bluuebunny/crossref_metadata_2025_split huggingface dataset:
0180 The Impact of Fatigue on Patient Care and Risk of Post-Shift Driving Collisions among 12-Hour Day and Night Shift Nurses
Authors: James Lois , James Stephen 
Published: May 2023

Abstract

Introduction
Evidence across industries links work-related fatigue with errors, accidents, and adverse long-term health outcomes. Within the healthcare profession, 12-hour day and night shifts have been widely adopted for nurses, despite concerns about fatigue from these shifts affecting nursing performance and safety. The purpose of this study was to determine the impact of 12-hour day-vs-night-shift-accumulated fatigue on patient care and driving safety.

Methods
This between-groups, repeated-measures quasi-experiment was conducted in the Washington State University (WSU) College of Nursing and Sleep and Performance Research Center. 44 nurses working 12-hour day shifts and 49 nurses working 12-hour night shifts were recruited from Providence Medical Center. Participants reported to WSU for testing on two separate occasions—once immediately following their 3rd consecutive 12-hour shift and once on their 3rd consecutive day (72 hours) off work. Nurses' sleep was monitored using wrist actigraphy, and were tested for patient care using LAERDAL medical simulation, and driving safety using an immersive driving simulator.

Results
We found that both day and night shift nurses were significantly more sleep restricted and subjectively sleepy following three consecutive shifts. Night shift nurses were significantly more impaired on patient care skills, in particular the communication domain, compared to day shift nurses (who were largely able to maintain performance across all tests). Furthermore, night shift participants had significantly greater lane deviation during the post shift drive home, a key indicator of collision risk, demonstrating impaired driving safety.

Conclusion
This study provides objective evidence of the impact of shift work-related fatigue on patient and nurse safety, allowing us to make concrete recommendations regarding safe shift-scheduling for day and nightshift nurses—information that may help keep nurses safer and improve patient care.

Support (if any)
0184 Can Subjective Sleepiness Pre-flight Predict the Use of Controlled Rest on the Flight Deck?
Authors: Hilditch Cassie , Arsintescu Lucia , Pradhan Sean , Gregory Kevin , Flynn-Evans Erin 
Published: May 2023

Abstract

Introduction
Pilot sleepiness in flight continues to be an issue in aviation due to irregular and extended working hours. In some regions of the world, pilots are allowed to use an in-flight countermeasure called controlled rest, which involves taking a short nap on the flight deck. The use of this countermeasure in practice is understudied. We aimed to investigate whether subjective sleepiness ratings taken pre-flight are predictive of controlled rest use.

Methods
Data from 94 long (&gt; 6 hours flight duration), non-augmented (two flight crewmembers) flights were analyzed (n = 30 pilots). Mixed-effects logistic regression was used to assess the likelihood of controlled rest based on a Karolinska Sleepiness Scale rating (KSS) taken at pre-flight.

Results
Controlled rest was taken on 62.77% (n = 59) of the analyzed flights. Pilots with higher KSS ratings (i.e., subjectively sleepier) pre-flight were more likely to take controlled rest during the subsequent flight (b ± SE: 1.03 ± 0.33; OR = 2.81, 95% CI [1.47, 5.37]; p = .002; R2 (Marginal): .28, R2 (Conditional): .51). That is, for every one-unit increase in KSS ratings, there was a near three-fold increase in the odds of taking controlled rest in flight.

Conclusion
Our results suggest that subjective sleepiness prior to a flight may be predictive of the decision to take controlled rest later in the flight. Further research is needed to understand the influence of other scheduling factors and individual differences.

Support (if any)
NASA Airspace Operations and Safety Program, System-Wide Safety Project.
0186 Continuous Theta Burst Transcranial Magnetic Stimulation and Signal Detection Performance on a Military Go/No-Go Task
Authors: Hildebrand Lindsey , Jankowski Samantha , Henderson-Arredondo Kymberly , Trapani Christopher , Patel Salma , Chen Yu-Chin , Chou Ying-Hui , Dailey Natalie , Killgore William 
Published: May 2023

Abstract

Introduction
Repetitive transcranial Magnetic Stimulation (rTMS) is an emerging non-pharmacological treatment method utilized to treat multiple clinical diagnoses to include anxiety, depression, and now insomnia. As part of a larger project, we showed that a single rTMS stimulation with continuous theta burst stimulation (cTBS) to the default mode network (DMN) was associated with improved sleep. However, there is little known about potential effects on attention and vigilance because of cTBS to the DMN. We hypothesized that active cTBS would have no significant impact on signal detection tasks post-TMS administration.

