Sleep Changes Research Articles

Prevalence and Clinical Characteristics of Depression among Elderly Patients Attending Primary Health Care Centers in Diyala Governorate

Background: Depression is one of the most common mood conditions among the elderly, which is linked to severe consequences such as difficulty in concentration and mood disturbances, followed by a lack of interest in social activities, apathy, pessimism, and changes in appetite and sleep. Aim of the study: To determine the prevalence and clinical characteristics of depression and the associated factors among 60-year-olds and over. Methodology: A descriptive cross-sectional study conducted on a group of 218 patients attending selected primary health care centers (PHCC) in Diyala governorate from Al-Khales and Baquba first sectors from first of September 2020 till first of April 2021. A direct interview was conducted by the researcher. Depression in the studied group was measured using the Arabic version of the short form of Geriatric Depression Scale (GDS). Socio-demographical factors were also inquired about in this study. Results: The prevalence of depression among the study participants was 63.3%. There was a statistically significant association between depression and gender (higher in females 69.2%), marital status (in widowed 84.8%), current residence (93.3% in those living alone), and source of monthly income (78.1% in those on financial assistance), medical illnesses (70.2%), and past history of depression (71.3%). Conclusions: Depressive symptoms are prevalent among elderly patients attending primary health centers in Diyala Governorate and are associated with female gender, being a widow, living alone, financial insecurity and chronic illnesses.

Sleep: Hemispheres fight for dominance.

A new study shows that bearded dragons have a peculiar way to coordinate sleep state changes between brain hemispheres. The hemisphere that acts first imposes its activity on the other during their REM sleep-like state.

Long haul in asymptomatic and mild symptomatic COVID-19 patients: A community-based study in Northern India

Introduction: COVID-19, is a highly contagious disease caused by Novel Corona Virus SARS-Cov-2. After initial infection, most patients recover completely, but in some patients, symptoms may persist for variable duration. This study was planned to evaluate different persistent symptoms of long COVID among the people of Northern India, who had asymptomatic or mild disease during active infection stage. Methods: A cross sectional study was done in Chandigarh, India, during August 2021 to June 2022. A total of 647 recovered COVID-19 patients, who had suffered of COVID almost ≥3 months back were included in the study. A self-designed questionnaire was developed for the survey. Participants were followed up till 3 months. Results: Out of 647 subjects enrolled, 27.5% had some post-COVID symptoms. Among symptomatic, 55.1% were males and 44.9% were females. Post-COVID headache was significantly more common in females. Sleep disturbances and history of pain and pressure that spreads to arms were significantly more common among non-smokers. Sleep disturbances and change of appetite were significantly more common among non-alcohol users. Chest discomfort and change of appetite were found to be significantly more common among non-hypertensive subjects. Symptoms of chest discomfort, sleep disturbances, anxiety, feeling of sadness on daily basis and forgetfulness was significantly more common among subjects without underlying heart disease, while weakness among patients with underlying lung disease. Poor concentration was found to be significantly more common among patients without underlying lung disease and that in the age group 26-50 years, followed by 51-75 years and 76-100 years. Conclusion: This study attempted to assess the prevalence of post COVID complications among the asymptomatic and mild COVID patients. From the clinical point of view, physicians should be aware of the symptoms, signs, and biomarkers present in patients previously affected by COVID-19 to promptly assess, identify and halt long COVID-19 progression, minimize the risk of chronic effects and to re-establish pre-COVID-19 health.

Clinical Efficacy Evaluation of Ultrasound-Guided C2 Dorsal Root Nerve Pulsed Radiofrequency Combined with Stellate Ganglion Block in the Treatment of Cervicogenic Headache: A Retrospective Cohort Study.

To explore the therapeutic effect of C2 dorsal root ganglion pulsed radiofrequency (PRF) combined with stellate ganglion block (SGB) in patients with cervicogenic headache (CEH). We retrospectively reviewed 90 patients diagnosed with CEH who were admitted to our hospital between May 2019 and May 2022. All patients were divided into three groups (n = 30 each) according to the actual treatment method used: ultrasound-guided SGB, ultrasound-guided C2 dorsal root ganglion PRF treatment, and ultrasound-guided C2 dorsal root ganglion PRF combined with SGB treatment. Patients' pain intensity, sleep, and mood changes were assessed by statistically analyzing their pain visual analog scale (VAS), Pittsburgh Sleep Quality Inventory (PSQI), and short-form McGill Pain Questionnaire affective item scores before and after treatment. The post-treatment VAS, PSQI, and McGill scores were significantly decreased in all patients (P < 0.05), and all three scores in ultrasound-guided C2 dorsal root ganglion PRF combined with SGB were lower than those in ultrasound-guided SGB alone and ultrasound-guided C2 dorsal root ganglion PRF alone (P < 0.05). The use of ultrasound-guided C2 dorsal root ganglion PRF combined with SGB in patients with CHE is effective in alleviating pain and improving sleep, and deserves to be replicated in the clinic.

