bluuebunny/crossref_metadata_2025_split huggingface dataset:
P046 The Utility of Maintenance of Wakefulness Test (MWT) in Paediatric Narcolepsy
Authors: Gonski K , Thambipillay G , Williamson B , Teng A 
Published: November 2022

Abstract

Introduction
The Maintenance of Wakefulness Test (MWT) has been used as an objective measure of the ability to stay awake and can be used to assess effectiveness of treatment. There are no universally accepted guidelines for assessing effective treatment or driving readiness in adolescents with narcolepsy and there is only limited data published on the use of MWT in children. The purpose of this study is to present a single-centre experience recording the use of MWT in a paediatric series.

Methods
This study reviewed the charts of children with narcolepsy who had an MWT performed between April 2014-January 2022. Demographics, clinical characteristics, MWT findings, change in management and driving status were obtained.

Results
MWT-40 minute protocol was used on 12 children with narcolepsy (median age 16.38 years, range 15.92 – 18.97years), of which 9 (75%) had cataplexy and four (33%) were males. The MWT was used to assess response to treatment and driving suitability. Two (17%) fell asleep during the 4 wake-trials. The median mean sleep latency for all studies was 16.88 minutes (range 5.75-28 minutes). In these two patients, findings from the MWT resulted in changes in management. Eight obtained their learners-driver’s licence after the

MWT
Five signed “driving contracts” with their physician.

Discussion
Our result suggests that the MWT has clinical usefulness in evaluating responses to treatment in adolescents with narcolepsy. Changes in management occurred in all patients who failed MWT. This test was used in half patients to help determine readiness for driving in this group.
P050 Sleep, Eat, Comment, Repeat: Understanding the influence of sleep on the eating behaviours of shiftworkers through comments on Facebook
Authors: McIntosh E , Gupta C 
Published: November 2022

Abstract

Introduction
Shiftworkers experience altered sleeping patterns and eating habits compared to dayworkers. This leads to long-term negative health outcomes. While characteristics of shiftwork, such as work hours and food availability, impact eating habits, the impact of altered sleeping on the eating behaviour of shiftworkers is unknown. The aim of this study was to explore how sleep patterns impact the eating behaviour of shiftworkers through the analysis of Facebook comments.

Methods
The Facebook search function was used to identify posts relating to shiftwork, sleep, and food on public pages. Comments were collected if they were posted by self-identified shiftworkers, relatives of shiftworkers, or partners of shiftworkers. Thematic analysis was conducted on all comments to identify themes relating to sleeping and eating.

Results
144 comments were collected and analysed. Comments reported feelings of sleepiness as motivating the choice for unhealthy foods and the choice to eat large quantities of food. Multiple comments also discussed how unhealthy food on shift contributed to poor sleep post-shift.

Discussion
Given that, in a naturalistic environment like Facebook, shiftworkers display an understanding of an influence of sleepiness on food choice, interventions can move past making shiftworkers aware of poor sleeping and eating patterns and move to strategies that optimise the timing of these behaviours. Such strategies should consider the relationship between sleep and eating to inform strategies to promote healthy eating patterns together with healthy sleep, with the goal of improving shiftworker health and safety.
P052 Treatment preferences and help seeking behaviours of Australian adults with insomnia symptoms
Authors: Haycock J , Lack L , Hoon E , Sweetman A , Appleton S , Loffler K , Scott H , Lovato N 
Published: November 2022

Abstract

Introduction
Clinical guidelines for the treatment of insomnia recommend Cognitive Behavioural Therapy for insomnia (CBTi) as the first-line treatment, ideally provided by a psychologist. However, previous research shows most people with insomnia are not referred to a psychologist, and many are prescribed sedative-hypnotic medicines. This study surveyed people seeking treatment for insomnia to better understand their help-seeking behaviours and treatment preferences.

Methods
A total of 745 Australian adults seeking treatment for insomnia (Age M = 54.46, SD = 13.39, 69% female) completed an online survey about sleeping difficulties, help seeking behaviours, and treatment preferences. Insomnia Severity Index (ISI) scores of 15+ were used to identify people with chronic insomnia. Open ended questions allowed participants to provide detailed qualitative information. Content analysis was used to analyse these data.