Methods
Twenty adults with clinical insomnia completed this study (Mage=26.90, SD=6.56). Participants completed two overnight visits in total; one where they received active cTBS and one where they received sham cTBS over an easily accessible node of the DMN (left angular gyrus). We analyzed signal detection performance utilizing a Go-No-Go (GNG) task. Three variables were calculated as a result: hit rate, correct rejection rate, and false alarm rate. Higher scores on hit rate and correct rejection rate indicate higher correct responses. Higher scores on false alarm rate indicates a higher number of incorrect responses. We conducted a repeated measures ANOVA with factors of condition, administration, and reversal.

Results
There was no main effect of condition on GNG hit rate (F(1,17)=1.365, p=.259, ηp2 =.074), GNG false alarm rate (F(1,17)=.210, p=.091, ηp2 =.244), or GNG correct rejection rate (F(1, 17)=1.677, p=.213, ηp2 =.090). We also found there were no significant interaction effects of TMS condition on performance on reversal conditions for GNG hit rate (F(1,17)=0.45, p=.834, ηp2 =.003), GNG false alarm rate (F(1,17)=1.572, p=.227, ηp2 =.085), or GNG correct rejection rate (F(1, 17)=1.510, p=.236, ηp2 =.082). Posthoc pairwise comparisons demonstrated that participants did not significantly differ on GNG hit rate, false alarm rate, or correct rejection rate between their active cTBS and sham cTBS session (p&gt;.05).

Conclusion
Active cTBS was not significantly associated with any decline in response inhibition or signal detection. It is helpful for future recipients to know they are not adversely affected in attention or vigilance after receiving cTBS rTMS of the DMN for treatment of insomnia.

Support (if any)
W81XWH2010173
0192 Sleep Hygiene and Self-Efficacy for Sleep Hygiene among Good and Poor Sleepers: A Secondary Analysis
Authors: Gipson Christine , Dickerson Suzanne 
Published: May 2023

Abstract

Introduction
College students are at risk for sleep disturbances that may influence academic performance and cognitive function. Poor sleep hygiene and sleep quality over time results in inadequate sleep and daytime sleepiness, which, if not addressed, eventually leads to sleep deprivation and adverse health effects. The current study aims to identify if sleep hygiene practices and self-efficacy relate to poor and good sleepers categorized according to the Pittsburg Sleep Quality Index (PSQI) Score &gt; or &lt; 5) among a sample of college students.

Methods
Secondary analysis of baseline data from college student participants aged 18-26 from an intervention study was used. All participants completed demographic, sleep hygiene, and sleep quality assessments. (e.g., Sleep hygiene index [SHI], Self-efficacy for sleep hygiene inventory [SHESHI], and PSQI). Descriptive statistics were calculated for demographic, sleep quality, and sleep hygiene variables.

Results
The sample (n=119) included 15 Freshmen, 30 Sophomores, 52 Juniors, and 21 Seniors, of which 26 were male and 93 female college students. The total sample mean age=20.6 y +2.0, range: 18-26; 82.4% were White, 55% worked part-time, and 69.8% considered themselves night owls. Data were examined to determine if poor and good sleepers differed across key demographic variables. There were no statistically significant differences between the groups. The sample comprised 47.0 % (n=56) poor sleepers and 52.9% (n=63) good sleepers. A Mann-Whitney U test was run to determine if there were differences in self-efficacy scores and sleep hygiene practices between poor and good sleepers. Mean rank self-efficacy scores for poor sleepers (44.15) were significantly lower than for good sleepers (74.09), U=876, z = -4.725, p &lt;.001. Mean rank sleep hygiene index scores for poor sleepers (76.05) were significantly higher than good sleepers (45.73) U=865, z = -4.793, p &lt;.001.

