bluuebunny/crossref_metadata_2025_split huggingface dataset:
O047 An online sleep education workshop for trainee psychologists improves sleep knowledge, skills, and confidence to treat insomnia: A waitlist comparison study
Authors: Meaklim H , Junge M , Rehm I , Monfries M , Kennedy G , Bucks R , Meltzer L , Jackson M 
Published: November 2022

Abstract

Introduction
Despite the clear influence of poor sleep on mental health, nearly half of trainee psychologists receive no sleep education. This limits their ability to manage common sleep disorders, such as insomnia, that adversely impact mental health. This study examined the effectiveness of an online sleep education workshop for improving trainee psychologists’ sleep knowledge and their skills and confidence to deliver evidence-based interventions for insomnia.

Methods
Trainee psychologists enrolled in a six-hour online sleep education workshop (n=186, M age=32, 80% female) or waitlist comparison group (n=70, M age=32, 81% female) offered at their university as part of their postgraduate coursework or a voluntary workshop. Sleep education assessments were completed at pre-and post-intervention (2-4 weeks) and long-term follow-up (12 months).

Results
Workshop attendees demonstrated significant improvements in sleep knowledge post-intervention (pre: 55% vs. post: 80% correct) relative to the waitlist comparison group (pre: 52% vs. post: 51% correct; p&lt;.001). Post-intervention, workshop attendees reported increased confidence in treating insomnia using an evidence-based approach compared to the waitlist group (p&lt;.001). At 12 months post-intervention, 92% of trainees reported utilizing the knowledge and skills learned in the sleep education workshop in their clinical practice.

Discussion
Psychologists are front-line mental health service providers, yet sleep education is missing from the psychology curriculum. Online sleep education workshops provide trainee psychologists with the essential sleep knowledge, skills, and confidence they need to manage insomnia in clinical practice. Such online workshops can be scaled to deliver cost-effective training to psychologists nationally and successfully bridge the evidence-practice gap.
O049 Insomnia severity and cognitive performance following two weeks’ nightly supplementation with 150mg Cannabidiol (CBD) for primary insomnia
Authors: Narayan A , Downey L , Hayley A 
Published: November 2022

Abstract

Introduction
Cannabidiol (CBD) may have sleep promoting effects, but clinical dosage and safety recommendations are still lacking. This study was the first to examine whether the approved Therapeutic Goods Association (TGA) daily over-the-counter maximum dose of oral CBD oil (150mg) improved the self-rated severity of primary insomnia and explored CBD effects on higher-order cognitive performance tasks.

Methods
Participants (n = 30) with moderate-severe primary insomnia completed a one-week single-blind placebo-run in period followed by a 2-week double blind, parallel, randomised placebo-controlled dosing period with four assessment visits (V0-V4). Intra-group and between-group Insomnia Severity Index (ISI) (V0 and V4) and cognitive performance (ECog Pro) (V1, V2 and V4) outcomes were assessed using paired sample t-test with independent t-tests, and separate linear mixed effect models with Maximum Likelihood Estimation and independent T-tests, respectively.

Results
Preliminary findings showed reduced ISI for treatment (n = 5; baseline mean 16.60 to 9.60 post treatment, mean difference = -7.00, SD = 4.47) and placebo (n = 8; baseline mean 18.13 to 9.25 post treatment, mean difference = -8.88, SD = 3.68) over time (both p &lt; .001). At conclusion, CBD did not outperform a placebo (p = .427). Numeric and spatial working memory accuracy (%) and reaction time (ms) indicated no intra-group or between-group differences at any time point (all p &gt; 0.05).

Discussion
Decreased insomnia severity from moderate to subthreshold levels indicate potential clinical benefits of daily CBD supplementation as a sleep aid for primary insomnia. Preserved higher-order neurocognitive abilities suggest a good safety profile.
O056 The effect of acetazolamide and oxygen (ACZ+O2) combination therapy on loop gain and OSA severity
Authors: Landry S , Collet J , Thomson L , Beatty C , Mann D , Wong A , Turton A , Sands S , Joosten S , Hamilton G , Edwards B 
Published: November 2022

Abstract

Introduction
One third of patients with OSA have high loop gain. Acetazolamide (ACZ) and supplemental oxygen (O2) individually reduce loop gain (via different mechanisms) and the apnoea-hypopnoea-index (AHI). The current study aimed to explore the efficacy of combining both ACZ and O2 to maximally lower loop gain.

