bluuebunny/crossref_metadata_2025_split huggingface dataset:
0680 Nocturnal wakefulness and suicide risk in the Australian population
Authors: Wasgewatta Sanjiwika , mansfield darren , Drummond Sean , Tubbs Andrew , Grandner Miachael , Perlis Michael 
Published: May 2022

Abstract

Introduction
Temporal patterns for suicide over a 24-hour period have shown mixed results among prior studies. However, analyses of 24-hour temporal patterns for wakeful actions including suicidal behavior, should adjust for expected sleep requirements that inherently skew such activities to conventional wakeful times. This study analysed the time-of-day for suicide cases from the Australian population for the year 2017, adjusting for expected sleep patterns. Identification of time-of-day trends using this methodology may reveal risk factors for suicide and potentially modifiable contributors.

Methods
The Australian Coronal database was accessed and data for suicide deaths were extracted for the most recent completed year, 2017. Time of suicidal action is frequently unable to be pinpointed and for this analysis an estimation was performed from time last seen alive and time found subsequently using data extracted from police and coronial reports. Time of suicide was allocated to one of four 6-hourly time bins across 24 hours from the mid position of time last seen alive and time found subsequently. Cases were excluded if allocation to a time bin was not able to be confidently determined if time last seen and time found crossed both boundaries for a given time bin. Prevalence of suicide for each time bin was adjusted for the likelihood of being awake for each bin according to sleep-wake norms published in 2020 from a large Australian community survey of 1966 subjects. Observed prevalence of suicide were compared to expected values predicted from likelihood of being awake across each time bin calculated as a standardised incidence ratio (SIR).

Results
For year 2017 there were 2208 suicides for which 1407 were able to be allocated into one of four 6-hourly time bins. Reasons for exclusion were cases for which allocaton into a time bin was not able to be performed. When adjusted for the likelihood of being awake based from population norms, cases were significantly more likely to enact suicide between the hours of 2301-0500 than predicted (SIR 3.93, P&lt; 0.001). Furthermore, there was a lower-than expected rate of suicide for the time bins, 1101-1700 (SIR 0.86, P=0.002). When subcategories of suicide cases were analsysed, suicide death in asssociation with alcohol consumption demonstrated the strongest for relatoinship to the 2301-0500 time bin (SIR 6.03, P&lt; 0.001).

Conclusion
Higher than expected rates of suicide overnight associated proposes that nocturnal wakefulness may represent a modifiable risk factor for triggering suicide events. Nocturnal wakefulness may be linked to increased rates of loneliness and depair as well as greater tendency toward impusive actions and behaviors. Impusivity may be compounded by alcohol consumption Our findings offer a potential mechanism for which individuals with insomnia have increased suicidal thoughts and behaviors.

Support (If Any)
Untied grant provided by Rhinomed LTD
0689 Sedative and Stimulant Misuse and Suicide Ideation in a Community Sample
Authors: Bobadilla Vanessa , Fernandez Fabian-Xosé , Tubbs Andrew , Chakravorty Subhajit , Perlis Michael , Hale Lauren , Branas Charles , Killgore William , Wills Chloe , Grandner Michael 
Published: May 2022

Abstract

Introduction
Previous studies have shown that prescription sleep medications are associated with suicide ideation. In this study we seek to identify the risk of off-label or illicit use of sedatives/hypnotics to predict suicidal ideation.

Methods
Data were from the Sleep and Healthy Activity, Diet, Environment, and Socialization (SHADES) Study, including N=1,003 working-age adults. For the present study, the data on off-label or illicit stimulants and sedatives were examined. Suicide ideation was assessed by whether participant reported any ideation in the past 2 weeks (PHQ, Item #9). Covariates included age, sex, education, race/ethnicity, and smoking. Additional models included adjustment for insomnia severity (ISI), daytime sleepiness (ESS), sleep duration (NHANES), psychiatric health (PHQ4), and general stress (PSS).

