bluuebunny/crossref_metadata_2025_split huggingface dataset:
O058 Awareness of errors is impaired by sleep restriction but not total sleep deprivation
Authors: Boardman J , Cross Z , Bravo M , Andrillon T , Anderson C , Drummond S 
Published: November 2022

Abstract

Introduction
Detecting and correcting errors is important in preventing detrimental consequences of sleep loss. We report the first study to utilise both behavioural and EEG measures of error awareness, and we compare the effects of total sleep deprivation (TSD) and sleep restriction (SR).

Methods
Twenty-seven healthy adults (14F, age=27.2±5.1y) were studied both well-rested (

WR
9h sleep/night) and following SR (3 nights of 3h sleep/night), completing the Error Awareness Task (EAT) once/day (8-9h post-habitual wake). Thirteen healthy adults (3F, age=26.2±4.1y) underwent 34h TSD, completing the Error Awareness Task (at 3h and 27h post-wake). The EAT required participants to withhold responding to “nogo” stimuli and signal errors when they occurred. ERP measures included the Error Related Negativity (ERN) and Error Positivity (Pe).

Results
SR increased error rate (p&lt;.001), decreased error awareness (p&lt;.001) and slowed error recognition (p&lt;.01). ERN amplitude was unaffected, and Pe amplitude was reduced. TSD did not significantly affect error rate, error awareness rate, the time taken to detect errors, or either ERP measure.

Discussion
SR impaired the ability to recognise errors in real time, despite a greater number of errors being made. EEG findings further indicate conscious error awareness is reduced following SR. However, unconscious error detection appears resilient to sleep loss. Findings suggest error awareness may be more sensitive to chronic versus acute sleep loss. In occupations where SR is common, recognition of errors may be reduced. Reduced error recognition may explain the increased accident and injury rates seen in contexts where sleep loss is common.
O060 The relationship between sleep and appetitive conditioning: A systematic review and meta-analysis
Authors: Kavaliotis E , Boardman J , Clark J , Ogeil R , Verdejo-Garcia A , Drummond S 
Published: November 2022

Abstract
Appetitive conditioning involves learning to associate previously neutral stimuli with pleasant or rewarding cues. Elements of appetitive conditioning underpin various maladaptive consummatory behaviours, including regular consumption of unhealthy foods, recreational substance use, and clinical symptoms of certain mental disorders (e.g., binge-eating disorder, substance use disorder). One modifiable mechanism underlying appetitive conditioning appears to be sleep, due to its critical role in new learning. This systematic review and meta-analysis (PROSPERO registration: CRD42021234793) examined the relationship between sleep and appetitive conditioning. Inclusion criteria included: a) appetitive conditioning paradigm; b) measure of conditioning; c) sleep measurement and/or sleep loss; and d) written in English. Searches of seven databases returned 3343 publications as of March 2022. The final sample consisted of 40 studies using animal models. No human studies were identified. We found: a) sleep loss interfered with appetitive conditioning tasks involving natural reinforcers (i.e., food; p &lt; 0.001); b) tasks involving drug reinforcers showed potentiating effects of sleep loss (p &lt; 0.001); c) extinction learning was negatively impacted by sleep loss, irrespective of reinforcer; and d) post-learning sleep was associated with increases in REM sleep (p = 0.02). Findings suggest sleep loss potentiates the impact of psychoactive substances to produce an increased risk of problematic substance use. This indicates sleep may be an important target in treating substance use disorders. In obese/overweight populations sleep loss may be associated with deficits in the conditioning and extinction of reward behaviours. Further research is needed to assess the relationship between sleep and appetitive conditioning in humans.
O061 Sleep hygiene guidelines for shift workers: consensus guidelines via a Delphi study
Authors: Shriane A , Bin Y , Ferguson S , Rigney G , Vincent G 
Published: November 2022

Abstract

Introduction
Current sleep hygiene guidelines are impractical for shift workers, given their inability to maintain regular sleep schedules. Further, the present guidelines contradict fatigue risk management advice (e.g., advising against caffeine and daytime napping). The aim of the present study is to develop a set of tailored sleep hygiene guidelines for shift workers via a Delphi approach.

