bluuebunny/crossref_metadata_2025_split huggingface dataset:
0128 Muscle injury induces an increase in total and NREM sleep time
Authors: Vanneau Théo , Quiquempoix Michael , Erkel Marie-Claire , Drogou Catherine , Trignol Aurélie , Sauvet Fabien , Léger Damien , Gomez-Merino Danielle , Chennaoui Mounir 
Published: May 2023

Abstract

Introduction
This study describes macro- and micro- sleep responses to a myotoxic skeletal muscle injury and investigates possible mechanisms.

Methods
We recorded the electroencephalogram(EEG)/electromyogram(EMG) of 24 wistar rats before and after induction of Tibialis Anterior muscle injury (n=8 per group: control, control +buprenorphine and injured). A top-down analysis of sleep characteristics was processed from total sleep time (TST), sleep stages, sleep stability, spectral-analysis, and spindles. To further investigate the mechanisms involved, we analyzed the protein level of sleep regulatory molecules including TNF-α, IL-1β, IGF-1, BMAL1 in plasma, frontal cortex, hippocampus, and tibialis anterior, collected at Day +2 after injury from non-EEG/EMG implanted rats.

Results
Muscle injury induces a significant increase in total sleep time at 48 and 72h post-injury, specific to NREM sleep. These increases occur during the dark period and are associated with higher stability of sleep over 24h, without change in the different power/frequency spectral bands of NREM/REM sleep. There was no corresponding sleep increase in slow-wave activity or spindle density, nor were there changes in brain levels of the sleep-regulating proinflammatory cytokine IL-1β, which is otherwise involved in the local response to injury. Conversely, decreased protein levels of brain IGF-1 and muscle BMAL1, a core circadian clock gene, after injury may play a role in increased sleep time.

Conclusion
Muscle injury induces an increase in total sleep time at 48- and 72-hours post-injury, specific to NREM sleep during the dark period in rats and is associated with higher sleep stability over 24 hours.

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0133 Adapting and validating a modern situational measure for dream content and experience
Authors: Garcia Odalis , Duggan Katherine 
Published: May 2023

Abstract

Introduction
Dream content is typically measured using self-reports which draw heavily on psychoanalytic theory. There is a need for a modern, reliable, validated, and comprehensive measure of dream content and experience. The DIAMONDS taxonomy has been developed and extensively validated by social/personality psychologists to assess psychologically salient features of waking situations. According to the continuity hypothesis, dreams reflect waking life; thus, this measure may also provide valuable information for dream content. We are adapting and validating this measure for dream content using self-reports and external raters.

Methods
We have begun an extensive construct validation process to adapt the DIAMONDS for dreams, including an extensive literature search and the development of a large item pool. Then, in a first preliminary study (N = 55), we examined the substantive validity by having an external rater code participants’ dream narratives using the adapted DIAMONDS. Next, in a second preliminary study from an online sample (N = 74), participants self-rated their own dream narratives using the adapted DIAMONDS.

Results
We developed a preliminary item pool (41 items) covering five proposed dream-specific factors: dream continuity, plausibility, clarity, memory degradation, and physiology. These items were added to the existing DIAMONDS. Results of the first preliminary study suggest all original DIAMONDS items have appropriate distributional properties when used to assess dream content; 20 of the newly developed items had abnormal skew and/or kurtosis. Items were modified; results of the second study show an improvement in the distributional properties of the adapted items. Notably, participants in the second study did not report an element of their dreams as being missing from the adapted DIAMONDS measure.

Conclusion
Thus far, we have gathered preliminary substantive validity evidence for the adapted DIAMONDS for dream content. Moving forward, we will evaluate whether the adapted measure predicts next day affect in a larger sample (predictive validity). In the long term, we hope to gather enough substantive, structural, and external validity evidence to validate the adapted DIAMONDS for dream content and experience.

Support (if any)
P30 GM114748
0167 Influence of light exposure, exercise, caffeine intake, and nicotine use on sleep of U.S. Navy sailors during home port operations
Authors: LaGoy Alice , Roma Peter , Kubala Andrew , Rosado Luis , Deering Sean , Cuellar Joseph , Chinoy Evan , Russell Dale , Markwald Rachel 
Published: May 2023

Abstract

Introduction
Insufficient sleep is pervasive in U.S. Navy (USN) sailors and has been associated with increased risk of injury and mood disturbances. As such, monitoring sleep and identifying modifiable targets that influence sleep in this population is essential. We examined the sleep of USN sailors during 9-months in port and explored the influence of different lifestyle behaviors on sleep.

