bluuebunny/crossref_metadata_2025_split huggingface dataset:
P051 Evaluating sleep stage concordance of CardioRespiratary Sleep Staging (CReSS) on level III portable sleep study via simultaneous deployment of polysomnograph and level III portable sleep study
Authors: Hassinger D 
Published: November 2022

Abstract

Background
Polysomnograph (PSG) has traditionally been the gold-standard for evaluation of sleep disorders; however, it is complex and costly. Alternatives to PSG have been available for some time with aim to simplify the process. One challenge of home sleep testing has been the ability to stage sleep. The conventional type 2 device does provide limited electroencephalogram (EEG) but is restricted by quality and efficiency. Use of photoplethysmography (PPG) to stage sleep has been validated in 2017. There is limited research for evaluating sleep stage concordance using simultaneous deployment of laboratory EEG and PPG.

Aims
To evaluate a commercially available, proprietary algorithm (CReSS) which utilises PPG based sleep staging in comparison with laboratory PSG EEG for sleep stage concordance when data is acquired simultaneously and processed in parallel post acquisition

Results
Confusion matrix analysis demonstrates an accuracy of 80% across all staging. Upon further analysis, precision and recall for wake, light sleep, deep sleep and REM sleep was 82% and 78%, 77% and 90%, 96% and 48%, and 83% and 77% respectively. When classifying sleep/wake and REM/non-REM the accuracy was 90% and 95% respectively. Comparison of sleep distribution and AHI v REI established data was statistically significant in the percentage of light sleep (p=0.004) and deep sleep (p=0.005) along with the AHI vs. REI (p=0.013).

Conclusion
It was observed that sleep stage concordance aligned with literature values and that REI was usually underestimated compared to the AHI.
P053 Acceptability, Adaptability and Adherence to Continuous Positive Airway Pressure Therapy among Aboriginal Australians - The “A5” Top End Northern Territory Australian Study
Authors: Howarth T , Heraganahally S , Crespo J , Perez A , B Atos C 
Published: November 2022

Abstract
Obstructive sleep apnoea (OSA) is highly prevalent among the Australian Indigenous population. In this setting, alongside a high prevalence of chronic medical comorbidities, OSA may further perpetuate adverse health outcomes. Though CPAP is a well-established, proven therapeutic modality, acceptability, and adherence have not been examined among the Australian Indigenous population.
730 Indigenous Australian patients with a diagnostic sleep study recorded between 2011 and 2020 were included. CPAP therapy was assessed as Accepting (any recorded use), Adapting (≥30 days use) and Adhering (≥30 days with ≥4 hours use on ≥70% of nights).
649 (89%) Indigenous patients had OSA (25% mild, 25% moderate & 50% severe). The majority of patients were male (53%), aged a median 47 years and were obese (72%), with 44% residing in remote locations. 309 (48%) Accepted CPAP, 197 (30%) Adapted to CPAP and 67 (10%) Adhered to CPAP. Acceptance, Adaptation and Adherence were higher in patients with Severe vs. Mild OSA (63, 44 & 16% vs. 23, 10 & 3%). OSA severity was associated with Acceptance and Adaptation to CPAP therapy but was not associated with Adherence. Remote residence was significantly and negatively associated with Adaptation and Adherence to therapy.
Remote location was found to be the major factor defining whether patients continued therapy for ≥30 days and adhered to therapeutic guidelines. Given that 80% of Indigenous Australians in the NT reside in remote communities significant work needs to be done to promote adaptation and adherence to therapy in order to reduce morbidity associated with sleep disorders.
P058 The mediating effect of sleep on the relationship between precarious employment and mental health
Authors: Jaydarifard S , Smith S , Mann D , Rossa K , Huda M , Nikooharf Salehi E , Shekari Soleimanloo S 
Published: November 2022

Abstract

Introduction
Precarious work is characterised with high job insecurity, low income, and reduced rights and social protections. Current evidence suggests that precarious work is a risk factor for poor mental health. The relationship between these factors, and especially the contributing role of sleep may play in poor outcomes from precarious work, is unknown. This study investigated the mediating effects of sleep quality and duration on the relationship between precarious employment and poor mental health.