Methods
Draft guidelines were developed by the research team, who reviewed the current guidelines and examined existing evidence on sleep hygiene in shift workers. Experts from sleep, shift work, and occupational health fields (n=155) were invited to review these draft guidelines via a three-round series of online questionnaires. In each round, experts voted on each guideline, with consensus reached once there was 70% agreement on including the item as written. Expert feedback from each round was discussed and incorporated by the research team as appropriate.

Results
The research team drafted 17 sleep hygiene recommendations, covering sleep scheduling, napping, sleep environment, substance consumption, diet, and exercise. Of those experts invited, 68 (44%) agreed to participate, with 55 of these (81%) completing all three rounds. Consensus was reached on all original items after three rounds, with two additional items (medication use and sleep inertia) and an introductory statement developed, to create a final set of guidelines with 19 items.

Discussion
This is the first study to create evidence-based, expert-developed sleep hygiene guidelines for shift workers. Future research is planned to investigate the acceptability and implementation of the guidelines amongst end-users.
O067 The role of biological sex in the relationship between circadian alignment and well-being in elite athletes
Authors: Mascaro L , Rajaratnam S , Leota J , Hoffman D , Drummond S , Facer-Childs E 
Published: November 2022

Abstract

Introduction
Circadian rhythms govern physiological timing and influence sleep, well-being, and performance. Desynchrony between circadian timing and behaviours (circadian misalignment) can compromise daily functioning. We investigated sex differences in sleep and circadian timing, and their relationship with sleep and mental health outcomes in elite athletes.

Methods
Participants were 87 elite Australian Rules Football (AFL) athletes (43% female; M-age =23.8±4.0 years). Data were collected prior to the start of the 2021 and 2022 AFL seasons (n= 54 participating in a repeat assessment). Circadian phase was assessed via salivary DLMO (collected hourly from 5hrs pre- to 1h post-habitual bedtime). A questionnaire battery, and two weeks of actigraphy were also completed.

Results
Female athletes had a significantly later circadian phase (DLMO; 20:42 vs 20:13) and midsleep time (03:24 vs 02:58), and worse self-reported athlete psychological strain (APSQ), daytime sleepiness, and insomnia, relative to male athletes. There was no sex difference in phase angle (interval between sleep onset and DLMO times; M = 2.5hrs ± 49 mins). DLMO time did not predict sleep efficiency, sleep latency, insomnia, sleepiness, or APSQ. Phase angle predicted APSQ for female athletes only, via a quadratic trend (p=.001): psychological strain was worse among female athletes with shorter and longer phase angles.

Discussion
Our results suggest female athletes have a later circadian phase, which is not associated with adverse outcomes except for higher psychological strain for those with greater circadian misalignment. Sports practitioners may require specific attention for circadian alignment in female athletes who are at particular risk when misaligned.
O068 Slow frequency wake EEG and hypoxemia during sleep predicts vigilance performance following extended wakefulness in patients with OSA
Authors: Choo G , Stevens D , Marshall N , Openshaw H , Bartlett D , Rae C , Wong K , McEvoy R , Grunstein R , D'Rozario A , Vakulin A 
Published: November 2022

Abstract

Study Objectives
Obstructive sleep apnea is highly prevalent, but heterogeneous making identifying patients at risk of driving impairment challenging. Resting wake electroencephalography (qEEG) is associated with vigilance performance in healthy subjects. We examined if qEEG and clinical measures predict vigilance impairment in OSA.

Methods
Fifty-four patients underwent baseline PSG and 28hr extended wakefulness (EW) with 2 hourly psychomotor vigilance test (PVT) and Karolinska drowsiness test and driving simulator performance at baseline and following EW. Resting wake EEG was subjected to fast Fourier transform analysis to derive EEG power in delta, theta, alpha and beta ranges. Cluster analysis assigned participants into groups of either resistant (n=39) or vulnerable (n=15) to alertness failure based on PVT and driving performance. Backward stepwise regression models were used to determine the strongest clincal and wake EEG predictors vigilance impairment.

Results
Compared with resistant patients, the vulnerable group exhibited increased wake EEG delta (p&lt;0.001) and theta (p=0.003) power during eyes open across all testing periods. The only significant predictors of vulnerability to alertness failure (PVT and driving) included O2Nadir from baseline PSG and baseline wake EEG theta and delta (eyes open) respectively explaining 42 and 32% of the variance in vigilance outcome in models that included Age, BMI, ESS, SOL, TST, AHI, O2 Nadir.

