bluuebunny/crossref_metadata_2025_split huggingface dataset:
0622 Clustering bipolar disorder risk variants by their effect on sleep and circadian traits
Authors: Kunorozva Lovemore , Smith Kirk , Maher Matthew , Udler Miriam S , Lane Jacqueline 
Published: May 2023

Abstract

Introduction
Bipolar disorder (BD) is a mood disorder that causes noticeable, sometimes extreme, changes in mood and behaviour. BD affects nearly 50 million individuals worldwide including 2-4% of the US population. Previous studies have reported sleep and circadian disturbances in patients with BD. Genetic studies have identified 63 risk variants for bipolar disorder (BD).

Methods
To enable new insights into BD disease causing pathways, we clustered BD risk variants by their effect on sleep and circadian rhythm traits. A Bayesian soft-clustering approach was used to determine if BD variants cluster according to effect on eight subjectively and two objectively measured sleep and circadian traits (using sleep and circadian trait GWAS from the UK Biobank in European ancestry, n = 453,000).

Results
We found evidence of genetic correlation between BD and sleep/circadian traits (p&lt; 0.05). Bipolar risk variants cluster into two clusters based on their association with sleep and circadian traits. The two clusters are: Cluster 1: late chronotype, shorter time in bed (by actigraphy), difficulty waking up, longer sleep duration (self-report), longer periods of daytime sleepiness, longer and frequent naps and increasing insomnia and Cluster 2: early chronotype, longer time in bed (by actigraphy), longer sleep duration (self-report) and less insomnia. In general, cluster 1 appears to be contributing to sleep insufficiency, while cluster 2 appears to be contributing to hypersomnia or more “typical” sleep.

Conclusion
In conclusion, sleep and circadian trait clusters indicate bipolar genetic risk may function through two distinct mechanisms. Some genetic risk variants appear to be related to sleep insufficiency, while others are related to hypersomnia, suggesting that it may be possible to genetically subtype BD. This finding may allow classification of BD-patients by distinct genetic pathways linking to their sleep-circadian disturbances, potentially offering a way forward toward genetically informed diagnosis, surveillance and management of BD-patients.

Support (if any)
N/A
0649 Sex Differences in the Effects of TMS on Depression
Authors: Desai Shivani , Hildebrand Lindsey , Reich-Fuhrer Melissa , Grandner Michael , Killgore William 
Published: May 2023

Abstract

Introduction
As part of a larger study to examine the effects of repetitive transcranial magnetic stimulation (rTMS) over a single node of the default mode network (DMN) on sleep quality, we also examined secondary effects on depression. We hypothesized that rTMS would be more effective in females, rather than males, due to previously established higher rates of depression in the female population.

Methods
We administered continuous theta burst stimulation (cTBS) rTMS or sham stimulation, in a counterbalanced order separated by at least 5 days, over the left inferior parietal node of the DMN in 20 participants with clinical insomnia, 8 males (Mage=31.6, SD=6.7) and 12 females (Mage=23.8, SD=4.3). Beck Depression Inventory (BDI) scores obtained immediately before and after the stimulation sessions were compared using mixed (condition x time x sex) ANOVA to determine the effectiveness of rTMS in reducing symptoms of depression between the sexes.

Results
Overall, there was a large effect size (ηp2=0.207, p=0.077) in BDI scores between scores after the sham cTBS TMS session (M=12.47, SD=2.54) and scores after the active cTBS TMS session (M=10.00, SD=2.01). However, when separating for sex, males did not show a statistically significant reduction in depressive symptoms for the active session compared to the sham session (ηp2=0.08, F(1,6)=19.00, p=0.508). While the treatment did not significantly change depressive symptoms in females, large effect size was observed (ηp2=0.261, F(1,7)=18.06, p=0.16), suggesting potential efficacy of the treatment. Post-hoc pairwise comparisons reveal a greater change in depression symptom scores for active vs sham cTBS TMS in women (M=-4.00, SD=2.00), than men (M=-0.71, SD=1.43).

Conclusion
An intervention using cTBS rTMS to improve sleep also led to a trend toward reduced depression, that was more evident among women. As reported elsewhere, this treatment significantly improved polysomnographic sleep, and the present preliminary results suggest that it may also be useful for modestly improving depressive mood, but further research will be necessary due to the limited sample size. It is not clear whether the trends toward mood among women was due simply to higher baseline depression scores in that group, but the findings suggest that additional work is warranted.

