bluuebunny/crossref_metadata_2025_split huggingface dataset:
0060 Sleep disparities by race/ethnicity during pregnancy: an Environmental influences on Child Health Outcomes (ECHO) study
Authors: Lucchini Maristella , O'Brien Louise , Kahn Linda , Brennan Patricia , Baron Kelly , Knapp Emily , Lugo Claudia , Shuffrey Lauren , Dunietz Galit , Zhu Yeyi , Alcantara Carmela , Fifer William , Elliott Amy 
Published: May 2022

Abstract

Introduction
Poor sleep during pregnancy is common and associated with increased risk of adverse perinatal outcomes. Racial/ethnic minoritized groups in the United States experience worse sleep than non-Hispanic Whites (nHW), likely due to downstream effects of systemic and structural discrimination. Nonetheless, the extent of sleep disparities in the perinatal period remains understudied. In this analysis we estimated the prevalence of subjective measures of sleep in a multi-racial/ethnic pregnant population from the Environmental influences on Child Health Outcomes (ECHO) program.

Methods
Participants self-reported their race and ethnicity and were grouped into four categories: 1)nHW, 2)non-Hispanic Black/African American (nHB/AA), 3)Hispanic, 4)non-Hispanic Asian (nHA). Our analysis examined trimester-specific nocturnal sleep duration, sleep quality, and sleep disturbances (derived from the Pittsburgh Sleep Quality Index and the ECHO maternal sleep health questionnaire) by race/ethnicity. A total of 1119,2409 and 1284 participants in the first (T1), second (T2) and third trimesters (T3) reported on sleep duration. 1107,1742 and 783 participants in T1,T2 and T3 reported on sleep quality. 1112,1758, and 787 participants in T1,T2 and T3 reported on sleep disturbances Linear or multinomial regression were used to estimate associations between race/ethnicity and each sleep domain by trimester, controlling for body mass index (BMI) and age. We repeated analyses within education strata (high school degree, GED/equivalent; some college and above)

Results
nHB/AA participants reported shorter sleep duration (T2: β=-0.55 [-0.80,-0.31]: T3: β=-0.65 [-0.99,-0.31]), and more sleep disturbances (T2:β=1.92 [1.09,2.75]; T3:β=1.41 [0.09,2.74]) compared to nHW. Hispanic participants reported longer duration compared to nHW (T1: β=0.22 [0.00004, 0.44];T2: β=0.61 [0.47,0.76];T3: β=0.46 [0.22,0.70]), better sleep quality (Compare to Very good quality OR for Fairly good T1: OR=0.48 [0.32,0.73], T2: OR=0.36 [0.26,0.48], T3: OR=0.31 [0.18,0.52]; Fairly bad T1:OR=0.27 [0.16,0.44], T2:OR=0.46 [0.31,0.67], T3: OR=0.31[0.17,0.55]), and fewer sleep disturbances (T2 β=-0.5 [-1.0,-0.12]; T3 β=-1.21 [-2.07,-0.35]). Differences persisted within the subsample of high SES women.

Conclusion
These findings highlight racial/ethnic disparities across multiple domains of sleep health during pregnancy. Given the stark racial/ethnic disparities in perinatal outcomes and their associations with sleep health, further research is warranted to investigate the determinants of these disparities, such as downstream effects of systemic and structural discrimination

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0067 Sleep Disparities and the Academic Achievement Gap in 1.9 Million College Students
Authors: Nickel Allison , Scullin Michael 
Published: May 2022

Abstract

Introduction
Adults from under-represented minority groups (URM) disproportionately experience sleep disturbances. Sleep disparities can be prevalent in academic settings, however, it is still unknown whether sleep disparities directly contribute to other disadvantages in URM students, such as the academic achievement gap. Using a national database of college students collected over 20 years, we investigated whether poor sleep quality mediated the relationship between race/ethnicity and grade point average (GPA).

