bluuebunny/crossref_metadata_2025_split huggingface dataset:
O031 Independent validation of a physiology-based model to predict oral appliance treatment outcomes
Authors: Dutta R , Tong B , Osman A , Eckert D 
Published: November 2022

Abstract

Background
Oral appliance therapy (OAT) is a well-tolerated treatment for obstructive sleep apnoea (OSA). However, efficacy varies. On average, OAT reduces OSA severity by ~50% leaving a substantial proportion of OAT patients either undertreated or untreated. Thus, a major clinical priority is to develop clinically feasible prediction tools to accurately predict which patients will respond to OAT and vice versa. Accordingly, we developed a model to estimate OSA endotypes and have adapted it to predict OAT outcomes. Here we used our recently developed physiology-based OAT prediction model to predict OAT responses in an independent validation sample.

Methods
91 people with OSA who were prescribed OAT by their treating physician had an in-laboratory diagnostic study followed by an OAT efficacy polysomnography after ≥4 weeks acclimatisation. 7 polysomnography variables from the diagnostic study plus age and body mass index were included in our machine learning based model designed to predict OAT response. Prediction performance characterises according to standard apnoea/hypopnoea index (AHI) definitions were assessed.

Results
Mean accuracy of the model to predict OAT responders vs. non-responders in this independent validation sample was high across different OSA treatment outcome definitions ranging from 70% (&gt;50% reduction in AHI), 79% (AHI&lt;10 events/h) to 95% (AHI&lt;5 events/h). Corresponding specificity was also high at 87%, 97% and 99%, respectively.

Discussion
These new findings provide additional support for the use routinely collected sleep study and clinical data with machine learning based approaches underpinned by OSA endotype concepts to help predict OAT treatment outcomes for people with OSA.
O033 Butyrylcholinesterase is a potential biomarker for Sudden Infant Death Syndrome
Authors: Harrington C , Al Hafid N , Waters K 
Published: November 2022

Abstract

Background
Autonomic dysfunction has been implicated in the pathophysiology of Sudden Infant Death Syndrome (SIDS). Butyrylcholinesterase (BChE) is an enzyme of the cholinergic system, a major branch of the autonomic system, and may provide a measure of autonomic (dys)function. This study was undertaken to evaluate BChE in infants and young children who had died from SIDS or Sudden Unexpected Death.

Methods
We measured BChE specific activity (BChEsa) in the eluate of 5μL spots punched from the dried blood spots (DBS) taken at birth as part of the newborn screening program. Results for each of 67 SUDI deaths classified by the coroner (aged 1 week – 104 weeks) = Cases, were compared to 10 date of birth - and gender-matched surviving controls (Controls), with five cases reclassified to meet criteria for SIDS.

Findings
Conditional logistic regression showed that in groups where cases were reported as “SIDS death” there was strong evidence that lower BChEsa was associated with death (OR=0·73 per U/mg, 95% CI 0·60 – 0·89, P=0·0014), whereas in the “Non-SIDS death” group there was no evidence of a linear association between BChEsa and death (OR=1·001 per U/mg, 95% CI 0·89 – 1·13, P=0·99).

Conclusion
BChEsa, measured in DBS taken 2-3 days after birth, was lower in babies who subsequently died of SIDS compared to surviving controls and other Non-SIDS deaths. We conclude that a previously unidentified cholinergic deficit, identifiable by abnormal BChEsa, is present at birth in SIDS babies and represents a measurable, specific vulnerability prior to their death.
O044 The association of the sleep regularity index with subjective cognitive function and academic skills in adolescents
Authors: Hand A , Stone E J , Lu S , Chacos E , Carskadon A M , Lockley W S , Wiley F J , Bei B , Klerman B E , Rajaratnam M W S , Phillips J K A 
Published: November 2022

