Daytime Sleepiness Scores Research Articles

Effects of ganaxolone on non-seizure outcomes in CDKL5 Deficiency Disorder: Double-blind placebo-controlled randomized trial

CDKL5 deficiency disorder (CDD) is a rare developmental and epileptic encephalopathy. Ganaxolone, a neuroactive steroid, reduces the frequency of major motor seizures in children with CDD. This analysis explored the effect of ganaxolone on non-seizure outcomes. Children (2–19 years) with genetically confirmed CDD and ≥ 16 major motor seizures per month were enrolled in a double-blind randomized placebo-controlled trial. Ganaxolone or placebo was administered three times daily for 17 weeks. Behaviour was measured with the Anxiety, Depression and Mood Scale (ADAMS), daytime sleepiness with the Child Health Sleep Questionnaire, and quality of life with the Quality of Life Inventory-Disability (QI-Disability) scale. Scores were compared using ANOVA, adjusted for age, sex, number of anti-seizure mediations, baseline 28-day major motor seizure frequency, baseline developmental skills, and behaviour, sleep or quality of life scores. 101 children with CDD (39 clinical sites, 8 countries) were randomized. Median (IQR) age was 6 (3–10) years, 79.2 % were female, and 50 received ganaxolone. After 17 weeks of treatment, Manic/Hyperactive scores (mean difference 1.27, 95%CI –2.38,-0.16) and Compulsive Behaviour scores (mean difference 0.58, 95%CI -1.14,-0.01) were lower (improved) in the ganaxolone group compared with the placebo group. Daytime sleepiness scores were similar between groups. The total change in QOL score for children in the ganaxolone group was 2.6 points (95%CI -1.74,7.02) higher (improved) than in the placebo group but without statistical significance. Along with better seizure control, children who received ganaxolone had improved behavioural scores in select domains compared to placebo.

Association of sleep timings, duration, consistency, and chronotype with premyopia and myopia among Indian children

Background To explore the association of sleep timings, duration, consistency, and chronotype with premyopia and myopia among Indian children. Methods This hospital-based cross-sectional study included 453 children, aged 6–12 years. Two myopia participants were selected for each individual with the corresponding premyopia or emmetropia. All children underwent cycloplegic autorefraction and ocular biometric tests. The Children's Sleep Habits Questionnaire (CSHQ) and parental information on behavioral habits were used to assess the association of sleep parameters with myopia and premyopia using logistic regression models. Results Both myopia and premyopia exhibited significant late bedtime, short sleep duration, early wakeup time on only weekdays, and longer weekend catch-up sleep than emmetropia children (p < 0.05). In multivariate analysis, late bedtime (more than 24:00 a.m.) on weekdays (Odds ratio, OR = 3.63, 95% CI [0.74, 8.68]) as well as on free days (OR = 1.04, 95% CI [0.02, 8.08]); and early wake-up time only on weekdays (5:00–6:00 a.m., OR = 2.16, 95% CI [0.24, 6.76] and 06:00–07:00 a.m., OR = 2.42, 95% CI [0.51, 8.44]) were associated with increased risk of myopia (all p < 0.05) but not premyopia. After adjusting the confounding factors, when each of the eight CSHQ subscale components was analyzed, only bedtime resistance, night waking, and daytime sleepiness scores were significantly associated with a higher risk for premyopia and myopia (p < 0.05). Conclusions The sleep quality components, including bedtime resistance, night waking, and daytime sleepiness, equally involve a higher risk for myopia as well as premyopia.

Effects of transcranial magnetic stimulation on sleep structure and quality in children with autism.