Nighttime sleep and daytime sleepiness patterns among left ventricular assist device patients.

Despite the high prevalence of sleep disturbance in the heart failure population, information about its consequence on daytime function in patients with left-ventricular assist devices (LVADs) is limited. This study examined the nighttime and daytime sleep patterns and changes from pre-implant to 6months post-implant. This study included 32 LVAD patients. Demographics, nighttime and daytime sleep variables were collected pre-implant and at 1, 3, and 6months post-implant. Wrist actigraphy and self-report questionnaires measured objective and subjective sleep, respectively. Objective nighttime sleep data were sleep efficiency (SE), sleep latency (SL), total sleep time (TST), wake after sleep onset (WASO), and sleep fragmentation (SF). Objective daytime sleep data were nap times. Self-reported Subjective Sleep Quality Scale (SSQS) and Stanford Sleepiness Scale (SSS) were subjective measures. Increased SF and WASO scores and decreased TST and SE scores were found pre-LVAD implant, indicative of poor sleep quality. TST, SE, naptime and SSQS scores were higher at 3 and 6months post-implant compared to baseline. Decreases in TST and SF scores were observed at 3 and 6months post-implant along with increases in SSS scores. Increasing SSS scores and decreasing overall scores from pre- and up to 6months post-implant suggest improvement in daytime function. This study provides information on sleep-daytime function in the LVAD patient population. Improvements in daytime sleepiness do not imply "good" sleep quality, consistent with the extant knowledge in LVAD literature. Future investigations should elucidate the mechanism by which sleep-daytime function influences quality of life.

Association of nocturnal sleep duration and nocturnal sleep changes with instrumental activities of daily living disability among middle-aged and elderly Chinese

ObjectiveTo investigate the association of baseline nocturnal sleep duration and sleep changes with functional disability in middle-aged and elderly Chinese. MethodsData for this study were collected from the China Health and Retirement Longitudinal Study (CHARLS) from baseline (2011) to the Wave 3 follow-up (2018). 8361 participants free of IADL disability in 2011 and aged ≥ 45 years old were recruited and prospectively followed till 2018 to analyze the association between baseline nocturnal sleep duration and IADL disability. Of these 8361 participants, a total of 6948 participants had no IADL disability at the first three follow-up visits and completed the 2018 follow-up to analyze the association between nocturnal sleep changes and IADL disability.Nocturnal sleep duration (hours) was self-reported at baseline. The coefficient of variation (CV) of nocturnal sleep duration at baseline and three follow-up visits was used to calculate sleep changes and classified into mild, moderate, and severe degrees by the quantiles. Cox proportional hazards regression model was used to analyze the association of baseline nocturnal sleep duration with IADL disability, and the binary logistic regression model was used to analyze the association of nocturnal sleep changes with IADL disability. ResultsAmong the 8361 participants of 50237.5 person-years follow-up with a median follow-up of 7 years, 2158 (25.81%) participants developed IADL disabilities. Higher risks of IADL disability were observed among participants with sleep duration <7 h [HR(95%): 1.23(1.09–1.38)], 8∼<9 h [HR(95%): 1.05(1.00–1.32)] and ≥9 h [HR(95%): 1.21(1.01–1.45)] compared to those with 7∼<8 h. Among the 6948 participants, a total of 745 (10.72%) participants finally developed IADL disabilities. Compared with mild nocturnal sleep changes, moderate [OR(95%): 1.48(1.19–1.84)] and severe [OR(95%): 2.43(1.98–3.00)] sleep changes increased the probability of IADL disability. The restricted cubic spline model showed that a higher degree of nocturnal sleep changes was associated with a greater probability of IADL disability. ConclusionBoth insufficient and excessive nocturnal sleep duration were associated with higher risk of IADL disability in middle-aged and elderly adults, independent of the participants' gender, age, and napping habits. Higher nocturnal sleep changes were associated with a higher probability of disability in IADL. These findings highlight the importance of appropriate and stable nocturnal sleep, and the need to pay attention to population differences in the impact of nocturnal sleep duration on health.