Support (if any)
W81XWH2010173
0652 Subjective and objective sleep disturbances in individuals with psychotic disorders and their first-degree relatives
Authors: Arpaci Hazal , Spitzer Courtney , Raymond Nicolas , Talbot Christine , Kohnke Erin , Stickgold Robert , Manoach Dara , Keshavan Matcheri , Baran Bengi 
Published: May 2023

Abstract

Introduction
Sleep disturbances commonly precede or precipitate psychotic disorders. The primary goals of the present study are to compare self-reports of sleep quality and chronotype with objective measurements and to investigate their relations with clinical symptoms and psychotic-like experiences (PLEs) in early course, minimally treated patients with psychotic disorders (PSY), their young, first-degree relatives (familial high risk: FHR) and matched controls.

Methods
Seventy-three participants (13-35 yrs, n(PSY)=19, n(Controls)=30, n(FHR)=24) completed self-report measures of sleep quality (PSQI), chronotype (MEQ) and PLEs (Chapman Scales). Sleep quality and chronotype were objectively measured with actigraphy (average duration of measurements: 12 days). Psychosis and FHR groups were rated on the Positive and Negative Syndrome Scale (PANSS) by an expert clinician.

Results
PSQI was significantly different between the groups (F(2,67)= 11.8, p&lt; .001), this reflected that compared to controls, both the psychosis (p&lt;.001) and FHR (p=002) groups had worse self-reported sleep quality. For objective sleep quality, we observed a main effect of day-to-day variability in total sleep time (F(2,46)= 3.24, p=.048) , with significantly higher variability in PSY than controls (p= .038). Symptom severity in PSY and FHR correlated with PSQI (r=.31, p=.047), reflecting that those with higher psychotic symptoms had more sleep disturbances. PLEs in the entire sample also correlated with PSQI (r=.41, p&lt;.001). We did not observe any correlations between objective sleep quality and symptoms. There were no group differences in chronotype (subjective or objective). Chronotype did not correlate with symptoms or PLEs.

Conclusion
While both early-course patients and their first-degree relatives report significant sleep disturbances, objective measurements corroborate this only for day-to-day variability in sleep duration in the patient group. Further, symptom severity and PLEs correlate only with subjective sleep disturbances. These findings highlight the importance of objective assessment of sleep quality in this population and are in line with our polysomnography work that reveals an isolated deficit in NREM sleep in the context of similar sleep duration and architecture in psychosis.

Support (if any)
K01 MH114012 (Baran)
0700 Parasomnia-related homicides: A systematic review and a critical analysis of the medical literature
Authors: Castelnovo Anna , Schraemli Matthias , Schenck Carlos , Manconi Mauro 
Published: May 2023

Abstract

Introduction
Cases of homicide allegedly committed during sleep have been described since ancient history. The strongest link between violence and sleep disorders is represented by the so-called parasomnias, a group of sleep disorders characterized by episodic undesirable behaviors and/or mental experiences that arise during sleep.

Methods
We conducted a systematic search according to the PRISMA guidelines with 4 different search engines (Pubmed, Scopus, Embase and Cochrane) with the aim of gathering and critically evaluating all described cases of homicides associated with parasomnias

Results
We identified over 30 cases of homicide allegedly committed during a parasomnia episode. The diagnosis was of NREM sleep parasomnia for all cases except one, which received a diagnosis of REM-sleep behavior disorder (RBD). Victims were more often female family members, killed by firearms or sharp objects, usually nearby the bed. Aggressors often reported delusional/hallucinatory mental experiences associated with their episodes and rarely made any effort to cover up the crime. In the majority of the cases, no objective sleep data were available. Only a minority of patients had a positive childhood or family history. The court judgement was not uniform across cases.

Conclusion
Although rarely, homicides could be committed during parasomnias episodes. Despite being more frequently associated with violent behaviors, RBD less likely led to fatal aggressions. According to the observed behaviors, subjective reports and current neurophysiological knowledge, patients are only partially conscious and largely disconnected from the external environment, and could not be considered guilty for their actions.