Methods
Data were obtained from the Household, Income and Labour Dynamics in Australia (HILDA) survey (2017). A novel precarious employment score (PES) was developed capturing precarity across the following dimensions: Employment insecurity, level of income, and rights and social protections. Self-reported sleep quality and 24-hour sleep duration were included as mediators. Mediation analyses were conducted to evaluate the mediating effect of sleep duration and sleep quality on the relationship between precarious employment and mental health (SF-36 mental health subscale), after controlling for several covariates.

Results
The PES identified 1446 (female, n=839) workers in precarious and 7922 (female, n=3949) non-precarious employees out of 9368. There was no significant direct association between precarious employment and mental health (P=.53). We observed no significant changes due to sleep quality in the association between precarious employment and mental health (Coefficient=-0.003, 95%

CI
-0.01-0.00, P=0.32). However, this association was significant when considering sleep duration (Coefficient=0.34, 95%

CI
0.25-0.43, P&lt;0.001).

Discussion
Encouraging precarious employees to prioritise and promote sleep appropriately may promote well-being. Further objective measurement of sleep is warranted in this group.
P065 Sleep Perceptions of Carers in Palliative Care: A Qualitative Study
Authors: Lalor A , Ip K , Parikh D 
Published: November 2022

Abstract

Introduction
Carers of individuals receiving palliative care have heightened responsibilities as part of their role which significantly affects their sleep. Despite the recognised importance of sleep, and the evidence regarding the impact of disturbed sleep on one’s physical and psychological wellbeing, sleep of carers is often overlooked. Furthermore, research regarding the lived experience of carers regarding their sleep is limited. This study aimed to explore carers’ sleep experiences, perceived factors related to sleep, and sleep management strategies that they adopt, in order to inform tailored assessment and sleep interventions for carers of individuals receiving palliative care.

Methods
Nine carers providing home palliative care were interviewed regarding their sleep experiences. Interviews were audio-recorded, transcribed verbatim and analysed thematically.

Results
Five key themes were identified: (1) Sleep experiences are complex; (2) Sleep is not the priority; (3) Contributing factors of sleep vary; (4) Multiple sleep management strategies exist; and, (5) Need for carer preparedness and ongoing support; under one overarching theme being “sleep is individual for every carer”.

Discussion
Sleep is an individualised and complex experience that is perceived differently by carers. To improve carers’ self-appraisal in sleep quality, consideration of personal beliefs and attitudes should be accounted for to aid addressing factors that contribute to carers’ sleep disturbances. Further, carer-specific resources are crucial to improving quality and accessibility of support services (i.e. respite care).
P073 The sleep, performance, and physiological health consequences of watchkeeping schedules: A scoping review
Authors: Marando I , Lushington K , Matthews R , Banks S 
Published: November 2022

Abstract
Watchkeeping schedules are commonly used on submarines and expose personnel to circadian misalignment and sleep loss. This scoping review aimed to identify the most frequently investigated schedules and examine the effect they have on sleep, cognitive performance, and physiological health outcomes. Systematic searches took place on five online databases (MEDLINE, PsychINFO, PubMed, Scopus, Embase) and Google Scholar in May 2022. The inclusion criteria consisted of peer-reviewed journal articles, industry reports and both laboratory and field studies which directly measured or compared a watchkeeping schedule used on submarines. The initial search produced 4375 results and through screening, resulted in 20 mostly field-based studies for data extraction. Sleep was the most often outcome investigated with only a few studies looking at cognitive performance and/or physiological health. The 6h on/6h off was the most studied schedule which generally demonstrated poorer sleep, cognitive performance, and physiological health than other schedules (e.g., 4h on/8h off, 6h on/12h off). This is important as this schedule is the most frequently used by navies around the world. In other schedules, sleep and cognitive performance were poorest during the biological night, whilst physiological measures were indicative of circadian misalignment. The synthesis of studies in this review provides an understanding how the currently used watchkeeping schedules around the world negatively affect submariners and increase their risk for deleterious health outcomes. The review also highlights the need for future controlled research to understand how schedules might be improved.
P077 Neurocognitive outcomes of children with sleep disordered breathing: a systematic review with meta-analysis
Authors: Menzies B , Teng A , Burns M , Lah S 
Published: November 2022