The therapeutic potential of opioids in narcolepsy type 1: A systematic literature review and questionnaire study

ObjectiveNarcolepsy type 1 is a primary sleep disorder caused by deficient hypocretin transmission leading to excessive daytime sleepiness and cataplexy. Opioids have been suggested to increase the number of hypocretin-producing neurons. We aimed to assess opioid use and its self-reported effect on narcolepsy type 1 symptom severity through a literature review and questionnaire study. MethodsWe systematically reviewed literature on opioid use in narcolepsy. We also recruited 100 people with narcolepsy type 1 who completed an online questionnaire on opioid use in the previous three years. The main questionnaire topics were the indication for use, and the possible effects on narcolepsy symptom severity. Structured follow-up interviews were conducted when opioid use was reported. ResultsThe systematic literature review mainly showed improvements in narcolepsy symptom severity. Recent opioid use was reported by 16/100 questionnaire respondents, who had used 20 opioids (codeine: 7/20, tramadol: 6/20, oxycodone: 6/20, fentanyl: 1/20). Narcolepsy symptom changes were reported in 11/20. Positive effects on disturbed nocturnal sleep (9/20), excessive daytime sleepiness (4/20), hypnagogic hallucinations (3/17), cataplexy (2/18), and sleep paralysis (1/13) were most pronounced for oxycodone (4/6) and codeine (4/7). ConclusionsOpioids were relatively frequently used compared to a similarly young general Dutch sample. Oxycodone and, to a lesser extent, codeine were associated with self-reported narcolepsy symptom severity improvements. Positive changes in disturbed nocturnal sleep and daytime sleepiness were most frequently reported, while cataplexy effects were less pronounced. Randomised controlled trials are now needed to verify the potential of opioids as therapeutic agents for narcolepsy.

1289-P: Predictors of New-Onset Type 2 Diabetes after Infection with COVID-19 in the COVID-OUT Randomized Trial

Background: There are mixed data on whether COVID-19 infection is associated with increased incidence of type 2 diabetes (T2DM). The majority of data have been derived from retrospective datasets. We sought to identify predictors of new onset T2DM in a prospective cohort enrolled in the multi-site phase 3 randomized quadruple-blinded placebo-controlled COVID-OUT clinical trial. Methods: Adults with overweight or obesity aged 30-85 were enrolled within 3 days of a positive SARS-CoV-2 test and &amp;lt;7 days of symptoms. Participants were randomized to 1 or 2 of 3 oral medications (immediate-release metformin increasing over 6 days to 1500 mg daily for a total of 14 days; ivermectin 430mcg/kg/day for 3 days; fluvoxamine 50mg day 1 then 50mg twice daily through 14 days) or placebo using a two by three parallel treatment factorial design. Starting 60 days after randomization we sent automated email surveys every 30 days through 300 days about new diabetes diagnoses, as well as changes in weight and sleep. We conducted univariable analyses to determine predictors of T2DM diagnosis. Results: Among 1093 subjects, 25 reported a new diagnosis of diabetes within 300 days of COVID-19 infection. There were no significant differences in incidence by treatment arm or vaccination in univariate analysis. Participants with new onset T2DM had a higher baseline BMI (OR 1.08, 95% CI 1.03 to 1.13), and were more likely to report weight gain between the start of the pandemic and their first infection and more likely to report difficulty sleeping, OR 1.04 (95% CI 1.01 to 1.07) and OR 2.86 (95% CI 1.16 to 7.06), respectively. Multivariate analysis is pending. Conclusions: Patients with higher BMIs at baseline, those who gained weight between the onset of the pandemic and their first COVID-19 infection, or had difficulty sleeping were more likely to develop T2DM. Covid treatment with metformin, ivermectin, and fluvoxamine and vaccination status were not significant predictors of new T2DM. Disclosure J.M.Nicklas: None. E.J.Lemus wirtz: None. T.A.Murray: None. D.Liebovitz: None. S.Fenno: None. B.Anderson: None. N.Avula: None. N.Reddy: None. C.Bramante: None. Funding Rainwater Foundation; Parsemus Foundation; United Health Foundation; National Center for Advancing Translational Sciences (KL2TR002492, UL1TR002494); National Institute of Diabetes and Digestive and Kidney Diseases (K23DK124654-01-A1); National Heart, Lung, and Blood Institute (K23HL133604)