Methods
Sailors (n = 101, 31 ± 7 years old [mean ± SD], 21% female) wore a commercial wearable sleep-tracking device (Oura Ring, Gen2) during a 9-month home port maintenance period (September 2021 – May 2022). During the study, the sailors slept at home and had periods working on the ship (on-hull; higher demands) and off the ship (off-hull; lower demands). Participants also completed 5 self-report surveys that assessed sleep quality (Pittsburgh Sleep Quality Index; PSQI) and multiple lifestyle behaviors including: hours of natural light exposure, hours of moderate/vigorous physical activity, and intake of caffeine, nicotine, and alcohol. Sleep outcome measures from the wearable device included total sleep time (TST), standard deviation of TST (SD TST), and sleep efficiency (SE). Linear mixed models were used to examine the effects of lifestyle behaviors on sleep. Timepoint and on/off-hull condition were also included as fixed effects, while participant was included as a random effect.

Results
Participants slept 6.5 ± 0.7 hours a night (6.2 ± 0.9 on-hull; 6.4 ± 0.8 off-hull; p &gt; .05) and had slightly elevated PSQI scores that were higher on-hull (8.3 ± 4.6) than off-hull (6.5 ± 3.5; B = 1.83, Std. Error = 0.71, p = .01). Lifestyle behaviors were not significant predictors of PSQI, TST, SD TST, or SE (p &gt; .05).

Conclusion
Lifestyle behaviors had weak relationships with self-reported and objective sleep outcomes in this exploratory analysis. Therefore, modifying lifestyle behaviors may not significantly influence sleep in USN sailors during home port periods. Still, additional behavioral targets (e.g., diet), specific aspects of behavioral outcomes (e.g., light exposure timing, exercise intensity), and other work-related factors (e.g., workload, schedule) that can affect sleep should be explored in future efforts.

Support (if any)
Military Operational Medicine Research Program (work unit no. N2010).
0183 Bedtime Routine Stability in the Context of Developmental Risk
Authors: Janis Amy , Kellerman Ashleigh , Schwichtenberg A J 
Published: May 2023

Abstract

Introduction
Consistent bedtime routines are an important promoter of child sleep health. This is particularly true for children developing at elevated risk for sleep and developmental challenges. Consistent and calming bedtime routines are associated with fewer parent-reported night wakings, shorter sleep onset times, and (for some) longer nighttime sleep bouts. However, few studies systematically address bedtime consistency within the context of developmental risk. To inform future sleep promotion in children with developmental concerns, this study assessed bedtime routine consistency.

Methods
Across two video-recorded bedtimes, this study assessed the consistency of routines for children (n = 40) with social communication concerns from ages 8-61 months, M(SD)= 28.14(11.76). Each child was enrolled in an eight-session Family Routines Intervention (FRI). The goals of this intervention were to improve family social communication scaffolding within family routines. Bedtime routines were coded for caregiver involvement, sleep onset location, and dyad actions.

Results
Mothers were the most common bedtime caregiver (93-95%) and her involvement was consistent for most children (96%). Father involvement was less common (present for 25-38% of recordings) and was less consistent at 56%. Other caregivers were present for roughly 18% of dyads, but their involvement was not as consistent (13%). Sleep onset location varied widely with only 33-38% sleeping in a crib, yet crib placement was moderately consistent (64%). Roughly 20% of children slept in an adult bed, with similar consistency (63%). Book reading was the most common (40-43%) and consistent (73%) bedtime action. Bedtime media use was uncommon (8-15%) but surprisingly consistent (44%).

Conclusion
For children at elevated risk for sleep and developmental concerns, bedtime routines were notably diverse and inconsistent. Although bedtime routines were not the focus of the FRI study, it afforded a unique opportunity to objectively assess how families prepare their child for bed on distinct nights across a relatively short time (8-12 weeks). Not surprisingly, mothers were the primary caregiver, highlighting her potential role in future interventions. The variability in sleep onset location and bedtime actions were notable. These areas reflect clear targets for future interventions designed to promote relatively short, calming, and consistent bedtime routines.

Support (if any)
Purdue Research Foundation and the Gadomski Foundation
0191 SLEEP DIFFICULTIES AND SLEEP DISORDERS IN ADOLESCENT ATHLETES
Authors: Caron Jean-François , Forest Geneviève 
Published: May 2023

Abstract

Introduction
Recent studies have shown that sleep difficulties are highly prevalent in professional and elite athletes. Unfamiliar sleeping environments when travelling, high training loads, early morning training, competitive anxiety, etc., have been mentioned as contributing factors for sleep disturbances in athletes. In addition to being susceptible to these elements, young athletes also experience changes in sleep during adolescence. However, very little is known about the sleep of this population and whether it differs from that of young adult athletes. This was the aim of the present study.