Abstract
Children with sleep disordered breathing (SDB) are at an increased risk of neurocognitive impairments. This systematic review with meta-analysis aims to (i) establish whether SDB differentially impacts various neurocognitive domains (intelligence, attention/executive functions, memory, visual spatial skills, and language) and (ii) examine the effects of several moderating factors. Database searches, conducted according to the PRISMA guidelines, identified 77 studies that met pre-determined criteria, 63 of which were included in the meta-analysis. Most studies were of moderate to high quality. Children with SDB had significant impairments in all cognitive domains, albeit of different magnitude. The largest impairments were found in intelligence (verbal and overall). With respect to severity of SDB, neurocognitive deficits were evident in children with primary snoring (PS) as well as in children with obstructive sleep apnea (OSA). Other moderators: higher body mass index, younger age at testing, using questionnaires rather than polysomnography, and employing a control group instead of normative data, related to poorer neurocognitive outcomes in select domains. Overall, our study provides robust evidence of multiple neurocognitive impairments in children with SDB, with no evidence of sparing in children with PS. The findings of our study provide impetus for research and interventions for children with SDB across all severities.
P084 Is there a clinical role for repeating the Multiple Sleep Latency Test across childhood?
Authors: Nisbet L , Nixon G , Anantharajah A , Davey M 
Published: November 2022

Abstract

Introduction
The gold standard investigation for central disorders of hypersomnolence in children is the Multiple Sleep Latency Test (MSLT). MSLT diagnostic cut-offs are extrapolated from adult data. Currently there are no guidelines available regards the utility and timing of repeating paediatric MSLTs.

Methods
Retrospective review of children with ≥2MSLTs at our tertiary centre between 2005–2022. Narcolepsy defined as mean sleep latency (MSL) &lt;8min with ≥2 sleep onset REM (SOREM); idiopathic hypersomnolence (IH) defined as MSL &lt;8min with &lt;2 SOREM. MSLTs not meeting these criteria were labelled non-diagnostic.

Progress
19 children (9F) with initial non-diagnostic MSLT underwent repeat MSLT with 5 proceeding to a 3rd MSLT following 2 non-diagnostic MSLTs. Repeat MSLT resulted in diagnosis in 6/19 (32%) (3 narcolepsy, 3 IH); whereas only 1/5 3rd repeat MSLT was diagnostic (IH). Median age at initial MSLT was 7.5y (range 3.4-17.8y), with repeat after 2.9y (range 0.9-8.2y), and 3rd after 2.1 years (range 1.2-4.2y). Mean change in MSL on repeat testing was -2min (range -15.5min to +4.9min, p=0.18). MSL reduced to &lt;10 minutes in one child, allowing access to PBS subsidised treatment. Of the 7 diagnostic repeat MSLTs, 2 had ≥2 SOREM and reduced MSL, 1 had reduced MSL (with 3 SOREM on initial and subsequent test), 4 had reduced MSL without SOREM.

Outcome
A third of repeat MSLTs became diagnostic, suggesting repeat MSLT in childhood should be considered if clinical suspicion persists. Further work needs to address the repeat interval between MSLTs and current diagnostic cut-points in the paediatric population.
P087 What is keeping Australian farmers awake at night? Associations between sleep and mental health
Authors: Paech G , Fehlberg R , Tong K 
Published: November 2022

Abstract

Introduction
In Australia, suicide rates are higher in farmers compared to the general population. The relationship between poor sleep and mental health is well known, yet there is limited evidence examining Australian farmers’ sleep and the role sleep plays in farmers mental health. Therefore, this study investigated the sleep and mental health of Australian farmers using an online questionnaire.