Method
Randomised single-blind cross-over trial. Participants took ACZ (500mg orally) or placebo for 7 days. Within each arm, participants completed two polysomnograms (PSGs) during which they slept with supplemental oxygen (3L/min) or sham-air. Sleep and respiratory events were scored by a (blinded) technologist. In addition to standard scoring, respiratory events were scored without SpO2 or arousal information to calculate a ‘flow-based AHI’ (fAHI). PSG data were then imported into Matlab for loop gain analysis.

Results
Nine participants (5 males, Age=52.4±9.1, BMI=32.0±4.9, AHI=39.9±22.0) have so far completed the trial. Loop gain was significantly reduced by ACZ (-22%, -0.15 CI95:-0.03 to -0.26, p=0.011), O2 (-25%, -0.19 CI95:-0.08 to -0.29, p=0.001) and combination ACZ+O2 (-33%, -0.23 CI95:-0.12 to -0.34, p&lt;0.001) relative to placebo-sham-air condition. Similarly, fAHI was significantly reduced by ACZ (-34%, -15.7/hr CI95:-8.6 to -22.7, p&lt;0.001), O2 (-21%, -10.2/hr CI95:-3.1 to -17.3, p&lt;0.001) and ACZ+O2 (-45.2%, -21.3/hr CI95:-14.6 to -28.4, p&lt;0.001). While fAHI was significantly lower on ACZ+O2 compared with O2 (p=0.003), the difference between ACZ+O2 and ACZ was not significant (-5.6/hr, p=0.12). ACZ+O2 induced a &gt;50% reduction in fAHI in 4/9 participants.

Discussion
Our preliminary data demonstrate that ACZ+O2 may be an efficacious combination therapy for some OSA patients.
O059 A study in Physiological Activation Responses to Posture Shifts in Sleep and The Impact of Supine Avoidance Alarms
Authors: Rahimi M , Catcheside P 
Published: November 2022

Abstract

Introduction
This study assessed the frequency and duration of arousal responses associated with posture shifts during sleep and the time taken to resume sleep following posture shifts with versus without a supine-avoidance alarm.

Method
Sleep and posture shift outcomes during a baseline in-home sleep study (Embletta MPR plus an inactive supine-avoidance alarm device) and subsequent sleep study after 6-8 weeks of supine-avoidance treatment were examined in 66 patients with supine-predominant OSA. A technician blinded to supine-treatment data scored each sleep study, including arousal responses (3-15 and ≥15-sec EEG changes). All posture shifts lasting &gt;5 sec were identified from sleep study and supine-alarm device posture recordings. All sustained (≥30 sec) posture shifts commencing from established sleep during baseline and supine-avoidance nights were assessed for arousal responses (within -30 to +3 sec of each posture shift) and the time taken to resume sleep following each posture shift.

Results
The study population was 62.1% males with a mean±SD age 52.8±11.9 years, BMI 31.9.4±7.8 kg/m², AHI 18.0±9.9 /hr (supine AHI=40.2±38.8 /h). From a total of 418 (baseline) vs 283 (supine-avoidance) sustained posture shifts (median [IQR] 6[3-10] vs 6[3-9] per patient), the majority [342/418 vs 244/283; 91[75-100] vs 100[84-100]%) were associated with an arousal, followed by 0.5 [0.0 to 1.0] min before sleep resumed, with no difference with versus without the supine-alarm.

Conclusion
Posture shifts from sleep are mostly associated with brief arousal prior to any supine-avoidance alarm, after which a supine avoidance alarm effectively discourages supine positioning with minimal disturbance to the resumption of sleep.
O064 A Portable Ocular Assessment for Predicting Fitness to Drive under Extended-Wakefulness Conditions – 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
In response to the high incidence of fatigue-based vehicle accidents, roadside assessments of sleepiness are in significant demand. For this purpose, we’ve piloted the existing 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 simulated driving performance.

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 one 60-minute drive on the AusEd driving simulator, in addition to three administrations of 60-second prosaccade and antisaccade assessments using the NeuroFlex® VR platform.

Results
Steering deviations from the median lane position showed a time main effect, F(4,24.49) = 13.38, p &lt;.001, with the most diminished performance occurring at 19 (M=59.50cm, SD=26.61cm) and 25-hours post-wake (M=72.88cm, SD= 40.09cm) (vs. peak performance @13-hours post-wake M=35.09, SD=12.81; M diff.= 24.41 and 37.79 respectively, p &lt;.001). One moderate association between prosaccade latency and steering deviation was found in the final battery following 25-hours of wakefulness (r=.51, p= 0.04). No significant associations were found for antisaccade latency.

