bluuebunny/crossref_metadata_2025_split huggingface dataset:
0207 Mothers’ Adverse Childhood Experiences and Protective Factors are Associated with Rest-activity Rhythms in their Children
Authors: Condon Eileen , Jeon Sangchoon , Sadler Lois , Redeker Nancy 
Published: May 2022

Abstract

Introduction
Mothers’ history of adverse childhood experiences (ACEs; e.g. maltreatment, household dysfunction) are associated with poor health outcomes in their children, but mechanisms underlying this intergenerational transmission are poorly understood. Given links between circadian rhythm and the stress-response system, we test the hypothesis that maternal ACEs influence child health through disrupted rest-activity rhythm (RAR) in the mother and child. We also explore whether mothers’ benevolent childhood experiences (BCEs) are protective against disrupted RAR.

Methods
We conducted a cross-sectional pilot study of maternal-child dyads with preschool-age children. Mothers reported history of childhood adversity (ACEs Scale, Childhood Trauma Questionnaire) and protective factors (BCE Scale). Dyads wore wrist actigraphs for 8-10 days and mothers completed daily electronic diaries. Nonparametric measures of RAR (e.g. interdaily stability [IS], intradaily variability [IV]) were calculated. We used linear regression to examine associations between mothers’ childhood history and maternal and child RAR measures, controlling for household size and maternal employment.

Results
Maternal-child dyads (N=20) identified as white (75%), Black (15%), and Hispanic/Latina (10%). Mean child age was 4.2 years (40% female). Average household size was 4.5 ±.1.1 and 65% of mothers were employed. Forty-two percent of mothers reported 1-2 ACEs and 25% reported 3 or more ACEs. Maternal childhood history was not associated with mothers’ RAR. However, maternal ACEs and CTQ total score were associated with decreased child IS (ACEs: β= -0.47, SE=0.01, p=.02; CTQ total: β= -0.53, SE=.01, p=.001) and increased child IV (ACEs: β=0.29, SE=.01, p=.051; CTQ total: β=0.38, SE+.00, p=.03). CTQ subscales revealed maternal childhood physical abuse (β= -0.54, SE=.01, p&lt;.0001), emotional abuse (β= -0.42, SE=.00, p=.002), and sexual abuse (β= -.73, SE=.00, p&lt;.0001) were associated with decreased child IS, while maternal childhood emotional neglect was associated with increased child IV (β= 0.39, SE=.01, p=.04). Maternal BCEs were associated with decreased child IV (β= -0.44, SE=.01, p=.03).

Conclusion
Maternal ACE history may influence child health through effects on children’s circadian rhythm (i.e. decreased synchronization, increased fragmentation), while maternal BCEs may protect against rhythm fragmentation. Additional research is needed to support these novel preliminary findings.

Support (If Any)
National Institute of Nursing Research (K99NR018876) and American Nurses Foundation.
0220 Changes in Light Exposure During the Daylight Saving Time to Standard Time Transition
Authors: Linton Sabrina , Withrow Dana , Wright Kenneth , Rodheim Katrina 
Published: May 2022

Abstract

Introduction
Although sunrise and sunset do not change, the Daylight Saving Time (DST) to Standard Time (ST) transition results in an earlier clock hour of sunrise and sunset. It has been hypothesized that ST results in brighter mornings and dimmer afternoons/early evenings compared to DST. However, how the time change from DST to ST influences light exposure measured at the level of the individual has not been quantified. Thus, we aimed to determine if the time change from DST to ST increases morning and decreases evening light exposure under typical living conditions.

Methods
25 young healthy adults [7 males (25.6±7.8yr; mean±SD)] completed a ~2 week-long at home protocol. Light exposure was collected with wrist worn Actiwatch Spectrum Plus (Philips Respironics, Bend, OR) one week prior and one week after the transition from DST to ST in Fall 2020. Participants were instructed to continue with their typical work/school schedule, to maintain a nighttime sleep schedule, and to not stay up all night throughout the study. Data were analyzed comparing light exposure levels in the morning (0600-1200h) and afternoon/early evening hours (1200-1800h) across the work/school week with mixed model ANOVA and planned comparisons assessed.

Results
A significant week by time-of-day by week interaction (p&lt;0.05) was observed showing brighter light exposure levels in the morning during the week after the change from DST to ST (p &lt; 0.01), whereas similar light exposure levels were observed in the afternoon/evening hours across weeks (p = 0.64).