Results
Preliminary findings show 64% of participants with insomnia discussed sleep with their GP in the past year but only 16% received a referral to a psychologist or CBTi (7%). Reasons for not seeing a psychologist include GP had not referred (43%) and cost concerns (25%). Only 13% of participants who selected CBTi as their preferred treatment had been able to access this treatment.

Discussion
Most people in Australia who are seeking treatment for insomnia discuss sleep with their GP, but do not receive a referral to a psychologist. Understanding the help seeking behaviours and treatment preferences of people with insomnia symptoms will help identify barriers in the management of insomnia, and ensure more people have access to evidence-based treatment.
P054 Effects of treatment of sleep disordered breathing on actigraphic sleep measures and daytime functioning in children with Down syndrome
Authors: Horne R , Shetty M , Davey M , Walter L , Nixon G 
Published: November 2022

Abstract

Background
Children with Down syndrome (DS) are at increased risk of obstructive sleep disordered breathing (SDB), which is associated with sleep disruption affecting daytime functioning. We examined the effects of treatment of SDB on sleep and daytime functioning in children with DS.

Methods
Children with DS and SDB (n=34) completed a baseline and follow-up study which included 7 days of actigraphy in conjunction with a parental sleep diary. Parents also completed a number of questionnaires assessing sleep, behaviour, daytime functioning and quality of life (QOL). All children had overnight polysomnography (PSG) at baseline and 24 had PSG at follow-up.

Results
15 children (44%) were treated. At baseline the treated group had more severe SDB at baseline compared to the untreated group: obstructive apnoea hypopnoea index (OAHI) 29.3 ± 38.2 events/h vs 3.3 ± 5.2 events/h (p&lt;0.01). Actigraphy showed no significant differences in total sleep time or sleep efficiency from baseline to follow up in either the treated or untreated group. Wake after sleep onset increased at follow-up in the untreated group (p&lt;0.01). The sleep disturbance (p&lt;0.01) and total problems (p&lt;0.05) scales on the OSA-18 and the SDB subscale on the Pediatric Sleep Problem Survey Instrument (p&lt;0.01) improved in the treated children. No changes were seen in any of the measures in the untreated children.

Conclusions
Treatment of SDB improves QOL, despite treatment having no demonstrable impacts on actigraphic sleep measures. In contrast despite having less severe SDB children who were untreated had no improvements in QOL and increased sleep disruption.
P064 Process O May Contribute to the 90 min NREM/REM Sleep Cycles
Authors: Lack L , Lovato N 
Published: November 2022

Abstract
The mechanism responsible for the ubiquitous NREM/REM sleep cycles of approximately 90-min period length in humans remains largely unknown. It was originally said to be a product of the 90-minute Basic-Rest-Activity-Cycle (BRAC) assumed to pervade throughout sleep and wakefulness. However, the evidence for the existence of the BRAC during wakefulness is weak and questionable. It is important to consider other possible contributors to this fundamental sleep cycle process.
Process O (state onset, offset) has been suggested to account for empirical data inexplicable by Processes S and C. The data in question is the significant increase in alertness following a brief nap (&lt;10min sleep) and the longer than predicted sleep episodes (40-90 min) following a brief awakening towards the end of a normal sleep period.
Process O is proposed to operate similarly to Process S but with a build-up of inhibition to an ongoing state (wake or NREM sleep or REM sleep) that is rapid but self-limiting after 1-2 hours. It also has a rapid (~10min) dissipation of inhibition to the previous state with the offset of that state such that resuming the previous state (onset) rejuvenates the functions of that previous state (wakefulness, NREM, or REM sleep).
In operation during the sleep period Process O accumulates inhibition to NREM sleep over the first 80-100 minutes enough to flip the ‘sleep switch’ to another state (REM sleep). Only a brief period (5-10min) is needed to dissipate NREM inhibition such that NREM, still stronger than REM, can resume another cycle.
P066 A randomised, double-blind, placebo-controlled, single-dose, crossover, pilot study investigating the effects of cannabinol (CBN) 30 mg and 300 mg on sleep architecture and next-day function in insomnia disorder
Authors: Lavender I , Suraev A , McCartney D , Irwin C , Kevin R , D'Rozario A , Gordon C , Marshall N , Saini B , McGregor I , Grunstein R , Yee B , Hoyos C 
Published: November 2022

