bluuebunny/crossref_metadata_2025_split huggingface dataset:
P009 The effects of low-dose morphine on sleep and breathlessness in chronic obstructive pulmonary disease
Authors: Altree T , Loffler K , Toson B , Currow D , Eckert D 
Published: November 2022

Abstract

Introduction
Low-dose morphine is prescribed for refractory breathlessness in chronic obstructive pulmonary disease (COPD). Preliminary investigations suggest improved perceived sleep quality, although concerns exist regarding opioid-induced sedation. This study assessed the effects of morphine on subjective sleep quality and alertness, and potential links between sleep quality and breathlessness.

Methods
Analysis of sleep questionnaire and breathlessness data at baseline and after one week of low-dose slow-release morphine versus placebo according to a double-blind randomised controlled design was performed. Participants were randomised to placebo, 8mg or 16mg/day oral morphine for one week (before further dose escalation). Epworth Sleepiness Scale (ESS), Karolinska Sleep Score (KSS), Leeds Sleep Evaluation Questionnaire (LSEQ) and breathlessness severity scores were assessed. Dose effects on sleep measures were assessed via linear regression (including baseline sleep measures). Drug effects on the relationship between sleep quality and breathlessness were assessed via linear mixed models with random effects and three-way interaction between sleep measures, dose, and visit.

Results
156 patients were randomised as follows: 8mg, n=55; 16mg, n=51; placebo n=50. Overall, there was a neutral effect of morphine on ESS, KSS, and LSEQ (all p&gt;0.05). Morphine did not modify the relationship between sleep measures and breathlessness.

Discussion
Despite safety concerns, one week of morphine did not negatively impact subjective sleep or daytime alertness measures. There was no clear relationship between morphine’s effects on sleep and next-day breathlessness perception. Objective data assessing sleep and next-day alertness are required to further explore potential links between sleep and breathlessness in people with COPD.
P010 Success and failure rates of ambulatory home sleep studies (Level 2) among Indigenous patients
Authors: Atos C , Heraganahally S , Howarth T 
Published: November 2022

Abstract

Introduction/Aim
Level 2 sleep studies are being increasingly performed worldwide in order to minimise the cost and access to level1 in-lab polysomnography. However, their accuracy and validity remain disputed. For populations residing in regional and remote localities, access to level1 sleep studies are further compromised, such as among Indigenous people of Australia, where 80% reside in remote communities. There is limited information in the literature regarding the efficacy of level2 sleep studies among Indigenous patients. Hence, in this study we evaluated the efficacy of level2 sleep studies amongst an Indigenous population.

Methods
552 level2 sleep studies from Indigenous patients recorded between 2011-2020 were included. Sleep studies were analysed and scored manually by registered polysomnographic technologist as per standard guidelines. The studies were also assessed to determine the soundness of the study. Demographic and clinical information of patients was also collected.

Results
50% of the patients were female, and 51% resided in remote or very remote locations. Of the 552 studies, 47(8.5%) were failed. There was no significant differences in demographic factors between failed and successful studies. The most common reason for failure was intolerance of the sensors which resulting in removing the device.

Conclusion
Level 2 sleep studies showed high success rate amongst this Indigenous population with just 8.5% failure rate. As there is limited access to level 1 sleep studies among the Indigenous Australian population due to remoteness, this study shows that level 2 sleep studies are a feasible alternative in the diagnosis for the presence of sleep disorders.
P014 IgLON5 Disease – A Review of 2 Cases and Sleep Manifestations
Authors: Banks J , Sachs G 
Published: November 2022

Abstract

Background
IgLON5 disease is a novel autoimmune tauopathy with diverse sleep and neurologic manifestations. Sleep disorder is a common initial presentation and may precede disease progression. Neurological symptoms frequently overlap with extrapyramidal syndromes, motor neuron disease and dementia.
Diagnosis is confirmed by anti-IgLON5 IgG in CSF and/or serum. Strong HLA-DRB1*1001 and HLA-DQB1*0501 association supports autoimmune mechanism. Video-PSG is recommended to identify treatable sleep-disordered breathing and parasomnia, present in up to 90% of cases.
Treatment is empirical immunomodulation plus supportive cares. Mortality is high due to sudden cardiorespiratory arrest

Methods
Case reports.

