brown Randi , Williams Nolan 
Published: May 2023

Abstract

Introduction
Ibogaine is an indole alkaloid traditionally used in spiritual and healing rites in some African cultures. Ibogaine is primarily studied in the context of substance dependence, but indications suggest it may enhance recovery from trauma. Here, we investigated the effects of ibogaine treatment for multisystem effects of exposure to repeated blasts and combat on self-reported sleep disturbance, insomnia severity, and trauma-related symptoms.

Methods
Participants were Special Operations Veterans who independently and voluntarily underwent ibogaine treatment at a specialized clinic outside the USA. After meeting rigorous screening requirements, 30 participants were enrolled, all endorsing histories of repeated combat and blast exposure and traumatic brain injury. Participants were seen in person for baseline, immediate post-treatment, and 1-month post-treatment assessments, including the Clinician-Administered Posttraumatic Stress Disorder (PTSD) Scale for DSM-5 (CAPS-5), the Pittsburgh Sleep Quality Index (PSQI), and the Pittsburgh Insomnia Rating Scale (PIRS). Twenty-six participants completed sleep measures at baseline and 1-month post-treatment.

Results
Two-tailed paired samples t-tests revealed significant effects of time, with post-treatment improvements in CAPS (ΔM = -26.8±11.1, t(25) = 12.283, p &lt; .001), PSQI (ΔM = -6.5±5.6, t(25) = 5.920, p &lt; .001), and PIRS (ΔM = -23.8±15.5, t(24) = 7.690, p &lt; .001). However, pre-post changes in PTSD symptom severity were not a significant predictor of improvements in PSQI (R² = .229, b = .354, p = .074) or PIRS (R² = .232, b = .339, p = .090) after controlling for age (p = .206 and p = .165, respectively).

Conclusion
To our knowledge, this is the first study examining the effects of ibogaine use on sleep in humans. Results indicated that while sleep and PTSD symptom severity improve 1-month post-treatment, they might be impacted by different mechanisms targeted by ibogaine. Even though a small sample size may have hindered the ability to reach desired probability values, the variance explained by the improvement in PTSD symptoms was still relatively modest (up to 23%). These promising findings demonstrate ibogaine’s therapeutic potential for disturbed sleep in the context of traumatic brain injury and trauma. Potential explanations are discussed.

Support (if any)
This study was supported by a private fund.
0677 Blunted daily light rhythm amplitude in adults with opioid use disorder (OUD)
Authors: Cox Rebecca , Haller Sophie , Martinez-Lisowska Zofia , Kuppa Abhignya , Sprecher Kate , Withrow Dana , Barry Declan , Scheinost Dustin , Redeker Nancy , Yaggi H , Wright Kenneth 
Published: May 2023

Abstract

Introduction
Accumulating evidence implicates sleep and circadian rhythm disruption in substance use disorders, including opioid use disorder (OUD). Blunted amplitude in daily rhythms of circadian-relevant variables (e.g., activity, light) may be a marker of psychopathology, as depressed adults demonstrate a smaller activity amplitude compared with healthy controls. The present study compared the light and activity amplitudes of adults with OUD with healthy controls.

Methods
Light and activity data were collected from adults with OUD who were recently stabilized on medication-assisted treatment (N=27; Mage=44.25±13.21). Participants wore an Actiwatch for an average of 14.5 (SD=4.14) days. Light and activity data collected from healthy adults (N=15; Mage=22.88±2.76) who wore an Actiwatch an average of 11.59 (SD=1.07) days in a separate study were included as a comparison group. Light and activity amplitudes for each day and a composite amplitude for the sampling period were calculated using non-orthogonal spectral analysis.

Results
Results of mixed model ANOVA with subject as a random factor and group and day as fixed factors revealed a significant main effect of group on daily light amplitude (p&lt;.01), such that the OUD group exhibited lower daily light amplitudes compared to healthy controls, and a trend-level main effect of group on daily activity amplitude (p=.09), such that the OUD group exhibited lower daily activity amplitudes compared to healthy controls. With age included as a covariate in the model, the main effect of group on light remained significant, whereas the trend-level effect on activity became non-significant. Results of between-subjects t-tests indicated significantly lower composite light and activity amplitudes during the entire sampling period in the OUD group compared to healthy controls (p’s&lt;.05).

