bluuebunny/crossref_metadata_2025_split huggingface dataset:
P026 Feasibility and acceptability of a novel approach to sleep disorder screening and management for prospective shift workers
Authors: Brown B , Adams R , Wanstall S , Crowther M , Rawson G , Vakulin A , Lechat B , Rayner T , Eastwood P , Reynolds A 
Published: November 2022

Abstract

Introduction
Sleep disorders negatively impact health and occupational safety. Individuals commencing shift work with an undiagnosed sleep disorder may be at an increased risk of negative health and safety outcomes due to the addition of sleep schedule interruption associated with shift work. The aim of this study was to assess the feasibility and acceptability of screening for, and treating, sleep disorders in pre-service shift workers.

Methods
Paramedic students were invited to participate in an intervention comprising of sleep disorder screening (obstructive sleep apnoea, insomnia, restless legs syndrome) and 15 weeks of non-invasive sleep monitoring (Withings Sleep Analyser) with regular follow-up (3, 6, and 12 weeks). Those at risk of a sleep disorder were contacted by the study physician and offered treatment pathways for their identified disorder (primary care or sleep specialist). Feasibility and acceptability will be assessed by a) reaching recruitment targets, b) participation rates, and c) qualitative interviews at 6 and 12 weeks.

Results
Thirty participants are currently active in the trial with 63% female and an average age of 23 years. Seventeen participants (57%) met criteria for a sleep disorder based on baseline data and treatment pathways were initiated in July 2022 with a planned completion date of October 2022.

Discussion
Participation rates, sleep parameters (collected through the sleep monitoring device), objective and subjective sleep disorder severity, and qualitative findings about feasibility and accessibility will be presented. Findings from this study will provide insight into barriers associated with accessing treatment for sleep disorders within pre-service shift workers.
P027 Predictors of CPAP failure in severe obstructive sleep apnoea and obesity hypoventilation syndrome patients
Authors: Chen K , Laks L , Cossa G , Brillante R 
Published: November 2022

Abstract
There are mixed findings regarding predictors of failing continuous positive airway pressure in the obstructive sleep apnoea and obesity hypoventilation population, with duration of time under 90% oxygen saturation independently associated with treatment failure. Our study examined predictors of CPAP failure in severe OSA and OHS patients using baseline characteristics, diagnostic polysomnography, arterial blood gases and TcCO2 oximetry data.
An observational review of patients in an accredited sleep laboratory from 2016 to 2021 was performed. Patients with treatment studies demonstrating CPAP failure were compared to patients controlled on CPAP therapy via pressure determination study. Independent t-test compared group characteristics and multivariate logistic regression was performed to assess predictors of CPAP failure. Data is presented as mean unless otherwise stated.
Twenty patients who required bilevel support ventilation were compared to thirty-five patients controlled by CPAP. Total sleep time (266vs328minutes, p=0.007) and sleep efficiency (62% vs 75%, p=0.028) was lower in the BSV group. Patients who failed CPAP spent a greater percentage of T&lt;88% on their diagnostic study (T&lt;88%, 46.4%vs9.66%, p=0.001). Percentage of T&lt;88% oxygen saturations were significant in being able to predict CPAP failure (p&lt;0.001) using a model including arterial blood gas PaCO2 and TcCO2 data. TcCO2, blood gases and baseline demographic data were not significant in determining CPAP failure.
Our study strengthens the duration of time spent hypoxic or T&lt;88% as a significant predictor of CPAP failure.
Surprisingly, TcCO2 data and paired arterial blood gas data was not able to predict who would require bilevel ventilation in our cohort.
P028 Sensory Sensitivity, Anxiety and Hyperactivity are Related to Different Parent-Reported Sleep Problems in Children with Autism Spectrum Disorder
Authors: Matassoni E , Conduit R 
Published: November 2022

Abstract

INTRODUCTION
This study aimed to understand how ASD symptoms may relate to different sleep problems.

