bluuebunny/crossref_metadata_2025_split huggingface dataset:
O071 The performance accuracy of wrist-worn oximetry and its automated output parameters for screening obstructive sleep apnoea in children
Authors: Ohn M , Maddison K , Evans D , Nguyen J , Bear N , Khan N , Eastwood P , von Ungern-Sternberg B S , Wilson A , Walsh J 
Published: November 2022

Abstract

Introduction
Children with obstructive sleep apnea (OSA) are at increased risk for perioperative adverse events. Whilst polysomnography (PSG) remains the reference standard for OSA diagnosis, oximetry is a valuable screening tool; visual analysis of desaturation clusters derived from a tabletop oximeter is the traditional practice. However, wearable oximetry with automated analysis could be an alternative option. This study investigated the accuracy of a wrist-worn oximeter as an OSA screening tool for a paediatric surgical population.

Method
Children scheduled for adenotonsillectomy without significant co-morbidities underwent concurrent overnight PSG and oximetry (Nonin WristOx2 3150) preoperatively. To determine the obstructive apnea-hypopnea index (OAHI), PSG was scored manually, and oximetry data were auto-analysed by Nonin proprietary software to determine the 3% oxygen desaturation index (oximetric ODI3). Logistic regression assessed the predictive performance of ODI3 and covariates (age, gender, BMI z-score) for detecting any OSA and moderate-severe OSA.

Results
Seventy-six children (34 females, aged (mean±SD) 5.7±1.6years) were classified based on PSG-derived OAHI as having no OSA (n=31), mild (n=31), and moderate-severe OSA (n=14). The moderate-severe OSA (OAHI≥5 events/hr) prediction analysis showed that oximetric ODI3 (OR 1.38, 95% CI 1.15, 1.65, p=0.001) was the sole OSA predictor. At a cut-off of ODI3=5events/hr, sensitivity and specificity were 78.6% and 75.8%, respectively, capturing all severe OSA cases (ROC-AUC=0.857). For any OSA (OAHI≥ 1 event/hr), prediction analysis showed reduced accuracy in performance: 75.6% sensitivity, 61.3% specificity (ROC-AUC=0.7097).

Conclusion
Wrist-worn oximetry-derived automated ODI3 can reliably identify moderate-severe OSA. Easy acquisition and interpretation may expedite the preoperative identification of OSA at-risk children.
O072 Episodes of drowsiness present during cognitively demanding tasks
Authors: Gnani Srinivasan A , Mann D , Smith S , Gadam S , Shekari Soleimanloo S 
Published: November 2022

Abstract

Introduction
Insufficient sleep is associated with impaired performance in cognitive tasks and executive functioning. Adolescence is a time of increasing autonomy and lifestyle changes, where social, educational, and work demands often impact on sleep opportunity. The impact of habitual short sleep opportunity on cognitive functioning is poorly understood. We examined the difference in EEG-based alertness during low and high load cognitive tasks in sleep restricted young adults.

Methods
Ninety-nine habitually sleep restricted young adults (M=20.65, SD=1.91, 73% female) participated in the study. EEG-based (F4-M1, O2-M1) alertness was examined under two conditions: (1) low load; a simulated slow drive and (2) high load; a weekly activity mapping task. A novel model predicted alertness as a continuous function of EEG power in beta, alpha, theta, and delta frequency bands. Model output 1 indicates alertness (i.e., wake), while values approaching zero indicate reductions in alertness. Statistical significance was assessed by two-tailed t-test (unequal variance), and effect size reported by Cohen’s D.

Results
Mean model output values were significantly (p&lt;0.0001) lower during the driving task (0.16, 95%CI=0.12-0.19) compared to the mapping task (0.92, 0.87-0.97), with substantial effect size (D=3.9).