Conclusion
Preliminary descriptive findings highlight significant characteristics of sleep hygiene efficacy in college students with good and poor sleep. All surveys were subjective measures. Future use of an objective measure of actual sleep time and sleep health index would add to an understanding of sleep issues in college students.

Support (if any)
N/A
0195 The association of electronic device use before bedtime on objective sleep quality measured with Odds Ratio Product
Authors: Lambing Kari , Bender Amy 
Published: May 2023

Abstract

Introduction
Previous research has shown mixed results when it comes to electronic device use and the impact on sleep quality. The use of electronic devices before bedtime can impact sleep quality through engaging content and the impact of blue light on melatonin secretion. In the present study, we assessed the relationship between electronic device use and sleep under real-world conditions.

Methods
Nineteen participants (age 41.1±10.9; 9 females) recorded their sleep with in-home PSG using the Cerebra Sleep System for 18 to 31 nights (21.5±3.4). Sleep quality was measured using odds ratio product (ORP) derived from spectral analysis of the frontal EEG channels during wake, NREM and REM sleep. Participants completed a nighttime questionnaire within one hour of bedtime where they were asked “Did you do any of these activities today” and indicated “social media or surfed the internet in the last hour before bedtime”. The Karolinska Sleepiness Scale (KSS) was also completed during the before bedtime test battery.

Results
Across the 19 participants, 17 participants reported using social media or surfing the internet within an hour before bedtime for at least one night. Participants reported usage for 9.6 ± 8.2 nights on average (n=165) but no usage for 11.7 ± 7.9 nights on average (n=210). On nights that internet or social media usage before bedtime was reported, participants had lower levels of evening sleepiness on the Karolinska Sleepiness Scale than on nights where no usage was reported (p &lt;.001). On these nights, participants also had higher ORPNREM (p &lt;.001), higher ORPREM (p&lt;.001), higher ORPTRT (p&lt;.001), higher ORP-9 (p&lt;.001) which is an indication of poorer sleep depth after an EEG arousal.

Conclusion
On the nights when electronic devices were used before bedtime, participants experienced less sleepiness and had worse objective sleep quality during the night. These results indicate the utility of ORP to be sensitive enough to detect changes in sleep quality after electronic device use.

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0197 To delay perchance to sleep: The daily association between pre-sleep arousal and bedtime procrastination
Authors: Carlson Steven , Johnson Kimberley , Williams Paula 
Published: May 2023

Abstract

Introduction
Bedtime procrastination, a behavior associated with poor sleep health and wellbeing, refers to voluntary delays of bedtime. Although bedtime procrastination is often defined as a needless or mindless delay, bedtime procrastinators often report delaying their bedtime strategically to regulate sleep-interfering processes. One such process is pre-sleep arousal, an important vulnerability for and perpetuating factor in insomnia. Preliminary evidence supports this association, as some bedtime procrastinators report delaying bedtime to avoid anxiety-producing bedtime routines. However, this association has not been directly examined. To further investigate strategic delay in bedtime procrastination, the current study examined the association between pre-sleep arousal and bedtime procrastination using a daily diary design.

Methods
390 young adult participants (Mage = 24.4, SD = 6.5) completed 14-days of experience sampling procedures, including completing self-report measures of nightly pre-sleep arousal and morning ratings of prior-night bedtime procrastination. Associations between pre-sleep arousal and bedtime procrastination were estimated with multilevel models using centering procedures which disaggregated between- and within-person covariance. Gender and age were entered into each model as covariates.

Results
Pre-sleep arousal was associated with increased bedtime procrastination both within- (B = 0.01, p &lt; 0.001) and between-persons (B = 0.02, p &lt; 0.001). Additionally, cognitive pre-sleep arousal was more strongly associated with bedtime procrastination (Bwithin = 0.014, p &lt; 0.001; Bbetween = 0.032, p &lt; 0.001) than somatic arousal (Bwithin = 0.007, p = 0.165; Bbetween = 0.038, p &lt; 0.001).