Abstract

Introduction
There is a clear need for novel interventions for insomnia disorder. Growing evidence suggests a role of the endogenous cannabinoid system in regulating circadian sleep-wake cycles, highlighting a potential avenue for novel therapeutics. Cannabinol (CBN), a trace cannabinoid formed through oxidation of delta-9-tetrahydrocannbinol (THC), is hypothesised to impact sleep. Despite anecdotal and preclinical evidence, the effects of CBN isolate on sleep have never examined through well-designed clinical trial procedures.

Methods
This randomised, double-blind, placebo-controlled, three-arm, crossover, single-site, pilot study will investigate the acute effects of oral dose CBN at 30 and 300 mg in twenty patients with clinician-diagnosed insomnia disorder (and Insomnia Severity Index [ISI] Score ≥15). Across three treatment sessions, each separated by two-weeks washout, participants will receive two doses of CBN and matched placebo, at random. Participants will undergo overnight sleep assessment using in-laboratory polysomnography and next-day neurobehavioral function tests. The primary outcomes are CBN (30 and 300 mg) effects on sleep continuity (wake after sleep onset minutes), compared to placebo, measured using polysomnography. Secondary outcomes include changes to sleep micro-architecture, traditional sleep staging, and absolute spectral power during non-rapid eye movement sleep. Various other subjective and objective safety measures will be obtained.

Discussion
This study will provide novel preliminary data on the effects of CBN on sleep and next-day function in adults living with insomnia disorder which will inform the design of larger clinical trials.
P071 Actigraphy-Derived Rest-Activity Rhythms Predict Sleep-Related Self-Report Outcomes in Women Receiving Chemotherapy for Breast Cancer
Authors: Maccora J , Bean H , Phillips A , Diggens J , Ftanou M , Alexander M , Stafford L , Francis P , Bei B , Wiley J 
Published: November 2022

Abstract

Introduction
Circadian rest-activity rhythms (RARs) disruption is common during chemotherapy for breast cancer, but little is known regarding its association with sleep and daytime functioning. In this study, we evaluated whether objectively-assessed RARs prospectively predict self-reported insomnia and fatigue symptoms, daytime sleep-related impairment, and sleep disturbance.

Methods
This is a secondary analysis of a trial. Participants (N=101) were randomized to cognitive behavioural plus light therapy or relaxation audios. Participants wore an actigraph continuously throughout the 6-week intervention. RAR indices (interdaily stability, intradaily variability, relative amplitude, least active 5h period [L5], most active 10h period [M10]) were calculated based on two weeks (4 & 5). Self-reported outcomes were assessed at weeks 3 and 6. Self-reported outcomes at week 6 were predicted by RAR indices controlling for self-reported outcomes at week 3 and intervention condition.

Results
Lower L5 predicted lower self-reported insomnia and fatigue symptoms, sleep-related impairment, and sleep disturbance (all p&lt;.05). With the exception of insomnia symptoms (p&gt;.05), higher inter-daily stability predicted lower symptoms of fatigue, sleep-related impairment and sleep disturbance (all p&lt;.05). Similarly, excluding sleep disturbance (p&gt;.05), higher relative amplitude predicted fewer endorsed symptoms on self-reported measures (all p&lt;.01). Neither M10 nor intradaily variability predicted self-reported outcomes (all p&gt;.05).

Discussion
RAR disruption demonstrated the most reliable association with daytime sleep-related complaints. The entrainment of a robust diurnal rhythm may reflect a novel intervention target. Direct intervention on distinct RAR characteristics may yield secondary gains on several self-reported sleep-related outcomes, particularly those related to daytime functioning.

Trial Registration
ACTRN12618001255279
P072 Predicting vigilance in a shift-work context with under-mattress sensor data from the preceding sleep
Authors: Manners J , Guyett A , Stuart N , Nguyen P , Lechat B , Eckert D , Kemps E , Catcheside P , Scott H 
Published: November 2022

Abstract

Introduction
Performance impairments are risky in many industries, including healthcare and defence. Predicting when impairments are more likely to occur is critical to reduce costly workplace accidents and errors. This study created models for predicting vigilance during simulated night shift-work from under-mattress sleep sensor data.