METHODS
128 parents of children with ASD aged 4-14 participated in an anonymous survey. Parents completed the Short Sensory Profile (SSP), Children Sleep Habits Questionnaire (CSHQ), Strengths and Weaknesses of Attention-Deficit/Hyperactivity-symptoms and Normal-behaviours (SWAN) and Revised Child Anxiety and Depression Scale (RCADS). It was hypothesised that: 1) hyper-sensitivity indicated by the SSP, would be positively correlated with night waking from the CSHQ; 2) children at risk of Delayed Sleep Phase Syndrome (DSPS), indicated by the CSHQ, would be more light sensitive as indicated by the SSP; 3) anxiety measured by the RCADS would be positively correlated with longer Sleep Onset Latency (SOL) from the CSHQ; and 4) hyperactivity and inattentiveness from the SWAN would be positively correlated with SOL and parasomnias from the CSHQ.

RESULTS
Results revealed: 1) under-responsivity and low energy from the SSP were correlated with night waking (r = -.31 and r = .36, p &lt; .05). 2) children at risk of DSPS demonstrated greater light sensitivity than those not at risk (t (55) = 2.83, p &lt; .01); 3) Anxiety was not correlated with SOL; 4) Hyperactivity and inattention were related to longer SOL (r = .25 and r = .61, p &lt; .05) and hyperactivity was correlated with parasomnias (r = .29, p &lt; .05).

DISCUSSION
These findings suggest that different sleep problems may relate to different ASD symptomology, and that symptom-based approaches should be considered for future research.
P031 Comparison of Level three sleep study against Level two studies in the diagnosis of OSA among Indigenous patients at the Top End Northern Territory of Australia
Authors: Crespo J , Howarth T , Heraganahally S 
Published: November 2022

Abstract

Introduction/Aim
Level three sleep studies are performed on portable devices which provide information on 3 channels. Some studies have reported that the accuracy of level 3 studies could be as accurate as polysomnography in a sub-set of population in the diagnosis of OSA. However, there is limited information in the literature regarding the effectivity of level 3 study in comparison to level 1 or level 2 study among Indigenous patients.

Methods
Patients included in this study were adult Indigenous patients identified to have undergone both level 2 and level 3 sleep study. We assessed the accuracy of diagnosing the presence of OSA as per AHI

Results
There were 12 indigenous patients identified to have undergone both level 2 and level 3 study. Four out of the 12 level 2 sleep studies failed due to sensor dropouts. Excluding patients with failed studies, 4 out of the 8 patients showed a higher AHI on their level 2 sleep study compared to level 3 study. Six patients had the same severity of OSA identified on both Level 2 and Level 3 studies.

Conclusion
This study shows mixed results in the efficacy of Level 3 studies compared to Level 2 studies, though failure rates may be lower on Level 3 studies. A larger sample size is required to further elaborate on the validity and efficacy of Level 3 studies in the diagnosis of OSA among indigenous Australian population.

Grant Support
Nil to declare and no funding received for this study
P035 Understanding cosleeping arrangements, motivations and satisfaction with sleep location in cosleeping mothers
Authors: D'Souza L , Morris Z , Borgkvist A , Blunden S 
Published: November 2022

Abstract

Introduction
Nighttime infant care practices differ across the globe. In western cultures, where independent solitary sleep is the norm, there is an expectation that parental presence at bedtime is minimized in favour of teaching children independent sleep initiation, maintenance, and resumption skills. In non-western cultures, parental presence at bedtime and overnight is the accepted norm. Despite and against current safe-sleep recommendations, rates of co-sleeping and bed-sharing are increasing in western countries. The purpose of this study was to understand motivations and satisfaction with mother’s choice to engage in co-sleeping.

Methods
Using an internet-based survey, this cross-sectional study aimed to understand mothers’ (n=3298) motivations to engage in co-sleeping (includes room-sharing and bed-sharing), and the satisfaction with their sleep arrangements.

Results
Quantitative analysis reported on the variability in co-sleeping arrangements, intentions, preference and satisfaction with the child (under 12 years) current sleep location.
Qualitative analysis reported on parent’s motivation to engage in cosleeping and reasons for dissatisfaction with the sleeping arrangement.