Conclusions
This study demonstrates that sleep restricted young adults are less alert during tasks with low cognitive demands, even though the task we tested (simulated drive) represents high real-world risk. In contrast, these individuals show elevated levels of alertness during cognitively demanding tasks despite absence of real-world risk. Further study investigating potential mitigating effects through sleep modulation may reveal simple health recommendations
P016 Evaluating the effectiveness of an interactive educational intervention on sleep health for second-year pharmacy students
Authors: Basheti M , Bussing J , Grunstein R , Gordon C , Saini B 
Published: November 2022

Abstract

Background
Pharmacists are usually the most frequently consulted professionals in primary care for health concerns, such as sleep disturbances. However, conventionally, curricular space devoted to sleep health has been insufficient and this eventuates in suboptimal care provision. For example, pharmacists often provide over the counter/complementary medicines rather than the recommended behavioural counselling for insomnia management. Clearly, pedagogically informed learning experiences about sleep health/insomnia management are important to improve practice.

Objectives
To develop, implement and evaluate an interactive sleep health educational intervention for 2nd year pharmacy students.

Methods
An educational intervention utilising a flipped classroom approach, with interactive lectures, self-reflection around personal sleep habits, and role-playing behavioural treatment provision was designed and implemented. A questionnaire assessing pre- and post-intervention changes in knowledge about and attitudes towards sleep as well as post-intervention learning satisfaction, was administered to students.

Results
Mean total knowledge scores for participating students (n=125, 70.4% females) improved significantly post-intervention from a baseline of 11.1 ± 3.8 to 17.1 ± 3.5 post-intervention, p &lt;0.05 (Score range= 0-25). The mean total attitudes scores also improved from 28.8 ± 3.2 at baseline to 29.4 ± 3.8 (Score range= 10-50), p=0.07; however, this change was insignificant.

Conclusion
Carefully crafted educational interventions for pharmacy students can help improve sleep health knowledge. Whilst a trend to improved sleep health attitudes was evident, it was not significant, possibly because of positive sleep health attitudes even at baseline. Such programs should be incorporated into pharmacy pre-registration curricula to potentially enhance future pharmacists’ skills in sleep health provision.
P025 Using questionnaires to predict OSA in patients presenting to sleep clinics
Authors: Brink A , Munns S , Nolan G , Pyne N 
Published: November 2022

Abstract

Purpose
In sleep clinics, the Epworth Sleepiness Scale (ESS) and STOP-Bang (SB) questionnaire are widely used to determine the probability that a patient has obstructive sleep apnoea (OSA), though neither were designed as a triaging tool specifically for patients with suspected OSA. Previously we found that ESS had poor correlation with OSA presence and severity as determined by the apnoea-hypopnoea index (AHI) &gt;15. In this paired clinical chart audit, we determined if the SB has improved predictive ability and thus better suitability for triaging sleep clinic patients suspected of OSA compared to ESS.

Method
101 sleep clinic patients (56 male, 45 female) completed both ESS and SB questionnaires and underwent overnight polysomnography (OPSG) to determine AHI. Correlation of ESS and SB to AHI was determined using Spearman’s rho, and predictive ability of each questionnaire was determined using ROC curves and logistic regression.

Results
ESS was not significantly correlated to AHI in men (p=0.208) or women (p=0.533) and had poor sensitivity (60.2%) and specificity (47.8%). In contrast, SB was correlated to AHI in both men (p=&lt;.001) and women (p=0.045), and had improved sensitivity (94.1%). An ESS&gt;8 was not predictive of clinically significant OSA (AHI&gt;15, p=0.244), whereas SB&gt;3 was associated with 4.4 times higher odds of clinically significant OSA (p=.007).

Discussion
In our cohort, SB is more suitable than ESS for triaging patients presenting to sleep clinics due to its higher predictive ability for OSA. This finding has important implications for OPSG rebates and patient access to publicly funded treatment schemes.
P030 A systematic review of the influence of nature play and exposure on sleep measures in children aged 3-13 years old
Authors: Coussens S , McLoughney T 
Published: November 2022

Abstract

Introduction
There are significant benefits to exposing children to nature, including reduced risk of mental illness, enhanced attentional capacity, and greater circadian synchronisation. Furthermore, recent findings indicate exposure to greenspace is positively associated with improved sleep quality and quantity in adults. However, there is conflicting evidence regarding the impact of nature exposure and outdoor play on sleep measures for children. This systematic review aims to investigate whether nature experience through play or education has a significant effect on sleep measures in children.