Discussion
Despite the lack of significant associations with steering deviations, eye-movement latency did demonstrate durational increases over extended wakefulness. In this preliminary investigation we were limited to the existing output generation of the NeuroFlex® platform. Therefore, with refined data analyses of ocular control, we see promise in the NeuroFlex® platforms capability of detecting road users’ fitness to drive.
O069 The effects of sleep disordered breathing on sleep spindle activity in children and the relationship with neurocognition
Authors: Shetty M , Perera A , Kadar M , Davey M , Nixon G , Walter L , Horne R 
Published: November 2022

Abstract

Introduction
Conventional sleep macro-architecture measures of sleep disruption have not been associated with the adverse neurocognitive sequelae of sleep disordered breathing (SDB). Sleep spindles protecting the sleeping brain from external sensory stimuli and can serve as markers of sleep integrity. We investigated the relationship between sleep spindles and sleep fragmentation and neurocognition across the spectrum of SDB in children.

Methods
Children 3-12y referred for clinical assessment of SDB and age matched control children from the community were recruited. Sleep spindles were identified manually during N2 and N3 sleep. Spindle activity was characterised as spindle number, spindle density (number of spindles/ h) and spindle intensity (spindle density x average spindle duration). The Stanford-Binet Intelligence Scales measured global intellectual ability and the NeuroPSYchological assessment (NEPSY-II) measured language, attention, visuospatial ability and sensorimotor skills.

Results
Children were grouped into control, Primary Snoring, Mild OSA and Moderate/severe OSA, N=10/ group. All measures of spindle activity were lower in the SDB groups compared to the Control children and this reached statistical significance for Mild OSA (p&lt;0.05 for all). Spindle activity was not correlated with any measure of the Stanford-Binet. Overall, all measures of spindle activity were positively correlated with the Design Copy and the Inhibition Naming combined scale score and negatively correlated with Auditory Attention subscales of the NEPSY-II.

Conclusion
The reduced spindle activity observed in the children with SDB, particularly Mild OSA, indicates that sleep micro-architecture is disrupted and that this disruption may underpin the negative effects of SDB on attention, learning and memory.
O070 Longitudinal associations of sleep microarchitecture with future cognitive function in middle-aged and older men from a community-based cohort study
Authors: Parker J , Vakulin A , Melaku Y , Wittert G , Martin S , D'Rozario A , Catcheside P , Lechat B , Teare A , Toson B , Appleton S , Adams R 
Published: November 2022

Abstract

Study objectives
Prospective studies examining associations of sleep microarchitecture with future cognitive function predominantly recruited from small samples with relatively short follow-up. Therefore, this study examined sleep microarchitecture predictors of cognitive function (visual attention, processing speed, and executive function) after 8–10 years in community-dwelling middle-aged and older men.

Methods
Of 433 Florey Adelaide Male Ageing Study participants who underwent home-based polysomnography (2010–2011), 157 completed baseline and follow-up cognitive testing. Whole-night F4-M1 sleep EEG recordings were processed following artefact exclusion, and quantitative EEG features obtained using validated algorithms. Trail-making tests A (TMT-A) and B (TMT-B) were administered at baseline (2007–2010) and follow-up (2018–2019) examinations. Linear regression models were adjusted for baseline obstructive sleep apnea, demographic, biomedical, and behavioural factors, and cognitive performance.

Results
At baseline, participants were aged mean (SD) 58.9 (8.9) years with normal cognition. In unadjusted models only, lower REM sleep delta and higher alpha power were associated with worse TMT-A performance at follow-up (delta, B= -0.02, 95% CI [-0.04, -0.001], p=0.042; alpha, B=0.08, 95% CI [0.01, 0.15], p=0.024). Lower overall and slow sleep spindle density in N2 and N3 were associated with worse TMT-A performance at follow-up (all p&lt;0.05). The association of higher fast spindle density in N3 with worse TMT-B performance (B =1.06, 95% CI [0.13, 2.00], p=0.026) was not significant after adjustment for baseline cognition.