Lack of association between behavioral development and simplified topographical markers of the sleep EEG in infancy

The sleep EEG mirrors neuronal connectivity, especially during development when the brain undergoes substantial rewiring. As children grow, the slow-wave activity (SWA; 0.75–4.25 Hz) spatial distribution in their sleep EEG changes along a posterior-to-anterior gradient. Topographical SWA markers have been linked to critical neurobehavioral functions, such as motor skills, in school-aged children. However, the relationship between topographical markers in infancy and later behavioral outcomes is still unclear. This study aims to explore reliable indicators of neurodevelopment in infants by analyzing their sleep EEG patterns. Thirty-one 6-month-old infants (15 female) underwent high-density EEG recordings during nighttime sleep. We defined markers based on the topographical distribution of SWA and theta activity, including central/occipital and frontal/occipital ratios and an index derived from local EEG power variability. Linear models were applied to test whether markers relate to concurrent, later, or retrospective behavioral scores, assessed by the parent-reported Ages & Stages Questionnaire at ages 3, 6, 12, and 24 months. Results indicate that the topographical markers of the sleep EEG power in infants were not significantly linked to behavioral development at any age. Further research, such as longitudinal sleep EEG in newborns, is needed to better understand the relationship between these markers and behavioral development and assess their predictive value for individual differences.

Changes in health and sleep quality after anti-retroviral treatment modification in Japanese people living with HIV

BackgroundAnti-retroviral treatment (ART) modification for treatment simplification is performed in virologically controlled people living with Human Immunodeficiency Virus (PLWH). However, studies on the impact of these stable treatment modifications on health-related quality of life (HRQoL) measured using patient-reported outcomes (PROs) in clinical practice are scarce; this was the focus of this study. MethodsPLWH who visited Teikyo University Hospital between October 2019 and March 2021, and whose ART was changed to a newly recommended single-tablet regimen for treatment simplification, were included in the study. HRQoL and sleep quality were evaluated using the Short-Form (SF) 8 and Pittsburgh Sleep Quality Index (PSQI) global score, respectively, at two time points: before and after treatment modification. Comorbidities, duration of Human Immunodeficiency Virus diagnosis, ART initiation, ART regimens, and blood test data before and after treatment were assessed. The SF-8 was used to calculate the physical component summary (PCS) and mental component summary (MCS) scores. ResultsForty-nine patients (all male) were included into the study. There was no change in the PCS score before and after ART modification. The MCS score significantly improved from 48.50 ± 6.56 to 50.76 ± 4.37 (p = 0.0159). Thirteen patients' ARTs were changed to dolutegravir/lamivudine. Their HRQoL and sleep quality changes were further analyzed. Their MCS and PSQI scores had improved significantly. Thirty patients’ ARTs were changed to bictegravir/tenofovir alafenamide/emtricitabine; however, there were no significant changes in their HRQoL or PSQI score. ConclusionART modification for treatment simplification based on PROs may improve the HRQoL of PLWH.

What a difference a year makes: Objective rest/activity patterns, circadian phase markers, and sleep quality before and during the COVID-19 pandemic

ObjectivesThe COVID-19 pandemic led to numerous changes in sleep duration, quality, and timing. The goal of this study was to examine objective and self-reported changes in sleep and circadian timing before and during the pandemic. MethodsData were utilized from an ongoing longitudinal study of sleep and circadian timing with assessments at baseline and 1-year follow-up. Participants had baseline assessment between 2019 and March 2020 (before pandemic) and 12-month follow-up between September 2020 and March 2021 (during pandemic). Participants completed 7 days of wrist actigraphy, self-report questionnaires, and laboratory-collected circadian phase assessment (dim light melatonin onset). ResultsActigraphy and questionnaire data were available for 18 participants (11 women and 7 men, Mean = 38.8 years, SD = 11.8). Dim light melatonin onset was available for 11 participants. Participants demonstrated statistically significant decreases in sleep efficiency (Mean = −4.11%, SD = 3.22, P = .001), worse scores on Patient-Reported Outcome Measurement Information System sleep disturbance scale (Mean increase = 4.48, SD = 6.87, P = .017), and sleep end time delay (Mean = 22.4 mins, SD = 44.4 mins, P = .046). Chronotype was significantly correlated with change in dim light melatonin onset (r = 0.649, P = .031). This suggests that a later chronotype is associated with a greater delay in dim light melatonin onset. There were also non-significant increases in total sleep time (Mean = 12.4 mins, SD = 44.4 mins, P = .255), later dim light melatonin onset (Mean = 25.2 mins, SD = 1.15 hrs, P = .295), and earlier sleep start time (Mean = 11.4 mins, SD = 48 mins, P = .322). ConclusionOur data demonstrate objective and self-reported changes to sleep during the COVID-19 pandemic. Future studies should look at whether some individuals will require intervention to phase advance sleep when returning to previous routines such as returning to office and school settings.