Conclusion
These findings indicate that OUD is characterized by blunted light amplitude, which could both reflect and contribute to disruptions in circadian physiology in OUD. Light amplitude may be a novel target for behavioral OUD interventions. Future research is needed to determine whether blunted light amplitude is associated with OUD treatment outcomes and to further examine activity amplitude in OUD with larger sample sizes.

Support (if any)
U01 HL150596; T32 HL149646; CTSA Grant UL1 TR002535; Office of Naval Research MURI N00014-15-1-2809
0682 Adapting a Transdiagnostic Sleep Intervention for Young Adults with Autism Spectrum Disorder: Preliminary Data
Authors: Lenker Kristina , Cozzi Anna , Murray Michael , Harvey Allison , Calhoun Susan , Fernandez-Mendoza Julio 
Published: May 2023

Abstract

Introduction
Young adults with Autism Spectrum Disorder (ASD) frequently report a multitude of pervasive sleep and circadian problems, including difficulties initiating and maintain sleep, excessive sleepiness, delayed phase, and irregular sleep–wake schedules. These sleep and circadian problems often occur in unison rather than as isolated problems and further impair social functioning, cognition, mood, and overall quality of life, during a particularly challenging developmental stage. Although sleep and circadian problems have been identified as a critical and unmet public health concern for young adults with ASD, and there is a robust evidence for transdiagnostic sleep interventions, there is a paucity of research on the efficacy of these interventions in young adults with ASD.

Methods
Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C), a patient-centered sleep intervention which has demonstrated improvements in sleep and circadian problems and reduce symptomology in both mental and physical health domains across a variety of mental health disorders, will be adapted and iteratively pilot-tested, so that its contents and service delivery methods are appropriate for young adults with ASD. Qualitative methods (semi-structured interviews) will be used to conduct and analyze feedback from key stakeholders (n=20; 10 dyads of young adults with ASD and their caregivers), and used to directly guide adaptations of TranS-C.

Results
Preliminary data of 5 young adults (18-24y) with ASD show that these individuals are likely to receive multiple sleep disorder diagnoses at equally similar rates (60% circadian rhythm sleep disorder, 60% insomnia disorder), and concurrently present with comorbid mental health problems (60% anxiety disorder, 60% depression).

Conclusion
Our preliminary data along with existing studies suggest that (1) sleep and circadian problems experienced by individuals with ASD are multidimensional in nature, (2) negatively impact daytime functioning, both within several cognitive and mental health domains, and (3) require transdiagnostic approaches in individuals with ASD to address the broader range of sleep and circadian dysfunction experienced. Potential adaptations to TranS-C format and delivery may serve as a novel module for promoting intervention adherence and responding to unique features of ASD.

Support (if any)
Brad Hollinger Autism Research Endowment Award
0691 Quality of life and subjective sleep characteristics among a middle-aged population in Korea
Authors: Baek Younghwa , Jung Kyoungsik , Kim Jimi , Lee Siwoo 
Published: May 2023

Abstract

Introduction
Sleeping problems are associated with physical and mental conditions as well as quality of life (QoL). This study aimed to evaluate the association between sleep characteristics and QoL in a middle-aged population.

Methods
This cross-sectional study included 4051 adults (1751 males and 2300 females) aged 30-50 who were selected through a multi-stage stratified sampling based on sex, age, and region between 2017 and 2019. Sociodemographic, sleep characteristics, and QoL were evaluated and compared. Sleep characteristics were determined using the Pittsburgh Sleep Quality Index, and were defined as sleep duration (SD), sleep quality (SQ), sleep efficiency (SE), and sleep latency (SL). QoL was evaluated using the SF-12, which calculated physical and mental QoL. Degrees of insomnia symptoms were classified into 0-3 by summing up the number of cases of sleep duration (≤6.5 hours), sleep efficiency (&lt; 85%), and sleep latency (&gt; 30 min). We used linear regression models to estimate the relationship between sleep characteristics and degrees of insomnia symptoms with QoL, adjusting for sociodemographic covariates.

