bluuebunny/crossref_metadata_2025_split huggingface dataset:
0221 Time to wake up! Adolescents woken up by an alarm or family member get short sleep on schooldays and weekends/holidays
Authors: Gooley Joshua , Charoenthammanon Rachel 
Published: May 2023

Abstract

Introduction
Many adolescents get insufficient sleep on schooldays because they need to wake up early. It is often assumed that students can sleep in longer on non-schooldays (weekends and holiday periods) to recover their sleep debt. However, few studies have explored the degree to which adolescents are given the freedom to extend their nocturnal sleep. Here, (1) we investigated how often adolescents are awoken by an alarm or family member on schooldays and non-schooldays, and (2) we tested whether this results in shorter sleep even on non-school days.

Methods
Adolescents aged 13-18 years (n=66; 10 schools in Singapore) wore an actigraphy watch (Actigraph wGT3X-BT) and completed daily diaries for 7 days during their school and holiday periods. Each morning, students indicated their reason for having woken. Actigraphy-derived sleep parameters included sleep onset, sleep offset, and the nocturnal sleep period. Simple effect sizes (e.g., mean difference in sleep period) were calculated for schooldays versus non-schooldays, and for days waking up to an alarm or family member versus other reasons.

Results
Adolescents’ nocturnal sleep was about 1.7 hours shorter on schooldays (mean=6.50h, 95% CI=6.24h-6.75h) compared with non-schooldays (mean=8.17h, 95% CI=7.89h to 8.45h) because they woke up much earlier. Students were awoken by an alarm or family member on 78% of schooldays, and this was associated with shorter nocturnal sleep compared with waking up for other reasons (mean difference in sleep period=-1.16h, 95% CI=-1.59h to -0.80h). By comparison, adolescents were awoken by an alarm or family member on 41% of non-schooldays. In such instances, students also obtained shorter sleep by about an hour (mean difference in sleep period=-1.21h, 95% CI=-1.46h to -0.94h) and slept less than the recommended amount for their age group (mean sleep period=7.38h, 95% CI=7.18h to 7.59h).

Conclusion
Adolescents’ nocturnal sleep was frequently interrupted by an alarm or family member on both schooldays and non-schooldays. Chronic sleep restriction extends beyond schooldays if adolescents are not allowed to wake up naturally on their ‘free days’. This may have deleterious effects on students’ performance and wellbeing.

Support (if any)
The research was funded by the National Institute of Education, Singapore (OER 14/21 JJG).
0224 Chronic change in sleep oscillation expression in older adults with insomnia with zolpidem or lemborexant and its effect on memory
Authors: Barabadi Negin Sattari , Dave Abhishek , Niknazar Hamid , Chen Ivy , Neikrug Ariel , Benca Ruth , Mander Bryce 
Published: May 2023

Abstract

Introduction
Aging is accompanied by increased insomnia and memory decline. Enhancing GABAergic and antagonizing orexinergic function are both ways to treat insomnia, but how these mechanisms impact sleep oscillations, and consequently memory, among older adults with insomnia is unknown. Thus, chronic effects of zolpidem and lemborexant on quantitative sleep electroencephalography (EEG) and quality of memory among older adults with insomnia were evaluated.

Methods
116 older adults (71.01±4.81y, 78.67% female) with insomnia (Insomnia Severity Index 18.73±3.13) completed a phase 3 study (E2006-G000-304; NCT02783729) with placebo (n=29), zolpidem-extended-release (6.25mg,n=26;ZOL), and lemborexant (5mg,n=29[LEM5]; 10mg,n=32[LEM10]) using polysomnography before (at baseline) and 29-30 days after chronic treatment. Spectral analysis was performed on artifact-free EEG data during NREM sleep. Changes in relative power within canonical frequency bands (i.e., slow-oscillation[0.5-1Hz], delta[1-4.5Hz], theta[4.5-7.5Hz], alpha[7.5-11Hz], slow-sigma[11-13Hz], fast-sigma[13-16Hz], beta[16-28Hz] and gamma[28-35Hz]) from baseline were compared between groups at averaged frontal electrodes at each visit. Working (WM) and episodic memory (EM) were measured at waketime using ANOVA models and Pearson correlations.