Conclusion
Consistent with expectations, individuals were exposed to brighter mornings but contrary to expectations individuals were not exposed to dimmer afternoons/early evenings during ST versus DST. Early morning light exposure is important for entrainment of the on average longer-than-24-hour human circadian period to the 24h day, and for maintenance of sleep schedules that are conducive to work/school start times. Future research is needed to highlight the health, performance, and safety benefits of brighter morning light exposure demonstrated here during ST, especially given current efforts to end the time change between DST and ST.

Support (If Any)
0299 The Effects of Chronic Sleep Restriction on Calorie and Macronutrient Intake
Authors: Hilditch Cassie , Costedoat Gregory , Flynn-Evans Erin 
Published: May 2022

Abstract

Introduction
Chronic sleep restriction (CSR) has been associated with increased calorie intake and increased consumption of fats and carbohydrates, with inconsistent changes in protein. However, the majority of studies have either been observational field studies with no sleep intervention, or laboratory-based studies where food availability may not have reflected participants’ real-world choices. We hypothesized that calorie, fat, and carbohydrate intake would increase during a week of imposed CSR compared to a week of sleep satiation (SS) among individuals living in their home environment.

Methods
Twelve healthy participants (6 females) kept a fixed sleep-wake schedule, with a constant waketime, at home for four weeks (actigraphy confirmed compliance). During weeks one and three, participants maintained 9 hours in bed. During weeks two and four, participants were randomly assigned to experimental weeks of 5 and 9 hours of time-in-bed in a crossover design. Participants documented their food consumption during both experimental weeks using a picture-based meal logging application (MealLogger). Intake of calories and macronutrients were classified by two blinded evaluators. Descriptive statistics were calculated in SAS (Cary, NC).

Results
Participants averaged 4.43 ± 0.33 (SD) hours of sleep per night during CSR compared to 7.42 ± 0.42 hours during SS. Participants consumed a daily average of 1812 ± 672 kilocalories, 71 ± 31 grams of total fat, 217 ± 69 grams of carbohydrates, and 84 ± 40 grams of protein during CSR, compared to 1682 ± 514 kilocalories, 68 ± 23 grams of total fat, 198 ± 61 grams of carbohydrates, and 77 ± 32 grams of protein during SS.

Conclusion
Preliminary descriptive findings suggest that, on average, participants consumed more calories, from an increase in consumption of each macronutrient group, during a week of sleep restriction compared to a week of sleep satiation. Further analysis is needed to determine whether these differences are statistically different and to identify when calories were consumed in each of the experimental conditions.

Support (If Any)
Supported by the Force Health Protection Program of the Office of Naval Research (SAA2402925-1, Contract Award no. N0001418IP00050) and the NASA Airspace Operations and Safety Program, System-Wide Safety.
0332 Objective and subjective sleep quality in Mexican Americans and non-Hispanic Whites: the HABLE-Dormir Study
Authors: Leng Yue , Johnson Leigh , Stone Katie , Redline Susan , O'Bryant Sid , Yaffe Kristine 
Published: May 2022

Abstract

Introduction
The ongoing prospective Health & Aging Brain among Latino Elders (HABLE)-Dormir Study is designed to investigate the association between objective and subjective sleep quality and cognitive impairment among Mexican Americans and non-Hispanic Whites (NHWs).

Methods
We plan to recruit 1000 community-dwelling Mexican Americans and NHWs and elders (age 50 and above). Objective sleep duration and fragmentation were assessed by 7-day wrist actigraphy; presence of sleep disordered breathing (SDB) was determined using WatchPAT; and subjective sleep quality and excessive daytime sleepiness (EDS) were examined by Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS), respectively.

Results
To date, 367 participants have been enrolled (62% women, 45% Mexican Americans, mean age 67.3±8.4 years); 296 (81%) of the participants had normal cognition, 56 (15%) had mild cognitive impairment (MCI), and 15 (4%) had dementia. On average, participants had a mean sleep duration of 7.3±1.1 hours, sleep efficiency of 88.3±5.3%, and wake after sleep onset (WASO) of 55.2±29.3 minutes. Almost half (51%) of the participants had moderate to severe SDB defined by WatchPAT-derived respiratory event index (REI) &gt;=15, 54% had self-reported poor sleep quality (PSQI&gt;5), and 10% reported EDS (ESS&gt;=11). After adjustment for age, Mexican Americans had lower sleep efficiency (86.5% vs. 89.5%, p&lt;0.001) and greater WASO (63.6 vs. 48.9 minutes, p&lt;0.001), compared to NHWs. Sleep duration did not differ significantly among NHWs (7.2 hours) and Mexican Americans (7.4 hours); p=0.20. The prevalence of moderate to severe SDB was similar in NHWs (51.2%) and Mexican Americans (50.0%); p=0.84. Besides, NHWs and Mexican Americans had similar PSQI and prevalence of EDS.