Discussion and Conclusion
The results of the study overwhelmingly highlights the need for education and information for parents who want to engage in overnight proximal sleeping arrangements with their children. The study lends support to adopt risk minimization approach when providing safe sleep related information to parents. Findings will help inform clinical delivery of culturally appropriate and safe practices to ensure safe sleeping, and enable parents to make informed choices in relation to their children sleep location.
P037 Differences in endotypes in people with multiple sclerosis in those with versus without OSA
Authors: Sloane J , Djonlagic I , Chiang A , Hensen H , Eckert D 
Published: November 2022

Abstract

Background
Obstructive sleep apnoea (OSA) is as common if not more common in people with multiple sclerosis (MS) versus the general population. However, in contrast to the typical OSA risk factors in the general population, MS is far more common in women versus men, many of whom are not obese. Thus, while some people with MS likely get OSA via the same mechanisms as the general population (i.e., anatomical compromise), others may develop OSA due to specific MS-related consequences (e.g., CNS lesions that effect respiratory or upper airway neuromuscular control- i.e. via non-anatomical mechanisms). Accordingly, we investigated if the key OSA endotypes that contribute to OSA differ in people with MS in those with versus without OSA.

Methods
Nine people with MS with moderate-severe OSA (AHI=41±22events/h) and seven people with MS without moderate-severe OSA (AHI=9±3events/h) completed in-home level 2 sleep studies (n=11 Boston, n=5 Sydney). OSA endotypes were estimated using validated algorithms from the staged sleep study airflow signals and compared between those with versus without moderate-severe OSA.

Results
Respiratory control instability (loop gain) was significantly higher in people with OSA versus without (0.62±0.2 vs. 0.45±1, p=0.04). Upper airway collapsibility was also higher in OSA participants (Vpassive at the lowest decile= 53±13 vs. 74±6 %eupnea, p&lt;0.01). Other OSA endotypes were not systematically different between groups.

Discussion
These findings suggest that while some people with MS likely get OSA via primary anatomically driven mechanisms, in others, OSA may be largely driven via non-anatomical mechanisms, potentially related to MS-specific disease consequences.
P038 Sleep disorders, perceived control over sleep and depression in paramedic students
Authors: Evans M , Reynolds A , Brown B , Wanstall S , Crowther M , Rawson G , Vakulin A , Lechat B , Rayner T , Eastwood P , Adams R 
Published: November 2022

Abstract

Introduction
University students are commonly affected by sleeping difficulties and poor mental health, and ~20% of this demographic live with a clinical sleep disorder. This is particularly concerning for students who will progress into careers which will introduce further sleep disturbance via shift work schedules. The aim of the current study was to explore the relationship between sleep disorders and depression in paramedic students, and determine whether perceived control over sleep moderates the relationship.

Methods
Data from fifty-three Flinders University Paramedic students was included, consisting of sleep disorder screening (obstructive sleep apnea, insomnia and restless legs syndrome), and mental health (Patient Health Questionnaire-9) questionnaires. PHQ-9 scores ranged from 0 to 27, with higher scores indicating more severe depression. Regression analysis adjusted for age and sex at birth were conducted using SPSS version 27.

Results
Meeting criteria for a sleep disorder (n=21, 38.2%) was associated with higher depression scores (mean+standard error) in paramedic students (for sleep disorders vs no sleep disorders, 11.4±0.9 v 4.3±0.8, F₁,₅₂=33.5, p &lt;.001). High perceived control over sleep was associated with lower depression scores than low perceived control 5.3±0.9 vs 9.6±1.1, F₁,₅₂=9.0 p = .004) but no moderating effect was observed (p = 0.17).

Discussion
Sleep disorders and low perceived control over sleep are independently associated with higher depression scores. Investigation and management of factors contributing to low perceived control over sleep, together with early screening and management of sleep disorders are important priorities to support paramedic student sleep and mental health prior to commencing shift work.
P039 A novel mean disease alleviation outcome measure in the management of adult obstructive sleep apnoea
Authors: Every J , Sideris A , Do T , Jones A , Weaver E , Mackay S 
Published: November 2022

Abstract

Introduction
Current methods assessing device and surgical treatment efficacy for OSA, such as apnoea hypopnea index (AHI), do not factor in compliance. Clinical effectiveness may be better represented when long-term compliance is incorporated into a mean disease alleviation score (MDA). Here, MDA scores between surgery and device are compared in a high-volume adult OSA clinic.