Methods
Articles were searched for using 7 databases and Google Advanced Search for grey literature searching. The review is in accordance with PRISMA guidelines and is registered with PROSPERO. Articles were screened using Covidence. The target population included children aged 3 to 13 years old. The main outcome was sleep measures (i.e., sleep latency, duration, and/or quality), and the intervention was (including, but not limited to) outdoor play, nature exposure, or/and nature education.

Results
The article search returned 2538 articles; 9 of those articles contained adequate results for direct inclusion and analysis. The majority of the 9 articles demonstrated no association between increased outdoor play or nature exposure and sleep outcomes. However, the results are not yet finalised with further data to potentially be included.

Discussion
Preliminary observations posit there is insufficient literature to determine the influence of nature play and education on children’s sleep outcomes. It may be suggested that future research focuses more directly on the relationship between nature and children’s sleep.
P033 Associations between sleep and emotional self-regulation in toddlers
Authors: D'Cruz A , Downing K , Sciberras E , Hesketh K 
Published: November 2022

Abstract

Introduction
Emotional self-regulation (ESR) skills are vital for mental and physical health. There is growing evidence linking sleep to ESR in school-aged children, but associations in toddlers remain unclear. The current study examined associations between toddlers’ sleep duration and behaviors and ESR.

Materials and methods
This study utilized baseline data from 1358 toddlers (Mage=26±3.9mo) from the Let’s Grow trial. Total sleep duration was calculated by summing parent-reported average nighttime sleep and daytime nap duration. Sleep behaviors (bedtime routine, bedtime resistance, sleep latency, and night waking) were assessed using the Children’s Sleep Habits Questionnaire and Brief Infant Questionnaire. Toddlers’ ESR skills were assessed via a 4-item parent-report scale adopted from the Fast Track Project Child Behaviour Questionnaire, with a lower score indicating better ESR. Linear regression models assessed associations of sleep duration and behaviors with ESR.

Results
Toddlers’ average daily total sleep, nighttime sleep, and nap duration were 12.1h, 10.6h, and 1.5h, respectively. Girls and boys had similar nighttime sleep, total sleep, and ESR scores. However, girls had longer naps than boys (1.6h vs 1.4h, t=-3.5, p=0.0004). Total sleep, nighttime sleep, and nap duration were inversely associated with ESR (all p&lt;0.01), indicating that higher sleep duration was associated with better ESR. Sleep behaviors were positively associated with ESR (all p&lt;0.01), with more problem sleep behaviors associated with poorer ESR.

Conclusion
Initial results suggest that improving sleep duration and behaviors are associated with better ESR in toddlers. Supporting parents to improve their toddlers’ sleep may help foster better ESR skills.
P034 Measurement Type Moderates the Relationship between Sleep and Aggression: A Meta-Analytic Investigation
Authors: Demichelis O , McKay K , Grainger S , Henry J 
Published: November 2022

Abstract

Introduction
A recent meta-analysis showed that poor sleep is both associated with and can directly cause increased aggression. However, no assessment was made of whether objective indicators of sleep and subjective perceptions of sleep contributed equally or differentially to these effects.

Methods
To test this question, the present meta-analysis directly tests the role of measurement (objective vs subjective) in understanding the relationship between sleep and aggression.

Results
By integrating 94 effect sizes using multi-level meta-analysis, the results revealed that aggression is significantly associated with both subjective and objective sleep estimates. Importantly, measurement type emerged as a significant moderator of this relationship, with subjective sleep more strongly associated with aggression than objective sleep.

Conclusion
This finding is discussed in relation to the broader implications for how behavioral, or sleep, interventions and research are conducted.
P042 Actigraphy-derived sleep characteristics of healthy children who benefit the most from a sleep extension protocol
Authors: Galland B , Haszard J , Morrison S , Jackson R , Meredith-Jones K , Elder D , Beebe D , Taylor R 
Published: November 2022

Abstract

Introduction
Although experimental manipulation of sleep can extend children’s sleep via earlier bedtimes, this is not always possible. We aimed to determine true sleep gains made with a one hour earlier bedtime, and which actigraphy variables at baseline predicted the best gains.