Conclusion
The results suggest that pre-sleep arousal is a putative mechanism for bedtime procrastination. Cognitive arousal, including worry and rumination, may be particularly relevant for the development of this behavior. This finding supports the notion that bedtime procrastination may occur as a (maladaptive) strategy to regulate pre-sleep arousal. Alternatively, findings may suggest that bedtime procrastinators engage in arousing pre-sleep activities. Regardless, the association between bedtime procrastination and pre-sleep arousal suggests that bedtime procrastination is relevant in the development and/or maintenance of sleep-related disorders. Treatment of bedtime procrastination may be enhanced by considering the role this behavior has in regulating pre-sleep arousal.

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0200 Effects of Early-Life Sleep Disruption on Spatial Learning, Tau Burden, and Neurodegeneration in the PS19 Mouse Model of Tauopathy
Authors: Vetter Kenny , Pettibone Ward , Tejiram Rachel , Kam Korey , Varga Andrew 
Published: May 2023

Abstract

Introduction
Sleep disruption is thought to increase tau hyperphosphorylation and tangle formation. This study aims to identify the impact of chronic early-life sleep disruption on late-life tau burden, neurodegeneration, and spatial memory.

Methods
Eight-week-old PS19 (MAPT P301S) mice and wildtype littermates were subjected to chronic daily sleep disruption (SD) or allowed to sleep ad libitum (AL) for eight weeks. SD was achieved using an automated physical stimulus every 10 seconds for 18 hours daily between ZT 0 and 18. Spatial memory testing occurred at 6, 8, and 10 months of age using the Barnes maze where latencies to find and enter the escape box were recorded on 4 consecutive days (n: WT AL=22, WT SD=21, PS19 AL=15, PS19 SD=28). Brains were subsequently collected between 10 and 14 months of age and analyzed in a subset. Tau pathology was analyzed with AT8 immunohistochemistry on paraffin sections and quantified by counting tau-positive hippocampal neurons using QuPath software. Neurodegeneration was quantified by measuring the combined area of both the lateral and third ventricles.

Results
Spatial memory was equivalent among all genotypes and sleep conditions at 6 months. We observed a main effect of PS19 genotype with worse spatial memory at 8 and 10 months. Notably, early life SD imparted a protective effect on spatial memory at 8 and 10 months vs ad lib sleep in PS19 mice with no effect on controls. PS19 mice experiencing early life SD showed no difference in late-life hippocampal tau burden (SD: mean 462 AT8+ neurons (SEM: 268), n=5, AL: 284 AT8+ neurons (SEM: 98), n=5, p=0.56) as well as no difference in total ventricle area (SD: mean 1.2 square mm (SEM: 0.5), n=5, AL: 2.0 square mm (SEM: 0.4), n=5, p=0.26).

Conclusion
Counter to our initial hypothesis, early-life SD resulted in preservation of late-life spatial memory, without changes to neurodegeneration as measured by ventricle area or changes to tau hyperphosphorylation in the hippocampus. Dissociation of tau burden and memory has been observed in models of immune modulation suggesting further investigation regarding effects of sleep disruption on immune function in the context of neurodegenerative models.

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0201 Prebiotic Diet Impact on Cognitive Performance, Sleepiness, and Mood During Combined Sleep Restriction and Circadian Misalignment
Authors: Ekin Sarila , Withrow Dana , Kuppa Abhignya , Sprecher Kate , Fleshner Monika , Gonzalez Antonio , Lowry Christopher A , Turek Fred , Vitaterna Martha , Dorrestein Pieter C , Knight Rob , Wright Kenneth 
Published: May 2023

Abstract

Introduction
The gut microbiome plays a crucial role in health and affects mood and behavior. The composition and function of the gut microbiome can be modified by prebiotics, which are defined as substrates selectively utilized by host microorganisms conferring a health benefit. This study examined the effects of a prebiotic diet combination of polydextrose (PDX) and galacto-oligosaccharides (GOS) on cognitive performance and sleepiness during combined sleep restriction and circadian misalignment.

