Assessment Of Sleep Disturbance Research Articles

An expedited model for identifying potential patients with periodic leg movements.

Periodic leg movements during sleep (PLMS) may have crucial consequences in adults. This study aimed to identify baseline characteristics, symptoms, or questionnaires that could help to identify sleep-disordered breathing patients with significant PLMS. Patients aged 20-80 years who underwent polysomnography for assessing sleep disturbance were included. Various factors such as sex, age, body measurements, symptoms, apnea-hypopnea index (AHI), and sleep quality scales were analysed to determine the presence of PLMS. The study included 1480 patients with a mean age of 46.4 ± 13.4 years, among whom 110 (7.4%) had significant PLMS with a PLM index of 15 or higher. There were no significant differences observed in terms of sex or BMI between patients with and without significant PLMS. However, the odds ratios (OR) for PLMS were 4.33, 4.41, and 4.23 in patients who were aged over 50 years, had insomnia, or had an ESS score of less than 10, respectively. Notably, the OR increased up to 67.89 times in patients who presented with all three risk factors. Our analysis identified significant risk factors for PLMS: age over 50, self-reported insomnia, and lower daytime sleepiness levels. These findings aid in identifying potential PLMS patients, facilitating confirmatory examinations and managing associated comorbidities.

Assessment of sleep disturbance in patients with Wilson’s disease

BackgroundWilson’s disease (WD) is frequently manifested with anxiety, depression and sleep disturbance; this investigation aimed to elucidate these manifestations and identify the influencing factors of sleep disturbance.MethodsSleep disturbance, anxiety and depression were compared in 42 WD and 40 age- and gender-matched healthy individuals. 27 individuals indicated a neurological form of the disease (NV), and 15 had a non-neurological variant (NNV).ResultsThis investigation revealed that the Parkinson’s disease sleep scale (PDSS) score of WD individuals was lower, whereas their Epworth Sleepiness Scale (ESS), Pittsburgh sleep quality index (PSQI), Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HAMD) scores were higher than the healthy individuals (p < 0.05). Furthermore, the WD subjects had markedly increased prevalence of poor sleep quality, anxiety, and depression than healthy individuals (p < 0.05). Subgroup analysis showed that NV subjects had significantly higher scores on the UWDRS, PSQI, HAMA, and HAMD scales than those in the NV group, as well as higher rates of EDS, anxiety, and depression (p < 0.05). In patients with sleep disturbance, we identified UWDRS, neurological variant, and depression as associated factors. The linear regression model demonstrated depression as the dominant risk factor.ConclusionsDepression is highly correlated with and is a determinant of sleep disturbance in WD patients.

Psychometric evaluation of the PROMIS SD-SF-8b instrument in individuals experiencing vasomotor symptoms due to menopause

BackgroundWomen with vasomotor symptoms (VMS) due to menopause frequently experience poor sleep quality. The Patient-Reported Outcomes Measurement Information System Sleep Disturbance – Short Form 8b (PROMIS SD-SF-8b) has been developed to assess sleep disturbance. The study objective was to use data from the fezolinetant SKYLIGHT 1 and 2 studies in individuals with VMS to assess the psychometric properties of the PROMIS SD-SF-8b.MethodsIndividuals (aged ≥ 40–≤65 years) with moderate-to-severe VMS (≥ 7 hot flashes/day) were enrolled. Besides PROMIS SD-SF-8b, eight other patient-reported outcome (PRO) measures were used for the psychometric evaluation. All the PRO assessments were completed at weeks 4 and 12 during the treatment period and most were completed at baseline. Psychometric analyses included factor analysis and reliability, construct validity, and sensitivity to change assessments. The within-patient threshold for a clinically meaningful change in sleep disturbance was derived.ResultsOverall, 1022 individuals were included from the SKYLIGHT 1 and 2 studies. Mean PROMIS SD-SF-8b total score at baseline was 26.80, which decreased to 22.68 at week 12, reflecting improved sleep disturbance. The confirmatory factor analysis supported the proposed PROMIS SD-SF-8b domain structure. Internal consistency was excellent, with Cronbach’s alpha values of 0.915 and 0.935 and a McDonald’s omega of 0.917. Item-to-item and item-total correlations were sufficient and moderate test-retest reliability was noted. The construct validity assessments showed that moderate Spearman rank correlations (r: 0.608 to 0.651) were observed between PROMIS SD-SF-8b total scores and measures of sleep disturbance and sleep-related impairment, and that significant differences were noted in the total scores across PRO categories. The responsiveness of PROMIS SD-SF-8b total scores was supported by the results from the correlations in change scores and comparisons of mean change scores by PRO categories. Statistically significant differences in mean scores were observed between responder and non-responder PRO groups. A PROMIS SD-SF-8b total score of 8 points was identified as the within-patient threshold to use to confirm a meaningful change in sleep disturbance.ConclusionsThe psychometric properties of the PROMIS SD-SF-8b support its use to measure sleep disturbance in women with VMS due to menopause.Trial registrationClinicalTrials.gov numbers: NCT04003155 and NCT04003142.