ID: 210704 Objectively Measured Improvement in Patients Treated With Dorsal Root Ganglion Stimulation

Dorsal root ganglion stimulation (DRG-S) is effective in treating CRPS type I or II (causalgia) of the groin and lower extremities. Despite considerable efforts toward establishing biomarkers of pain, methods to measure pain are primarily focused on patient reported outcomes (PRO). This study will quantify changes in function, affect, sleep, and quality of life using a commercially available wearable device and correlate these objective metrics with patient-reported outcomes collected prior to and post permanent implant of a DRG-S system.

Associations between sleep health and obesity and weight change in adults: The Daily24 Multisite Cohort Study

ObjectivesTo examine cross-sectional and longitudinal associations of individual sleep domains and multidimensional sleep health with current overweight or obesity and 5-year weight change in adults. MethodsWe estimated sleep regularity, quality, timing, onset latency, sleep interruptions, duration, and napping using validated questionnaires. We calculated multidimensional sleep health using a composite score (total number of “good” sleep health indicators) and sleep phenotypes derived from latent class analysis. Logistic regression was used to examine associations between sleep and overweight or obesity. Multinomial regression was used to examine associations between sleep and weight change (gain, loss, or maintenance) over a median of 1.66 years. ResultsThe sample included 1016 participants with a median age of 52 (IQR = 37-65), who primarily identified as female (78%), White (79%), and college-educated (74%). We identified 3 phenotypes: good, moderate, and poor sleep. More regularity of sleep, sleep quality, and shorter sleep onset latency were associated with 37%, 38%, and 45% lower odds of overweight or obesity, respectively. The addition of each good sleep health dimension was associated with 16% lower adjusted odds of having overweight or obesity. The adjusted odds of overweight or obesity were similar between sleep phenotypes. Sleep, individual or multidimensional sleep health, was not associated with weight change. ConclusionsMultidimensional sleep health showed cross-sectional, but not longitudinal, associations with overweight or obesity. Future research should advance our understanding of how to assess multidimensional sleep health to understand the relationship between all aspects of sleep health and weight over time.

Self‐report sleep duration associates with plasma Aβ42/40 rate of change in late middle‐aged, African American Adults

AbstractBackgroundSleep abnormalities may play a prominent role in the pathogenesis or exacerbation of Alzheimer’s disease (AD). Sleep is considered a modifiable target for prevention and treatment. Racial sleep health disparities exist, and may contribute to the disproportionately increased risk for developing AD associated with being African American. Yet, the relationships between sleep health and AD pathophysiology in African American individuals are under‐studied. This investigation was designed to address research gaps by evaluating the associations of self‐report sleep duration, sleep disturbances, and daytime sleepiness with change in plasma‐derived amyloid β 42/40 ratio (Aβ42/40) in an African American sample.MethodArchival data from African American participants enrolled in the Wisconsin Registry for Alzheimer’s Prevention study and the Wisconsin Alzheimer’s Disease Research Center were utilized. Data included the Medical Outcomes Study Sleep Scale (MOS‐Sleep), Epworth Sleepiness Scale (ESS), and demographic information. Sleep duration was determined by MOS‐Sleep #2, sleep disturbances were captured by a related MOS‐Sleep subscale (SLPD4), and ESS assessed daytime sleepiness. Participants provided plasma samples across multiple timepoints. PrecivityADTM assays quantified Aβ42/40. Aβ42/40 rate of change (Aβ42/40_ROC) was computed for follow‐up collections to serve as the primary outcome measure. Aβ42/40_ROC was computed as the difference in Aβ42/40 between follow‐up and first collection divided by years between collections. Linear mixed‐effects models determined associations with Aβ42/40_ROC. Observations were nested within participant. Fully adjusted models included age at collection, gender, BMI, education, parental history of dementia, and APOEe4 carrier status.ResultData included 339 follow‐up collections from 143 participants. Women provided 70.8% of collections, with average age at collection = 66.6 ± 8.84 years, Aβ42/40_ROC = ‐0.0005 ± 0.003, and sleep duration = 6.35 ± 1.00 hours. Sleep duration significantly associated with Aβ42/40_ROC in the fully adjusted model (β = ‐0.0005; SE = 0.0002; p = 0.02) (Figure 1). Associations between SLPD4 and ESS with Aβ42/40_ROC were nonsignificant.ConclusionLonger self‐report sleep duration associated with a steeper reduction rate for plasma Aβ42/40, a biomarker for amyloid pathology. Further research is necessary to clarify the relationships between sleep health components and changes in AD‐related biomarkers within African American adults to identify focal risk factors and interventional strategies.

