Sleep Daytime Research Articles

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.

Using Clinical Scales and Digital Measures to Explore Falls in Patients with Lewy Body Dementia

Introduction: PRESENCE was a phase 2 clinical trial assessing the efficacy of mevidalen, a D1 receptor positive allosteric modulator, for symptomatic treatment of Lewy body dementia (LBD). Mevidalen demonstrated improvements in motor and non-motor features of LBD, global functioning, and actigraphy-measured activity and daytime sleep. Adverse events (AEs) of fall were numerically increased in mevidalen-treated participants. Methods: A subset of PRESENCE participants wore a wrist actigraphy device for 2-week periods pre-, during, and posttreatment. Actigraphy sleep and activity measures were derived per period and analyzed to assess for their association with participants’ reports of an AE of fall. Prespecified baseline and treatment-emergent clinical characteristics were also included in the retrospective analysis of falls. Independent-samples t test and χ² test were performed to compare the means and proportions between individuals with/without falls. Results: A trend toward more falls was observed with mevidalen treatment (31/258 mevidalen-treated vs. 4/86 in placebo-treated participants: p = 0.12). Higher body mass index (BMI) (p < 0.05), more severe disease measured by baseline Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) part II (p < 0.05), and a trend toward improved Alzheimer’s Disease Assessment Scale-Cognitive Subscale 13 (ADAS-Cog₁₃) (p = 0.06) were associated with individuals with falls. No statistically significant associations with falls and treatment-emergent changes were observed. Conclusion: The association of falls with worse baseline disease severity and higher BMI and overall trend toward improvements on cognitive and motor scales suggest that falls in PRESENCE may be related to increased activity in mevidalen-treated participants at greater risk for falling. Future studies to confirm this hypothesis using fall diaries and digital assessments are necessary.

Daytime napping, nighttime sleeping duration, and risk of hepatocellular carcinoma and liver disease-related mortality

Background & AimsSleep duration has been linked to metabolic dysfunction and chronic inflammation, which may contribute to the development of liver cancer and chronic liver disease (CLD). However, little is known about the relationship between sleep or napping duration and hepatocellular carcinoma (HCC) risk and CLD mortality. MethodsWe followed 295,837 individuals in the National Institutes of Health-American Association of Retired Persons (NIH-AARP) Diet and Health Study. We examined the associations of nighttime sleep duration and daytime napping duration with risk of HCC incidence and CLD mortality. Cox proportional hazards regression was used to calculate multivariable hazard ratios (HRs) and 95% confidence intervals (95% CIs). ResultsA total of 357 incident HCC cases and 578 CLD deaths were identified after a median follow-up time of 15.5 years. After adjusting for confounder factors, we found U-shaped associations of nighttime sleep duration with the incidence of HCC (HR<5 vs. 7–8 h = 2.00, 95% CI: 1.22–3.26 and HR≥9 vs. 7–8 h = 1.63, 95% CI: 1.04–2.65) and CLD mortality (HR<5 vs. 7–8 h = 1.78, 95% CI: 1.18–2.69 and HR≥9 vs. 7–8 h = 1.91, 95% CI: 1.35–2.70). Daytime napping was associated with higher risk of HCC (HR≥1 vs. non-nappers = 1.46, 95% CI: 1.04–2.06) and higher CLD mortality (HR≥1 h vs. non-nappers = 1.54, 95% CI: 1.18–2.01) compared with no napping. ConclusionsWe observed U-shaped associations for nighttime sleeping and risk of HCC and CLD mortality. Additionally, longer daytime napping duration was associated with higher risk of HCC and CLD death. Our study suggests that clinical follow up of individuals at risk for liver cancer or living with a liver disease should include information on nighttime and daytime sleep. Impact and implicationsSleep or napping duration may play a role in the development of liver cancer and chronic liver disease, but little is known about the relationship between them. In addition, abnormal sleep patterns in patients with chronic liver disease may further promote the development of liver disease, creating a vicious cycle. Our study suggests that clinical follow up of individuals at risk for liver cancer or living with a liver disease should include information on nighttime and daytime sleep, as they can be potentially important factors in the development and progression of liver disease.