Abstract
High-level cognitive function is essential for academic performance in adolescents. While obtaining sufficient sleep duration has been shown to support cognitive function less is known about the role of sleep regularity in cognitive function. We investigated how sleep regularity relates to self-report cognitive function in 179 Year 7 students (M±SD=12.81±0.41 years, 56% females) in Australia. Sleep/wake timing was measured via wrist actigraphy and daily sleep diaries over two-school-weeks. Sleep regularity was measured using the Sleep Regularity Index (SRI) calculated via actigraphy measured sleep (SRI range = 58-95). Self-report cognitive function was measured using the PROMIS Paediatric Cognitive Function questionnaire, which requires participants to self-report cognitive performance over the last four-weeks. Academic skills were measured using two-subtests (reading comprehension and numerical operations) from the Weschler Individual Achievement Test – Third Edition (WIAT-III). We found that adolescents with more regular sleep self-reported better subjective cognitive function (β = .39, p = .001), even when controlling for age, sex, circadian phase assessed using DLMO, and total sleep time. In contrast, average total sleep time (range = 5.78-11.30 hours) alone was not associated with subjective cognitive function (β = .06, p = .99). Higher self-reported cognitive function was also associated with improved reading and numerical ability on the WIAT-III (β = .42, p =.04; β = .37, p =.02, respectively). The SRI did not predict performance on the WIAT (p &gt;.05). Our findings suggest regular sleep may be important in supporting optimal cognitive functioning. These results have important implications for learning adolescence.
O050 Associations between sleep-wake state discrepancy and clinical characteristics in older adults with chronic insomnia before and after Cognitive Behaviour Therapy (CBTi)
Authors: Bensen-Boakes D , Scott H , Lack L , Lovato N 
Published: November 2022

Abstract

Introduction
Individuals with chronic insomnia often self-report more wakefulness and less sleep than is derived from objective measures, which is called sleep-wake state discrepancy (SWSD). This study investigated associations between SWSD and clinical characteristics in older adults with sleep maintenance insomnia before and after Cognitive Behaviour Therapy (CBTi).

Method
Seventy-three adults (female=53%, mean age=63.2, SD=6.3) were recruited. Participants completed sleep diaries and wore actigraphy for one week, as well as questionnaires related to sleep quality and daytime functioning immediately before and after CBTi. SWSD was calculated as the difference between subjective (sleep diary reported) and objective (actigraphy derived) total sleep time (TST) at pre- and post-treatment.

Results
Before treatment, SWSD was not associated with age or any clinical variables, ps &gt; .05. Following treatment, SWSD significantly reduced (p&lt;.001), despite no improvement in objective TST, and was significantly associated with improvements in insomnia severity (r=-.57), fatigue (r=-.26), sleep self-efficacy (r=.33), and beliefs about sleep (r=-.38), ps &lt; .05.

Discussion
These findings suggest SWSD does not correlate with any other routinely-measured clinical characteristic prior to treatment. Given the associations with treatment outcomes, the need to incorporate objective measures, in conjunction with sleep diary assessments, to determine the degree of discrepancy and therapeutically address using CBTi is warranted. Following treatment, the reduction in discrepancy was driven by sleep diary reported TST that more closely matched objective TST, which remained relatively unchanged from pre-treatment. This has important implications for CBTi and suggests improvements in the accuracy of perceived sleep is a major therapeutic mechanism.
O066 The Impact of Work Break Characteristics on Sleep Duration in Heavy Vehicle Drivers
Authors: Harris R , Beatty C , Cori J , Spitz G , Soleimanloo S , Peterson S , Naqvi A , Barnes M , Downey L , Shiferaw B , Anderson C , Tucker A , Clark A , Rajaratnam S , Howard M , Sletten T , Wolkow A 
Published: November 2022

Abstract

Introduction
Heavy vehicle drivers (HVDs) frequently experience reduced sleep due to travelling long distances under non-standard work hours. Short sleep in HVDs can increase risk of motor vehicle crashes and falling asleep while driving. This study sought to examine the influence of break duration between shifts, break onset time, and prior shift duration on HVDs’ total sleep time (TST) between consecutive work shifts, and the interaction between break duration and break onset time.

Methods
Twenty-seven HVDs’ sleep and shift work were monitored for up to nine weeks through actigraphy, sleep diaries, and work diaries. Differences in TST between consecutive shifts and days off were assessed. Linear mixed models and pairwise comparisons evaluated the impact of break duration, break onset time, and prior shift duration on TST between shifts.