Progress to date
Case 1 - 70-year-old male with recurrent respiratory arrests of apparent mixed aetiology and progressive dysphagia over 6 months. Preliminary investigations were unremarkable. Tracheostomy was inserted and immunoglobulin empirically commenced. IgLON5 antibodies were identified on CSF. HLA-DRB1*1001 and HLA-DQB1*0501 were positive. Pulse methylprednisolone and rituximab were administered. Intermittent respiratory failure subsided but bulbar symptoms progress. PSG showed NREM and REM parasomnia plus ataxic breathing.
Case 2 - 58-year-old man presenting with altered level of consciousness. Examination findings included unsteady gait, strabismus, myoclonus, and truncal instability. IgLON5 IgG was identified on CSF. Sleep study showed ataxic breathing. Patient was treated with IVIG plus rituximab and CPAP. History is suspicious for evolving parasomnia.

Intended outcome and impact
IgLON5 disease is a newly recognized disorder with sleep manifestations. The ataxic breathing has not been well described. IgLON5 disease teases a novel association between autoimmunity and neurodegeneration.
P017 A Model for Behavioural Sleep Intervention via Telehealth for Children Diagnosed with Autism Spectrum Disorder
Authors: Bennett-Stewart A 
Published: November 2022

Abstract
Approximately 1 in 150 people in Australia are diagnosed with Autism Spectrum Disorder (ASD) (Australian Institute of Health and Welfare, 2017). Studies suggest up to 80% of children diagnosed with ASD experience sleep difficulties (Cortesi et al., 2010). Behavioural sleep intervention is effective to improve sleep difficulties for children diagnosed with ASD (Jin, Hanley & Beaulieu, 2013). Additionally, caregiver support via telehealth can provide clients with greater access and flexibility of services. This paper will explore the current research on behavioural sleep intervention from a Behaviour-Analytic perspective and provide a model for behavioural sleep intervention via telehealth. This three-phase model includes: (1) an initial comprehensive behavioural sleep assessment, including the Sleep Assessment and Treatment Tool (Hanley, 2005) and baseline data collection to gather information on the child’s current sleep schedule and behaviours, (2) supporting caregiver implementation of an individualised behavioural sleep intervention via telehealth, including daily data collection and graphing to monitor efficacy throughout the intervention, and (3) ongoing review and revision alongside the caregiver until their and their child’s sleep goal has been achieved. By providing evidence-based behavioural sleep intervention via telehealth, children diagnosed with ASD can achieve healthy sleep.
P018 Effect of CBT-I on sleep-wake state discrepancy in individuals with co-morbid insomnia and sleep apnoea: A randomised controlled trial
Authors: Bensen-Boakes D , Osman A , Lack L , Catcheside P , Antic N , Smith S , Chai-Coetzer C , O'Grady A , Dunn N , Robinson J , McEvoy D , Sweetman A 
Published: November 2022

Abstract

Introduction
Cognitive behavioural therapy for insomnia (CBT-I) is the recommended treatment for insomnia and improves insomnia symptoms. However, CBT-I effects on sleep-wake state discrepancy have not previously been examined in a sample of individuals with co-morbid insomnia and sleep apnoea (COMISA). This randomised controlled trial investigated the effect of CBT-I, versus no-treatment control, on sleep-wake state discrepancy in people with COMISA.

Methods
145 participants had their subjective and objective sleep parameters recorded at pre- and post-treatment via overnight sleep diaries and polysomnography.

Results
Pre-treatment, individuals with COMISA significantly (p &lt; 0.05) underestimated their sleep duration (M min = −51.9, SD = 94.1) and sleep efficiency (M % = −9.6, SD = 18.3) and significantly (p &lt; 0.05) overestimated sleep onset latency (M min = 34.5, SD = 86.1). Post-treatment, there were significant reductions in sleep-wake state discrepancy parameters in both groups, but no significant interaction effects to support any differences between CBT-I versus waitlist control groups (all interactions, p &gt; 0.367).