Methods
Eleven healthy adults (aged 24.6 ± 4.5, 6 females, 5 males) completed a randomized, double-blind, cross-over study lasting a total of 39 days. Participants consumed 14 days of prebiotic (7.5g/day each of PDX [Danisco] and GOS [FrieslandCampina]) or maltodextrin placebo diets at home(sachets dissolved in water with breakfast) while maintaining ~8h sleep per night at habitual times for two separate weeks before undergoing ~4 days of in laboratory testing under combined sleep restriction (3h sleep opportunity per day) and circadian misalignment (wakefulness at night) conditions. Prebiotic or placebo diet continued in-laboratory. Cognitive function testing occurred every 3h during scheduled wakefulness and included the Psychomotor Vigilance Task (PVT), Stroop Color and Word Test (STROOP) visual analog mood scales (VAS), positive and negative affect scales (PANAS), and the Karolinska sleepiness scale (KSS). Participants had a 3-day washout, then repeated the same procedure with the second condition.

Results
Sleepiness on the KSS was reduced, and positive mood on the PANAS and calm mood were increased under prebiotic versus placebo (all p &lt; 0.05). Median reaction time on the PVT was faster, whereas median reaction times for congruent stimuli on the STROOP task were slower under the prebiotic diet versus placebo (all p &lt; 0.05).

Conclusion
A prebiotic diet had beneficial effects on many performance, sleepiness and mood outcomes during combined sleep restriction and circadian misalignment. These findings have important implications for shift workers, emergency responders, and military personnel working under the demanding conditions of sleep restriction and circadian misalignment.

Support (if any)
Office of Naval Research MURI N00014-15-1-2809, NIH CTSA Grant UL1 TR002535 and Undergraduate Research Opportunities Grant, University of Colorado Boulder.
0202 Sleep Deprivation: Cognitive Decline and Hippocampal Neuroinflammation
Authors: Olsen Laura , McCubbins Hunter , Moore Raquel , Gargas Nathan , Rohan Joyce , Hatcher-Solis Candice 
Published: May 2023

Abstract

Introduction
A highly conserved biological process, sleep is imperative for healthy brain function. Sleep deprivation (SD) disrupts cognition and increases susceptibility to neurological disorders. The first step to developing mitigation strategies, this study investigated mechanisms underlying sleep-induced cognitive impairment, including hippocampal neuroinflammation.

Methods
All animal activities were approved under an IACUC protocol. Male Sprague-Dawley rats (N = 50) underwent 120 h of SD. Novel Object Recognition (NOR) and Passive-Avoidance Task (PAT) assessed cognitive performance (n = 6-12), followed by humane euthanization. Protein analysis of hippocampal tissue was performed using immunohistochemistry (IHC, n = 3-6) and enzyme-linked immunoassay (ELISA, n = 8-13). Microglia (Iba-1 marker) and astrocyte (GFAP marker) populations were quantified using IHC and ImageJ. The ELISA V-PLEX assay was used to assess concentration of pro-/anti-inflammatory mediators.

Results
Tested 24 h after training, SD rats had significantly lower cognitive performance in NOR (p&lt; 0.05) and PAT (p&lt; 0.01). Percentage of Iba-1+ microglia in the stratum radiatum of CA1 (p&lt; 0.05) and CA2 (p&lt; 0.05) hippocampal subregions was higher among SD rats. This SD-induced increase in microglia was not found in the pyramidal layer of CA1/2/3 (p&gt;0.05). There was no SD-associated change in percentage of GFAP+ astrocytes in any hippocampal subregion (p&gt;0.05). ELISA analysis found SD rats had higher levels of pro-inflammatory chemokine ligand 1 (CXCL1, p&lt; 0.05) and anti-inflammatory interleukin-10 (IL-10, p=0.07) in the hippocampus.

Conclusion
SD-induced cognitive impairment was associated with increased microglia presence in CA1/2 subregions of the hippocampus. Increased expression of hippocampal CXCL1 after SD indicates these CA1/2 microglia are pro-inflammatory, leading to neuroinflammation in regions that mediate declarative memory. Although IL-10 trended to increase after SD, this neuroprotective anti-inflammatory factor did not prevent SD-induced performance decline or microglia recruitment. Based on these findings, it is suggested that blocking pro-inflammatory microglia pathways in the CA1/2 may prevent SD-induced cognitive dysfunction.

Support (if any)
AFOSR grant 20RHCOR04