Methods
Farmers aged 18 and older (n=101; 52 males) completed a questionnaire (REDCap). The questionnaire included the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI) and Depression Anxiety Stress Scales (DASS-21). PSQI and ISI scores were split into normal values (‘below threshold’; PSQI&lt;5; ISI&lt;8) and abnormal values (‘above threshold’). Independent t-tests (Mann-Whitney) were performed to assess differences in mental health between the two threshold groups.

Results
Most participants worked full time (89%) on a family farm (70%) and were aged 26-55 (61%). Individuals with PSQI scores above threshold had higher DASS-21 scores across all subscales (p≤0.01; Depression 4.9±3.9; Anxiety 7.6±4.4; Stress 3.8±3.7) compared to those below threshold (Depression 2.9±3.0; Anxiety 5.1±3.2; Stress 1.9±2.0). All DASS-21 subscales scores were also higher in individuals with ISI scores above threshold (p&lt;0.001; Depression 5.0±3.9; Anxiety 7.3±4.2; Stress 3.8±4.1) compared to those below threshold (Depression 2.5±2.9; Anxiety 4.5±3.0; Stress 1.7±1.9).

Discussion
Results suggest that Australian farmers who have insomnia symptoms and poor sleep quality are at a higher risk of poor mental health. Identifying at-risk individuals by examining sleep quality, then investigating and treating sleep problems, may improve mental health amongst farmers.
P088 Sleep study report checking on night shift: Does it have an impact on the quality of the night study
Authors: Partridge G , Partridge G 
Published: November 2022

Abstract

Introduction
The aim of this study is to determine if the process of sleep study report-checking by the sleep scientist during an overnight shift affects the quality of sleep study acquisition performed during that shift.

Methods
In this unit one sleep scientist performs 3 sleep studies per night on a 10 or 12 hour shift. All studies are assessed at the time of scoring for quality of acquisition as ‘excellent’, ‘average’, ‘poor’ or ‘failed’. Scored studies are checked by another sleep scientist for accuracy in regard to patient demographics, study date, referring doctor, and sleep parameters. Between October 2021 and May 2022 two senior sleep scientists performed 87 sleep studies (both diagnostic and CPAP titration) and checked an average of 5 (SD 3.2) reports per night. The quality of their study acquisition was compared with 127 historical controls by the same scientists during the previous year. The proportions of ‘excellent’ and ‘average’ quality acquisitions in cases and controls were compared using the McNemar test (MedCalc 2012).

Results
There were no ‘poor’ or ‘failed’ studies. The percentages of ‘excellent’ study acquisition in cases (93.1%) and controls (89.7%), and ‘average’ cases (6%) and controls (11%) were not statistically different (p=0.58, 95% CI -5.7 to 11.2) .

Discussion
Results of this study demonstrate the process of report-checking on an overnight shift does not impact on the quality of the study acquisition, in our unit.
P089 Medical co-morbidities among Indigenous patients with OSA
Authors: Perez A , Howarth T , Heraganahally S 
Published: November 2022

Abstract

Introduction
Obstructive sleep apnoea is being increasingly recognised among Indigenous Australian adults. Moreover, other medical co-morbidities are also highly prevalent among Indigenous Australians. The bidirectional relationship between OSA and long-term metabolic consequences and its linkage to chronic medical conditions such as cardiovascular disease, hypertension and diabetes is well recognised. However, literature pertaining to presence of medical co-morbidities among Indigenous patients diagnosed with OSA is sparce. We therefore aimed to document the medical co-morbidities among Indigenous patients diagnosed to have OSA.

Methods
Demographic characteristics, clinical characteristics and presence of medical co-morbidities among patients diagnosed to have OSA with an AHI &gt;5/hour were assessed.

Results
Of a total 741 Indigenous patients who underwent a diagnostic sleep study between 2011- 2020, 662/741 (89%) were diagnosed to have OSA. At least one comorbidity was reported in 79% of patients, of which Hypertension was the most common in 52%, followed by diabetes in 39% and heart disease including coronary artery disease in 37%. Among patients with a comorbidity, 58% had three or more recorded. The prevalence of comorbidity and multimorbidity did not significantly differ by severity of OSA, aside from hypertension which was noted in 57% of patients with severe OSA compared to 46% with mild OSA. Furthermore, patients who have severe OSA were more likely to be male.