Results
In adjusted models examining sedatives/hypnotic use, higher likelihood of suicidal ideation was associated with any use (OR=1.77, 95%CI[1.26,2.47]), recent use (OR=2.71, 95%CI[1.77,4.15]), desire to use (OR=2.14, 95%CI[2.74,6.26]),problematic use (OR=7.39, 95%CI[3.32,16.47]), role limitations (OR=7.94, 95%CI[3.39,18.59]), others expressing concern (OR=4.38, 95%CI([2.29,8.41]), and inability to control use (OR=7.15, 95%CI[3.60,14.20]). Similarly, models examining stimulant use showed that higher likelihood of suicide ideation was associated with history of use (OR=1.81, 95%CI[2.01,3.93]), recent use (OR=4.44, 95%CI[2.63,7.49]), desire to use (4.82, 95%CI[2.78,8.34]), problematic use (OR=17.04, 95%CI[5.67,51.24]), role limitations (OR=9.07, 95%CI[3.47,23.68]), others expressing concern (OR=17.26, 95%CI([7.48,39.84]), and inability to control use (OR=6.44, 95%CI[3.26,12.71]). When sleep and mental health variables were added to the model, results were attenuated but remained significant at the p&lt;.05 level.

Conclusion
Illicit use of substances that both promote sleep or arousal are associated with suicidal ideation, over and above contributions of sleep disturbance and mood/stress. It is possible that these behaviors represent self-medication attempts or an adverse effect of these drugs. Further research on these problematic associations is recommended.

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0693 A Characterization of Social Rhythms in Obsessive-Compulsive Disorder
Authors: Pinney Elizabeth , Boland Eliane , Coles Meredith 
Published: May 2022

Abstract

Introduction
Recent evidence has shown that obsessive-compulsive disorder (OCD) is linked to shifts in biologically driven sleep timing, indicating the role of biological rhythms within the disorder. Specifically, initial evidence suggests that biological disruptions in OCD may play a role in symptom severity and OCD treatment efficacy. Germane to the study of biological rhythmicity is the consideration of social rhythms within OCD. Disruptions in social rhythmicity are found in other psychological disorders associated with biological rhythm vulnerabilities (i.e., Bipolar Spectrum Disorder, Depression, and Post-Traumatic Stress Disorder.) Given the shared features and high rates of comorbidity between OCD and these disorders, it is reasonable that social rhythm disruptions would be found in OCD as well. As no research to date has examined this, we sought to examine the regularity and distribution of social rhythm in individuals with clinically significant obsessive-compulsive symptoms. Further, we examined the role of affect and symptom severity across OCD subtypes.

Methods
19 adults meeting criteria for a primary diagnosis of obsessive-compulsive disorder completed the Social Rhythm Metric at home for a period of 7 days. As part of a larger study, participants completed measures of sleep (Pittsburgh Sleep Quality Index), affect (Positive and Negative Affect Schedule), and obsessive-compulsive symptom severity and subtype (Obsessive-Compulsive Inventory) following diagnosis.

Results
We found the mean social rhythmicity in those with an OCD diagnosis to be 3.05 (SD=1.14.), similar to means found previously in other psychiatric disorders such as Bipolar Spectrum Disorder and Post-Traumatic Stress Disorder. Individuals with OCD who also reported delayed bedtimes were shown to have significantly lower social rhythmicity (p=.005) than those without delayed bedtimes. Additionally, we found that social rhythmicity correlated similarly across OCD subtypes and was not strongly correlated with negative affect.

Conclusion
In the current study, we provide a preliminary characterization of social rhythmicity in those with OCD. Results suggest that social rhythm may play a role in OCD similar to bipolar disorder and further study is warranted. Overall, this study contributes to burgeoning research into the association between biological rhythms and OCD.

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0699 Predictors of Mortality in Obesity Hypoventilation Syndrome: A National Inpatient Sample Study
Authors: Shah Syed , Alqalyoobi Shehabaldin , Qureshi Waqas , Obi Ogugua , Ibrahim Mohammed , Teodorescu Mihaela 
Published: May 2022

Abstract

Introduction
Obesity Hypoventilation Syndrome (OHS) has been linked to adverse cardiovascular outcomes and mortality in multiple observational studies. Few single-center observational studies have reported poor outcomes of inpatient admissions in OHS. Data regarding nationwide outcomes of hospital admissions in OHS is scarce. We conducted a retrospective study to identify predictors associated with mortality using the National Inpatient Sample (NIS) database.