Methods
We conducted secondary analyses on American College Health Association – National College Health Assessment survey data (ACHA-NCHA). The ACHA-NCHA I, II, IIb, IIc, and III surveys were conducted between 2000 and 2020, and included approximately 1,900,000 participants. We analyzed responses to questions regarding race/ethnicity, socioeconomic status, academic achievement (GPA), daytime sleepiness, and sleep health. Non-URM students were those identifying as non-Hispanic White or Asian whereas URM students included all other racial/ethnic identifications. We calculated a sleep-problems composite score by transforming each sleep item response into a z-score and averaging across all items.

Results
Sleep disparities were evident amongst the college students; relative to non-URM students, URM students reported fewer days per week that they felt rested (95% CIs: 3.884–3.895 vs. 4.155–4.161) and worse sleep-problem composite scores (95% CIs: .0453–.0496 vs. -.0226 – -.0199). In addition, there was significant evidence for an academic achievement gap, such that URM students reported significantly lower GPAs than non-URM students (95% CIs: 3.162–3.166 vs. 3.344–3.346). Feeling rested and sleep problem composite scores partially mediated the relationship between race/ethnicity and academic achievement (ps &lt; .001), explaining 4.1% and 5.1% of the variance, respectively. These results were lower in magnitude than the contribution of socioeconomic status (25.3% of the mediation variance); however, sleep problems and feeling rested continued to explain significant variance even when controlling for socioeconomic status.

Conclusion
Sleep disparities contribute to academic achievement gaps experienced by URM students. The current findings indicate that university-wide sleep health programs may help to remove an unnecessary barrier to academic achievement, particularly if such programs incorporate behavioral change theory and address system-level financial, sociocultural, and environmental barriers to sleep quality.

Support (If Any)
National Science Foundation (1920730 and 1943323)
0072 A Mexican Spanish Version of the Insomnia Severity Index
Authors: Granados Karla , Begay Tommy , Valencia Dora , Delgadillo Marcos , Ghani Sadia , Molina Patricia , Alfonso-Miller Pamela , Fernandez-Mendoza Julio , Wills Chloe , Grandner Michael 
Published: May 2022

Abstract

Introduction
Data were collected for the Insomnia Severity Index (ISI). To ensure the validity of study subject responses, the ISI was translated into Mexican Spanish by a bilingual research study team, based on a previous Spanish translation. It was then administered to study subjects in their preferred language.

Methods
Data were collected from a sample of N=100 individuals of Mexican Descent in Nogales, Arizona, at the US-Mexico border. The Insomnia Severity Index (ISI) is a 7-item scale that quantifies the degree to which an individual experiences insomnia symptoms. A Spanish translation already exists, but this had not been previously localized to Mexican Spanish. To localize the measure, the following procedure was followed: (1) a bilingual community member edited the translation; (2) a certified medical translator edited the revised items; (3) a focus group of N=5 bilingual community members made contextual edits to the new measure; (4) a back-translation was performed; (5) an additional bilingual focus group examined the final version for compatibility; and (6) the medical translator certified the accuracy of the final version. As a result of this process, text edits to items 4 and 6 were made to accomplish the localization (the other items remained unchanged). T-tests examined differences between those who completed the measure in Mexican Spanish vs English.

Results
Of the N=100 survey respondents, N=42 completed the ISI in Spanish. Those who completed the ISI in Spanish reported significantly lower overall scores (8.2 vs 9.8, p=0.048). No significant differences were seen for individual items regarding early morning awakenings (p=0.13), satisfaction (p=0.71), interference with daily functioning (p=0.29), whether sleep problems are noticeable (p=0.06), and worry/distress about sleep (p=0.14). However, those completing the measure in Spanish reported lower scores on items regarding difficulty falling asleep (p=0.03) and staying asleep (p=0.001).

Conclusion
When adapting the ISI to a Spanish-speaking population at the US-Mexico border, modifications were made to the existing Spanish translation to improve linguistic and cultural appropriateness.