Conclusion
In this initial analysis, Mexican Americans have worse objective sleep quality, but similar sleep duration, prevalence of SDB and subjective sleep quality as compared to NHWs. Continued investigations are needed to explore potential racial/ethnic disparities in sleep health and how differences in objective and subjective measurements vary by race and ethnicity.

Support (If Any)
0338 Association of Evening Circadian Preference and Languid/Flexible Circadian Type with Predisposing, Perpetuating Factors, and Treatment Acceptability in Patients with Chronic Insomnia Disorder
Authors: Singh Rupsha , Lenker Kristina , Calhoun Susan , Fernandez-Mendoza Julio 
Published: May 2022

Abstract

Introduction
Circadian factors may contribute to sleep difficulties among chronic insomnia disorder (CID) patients who do not otherwise meet full criteria for a circadian rhythm sleep-wake disorder, particularly delayed and advanced sleep-wake phase disorders. Current nosology suggests that using circadian preference measures can provide important diagnostic information and aid in differential diagnosis. However, there is a lack of research identifying clinical factors associated with circadian dimensions in patients with CID.

Methods
195 patients (45.50±15.99 years old, 66.2% female, 15.9% minority) with a diagnosis of CID and absent of any other sleep disorder were evaluated at the Behavioral Sleep Medicine (BSM) program of Penn State Health Sleep Research & Treatment Center. All patients completed measures of circadian preference and type, insomnia severity, arousability, sleep reactivity, pre-sleep arousal, sleep-wake schedule and incompatible behaviors, dysfunctional beliefs and attitudes, mood and stress, and insomnia treatment acceptability. Multivariable linear regression examined which predisposing, perpetuating and treatment acceptability factors were associated with each circadian dimension, while adjusting for age, sex, race/ethnicity and insomnia severity.

Results
About 30% of the sample was classified as evening, 29% as morning, 74% as languid, and 43% as flexible types. Sleep-wake irregularity was associated with eveningness (β=-0.276, p&lt;0.01), languidity (β=0.280, p&lt;0.01) and flexibility (β=0.184, p&lt;0.01). Pre-sleep cognitive arousal (β=-0.182, p&lt;0.01) and sleep expectations (β=-0.127, p&lt;0.05) were associated with eveningness. Negative cognitions about the consequences of insomnia (β=0.230, p&lt;0.01) and sleep expectations (β=0.268, p&lt;0.01) were associated with languidity. Sleep-incompatible behaviors (β=0.165, p&lt;0.05) and perceived stress (β=0.267, p&lt;0.01) were associated with flexibility, while trait anxiety (β=-0.137, p=0.058) and negative cognitions about the consequences of insomnia (β=-0.318, p&lt;0.01) were associated with rigidity. Less agreeability to pharmacotherapy over behavioral therapy was associated with morningness (β=0.129, p&lt;0.05), while greater agreeability to behavioral therapy over pharmacotherapy (β=-0.158, p&lt;0.05) was associated with rigidity.

Conclusion
Sleep-wake irregularity in patients with CID is a perpetuating factor strongly associated with evening and languid/flexible circadian types, while other predisposing and perpetuating factors can be also determined by circadian preference and/or type. Circadian measures in the evaluation of CID patients may help clinicians individualize BSM treatments, including patients’ acceptability.

Support (If Any)
0407 Early Efficacy With Once-Nightly Sodium Oxybate (ON-SXB; FT218): Post-hoc Analyses From REST-ON
Authors: Krahn Lois , Roy Asim , Winkelman John , Morse Ann Marie , Seiden David , Dubow Jordan , Gudeman Jennifer 
Published: May 2022

Abstract

Introduction
Extended-release once-nightly sodium oxybate (ON-SXB; FT218) is in development for adults with narcolepsy. In REST-ON, significant improvements on the Maintenance of Wakefulness test, Clinical Global Impression of Improvement rating, and number of weekly cataplexy episodes occurred with all analyzed ON-SXB doses vs placebo (week 3, 6-g dose; week 8, 7.5-g dose; week 13, 9-g dose; all P&lt;0.001). ON-SXB was superior to placebo on Epworth Sleepiness Scale (ESS) score and sleep quality and refreshing nature of sleep using visual analog scales (VAS; all P&lt;0.001). ON-SXB 4.5 g significantly reduced cataplexy episodes vs placebo at week 1 (P&lt;0.05). Post hoc analyses investigated ON-SXB efficacy on ESS score, VAS sleep quality, and VAS refreshing nature of sleep at weeks 1 and 2.