Sleep quality and temperament in association with autism spectrum disorder among infants in Japan

BackgroundSleep problems and irritable temperaments are common among infants with autism spectrum disorder (ASD). The prospective association between such sleep problems and irritable temperaments and ASDs needs to be determined for elucidating the mechanism and exploring the future intervention study. Thus, in this study, we investigated whether sleep quality and temperament in 1-month-old infants are associated with the onset of ASD in 3-year-old children. We also assessed its sex-stratified associations.MethodsWe conducted a longitudinal study using data from 69,751 mothers and infants from a large-cohort study, the Japan Environment and Children’s Study. We examined the prospective association between infant sleep quality and temperament at 1 month of age and ASD diagnosis by 3 years of age.ResultsHere we show infants with longer daytime sleep have a higher risk of later ASD than those with shorter daytime sleep (risk ratio [RR]: 1.33, 95% confidence interval [CI]: 1.01–1.75). Infants who experienced intense crying have a higher risk of ASD than those who did not (RR: 1.31, 95% CI: 1.00–1.72). There is a difference in sex in the association between a bad mood and later ASD. In particular, female infants experiencing bad moods have a higher risk of ASD than others (RR: 3.59, 95% CI: 1.91–6.75).ConclusionsThe study findings provide important information for future intervention to reduce the risk of future ASD.

RNAi of Complex I and V of the electron transport chain in glutamate neurons extends life span, increases sleep, and decreases locomotor activity in Drosophila melanogaster.

RNAi targeting the electron transport chain has been proven to prolong life span in many different species, and experiments specifically with Drosophila melanogaster and Caenorhabditis elegans have shown a distinct role for neurons. To determine which subset of neurons is implicated in this life span extension, we used the GAL4/UAS system to activate RNAi against genes of Complex I and Complex V. We found life span extension of 18-24% with two glutamate neuron (D42 and VGlut) GAL4 lines. We used the GAL80 system to determine if the overlapping set of glutamate neurons in these two GAL4 lines imparts the life span extension. Limiting GAL4 activity to non-VGlut glutamate neurons in the D42 background failed to extend life span, suggesting that glutamate neurons have an important role in aging. Interestingly, RNAi of the electron transport chain in D42 glutamate neurons also caused an increase in daytime and nighttime sleep and a decrease in nighttime locomotor activity. Changes to sleep patterns and prolonged life span were not accompanied by any changes in female fertility or response to starvation. Our findings demonstrate that a small subset of neurons can control life span, and further studies can look into the contributions made by glutamate neurons.

Association of Family History, Life-Style Related Factors, Dietary Patterns, and Psychological Status with &lt;i&gt;Amavata&lt;/i&gt; (~Rheumatoid Arthritis) among the Population of Jamnagar, India: A Matched Case-Control Study

Background: The modern medical community now recognises Amavata as a condition that can lead to Rheumatoid Arthritis (RA) due to a combination of genetic predisposition, poor dietary habits, altered lifestyle, disturbed sleep, disturbed psychological condition, etc. Amavata’s origins are said to be two thousand years old, but there is no rigid evidence to support this. Aim: To evaluate the association of family history, different dietary patterns and lifestyle related risk factors such as Vyayama, improper bowel movements, disturbed/irregular sleep patterns, psychological stress, etc., in the pathology of Amavata (~RA). Materials and Methods: A matched case-control study was conducted from 18 April 2018 to 09 January 2020, containing 150 cases (patients of Amavata), and 150 controls (healthy volunteers), matching in age (between 18-50 years), and both the sexes (1:1 ratio) selected from Jamnagar district. After receiving written informed permission, data were obtained using CRF (Case Record Form). An open-ended questionnaire through the one-to-one interview was used to obtain data on eating habits, psychological and emotional circumstances previous to sickness, lifestyle features such as sleep, Vyayama (physical activity), and bowel patterns. Chi-square tests and Odds Ratios (OR) were computed. Results: The statistical analysis revealed that positive family history (χ2 = 63.021, p&lt;0.001), Avyayama (lack of physical activity) (OR = 7.43, χ2 = 79.95, p&lt;0.001), Diwaswapna (day time sleep) (OR = 12.86, χ2 = 93.048, p&lt;0.001), disturbed night sleep (OR = 44.25, χ2 = 159.61, p&lt;0.001), constipation (OR = 85.17, χ2 = 144.10, p&lt;0.001), Atishrama (occupational stress)(OR = 22.86, χ2 = 96.989, p&lt;0.001), disturbed psychological status (p&lt;0.001) and faulty dietary patterns (p&lt;0.001) were found to have statistically significant association with Amavata (~RA). Conclusion: Strong positive associations were found between positive family history, Avyayama (lack of physical activity), Diwaswapna (daytime sleep), disturbed night sleep, constipation, disturbed psychological status, Atishrama (occupational stress), and faulty dietary patterns (Adhyashana, Vishamashana, Viruddhashana) with Amavata which are statistically significant and they can be considered as the potential risk factors for the incidence of Amavata (~RA).