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0094 Oscillatory Theta-Band Activity as a Sleep Stage Independent Measure of REM-like Activity throughout Sleep
Authors: Vattikuti Shashaank , Balkin Thomas , Braun Allen , Riedy Samantha , Doty Tracy , Hughes John 
Published: May 2022

Abstract

Introduction
The importance of human cortical theta-band power during REM is suggested by its association with aspects of emotional processing. Currently, this is measured first by visual-inspection of polysomnography to define REM-sleep (scored-REM) and then summing the total theta power within. However, activity attributed to scored-REM has been hypothesized to occur during some scored-NREM (“covert REM”) and total theta conflates different theta-band sources. Oscillatory theta-band activity (OTA) in the hippocampus and associated regions is the hallmark of REM-like sleep in invasive animal studies. We posit that an EEG assessment specifically targeting all-night OTA is a more accurate biomarker of theta-dependent REM functions than current methods. As a first step towards testing this hypothesis, we developed a sleep stage independent approach to isolate REM-like OTA from scalp-EEG. For validation, we compared this measure to conventional-staging and high-frequency activity.

Methods
Our method uses Irregular-Resampling Auto-Spectral Analysis to remove the aperiodic spectrum (a major source of theta-band power), followed by low-band power normalization to derive the relative oscillatory-theta activity (OTA). Covert REM-containing epochs were calculated based on OTA exceeding a threshold. We combined data from two in-laboratory studies resulting in a sample size of 42 healthy young adult subjects. Analyses used non-sleep restricted overnight EEG recordings from a frontal channel.

Results
A clear oscillatory-theta peak was observed after processing. Using all sleep stages, we found separation of OTA from total theta-band power evidenced by conventional staging (OTA: scored-REM&gt;scored-NREM, p=0.003 vs total theta: scored-REM&lt;scored-NREM, p&lt;0.001) and correlation with beta-band activity (OTA: r=0.2, p&lt;0.001 vs total theta: p=0.4). Supporting “covert REM”, OTA was present during scored-NREM (p&lt;0.001). On average during a single sleep episode, covert REM was found in 28% of scored- NREM epochs (range=2-85%).

Conclusion
We developed a novel automated method for measuring REM-like oscillatory-theta activity, independent of conventional sleep staging methods. This method was used to measure REM-like activity across all sleep stages and, as reported in a companion abstract, test the hypothesis that this constitutes a better predictor of REM-dependent behavioral effects than current conventions.

Support (If Any)
This effort was fully supported by the Department of Defense Military Operational Medicine Research Program (MOMRP).
0109 Working Memory across Sleep and the Menstrual Cycle in Young and Midlife Women
Authors: Shuster Alessandra , Zhang Jing , Sattari Negin , Simon Katharine , Alzueta Elisabet , Dulai Teji , de Zambotti Massimiliano , Baker Fiona , Mednick Sara 
Published: May 2022

Abstract

Introduction
The menses phase of a woman’s menstrual cycle, compared to other phases, is more likely to be associated with poorer sleep quality and alterations in cognitive performance, specifically impaired working memory. However, the relationship among these factors has been poorly investigated, and how age impacts these relationships is currently unknown. The present study examines the effect of menstrual cycle phase and sleep on working memory performance in young and midlife women.

Methods
Fifty-five young and midlife women (n = 29, 18 – 35 years; n = 26, 45 – 56 years) completed four remote assessments at different phases of their menstrual cycle: menses, late-follicular, mid-luteal, and late-luteal, defined based on days of menses and ovulation. On each visit, participants completed the operation span (OSPAN) working memory task in the evening and were re-tested for sleep-related performance change in the morning. In addition, participants wore an Oura ring, a multi-sensor wearable sleep tracker, throughout the night. Mixed linear regression, correlation models, and paired t-tests were used to determine the relationship between menstrual phase, sleep, and OSPAN outcomes in both groups.

Results
In midlife women only, OSPAN performance improvement significantly changed across menstrual cycle phases (p &lt; .05). The greatest post-sleep improvement in OSPAN performance was detected during the mid-luteal and late-follicular phases of the cycle, while lower performance gains were detected during menses and late-luteal phases. Post-hoc paired t-tests confirmed that post-sleep performance was significantly worst during menses compared to each of the other phases (p &lt; .05). Additionally, during the mid-luteal phase, time spent in deep sleep positively correlated with post-sleep performance in midlife women (r = .55, p &lt; .05). No significant effects were detected in young women.