Methods
Three hundred and forty-five patients seen over a 13-year period in a high-volume adult OSA clinic staffed by an experienced sleep-trained otolaryngologist and sleep physician were included. Patients were managed with device (Continuous Positive Airway Pressure (CPAP), Mandibular Advancement Splint (MAS) or underwent multilevel airway surgery. Mean disease alleviation was calculated as the product of therapeutic efficacy (change in AHI) and adjusted compliance. Surgical compliance was assumed as one hundred percent. Cardinality matching was utilised to account for differences in patient and disease factors between subgroups.

Results
Surgically treated patients demonstrated higher MDA than device users (67.3 ± 29.9% vs. 59.4 ± 31.1%, p=0.039), despite higher therapeutic efficacy seen in device users (85.0±24.4% vs. 67.0±29.9%, p&lt;0.001). Surgical patients were younger, had lower comorbidity scores, lower BMI, and suffered worse daytime sleepiness than device users. Cardinality matching for these factors demonstrated similar mean MDA between groups (66% vs 58%, p=0.11). Device users had to utilise &gt;8hrs per night of compliant use to reach a similar MDA to matched surgical patients.

Discussion
In Adult OSA patients with less-than-ideal CPAP compliance, multilevel airway surgery is an equivalent and effective alternative, based on novel MDA measures.
P041 Poor Sleep and Mental Health Issues Among First Nations Peoples
Authors: Fernandez D , McDaid L , Tran N , Jabran D , King S , Fatima Y 
Published: November 2022

Abstract
To evaluate the evidence on sleep and mental health issues in First Nations peoples.
A systematic literature search was conducted covering academic and grey literature databases for studies with quantitative data on sleep and mental health association in First Nations Peoples published until November 2021.
The National Institutes of Health Quality Assessment Tool was used for quality assessment, and the Aboriginal and Torres Strait Islander Quality Appraisal Tool helped assess cultural appropriate conduct of research.
Seven studies (6 cross-sectional and 1 longitudinal) among three First Nations groups (n=3075) were included. In Indigenous Australian children, arousal problems increased aggression, and withdrawn behaviour, while early bedtime protected against behavioural problems (OR: 0.48, 95% CI: 0.28 -0.82). In Native American youth, insomnia symptoms increased depressive symptoms (OR: 4.87, 95% CI: 2.4 to 9.89), while in adults, short sleep increased the risk of anxiety (16%) and affective disorders (16%). Clinical sleep issues, restless leg (OR: 1.82; 95% CI: 0.53 to 3.12), insomnia (OR: 4.49; 95% CI: 3.14 to 5.83), and apnoea (OR: 2.46; 95%CI: 0.47 to 4.46) were associated with depression. Similarly, in Ameridian/Mestizo adults, restless leg syndrome increased the risk of depression (OR: 4.5, 95% CI: 2.2 to 9.7) and anxiety (OR: 3.6, 95% CI: 1.7 to 7.7). Majority of the studies scored high in quality assessment but the lack of information limited adequately assessing cultural appropriateness.
There is limited but strong evidence suggesting a strong role of poor sleep in mental health issues in First Nations peoples which compels investment in sleep health.
P043 Subjective sleep quality and impact of noise in a hospital respiratory ward
Authors: Gibney M , O'Driscoll D , Ogeil R , Young A 
Published: November 2022

Abstract

Background/Aim
Sleep is a restorative process that is vital for maintaining health. Hospital inpatients are at risk of poor sleep, with noise frequently reported as a major disruptor of sleep. This study sought to identify specific sources of noise disrupting sleep in respiratory inpatients.

Methods
Cross-sectional data were collected from respiratory ward inpatients at time of discharge through medical record review and completion of a questionnaire exploring sleep quality and factors disrupting sleep.

Results
Data includes 24 participants to date – recruitment continues. The median age was 63 years, thirteen participants (54%) were male and 12 (50%) slept in a shared room. The median number of comorbidities was seven and the most frequent admission diagnosis was COPD (29%). Sixteen patients (67%) rated sleep quality as fair to very poor, and 16 patients (67%) reported poorer sleep compared to home. Noise (10 patients – 42%) and acute medical issues (10 patients – 42%) were most frequently reported as more than a little disruptive to sleep. Seven patients in shared rooms (58%) reported noise as more than a little disruptive to sleep, compared with four patients in single rooms (25%). Environmental noise (e.g. doors banging, overhead speakers) was the most frequently reported source of noise disrupting sleep (7 patients – 29%), followed by other patients (4 patients – 17%).