Results
A significant main effect of intervention on frequency bands delta (p=0.02), slow-sigma (p&lt;.001), and fast-sigma (p&lt;.001) was found, with greater chronic suppression in power for ZOL compared to PBO for delta (p=0.002). Compared to PBO, ZOL showed greater increase in power for slow-sigma (p&lt;.001), fast-sigma (p&lt;.001) and beta (p=.03), and was also associated with greater increases in power compared to LEM5 for slow-sigma (p&lt;.001) and fast-sigma (p=.006), and compared to LEM10 for alpha (p=.04), slow-sigma (p&lt; 0.00), and fast-sigma (p&lt;.001). LEM5 showed greater beta (p=.05) than PBO. WM was significantly higher (better) for LEM5 compared to PBO (p=0.04), while EM was higher for PBO compared to ZOL (p=0.01). Increase in beta with ZOL was related to decreased change-from-baseline-WM (r=-0.43, p=.03); increases in theta and alpha with LEM5 were related to decreased change-from-baseline-EM [r=-0.38, p=0.04; r=-0.39, p=0.03]; and increase in delta with LEM10 was related to increased change-from-baseline-EM (r=0.43, p=0.02).

Conclusion
In older adults with insomnia disorder, chronic treatment with lemborexant and zolpidem had distinct effects on sleep oscillation expression and between power and memory. Functional consequences of these differential effects on sleep-oscillation expression and memory in insomnia patients should be further considered.

Support (if any)
Eisai
0225 Effect of thermoneutral temperature exposure in the APP/PS1 knock-in mouse model of Alzheimer’s disease
Authors: Wang Jun , Iradukunda Diane , Huffman Dillon , McLouth Chris , Bachstetter Adam , Murphy Michael , O’Hara Bruce , Duncan Marilyn , Sunderam Sridhar 
Published: May 2023

Abstract

Introduction
There is growing evidence that disordered sleep in Alzheimer’s disease (AD) may accelerate neuropathology, thus promoting a vicious cycle. In a previous study, we found that improving sleep through thermoneutral ambient temperature exposure may slow disease progression in 3xTg-AD mice. However, the confounding effects of temperature on metabolism in addition to sleep remained an open question.

Methods
To test whether the effect of thermoneutral warming on amyloid pathology is mediated by sleep changes rather than other non-specific physiologic effects of temperature, we conducted a new study on APP/PS1 knock-in (KI) mice. First, 6-m.o. male APP/PS1-KI mice were instrumented for EEG/EMG sleep analysis. After a week-long baseline recording, we split the mice into 4 separate groups: 1. SE (n=8), which were exposed to 30°C thermoneutral ambient temperature during the 12-hour light period; 2. SE-SD (n=9), which received sleep disruption through mild intermittent cage vibration alongside thermoneutral temperature exposure; 3. SD (n=8), which received sleep disruption at room temperature (22°C); and 4. CTRL (n=8), which were undisturbed and at room temperature. This design aims to decouple the sleep-enhancing effect of thermoneutral exposure from other non-specific effects. After four weeks of treatment, the animals were euthanized and the brains dissected to assay Aβ levels by ELISA. Vigilance states, i.e., Wake, REM, NREM, and slow wave sleep (SWS) within NREM – were scored in 4-second epochs from the EEG/EMG recordings and sleep metrics computed.

Results
Initial analysis of sleep revealed some SE-induced increases in SWS similar to our findings in 3xTg-AD mice. Sleep disruption reduces SWS even when thermoneutral warming occurs. Biochemical assays are in progress to reveal the treatment effects on Aβ levels in the brain.

Conclusion
Sleep disruption through vibration seems to be an effective way to negate the sleep-specific effect of thermoneutral temperature exposure. Incorporation of the biochemical assay data will help uncover the correlation between SWS and AD progression.

Support (if any)
R01AG068215
0227 Impact of 5-night sleep restriction on actigraphy-estimated sleep in young adolescents: preliminary associations with ADHD traits
Authors: Mason Gina , Christiansen Taylor , Dionisos Victoria , Barker David , Dickstein Daniel , Carskadon Mary , Saletin Jared 
Published: May 2023

Abstract

Introduction
Prior research suggests that children with attention-deficit/hyperactivity-disorder (ADHD) may experience disrupted sleep. In typically developing children, short-term sleep restriction increases sleep pressure and efficiency; however, whether a similar homeostatic response occurs in children with ADHD is unknown. Here we explore the effects of 5 nights of experimental sleep restriction on actigraphy-estimated sleep of children with and without high ADHD characteristics.