Methods
Participants in the double-blind, phase 3 REST-ON (NCT02720744) trial were ≥16 years old, had narcolepsy type 1 or 2, and were randomized 1:1 to ON-SXB (4.5 g, 1 week; 6 g, 2 weeks; 7.5 g, 5 weeks; 9 g, 5 weeks) or placebo. Participants recorded ESS scores and VAS for sleep quality and refreshing nature of sleep (1-100; 1=poor quality/unrefreshing sleep; 100=good quality/refreshing sleep) using electronic diaries. P-values were calculated using a mixed-effects model for repeated measures in the modified intent-to-treat (mITT) population (ie, participants receiving ≥1 dose of study drug having ≥1 efficacy assessment at week 3).

Results
In the mITT population (n=190; ON-SXB, n=97; placebo, n=93), baseline ESS scores were 16.6 and 17.5 with ON-SXB and placebo, respectively. At week 2, ESS score was significantly improved with ON-SXB vs placebo (P&lt;0.02) with numerical improvement seen at week 1. At baseline, sleep quality was 53.8 and 55.9 on VAS in the ON-SXB and placebo groups, respectively, and baseline refreshing nature of sleep was 46.5 and 49.9. At weeks 1 and 2, sleep quality (P&lt;0.01; P&lt;0.001) and refreshing nature of sleep (P&lt;0.05; P=0.001) were significantly improved for ON-SXB vs placebo.

Conclusion
Improvement in daytime sleepiness, sleep quality, and refreshing nature of sleep occurred with ON-SXB beginning the first week of treatment. Some patients may experience early narcolepsy symptom relief with ON-SXB.

Support (If Any)
Avadel Pharmaceuticals
0416 The Impact of Idiopathic Hypersomnia on Social and Romantic Relationships of Young Adults
Authors: Davidson Ryan , Blattner Margot , Scammell Thomas , Zhou Eric 
Published: May 2022

Abstract

Introduction
Idiopathic hypersomnia (IH) is a rare and debilitating neurologic disorder characterized by hypersomnolence, often beginning in adolescence. As IH has significant impacts on quality of life and may have greater social impact than narcolepsy, we studied how IH impacts social, romantic, and sexual relationships in young adults.

Methods
Young adults (18-39 years; N=106) with a self-reported IH diagnosis were recruited through national patient organizations. Participants completed an online survey to evaluate social, romantic, and sexual relationships, and communication with medical providers.

Results
Participants (mean=29.6 years; SD=5.2) were primarily female (90%), White/Caucasian (90%) and employed (80%). Almost all participants indicated that IH made social life or entering relationships more difficult (98% and 92%, respectively). Eighty-nine percent of participants indicated that IH had affected their sex life (“Too tired to engage in sexual activities or to feel aroused. …I want to sleep if I am in bed …”). IH symptoms impacted relationships in majority of participants (84%) and contributed to the breakup of a romantic relationship for almost 1 in 3 (32%). Rates of cohabitation and marriage were comparable to nationally representative samples. On the Multidimensional Scale of Perceived Social Support, participants reported receiving significantly more support from their significant others (mean=4.3; SD=1.8) compared to their family (mean=3.9; SD=1.6; p&lt;.05) or friends (mean=4.0; SD=1.6; p&lt;.05). There was no difference between the level of support received from family or friends (V = 2154; p =.77). Medical providers rarely asked about the social (34%) or sex lives (9%) of participants. In contrast, many participants wanted clinicians to ask about the impact of IH symptoms on social life (70%) and sex life (35%).

Conclusion
IH substantially impacts social and romantic health in young adults. Similar to findings in narcolepsy, individuals with IH appear to prioritize romantic partnerships over other personal relationships. Many participants were interested in discussing their social and sexual relationships with their medical providers. However, only a small proportion of clinicians ask about these relationships. To provide effective treatment for the whole patient, clinicians should be prepared to evaluate and provide further support for the social health of young adults with IH.