Support (if any)
None
0712 Improved Circadian Rest-Activity Patterns after Treatment with PAP therapy in the Patient with Idiopathic RBD and Comorbid OSA
Authors: Shin Jung-won , Park Kyoungeun , Jung Ki-Young 
Published: May 2023

Abstract

Introduction
Several studies suggest that sleep and circadian rhythm disruptions, and physical activity changes may serve as risk factors for the occurrence of Parkinson’s disease and its prodromal features. Obstructive sleep apnea (OSA) is commonly found in patients with RBD. The comorbid OSA is associated with non-motor symptoms, including daytime sleepiness, cogntive decline and autonomic nervous system dysfunction. Therefore, we investigated whether circadian rest-activity patterns and RBD-related symptoms will be improved after positive airway pressure (PAP) therapy in patients who had iRBD with comorbid OSA.

Methods
Seven patients were diagnosed as iRBD with OSA (AHI ≥ 10) confirmed by video-polysomnography. The patients wore actigraphy devices for 14 consecutive days befor and after PAP therapy for 3 months. The mean motor activity amount (MAA) and the motor activity block (MAB) during sleep were obtained from actigraphic data. Non-parametric circadian rhythm activity including inter-daily stability(IS), intra-daily variability, least 5 average, most 10 average and relative amplitude were anlayzed. In addition, we obtainted the REM sleep behavior disorder questionnaire for the previous 3-month period (RBDQ-3M) and of the Clinical Global Impression-Improvement scale (CGI-I).

Results
Four of 7 patients had good compliance of PAP usage (average usage &gt; 4hr during sleep), and three patients had poor compliance of PAP usage. In good compliance group, score of RBD-3M decreased ( p=0.029) and value of IS were increased (p=0.029 ) significantly. Also, 3 of 4 patients answered “Very much improved or much improved” in a questionnaire of CGI. In poor comliance group, there was no any significant change in all values. In addition, only one patient answered “ much imrpoved” and two patients answered “minimally improved” in CGI.

Conclusion
The PAP treatment of OSA in iRBD can be role as a lifestyle modifier that improves circadian rest-activity patterns and, it may be of value as a disease-modifying effect of behavioral or lifestyle changes that have been reported to be associated with decreased risk of neurodegenerative disorder. We will continue enroll the data and will investigate not only improvement of circadian rhythm, but also decreasing of motor activities during sleep after PAP therapy.

Support (if any)
0734 Gender Differences in US Military Personnel with Insomnia, Obstructive Sleep Apnea & Comorbid Insomnia and Obstructive Sleep Apnea
Authors: Mysliwiec Vincent , Brock Matthew , Matsangas Panagiotis , Pruiksma Kristi , Powell Tyler , Hansen Shana , Martin Jennifer , Taylor Daniel , Foster Shannon , Mithani Sara , Straud Casey , Young-McCaughan Stacey , Zwetzig Sarah , Peterson Alan 
Published: May 2023

Abstract

Introduction
Women constitute approximately 17% of the military. Yet, relatively little is known regarding sleep disorders and comorbid diagnoses effecting this gender. The aim of this study was to determine if there were gender-related differences in symptoms of sleep disorders and sleep-related impairment, comorbid sleep, behavioral medicine, and traumatic brain injury (TBI) diagnoses and polysomnographic (PSG) variables in military personnel with insomnia, OSA, and comorbid insomnia and OSA (COMISA).

Methods
Participants were 372 military personnel (46.2% females, 53.8% males) with an average age of 37.7±7.46 years and median BMI of 28.4 (5.50) kg/m2. Based on clinical evaluation and video-PSG, participants were diagnosed with insomnia (n = 118, 71.2% female), OSA (n = 118, 28.8% female) and COMISA (n = 136, 39.7% female). Insomnia severity, excessive daytime sleepiness, sleep quality, nightmare disorder, sleep impairment, fatigue, posttraumatic stress disorder (PTSD), anxiety, depression symptoms, and traumatic brain injury (TBI) were evaluated with validated questionnaires. Descriptive statistics, parametric and non-parametric pairwise comparisons and effect-size analyses were used to assess differences between sexes in terms of variables of interest.