Results
TST was significantly lower between consecutive shifts (M=6.38-hours) compared to days off (M=7.63-hours), p&lt;.001. Longer break durations were associated with more TST, p&lt;.001. Break durations up to 7-, 9-, and 11-hours resulted in, on average, 4.76-, 5.66-, and 6.41-hours of sleep, respectively. Breaks starting between 00:01-08:00h led to shorter TST compared to breaks starting between 16:01-20:00h, p&lt;.05. Prior shift duration and the interaction between break duration and break onset time were not associated with TST.

Discussion
HVDs’ TST between workdays are independently impacted by break duration and break onset time. Break durations between 7-11-hours, reflecting Australian and European break guidelines, result in insufficient sleep. Work regulations must evaluate appropriate break durations and break onset times to allow adequate sleep in HVDs.
P006 Case study: Dancing eyes post COVID-19 vaccination
Authors: Aiyappan V , Windler S 
Published: November 2022

Abstract

INTRODUCTION
We describe a case of rapid eye movements in NREM sleep in a patient who had Guillain-Barre Syndrome (GBS) post AstraZeneca ( AZ) COVID-19 vaccine. This has not been reported previously.

METHOD
An 81-year-old male with recent diagnosis of GBS secondary to AZ COVID-19 vaccination was referred of investigation of sleep disordered breathing. A Level 2 PSG showed rapid eye movements in the absence of atonia predominantly during N1 sleep. A second study one month later confirmed the persistence of the eye movements.

RESULTS
Study 1 revealed mild supine and REM-predominant obstructive sleep apnoea (AHI = 14.9/hr) with reduced REM latency (44.5 minutes) & slow wave sleep (1.6%). Study 2 showed normal REM latency (61.5 minutes). REM indices were 0.33 per minute of N1 sleep and 0.12 for N2 sleep. REM density was 3% during N1 and 0.55% in N2.

DISCUSSION
COVID-19 vaccinations have been associated with various side-effects, some of which have been attributed to autoimmune response. A previous study on GBS patients reported sleep architecture abnormalities including sleep onset REM periods and abnormal eye movements in NREM sleep, during acute phase attributed to autonomic dysfunction and transitory hypocretin-1 transmission reduction . Our patient had almost completely recovered from GBS when we performed Study 1. We believe this to be the first case of abnormal eye movements in sleep being identified on polysomnography in a patient with GBS following AZ Covid-19 vaccination
P012 The content and impact of dreams during late pregnancy – a qualitative exploration
Authors: Baddock S , Patterson J , Bilous E , Miller S 
Published: November 2022

Abstract

Background
While dreams are part of healthy sleep there remains controversy about their interpretation - whether intertwined with waking life or as structurally distinct. During pregnancy, dreaming has been correlated with emotional state and is often more frequent, vivid and disturbing, but there is little qualitative exploration of the content and impacts of pregnancy dreams.

Objective
The aim of this study was to explore dreaming experiences during late pregnancy.

Methods
Ten pregnant people (32-39 weeks gestation) with no diagnosis of a sleep disorder were recruited for a qualitative study describing experiences of sleep in late pregnancy, including exploration of their dreams. Following informed consent, semi-structured interviews were conducted face-to-face or via videoconference. Interviews were audio-recorded, transcribed, and analysed thematically. Analysis of dreaming data is presented.

Results
Participants were of New Zealand European (8) and European (2) background. Several experienced more frequent, often intense and impacting dreams, which included more sexual dreams, dreams perceived to be preparing for the future (for birth, baby and parenthood) and dreams associated with anxiety (about birth or losing the baby). These dreams were often disturbing and sometimes led to ongoing stressful thoughts the next day.