0897 Sleep Architecture and Epileptiform Discharges in Rett Syndrome

Abstract Introduction Rett syndrome (RTT) is an X-linked dominant neurodevelopmental disorder affecting females and is linked to mutations in the methyl-CpG-binding protein 2 (MeCP2) gene. Sleep issues and frequent epileptiform discharges are common in RTT. Typical comorbidities in RTT include poor growth, feeding difficulties, hyperventilation and breath-holding, seizures, scoliosis, and disrupted sleep. Although polysomnographic studies indicate sleep disruption in patients with RTT, few evaluate if the epileptiform activity is associated with significantly greater changes in sleep. We analyzed if epileptiform discharges were associated with greater sleep changes than those seen without epileptiform discharges. Methods This retrospective case control of 10 RTT subjects (mean age, 11.19 years; ranged from 1 to 33 years) underwent standard in-lab polysomnography (PSG) recording. Subjects were compared to 10 age and gender matched controls with an AHI &amp;lt; 5 and no chronic medical problems. Rett children were divided into those with epileptiform discharges and those without. The two groups were compared using binomial cutoffs for each sleep parameter, and significance was determined by Fisher’s Exact Test. All studies were scored using the AASM criteria. Results Comparing our cohort of RTT patients to control subjects, the RTT patients have higher N3% of sleep, decreased N2%, and shorter sleep onset latency. 4 of the 10 PSGs are notable for frequent interictal epileptiform discharges. However, comparing those RTT patients with epileptiform discharges to those without, only REM latency trending shorter in those with epileptiform discharges (p= 0.057). No other significant differences were seen sleep staging, latency, total sleep time, efficiency, periodic limb movements nor respiratory parameters. Conclusion Our cohort did not find major differences in sleep features between those RTT patients with epileptiform discharges compared to those without. This may be related to a lack of influence of epileptiform discharges on these parameters or related to our small sample size. Although our cohort did not show major significant differences between those with epileptiform discharges, further study is required to delineate a more subtle relationship of these discharges to sleep. Support (if any)

0111 Wearable-based Measures of Sleep Across the Menstrual Cycle in Healthy Women in the Reproductive Stage and Early Menopause

Abstract Introduction Sleep is an essential part of women’s health and well-being. Hormonal fluctuations that occur across the menstrual cycle or when approaching menopause might affect sleep quality. Most studies rely on self-reported data, or laboratory measures in small samples, to examine changes in sleep across the menstrual cycle. Here, we investigated sleep quality, as measured continuously with a wearable device, across the menstrual cycle in different reproductive stages (reproductive, menopausal transition). Methods 56 women participated, with 31 in the reproductive stage (age: 24.65 +/- 6.09 years) and 25 in the early menopausal transition (47.36 +/- 2.78 years). Participants were healthy, without sleep disorders, and free of premenstrual and mood complaints, as well as not using hormonal contraceptives. Sleep was tracked with the Oura ring across an entire menstrual cycle – confirmed as ovulatory using ovulation tests. Participants also completed a sleep diary each morning, rating sleep quality and how refreshed they felt. Measures were averaged for four phases: menses, ovulation, mid-luteal, late-luteal. Participants were assessed for mood symptoms (DASS-21) once during each of these phases. Results Objective measures of sleep quality (Total Sleep Time, Efficiency, and Wake After Sleep Onset) did not change across the menstrual cycle in either group or differ between groups. Similarly, self-reported sleep and mood symptoms remained stable across the menstrual cycle, although women in the menopausal transition reported poorer sleep quality and felt less refreshed than reproductive stage women, overall. Physiological measures (Temperature, Heart Rate, and Heart Rate Variability) during sleep reflected the well-known fluctuations across the menstrual cycle (e.g., increased temperature in the luteal phase vs. menses) in both groups of women. Conclusion Objective, wearable-derived measures indicate sleep quality remains stable across the menstrual cycle during reproductive and early-menopausal transition stages, at least in healthy women without mood or premenstrual complaints. While women in the menopausal transition reported a poorer sleep quality, there was no difference in objective sleep continuity measures between groups. Future studies are needed to better understand sleep across the reproductive lifespan, considering cycle-related (e.g., premenstrual syndrome) and other factors that could make some women sensitive to menstrual cycle effects on sleep. Support (if any) NIH, RF1AG061355 (BAKER/MEDNICK)