Conclusions
Slow frequency wake EEG (delta and theta) and hypoxemia are predictive of future alertness failure and driving impairments in patients with OSA. These findings are important for fitness to drive assessment in OSA but require validation in independent sample.
O074 A systematic scoping review of minimally invasive respiratory monitoring
Authors: Bull C , Lovell N , Bilston L 
Published: November 2022

Abstract

Introduction
Respiratory rate (RR) is a key marker of stress with evidence that raised RR is the vital sign most predictive of cardiac events. Respiratory monitoring is critical to detecting Sleep Disordered Breathing (SDB). COVID-19 highlighted the importance of infection control, and methods of detecting RR without direct airstream contact have wide application for diagnostic and monitoring in respiratory medicine. This scoping review aims to provide an up-to-date overview of indirect respiratory monitoring.

Method
Systematic literature searches were conducted according to PRISMA-ScR guidelines on PubMed, Embase, ProQuest and Scopus covering articles published between January 2012, until February 2022. Data was extracted into the following categories : physiological signal, sensor type, sensor location and field of use. Analysis methods and effectiveness of each method were also assessed.

Results
10736 articles were screened, 236 articles were included for analysis. 61.9% (n=146) monitored respiration through periodic motion of the chest and abdomen, 22.5% (n=53) cardiorespiratory coupling 7.6% (n=18) airstream temperature, 2.5% (n=6) respiratory sounds, 0.4% (n=) remote airflow monitoring, and 5.1% (n=12) combined markers. Medical and clinical research accounted for 42.4% (n=100) of papers, health and exercise monitoring 28% (n=66), and sleep monitoring 16.9% (n=40).22 different sensor types were identified, the most common being remote radar monitoring 17.8% (n=42), photoplethysmography 14.8% (n=35), AI assisted video monitoring 9.7% (n=23) and thermal imaging 8.5% (n=20).

Discussion
Indirect RR monitoring technology that is typically unutilized in clinical settings. Continued development in AI assisted signal analysis will make these methods more accessible for clinical and consumer use.
P001 Role of Stress Management on Perceived COVID-19 Health Risk Associated with Sleep (Quantity and Quality) of Undergraduate Business Students
Authors: Abbas A , Martín-Núñez J , Ar A , Dalat Ward Y , Rincón G 
Published: November 2022

Abstract

Introduction
Since the COVID-19 pandemic began in 2020, it has significantly caused disruptions in various aspects of daily life. In particular, students have been negatively affected by these changes due to unexpected alterations in educational modalities. Stress management can help students to adapt new normality easier and monitor their daily activities, which can reduce their COVID-19 risk while improving sleep quality for better health and academic performance.

Methods
For this pilot study, a Google form–based survey was distributed among 87 volunteer undergraduate business students from Tecnologico de Monterrey, Mexico. The survey was distributed during May 2021. The designed survey contains questionnaires related to perceived COVID-19 health risk, stress management, and sleep (quality and quantity). To test the mediating effects of stress management, we applied a mediation test using the “medmod” plugin of the Jamovi software.

Results
Analyzed results of the path estimate show that perceived health risk has a significant association with stress management (Estimate=.418, Z=5.58, p&lt;.001), and stress management has a significant association with sleep (Estimate=.618, Z=5.18, p&lt;.001). The value of mediation estimates calculated as =.618, Z=5.63, p&lt;.001, 95% confidence intervals (LLCI=0.403 – ULCI=0.833). The analysis confirms that stress management mediates perceived COVID-19 health risk and sleep (quantity and quality) of undergraduate students.

Conclusion
Based on the analyzed results of this pilot study, we conclude that stress management helps undergraduate students to accept and adopt new norms, cope with daily COVID-19 challenges, take greater preventive measures to decrease COVID-19 health risks, and improve the quantity and quality of sleep.
P004 Addition of an oral expiratory positive pressure valve (EPAP) to an oral appliance therapy device can resolve obstructive sleep aponea (OSA)
Authors: Aishah A , Osman A , Tong B , Pitcher G , Eckert D , Mukherjee S 
Published: November 2022

Abstract

Background
Mandibular advancement splints (MAS) provide effective therapy for many people with OSA. However, in ~50% of cases, MAS alone does not fully resolve OSA. A single-night study showed that ~45% of people with incompletely treated OSA with MAS alone had resolution (apnoea-hypopnea index [AHI]&lt;10 events/h) with the addition of an oral expiratory positive airway pressure (EPAP) valve. This study aimed to determine the safety, tolerability, and longer-term efficacy of oral EPAP valve plus MAS in incomplete responders to MAS alone.