Methods
211 young elite athletes (M=14.9±1.6 years old; 60.4% females) completed online versions of the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and a modified STOP-BANG questionnaire. Summary independent T-tests were computed to compare our results to those of study samples of young adult elite athletes (M=19.6 ± 1.5 years old; 39.47% females) on the PSQI and ISI. Additional analyses were done to investigate differences in subgroups in the young elite athletes using t-tests and chi-squares on all measures.

Results
There was no difference between adolescents and young adult athletes for the PSQI (t(837)=-1.50, p=.30), and ISI (t(355)=.287, p=.774). Results also showed that, among young athletes, female athletes showed higher PSQI (t(201)= 3.65; p&lt;.001) and ISI scores (t(206)=-2.27, p=.024) than males, suggesting more sleep disturbances. On the other hand, male athletes as well as team sports athletes and contact sport athletes were more at risk for obstructive sleep apneas (χ2(2,N=207)=73.25, p&lt;.001; χ2(2,N=210)=6.08, p=.048; χ2(2,N=210)=14.35, p=.001, respectively). Finally, athletes with ADHD showed higher PSQI (t(203)=4.83; p&lt;.001) and ISI scores (t(209)=2.89, p=.004), and more risk of sleep apnea than athletes without ADHD (χ2 (2, N=207)=73.25, p&lt;.001).

Conclusion
This study shows that young adolescent athletes have the same level of sleep disturbances as young adult elite athletes. These results are very concerning because they show that from a young age, athletes are experiencing significant sleep difficulties. These findings highlight the importance of promoting early intervention with athletes who become involved at an elite level at a very young age.

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n/a
0394 Effect of electrical vestibular nerve stimulation on sleep quality in young adults with insomnia: a randomized controlled trial
Authors: Goothy Sai Sailesh Kumar , Macias Shirin , Robinson Rachel , McCulloch Erin , Watson Sinead , McKeown Jason 
Published: May 2023

Abstract

Introduction
Insomnia is a common sleep disorder among all age groups which adversely affects physical and mental health. Young adults are considered a high-risk population group due to increased use of electronic media at bedtime, stress associated with balancing educational demands and unhealthy sleep practices. Previous research suggests that electrical vestibular nerve stimulation (VeNS) may improve sleep outcomes by influencing the hypothalamus and brainstem nuclei involved in regulating the circadian rhythm and wakefulness. The present study is a randomised, double blinded, sham-controlled trial with the aim of assessing the efficacy of VeNS on the sleep quality of young adults suffering from insomnia.

Methods
Eighty adults aged 18-24 years who scored 15 or higher on the Insomnia Severity Index (ISI) were recruited. Participants assigned to the intervention group (n=40) received 30 minutes per day of VeNS with 5 sessions per week for 4 weeks, while the control group (n=40) received sham stimulation for the same period. ISI scores were recorded at baseline and repeated weekly. The primary outcome was between-group change in ISI from baseline to day 28. Secondary outcomes included between-group change in the emotional states of depression, anxiety and stress measured by the DASS-21 questionnaire, and quality of life (QoL) measured by the WHOQoL-BREF.

Results
A group-by-time interaction effect on change in ISI score from day 0 to day 28 (F3, 248 = 295.56; P&lt; 0.001) was observed. The intervention group had a higher reduction in mean ISI score relative to the control group at day 28 (mean change [95% CI]: 7.23 [6.78, 7.67] vs. 0.98 [0.89, 1.06], P&lt; 0.001; respectively). Furthermore, the intervention group showed improvements in depression, anxiety, and stress scores (P&lt; 0.001) and QoL outcomes (P&lt; 0.001) compared with the control group.

Conclusion
Regular VeNS usage over 4 weeks lead to a clinically meaningful decrease in ISI scores and improved general well-being in young adults with insomnia. VeNS may have potential as a drug-free and non-invasive therapy to improve sleep outcomes.