Conclusion
These findings suggest a complex interaction between sleep, menstrual cycle phase, and cognitive performance in midlife women. Our data suggest that deep sleep may mediate post-sleep performance during specific cycle phases. Reasons why these results are not evident in younger women are yet to be determined.

Support (If Any)
Supported by: RF1AG061355 (Baker/Mednick)
0119 Effects of Total Sleep Deprivation on Performance on a Continuous Performance Matching Task
Authors: Hudson Amanda , Hinson John , Whitney Paul , Lawrence-Sidebottom Darian , Van Dongen Hans , Honn Kimberly 
Published: May 2022

Abstract

Introduction
Tasks requiring individuals to identify specific stimuli may create response/non-response conflict, which may impair performance depending on stimulus feature overlap. Whether sleep deprivation interacts with such impairment is unknown. We investigated the effects of total sleep deprivation (TSD) on stimulus identification in a continuous performance matching task (CPMT).

Methods
N=85 adults (ages 21–40; 50f) completed a 4-day laboratory study with 10h baseline sleep (22:00–08:00), a 38h acute TSD or 10h sleep opportunity (control condition), and 10h recovery sleep. The ~6min CPMT was administered every 2–4h during wakefulness. Participants completed 300 trials where a 3-digit number was flashed on the screen for 100ms. They were instructed to respond (mouse-click) within 900ms, but only if the number was the same as the preceding number (i.e., a repeat); for all other trials a response was to be withheld. The 5 daytime testing sessions (09:00–21:00) at baseline (day 2) and after TSD/control (day 3) were used for analysis. Trials were classified based on number of digits matching the preceding trial (stimulus feature overlap): none (180 trials), one (30 trials), two (near-repeat; 30 trials), or all (repeat; 60 trials). Hit and false alarm (FA) rates were analyzed with mixed-effects ANOVA for day, condition, trial type, and their interactions. Mean response time (MRT) was analyzed equivalently for repeat trials only.

Results
Hit rate declined from day 2 to day 3 in the TSD group (F[1,83]=0.15, p&lt;0.001), but not the control group (F[1,83]=0.018, p=0.335). Though FA rate was low overall (&lt;0.06), FA frequency was higher on trials with greater stimulus feature overlap. FA rate increased on day 3 for the TSD group (all p&lt;0.004), especially for near-repeats (F[1,415]=-0.014, p&lt;0.001). Changes in MRT were statistically significant, but negligible (&lt;20ms).

Conclusion
Our results suggest that greater stimulus feature overlap on the CPMT was associated with greater costs required to resolve conflict. Sleep deprivation exacerbated these costs. Interpretation is limited however, because a response was not required for non-repeat trials. Implementing a two-alternative forced choice version of the task in future TSD studies would address this limitation.

Support (If Any)
PRMRP W81XWH-16-1-0319 and W81XWH-20-1-0442
0142 From Shore to Shipboard: Severity of Sleep Disturbance and Sleep-Related Impairment of Sailors Aboard US Navy Warships
Authors: Kubala Andrew , Jameson Jason , Roma Peter , Russell Dale , Markwald Rachel 
Published: May 2022

Abstract

Introduction
Sleep quality is known to be negatively impacted during military operations at sea. Yet, there are limited naval studies that explore measures of sleep disturbances and sleep-related impairment, especially in relation to different warship classes. This analysis compares sleep disturbances and sleep-related impairment across two warship classes during similar at-sea periods.

Methods
432 sailors (77.6% male; 27.4±7.1 years) participated in a training evolution aboard either a destroyer (DDG; n=194) or an amphibious class ship (LHD; n=238). Participants completed a 7-day recall questionnaire assessing their sleep and health behavior prior to getting underway (baseline) and 1–2 days prior to completing a 2-week underway (underway). Primary outcomes included the PROMIS Sleep-Related Impairment scale (P-SRI) and the PROMIS Sleep Disturbance scale (P-SD). While underway, participants self-reported their diet quality, daily caffeine and nicotine intake, overall health, and daily time spent exercising; these factors were included as covariates in all analyses. Linear mixed effects models were used to explore the within-subject effect of baseline vs. underway sleep and a between-subjects effect by ship class (i.e., DDG or LHD). Independent t tests and chi-square tests were used to compare ship groups at baseline.