Obstructive sleep apnea syndrome: nocturnal intermittent hypoxia and telomerase complex activity

Obstructive sleep apnea syndrome (OSAS) is a common pathology of the respiratory system characterized by upper airway blockage during sleep. The blockage is caused by intermittent throat collapse and thereby no lung ventilation with preserved respiratory efforts. Earlier we demonstrated that telomeres at the end of chromosomes shorten during intermittent nocturnal hypoxia and sleep fragmentation in OSA patients; the elimination of OSA triggers contributed to an increase in relative telomere length (RTL). The search for the relationship between telomeres and the telomerase complex activity with the sleep stages, as well as indicators of blood oxygen saturation in OSA, seems relevant.Aim. To evaluate the activity of the telomerase complex main components and to determine its relationship with the sleep phases and the level of desaturation in patients with OSA.Methods. The main group included 32 men (age 51.2 ± 3.1 years) with complaints of snoring, respiratory arrest during sleep, and increased daytime sleep. The control group consisted of 26 matched volunteers without clinical manifestations of OSA. Patients of both groups did not have any exacerbations of their chronic conditions at baseline. The study included questionnaires, polysomnography monitoring, analysis of the RLT by PCR, ELISA to determine activity of the telomerase complex components, and statistical analysis.Results. Differences were revealed in the functioning of telomeres and the TERT, TEP1. A positive relationship between the oxygen blood saturation, telomere length and TER1 activity was found in OSA patients.Conclusion. We have identified the decrease in RTL and the telomerase complex activity and proved their positive relationship with the oxygen saturation during intermittent nocturnal hypoxia in OSA patients.

A longitudinal study of infant 24-hour sleep: comparisons of sleep diary and accelerometer with different algorithms.

To longitudinally compare sleep/wake identification and sleep parameter estimation from sleep diaries to accelerometers using different algorithms and epoch lengths in infants. Mothers and other caregivers from the Nurture study (southeastern United States, 2013-2018) reported infants' 24-hour sleep in sleep diaries for 4 continuous days, while infants concurrently wore accelerometers on the left ankle at 3, 6, 9, and 12 months of age. We applied the Sadeh, Sadeh Infant, Cole, and Count-scaled algorithm to accelerometer data at 15 and 60 seconds epochs. For sleep/wake identification, we assessed agreement by calculating epoch-by-epoch percent agreement and kappas. We derived sleep parameters from sleep diaries and accelerometers separately and evaluated agreement using Bland-Altman plots. We estimated longitudinal trajectories of sleep parameters using marginal linear and Poisson regressions with generalized estimation equation estimation. Among the 477 infants, 66.2% were black and 49.5% were female. Agreement for sleep/wake identification varied by epoch length and algorithm. Relative to sleep diaries, we observed similar nighttime sleep offset, onset, and total nighttime sleep duration from accelerometers regardless of algorithm and epoch length. However, accelerometers consistently estimated about 1 less nap per day using the 15 seconds epoch, 70 and 50 minutes' shorter nap duration per day using the 15 and 60 seconds epoch, respectively; but accelerometers estimated over 3 times more wake after nighttime sleep onset (WASO) per night. Some consistent sleep parameter trajectories from 3 to 12 months from accelerometers and sleep diaries included fewer naps and WASOs, shorter total daytime sleep, longer total nighttime sleep, and higher nighttime sleep efficiency. Although there is no perfect measure of sleep in infancy, our findings suggest that a combination of accelerometer and diary may be needed to adequately measure infant sleep.

0625 Sleep when the baby sleeps? The effect of daytime nap behaviors on postpartum depression severity: a stress buffering hypothesis