July 14th 2016 Nice Terrorist Attack Court Trial: A Protocol on Sleep Quality and Somatic Symptoms as Markers of Risk for Traumatic Reactivation in Adolescents Exposed to This Attack.

The court trial of the 14th of July 2016 terrorist attack in Nice (France) opened in September 2022 and ended in December 2022. Engaging in court proceedings, whether as a victim or a witness, can lead to a significant risk of traumatic reactivation (i.e., the re-emergence of post-traumatic stress symptoms). The present protocol aimed to improve knowledge of the pathophysiology of traumatic reactivation due to the media coverage of the trial by assessing sleep disturbances and somatic symptoms that could reappear if there is a traumatic reactivation. Method and Analysis: This is a monocentric longitudinal study, with recruitment solely planned at the Nice Pediatric Psychotrauma Center (NPPC). We intended to include 100 adolescents aged 12 to 17 years who were directly or indirectly exposed to the attack and included in the "14-7" program). Assessments began one month before the trial, in August 2022, and were scheduled once a month until the end of the trial. A smartwatch recorded sleep activity. Somatic and PTSD symptoms and sleep were assessed through validated questionnaires. The main analyses comprised the variance and regression analyses of predictors of clinical evolution over time. Ethics and Dissemination: The National Ethics Committee "NORD OUEST III" approved the "14-7" program protocol (number 2017-A02212-51). The specific amendment for this research was approved in April 2022 by the same national ethical committee. Inclusions started in August 2022.

E12 Sleep disturbance among Juvenile idiopathic arthritis patients

Abstract Background Juvenile idiopathic arthritis (JIA) is a common pediatric condition that is often associated with chronic pain and physical disability. Moreover, it is also comorbid with sleep problems which considerably affects the patient’s daily functioning [1]. Objectives The aim of this study was to assess sleep disturbances among JIA patients. Methods We conducted a cross-sectional study including patients with JIA according to the International League of Associations for Rheumatology (ILAR). Sociodemographic data as well as disease characteristics were collected. Sleep disturbance was assessed by two questionnaires: the BEARS Sleep Screening algorithm and PROMIS sleep disturbance short form according to the age of the patients (&amp;lt;18 years old, &amp;gt;18 years old respectively). The BEARS is an instrument divided into major sleep domains: bedtime problems, excessive daytime sleepiness, awakenings during the night, regularity and duration of sleep and snoring. PROMIS is an 8-item questionnaire that assess sleep quality. A higher T score corresponds to a poorer the sleep quality. Results The study included 31 patients. The mean age of the participants was 28.67 years [9–45 years]. There was a female predominance: 35.5% males vs 64.5% females. The mean age at onset was 6.6 years [2–13] and the mean disease duration was 256.5 months [36–444]. The distribution of the different subtypes was as follows: Enthesitis-related arthritis (n = 4), RF-positive polyarthritis (n = 10), RF-negative polyarthritis (n = 6), oligoarthritis (n = 7) and systemic arthritis (n = 4). Nineteen patients were receiving corticosteroids. Disease-modifying anti-rheumatic drugs were used by 18 patients: methotrexate (n = 11), sulfasalazine (n = 3), leflunomide (n = 4), biologics (n = 13). Twelve patients developed complications: coxitis (n = 11), growth retardation (n = 9), uveitis (n = 4). The majority of the respondents (90.3%) reported using screens daily before going to sleep. Among patients aged &amp;lt;18 years, 2 had an individual bedroom while 8 shared theirs with their siblings. Among the ten patients who answered the BEARS Sleep Screening algorithm, 40% had an excessive daytime sleepiness, 20% had night awakenings and 30% suffered from a snoring problem. Regularity and duration of sleep was respected in 6 out of the 10 patients. The most common bedtime problem mentioned were refusal to go to bed (73%) as well as bedtime stalling (23%). As for the PROMIS form, the mean score was 55.52 [27–66]. None to slight, mild, moderate and severe sleep disturbance were found in 16.1%, 19.3% and 6.4% of cases respectively. There was a significant association between poor sleep quality and higher disease activity (DAS28 ESR) (P &amp;lt; 0.043). However, we did not find a significant association between the sleeping disturbances and age at onset (P = 0.08), disease duration (P = 0.073), the CHAQ score (P = 0.059), corticosteroid use (P = 0.063) and the screen use (P = 0.092). Conclusion This study highlights the high prevalence of sleep disturbance among JIA patients which may affect their physical, emotional and cognitive well-being. It is important to screen for sleep problems for a better management of the disease. [1] Owens J. Classification and epidemiology of childhood sleep disorders. Prim Care 2008; 35(3):533–46