Methods
Secondary analysis within a randomised crossover trial (99 children; 49.5% female; mean age=10.3 years, range 8-12 years). Each child underwent one week of sleep restriction and extension in a random order (1h later or earlier bedtime respectively) separated by a one-week washout. Sleep data comparing baseline and extension weeks were analysed using linear or logistic regression, controlling for randomised order.

Results
The mean (SD) difference in total sleep time (TST) with sleep extension was 14.3 (44.1) min/night. Thirty-three percent extended their sleep by at least 30 min/night. At baseline, having lower sleep quantity (TST) and quality (efficiency, WASO, waking frequency) significantly predicted more sleep gain. For each 1 h lower TST at baseline, 29.7 min (95%

CI
19.4, 40.1) more sleep was gained. At baseline, a TST below 8 h 49 min was the optimal cut-point to predict whether children could extend their sleep by at least 30 min/night (found in 40% of children). Adjusting for relevant demographics and sleep hygiene made little difference.

Conclusion
Children who slept less than 8 h 49 min/night obtained the most sleep gain from a 1 hour earlier bedtime maintained over a week. Maintenance over the longer term is unknown. Findings have implications for understanding the sleep requirements of children.
P048 Polysomnographic titration of non-invasive ventilation in motor neurone disease (3TLA): Protocol for a process evaluation of a clinical trial
Authors: Graco M , Berlowitz D , Sawyer A , Carey K , Holland A , Lannin N 
Published: November 2022

Abstract

Introduction
We are undertaking a multicentre randomised controlled trial to determine the effectiveness of including a sleep study (polysomnography, PSG) to assist the commencement of non-invasive ventilation (NIV) in people with motor neurone disease (MND); the PSG4NIVinMND trial. A process evaluation will be conducted alongside the clinical trial. The aim of the process evaluation is to understand: 1) the implementation of the PSG4NIVinMND intervention in the seven trial sites, including the barriers and enablers; and 2) the causal mechanisms through which the PSG4NIVinMND intervention produces change.

Methods
The process evaluation has a mixed-methods design, comprising qualitative and quantitative components, and is guided by two theoretical frameworks: RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) and the Theoretical Domains Framework (TDF). Qualitative data include semi-structured interviews with clinical trial participants (people with MND) and their carers, and focus groups and surveys with health professionals involved in delivering the intervention. Quantitative process data will also be collected from the clinical trial. Data will be analysed iteratively throughout the trial.

Results
Six of the seven sites have commenced recruitment to the PSG4NIVinMND trial. Baseline focus groups and surveys have been completed with health professionals from these sites. Data collection and analysis will continue until the PSG4NIVinMND trial has concluded.

Conclusion
This process evaluation will provide valuable insights into how the PSG4NIVinMND intervention was implemented in the trial sites, for whom and how the PSG4NIVinMND intervention was (and was not) effective, and how it could be implemented into routine clinical practice.
P057 Prevalence of poor sleep in First Nations peoples across the globe: A systematic review
Authors: Jabran D , Potia A , Smith S , Solomon S , Fernandez D , Fatima Y 
Published: November 2022

Abstract
This review aims to collate and assess the extant literature on the prevalence of sleep issues among First Nations peoples across the globe.
A systematic literature search, was conducted across key academic databases and grey literature sources to retrieve studies published until November 2021. Studies offering quantitative data on sleep issues in First Nations Peoples were included. The NIH Quality Assessment Tool was used to assess the methodological quality and an adapted version of the Indigenous Quality Appraisal tool was used to evaluate First Nations' engagement in research. Results: A total of 65 studies,(28 longitudinal, 37 cross-sectional) met the inclusion criteria for this review. The included evidence indicated that the First Nations Australians reported night-time awakenings (22%), severe daytime sleepiness (27%), short sleep duration (35%) and long sleep duration (41%). The Māori population from New Zealand consistently reported insufficient sleep (36%) and short sleep duration (28.6%). The First Nations Americans / Alaska Native populations reported insomnia (25% to 33%) and insufficient sleep (15% to 40%). The Cree First Nations from Canada had a higher prevalence of insomnia (38.5%) and sleep deprivation (25% to 40%). Most studies scored "quality" in quality assessment. However, First Nations' engagement in research could not be adequately assessed due to limited information.
The review findings highlight that a significant proportion of First Nations peoples are experiencing poor sleep. Considering the established link between poor sleep and adverse health outcomes, sleep health equity in First Nations communities should be a high priority for service providers and policymakers.
P059 Respiratory control stability in posttraumatic stress disorder
Authors: Jordan A , Tjondrorahardja E , Poon T , Felmingham K 
Published: November 2022