Methods
We reviewed the NIS database to assess the outcomes of all weighted hospitalizations with an ICD 9 or ICD 10 code for OHS from 2007 to 2018. Patients with age &lt;18, BMI &lt;35, and ICD 9 and ICD 10 codes for neuromuscular disorders, chest wall disorders, or miscellaneous disorders of hypoventilation during the index hospitalization were excluded. The primary outcome was in-hospital mortality. We applied multivariable Cox regression modeling for the association of inpatient mortality with the diagnosis of OHS adjusted for age, sex, race, smoking history, BMI, GERD, OSA, renal failure, use of non-invasive and invasive MV, bronchoscopy, urban vs. rural hospital location, academic hospital status, COPD, asthma, acute PE, pulmonary hypertension, pneumonia and dependence on long-term oxygen or invasive or non-invasive mechanical ventilation. Hazard ratios (HR) with 95% confidence intervals (CI) were reported.

Results
A total of 1,115,927 hospitalizations were included in the final analysis. Increasing age, Native American race (compared to White), higher BMI, renal failure, a requirement of invasive and non-invasive mechanical ventilation, acute pulmonary embolism, ILD, and pulmonary hypertension were independently associated with increased risk of mortality during the hospitalization (p-value &lt;0.05). Female sex, academic and urban hospital status, smoking, COPD, asthma, GERD, and OSA were independently associated with reduced risk for inpatient mortality (p-value &lt;0.05). Black, Hispanic, Asian or Pacific Islander races (compared to White) were also associated with decreased risk of mortality (p-value &lt;0.05). Home ventilator dependence, pneumonia, or oxygen dependence were not significantly associated with the risk of death.

Conclusion
Invasive mechanical ventilation (aHR 3.71, 95%CI 3.62-3.81) acute renal failure (aHR 1.93, 95%CI 1.87-2.00), and BMI &gt; 70 (aHR 1.54, 95%CI 1.46-1.63) were the strongest predictors of inpatient mortality in our review of nationwide hospitalizations in OHS.

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0711 Do postmenopausal women with insomnia and obstructive sleep apnea have deterioration in sexual function?
Authors: Ishikura Isabela , Lucena Leandro , Andersen Monica , Tufik Sergio , Girão Manoel , Hachul Helena 
Published: May 2022

Abstract

Introduction
Sleep problems and sexual dissatisfaction are among the most common complaints during and after the menopause transition. The prevalence of insomnia and obstructive sleep apnea (OSA) reach 31% and 44% of postmenopausal women, respectively. The sexual dissatisfaction is frequently caused by a decline in hormonal levels and urogenital atrophy, resulting in inadequate lubrication and pain during intercourse, with orgasm difficulties and low sexual. Both behaviors – sleep and sexual function - play an important part in women’s wellness. The objective of this study was to investigate whether insomnia in association with OSA would increase climacteric and sexual symptoms compared with women with only insomnia or OSA.

Methods
Our sample comprised 47 postmenopausal women distributed into 3 groups: 1) insomnia, 2) OSA, and 3) OSA+insomnia. All participants completed the questionnaires: Insomnia Severity Index, Female Sexual Function Index, and Blatt-Kupperman menopausal index. Of the 47 participants, 34 women undergone polysomnography. The 3 groups were compared in respect of climacteric symptoms, sexual function score, and sleep.

Results
Our results showed that 85.1% of the postmenopausal women were classified with insomnia, 46.8% were diagnosed with OSA, and 82.9% had low sexual function. All groups had sleep efficiency of &lt;80%, wake after sleep onset of &gt;65 min, and a total sleep time of &lt;6h, indicating poor sleep quality. There were no statistically significant differences among the groups in all sexual domains. The group of OSA+insomnia reported more climacteric symptoms (27.1±9.7) when compared to OSA group (15.7±9.6, P=0.03).

Conclusion
In our sample, the presence of insomnia and OSA associated with postmenopause revealed a low score for sexual function. Climacteric symptoms were higher in the groups with insomnia, and the association with low sexual function can lead to worsening of clinical condition.

Support (If Any)
Support: AFIP and CNPq. ACKNOWLEDGEMENTSOur studies are supported by the following funding agencies: AFIP (Associação Fundo de Incentivo à Pesquisa), CNPq (fellowships to LL, MLA, HH and ST). This study received indirect funding from AFIP and CNPq.
0714 Population-Level Snoring and Probable Sleep-Disordered Breathing Associated with Greater Sedentary Activity
Authors: Abdi Harun , Mason Brooke , Wills Chloe , Tubbs Andrew , Killgore William , Grandner Michael 
Published: May 2022

Abstract

Introduction
Increased frequency of snoring can be an indicator of sleep-disordered breathing, which is associated with a myriad of comorbidities, including increased cardiovascular disease risk. Previous studies have shown that sleep-disordered breathing is associated with less physical activity, but few studies examined this at the population lavel, or relative to primary snoring.