Methods
The parent study compared two conditions for phase delaying individuals to adjust to night shift-work. Participants (N=11) attended the laboratory for eight days per condition, one month apart. After a baseline sleep (10PM-7AM), participants remained awake for 27hrs, then slept from 10AM-7PM for the next four days with sleep metrics recorded by an under-mattress sensor (the Withings Sleep Analyzer). At night, participants completed simulated night shifts, including six psychomotor vigilance tasks (PVTs) per shift (48 resulting datapoints per participant). The current study predicted PVT performance from the preceding daytime sleep based on 27 sleep variables using machine learning (Extra trees) models. Data were randomly split into a 67% subset for model training and variable reduction, and a 33% subset for testing model fit.

Results
12 variables were retained following feature reduction. The final models demonstrated good fit for reaction time &lt;500ms (R² = 0.79, RMSE = 20.4ms), reciprocal reaction time (R² = 0.70), and number of lapses (R² = 0.69).

Discussion
These preliminary findings are comparable to current fatigue prediction models, supporting that vigilance can be predicted from unobtrusively collected sleep data. Further research will confirm whether these models may assist in the safer delegation of work tasks and self-management of shift-workers.
P075 Feasibility of 12 weeks melatonin supplementation in Mild Cognitive Impairment
Authors: Menczel Schrire Z , Phillips C , Duffy S , Marshall N , Mowszowski L , LaMonica H , Gordon C , Naismith S , Grunstein R , Hoyos C 
Published: November 2022

Abstract

Introduction
Melatonin has been hypothesised to slow cognitive decline in older adults due to its proposed multiple therapeutic benefits.

Methods
Participants with Mild Cognitive Impairment (MCI) were recruited from the community for a pilot 12-week randomised placebo-controlled trial of 25mg oral melatonin to target brain oxidative stress and cognition. Primary outcomes were feasibility, acceptability, and tolerability. Secondary outcomes were brain oxidative stress (magnetic resonance spectroscopy) and cognition at 12 weeks.

Results
The study recruited 40 participants who were randomised to receive melatonin or placebo. Feasibility of recruitment, calculated by the percent of individuals who met inclusion and exclusion criteria on screening, was 42/389, 11%. The most common exclusion criteria met was age. Acceptability of intervention, defined as the number of participants who agreed to be randomised, was 40/42, 95%. At 12 weeks, adherence data collected by both medication diaries and pill counting was over the 80% threshold for all participants. Additionally, 38 participants completed MRI scans and 40 participants completed the cognitive assessment battery, providing preliminary data to support future trials.

Discussion
The results of this feasibility trial demonstrate challenge to find individuals in the general community that fit the criteria for MCI. However, once recruited, this population has shown the ability to follow the protocol and adhere to the trial medication. These results will inform a future definitive randomised controlled trial to specifically test the efficacy of melatonin on modifiable risk factors of dementia, as well as cognition and brain function.
P076 Safety of higher doses of melatonin in adults: A systematic review and meta-analysis
Authors: Menczel Schrire Z , Phillips C , Gordon C , Naismith S , Marshall N , Grunstein R 
Published: November 2022

Abstract

Introduction
Melatonin is commonly used for sleep and jetlag at low doses. There is less documentation on the safety of higher doses which are being increasingly used for a wide variety of conditions. This systematic review aimed to investigate the safety of higher doses of melatonin in adults.

Methods
We searched Medline, Scopus, Embase and PsycINFO databases from study inception until December 2019 with convenience searches until October 2020. The inclusion criteria were randomised controlled trials investigating high-dose melatonin (≥10mg) in human adults over 30 years of age. The outcomes examined were the number of adverse events (AEs), serious adverse events (SAEs) and withdrawals due to AEs. A meta-analysis was conducted on studies lasting 3 months or longer.