Abstract

Rationale
A recent meta-analysis indicated that 75.7% of individuals with posttraumatic stress disorder (PTSD) also suffer from obstructive sleep apnoea (OSA). The reason for the high prevalence of OSA in PTSD is currently unknown. This study investigated whether respiratory control stability (which is known to contribute to OSA in the general population) varies with PTSD symptoms.

Methods
First year University students were recruited and completed an online questionnaire battery including: Life Events Checklist (LEC), PTSD checklist for DSM-5 (PCL-5), Shortness of Breath Questionnaire (SOBQ) and Berlin Sleep Questionnaire. 1/3 of participants timed their maximum breath hold (performed at functional residual capacity) at home on 3 occasions using a stopwatch as per Messieno et al (2018).

Results
313 complete survey responses were obtained. The mean age of participants was 19.9 years and 214 respondents were women. 19 participants were at high risk of OSA based (Berlin Questionnaire) and 80 had probable PTSD (LEC items 1-16 “happened to me” or “witnessed it” plus PCL-5&gt;33). In the whole sample, there was a significant relationship between PTSD symptoms and Shortness of Breath (Pearson p&lt;0.001, r2=0.2). There was no relationship between PTSD symptoms and at-home measured maximum breath-hold duration (n=107, p=0.44, r2=0.006).

Conclusions
In an unselected University student population, posttraumatic stress disorder symptoms are associated with self-reported shortness of breath during everyday activities. However, there was no evidence of a relationship between a surrogate of respiratory control stability (maximum breath-hold duration) and PTSD symptoms.
P062 Agreement between arterial and capillary CO2 level in patients undergoing sleep study for suspected hypoventilation
Authors: Kafili D , Bashford J , Erigadoo S 
Published: November 2022

Abstract

Background
Measurement of arterial CO2 (PaCO2) is the gold standard for diagnosis of sleep hypoventilation during polysomnography. However, arterial PaCO2 measurement is a labour-intensive and painful. Previous audit in our unit demonstrated ABGs are often delayed or omitted when requested. Continuous monitoring of transcutaneous carbon dioxide (TcCO2) is often used as a surrogate marker of PaCO2, however caution should be applied in interpreting TcCO2 due to the “sensor drift” phenomenon. Arterialized capillary blood gas (CBG) measurement has been described in various settings and is used in many respiratory units. Concordance with ABG and TcCO2, however, is poorly described in the literature. A retrospective review was performed to assess concordance of arterialized capillary CO2 level (PcCO2) with TcCO2 measured during routine polysomnography.

Methods
This is a retrospective audit of patients with provisional diagnosis of sleep-related hypoventilation syndrome who attended Sunshine Coast University Hospital Sleep Disorders Centre for overnight sleep studies. Continuous TcCO2 was monitored and arterialized PcCO2 measured at the outset and completion of study. CO2 results will be compared to assess concordance. Where an ABG was performed simultaneously with a CBG the concordance will be reported.

Progress to Date
Full results to follow. It is anticipated that 30-40 patients will be included. Few ABGs were performed.

Anticipated outcome
Initial evaluation suggests PcCO2 may be a viable alternative to ABG based on concordance with limited ABG data. PcCO2 may be superior to TcCO2 due to the common phenomenon of TcCO2 “drift”. A prospective study, utilising ABG, CBG and TcCO2 is needed.