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0396 Efficacy of electrical vestibular nerve stimulation for the management of insomnia: a randomized controlled trial
Authors: Macias Shirin , Robinson Rachel , McCulloch Erin , Sittlington Julie , Curry Grace , Cheung Teris , Watson Sinead , McKeown Jason 
Published: May 2023

Abstract

Introduction
Insomnia is one of the most prevalent health concerns in the general population. Cognitive behavioural therapy (CBT) and pharmacological interventions are recommended for the treatment of insomnia. However, CBT can be expensive and difficult to access, while the use of pharmacotherapy can be limited by reports of adverse events. Due to these limitations, there is a strong need for alternative measures to manage insomnia. Preliminary research indicates the potential that electrical vestibular nerve stimulation (VeNS) has as a non-invasive method for managing insomnia. The aim of this study is to evaluate the efficacy of VeNS as a method of managing sleep quantity and quality in individuals with insomnia, as compared to a sham control.

Methods
The study was a two-armed, double-blind randomized controlled trial that was conducted across two research sites in the United Kingdom (UK) and Hong Kong (HK). Participants aged over 18 years with an Insomnia Severity Index (ISI) score of 15 or higher were randomly assigned to intervention and control groups. The intervention group was instructed to use the VeNS device at home for 30 minutes daily for 4 weeks, while the control group was instructed to use the sham device for the same period. ISI values were captured at baseline, at 2 weeks and at 4 weeks. Sleep quality and quality of life (QoL) were assessed at baseline and at 4 weeks using the Pittsburgh Sleep Quality Index (PSQI) and the 36-item Short Form Health Survey (SF-36), respectively.

Results
A total of 146 participants were recruited from the HK (n=94) and UK (n=52) research sites. The study has recently been completed with the statistical analysis ongoing. The between-group change in ISI values (primary outcome), sleep quality and QoL from baseline to week 4 will be examined.

Conclusion
The results of this study will help determine whether the relatively inexpensive, and non-invasive technique of VeNS is effective in the management of insomnia. The data collected will be used to support regulatory submissions, primarily to the US Food and Drug Administration.

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0495 Epworth Sleepiness Scale Worth for Sleep Apnea Screening: A Large Cohort of Polysomnographies via Natural Language Processing
Authors: Maghsoudi Arash , Nowakowski Sara , Rahman Mahbubur , Nguyen Trung , Agrawal Ritwick , Sharafkhaneh Amir , Razjouyan Javad 
Published: May 2023

Abstract

Introduction
Obstructive sleep apnea (OSA) is a major sleep disorder that presents with excessive daytime sleepiness (EDS). Epworth Sleepiness Scale (ESS) as a measure of EDS is used to monitor population sleep health. We aim to assess the association between ESS and apnea hypopnea index (AHI) extracted from polysomnography (PSG) reports using natural language processing (NLP) algorithms.

Methods
We curated 90,483 PSG notes from the nationwide Corporate Data Warehouse (CDW) of Veteran Affair (VA) from 10/1999 to 10/2020. We used rule-based nearest neighbor and forward-backward NLP techniques to extract ESS and AHI from PSG reports. We reported the performance of NLP algorithm compared to chart review. We used AHI&gt;5 as the cut-point to identify OSA and incremented the threshold for abnormal ESS from 5 to 15 to find the best cut-point for stratification of EDS. We used logistic regression to report the performance of the ESS cut-point using the area under the curve (AUC). The model also adjusted for age, sex, BMI, race, ethnicity, and Charlson comorbidity index.

Results
39,318 patient clinical notes’ (age 50±15 years; BMI 30±5) notes documented both AHI and ESS. (50±15 year; 30±5 BMI). NLP algorithms accuracy was ≥ 90%. We observed the same level of sensitivity (57%) or specificity (42%) for ESS of 5 and 10, but the ESS of 5 resulted in the best negative (27%) and positive (72%) predictive value for AHI prediction. The area under curve for prediction OSA based on ESS cut-off of 5 was 0.50 (95%CI, 0.49, 0.51) and the AUC improved to 0.65 (95%CI, 0.64, 0.65) after adjustment.

Conclusion
Our results suggest that ESS is not an effective tool for predicting AHI. Reducing the ESS cut-off to 5 may enhance its predictive value, but it does not have clinical implication in identifying patient with OSA. Sleep medicine clinicians may use other sleep questionnaires, such as the STOP-Bang questionnaire, which is reported to be a reliable, concise, and easy-to-use screening tool.