Associations of sleep disturbances with cognitive function and plasma Alzheimer’s biomarkers in Chinese rural‐dwelling older adults: A population‐based study

AbstractBackgroundSleep disturbances have been associated with cognitive impairment, but their associations with plasma Alzheimer’s disease (AD) biomarkers have been rarely explored. We sought to investigate the relationships of self‐reported and cardiopulmonary coupling (CPC)‐assessed sleep disturbances, cognitive function, and plasma AD biomarkers among rural‐dwelling older adults in China.MethodThis population‐based cross‐sectional study included 1987 dementia‐free individuals (age ≥60 years, 55.0% women) who participated in the CPC‐substudy as part of the baseline assessments of the MIND‐China Study; of these, 830 had data on plasma Aβ42, Aβ40, total‐tau, and neurofilament light chain (NfL) that were measured using the single molecule array (SIMOA) technology. We collected data via face‐to‐face interviews, clinical examinations, and neuropsychological test. Sleep disturbances were assessed using the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), the self‐administered Berlin Questionnaire, and the ECG‐based CPC analysis. We used the neuropsychological test battery to assess memory, language, attention, and executive function. Data were analyzed using logistic and general linear regression models.ResultOf the 1987 participants, CPC‐measured total sleep time (TST) &gt;8 hours/night (vs. 5‐8 hours) was significantly associated with a lower composite z‐score of memory (β = ‐0.080; 95% CI = ‐0.160 ‐ ‐0.001), language (‐0.114; ‐0.186 ‐ ‐0.042), attention (‐0.104; ‐0.175 ‐ ‐0.033), and executive function (‐0.117; ‐0.193 ‐ ‐0.041). Self‐reported poor sleep quality was associated with a lower composite z‐score of attention function (β = ‐0.077; 95% CI = ‐0.143 ‐ ‐0.011). Self‐reported excessive daytime sleepiness (EDS) was associated with a lower composite z‐score of memory (β = ‐0.217; 95% CI = ‐0.350 ‐ ‐0.084), language (‐0.182; ‐0.303 ‐ ‐0.061), and attention function (‐0.162; ‐0.282 ‐ ‐0.041). In the plasma biomarker subsample, CPC‐measured TST &gt;8 hours/night was significantly associated with lower plasma Aβ42/Aβ40 ratio (β = ‐0.522; 95% CI = ‐0.764‐ ‐0.281) and higher plasma concentrations of Aβ40 (13.419; 6.515‐20.323), total‐tau (0.216; 0.071‐0.360), and NfL (0.071; 0.002‐0.140). There was no significant association between CPC‐measured apnea hypopnea index (AHI) and plasma AD biomarkers (P&gt;0.05).ConclusionLong sleep duration and self‐reported EDS were associated with poor memory, language, and attention function among older adults, in which AD pathology and neurodegeneration may be the common pathways linking sleep disturbances with cognitive impairment.

Objective assessment of sleep parameters using multimodal AX3 data in older participants