Methods
This analysis used a linear regression analysis on the 2017- March 2020 data collected from the National Health and Nutrition Examination Survey (NHANES) to explore the relationship between the minutes of sedentary activity and the frequency of snoring. Participants were asked how often they snored in the last 12 months. Responses were categorized as “Never”, “Rarely-- 1-2 nights/week”, “Occasionally-- 3-4 nights/week”, or “Frequently-- &gt;=5 nights/week.” Self-reported sedentary activity was measured in minutes during a typical day. A modified STOP-BANG score was created based on NHANES measures of snoring, daytime tiredness, snorting/gasping during sleep, hypertension, body mass index, age, and gender (no measure of neck circumference). Reported results were unweighted; weighted results forthcoming.

Results
Significant unadjusted results indicate that those who reported snoring frequently had 19.2 minutes more sedentary time ([7.98,30.4], p&lt;0.0001); and those with estimated sleep apnea had 16.2 more minutes of sedentary time than those without sleep apnea ([7.19,25.2], p&lt;0.001). When adjusted for sex, age, race, education level, and marital status, the estimated difference between frequent snorers and those that reported never snoring increased to 35.9 minutes of more sedentary activity ([24.4,47.3], p&lt;0.0001) a day. After adjusting for covariates, those with probable sleep apnea showed 43.9 more minutes of sedentary activity compared to those without sleep apnea ([34.1,53.6], p&lt;0.001).

Conclusion
Overall, those who snore frequently (5 or more nights a week) or have a high risk of sleep apnea show a larger number of sedentary minutes per day then those that don’t snore or have probable sleep apnea. These relationships may be bidirectional, and directionality should be addressed in future studies.

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0718 Is There a way to Predict abnormal Polysomnography Following a Negative Home Sleep Apnea Test?
Authors: Aydinoz Secil , Thakkar Mahesh , Sahota Pradeep 
Published: May 2022

Abstract

Introduction
Obstructive sleep apnea (OSA) is characterized by recurrent episodes of obstruction of the upper airway that cause decreased or absent breathing during sleep. An OSA diagnosis is made when the patient experiences recurrent episodes of partial or complete collapse of the upper airway during sleep, which results in apneas or hypopneas, respectively. Polysomnography (PSG) is the gold standard test for diagnosis. HSATs (Home Sleep Apnea Tests) are types of sleep tests that can be conducted in a patient's home to detect obstructive sleep apnea. These tests are becoming increasingly common due to their affordability and convenience. Currently, an in-lab PSG is recommended if the initial HSAT is negative and there is a high clinical suspicion of OSA. Aim of this study is to identify a predictive component of negative HSAT which in turn shows positive PSG.

Methods
We reviewed 50 electronic medical records of patients who underwent an HSAT followed by an in-lab PSG at our Sleep Disorders Center. Patient demographics, comorbidities, HSAT data and PSG data were analyzed. Chi-square test and independent sample t-test were used to compare groups. Predictors of the negative PGA was assessed with Logistic regression. Statistical analysis was performed using Statistical Package of Social Science (SPSS) for Windows, version 15.0 (SPSS Inc, Chicago, IL). A p value &lt;0.05 was considered as statistically significant.

Results
There was no correlation between age, gender, body mass index, comorbidities, and lowest oxygen level in HSAT to predict the result of following PSG.

Conclusion
The results of this study showed no statistically significant predictor in patients who underwent an HSAT followed by an in-lab PSG, although there seems to be a weak correlation between the lowest oxygen levels in HSAT and positive PSG. The gold standard for diagnosing OSA remains in-laboratory PSG; HSAT is an alternative in a select group of patients. For most patients with suspected mild OSA, in-laboratory PSG is preferred since HSAT may under-detect sleep-related events.