Methods
Nineteen young adolescents (Mage=12.24yr, range 10.17-13.88yr; 10F/9M) participated in an at-home crossover protocol. After ≥5 nights of stabilization (10hr time-in-bed[TIB] set to habitual risetimes), participants had five nights of sleep optimization (SO; same stabilization schedule) or restriction (SR; 7.5hr TIB, sleep opportunity reduced by delaying bedtime and advancing risetime equally), a 2-3 night restabilization, and then the reverse schedule. Sleep was assessed via wrist-worn actigraphy (AMI Micro Motionlogger), sleep diaries, and twice-daily phone calls ensuring schedule adherence. Primary sleep variables included: total sleep time (TST; min), sleep period time (SPT; min), and sleep efficiency (TST/SPT*100). Children were grouped by parent-rated Conners 3 ADHD-Probability-Index: &lt; 50% (low-ADHD; n=10, 8F) or &gt;=50% (high-ADHD; n=9, 2F).

Results
Mixed-effects ANOVAs evaluating condition (SO vs. SR) and group (low- vs. high-ADHD) on schedule adherence indicated significant effects of condition; that is, SR reduced both SPT (M±SD SO=9.08[0.54]hr, SR=7.10[0.57]hr; F(1,17)=479.75, p&lt;.001, ηp2=.97) and TST (M±SD SO=7.92[0.97]hr, SR=6.38[0.86]hr; F(1,17)=302.13, p&lt;.001, ηp2=.95). No group or group-by-condition effects were significant (all ps&gt;.21). For sleep efficiency, a group-x-condition interaction (F(1,17)=8.29, p=.01, ηp2=.33) revealed that SR significantly increased sleep efficiency in low-ADHD children (M±SD SO=85.08[9.95]%, SR=89.74[7.66]%, Bonferroni-p&lt;.001) but not in high-ADHD children (M±SD SO=90.67[3.74]%, SR=91.21[3.19]%, Bonferroni-p=.61). Other between-group effects were not significant (all ps&gt;.12).

Conclusion
These preliminary data indicate that our sleep restriction protocol successfully reduces sleep opportunity and sleep duration in peripubertal children, including those with high ADHD traits. Notably, sleep restriction improved sleep efficiency in low-ADHD children, whereas sleep efficiency was high and unchanging in our high-ADHD group. It is possible that high-ADHD children maintained higher sleep pressure even after stabilization. While data collection (matching groups on sex and age) continues, we are examining waking EEG markers to explore this possibility.

Support (if any)
R01HD103655, P20GM139743
0228 Investigating Application of Phase Contrast MRI to Study CSF Movement in Aging and Sleep Deprivation
Authors: Pedersen Taylor , Flores Jaqueline , Peskind Elaine , Iliff Jeffrey , Levendovzsky Swati 
Published: May 2023

Abstract

Introduction
The glymphatic system facilitates solute transport through the exchange of cerebral spinal fluid (CSF) and interstitial fluids using a brain-wide system of perivascular spaces. Such exchange is primarily active during sleep. Aging and sleep disruptions have been shown to decrease glymphatic clearance and increase risk of cognitive impairment. Here, we used phase contrast MRI (PC MRI) to measure CSF egress from the Aqueduct of Sylvius (AoS) as a marker of CSF circulation in the setting of sleep deprivation and aging.

Methods
Under approved IRB protocols six young adults (22±3 yo, 4F) underwent a night of full sleep and a night of sleep deprivation in a 3T Philips Ingenia Elition scanner with a 32-channel head coil. Additionally, six older adults (66±3 yo, 2F) were scanned using identical MRI protocol but only after full sleep. The PC MRI was a single slice acquisitions with 14 samples within a cardiac cycle. The slice was perpendicular to the AoS and care was taken to avoid any phase wrapping. All individuals also completed the General Practitioner’s assessment of cognition (GPCOG) in the morning prior to their scan. CSF velocity in cm/s was calculated from the phase data. Heart rate (HR) was recorded during the scan using a pulse-oximeter.

Results
CSF velocity was numerically lower after sleep deprivation (2.6±2.1 cm/s) than after a night of full sleep (3.1±2.0 cm/s) in young adults, but the difference was not significant. CSF velocity in the older adults was lower (2.0□0.5 cm/s, marginally significant at p = 0.10) than in young adults. HR in older adults (59±6) was significantly lower than the young adults under both conditions (full sleep: 68±4, sleep deprivation: (66±11) and, across all participants, HR was weakly correlated (r=-0.35) with CSF velocity. GPCOG was not significantly different across conditions or groups.

Conclusion
Although only marginally significant, CSF velocity in the AoS, measured by PC MRI is sensitive to HR variations and aging but not to sleep. Continued investigation with a larger sample size is underway to understand if these preliminary observations hold and if CSF velocity in the AoS is associated with glymphatic transport.