AbstractBackgroundSleep disturbances are both risk factors for and symptoms of dementia. Current methods for assessing sleep disturbances are largely based on either polysomnography (PSG) which is costly and inconvenient, or self‐ or care‐giver reports which are prone to measurement error. Low‐cost methods to monitor sleep disturbances longitudinally and at scale can be useful for assessing symptom development. Here, we develop deep learning models that use multimodal variables (accelerometers and temperature) recorded by the AX3 to accurately identify sleep and wake epochs and derive sleep parameters.MethodEighteen men and women (65‐80y) participated in a sleep laboratory‐based study in which multiple devices for sleep monitoring were evaluated. PSGs were recorded over a 10‐h period and scored according to established criteria per 30 sec epochs. Tri‐axial accelerometers and temperature signals were captured with an Axivity AX3, at 100Hz and 1Hz, respectively, throughout a 19‐h period, including 10‐h concurrent PSG recording and 9‐h of wakefulness. We developed and evaluated a supervised deep learning algorithm to detect sleep and wake epochs and determine sleep parameters from the multimodal AX3 raw data. We validated our results with gold standard PSG measurements and compared our algorithm to the Biobank accelerometer analysis toolbox. Single modality (accelerometer or temperature) and multimodality (both signals) approaches were evaluated using the 3‐fold cross‐validation.ResultThe proposed deep learning model outperformed baseline models such as the Biobank accelerometer analysis toolbox and conventional machine learning classifiers (Random Forest and Support Vector Machine) by up to 25%. Using multimodal data improved sleep and wake classification performance (up to 18% higher) compared with the single modality. In terms of the sleep parameters, our approach boosted the accuracy of estimations by 11% on average compared to the Biobank accelerometer analysis toolbox.ConclusionIn older adults without dementia, combining multimodal data from AX3 with deep learning methods allows satisfactory quantification of sleep and wakefulness. This approach holds promise for monitoring sleep behaviour and deriving accurate sleep parameters objectively and longitudinally from a low‐cost wearable sensor. A limitation of our current study is that the participants were healthy older adults: future work will focus on people living with dementia.

0639 Delayed Presentation of Sleep Disruption and Depressive Symptoms in Males Post Mild Traumatic Brain Injury (mTBI)

Abstract Introduction The relationship between sleep disruption and depressive symptoms is well established. Mild traumatic brain injury (mTBI) is commonly associated with emotional dysregulation and decreased sleep quality. Less is known about the course of mTBI and its association with mood symptoms over time. We hypothesized that those in acute stages of mTBI (2W; 1M) would significantly differ in sleep quality and depressive symptoms compared with healthy controls. As there are often sex differences in sleep and depression, we focused here exclusively on males with mTBI. Methods This study included 56 healthy males, split into six groups. The sample included 15 healthy males (Mage=23.67, SD=5.066) and 41 males (Mage=26.88, SD=8.509) with mTBI, at differing stages post-injury: 2 weeks and 1, 3, 6, and 12 months. Participants completed the Pittsburgh Sleep Quality Index (PSQI) and the Beck Depression Index (BDI-II) to assess sleep disturbance and mood, respectively. Higher scores on both measures indicate a more severe presentation of disruptive symptoms. We conducted a one-way ANOVA to examine how the mean score for both measures varied at each time point. Results Compared to healthy controls there was no significant variance in average depression scores at 2W, 1M, 6M, and 12M (p&amp;gt;.05). However, at 3M post-mTBI males reported significantly higher depression scores than healthy controls M =9.8, SD=9.48, p=.035. Participants with mTBI reported greater sleep disruption when compared to healthy controls at 3M M =7.30, SD=3.16, p=.035 and 12M M=7.0, SD=3.39, p=.037, but not at other time points. Conclusion Contrary to our hypotheses, we found that males did not significantly vary from healthy controls for either measure in the acute stages of mTBI. These results indicate that males may not initially present depressive symptoms and sleep disruption post-mTBI, which could result in an inaccurate assessment of injury severity and an improper treatment plan moving forward in recovery. Further research conducted with a larger sample size would be useful in establishing that males suffering from mTBI experience the most severe presentation of symptoms roughly 3M after injury. Future work will need to examine whether these same trends are present among females. Support (if any) W81XWH-12-1-0386

Assessment of Sleep Disturbances and Sleep Disordered Breathing in Primary Immunodeficiency Disorders