Results
79 studies were identified with a total of 3861 participants. 29 studies (37%) made no mention of the presence or absence of AEs. Only 4 studies met the pre-specified low-risk of bias criteria for meta-analysis. In that small subset, melatonin did not cause a detectable increase in SAEs (Rate Ratio=0.88 [0.52, 1.50], p=0.64) or withdrawals due to AEs (0.93 [0.24, 3.56], p=0.92), but did appear to increase the risk of AEs such as drowsiness, headache, and dizziness (1.40, [1.15, 1.69], p&lt;0.001).

Discussion
There has been limited AE reporting from high-dose melatonin studies. Based on this limited evidence, melatonin appears to have a good safety profile. Better safety reporting in future long-term trials is needed to confirm this as our confidence limits were very wide due to the paucity of suitable data.
P079 A new lens on preschool sleep: Using wearable cameras to capture pre-bedtime activities
Authors: Miller L , Kuroko S , Meredith-Jones K , Taylor R , Taylor B , Russell-Camp T , Smith C , Galland B 
Published: November 2022

Abstract

Introduction
While bedtime routines are often recommended to address behavioural sleep problems in young children, these recommendations are based on parental subjective assessment of behaviours which may not be accurate. The aim of this study was to establish the feasibility of using wearable cameras to objectively measure bedtime routines and pre-bedtime screen use in preschool-aged children.

Methods
Sixteen children aged 3-4 years wore a GoPro video camera for two hours prior to bedtime on three consecutive evenings. Subsequent sleep parameters were monitored for seven nights by actigraphy. Standardised questionnaires and a sleep diary provided traditional measures of child sleep behaviours. Feasibility was determined by adherence to protocol and ability to develop a reliable behavioural coding scheme from the video data. Acceptability was determined through feedback questionnaires and exit interviews.

Results
Participant families found the cameras acceptable, with the majority of parents agreeing the cameras were easy to use (94%) and keep on their child (81%). Parents felt that wearing the camera did not change how they parented their child (88%), or their child’s behaviours (81%). A behavioural coding scheme incorporating self-care activities, nutrition, reading, physical contact and screen use (time, device type, media content) was successfully developed with interrater reliability established by two independent coders (kappa &gt;0.8).

Conclusions
Wearable cameras provide a feasible and acceptable method to measure bedtime routines and screen use in preschool-aged children. This appears to be is the first study to use wearable cameras to objectively measure pre-bedtime activities in this age-group.
P080 State-dependency of nocturnal swallowing in healthy adults: Incidence, motor function and coordination with breathing
Authors: Monroe M , Carter S , Eckert D , Wallace E , Bilston L , Hudson A , Butler J , Gandevia S , Kerr G , Burke P 
Published: November 2022

Abstract

Introduction
Swallowing involves a complex motor pattern and coordination with breathing and other oro-motor behaviors. Sleep has major depressive effect on many of the motor neuronal pools that facilitate swallowing, particularly upper airway muscles. This study examines the state-depedence of the swallow motor program and coordination with breathing.

Methods
Adult subjects recruited from community undertook an overnight sleep laboratory study. Subjects were instrumented to monitor sleep (EEG), breathing (nasal mask, pneumotach), swallowing / airway valving events (epiglottic pressure, submental EMG) and pharyngeal muscle activity (peroral genioglosuss EMG electrodes).We report preliminary findings (N=5; 2 female; age: 23-57 yrs) from an ongoing study. Data reported mean ± SD.

Results
Nocturnal swallowing occurred intermittently thoughout the night, the majority triggered during an arousal from sleep (43-98% of all nocturnal swallows). Pharyngeal swallowing pressure was 147±44 cmH2O during quiet wake, 137±25 cmH2O during arousal from sleep, and 78 ± 23 cmH2O in stable sleep (p=0.02, RM-ANOVA). Swallows generated a brief, near-maximal burst of genioglossus EMG activity during quiet wake (90 ± 2 %, N=2) and during arousal from sleep (107 ± 24 %). In stable sleep, swallow EMG activity was 34 ± 1 %. Swallows during wakefulness occurred during expiration, the vast majority bracketed by expiration (Ex/Ex). Swallows in sleep, or during arousal from sleep, occurred in all phases of the respiratory cycle.

Conclusions
Swallows elicited during arousal from sleep generate ballistic EMG and pharyngeal pressures equivalent to wake state. In contrast, swallowing in stable sleep produces a markedly attenuated EMG and pharyngeal pressure.