Results
Female service members had significantly greater symptoms of nightmare disorder, PTSD, anxiety, and depression than their male counterparts. There were no significant differences between males and females with insomnia or OSA in sleep-related symptoms, impairment, or PSG based apnea-hypopnea index (AHI). Male service members with COMISA had a significantly greater AHI; females with COMISA had significantly greater symptoms of nightmare disorder, PTSD and anxiety.

Conclusion
In the largest study to date to clinically evaluate sleep disorders in military personnel, COMISA was the most frequent diagnosis. Surprisingly, there were minimal differences in self-reported symptoms of sleep disorders and PSG characteristics. However, male servicemembers with COMISA have more severe sleep disordered breathing while female servicemembers with COMISA have greater mental health morbidity. Military service may result in distinct sleep disorder phenotype(s).

Support (if any)
This work was supported by the Defense Health Agency, Defense Medical Research and Development Program, Clinical Research Intramural Initiative for Military Women’s Health (DM170708; Mysliwiec) and the US Air Force (USAF) Air Force Materiel Command (AFMC), Wright Patterson Air Force Base, Ohio (FA8650-18-2-6953; Peterson).
0753 Mothers’ sleep and executive function: Downstream implications for parenting and toddlers’ executive function
Authors: McQuillan Maureen , Empson Kayla , Staples Angela , Deater-Deckard Kirby , Bates John 
Published: May 2023

Abstract

Introduction
Mothers’ sleep is positively associated with positive parenting (e.g., responsiveness) — what has not been established is how mothers’ executive function (EF) could mediate this association, and how, in turn, mothers’ parenting could influence the development of their toddlers’ EF.

Methods
Mothers and toddlers (N = 351) were followed at child ages 30, 36, and 42 months. Mothers were M = 32.70 years old (SD = 5.03); 49% of toddlers were male. The sample was largely middle class and 90% White. Fifteen percent of mothers were single. Thirty-one percent of mothers did not work outside the home, and 28% worked full time. Mothers’ sleep was measured via actigraphy. Mothers’ positive parenting was measured both in the home and the lab. At home, the toddlers’ bedtime routine was observed and rated for mothers’ responsiveness and involvement. In the lab, mothers’ positive affect during free play with their toddler was coded (with independent, inter-rater reliability of ICC = .80). The lab measure was correlated with the home visit measure (r = .22, p &lt; 0.01). Mothers’ EF was measured via self-report on the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF), which assesses everyday metacognition, behavior regulation, and emotion regulation. The average, where higher scores reflect worse EF, was used. Toddlers’ EF was measured by coders’ ratings of toddlers’ ability to sustain focused attention during independent free play in the lab visit (ICC = .83).

Results
Cross-sectionally, mothers’ sleep was associated with their EF (B = .12, p&lt;.05). In a structural equation model across time, mothers’ actigraphic sleep that was shorter, later, and more variable predicted worse EF (B = 0.07), which in turn predicted less positive parenting (B = - 0.08), at levels trending towards significance. Mothers’ positive parenting was associated with toddlers’ observed sustained, focused attention, both within (r = .13, p &lt; 0.05) and across time (r = .13, p &lt; 0.05).

Conclusion
These findings suggest that a mother’s sleep can affect her EF and parenting, which can then support toddlers’ sustained attention development, an important aspect of executive function.

Support (if any)
Grants MH099437 from NIMH and HD073202 from NICHD
0776 Effects of Perceived Discrimination on Sleep and Internalizing and Externalizing Behaviors in Hispanic/Latinx Adolescents
Authors: Durley Ingrid , Arra Nicole , Kiss Orsolya , Harkness Anya , Camacho Leticia , Baker Fiona C 
Published: May 2023

Abstract

Introduction
Racism negatively affects children’s health, behavior, and relationships. Current literature focuses on associations between perceived discrimination and daytime behaviors in children and adolescents, with less known about associations with sleep behavior, an essential aspect on health during development. Racial/ethnic minorities, including Hispanic/Latinx youth, are at increased risk of sleep problems, along with mental health issues. Here, we examined the relationship between perceived discrimination and sleep and behavioral problems, and the potential role of familial cultural heritage connectedness as a mediator, in Hispanic/Latinx adolescents in the Adolescent Brain Cognitive Development (ABCD) Study®.