Corticostriatal connectivity mediates the reciprocal relationship between parent-reported sleep duration and impulsivity in early adolescents.

Adolescence, a developmental period characterized by significant changes in sleep, is associated with normative increases in impulsivity. While short sleep duration has been linked to elevated impulsivity, the neural mechanism underlying the relationship between short sleep duration and elevated impulsivity remains poorly understood. We analyzed a dataset of 7,884 drug-naive 9-10 year-olds from the Adolescent Brain Cognitive Development (ABCD) study. Among them, 5,166 have two-year follow-up neuroimaging data. Linear mixed-effects models, mediation analyses, and longitudinal mediation analyses were used to investigate the relationship between parent-reported sleep duration, impulsivity, and functional and structural connectivity between the cortex and the striatum. We found that less sleep duration is significantly associated with higher positive and negative urgency, which are two affect-related components of impulsivity. In addition, we observed a link between short sleep duration and reduced corticostriatal connectivity. Neural pathways associated with short sleep duration-functional connectivity between the cingulo-opercular network and the left caudate, and between the cingulo-parietal network and the right pallidum-mediated the association between sleep duration and positive urgency both at baseline and two-year follow-up. Longitudinal mediation analyses further revealed that short sleep duration and elevated positive urgency exacerbated each other through these two corticostriatal connectivities. These findings highlight the key role of corticostriatal connectivities in the reciprocal relationship between short sleep duration and elevated impulsivity. Given the increasing prevalence of short sleep duration in adolescents, the link between sleep duration, impulsivity, and corticostriatal connectivities has important implications for timely interventions to address impulsive problems in early adolescents.

0141 Short-Term Stability of Sleep Parameters in Comorbid Nightmares and Chronic Insomnia Disorder

Abstract Introduction Nightmares are highly comorbid with insomnia and have been associated, yet not consistently, with distinct polysomnographic (PSG) disturbances, such as reduced total sleep time (TST), sleep efficiency and slow wave sleep as well as increased nocturnal awakenings and wake after sleep onset (WASO) or abnormal REM sleep. However, most prior studies have relied on a single night of PSG and the degree of stability of sleep parameters or overall differences between individuals with nightmares comorbid with insomnia disorder (NCI), individuals with chronic insomnia disorder (CID) and otherwise good sleeping controls (GSC), remain unknown. Therefore, the aim of this study was to determine if there were significant differences amongst these aforementioned groups in the way their sleep changes across time while being studied in the lab. Methods A total of 142 GSC, 126 CID and 24 NCI participants underwent 8-hour PSG recordings for 4 consecutive nights. Outcomes included sleep continuity, architecture, and REM-related parameters across nights 1 through 4. Intraclass correlation coefficients (ICC) with mixed-effect variances and repeated-measure analysis of variance (ANOVA) were used to determine short-term stability as well as between-subjects and time-by-group interaction effects, respectively. Results ICC were similar across groups on all outcomes (ICCs&amp;gt;0.6) except that the NCI group did not display stability for WASO, stage 1 sleep, REM latency or REM interval. There were no significant time-by-group interaction effects on PSG parameters (ps&amp;gt;0.05). There were significant between-group effects for SOL, number of awakenings, WASO, TST, REM latency, and number of REM episodes (all ps&amp;lt; 0.05), where the NCI group showed significantly longer SOL (58.10±11.08), shorter TST (6.64 hours±1.02), and less REM episodes (3.81±0.76). Conclusion This study suggests greater night-to-night variability and overall disturbance in nighttime sleep continuity and REM sleep in individuals with NCI. These disturbances may be attributed to the occurrence of nightmares, causing wakefulness out of REM sleep, as well as a greater level of hyperarousal as evidenced by the greater SOL and reduced TST, relative to the other groups. These data also suggest the utility of objective sleep measures in nightmare research and clinical practice alike. Support (if any) National Institutes of Health (UL1TR000127)