Results
Sleep characteristics of the participants include average sleep duration 6.8 hours (≤6 h short, 45%; ≥9 h long, 3%), sleep quality 4.6 points (poor SQ, 29%), sleep efficiency 94.5% (&lt; 85% SE, 11%), and sleep latency 19.7 minutes (&gt;30 min SL, 9%). About 26% had one insomnia symptom and 11% had two or more insomnia symptoms. All sleep characteristics showed significant associations with physical and mental QoL. Particularly, physical QoL was associated with long SD (coefficients [B]: -1.56, 95% confidence interval [CI]: -2.77, -0.35), low SE (B: -2.32, 95% CI: -2.94, -1.7), and long SL (B: -3.3, 95% CI: -3.97, -2.6), and mental QOL was associated with low SE (B: -3.3, 95% CI: -4.0, -2.5) and long SL (B: -5.1, 95% CI: -5.8, -2.5). Physical and mental QoL was significantly linearly decreased with number of insomnia symptoms (for physical QoL, B: -0.87, -2.87, and -4.24; for mental QoL, B: -1.1, -4.01, and -5.9, by number of insomnia symptoms 1, 2, and 3, respectively).

Conclusion
Poor sleep characteristics were negatively associated with QoL in Korean middle-aged adults.

Support (if any)
This was funded by the Korea Institution of Oriental Medicine, KSN2023120.
0694 Sleep Disorders and Serious Mental Illnesses: Comorbidity, Treatment, & Demographic Factors in VA Health Record Data
Authors: Bonfils Kelsey , Longenecker Julia , Seo Yeonjung , Soreca Isabella , Hammer Lillian , Tighe Caitlan , Haas Gretchen , Bramoweth Adam 
Published: May 2023

Abstract

Introduction
People diagnosed with serious mental illnesses (SMI), including schizophrenia-spectrum disorders, bipolar disorders, and major depression with psychosis, report high rates of clinically significant sleep disturbance. Yet, examination of how demographic- and health-related factors impact diagnosis and treatment in this group is scarce. We aimed to fill this gap by examining medical records of Veterans receiving treatment in VA VISN 4 healthcare facilities.

Methods
We used VA health record data to examine comorbidity between SMI and sleep diagnoses and receipt of sleep treatment from 2011-2019 (total N=573,974). A combination of descriptive and statistical techniques were used to investigate prevalence of sleep disorders, receipt of sleep treatment, and associations with demographic- and health-related factors.

Results
In 2019, 21.8% of Veterans with SMI were diagnosed with sleep disorder(s) in the medical record. White Veterans with SMI were more likely to have a sleep disorder than Veterans identifying as racial minorities. Veterans with SMI and sleep disorders were also younger, had higher BMIs, and had more medical comorbidities. Veterans with SMI were more likely to receive sleep treatment than Veterans without SMI, primarily driven by higher rates of sleep medication. Importantly, in contrast to findings regarding sleep disorder comorbidity, Veterans identifying as racial minorities received sleep treatment at a higher rate than White Veterans, and Veterans with higher BMIs received sleep treatment at a lower rate. Demographic factors including sex, age, and rurality were also associated in varying ways with rates of sleep treatment.

Conclusion
Our findings suggest that Veterans with SMI are being treated for sleep disorders at higher rates than Veterans without SMI. However, diagnosis and treatment are differentially impacted by demographic and health-related factors. Work is needed to better understand drivers of demographic differences and to examine any potential inequities in diagnosis or treatment of sleep disorders in Veterans with SMI.

Support (if any)
This work was funded by the Veterans Health Foundation (Co-PIs: Bonfils & Longenecker). Additional support was provided by pilot project funds (PI: Bramoweth) from the Department of Veterans Affairs VISN 4 Mental Illness Research, Education and Clinical Center and the Mississippi Center for Clinical & Translational Research (U54GM115428).
0705 Restless sleep disorder and periodic limb movement disorder in children with history of prematurity
Authors: DelRosso Lourdes , Mogavero Maria , Bruni Oliviero , Ferri Raffaele 
Published: May 2023

Abstract

Introduction
Children with history of prematurity are at higher risk of complications, comorbidities and iron deficiency, including restless legs syndrome and periodic limb movements of sleep (PLMS). In this study we assess the prevalence of restless sleep disorder and PLMS in children with history of prematurity.

Methods
Retrospective chart review of sleep studies in children aged 1-18 years, with history of prematurity, from July 2021 to July 2022 at Seattle Children's Hospital. Only diagnostic studies in children without diagnosis of a genetic syndrome or airway surgery were included.