Abstract Introduction The early postpartum is a time of expected maternal sleep loss, normalized as part of infant care. While short duration and disrupted nocturnal sleep are posited risk factors for postpartum depression (PPD), the role of daytime sleep remains less understood, despite the widespread recommendation that mothers sleep when their baby is sleeping. This study examined associations between napping, stress, and longitudinal PPD in a sample of in a sample of healthy first-time mothers, using a prospective ambulatory field study design. Methods Fifty primiparous women (62% non-White; mean age=32 years) without a history of sleep disorders or psychopathology completed 10-days (9-nights) of actigraphy and sleep diaries at postpartum week 6. Sleep variables included nighttime duration and efficiency, and daytime nap frequency, timing and duration. Participants completed 3-days of superimposed ecological momentary assessment (EMA) rating naturalistic infant-related stressors (task demand; effort-reward-imbalance) at four daily intervals. Hierarchical mixed models tested whether daytime sleep characteristics predicted lower depression levels (via Edinburgh Postnatal-Depression Scale - EPDS) at 6-weeks, 8-weeks, and 3-months postpartum. Time-varying within-person covariates included time-of-day, baseline depression and anxiety (via Generalized-Anxiety-Disorder-7 scores), and previous night sleep. To test the putative stress-protective role of napping, we examined pre-post nap differences in EMA ratings. Results Sixty percent (n = 30/47) of women napped regularly (&amp;gt;3x/1 week, between 1-5 PM, &amp;lt; 90 min by both diary and actigraphy), rating 80% of these naps “intentional.” Women with greater nap regularity at 6-weeks had lower depression levels at all timepoints (Betas = -2.4(1.6); -1.4(.5), -.5(.01) ps&amp;lt;.001, respectively), and less of an increase in depression symptoms at 3-months postpartum, compared to non-nappers [Beta(SE)=-1.2 (.5); R^2=.21; p&amp;lt;.001]. At 6-weeks, regular nappers reported lower stress post-nap (effort-reward-imbalance; demand) [Beta(SE)=-6.3(1.4); 1.2(.12,), R^2=.27, .32, respectively; ps&amp;lt;.01]. Conclusion This study demonstrates a contemporaneous mood-protective role of daytime sleep in a perinatal sample, using 24-hr objective sleep assessment coupled with daily assessments of naturalistic stressors. Moreover, these results provide support for the protective role of regular daytime sleep on development of PPD over time. Among new mothers who regularly nap, lowered post-nap stress may be one pathway through which daytime sleep buffers against PPD severity. Support (if any) NIMH-1R36MH118000-01, CTSI89431, T32-HL007713

0249 Individual differences of sleep pattern and duration between two consecutive night shifts among night workers

Abstract Introduction Working at night leads to shortened and disturbed daytime sleep. Night workers usually adopt one of several sleep patterns between consecutive nights: sleeping right after night work (morning sleep), delaying sleep to the afternoon (afternoon sleep), or dividing sleep into two or more episodes (split sleep). However, few studies have examined sleep pattern and duration between consecutive nights in real-world workers. The objective of this study was to examine individual differences in sleep pattern and duration when working consecutive night shifts. Methods Night workers (n=241, 43.0±16.5y, 67.2% female) from various occupations who reported working consecutive nights completed an online survey. The survey included questions on socio-demographics and daytime sleep and nap schedules. Sleep pattern (morning vs. afternoon vs. split) and total sleep time (sleep+naps) were derived from survey responses. Cross-tabulations and ANOVA were conducted. Results On average, night workers reported a total daytime sleep of 5.37±2.69 hours (range 0-14.25 hours). 65.1% reported morning sleep, 10% afternoon sleep, and 24.9% split sleep. Split sleepers (6.78±2.13 hours) reported longer total sleep than morning (4.86±2.75 hours) or afternoon (5.11±2.37 hours) sleepers. Younger age (&amp;lt; 50y), single marital status, shorter night shift tenure (≤10 years), working ≤3 consecutive shifts, and having ill or disabled dependents were associated with greater prevalence of morning sleep; older age (≥50y), married or separated/widowed, &amp;gt;10 years night shift tenure, working ≥4 consecutive shifts, and having no dependents were associated with greater prevalence of afternoon or split sleep. Having childcare responsibility was associated with more split sleep than no children. Similarly, younger age (&amp;lt; 50y), singles, shorter night shift tenure, working three or fewer consecutive shifts, having ill or disabled dependents, and having a second job were associated with shorter total sleep. However, having childcare responsibility was associated with greater total sleep. Conclusion Sleep timing and duration between consecutive nights were influenced by age, marital status, dependents, night work tenure, and number of consecutive night shifts. Future studies are needed to explore what sleep pattern is most beneficial for sleep, performance, safety, and health outcomes of these workers. Support (if any) The study was supported by grant R01 AG044416 from the US National Institutes of Health.