Methods
Data were analyzed from 1,213 Hispanic/Latinx adolescents (Mean age =11.89 years, range: 10-14 years, 48.22% female), collected as part of the ongoing ABCD Study® from the 2nd year follow up. Sleep was assessed with a question about having trouble falling or staying asleep in the past two weeks from the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS-5) (youth-report). Participants completed the Perceived Discrimination scale, an 11-item self-report about racial/ethnic perceived discrimination in the past year from teachers, peers, and other adults. Cultural heritage connectedness was gathered from the Vancouver Index of Acculturation (caregiver-report). Internalizing and externalizing behaviors were assessed using the Child Behavior Checklist (caregiver-report). Regression models examined associations between perceived discrimination and sleep behavior and externalizing/internalizing behavior, considering age, socio-demographic characteristics, parental education, and familial immigration status.

Results
Perceived discrimination correlated with more sleep problems (p&lt; 0.01), with a stronger effect in female than male participants (p&lt; 0.01). Perceived discrimination was also associated with internalizing and externalizing behaviors (p&lt; 0.01). Connectedness to cultural heritage partially mediated the association between perceived discrimination and externalizing behaviors (p&lt; 0.01), but not with sleep problems or internalizing behaviors.

Conclusion
Results show perceived discrimination is associated with sleep problems in Hispanic/Latinx adolescents, with a stronger relationship in female participants. Future investigation of links between perceived discrimination and health outcomes, including sleep and behaviors, is needed using longitudinal data and youth self-reports of the Vancouver Index of Acculturation, rather than caregiver reports to further investigate the potential role of cultural connectedness is these relationships.

Support (if any)
NIH U01DA041022
0803 Sleep Patterns in Patients with Congenital Central Hypoventilation Syndrome and Their Parents
Authors: Shah Amit , Leu Roberta , Harford Kelli-Lee , Harris Ryan , Kasi Ajay 
Published: May 2023

Abstract

Introduction
Congenital central hypoventilation syndrome (CCHS) is a rare genetic disease affecting control of breathing necessitating lifelong assisted ventilation (AV) via noninvasive positive pressure ventilation (NPPV), diaphragm pacing (DP), or positive pressure ventilation via tracheostomy (PPV-T). Owing to abnormal ventilatory responses, patients require monitoring during sleep by a caregiver. The aims of this study were to assess sleep patterns in the patient-parent dyads using actigraphy and sleep diary.

Methods
Patients with CCHS and their parents completed the Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD), Epworth Sleepiness Scale (ESS), sleep diaries, and used wrist actigraphy for 7 days. The analyzed data included AV modality, ESS, ESS-CHAD scores, and actigraphy outcomes— sleep latency (SL), sleep efficiency (SE), total sleep time (TST), wake after sleep onset (WASO), and wake frequency.

Results
The median (IQR) ages of the 11 patient-parent dyads who completed the study were 11(8-13.5) and 41(39-47.5) years, respectively. AV modalities were NPPV (n=3), DP (n=2), and PPV-T (n=6). The median (IQR) ESS-CHAD and ESS scores for the patient and parents were 8(2-9) and 6(3.5-7), respectively indicating higher normal daytime sleepiness. In patients with CCHS, actigraphy showed median (IQR) SL of 14.6(10.1-19.6) minutes, decreased SE of 78.5% (72.5%-84%), decreased TST of 7.2(6.6-8.1) hours, elevated WASO of 1.7(1.1-2.3) hours, and frequent awakenings of 22.2(18.4-23.6) per night. In the parents, actigraphy showed median (IQR) SL of 7(3.6-10.9) minutes, normal SE of 81.6% (80%-86%), decreased TST of 6.7(6-6.8) hours, elevated WASO 1.1(1-1.3) hours, and frequent awakenings of 19.3(15.4-22.4) per night. Two separate patients and parents slept &lt; 6 hours per day. Among 2 patients with nighttime home nursing, the parents had SE &gt;85%, TST ≥7.3 hours, and reported better sleep quality.

Conclusion
Patients with CCHS and their parents are at risk for sleep disturbances. Specifically, patients with CCHS had decreased median TST and SE, and parents had decreased median TST. Both patients and parents had frequent night wakings indicating sleep disruptions. Nighttime home nursing may improve parental sleep. Apart from vigilant management of AV in patients with CCHS, clinicians should also evaluate sleep quality in patients with CCHS and their parents.

Support (if any)