Results
During the study, 2,577 sleep studies were conducted, 162 were in children with history of prematurity (6%): 25 were split or titration studies (14%), 29 children had syndromes (Down, Prader Willi, Wiedmann Beckmann, Achondroplasia), 4 tracheostomy studies, 6 in infants aged &lt; 12 months and 6 were post airway intervention. Ninety-two diagnostic studies were included in analysis. Median birth age was 31 weeks, interquartile range (IQR) 27-34 weeks. Thirty-two (34.8%) children were referred for restless sleep and 55 (59.8%) for snoring; 18% had PLMS index &gt;5/hour, 14% fit the criteria for restless sleep disorder (RSD). There were no statistically significant differences in PSG parameters between the children with RSD, PLMS and the remaining group, except for lower obstructive apnea/hypopnea index (Kruskal-Wallis ANOVA 8.621, p=0.0135) in the RSD group (median 0.7, IQR 0.3-0.9) than in the PLMS (median 1.7, IQR 0.7-3.5), or than in the nonRSD/nonPLMS group (median 2.0, IQR 0.8-4.5). Altogether, children with RSD and those with PLMS had restless sleep as an indication for the sleep study in 70% of cases while snoring was the indication in only 26.7% of them.

Conclusion
We have previously reported that in the Seattle Children's Hospital Sleep Center the prevalence of RSD is 7.7% and that of PLMS is 9.3%; in this new analysis we found a higher frequency of RSD and elevated PLMS in children with history of prematurity. Premature children are higher risk of iron deficiency, among other complications and comorbidities. These new results confirm the previous reports of increased PLMS and add new knowledge on the prevalence of RSD in these children

Support (if any)
0715 Machine Learning Model to Predict Isolated REM Sleep Behavior Disorder Phenoconversion Time and Subtype using EEG
Authors: Jeong El , Shin Yong Woo , Byun Jung-Ick , Sunwoo Jun-Sang , Kim Han-Joon , Han Sun Jung , Jung Ki-Young 
Published: May 2023

Abstract

Introduction
More than 80% of patients of isolated rapid eye movement (REM) sleep behavior disorder (iRBD), a prodromal disease of α-synucleinopathies, progress to neurological disease like Parkinson's disease (PD), dementia with Lewy bodies (DLB), and multiple system atrophy (MSA). Resting-state EEG measurements taken at baseline have been related to the phenoconversion. The timing of the conversion and the disease to which it will convert are crucial issues in iRBD. This work used baseline EEG in iRBD to create a prediction model for the phenoconversion time and subtype of α-synucleinopathy.

Methods
Resting-state EEG and neurological assessments were performed at baseline on patients with iRBD. EEG spectral power, Shannon entropy and weighted phase lag index were employed as features. Four models were used to predict subtypes for the PD-MSA and DLB groups, and three models were used to predict survival. External validation was also performed.

Results
29 patients out of 143 who were followed up to nine years (mean 3.4 years) later developed α-synucleinopathies (14 PD, 9 DLB, 6 MSA). With a concordance index of 0.8130 and an integrated Brier score of 0.0921, the random survival forest was the best model for predicting survival. For the subtype prediction analysis, the model with the highest accuracy, extreme gradient boosting, had an accuracy of 86.52%. Both models indicated a high importance on EEG slowing related features.

Conclusion
It is possible to predict the timing and subtype of phenoconversion in iRBD using machine learning models of using EEG biomarkers. To confirm our findings, further study is required, including large sample data from various countries.

Support (if any)
0718 Sleep-Related Neck Myoclonus Clinical Characteristics: a Case Series
Authors: Dandawate Nupur , Grayson Kammi , Rodriguez Alcibiades 
Published: May 2023

Abstract

Introduction
Sleep-related neck myoclonus is an involuntary, brief muscular contraction of the neck that occurs during Rapid Eye Movement (REM) stage sleep. Neck myoclonus has been suggested to be a normal physiological phenomenon with unclear clinical significance; however, at times, these movements may cause symptoms, especially at high rates. We describe a series of 6 cases of patients with neck myoclonus in REM sleep and studied metrics of their polysomnograms (PSGs) to assess for any possible associations.