Methods
Seven people with OSA (AHI=26±13events/h) not fully resolved with MAS alone (AHI&gt;10events/h) were recruited. In-laboratory polysomnography with MAS plus oral EPAP was performed on night 1. Participants then used MAS+EPAP at home for 30-days and completed weekly questionnaires to assess safety, tolerability, and next-morning sleepiness (Karolinska sleepiness scale, KSS). Impact on daytime sleepiness (Epworth sleepiness scale, ESS) was assessed at night 1 and 30. A final at-home WatchPAT study was performed at night 30.

Results
OSA was successfully treated (AHI&lt;10events/h) in 4/7 participants during the night 1 in-laboratory study (MAS alone vs. MAS+

EPAP
13±2 vs. 7±2events/h). Five had treatment success by night 30 (6±3events/h). Daytime sleepiness (ESS) did not change after 30 days of MAS+EPAP although next-morning sleepiness tended to reduce (

KSS
4.4±1.9 vs. 3.3±1.5, p=0.047 n=7). Oral EPAP was generally well-tolerated with no major side effects reported.

Discussion
Oral EPAP may be an effective treatment addition for some people with OSA who have an incomplete therapeutic response to MAS alone.
P007 CPAP implementation and its outcomes among Indigenous adult patients with OSA in the Top End Northern Territory of Australia
Authors: Al-Dossary B , Howarth T , Heraganahally S 
Published: November 2022

Abstract

Introduction/Aim
Obstructive sleep apnoea (OSA) is reported to be highly prevalent among Indigenous Australians. However, the studies assessing the outcome of CPAP therapy among this population is sparsely reported. In this study we compared the polysomnographic (PSG) characteristic among Indigenous patients who underwent both diagnostic and continuous positive airway pressure (CPAP) implementation study in the Top End Northern Territory of Australia.

Methods
All adult Indigenous patients identified to have undergone both a diagnostic polysomnography followed by an in-lab CPAP implementation study were included.

Results
145 patients (44% female) were included with a median age 49 years, and median BMI of 35 kg/m2. The OSA severity was - 5% mild, 26% moderate & 68% severe on the diagnostic sleep study. On application of CPAP the Total Arousal Index (diagnostic 28 to 16/hour on CPAP), Total Apnea Hypopnea Index (AHI) (diagnostic 48 to 8/hour on CPAP), Non-rapid eye movement (NREM) AHI (diagnostic 46 to 8/hour on CPAP), Rapid eye movement (REM) AHI (diagnostic 56 to 8/hour on CPAP) and SpO2 (diagnostic 93% to 95 % on CPAP) significantly improved.

Conclusion
This study demonstrates that there is significant improvement in arousal Index, reduction in AHI both during NREM and REM sleep along with improvement in overall oxygen saturation upon application of CPAP among Indigenous patients with OSA. Hence, long term CPAP therapy should be offered/considered among Indigenous patients diagnosed to have OSA when clinically appropriate.

Grant Support
Nil to declare and no funding received for this study
P011 Preschoolers’ Engagement with Screens: Time of Day and Associations with Sleep and Cognitive Development
Authors: Axelsson E , Paech G , Metse A 
Published: November 2022