Support (if any)
This work is supported by the VA Center for Innovations in Quality, Effectiveness and Safety (CIN 13-413); National Institute of Health (NHI) Grant # 1K25HL152006-01 (PI: Razjouyan) and Grant # R01NR018342 (PI: Nowakowski).
0524 Early CPAP Adherence as a Primary Predictor of CPAP Adherence at One Year
Authors: Hevener William , Lane Bretton , Nyanhongo Simba , Munafo Dominic 
Published: May 2023

Abstract

Introduction
CPAP/APAP therapy remains the gold standard for treating OSA. Unfortunately, many patients struggle with long term CPAP/APAP adherence. Patients frequently have only 90 days to meet Medicare criteria for adherence to assure coverage of their CPAP/APAP therapy. Lack of adherence often leads to reevaluation, and a new trial of CPAP/APAP. Despite all of these efforts a significant number of patients are ultimately unsuccessful. When this process is drawn out over many months it can drain resources, time and patient motivation. We sought to determine if we could, during the first 30 days of CPAP/APAP therapy, identify those patients who were ultimately going to be unsuccessful.

Methods
A retrospective data analysis was completed on 7498 CPAP/APAP naive patients who began CPAP/APAP therapy in 2020-2021 with ResMed devices. Data was analyzed for percent of days with adherence (&gt;4h/night) at 30 days, 60 days, 90 days, 180 days and 365 days. Additionally, AHI, sex, state, number of mask refits, and payor type (HMO, Medicare, self-pay, Medicare Advantage and Medicaid Advantage) were examined.

Results
Patients were 68% male. The age was 55.1±14.0 and AHI 29.8±25 (mean±SD). 1157 of the patients were &lt; 10% adherent to CPAP/APAP (no more than 3 days &gt;4h) during the first 30 days. Of the 1157, only 312 patients (27%) showed any use over 4h. The remaining 845 (73%) showed no CPAP/APAP use &gt;4h during the first 30 days. At one year only 220 patients (19%) of the original 1157 showed any use over 4h. Of the 220 patients who showed any use &gt;4h at year one, 83% were in the original 312 who showed any use &gt;4h at 30 days. The other variables analyzed including AHI, sex, state, number of mask refits, and payor type were not independent predictors of long term adherence.

Conclusion
Patients with &lt; 10% adherence at 30 days were unlikely to achieve adherence during one year of follow up. Identifying and intervening early in this population may facilitate ultimate CPAP/APAP adherence or the successful initiation of alternative therapies.

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0526 Effect of Body Position and Sleep State on Sleep Disordered Breathing Distribution in Infants Ages 6 to 12 months
Authors: Betz Kelly , El-Kersh Karim , Nguyen Quang , Kluthe Theresa , Senthilvel Egambaram 
Published: May 2023

Abstract

Introduction
The effect of body position and sleep state on events distribution in infants ages 6 to 12 months needs further study. We aimed to study this distribution and determine the difference of body position in infants with and without sleep disordered breathing.

Methods
This was a single center, retrospective study that included infants ages 6 to 12 months who were evaluated for suspected sleep disordered breathing and underwent a full overnight polysomnography in an academic sleep disorders center over a period of 10 years. Infants with ages 6 to 12 months with obstructive sleep apnea hypopnea index (OAHI) and central apnea index (CAI) ≥ 1 (sleep disordered breathing [SDB] group) were compared with infants with normal AHI who represented the control group (CG). Total OAHI, CAI, apnea hypopnea index (AHI) in different body positions, rapid eye movement (REM), and Non-REM sleep were collected.

Results
A total of 36 infants had SDB and 18 infants had normal AHI. The median age was not significantly different between both groups with a median age of 10 months (IQR 7.75-11) in SDB group and 8.5 months in CG (IQR 7.25- 10.00) (p=0.258). Male sex was predominant in both groups (58.3% in SDB group and 61.1% in CG). There were no significant differences between both groups in the BMI, median total sleep time, REM% sleep time, and Non-REM% sleep time. The supine sleep time in the SDB group [258.90 minutes (IQR 149.35-381.25)] was significantly higher than the supine sleep time in the CG [165.90 minutes (IQR 54.55 to 285.05)] (p=0.035). In the SDB group, REM AHI [8.55 (IQR 5.02 – 15.25] was significantly higher than Non-REM AHI [0.50 (IQR 0.30-1.20)] (p&lt; 0.001). In the SDB group, there were no significant differences in the supine vs. off-supine distribution of respiratory events.

Conclusion
Obstructive and central respiratory events in infants ages 6 to 12 months occurred predominantly in REM sleep compared to Non-REM sleep. Infants with SDB significantly spent more time in supine position when compared to infants without SDB but the respiratory events distribution in infants with SDB did not have a significant positional distribution.

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