Methods
We assessed each patient's age, sex, sleep related complaints, as well as PSG findings such as Neck Myoclonus Index (NMI), Neck Myoclonus Arousal index (NMAI), Arousal Index, Periodic Limb Movements of sleep Index (PLMS Index), total Apnea Hypopnea Index (AHI), and REM AHI.

Results
There were 6 patients ranging in ages from 6 to 45 years, 4 out of 6 of which were men. Four out of six patients complained of sleep maintenance insomnia, 1 out of 6 complained of daytime headache, and none complained of abnormal movements in sleep. The NMI for the patients ranged from 9 to 51.6 and their NMAI ranged from 3 to 45. Their PLMS index ranged from 0 to 40.7, out of which 2 patients had abnormal elevations in PLMI as defined by AASM criteria. Overall arousal indices ranged from 6.3 to 18.3. Five out of 6 patients had clinically significant obstructive sleep apnea per the AASM criteria, with AHI ranging from 0.2 to 8.7 and REM AHI 0.8 to 11.2.

Conclusion
Though historically sleep-related neck myoclonus has been considered a normal physiological process, suggestions have been made to find a pathological cut off to better define the relationship between the frequency of neck myoclonus and other REM sleep disorders. Despite our 6 patients having frequent sleep-related neck myoclonus, this remains of unclear clinical significance as 5 out of 6 were also found to have clinically significant obstructive sleep apnea and 2 out of 6 had abnormally elevated PLMS Index. Co-morbidities need to be taken into account as well. Hence, this supports the necessity of defining a pathological cut off for a neck myoclonus index to better understand its significance.

Support (if any)
0720 Depression and pain are barriers to benzodiazepine and z-drug deprescribing
Authors: Fung Constance , Ghadimi Sara , Mitchell Michael , Martin Jennifer , Dzierzewski Joseph , Moore Alison , Zeidler Michelle , Badr Safwan , Guzman Andrew , Der-Mcleod Erin , Naeem Saadi , Perdomo Claudia , Smith Jason , Alessi Cathy 
Published: May 2023

Abstract

Introduction
Clinical guidelines recommend avoiding benzodiazepines and z-drugs (BZRAs) in older adults due to an increased risk of adverse outcomes (e.g., falls) in this population. Efforts to reduce BZRA use among older adults are growing, yet long-term BZRA deprescribing among patients with insomnia is challenging. We examined whether clinical conditions commonly comorbid with insomnia (i.e., depression, pain, nightmares, and anxiety) are barriers to BZRA deprescribing.

Methods
In an ongoing multi-site trial comparing two BZRA deprescribing programs (both include cognitive behavioral treatments for insomnia), participants aged &gt;=55 years with chronic BZRA use for insomnia (N=165, mean age 68.7, sd 7.9) completed baseline Patient Health Questionnaire-9 (PHQ9), Brief Pain Inventory (BPI), Disturbing Dreams and Nightmare Severity Index (DDNSI), and Generalized Anxiety Disorder-7 (GAD-7). Deprescribing outcomes (discontinuation, dose, and frequency of use over 7-days) were assessed 1 week and 6 months after completing the deprescribing program. Using logistic and linear regression models, we assessed whether depression, pain severity, nightmare severity, and anxiety were predictors of BZRA deprescribing outcomes, controlling for site, gender, and age.

Results
Among participants assessed 1 week (n=133) and 6 months (n=106) after intervention, 77% and 66% discontinued their BZRA use, respectively. Worse PHQ-9 was associated with reduced odds of discontinuation (OR 0.88, 95% CI 0.79-0.99, p=.027) at 6 months, but not frequency of use or dose at follow up. Pain severity predicted more frequent use (b=0.26, p=.02) and higher dose (b=0.94, p=.016) but not discontinuation at 6 months. DDNSI (p values &gt;=.068) and GAD-7 (p values &gt;= 0.15) were not significant predictors of discontinuation, frequency, or dose at follow-up.

Conclusion
More severe depression at baseline is a predictor of BZRA deprescribing failure long-term. Pain is also a barrier to BZRA reduction efforts. Programs aimed at reducing and discontinuing BZRAs used for insomnia should consider interventions that not only address underlying insomnia, but also depression and pain.

Support (if any)
NIA R01AG057929; VA IIR 17-234