Support (if any)
0229 Reward motivation improves placekeeping performance after total sleep deprivation and a night of rest
Authors: Wernette Elle , Altmann Erik , Fenn Kimberly 
Published: May 2023

Abstract

Introduction
Sleep deprivation impairs some higher-order cognitive processes, but it is unclear if this reflects impaired ability to perform complex tasks, a reduction in motivation, or both. There is evidence that reward motivation attenuates the effect of sleep deprivation on lower-level cognitive processes, namely vigilant attention. We investigated the extent to which reward motivation would mitigate the effect of sleep deprivation on placekeeping, a higher-order cognitive process that plays a central role in accurate performance of procedural tasks. To conduct the study under pandemic conditions, we developed a novel method to conduct sleep deprivation research remotely.

Methods
Participants (N = 414) joined a Zoom meeting in the evening and completed the Psychomotor Vigilance Task (PVT) and a placekeeping task (UNRAVEL). At 00:00, we randomly assigned participants to stay awake in the meeting overnight (Deprivation) or leave the meeting and sleep (Rested). Two trained researchers stayed in the meeting overnight to monitor participants. At 08:30, Rested participants re-joined the meeting, and all participants completed the PVT and UNRAVEL again. Some participants (Motivated), but not others (Nonmotivated), could earn a monetary reward based on their morning UNRAVEL accuracy. Performance on the PVT was completed before the motivation manipulation.

Results
We examined morning UNRAVEL accuracy using a 2 (Sleep: Deprivation, Rested) x 2 (Reward: Motivated, Nonmotivated) between-participants design with evening performance as a covariate. Deprivation participants made more errors than Rested participants, Motivated participants made fewer errors than Nonmotivated participants, and there was no interaction between the factors.

Conclusion
Motivational interventions may be an effective way to mitigate some of the effects of sleep deprivation on higher-order cognitive tasks. However, reward motivation affected Deprivation and Rested participants similarly, and, therefore, did not compensate for impairments specific to sleep deprivation. Consistent with results of studies testing effects of naps and caffeine, the present results suggest that sleep deprivation impairs the ability to perform a procedural sequence accurately in a way that is difficult to mitigate.

Support (if any)
This work was funded by the Office of Naval Research (N00014-20-1-2739).
0230 Sleep Duration Associated with Hospital Utilization in the US: Revisiting Andersen's Behavioral Model of Health Service Use
Authors: Moise Rhoda , Narcisse Marie-Rachelle , Locklear Clarence , Turner Arlener D , Seixas Azizi , Rogers April , Jean-Louis Girardin 
Published: May 2023

Abstract

Introduction
One in three Americans is sleep deprived, sleep disturbances are associated with greater health service utilization and costs. This study examined factors associated with Emergency Department visits (ED) and overnight admission hospitalization (OA) in a large representative sample of adults aged ≥18 in the US.

Methods
Guided by Andersen's Behavioral Model of Health Service Use, zero-inflated negative binomial and multivariable logistic regressions were used to examine associations between predisposing, enabling, and health needs factors and health service utilization (α=0.05).

Results
ED visits significantly increased with age, female sex, Black race, and less than high school education (15%, 36%, and 85%, respectively). Enabling factors analysis found that those who were unemployed, had problems paying medical bills, lived under the federal poverty line, and did not have private insurance were more likely to have ED visits. ED visits also increased by health needs including adults reporting poor/fair health, increased number of chronic conditions, and very short or long sleep. Regarding OA, significant risk predisposing factors included female sex and foreign-born nativity. Factors for OA found adults who were unemployed and had with problems paying bills were more likely to be hospitalized. Adults with Medicaid, Medicare, and other insurance were more likely (70%, 34%, 44%, respectively) to be hospitalized. Of the health needs factors examined, OA odds increased for those with less than excellent health status, without a usual source of care, and an increased number of chronic conditions. Adults with very short or short sleep were also more likely to be hospitalized (48% and 22%, respectively).

Conclusion
This is the first-time sleep duration is examined as a health needs component of Andersen's Behavioral Model of Health Service Use. When determining predictors associated with hospital utilization, sleep duration should be considered a key factor as it significantly increases the odds of ED visits and overnight hospital admissions. Future studies should investigate the influence of other dimensions of sleep health and sleep disorders.