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0719 The Risk Of Progression Of Chronic Kidney Failure In Patients With Obstructive Sleep Apnea
Authors: Salman Salam , Chovatiya Jasmine , Justice Brittney , Holley Dallin , Verplancke Kiana , Kerr Christian , Walters Ryan , Ng Ian , Nazmul mohammed 
Published: May 2022

Abstract

Introduction
To describe the risks of chronic kidney disease (CKD) progression in patients with obstructive sleep apnea (OSA)

Methods
In this retrospective case control study; patients with CKD and OSA compared to patients with CKD without OSA who followed up at Creighton University Hospital Clinic. Data retrieved from Electronic Medical Records: demographics, time of diagnosis severity of OSA , apnea hypopnea index, severity of chronic kidney disease using serum creatinine and CKD -EPI equation for glomerular filtration rate cut offs. Patient’s kidney function was followed up for 10 years from their diagnosis of OSA. Worsening kidney function is defined on the basis of laboratory values including estimaed GFR( eGFR) and serum creatinine as well as Kidney Diseases Outcome Quality Initiative (KDOQI) 2002 definition and staging. We calculated the mean and SD when appropriate. P values less than 0.05 were considered statistically significant.

Results
269 patients without OSA included in the study. 416 patients with mild OSA, 343 with moderate OSA and 225 with severe OSA mean (SD) age 46.6 (16.3), 52.9(13.5), 56.9(14.1) and 55.3(15.1) years respectively; 59.1, 56.5, 39.1 and 35.6% were females respectively. CKD stage 1 42.8, 26.9, 26.5 and 28.9% respectively. Stage 246.5, 56.3, 54.2 and 46.7% respectively. Stage 3 10.7, 16.9, 19.2 and 24.3% respectivelyPatient’s renal functions who had CKD stage 2 or 3 with mild., moderate and severe OSA got worse in 21.2,31.5 and 26.7% respectively. compared to 13.1% with no sleep apnea.(p &lt;.001)) ,There was no significant difference on progression of CKD in late stages( CKD IV/V)

Conclusion
Patients with OSA and CKD are more likely to have worsening renal function compared to patients without OSA and this association may depend on severity of both CKD and OSA.

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0756 Preclinical Pharmacology of Solriamfetol: Potential Mechanisms for Wake Promotion
Authors: Gursahani Hema , Jolas Thierry , Martin Maryse , Cotier Sandrine , Hughes Sandrine , Macfadden Wayne 
Published: May 2022

Abstract

Introduction
Solriamfetol is a wake-promoting agent (WPA) approved for the treatment of excessive daytime sleepiness associated with narcolepsy and obstructive sleep apnea. The wake-promoting mechanism of solriamfetol may result from dopamine and norepinephrine reuptake inhibition. Preclinical pharmacology studies were conducted to further elucidate the molecular targets activated by solriamfetol and compare them to that of known WPAs and traditional stimulants.

Methods
In vitro binding and functional studies were conducted in a panel of cell lines or membrane preparations expressing transmembrane receptors and monoamine transporters to measure the activity of solriamfetol, comparator WPAs, and traditional stimulants. Electrophysiology studies were conducted in slice preparations from mouse ventral tegmental area (VTA). Studies to measure locomotor activity and wake-promoting effects were conducted in mice.

Results
In vitro functional studies showed agonist activity of solriamfetol at human, mouse, and rat TAAR1 receptors. hTAAR1 EC50 values (10–16 µM) were within the clinically observed therapeutic solriamfetol plasma concentration range and overlapped with the observed DAT/NET inhibitory potencies of solriamfetol in vitro. TAAR1 agonist activity was unique to solriamfetol; neither the WPA modafinil nor the DAT/NET inhibitor bupropion had TAAR1 agonist activity. Solriamfetol (1–10 µM) dose-dependently inhibited the firing frequency of dopaminergic VTA neurons in mouse brain slices, similar to known TAAR1 agonists; however, these effects were inhibited by a D2 antagonist, suggesting a DAT-mediated effect. Unlike traditional stimulants, solriamfetol did not increase locomotor activity in naive mice, but inhibited the increase in locomotor activity in DAT knockout mice.

Conclusion
Preclinical studies have identified agonist activity at the TAAR1 receptor and, possibly, lower potency agonist activity at 5-HT1A receptors as potential pharmacological targets for solriamfetol, in addition to its activity as a DAT/NET inhibitor. Given the current understanding of TAAR1 agonists as modulators of monoamine transmission with potential wake-promoting effects in multiple preclinical species, agonist activity at the hTAAR1 receptor may represent an additional pharmacological target underlying the wake-promoting effects for solriamfetol, in addition to its DNRI activity.

Support (If Any)
Jazz Pharmaceuticals