0193 Sleep profiles of drinking and non-drinking college students

Abstract Introduction Alcohol use and insufficient sleep are prevalent in American college students and studies suggest that these behaviors are reciprocally interrelated. However, there is limited information about the relationship between sleep and alcohol use in college students without sleep or alcohol disorders. This study aimed to characterize the relationship between sleep and alcohol use in healthy college students by considering the effects of using alcohol on same-day nocturnal sleep, next-day nocturnal sleep, and napping. Methods Thirty-one college students (n=12 consumed alcohol during the study, n=19 did not) completed twice-daily online diary reports and wore a wrist-actigraphy device across two weeks. Linear mixed models examined person-specific (e.g., drinker or non-drinker) and event-specific (e.g., drinking or non-drinking night; school or free night) effects of alcohol use on subjective and objective sleep outcomes. Results When averaged across all nights, sleep behavior did not differ between drinkers and non-drinkers (ps&amp;gt;0.05). On drinking nights, participants went to bed later (p&amp;lt; 0.05) but woke up at similar times compared to non-drinking nights, resulting in significantly shorter sleep durations on drinking nights (p&amp;lt; 0.05). There were no effects of alcohol use on subjective sleep quality or daytime sleepiness (ps&amp;gt;0.05) or on next-day nocturnal sleep variables (ps&amp;gt;0.05). Daytime sleep (i.e., napping) was observed in 25 (81%) participants. The proportion of nappers and number of naps per participant did not significantly differ by drinking status (ps&amp;gt;0.05). There were also no differences in actigraphy-derived daytime sleep variables between drinkers and non-drinkers (ps&amp;gt;0.05). Among drinkers who napped (n=9), naps were taken on 27% of days following drinking nights and on 17% of days following non-drinking nights (p&amp;gt;0.05). Conclusion This study bolsters prior reports that insufficient nocturnal sleep and daytime napping are common in college by validating self-reported sleep behaviors with objective actigraphy data. Efforts to convey the importance of proper sleep are still needed in the college context. Future research should examine consequences of layering acute bouts of excessive alcohol consumption onto insufficient nocturnal sleep. Support (if any) This work was supported by the NIH NIAAA grant R01AA028286 to JB and AS.

0732 Sleep multi-trajectories of couples up to 36 months postpartum and their covariates: the SEPAGES cohort study

Abstract Introduction Parents reported degraded sleep outcomes up to several years after child birth. Most published studies were cross-sectional, in early post-partum and focusing on maternal-child dyads. We aimed at identifying sleep multi-trajectories (SMT) including night (NSD) and daytime (DSD) sleep duration and subjective sleep loss (SSL) between 3 and 36 months postpartum in couples from the SEPAGES cohort. Methods From 484 mothers and 410 fathers included in the SEPAGES cohort, sleep information was collected by self-reports at 3, 18, 24 and 36 months postpartum. Couple SMT were modelled using Group-Based Trajectory Modelling method. Each couple was assigned to the group of SMT with the highest probability of belonging to. Multinomial logistic regression assessed sociodemographic, parental and child covariates associated SMT Results Three groups SMT were identified in couple who reported sleep data at least 2 times across the 4 time-points (N=188). In G1 (29.3%), couples had 8-9hr of mean NSD and a stable and relatively short mean maternal and paternal DSD (≈10min and ≈5min, respectively) while SSL was decreasing for mother (58% to 31%) but stable for father (≈30%) between 3 and 36 months postpartum. In G2 (27.7%), they had a stable but relatively short mean NSD (7-8hr), a maternal DSD decreasing by 20min between 3 and 18 months then being stable at 23min, a stable paternal DSD (≈10min) and high but decreasing SSL from 90% to 86% for mothers and 76% to 61% for fathers. In G3 (43.0%), couples had a stable mean NSD (8-9hr), a relatively long mean DSD, decreasing from 54 to 41min for mothers but increasing from 28 to 39min for fathers, and a stable but relatively high SSL (≈70% for mothers and ≈55% for fathers). From logistic regression, belated paternal chronotype increased odds for belonging to G2 while having a first child and born in autumn decreased odds to belong to G2 compared to G1. Conclusion We identified 3 different SMT between 3 and 36 months postpartum for the first time. We found several factors associated with each SMT. Studies are still warranted to investigate further interrelation with the child sleep patterns. Support (if any) -