Conclusion
Most patients described their sleep in hospital as worse than at home. Noise and acute medical issues disrupted sleep most frequently, with environmental noise and other patients the most frequent noise sources.
P047 Rehabilitation-led management of sleep disordered breathing: adapting a model of care for a rehabilitation centre in Australia
Authors: Graco M , Weber G , Joffe D , Saravanan K , Heriseanu R , Whitehead N , Alava-Bravo K , DelaCruz C , Sood S , Curran J , Kaumaitotoya E , Pryor J , Ross J , Chai-Coetzer C , Berlowitz D 
Published: November 2022

Abstract

Introduction
Sleep disordered breathing (SDB) is highly prevalent in tetraplegia, yet most remain undiagnosed and untreated for the disorder. We have described the care models of three international SCI rehabilitation centres that are independently diagnosing and treating SDB, and distilled their common pathways into the SCISTAR (SCI Sleep disordered breathing Treatment & Assessment in Rehabilitation) model.
The aim of this project was to adapt the SCISTAR model to suit the Royal Rehab Spinal Injuries Unit, and to prepare for the implementation of this new model of care.

Methods
A clinical advisory group, consisting of researchers, rehabilitation and respiratory health professionals, met six times over eight months to: • identify the multidisciplinary SDB clinical team,
• adapt the SCISTAR model,
• develop parameters for safe clinical practice,
• identify education needs,
• identify and acquire the necessary equipment.

Results
The SDB clinical team consists of two rehabilitation consultants, two physiotherapists and four nurses. All patients with SCI will be assessed for SDB following admission. Assessments will include symptoms, spirometry and sniff nasal inspiratory pressure, and a Level 3 overnight sleep study (ResMed ApneaLink). Patients diagnosed with un-complicated SDB will be prescribed CPAP, which will be initiated and progressed on the ward. Screening for hypoventilation and predominant central sleep apnoea will occur throughout the pathway and if identified, patients will be referred to a specialist respiratory service. Comprehensive education and equipment has been provided.

Conclusions
The new care model is currently being piloted for 12 months. A comprehensive evaluation has been developed.
P049 Barriers and facilitators to the delivery of insomnia management by general practice nurses: a qualitative analysis of patient perspectives
Authors: Grivell N , Hoon E , Chai-Coetzer C , Fuller J , McEvoy R 
Published: November 2022

Abstract

Introduction
With insufficient providers of insomnia care, alternative approaches to the delivery of insomnia treatments are being explored. Research has demonstrated that insomnia can be successfully managed by primary care nurses but patient attitudes towards this care are largely unknown. This study explored patient perspectives towards barriers and facilitators to practice nurse-delivered care to inform the development of patient-centred models of care for insomnia.

Methods
A qualitative sub-study within a process evaluation of sleep health care delivered in a pilot study in one general practice in metropolitan Adelaide. Semi-structured telephone interviews were conducted with patients with insomnia offered nurse-delivered or nurse-supported insomnia management. Thematic Analysis was used to identify themes within the data.

Results
Eleven patients participated (6 males; age mean [range] 59 years [29-72]; time at practice 14.3 years [4-21]; Sleep Condition Indicator 9.5 [3-14]). Two major themes were identified: 1. Patients are supportive of nurses providing care for uncomplicated insomnia; 2. Trust in practice nurse-delivered insomnia care is influenced by relationships with the GP, the practice, and the nurse. Participants reported confidence in practice nurses providing insomnia management provided that they had sufficient knowledge. Established relationships with the GP and the practice, along with previous appointments with the nurse, increased patient confidence in nurse-delivered insomnia care.

Discussion
Patient acceptance of practice nurse-delivered insomnia care supports further research into developing a role for practice nurses within insomnia management. The findings of this work will be tested and explored further within a large implementation study conducted in multiple general practices.