Conclusion
Dreams during late pregnancy tend to be more frequent and graphic, and may represent underlying anxieties or impact on emotional wellbeing. Whilst for some, intense dreams may be seen as a normal part of pregnancy, for others dreams in pregnancy can be disturbing and warrant discussion and exploration with health professionals to potentially resolve anxieties around pregnancy and birth.
P015 Improving sleep health management in primary care: A potential role for community nurses?
Authors: Basheti M , Bawa Z , Grunstein R , Grivell N , Saini B , Gordon C 
Published: November 2022

Abstract

Background
Community nurses commonly care for a diverse patient population, often with complex chronic diseases. Sleep health is a key contributor to overall wellbeing and sleep disturbances/disorders frequently co-exist with comorbidities and can hasten disease progression. Community nurses are therefore ideally situated to care for sleep disturbed patients, but to what degree this is currently being undertaken is not known.

Objectives
To explore community nurses’ current sleep health practices and to look into their perspectives around potential change that can improve sleep health care provision.

Methods
Qualitative semi-structured interviews were conducted with nurses working in community settings. Interviews were audio recorded, transcribed and thematically analysed.

Results
Twenty-three Australian community nurses were interviewed. Participants frequently encountered patients with sleep disturbances/disorders with insomnia and sleep apnea being the most common presentations. Data analysis yielded three themes: 1) Sleep health in the community serviced, 2) Sleep health awareness and management, 3) Community nurses A to ZZZ of improving sleep health. Whilst sleep apnea appeared to be managed appropriately, insomnia was often mismanaged. Participants described their sleep health knowledge as deficient with the majority advocating for increased sleep-related education. Other important factors for improved sleep health care were standardised treatment/referral pathways, increased health professional collaboration and sufficient patient consult time.

Conclusion
Community nurses commonly care for patients requiring increased sleep health care. However, they are currently underequipped to do so. Providing community nurses with appropriate resources, such as sleep-related education and standardised treatment frameworks could enable them to better manage sleep disturbance/disorder presentations.
P032 The Health Belief Model for Shift Workers Scale: The development and validation of a novel metric for use in shift working populations
Authors: Crowther M , Ferguson S , Gupta C , Reynolds A 
Published: November 2022

Abstract

Introduction
Shift work is associated with circadian misalignment, sleep loss and suboptimal health behaviours, which may contribute to longer term negative health outcomes. interventions based on behavioural models may improve health behaviours in shift workers. To implement and evaluate these interventions, a validated metric based on behavioural theory specifically for use with shift workers would be beneficial. The present study aimed to develop and evaluate the Health Belief Model for Shift Workers (HBM-SW) scale.

Methods
The HBM-SW development involved a seven-step process, including a literature review, expert panel analysis, cognitive interviews with shift workers, and administration to pilot sample of shift workers (n=153). Validation of the HBM-SW was compared to Pittsburgh Sleep Quality Index, International Physical Activity Questionnaire and Food Frequency Questionnaire.

Results
Utilising exploratory factor analysis for factor identification and item reduction, the developed scale loaded on seven factors in line with the theoretical framework of the Health Belief

Model
Perceived Threat, Perceived Severity, Perceived Benefits, Perceived Barriers, Cues to Action, Self-Efficacy and Health Motivation. The HBM-SW showed good – excellent (α =0.74-0.93) internal consistency and moderate – good (ICC =0.64-0.89) test re-test reliability. Using health behaviour outcome measures, the HBM-SW scale showed meaningful correlations with sleep quality, sleep duration, diet quality and leisure time physical activity, and acceptable validity and reliability.

Conclusion
Further testing should be conducted in a larger sample to facilitate confirmatory factor analysis. The Health Belief Model for Shift Workers scale is likely to be beneficial for in future studies of interventions for shift workers.
P055 Hospital admission rates and mortality among Indigenous patients with OSA – Top End Northern Territory perspective
Authors: Howarth T , Heraganahally S 
Published: November 2022