0381 Adverse Childhood Experiences Associated with Adult Sleep Duration, Control Over Sleep, and Daytime Sleepiness

Abstract Introduction Adverse childhood events have been linked with many mental and physical health risks, but less work has explored nighttime and daytime sleep problems, especially inability to control sleep. Methods Data were obtained from the Sleep and Healthy Activity, Diet, Environment, and Socialization (SHADES) study of N=1007 adults aged 22-60 years recruited from communities in southeastern Pennsylvania. Adverse childhood experiences were defined as a self-reported history of child abuse, parent divorce, parent death, parent with depression, parent with anxiety disorder, and childhood poverty (yes/no). Habitual sleep duration was assessed in hours, daytime sleepiness was assessed with the Epworth Sleepiness Scale (ESS), and control over sleep was assessed with the Brief Index of Sleep Control (BRISC). Covariates included age, sex, race/ethnicity, and education. Additional models included depression severity, assessed using a modified version of the Patient Health Questionnaire-9. Results History of child abuse was associated with 23 fewer minutes of nighttime sleep (p=0.001), and parent anxiety was associated with 15 fewer minutes (p=0.048). When depression was added to the model, the effects for sleep duration were attenuated (15.3 minutes, p=0.03). No other relationships were observed. Regarding control over nighttime sleep, decreased sense of control was reported by those who experienced child abuse (B=-0.4, p&amp;lt; 0.0005), parent divorce (B=-0.1, p=0.035), and parent depression (B=-0.2, p=0.02). After adjusting for depression, the relationship with child abuse was attenuated but maintained (B=-0.2, p&amp;lt; 0.0005). Elevated ESS scores were seen in those who reported child abuse (B=4.7, p&amp;lt; 0.0005), parent depression (B=4.3, p&amp;lt; 0.0005), and parent anxiety (B=3.9, p&amp;lt; 0.0005). After adjusting for depression, relationships were attenuated but maintained for child abuse (B=2.0, p=0.02), parent depression (B=2.2, p=0.004), and parent anxiety (B=2.2, p=0.017). Conclusion Adverse childhood events may lead to sleep/wake dysregulation, including less sleep at night, more sleepiness during the day, and decreased sense of control over sleep ability. Future efforts might focus on increasing control over nighttime sleep and reducing daytime sleepiness. Support (if any)

0772 Associations of Sleep Duration and Maternal Postnatal Depression in Infants with Autistic Siblings

Abstract Introduction Evidence suggests sleep differences emerge in the first three years of life for autistic individuals (MacDuffie et al., 2020) and may be a possible endophenotype in unaffected siblings (Naeem et al., 2021). In neurotypical samples, postnatal depression has also emerged as a potential contributor to infant sleep challenges (Dias &amp; Figueiredo, 2021). Questions remain on the associations between infant sleep duration, maternal postnatal depression, and family history of ASD as well as how these variables interact to predict future autistic traits. Methods Participants (N=74) were enrolled in a prospective longitudinal study on early autistic traits and included infants with an autistic sibling (n=33, EL) and with no familial history of ASD (n=41, LL). At 6 months, caregivers completed the Edinburgh Postnatal Depression Scale (EPDS) and a 24-hour retrospective sleep log. At 12 months, clinicians administered a standardized observation of autistic traits (SORF) the includes scores related to deficits in social communication (SCD) and restrictive and repetitive behaviors (RRBs). Results At 6 months, EL infants spent significantly more time asleep during the day than LL infants, (t(45)=2.89, p&amp;lt;.01). There were not significant differences in nighttime sleep duration or EPDS scores between groups. In examining the influence of self-ratings of maternal depression and likelihood status on sleep duration, the model was significant for daytime sleep (F(2, 36)=4.27, p=.02), but not nighttime sleep. Likelihood status, not EPDS score, predicted more hours spent asleep in the daytime. When assessing the role of status and sleep-related variables on future autistic traits, only decreased nighttime sleep duration at 6 months was related to greater RRBs at 12 months (F(3, 10)=15.26, p=.02), regardless of likelihood status. Conclusion The results of this study suggest that EL infants may sleep more in the daytime at 6 months. Reduced nighttime sleep at 6 months possibly signal future autistic traits, regardless of likelihood status. Future research should examine actigraphy data and its relationship to the etiology of ASD in larger samples. Support (if any) Funded by K23-MH120476, R21-DC071252, and T32GM081740.

Bedtime to the brain: how infants' sleep behaviours intertwine with non-rapid eye movement sleep electroencephalography features.

Adequate sleep is critical for development and facilitates the maturation of the neurophysiological circuitries at the basis of cognitive and behavioural function. Observational research has associated early life sleep problems with worse later cognitive, psychosocial, and somatic health outcomes. Yet, the extent to which day-to-day sleep behaviours (e.g., duration, regularity) in early life relate to non-rapid eye movement (NREM) neurophysiology-acutely and the long-term-remains to be studied. We measured sleep behaviours in 32 healthy 6-month-olds assessed with actimetry and neurophysiology with high-density electroencephalography (EEG) to investigate the association between NREM sleep and habitual sleep behaviours. Our study revealed four findings: first, daytime sleep behaviours are related to EEG slow-wave activity (SWA). Second, night-time movement and awakenings from sleep are connected with spindle density. Third, habitual sleep timing is linked to neurophysiological connectivity quantified as delta coherence. And lastly, delta coherence at 6 months predicts night-time sleep duration at 12 months. These novel findings widen our understanding that infants' sleep behaviours are closely intertwined with three particular levels of neurophysiology: sleep pressure (determined by SWA), the maturation of the thalamocortical system (spindles), and the maturation of cortical connectivity (coherence). The crucial next step is to extend this concept to clinical groups to objectively characterise infants' sleep behaviours 'at risk' that foster later neurodevelopmental problems.