IntroductionPatients with primary immunodeficiency disorders (PIDD) have lower health related quality of life (HRQoL) compared to the general population. Fatigue is a predominant symptom for PIDD patients and previous publications have demonstrated increased self-reported measures of fatigue in this population, including PROMIS-29 scores. Fatigue is also seen in patients with sleep related disorders including sleep disordered breathing (SDB). Thus, we examined the prevalence of sleep disturbances and SDB in patients with PIDD. MethodsPatients from our institution with a physician-confirmed diagnosis of PIDD were recruited for this IRB-approved study. Patients under 18 years of age, currently pregnant, or with previous diagnosis of SDB were excluded. Patients completed the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), and Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaires via REDCap. Patients then completed a home sleep apnea test (HSAT) using the Watch-PAT One device. ResultsA total of 24 patients with PIDD were enrolled in the study. Median age was 49.4 (range: 22.5–68.7) years, 18/24 (75%) patients were female. 22 out of 24 patients completed the questionnaires. Median values for PSQI, ESS, and FSS were 9.0 (2–18), 7.5 (0–20), and 4.9 (1.0–7.0), respectively. The median PROMIS Fatigue score was 57.9 (33.7–75.8). 14 out of 24 patients completed HSATs at the time of abstract submission. Sleep disordered breathing was defined as having an apnea-hypopnea index (AHI) of 5 events/hour or greater. For patients who completed HSATs, 10 (71%) met the threshold for having SDB. Based on guidelines established by the American Academy of Sleep Medicine, 6 (43%) had mild SDB, 3 (21%) had moderate SDB, and 1 (7%) had severe SDB. ConclusionPatients with an established diagnosis of PIDD, without previously diagnosed SDB, show a higher burden of poor sleep quality, daytime sleepiness, and fatigue based on scoring of self-reported questionnaires as compared to the general population. Overall, these patients were also noted to have a higher burden of sleep disordered breathing. These results provide preliminary evidence that undiagnosed sleep disturbances and SDB may contribute to the increased burden of fatigue in patients with PIDD.

The Sleep Disturbance Scale for Children: psychometric properties and prevalence of sleep disorders in Spanish children aged 6-16 years.

The present research aimed to investigate, for the first time, the validity and reliability of the Sleep Disturbance Scale for Children (SDSC) in a sample of 2733 Spanish children aged 6-16 years. We also described the prevalence and sociodemographic correlates of sleep disorder symptoms among young people, which had never been studied in Spain. Confirmatory factor analysis supported the original six-factor model and Cronbach's alpha for the total questionnaire was 0.82, which indicated good reliability. Moreover, all the SDSC subscales correlated positively and significantly with the total score (range=0.41-0.70), thus showing convergent validity. Considering T-scores >70 as pathological, we identified at least one sleep disorder in 116 participants (4.24%), including disorders of excessive somnolence (DOES; 5.82%), sleep-wake transition disorders (SWTD; 5.27%), and disorders of initiating and maintaining sleep (DIMS; 5.09%) among the most common problems. Students in secondary education and those from families with a low socioeconomic status were more likely to have DIMS, disorders of arousal, and DOES. Subjects with clinically elevated levels of sleep breathing disorders were more frequently of foreign origin and from disadvantaged families. Boys and primary school students were more prone to sleep hyperhidrosis, while SWTD were overrepresented among children with a low socioeconomic status. According to our results, the Spanish version of the SDSC seems to be a good instrument for assessing sleep disturbances in school-age children and adolescents, which is essential to prevent the significant implications of poor sleeping on the overall welfare of young people.

How sleep disturbance is associated with Chinese police officers' job satisfaction: A moderated mediation model.

Tasked with a wide variety of duties, police officers often encounter stressful situations and suffer from sleep disturbance. Previous studies have found that police officers with sleep disturbance generally reported lower levels of job satisfaction; however, the psychological mechanisms by which sleep disturbance is associated with job satisfaction are still relatively underexplored. This study investigated how sleep disturbance was associated with job satisfaction via the mediation of job involvement and via the moderation of resilience among police officers. Data from a sample of 827 Chinese police officers (86.9% men) was analysed. Participants completed a written questionnaire assessing sleep disturbance, job satisfaction, job involvement, resilience, and demographic information. A moderated mediation model was conducted to examine the research questions. Sleep disturbance was negatively associated with job involvement, which, in turn, was positively associated with job satisfaction. Furthermore, both direct and indirect effects of sleep disturbance on job satisfaction were moderated by resilience. Specifically, the negative association between sleep disturbance and job satisfaction was significant only for those with low levels of resilience, but not for those with high levels of resilience. In addition, the positive association between job involvement and job satisfaction was stronger for those with higher resilience compared with those with lower resilience. The findings advance understanding of the psychological mechanisms underlying the association between sleep disturbance and job satisfaction among police officers.