Conclusions
In this sample of community-dwelling middle-aged and older men with normal baseline cognition, sleep microarchitecture parameters were not independently associated with cognitive function after 8–10 years.
O073 Traditional Clinical and Novel Oximetry Measures as Predictors of Cardiovascular Events
Authors: de Chazal P , Sutherland K , Bin Y , Cook K , Cistulli P 
Published: November 2022

Abstract

Introduction
Intermittent hypoxia is a key mechanism linking Obstructive Sleep Apnoea (OSA) to cardiovascular disease (CVD). Oximetry analysis could enhance understanding of which OSA phenotypes are associated with CVD risk. We investigated if traditional clinical and novel oximetry measures including hypoxic burden (HB) calculated from the polysomnogram SpO2 signal can predict CVD outcomes in all-comers and OSA subsample cohorts from the Sleep Heart Health Study (SHHS).

Methods
CVD mortality outcome and complete covariate information was used. We implemented 31 oximetry measures and assessed the performance of the parameters in predicting CVD outcomes (CVD death or incident CVD) in the all-comers and sleep apnoea subsamples. The performance of each measure was assessed using an adjusted Cox proportional hazard ratio (HR) analysis.

Results
In the general subsample, HB successfully predicted CVD death (HR&gt;1.8, p&lt;0.05) but did not predict incident CVD. In the sleep apnoea subsample (AHI&gt;5) with no CVD at baseline, none of the SpO2 measures we considered predicted incident CVD.

Discussion
The ability of HB to predict CVD outcomes depends on the cohort and the CVD outcome. Our analysis of the selected SpO2 measures in an OSA subsample did not find strong links between any oximetry measures and incident CVD, and therefore no strong candidates for CVD risk phenotyping in the sleep clinic. Further work is needed to understand the complex relationship between OSA-related intermittent hypoxia patterns and development of CVD to further understanding of OSA phenotypes at risk of CVD consequences.
P002 CPAP therapy compliance and changes in cognitive function in patients with obstructive sleep apnoea
Authors: Adams R , Georgeson T , Szollosi I , Coulson E 
Published: November 2022

Abstract

Aims
Obstructive sleep apnoea (OSA) has been implicated in the pathophysiology of Alzheimer’s disease (AD). Intermittent hypoxia and arousals may contribute to mechanisms leading to accumulation of amyloid beta plaques and intraneuronal neurofibrillary tangles seen in AD. Treatment with Continuous Positive Airway Pressure (CPAP) improves symptoms and cardiovascular sequalae of OSA, and may also mitigate the progression of AD. We investigated, in patients with moderate to severe OSA, whether CPAP compliance altered cognitive test scores.

Methods
Cognitive testing with the Addenbrooke’s Cognitive Examination-Revised Version (ACE-R) was performed before commencing CPAP and repeated after 3 to 5 years. Student’s independent t-test was used to compare changes in ACE-R between compliant and non-complaint groups based on usage greater than 4 hours/day.

Results
30 subjects, mean age 67 years (SD=6.4), had baseline ACE-R of 90 (SD=4.75). At follow up, treatment compliant subjects demonstrated improvement in cognitive test scores in the memory and visuospatial cognitive domains with a mean improvement in memory of 1.5 points p=0.01 95% CI [0.33, 2.67], and mean improvement in visuospatial cognition of 0.95 points p=0.01 95% CI [0.23, 1.7]. Scores for CPAP non-compliant subjects showed no significant difference over time.

Conclusion
Sustained use of CPAP over time results in a statistically significant improvement in ACE-R test scores, in the subdomains of memory and visuospatial cognition. However, the clinical significance of these findings is unclear and requires further research, as the scores remained in the normative range.
P003 The Effect of Centella Asiatica on Inactive Frequency and Movement Distance in Insomnia Zebrafish (Danio rerio) Larvae Model
Authors: Afif Z , Santoso M , Khotimah H , Satriotomo I , Iskandar D , Hakimah A , Andriani N , Agustina K 
Published: November 2022

Abstract

Introduction
Insomnia is a global health problem. Zebrafish (Danio rerio) is an ideal model for studying sleep disorder due to its diurnal cycle. Centella Asiatica (CA) is thought to have an anti-insomnia effect, but its mechanism is not clearly understood. The aim of this study is to evaluate the effect of CA on insomnia zebrafish larvae model by observing sleep parameters including inactive frequency and movement distance.