Discussion
These findings suggest that treating the insomnia aspect of COMISA through CBT-I first may not be an effective method of reducing sleep-wake state discrepancy. This is possibly due to sleep apnoea being untreated, contributing to frequent awakenings and the discrepancy between perceived and polysomnography derived sleep parameters. Future studies could involve a COMISA group that receives treatment for their sleep apnoea symptoms before CBT-I.
P019 Automatic Detection of Patient-Ventilator Asynchrony during Non-Invasive Ventilation using Matrix Profiles
Authors: Juliandri M , Aicklin U , Ristanoski G , Hannan L , Sheers N , Howard M , Berlowitz D 
Published: November 2022

Abstract
Automated Patient-Ventilator Asynchrony (PVA) detection and classification has been described previously, however most approaches target specific asynchrony types, are not applicable in non-invasive ventilation, and require manual pre-processing, removing the opportunity for real-time analysis.
During our previous study of polysomnography-assisted NIV implementation (Hannan 2019), each participants’ sleep studies were manually, breath-by-breath scored for PVA. The data were collected over approximately 8 hours and included &gt; 650,000 breath cycles. The source data for the machine learning consisted of the 21 recorded signal traces exported as text files.
We employed an outlier detection approach to detect asynchrony with Artificial Intelligence (AI) models as the core engine. The fully automated approach starts with pre-processing to filter and de-noise the polysomnography data, with AI models, including Multidimensional Matrix Profiles, employed to find asynchronies from a signal subset.
We initially investigated the best features for PVA and arousal detection in a subset of the 59 participant sleep studies with the highest number of labelled asynchronies and arousals. These six participants had a total of 6,942 events: 799 Arousal, 3,026 Ineffective Triggering, 1,983 Double Triggering and 1,134 Auto Triggering. All events were used in the training/testing stage. The best-balanced model employed a denoising technique with 300 milliseconds as the aggregating data points interval across: mask pressure, ventilator measured flow, abdominal, and thoracic band traces. This approach resulted in 0.80 for both sensitivity and specificity.
P021 Associations between Virtual Reality (VR) Ocular Assessments and Vigilance during Extended Wakefulness – Preliminary Analysis
Authors: Bickley K , Adams R , Anderson C , Cori J , Howard M , Lack L , Lovato N , Stevens D , Vakulin A 
Published: November 2022

Abstract

Introduction
Sustained vigilance is essential for safety in high-risk workplaces, making rapid and accessible alertness failure vulnerability assessments extremely desirable. We are piloting existing technology, the NeuroFlex® Platform, which takes ocular performance measurements of both prosaccade and antisaccade eye-movements using a portable Virtual Reality (VR) headset. We’ve conducted preliminary comparisons between these measures and Psychomotor Vigilance during extended wakefulness.

Methods
Sixteen young-adults (females= 8; age M= 25.13, SD= 4.30) completed five test batteries starting 1-hour post-wake where repeated testing encapsuled more than 24-hours of extended wakefulness. Each battery consisted of two 10-minute visual Psychomotor Vigilance Tasks, in addition to three administrations of 60-second prosaccade and antisaccade assessments using the NeuroFlex® VR platform.

Results
Time main effects occurred for reciprocal reaction time, F(3.83,57.37) = 20.54, p &lt;.001, and proportions of lapses/trials, F(3.55,48.33) = 7.36, p &lt;.001. Vigilance troughs occurred around the circadian nadir (19-hours post-wake) with some recovery at final administrations (25-hours post-wake). No associations were found between prosaccade latency and vigilance metrics. Moderate negative (r=-.63, p=.01 & r=-.54, p=.03) associations were found between antisaccade latency and reciprocal reaction time near the nadir, but not the number of lapses per trial.

Discussion
This preliminary analysis has demonstrated potential sensitivity of the NeuroFlex® platforms ocular measurements to vigilance. Though we have not detected associations between lapses and eye-movement latency, we were limited to the existing output generation of the NeuroFlex® platform in this preliminary investigation. With refined data analyses, we see promise in the NeuroFlex® platforms capability of predicting alertness failure.
P022 Obstructive sleep apnoea and cancer risk: preliminary results of a case-control analysis using data from the Cancer Lifestyle and Evaluation of Risk Study (CLEAR) study
Authors: Bin Y , Cook K , Nair-Shalliker V , Sutherland K , Cistulli P 
Published: November 2022

Abstract

INTRODUCTION
Animal and cellular models suggest that obstructive sleep apnoea (OSA) plays a role in the development of cancer. Epidemiological studies have found inconsistent associations and typically lack control for lifestyle risk factors contributing to both OSA and cancer. We examined associations between OSA and common cancers in a case-control study.

METHODS
We analysed data from the New South Wales CLEAR Study which recruited adults with newly diagnosed cancer (n=8551 cases) and cancer-free controls (n=2230). Self-reported OSA was compared in women and men with a verified cancer diagnosis and controls of the same gender. Covariates included age, body mass index, smoking, passive smoking, alcohol intake, physical activity, skin colour, and time spent outdoors.