Abstract TP155: Patient Centered Outcomes In Pediatric Moyamoya Arteriopathy

Introduction: Little is known about quality of life, sleep, and mental health in children with moyamoya arteriopathy (MMA). A better understanding of patient-centered outcomes may lead to improved counseling and treatment of childhood MMA. Methods: MMA patients &lt;26 years old (when developmentally appropriate) and their parents/guardians completed a series of validated, age-appropriate questionnaires. Measures included the Pediatric Quality of Life (PedsQL) Inventory (assessing health-related quality of life), Patient-Reported Outcomes Information System (PROMIS) sleep questionnaires (assessing sleep disturbance, defined as disturbed sleep, and sleep impairment, defined as impairment of daily activities due to poor sleep), and PROMIS depression/anxiety questionnaires. Results: Seventeen participants with MMA were enrolled, with 8 children and 17 parent proxies completing questionnaires. Median age was 7.3 years (IQR 6.6, 10.1 years). The cohort included 8 (47%) females and children with both moyamoya disease (n=9, 53%) and moyamoya syndrome (sickle cell disease n=4, neurofibromatosis n=3, hemophilia A n=1). On the PedsQL (100 = best quality of life), children with MMA scored relatively low in emotional (mean = 73.2), social (mean = 74.5), and school/work (mean = 72.1) quality of life domains compared to the physical (mean = 82.6) domain. On parent proxy PROMIS sleep questionnaires, 53% of children with MMA qualified as having sleep disturbance (41% moderate-severe) and 47% had sleep impairment (35% moderate-severe). Of 25 child and parent proxy PROMIS depression/anxiety forms, 48% indicated moderate-severe anxiety and 24% moderate-severe depressive symptoms. Conclusions: Children with MMA have high rates of poor quality of life, sleep disturbance, sleep impairment, anxiety, and depressive symptoms. Future directions include comparison of patient centered outcomes in MMA to children with other stroke etiologies as well as unaffected siblings. A better understanding of patient centered outcomes will allow for improved counseling and targeted therapies to address MMA-related sleep, emotional, social, and school-based impairment.

Reliability and validity of the Turkish version of general sleep disturbance scale (GSDS-T) in stroke.

Stroke is a life-threatening condition with many complications. Sleep disturbances is one of them. Sleep disturbances effect quality of life, recovery and rehabilitation process. It is crucial to reveal sleep disturbances objectively in stroke patients. The aim of the study is to determine reliability and validity of the Turkish version of General Sleep Disturbance Scale (GSDS-T) in stroke patients. After translation and culture validation of the scale was done, Pittsburgh Sleep Quality Index (PSQI) and the Turkish version of the GSDS was applied at admission and at 24h to the 58 patients with stroke. Cronbach alpha coefficient of total score was found as 0.850 and test re-test reliability-related Cronbach alpha coefficient was 0.785. GSDS-T is a reliable and valid tool to assess sleep disturbance in stroke patients.

Assessment of Sleep Disturbances on Mental Health in Patients with Restless Legs Syndrome.

In our study, we aimed to evaluate the sleep disturbances of patients diagnosed with restless legs syndrome (RLS) regarding their mental health according to the severity of the disease. The study included 166 patients diagnosed with RLS and 161 healthy controls in the same age interval as patients. Sleep disturbances of patients were defined with the "personal information form" (PIF) prepared by the researchers, while the mental health status of patients was defined with the "Brief Symptom Inventory" (BSI). All RLS patients had an increase in BSI subscale points, with a positive correlation to disease severity, and subscale points were significantly higher than the control group (p < 0.05). Those with the "frequent waking" problem had higher BSI subscale points compared to those without the problem (p<0.01 or 0.001). Those with "waking with respiratory distress," "daytime sleepiness," "very early waking," and "sleep disorder" problems had statistically significantly high BSI subscale points for all subscales, apart from hostility, compared to those without these problems (p<0.01 or 0.001). It is considered that assessment of sleep disturbances causing disrupted quality of life and mood disorders is beneficial for the treatment of patients with RLS. Our study data appears to be related to the result that sleep disturbances and mental health disruptions might be associated with the disease severity among RLS patients.

Poor sleep quality in children with atopic dermatitis and its effects on behavior: A multicenter cross-sectional study from a low-middle-income country.

Sleep disturbance in children with atopic dermatitis (AD) frequently goes unnoticed and can be associated with behavioral challenges. The aims of this study were to determine (a) the prevalence and factors associated with sleep disturbance and behavioral problems and (b) the correlation between sleep disturbance and behavioral problems in children with AD. This cross-sectional study involved children aged 4-12 years old with moderate to severe AD. Age and sex-matched healthy children were recruited as the comparison group. The Children's Sleep Habits Questionnaire (CSHQ) and the Strengths and Difficulties Questionnaire (SDQ) were used to assess sleep disturbance and behavioral problems, respectively. Higher scores in both questionnaires signify more disturbance. Seventy patients and 141 controls were recruited. Median (interquartile range) age of patients was 5 (4,8) years. Patients had later sleep time (p < 0.001), longer night awakening (p < 0.001), and shorter sleep duration (p < 0.001) compared to controls. CSHQ total scores and all its domains, except for sleep-disordered breathing were significantly higher in patients compared to controls. Patients also had significantly higher SDQ total difficulties scores in all domains, except for peer problems. Severity of AD was significantly associated with high CSHQ and SDQ scores. There was a moderate positive correlation between the total CSHQ score and total SDQ score in patients (r=0.532). Children with moderate-to-severe AD had significantly more sleep disturbance and more behavioral problems than their healthy peers. Sleep disturbance had a positive correlation with behavioral problems. Severity of AD was associated with sleep disturbance and behavioral problems.