Association between Sleep Factors and Parkinson’s Disease: A Prospective Study Based on 409,923 UK Biobank Participants

Introduction: Limited evidence indicates an association between sleep factors and the risk of Parkinson’s disease (PD). However, large prospective cohort studies including both sexes are needed to verify the association between daytime sleepiness, sleep duration, and PD risk. Furthermore, other sleep factors like chronotype and snoring and their impact on increased PD risk should be explored by simultaneously considering daytime sleepiness and snoring. Methods: This study included 409,923 participants from the UK Biobank. Data on five sleep factors (chronotype, sleep duration, sleeplessness/insomnia, snoring, and daytime sleepiness) were collected using a standard self-administered questionnaire. PD occurrence was identified using linkages with primary care, hospital admission, death register, or self-report. Cox proportional hazard models were used to investigate the association between sleep factors and PD risk. Subgroup (age and sex) and sensitivity analyses were performed. Results: During a median follow-up of 11.89 years, 2,158 incident PD cases were documented. The main association analysis showed that prolonged sleep duration (hazard ratio [HR]: 1.20, 95% confidence interval [CI]: 1.05, 1.37) and occasional daytime sleepiness (HR: 1.15, 95% CI: 1.04, 1.26) increased the PD risk. Compared to those who self-reported never or rarely having sleeplessness/insomnia, participants who reported usually having sleeplessness/insomnia had a decreased risk of PD (HR: 0.85, 95% CI: 0.75, 0.96). Subgroup analysis revealed that women who self-reported no snoring had a decreased PD risk (HR: 0.85; 95% CI: 0.73, 0.99). Sensitivity analyses indicated that the robustness of the results was affected by potential reverse causation and data completeness. Conclusion: Long sleep duration increased the PD risk, especially among men and participants ≥60 years, while snoring increased the risk of PD in women. Additional studies are needed to (i) further consider other sleep traits (e.g., rapid eye movement sleep behavior disorder and sleep apnea) that might be related to PD, (ii) objectively measure sleep-related exposure, and (iii) confirm the effects of snoring on PD risk by considering the impact of obstructive sleep apnea and investigating its underlying mechanisms.

Daytime affect and sleep EEG activity: A data-driven exploration.

It has long been thought that links between affect and sleep are bidirectional. However, few studies have directly assessed the relationships between: (1) pre-sleep affect and sleep electroencephalogram (EEG) activity; and (2) sleep EEG activity and post-sleep affect. This study aims to systematically explore the correlations between pre-/post-sleep affect and EEG activity during sleep. In a community sample of adults (n = 51), we measured participants' positive and negative affect in the evening before sleep and in the next morning after sleep. Participants slept at their residence for 1 night of EEG recording. Using Fourier transforms, the EEG power at each channel was estimated during rapid eye movement sleep and non-rapid eye movement sleep for the full range of sleep EEG frequencies. We first present heatmaps of the raw correlations between pre-/post-sleep affect and EEG power during rapid eye movement and non-rapid eye movement sleep. We then thresholded the raw correlations with a medium effect size |r| ≥ 0.3. Using a cluster-based permutation test, we identified a significant cluster indicating a negative correlation between pre-sleep positive affect and EEG power in the alpha frequency range during rapid eye movement sleep. This result suggests that more positive affect during the daytime may be associated with less fragmented rapid eye movement sleep that night. Overall, our exploratory results lay the foundation for confirmatory research on the relationship between daytime affect and sleep EEG activity.

The Current Status and Potential Mechanism of Sleepiness: Narcolepsy

In modern society, narcolepsy had been a threat to the world for a long time. Due to the high societal pressure, narcolepsy is more and more common to be detected. Patients with narcolepsy report excessive daytime sleepiness, which can lead to serious consequences in the future if left untreated. Narcolepsy typically manifests in adolescence.[1] According to incomplete statistics, in 2017 there is a total of more than 140 million people that were confirmed that they were suffering from Narcolepsy cautiously. Narcolepsy has five main symptoms, which are clear to be diagnosed: excessive daytime sleep attack sometimes cataplexy and hypnagogic hallucinations, but the most common symptoms are sleep paralysis and nocturnal sleep. Some main causes, treatments, and solutions are also important to be understood. The paper aims at providing information about this serious brain condition and the potential solutions if individuals are under attack.