Support (if any)
Programs to Increase Diversity among individuals engaged in Health-Related Research (PRIDE) training grant from the National Institutes of Health (NIH) National Heart, Lung, and Blood Institute (NHLBI): R25HL-10-5444 (PIs: G Jean-Louis, OG Ogedegbe).
0231 Slow Wave Activity During Restricted Sleep Buffers Against Negative Effects on Daytime Positive Emotion in Pre-pubertal Children
Authors: Rech Megan , Baran Bengi , Myers Annika , Palmer Cara , Alfano Candice 
Published: May 2023

Abstract

Introduction
Increased slow-wave activity (SWA) following sleep loss is a well-established physiological marker of increased sleep pressure. Recent research found SWA changes in response to sleep loss partially accounted for next-day decrements in positive affect (Finan et al., 2015; 2017). To our knowledge, however, this line of inquiry has been limited to adults. Recently, we found greater SWA during a night of healthy sleep predicted greater next-day positive emotion among pre-pubertal children (Rech et al., 2022). Here, we explored whether SWA during the second of two nights of partial sleep restriction predicted next-day emotional responses in the same cohort.

Methods
N=24 healthy, unmedicated children (7 to 11 years) completed a baseline assessment and one night of at-home PSG monitoring (10 hours in bed). Ten days later, children completed one night of at-home sleep restriction (7-hour sleep opportunity) followed by one night of in-lab sleep restriction with PSG monitoring (6-hour sleep opportunity). The next day, children completed an in-lab emotional assessment where they provided arousal and valence ratings in response to positive affective images from the International Affective Picture System (IAPS).

Results
Controlling for age and total sleep time during the first sleep restriction night, hierarchical multiple regression analyses examined if N3 SWA in frontal, central, and occipital regions during the second sleep restriction night predicted IAPS ratings. In separate models, both frontal, F(1,20)=8.535, p=.008, and occipital SWA density, F(1,20)=12.313, p=.002, predicted valence ratings in response to positive images (where lower scores indicated more positive valence).

Conclusion
While preliminary, findings indicate relationships between “rebound” SWA after sleep restriction and next-day emotional functioning in pre-pubertal children. Findings suggest that, prior to the pubertal transition, trait-based differences in homeostatic sleep pressure and recovery from sleep loss might alter emotional responding, potentially influencing risk for later mood disturbances.

Support (if any)
This research was supported by NIMH grant #R21MH099351 awarded to C.A.A.
0232 A mindfulness intervention to improve sleep in a diverse sample: results from a pilot feasibility study
Authors: Johnson Dayna , Ward Laura , Jagtiani Ashna , Johnson Leslie , Barber Lauren , Gujral Unjali 
Published: May 2023

Abstract

Introduction
Emerging data suggests that stress is a contributor to sleep health disparities. Mindfulness techniques are effective at reducing stress, yet limited studies have examined its effect on sleep among a diverse sample. We examined stress, sleep, and cardiovascular risk factors before and after participation in a pilot 30-day mindfulness intervention study.

Methods
Among a sample of Asian, Black, Hispanic, and White young adults (n=18), participants underwent 35-days of wrist actigraphy, completed questionnaires on stress (Perceived Stress Scale) and sleep patterns (Pittsburgh Sleep Quality Index) and provided blood pressure and weight measurements at baseline, midpoint, and endpoint. Following approximately 5-days of actigraphy, participants received 1-hour of sleep hygiene education and started a 30-day mindfulness meditation via a mobile application (Headspace™). We calculated means and standard deviations (SD) or frequencies for stress levels, sleep quality, and sleep duration, body mass index, and blood pressure before and after the intervention.

Results
Participants on average were 30 years of age (SD=10.2), 88.9% female, and identified as Asian (11.1%), Black/African American (44.4%), Hispanic (22.2%-not mutually exclusive), and White (33.3%). Most participants had a bachelor’s degree or higher (88.9%). After completing the intervention, participants decreased in stress levels [15.7 (SD=7.7) vs. 13.4 (SD=7.5)] and poor sleep quality [8.3 (SD=2.1) vs 5 (SD=2.2)]. The distribution of short sleepers decreased, 27.8% to 11%. There were no changes in actigraphy-measured sleep duration. The prevalence of obesity and elevated blood pressure decreased from 53% to 47% and 16.7% to 11.1%, respectively.

Conclusion
We found it feasible to conduct a 30-day app-based intervention among a predominately racial/ethnic minority population. There were modest decreases in stress, short sleep, obesity, and hypertension after the completion of the intervention. Our results suggest stress reduction may be an avenue to improve sleep and cardiovascular health among racial minorities. These results should be replicated in a larger sample to confirm.

Support (if any)
National Institutes of Health, National Institute for Heart Lung and Blood 1R01HL157954 and K01HL138211; Georgia Center for Diabetes Translation Research (GCDTR) Pilot & Feasibility Pilot Award Program