RESULTS
OSA was more common in cancer cases than controls: 2.9% vs. 1.9% in women and 7.9% vs. 5.9% in men. For women, OSA was not significantly associated with melanoma (AOR 1.58, 95% CI 0.76-3.29), lung (1.54; 0.59 - 3.99), breast (1.35; 0.79-2.31), or bowel cancer (1.26, 0.61 - 2.59) after adjustment for potential confounders. For men, OSA was not significantly associated with bowel (1.37; 0.92-2.03), prostate (1.31; 0.94 -1.82), lung (0.96; 0.45-2.01), or melanoma (0.92; 0.58-1.48) after control for covariates.

DISCUSSION
Further analysis will consider rarer cancers and the role of shiftwork, sleep duration, and napping. Preliminary results support a link between OSA and common cancers only through shared risk factors. Information on OSA treatment is missing from this study. OSA treatment together with self-reported OSA may lead to under-estimation of any OSA-cancer association.
P029 Examining the Efficacy of Two Apps on Sleep and Anxiety in Children with Autism
Authors: Hunt S , Leahy R , Conduit R 
Published: November 2022

Abstract

INTRODUCTION
Children with Autism Spectrum Disorder (ASD) frequently experience a range of comorbidities alongside their condition. Particularly, sleep problems and anxiety disorders are highly prevalent, and often co-occur. The present study aimed to determine if using a mindfulness app before bed could reduce overall anxiety and improve sleep quality in children with ASD.

METHOD
Twelve children aged 7 to 12 with an ASD diagnosis participated in a blinded two-week controlled trial testing the use of two apps before bed. Children were allocated to the experimental mindfulness app or the active sleep melodies control app via counterbalancing.

RESULTS
Results of 2x2 mixed model ANOVAs revealed significant pre-post improvements in both apps for parent-reported sleep problems (p &lt; 0.05), and a significant interaction effect for parent-reported pre-sleep arousal (p &lt;0.05). Simple main effects analysis of the interaction results revealed that these differences were due to significant improvements in the active control group (p &lt; 0.05).

DISCUSSION
Potential reasons for significant improvements in the active control group may have been due to the personalised choice of sounds/melodies for the active control app, or difficulty with the comprehension of instructions in the mindfulness app for ASD children. Overall, these results provide preliminary evidence of the general benefits of using apps to aid with sleep in children with ASD.
P036 Rapid oscillatory ventilation seen during positive airway pressure titration studies: A case series
Authors: Duong V , Kee K , Stonehouse J , Wallbridge P 
Published: November 2022

Abstract
We have observed a phenomenon in some patients undergoing positive airway pressure implement/titration studies in our sleep lab, characterised by periods of extremely high respiratory rates of up to 80 breaths/min which appear to be device triggered. These episodes occur during periods of central apnoea and last up to 1.5-2.0 minutes. A possible related phenomenon has been reported in a case series of 4 patients published in the Journal of Clinical Sleep Medicine in 2018 (Gupta et al), however this was using a different CPAP device and respiratory rates were significantly lower than what we have observed. Apart from this, there are no reports in the literature that are consistent with the observations we have made in our lab.
Correspondence from the device vendor have suggested that the episodes are due to a rare state in the motor control system which maintains correct pressure in the mask circuit and may have been influenced by our lab not using the vendor’s proprietary heated tubing system. In addition, the incidence rate of this is said to be extremely low at 0.00087%, although our lab has already observed at least 5 cases of this in the 6 months from August 2021 to February 2022.
Our objective is to present a case series to inform the broader sleep community of our unique observations.
P040 Obstructive sleep apnea during REM sleep: Effects on morning and evening blood pressure
Authors: Falla C , Young A , Pope A , O'Driscoll D 
Published: November 2022

Abstract

Study Objectives
Obstructive sleep apnea (OSA) is linked to the emergence and progression of cardiovascular complications including hypertension, stroke, arrhythmias, coronary artery disease and heart failure. Epidemiological studies have reported that hypertension is associated with respiratory events during REM sleep. We examined the relationship between respiratory events during REM and morning and evening hypertension in a clinical sleep population.