0225 Effect of thermoneutral temperature exposure in the APP/PS1 knock-in mouse model of Alzheimer’s disease

Abstract Introduction There is growing evidence that disordered sleep in Alzheimer’s disease (AD) may accelerate neuropathology, thus promoting a vicious cycle. In a previous study, we found that improving sleep through thermoneutral ambient temperature exposure may slow disease progression in 3xTg-AD mice. However, the confounding effects of temperature on metabolism in addition to sleep remained an open question. Methods To test whether the effect of thermoneutral warming on amyloid pathology is mediated by sleep changes rather than other non-specific physiologic effects of temperature, we conducted a new study on APP/PS1 knock-in (KI) mice. First, 6-m.o. male APP/PS1-KI mice were instrumented for EEG/EMG sleep analysis. After a week-long baseline recording, we split the mice into 4 separate groups: 1. SE (n=8), which were exposed to 30°C thermoneutral ambient temperature during the 12-hour light period; 2. SE-SD (n=9), which received sleep disruption through mild intermittent cage vibration alongside thermoneutral temperature exposure; 3. SD (n=8), which received sleep disruption at room temperature (22°C); and 4. CTRL (n=8), which were undisturbed and at room temperature. This design aims to decouple the sleep-enhancing effect of thermoneutral exposure from other non-specific effects. After four weeks of treatment, the animals were euthanized and the brains dissected to assay Aβ levels by ELISA. Vigilance states, i.e., Wake, REM, NREM, and slow wave sleep (SWS) within NREM – were scored in 4-second epochs from the EEG/EMG recordings and sleep metrics computed. Results Initial analysis of sleep revealed some SE-induced increases in SWS similar to our findings in 3xTg-AD mice. Sleep disruption reduces SWS even when thermoneutral warming occurs. Biochemical assays are in progress to reveal the treatment effects on Aβ levels in the brain. Conclusion Sleep disruption through vibration seems to be an effective way to negate the sleep-specific effect of thermoneutral temperature exposure. Incorporation of the biochemical assay data will help uncover the correlation between SWS and AD progression. Support (if any) R01AG068215

0673 Sleep in PTSD: A Subjective Concern

Abstract Introduction Sleep complaints are a hallmark of posttraumatic stress disorder (PTSD). Prior studies examining sleep abnormalities in PTSD are inconsistent, with some reporting objective sleep changes including associated obstructive sleep apnea (OSA), possibly due to moderating variables including advancing age, traumatic brain injury (TBI), and medications. We sought to compare sleep disorders and objective and subjective sleep metrics in service members with and without PTSD while controlling for these potential confounders. Methods Case-controlled observational cohort study performed at an academic military sleep center. Detailed sleep history, sleep-related questionnaires, trauma history, and video-polysomnography was performed. Patients with a history of TBI, abnormal neuroimaging, or psychoactive medication use (antidepressants, antipsychotics, anxiolytics) were excluded. Results Patients (N=169, 124 males) were active duty service members (median age 37.1 years) reporting a sleep complaint. Of these, 43 (25.4%) had PTSD vs 126 (74.6%) without PTSD. In patients with PTSD vs no PTSD, there was no significant difference in the rate of OSA, mean total sleep time, sleep efficiency, mean apnea-hypopnea index, sleep stage percentage, or any other polysomnogram (PSG) variable. Stage N3 sleep was non-significantly increased in patients with PTSD (18% vs 14%, p=0.078). Subjective sleepiness was similar between those with and without PTSD (Epworth Sleepiness Score 12.9 vs 11.9, p=0.35). However, subjective insomnia symptoms (Insomnia Severity Index 20.4 vs 15.2, p&amp;lt; 0.0001) and perceived sleep quality (Pittsburgh Sleep Quality Index 15.4 vs 11.1, p&amp;lt; 0.0001) were worse in those with PTSD vs no PTSD. Conclusion In a relatively young active duty cohort with no history of psychoactive medication use or TBI, patients with PTSD had more subjective sleep complaints than those without PTSD but objective sleep parameters, including PSG variables and OSA rate, did not differ significantly. The higher stage N3 (slow wave) sleep percentage, though not statistically significant, suggests that PTSD patients sleep better in a monitored sleep lab than in their habitual sleeping environment. Support (if any)