Assessment of sleep disturbance in patients with atopic conditions

Sleep is critical to our overall health and well-being. Survey data of the Centers for Disease Control and Prevention report that 34.1% of children, 74.6% of adolescents, and 32.5% of adults have insufficient sleep.1 The coronavirus disease 2019 pandemic further negatively affected sleep among all age groups. Atopic conditions in children affect sleep, causing adverse changes in behavior, concentration, school performance, and growth.2,3 Sleep disturbances in children also directly affect their caregivers’ sleep.

Assessing sleep and pain among adults with myalgic encephalomyelitis/chronic fatigue syndrome: psychometric evaluation of the PROMIS® sleep and pain short forms.

PurposeTo evaluate the psychometric properties of the patient-reported outcome measurement information system® (PROMIS) short forms for assessing sleep disturbance, sleep-related impairment, pain interference, and pain behavior, among adults with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).MethodsData came from the Multi-Site ME/CFS study conducted between 2012 and 2020 at seven ME/CFS specialty clinics across the USA. Baseline and follow-up data from ME/CFS and healthy control (HC) groups were used to examine ceiling/floor effects, internal consistency reliability, differential item functioning (DIF), known-groups validity, and responsiveness.ResultsA total of 945 participants completed the baseline assessment (602 ME/CFS and 338 HC) and 441 ME/CFS also completed the follow-up. The baseline mean T-scores of PROMIS sleep and pain measures ranged from 57.68 to 62.40, about one standard deviation above the national norm (T-score = 50). All four measures showed high internal consistency (ω = 0.92 to 0.97) and no substantial floor/ceiling effects. No DIF was detected by age or sex. Known-groups comparisons among ME/CFS groups with low, medium, and high functional impairment showed significant small-sized differences in scores (η2 = 0.01 to 0.05) for the two sleep measures and small-to-medium-sized differences (η2 = 0.01 to 0.15) for the two pain measures. ME/CFS participants had significantly worse scores than HC (η2 = 0.35 to 0.45) for all four measures. Given the non-interventional nature of the study, responsiveness was evaluated as sensitivity to change over time and the pain interference measure showed an acceptable sensitivity.ConclusionThe PROMIS sleep and pain measures demonstrated satisfactory psychometric properties supporting their use in ME/CFS research and clinical practice.

Sleep disturbances in infants and young children following an acquired brain injury.

Sleep disturbances impact over half of older children and teens with acquired brain injury (ABI) following critical care hospitalization but are underevaluated in infants and young children. Given the importance of sleep in brain development and healing after injury, we hypothesized sleep disturbances would be associated with worse neurodevelopmental outcomes in infants with ABI. We performed a retrospective cohort study of 68 children aged 2-32 months following critical care hospitalization for ABI. The Brief Infant Sleep Questionnaire assessed sleep disturbances. Bayley Scales of Infant and Toddler Development, third edition and Adaptive Behavior Assessment System, third edition assessed developmental and adaptive functioning outcomes, respectively. t tests compared sleep characteristics in infants with ABI to historical healthy controls. Spearman's correlation evaluated relationships among sleep and outcomes. Multiple linear regression investigated relationships controlling for demographic and ABI characteristics. Compared to healthy controls, children with ABI had shorter nighttime sleep duration (P = .01), longer daytime sleep duration (P < .001), and longer duration of nighttime awakenings (P < .001). Duration of night awakenings negatively correlated with Bayley Cognitive scores (Spearman's correlation = -.40). Night awakenings negatively correlated with worse Adaptive Behavior Assessment System, third edition General Adaptive Composite scores (Spearman's correlation = -.42). When controlling for demographic and ABI characteristics, ≥ 3 awakenings was significantly associated with worse Adaptive Behavior Assessment System, third edition General Adaptive Composite (β = -11.3; 95% confidence interval = -19.2, -3.5). Sleep disturbances are associated with poorer outcomes in infants and toddlers after ABI. Sleep is vital to recovery and a potentially modifiable target to improve outcomes. Klapp JM, Hall TA, Riley AR, Williams CN. Sleep disturbances in infants and young children following an acquired brain injury. J Clin Sleep Med. 2022;18(10):2387-2395.