Methods
This study included data from in-laboratory diagnostic polysomnographic studies (n=797) from adults attending for investigation of OSA. Hypertension was defined using blood pressure measurements taken in the evening before and morning after polysomnography, and use of anti-hypertensive medication. Regression modelling was undertaken to examine the probability of evening and morning hypertension according to REM apnea hypopnea index (AHI), NREM AHI, gender, age, body mass index (BMI), alcohol use, total sleep time (TST), sleep time SpO2 &lt;90%, smoking and waist-to-hip ratio.

Results
The probability of morning hypertension was significantly independently associated with age (p&lt;0.001), BMI (p&lt;0.001) and REM AHI (p=0.012). No significant effect was found for male gender, NREM AHI, alcohol use, TST, sleep time SpO2 &lt;90%, smoking or waist-to-hip ratio (p&gt;0.05 for all). The probability of evening hypertension was only significantly associated with age (p&lt;0.001), BMI (p&lt;0.001) and TST (p=0.029).

Conclusions
Respiratory events during REM sleep are significantly associated with morning hypertension. Future research is needed to determine whether treatment of these events can prevent or reverse morning hypertension.
P044 “Get some sleep before baby”: Discourses of sleep and pregnancy in the media
Authors: Ladyman C , Signal L , Breheny M , Ross I , Dew K , Gibson R 
Published: November 2022

Abstract

Background
Physiological and psychosocial changes during pregnancy are often associated with altered sleep. Beliefs and expectations about sleep at this life-stage inform social discourses and help-seeking, in turn influencing women’s health and wellbeing. An understanding of discourses concerning sleep and pregnancy is required. Analysis of sleep-related messaging within mainstream media contributes to this understanding.

Method
Texts from New Zealand’s primary free online news source “Stuff” were identified using key words “sleep AND pregnancy” or “sleep AND pregnant” between December 2018 and December 2021. Forty-three relevant articles were collated. A critical discourse analysis was used to describe and interpret the texts in relation to discursive practices and wider social explanations.

Findings
Discursive constructions included: ‘banking’ sleep before baby; sleep’s role in ‘being the perfect mother’ (including ways to reduce risk of infant death through sleep practices); the inevitability that sleep will fail amongst the busy lifestyle of parenthood. Pregnant women were presented as responsible for good sleep yet not provided the knowledge of how to achieve it. Furthermore, pregnant women’s sleep situations were used to illustrate ‘desperate times’ associated with poor living or working situations.

Conclusions
Social discourses of sleep and pregnancy within mainstream media were sensationalised including tensions between discouraging ‘harmful’ sleep practices whilst also asserting that poor sleep is inevitable due to physiological changes and the negotiation of sleep with others, which would only worsen after birth. Findings will inform future research in the field of sleep as a social concept and practice among people during pregnancy.
P045 Profiles of Sleep Status in Older Adults and the Associated Characteristics
Authors: Jones C , Towers A , Gibson R 
Published: November 2022

Abstract

Introduction
Sleep problems become more prevalent in older adulthood having implications for healthy ageing. Characteristics of sleep status are under-explored among older populations.

Methods
Data from 13,309 adults ≥ 15 years was analysed from the 2013/2014 New Zealand Health Survey, 22% (2,932) were older adults (≥ 65 years; 56.51% female, 21.32% Māori). Five sleep profiles were established according to self-reported (a) presence of a sleep disorder; (b) excessive day-time sleepiness and (c) short sleep; (d) long sleep; and (e) typical sleep durations. Sociodemographic and health risk factors and health status were explored and multivariate multinomial models conducted to identify the factors associated with each sleep profile in older adulthood.

Results
Of the older adults, 27.8% were categorised within profiles that typified poor sleep (compared 19.35% of adults aged 15-64 years). Older adults were more likely to be classified within the ‘sleep disorder’, ‘excessive sleepiness’ or ‘long sleep’ profiles compared to the younger adults.
Among the older adults, multimorbidity and polypharmacy were independent predictors of the ‘sleep disorder’ profile, whereas ‘typical sleep’ was significantly associated with better health and socio-economic status. Inadequate nutrition, age and sex were significant predictors of ‘long sleep’. While age, sex, ethnicity, body mass index, and higher quantities of alcohol consumption were independently associated with ‘excessive sleepiness’.

Conclusions
This research helps establish a picture of the characteristics that coincide with profiles of poor sleep in older adulthood. Early recognition and management of sleep problems could improve physical and mental health status with aging.