Brain Age Prediction based on Sleep EEG in Shift Workers (P1-13.003)

<h3>Objective:</h3> Sleep architecture and microstructures alter with aging. This study was to investigate the association between a sleep EEG-based brain age index (BAI), predicted brain age minus chronological age, and shift work. <h3>Background:</h3> Shift work is associated with numerous negative health consequences, and BAI might reflect an individual’s brain health. <h3>Design/Methods:</h3> We have developed a deep learning technique to estimate brain aging from EEG from sleep polysomnogram by using DenseNet to train the brain age prediction model with a six-channel sleep EEG. To allow for EEG-BAI to capture brain aging more accurately, we have taken advantage of a BIG-DATA-driven machine learning approach with 4,215 sleep EEG. Then, we enrolled 12h-shift female nurses working at one university-affiliated hospital (n=37, mean age 28.9 y, shift work duration 5.4 y). Daytime sleep study in laboratory were adjusted to the habitual sleep hour after completing the 1st 12h-night shift and eating breakfast. They were clustered based on EEG-BAI and shift working period. We used K-means clustering method to divide into two groups. The group with low BAI group was defined as the good resilience group (GR), and the group with high BAI group was defined as the poor resilience group (PR). <h3>Results:</h3> Of the total nurses, 26 were classified into the GR and 11 into the PR. Compared with the PR, GR started shift work at younger age (22.4 vs. 24.1 y, p&lt;0.001), had more shift work experience (6.5 vs. 2.9 y, p&lt;0.005), younger chronological age (27.4 vs. 29.6 y, p&lt;0.005), and lower BAI (−0.4 vs. 1.0, p&lt;0.001). <h3>Conclusions:</h3> Our results demonstrate that the EEG-BAI can be a biomarker reflecting brain health for shift workers. To adjust well to shift work, it is recommended to start shift work at a young age. <b>Disclosure:</b> Ms. Choi has nothing to disclose. Dr. Yook has nothing to disclose. Hea Ree Park has nothing to disclose. Prof. Kim has nothing to disclose. Dr. Joo has nothing to disclose.

The sleep condition and its association with cognitive function of the elderly in six provinces of China

Objective: To analyze the association between sleep duration and cognitive function of the elderly in six provinces of China. Methods: Based on the cross-sectional survey data of the elderly from the Healthy Ageing Assessment Cohort Study in 2019, 4 644 participants' sociodemographic and economic indicators, lifestyle, prevalence of major chronic diseases, and sleep status, including night-time sleep duration, daytime sleep duration and insomnia, were collected by questionnaires. Cognitive function was evaluated by the Mini-Mental State Examination. Multivariate logistic regression was used to analyze the association between night-time sleep duration, daytime sleep duration and cognitive function. Results: The mean age of 4 644 respondents was (72.3±5.7) years, and 2 111 of them were males (45.5%). The mean total daily sleep time of the elderly was (7.9±1.9) hours, and the proportion of those who slept less than 7.0, 7.0-8.9 and≥9.0 hours was 24.1% (1 119), 42.1% (1 954) and 33.8% (1 571), respectively. The mean sleep time at night was (6.9±1.7) hours. About 23.7% (1 102) of the elderly did not sleep during the day, and the mean duration of the elderly who slept during the day was (78±51) minutes. Among the elderly with insomnia, 47.9% were still satisfied with their sleep quality. The mean value of MMSE score of 4 644 respondents was (24.5±5.3), and the cognitive impairment rate was 28.3% (1 316). The results of multivariate logistic regression model analysis showed that the OR (95%CI) value of the risk of cognitive impairment in older people who did not sleep, slept for 31 to 60 minutes and slept more than one hour was 1.473 (1.139 to 1.904), 1.277 (1.001 to 1.629) and 1.496 (1.160 to 1.928), respectively, compared with those who slept for 1 to 30 minutes during the daytime. Compared with those who slept for 7.0‒8.9 hours at night, the OR (95%CI) value of the risk of cognitive impairment in older people who slept more than 9.0 hours was 1.239 (1.011 to 1.519). Conclusion: The cognitive function is related to sleep duration in the Chinese elderly.