Support (If Any)
Jazz Pharmaceuticals.
0447 Racial disparities in patient outcomes and treatment engagement in cognitive behavioral therapy for insomnia among pregnant women
Authors: Kalmbach David , Cheng Philip , Pitts D'Angela , O'Brien Louise , Seymour Grace , Cuamatzi-Castelan Andrea , Bazan Luisa , Drake Christopher 
Published: May 2022

Abstract

Introduction
Insomnia affects over half of pregnant women, and epidemiological data suggest that insomnia rates are twice as high among black women relative to white women in pregnancy. Recently, cognitive behavioral therapy for insomnia (CBTI) has been supported as an efficacious intervention for prenatal insomnia. However, it remains unclear whether CBTI is equally efficacious across racial groups, which is necessary to help reduce race-related disparities in prenatal insomnia.

Methods
This study is a secondary analysis of a single-site trial. Thirty-nine women who self-identified as white (n=24) and black (n=15) completed CBTI during pregnancy. Insomnia was measured using the Insomnia Severity Index (ISI). Before CBTI, patients reported sociodemographics. Treatment outcomes were collected a week after completing treatment during pregnancy.

Results
Although racial groups did not differ in ISI before treatment, white patients reported significantly larger decreases in ISI relative to black patients after CBTI (-5.75 vs -2.13, p=.046). Notably, black women were less engaged in treatment than white women based on mean number of sessions attended (4.20 vs 5.54 sessions, p=.013). Even so, multivariate linear regression showed that posttreatment ISI was 4 points higher for black women than white women (b=4.10, p=.049) when controlling for baseline ISI (p=.001), obesity (p=.072), poverty (p=.091), sessions attended (p=.155), and short sleep (p=.406). Notably, 41.7% of white CBTI patients remitted relative to 26.7% of black CBTI patients, suggesting that white women are 56% more likely to remit from CBTI than black women.

Conclusion
Our data suggest that black pregnant women exhibit poorer response to digital CBTI than white pregnant women. Moreover, racial disparities in CBTI response during pregnancy were not attributable to differences in session attendance. We must identify barriers to treatment response in black women, thereby guiding refinement to CBTI to provide better care for black women during pregnancy.

Support (If Any)
Ameriican Academy of Sleep Medicine
0468 Predictors of Response to Digital CBTI in a Randomized Controlled Trial of Middle Aged and Older Adults with Insomnia
Authors: Gumport Nicole , Tutek Joshua , Tully Isabelle , Simpson Norah , Dietch Jessica , Zulman Donna , Rosas Lisa , Palaniappan Latha , Manber Rachel 
Published: May 2022

Abstract

Introduction
Digital CBTI (dCBTI) may serve as a good initial intervention in a stepped-care approach to treat insomnia. Understanding who is likely to respond to dCBTI can guide triaging of care, thus shortening wait times for those who most need to meet with an insomnia therapist. The purpose of this study was to examine baseline predictors of response to a dCBTI program after two months of access.

Methods
Participants were 173 middle aged and older adults with insomnia (M age=63.56 [SD=8.43], 76% female) who received the dCBTI SleepioTM for two months in the RCT of the Effectiveness of Stepped-Care Sleep Therapy in General Practice (RESTING) study. Baseline predictors included the Epworth Sleepiness Scale (ESS), Dysfunctional Beliefs and Attitudes about Sleep (DBAS), preference for treatment (digital vs. therapist-delivered), and comfort with technology. At baseline and two-month follow-up, participants completed outcome measures, including the Insomnia Severity Index (ISI) and the PROMIS-Sleep Related Impairment (PROMIS-SRI). Multilevel modeling was used.

Results
In the full sample, no predictors were associated with change on the ISI. Among our predictors, only higher DBAS scores were associated with a smaller reduction in PROMIS-SRI scores from baseline to two-month follow-up (Beta=-0.88, SE=0.35, p=0.01 , 95% CI=-1.57, -0.19). Among those who preferred digital CBTI (n=52), none of the predictors were associated with the ISI or PROMIS-SRI. Among those who preferred therapist-led CBTI (n=66), greater comfort with technology was associated with greater reduction on the ISI (Beta=-1.77, S =0.78, p=0.02 , 95% CI=-3.30, -0.24) and higher DBAS scores were associated with a smaller reduction on the PROMIS-SRI (Beta=-1.63, S =0.56, p&lt;0.01 , 95% CI=-2.73, -0.53).

Conclusion
The results highlight the importance of targeting dysfunctional beliefs and attitudes, which is consistent with research examining the DBAS in CBTI. Results also indicate that patient preference is an important factor to consider when triaging patients to insomnia care. While additional predictors should be examined, these preliminary findings indicate that dCBTI may be a good initial treatment option for those with high level of comfort using technology and lacking a preference for therapist-led CBTI.

Support (If Any)
R01AG057500 and T32MH019938