Abstract
Screen time is associated with poorer sleep in children, but there are calls for more evidence in the preschool years – a period of rapid cognitive and language development which are both influenced by sleep. The aim was to investigate preschool children’s length of exposure to screen media and associations with sleep duration and sleep quality, but also screen content and times of day children engaged with screens. Associations with cognitive development were also assessed. The study was conducted with an online questionnaire completed by caregivers recruited via social media. Most children engaged with content of an entertaining nature. Half of the children engaged with screens during the day only and half both during the day and at night. Longer time engaged with screens was associated with shorter sleep duration and poorer sleep quality and this was regardless of time of day of engagement. Greater screen time also predicted lower communication and problem solving scores, and more attention difficulties, but sleep duration was not a significant predictor of cognitive outcomes. The findings indicate that preschoolers’ engagement with screens has implications for their sleep even when engagement is predominantly occurring during the day. Greater screen time also has implications for cognitive development during a sensitive period. The findings raise questions about the time children spend on screens even during the day that could be spent on activities that better support sleep and development. Future studies with objective measures of sleep and direct measures of cognition with preschoolers are needed.
P013 Continuous Positive Airways Pressure (CPAP) Adherence in Remote Patients using Telemedicine Model of Care
Authors: Banks J , Parker J , Samaratunga D 
Published: November 2022

Abstract

Background
CPAP is an established first-line treatment for moderate-to-severe OSA. Adherence is universally low and is predicted by short-term adherence. Moderate-to-severe OSA is strongly associated with adverse cardiovascular outcomes. Evidence of CPAP benefit is limited to underpowered subgroups with arbitrarily defined "good adherence".
Covid-19 has generated widespread acceptance and uptake of telemedicine. This study aims to determine if CPAP adherence is affected when health service is provided by telemedicine rather than in-person.

Methods
Single-centre, retrospective, cohort study of moderate-to-severe OSA patients identified between 1/6/21 and 30/6/22. Medical records were reviewed for residential address, referral pathway (face-to-face or telemedicine), age, gender, BMI, ESS, AHI and AI. Short-term adherence was determined from CPAP downloads.

Progress to date
368 patients were identified, 40% had moderate-to-severe OSA. 31.5% were reviewed by telemedicine (64% remote, 36% local). Compared to in-person, remote telemedicine cohort was similar age (age ≥ 50, 64.9% vs 53.2%, p= 0.075) but more likely male (66.2% vs 50%, p= 0.014). ESS (9.7 ± 1.4 vs 9.1 ± 0.7, p= 0.38), BMI (36.1 ± 2.5 vs 33.5 ± 1.3, p= 0.08), AHI (27.5 ± 7.5 vs 21.7 ± 3.4, p= 0.12) and presence of moderate-to-severe OSA (48.6% vs 42.5%, p= 0.35) were similar. Patient subgroups including local, remote, telemedicine and face-to-face reviews were analysed. Adherence data is pending.

Intended outcome and impact
Pilot telemedicine programs (e.g. TeleSleep) are developing services designed to provide accessible and efficient care to remote patients. $800 per patient, environmental and transport savings can be anticipated.
P024 Defining sleep hygiene: A scoping review of intervention studies
Authors: El Kazzi M , De Pasquale C , Vincent G , Shriane A , Bin Y 
Published: November 2022

Abstract

Background
Inadequate sleep is common in the community. For those with subclinical sleep problems there are few interventions for improving their sleep. Sleep hygiene advice has received interest as a possible intervention, however, studies using sleep hygiene as an intervention have been inconclusive. A possible explanation is the inconsistency in sleep hygiene advice in these studies. This scoping review aimed to systematically review studies which used sleep hygiene as an intervention to clarify what individual components comprise “sleep hygiene”.

Methods
Search of 4 databases (EMBASE, MEDLINE, CINAHL, PsychINFO) revealed 298 intervention studies. Information pertaining to the use of sleep hygiene as an intervention was extracted.

Results
49% of papers defined sleep hygiene. 66% of papers used sleep hygiene as an active intervention while 34% used it as a control intervention. Sleep hygiene advice included caffeine (mentioned in 36% of papers), alcohol (31%), exercise (31%), food intake (29%), sleep time regularity (26%), light (25%), napping (23%), noise (22%), nicotine (18%), bed restriction (18%), stimulus control (18%), room temperature control (18%), stress (15%), and wind down routine (11%). The specific advice provided about each behaviour varied between studies. Advice also varied depending on the methodology used. Papers using cognitive behavioural therapy for insomnia were more likely to include advice about stimulus control and bed restriction and less likely to include advice about light, noise, and room temperature.

Conclusion
Research incorporating sleep hygiene as an intervention provide different sets of advice hence reducing study replicability. Consensus on what constitutes sleep hygiene is required.