Methods
This experimental study is divided into five groups of zebrafish larvae consisting of control group, insomnia group with 24 hours of light exposure for 7 days, insomnia group with CA concentration of 2.5, 5, and 10 µg/mL. Observation of zebrafish larval movement was carried out on 5, 6, and 7 dpf (day post fertilization) during 30 minutes before and after turning off light exposure.

Results
There were significant differences on 5, 6, and 7 dpf between the normal group, insomnia group, and all treatment groups with CA addition on inactive frequency and movement distance in light and dark conditions (p&lt;0.05).

Discussion
This study showed that CA has an anti-insomnia effect. CA can improve sleep quality of insomnia zebrafish larvae model by increasing inactive frequency and shortening movement distance.

Keywords
Centella Asiatica, zebrafish, inactive frequency, movement distance.
P005 A two-night randomised controlled cross-over trial of AVAPS AE auto-titrating bi-level ventilation vs standard in-lab titration in patients with motor neurone disease commencing overnight ventilatory support
Authors: Aiyappan V , Catcheside P , Grivell N , Hansen C , Keighley James G , Schultz D , Allcroft P 
Published: November 2022

Abstract

Introduction
Sleep disordered breathing in motor neurone disease (MND) is heterogeneous. Auto-adjusting AVAPS-AE mode of non-invasive ventilation (NIV) could simplify NIV setup and use in MND. This pilot study assessed NIV titration and longer-term outcomes with AVAPS AE auto-pressure support versus standard S/T mode NIV titration in patients with MND.

Methods
10 MND patients commencing NIV consented to a 2 consecutive night randomised controlled cross-over trial of auto-titrating AVAPS-AE versus standard S/T mode NIV titrated according to current clinical practice. Patients underwent in-laboratory polysomnography (PSG) on both nights before continuing on the second allocated mode of NIV.

Results
8 patients completed both cross-over nights and 9 subsequently continued on home NIV (4 on S/T and 5 on AVAPS-AE mode). Compared to baseline, both S/T and AVAPS-AE modes significantly reduced apnea hypopnea index (AHI; mean [95%CI] 14.8 [6.8-22.8] to 1.2 [0-2.7] and 3.6 [0-7.1] /h respectively), with no significant differences between modes on other PSG outcomes. Maximum EPAP (15.4 [13.4-17.4] vs 8.3 [4.9-11.6] cmH2O, p=0.003) and pressure support levels (16.3 [11.2-21.3] vs 6.6 [5.9-7.4] cmH2O, p=0.003) were higher with AVAPS-AE versus S/T mode respectively, although average pressure support levels were not different. Over 6 months of follow-up, average daily use was similar in both treatment groups (AVAPS-AE 7.3 [3.2-11.3]; S/T mode 7.8 [3.5-12] h/day).

Conclusion
Automated AVAPS-AE mode of BiPAP support appears to achieve similar control of sleep disordered breathing when compared to standard S/T mode, and to be well tolerated and used in patients with MND.
P008 The relationship between REM Sleep prior to Analogue Trauma and Intrusive Memories
Authors: Alkalame L 
Published: November 2022

Abstract
Intrusive memories are a core feature of posttraumatic stress disorder (PTSD). They both predict the onset of the disorder and drive broader PTSD symptomology. Outside PTSD, disruptions in REM sleep contribute to emotional dysregulation and an amplified reaction to negative emotional stimuli. The current study examined the association between REM sleep prior to analogue trauma and intrusive memories.
To manipulate REM sleep, 22 healthy adults (MAge = 26.05, SD = 5.22) were randomised to either to a circadian misalignment (CM) condition or normal control (NC) condition for four nights. In CM, participants slept normally for two nights followed by a 4-hour phase advance on night three and an additional 4-hour phase advance on night four. In NC, participants slept 8 hours. On the day after night 4, participants watched a trauma film in a controlled laboratory setting. Participants kept an intrusive memory diary for three days following viewing of the film.
Greater REM sleep percentage across 4 nights prior to analogue trauma was significantly associated with fewer intrusive memories independent of group in the 3 days after viewing of the film (p = .015).
Findings suggest REM sleep may serve to protect individuals against experiencing intrusive memories. This is consistent with evidence suggesting REM sleep influences the encoding of emotional memory. Occupations (e.g., emergency service workers/military personnel) who experience circadian disruptions likely to decrease REM sleep (e.g., from shift work) may be at heightened risk of experiencing intrusive memories after trauma exposure, and thus at increased risk of developing PTSD.