Discussion
Medical co-morbidities are highly prevalent among Indigenous patients diagnosed to have OSA, especially presence of hypertension, diabetes and heart disease. The long-term consequences are not known. Hence, further studies are warranted.
P099 Feasibility of assessing environmental factors in residential treatment settings: Preliminary associations between objective sleep and mental health outcomes
Authors: Rossa K , Salom C , Mann D , Edmed S , Morris L , Lorimer N , Stokes H , Dignan J , Smith S 
Published: November 2022

Abstract

Introduction
Circadian dysregulation is implicated in substance use and comorbid mental health problems, but is also exacerbated by these states. In addition to conventional treatment, environmental factors (light, temperature) are potential targets for improving sleep, circadian functioning, and recovery outcomes. This study explored the feasibility of objective sleep and environmental monitoring for recovering substance users in residential treatment, and also examined the relationship between objectively measured sleep-wake rhythms and mental health outcomes.

Methods
Fifty-two (Mage=38, SD=9.6; 56% female) individuals receiving treatment for substance use were included. Environmental light exposure, temperature, and activity data were collected via wrist-worn actigraphy, and in-room sensors for a minimum of 1-week of stay within a 6-week program. Actigraphy derived sleep-wake patterns were used to calculate Interdaily Stability (IS). Data were linked to routinely collected clinical measures of mental health.

Results
No individuals opted out of the environmental monitoring aspect of the study, indicating acceptability and feasibility. Environmental loggers mounted in individual rooms recorded average nightly temperatures &gt;21 degrees for 5/8 months. Objectively measured IS (M=.79; 95%CI=.67-.73) was negatively associated with Anxiety (r=-.33, p=.024) and Depression (r=-.36, p=.012), while sleep duration was not. Relationships between participant-level light exposure and clinical outcomes were also examined.

Discussion
Preliminary results indicate that circadian regularity appears important for mental health outcomes in this population and setting. The structured residential environment provides opportunities for regulating sleep-wake rhythms via scheduling of activities at circadian-appropriate times. This research suggests that optimising circadian- appropriate lighting and thermal comfort may lead to improved individual outcomes.
P101 Paediatric obstructive sleep apnoea in primary care: an integrative review of practitioner knowledge, practice, attitudes, and behaviours
Authors: Russo K , Burgess S , Soenen S , Zwar N 
Published: November 2022

Abstract

Introduction
Obstructive sleep apnoea (OSA) is a common health problem in children (1-6%) and is associated with deficits in various health, cognitive and behavioural domains. Early diagnosis, and treatment, significantly reduces associated sequelae. Primary care practitioners (PCPs) could play a crucial early and continuing role in the identification and management of OSA due to regular and ongoing interaction with the children and their families. PCPs must however have appropriate knowledge and confidence in their skills to address this effectively. The integrative review aims to explore and describe PCPs knowledge, practice, attitudes, and behaviours regarding identification and management of childhood OSA.

Methods
Five electronic databases were searched up to May 6th, 2022, in addition to reference lists of selected/key references. Quality appraisal of included studies (Mixed Methods Appraisal Tool) and meta-synthesis of extracted data, using a five-stage synthesis process, will be undertaken.

Results
The search yielded a total of 3341 potentially eligible papers. After screening of titles, abstracts, and full text papers, 26 papers are currently included. Data extraction, quality appraisal and data synthesis is ongoing. Inductively developed themes and sub-themes will be presented at the conference.

Discussion
The findings from this review will describe current practice and provide recommendations and strategies for improving PCP identification and management of childhood OSA, with the goal of reducing the impact and burden of OSA on children and their families. In addition, barriers and facilitators to identification, practitioner knowledge and skill discrepancies will be explored and recommendations for future research will be presented.