12. Sleep Disturbance in the First Year After Mastectomy Among Patients With or Without Reconstruction

Purpose: Reconstruction following mastectomy has become increasingly popular. Sleep disturbances following surgery have the potential to adversely impact quality of life. It is important for breast and reconstructive surgeons to understand how surgical extent, including reconstruction, may impact sleep habits of their patients. In this prospective longitudinal study, we aimed to examine sleep disturbance in patients who underwent mastectomy with and without reconstruction throughout the first year following surgery. Methods: Patients completed the PROMIS Sleep Disturbance short form preoperatively and then at 2 weeks, 6 months, and 12 months post-operatively. Independent sample t-test or Mann-Whitney U tests were used to compare groups who did or did not receive reconstruction. Association of factors with sleep disturbance over time was investigated using GEE linear regression. Results: This subset (n=123) of a larger cohort of postoperative patients included women who had a mastectomy with and without reconstruction; 34 (28%) had no reconstruction and 89 (72%) had reconstruction. Patients in the group receiving reconstruction were younger (49 vs 58 years, p=0.001) and had longer surgical duration (257 vs 132 minutes, p<0.001), but were not more likely to receive chemotherapy, radiation, or nodal surgery. Baseline anxiety, depression, or Pain Catastrophizing Score (PCS) was not different between groups. Sleep disturbance was higher in the reconstruction group at some later timepoints (6 and 12 months postoperatively (PROMIS sleep disturbance at 6 months:17.5 vs 22, p=0.003; PROMIS sleep disturbance at 6 months:18.7 vs 22.5, p=0.046). However, an overall model assessing sleep disturbance over the first year after surgery which concurrently took both age and surgical type into account, revealed that (younger) age (beta=-0.142, p=0.027), but not surgical type (beta=-2.704, p=0.113) was associated with greater sleep disturbance. Conclusion: Overall, this study suggests that younger age, rather than surgical types, is associated with greater sleep disturbance in the first year after surgery.

0549 Prevalence and Impact of Muscle Cramps in Patients with Restless Legs

Abstract Introduction Recent studies have shown alterations in Vitamin D binding protein in RLS, and Vitamin D is intimately related to calcium metabolism, while hypocalcemia is a well-known trigger for muscle cramps. The presence and consequences of muscle cramps in RLS has never been systematically studied. Therefore, the aim of this study was to determine the prevalence and impact of muscle cramps in RLS patients. Methods An email was sent to 4222 active members of the RLS foundation (RLSF) with a link to survey adult RLS patients. The survey included demographic information, questions on muscle cramps (including a visual analogue scale rating intensity), the Pittsburgh Sleep Quality Index assessing sleep disturbances, the 36-Item Short Form Survey Instrument (SF-36) evaluating health status, the 13-item short-form Cambridge-Hopkins diagnostic questionnaire (CH-RLSq13) for diagnosing RLS, and the International RLS Severity Scale measuring RLS severity. Patients who answered “yes” to the question “In the last 3 months have you experienced muscle cramps (defined as involuntary painful muscle contraction occurring at rest, not associated with exercise)?” were considered to have muscle cramps. Results A total of 509 RLSF members completed the whole electronic survey, while 317 participants (Age: 68.9±10.2; 73.1% Women; 97.8% White/Caucasian; BMI: 27.4±5.8) qualified as RLS patients and were included in further analysis. The prevalence of muscle cramps in RLS patients was 60.3%. RLS patients with (versus without) muscle cramps were more overweight (p=0.0119) and had lower scores (more disability) on several SF-36 health concepts including physical functioning (p=0.0093), role limitations due to emotional problems (p=0.0429), social functioning (p=0.0017), and more pain (p=0.0387). In addition, there was a weak (Spearman coefficient ρ=0.253) but significant positive correlation (p=0.0004) between intensity of muscle cramps and severity of RLS symptoms. Conclusion Muscle cramps were present in almost two-third of RLS patients and were associated with a negative impact on health status and severity of RLS. Therefore, from a clinical practice point of view, it seems warranted to screen for muscle cramps in RLS patients. RLS and leg cramps may theoretically be related to each other through calcium metabolism and/or through inflammatory mechanisms. Support (If Any) This study was not funded.