Abstract
Obstructive sleep apnoea (OSA) is highly prevalent among the Australian Indigenous population. Among other populations OSA has been linked to an increased risk of cardiac and respiratory disease and hospital presentations. It is plausible that CPAP adherence would reduce this risk. However, no such literature exists pertaining to the Indigenous Australian population.
Indigenous Australian patients with OSA (assessed 2011-2020) and at least one hospital recorded (assessed 2011 – 2021) were included. ICD codes were used to assess hospital presentations and defined as Respiratory, Circulatory or Metabolic.
Metabolic related hospital presentations were the most common (3,111 presentations, 66% of patients) followed by Circulatory system (1,900 presentations, 51% of patients) and Respiratory system (1,373 presentations, 45% of patients). Among the patients who had at least one of each respective presentation, the median number and rate of presentations was highest for Metabolic issues (median 4 presentations, rate 1.19/year), followed by Circulatory issues (median 3.5 presentations, rate 0.91/year) and Chronic Respiratory issues (median 3 presentations, rate 0.7/year). Adherence to CPAP significantly decreased the rate of Respiratory related presentations (beta -1.07 (95% CI -1.9, -0.2)).
A high rate of hospital presentations exists among Indigenous Australian patients with OSA. Promoting the use of CPAP among Indigenous Australian patients may aid in reducing morbidity and mortality.
P056 REducing Sleep Apnoea for the PrEvention of Dementia (REShAPED): The protocol of a multi-site feasibility randomised controlled trial
Authors: Hoyos C , Phillips C , Yaffe K , Martins R , Marshall N , Lagopoulos J , Jackson M , Mowszowski L , Grunstein R , Naismith S 
Published: November 2022

Abstract

Background
Obstructive sleep apnoea (OSA) is estimated to occur in up to 70% of older adults. There is accumulating evidence linking OSA with increased risk of cognitive decline and dementia. Here, we present the protocol for a pilot multi-site randomised controlled, parallel open-label trial which will evaluate the feasibility for a full-scale trial investigating the effects of treating OSA on cognitive decline in older adults at risk for dementia with OSA within memory clinic settings.

Methods
We will randomise 180 older adults to either the intervention group or to the control group for 2 years. Inclusion criteria include: 50-75 years; mild-severe OSA (defined average ODI≥10 with 3% oxygen desaturation determined by wrist oximetry over two nights); and subjective cognitive complaints or mild cognitive impairment. The treatment intervention arm intends to achieve an optimal treatment response based on reducing hypoxic burden with either CPAP, mandibular advancement splint, positional therapy, or oxygen therapy. Furthermore, participants will receive up to 8 sessions which involve motivational interviewing and collaborative goal setting to support OSA treatment adherence, and behavioural sleep management. The control arm will not receive OSA treatment as part of this trial, however there will be no OSA treatment restrictions, and any treatment pursued outside the trial will be documented. Primary outcomes are 1) acceptability of the trial participants; 2) alleviating hypoxic burden by reducing OSA severity; 3) tolerability of the outcome assessments. Secondary outcomes include safety and cognitive function. Outcomes will be collected at 0, 6 and 24-months.
P061 RAPID-OSA Study: Remote ApneaLink Providing Immediate Diagnosis of Obstructive Sleep Apnoea
Authors: Kafili D , Tay G 
Published: November 2022

Abstract

Introduction
In-laboratory polysomnography (PSG) is the gold standard for diagnosis of obstructive sleep apnea. However, studies showed portable sleep monitoring devices can reliably substitute PSG in patients with a high pre-test probability of moderate-to-severe OSA. In this prospective study, we assessed utility of ApneaLink for diagnosis of OSA in patients living in rural and remote QLD.

Method
Thirty-five patients, living in rural and remote QLD were included in the study. ApneaLink device with clear instructions was sent to patients via registered post for being worn for a single typical night. Results were analysed and patients were reviewed post study.

Progress to date
The study population included thirty five patients (58.8%) male with a mean age of 53.2 years old and median body mass index of 36 kg/m2. The mean time between receiving referral to concluding ApneaLink study was 56 days. This is statistically significant compared to our previous experience in 2017 with mean wait time of 153 days for in-laboratory sleep study (p-value 0.0001).
There was significant reduction in expenses in patients underwent level three sleep study compared to PSG. Total postage cost of our study was 1107 Aud with each AL device price of 350$ while in-laboratory study costs 2338$ per night.

Conclusion
AL has shown substantial cost effectiveness in diagnosis of OSA in patients with uncomplicated moderate to high pre-test probability by eliminating travel cost and reducing in-laboratory sleep study requirement. Full results to follow.