Results
Participants within ship class had a similar age, time in military service, and sex (p≥.06). Across both ship classes, there were increases in severity of sleep-related daytime impairment and sleep disturbances between baseline and underway (P-SRI: B=5.2±0.6; P-SD: B=3.4±0.5; p&lt;.001). Additionally, DDG participants had a significantly greater increase in sleep-related impairment between baseline and underway compared with their LHD-class counterparts (Group*Time interaction effect: B=4.3±0.9, p&lt;.001; LHD: 54.5±0.6 [baseline] vs. 54.5±0.5 [underway], DDG: 54.9±0.6 [baseline] vs. 60.2±0.6 [underway]).

Conclusion
These results suggest sleep-related impairment and sleep disturbances are greater while underway compared with an in-port environment. Although preliminary, these results suggest that differential impacts on sleep-related impairment may occur across ship classes, even when undergoing similar underway events. Further research is needed to understand how insufficient sleep and its consequences change in shipboard environments and how these effects may vary between ship classes so as to better inform targeted naval-focused sleep health improvement strategies.

Support (If Any)
Military Operational Medicine Research Program under work unit no. N2010.
0154 Differences in Monocyte Activation between People with Treated HIV Infection With or Without OSA
Authors: Borker Priya , Macatangay Bernard , Patel Sanjay 
Published: May 2022

Abstract

Introduction
Obstructive sleep apnea (OSA) has been associated with low grade systemic inflammation and greater cardiovascular risk, but the specific pathways mediating these effects are unclear. Monocyte activation is implicated in the development of cardiovascular disease in people with treated HIV infection. We sought to evaluate the impact of OSA on monocyte activation in people living with human immunodeficiency virus (HIV) infection.

Methods
Ten HIV seropositive participants with undetectable (&lt;50 copies/mL) HIV viremia and at least one year of antiretroviral therapy underwent home sleep apnea testing to evaluate for the presence (apnea-hypopnea index -AHI4% ≥15 events/hour) or absence (AHI4% &lt;5 events/hour) of OSA. Mononuclear cells were extracted and analyzed by flow cytometry. The composition of monocyte subsets (classical, intermediate, patrolling) was assessed using surface markers. Intracellular tumor necrosis factor alpha (TNFα), interleukin 1β (IL-1β), and interleukin 6 (IL-6) levels were measured by median fluorescence intensity (MFI, unit: au) and log-transformed. Differences in monocyte subset composition and intracellular cytokine levels between those with and without OSA were analyzed by t-test.

Results
Participants had a mean ± SD age of 61 ± 4.7 years, were 50% female, 80% Black race and had well-constituted CD4+ counts (mean ± SD: 934 ± 283 cells/ml). The mean AHI4% among participants with OSA (n=4) was 21.8 ± 4.4 events/hour whereas controls (n=6) had an AHI4% of 2.4 ± 2.0 events/hour (p-value = 0.001). There was no difference in the proportion of classical monocytes between groups (mean ± SD 83.8% ± 11.5% in participants with OSA vs. 84.9% ± 7.5% in controls, p=0.86). Intracellular TNFα was greater in monocytes from participants with OSA vs. controls (log-transformed MFI 3.49±0.20 au vs. 3.00±0.35 au, p=0.03). Additionally, there was a trend toward greater intracellular concentrations of IL-1β (mean log-transformed MFI 3.24±0.15 au vs. 2.95±0.48 au, p=0.22) and IL-6 (log-transformed MFI 3.28±0.16 au vs. 2.91±0.64 au, p=0.23), in participants with OSA vs. controls.

Conclusion
Pro-inflammatory cytokine levels are greater in monocytes obtained from people with treated HIV infection with OSA compared to those without OSA. Our findings suggest OSA may exacerbate chronic inflammation and cardiovascular risk in chronic HIV infection.

Support (If Any)
HL082610 and American Thoracic Society ASPIRE Fellowship