Sleep disorders are common in children with autism spectrum disorder (ASD). Transcranial magnetic stimulation (TMS) can influence the excitability of neuronal cells in stimulated areas, leading to improvements in sleep and other autistic symptoms. However, studies on clinical mechanisms of TMS in treating sleep disorders associated with ASD are limited. Therefore, we aimed to explore the effects of TMS on sleep structure and quality in children with ASD. Between January 2020 and December 2021, recruitment was advertised through child and adolescent outpatient clinics and online platforms by the Hangzhou Seventh People's Hospital and Lishui Second People's Hospital. Sixty children with ASD who met the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, were selected and randomly divided into the active TMS and sham TMS treatment groups. Thirty healthy children of the same age were recruited as controls. The active TMS group received bilateral low-frequency (0.5Hz) TMS targeting the dorsolateral prefrontal cortex on both sides in children with ASD, whereas the sham TMS group received sham stimulation with the same stimulation time and location as the experimental group. Both groups were treated for 6 weeks, and the participants were assessed using the Sleep Disturbance Scale for Children (SDSC) before treatment, at 3 weeks, and at 6 weeks of intervention. Independent sample t-tests and difference t-tests were used for statistical analysis of the data. No significant differences were observed in general demographic variables, such as age and sex, between the ASD and control groups (P>0.05). Independent sample t-test analysis showed that the total SDSC score, difficulty falling asleep, sleep maintenance, awakening disorders, sleep-wake transition disorders, excessive daytime sleepiness, and nocturnal hyperhidrosis scores were significantly higher in the ASD group than in the control group (P<0.05). Before treatment, no significant differences were observed in the factor or total SDSC scores between the sham TMS group and the active TMS group (P>0.05). After 15 and 30 treatment sessions, the total SDSC score, difficulty falling asleep, sleep maintenance, sleep-wake transition disorders, and excessive daytime sleepiness scores were significantly higher in the sham TMS group than in the active TMS group (P<0.05). The difference t-test analysis showed that after 30 treatment sessions, the reduction rates of the total SDSC score, difficulty falling asleep, sleep maintenance, awakening disorders, sleep-wake transition disorders, excessive daytime sleepiness, and nocturnal hyperhidrosis dimensions were significantly higher in the active TMS group than in the sham TMS group (P<0.05). Low-frequency TMS targeting the dorsolateral prefrontal cortex in children with ASD can effectively improve their sleep status, and significant improvement can be achieved after 6 weeks (30 sessions) of treatment.

Differences in Sleep Quality and Sleepiness among Veterinary Medical Students at Multiple Institutions Before and After the Pandemic Induced Transition to Online Learning

Poor sleep health has been previously documented in veterinary medical students. However, it is not known how universal or widespread this problem is. This study evaluated Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) scores to measure sleep health among students at seven colleges of veterinary medicine in the United States (US). Inadvertently, the transition to online only learning due to the global COVID-19 pandemic was also captured. Veterinary students were found to have universally poor sleep quality and high daytime sleepiness. The transition to online only learning appeared to have little impact on sleep quality, but improved daytime sleepiness scores were observed. The findings suggest poor sleep health is common among veterinary medical students at multiple institutions in the US and that further investigation is necessary.

Gender differences in obstructive sleep apnea with comorbid treatment-resistant depression

BackgroundA bidirectional relationship between major depression and obstructive sleep apnea (OSA) has been established, suggesting the possibility of overlapping and compounding disease processes. Depression, however, while more prevalent in women, is a highly heterogeneous disorder and can be difficult to treat regardless of gender. A common overlapping symptom of depression and OSA is fatigue. Gender differences in OSA symptomatology (and fatigue in particular) are also consistently observed. Here, we investigate OSA in specific relation to treatment-resistant depression.MethodsA cross-sectional exploratory design was used to analyse data from 94 patients with treatment-resistant depression from a subspecialist mood disorders outpatient service who had no previous sleep assessment. Participants completed overnight polysomnography and a battery of rating scales assessing mood, sleep, and daytime functioning. Linear regression models determined whether presence of fatigue in treatment-resistant depression predicted OSA severity.ResultsThere was a high prevalence (79%) of previously undiagnosed OSA in our sample of patients with treatment-resistant depression. Treatment-resistant depression was one factor to close the gap in obstructive sleep apnea prevalence between men and women in this group. Presence of OSA measured objectively by the Apnea Hypopnea Index was not associated with episode state (depressed vs. euthymic). Daytime sleepiness scores as measured by the Epworth Sleepiness Scale indicated higher than normal daytime sleepiness with no difference between genders. Men and women in our study reported similar amounts of fatigue as measured by the Profile of Mood States-Fatigue Subscale, however, daytime fatigue (but not sleepiness) predicted OSA severity in women only.ConclusionsWe argue that typical symptoms of treatment-resistant depression may overshadow key symptoms of undetected OSA. Specifically, we found that daytime fatigue may be one factor masking a potentially significant underlying sleep disorder in women only. Comprehensive assessment and screening for sleep apnea in patients with treatment-resistant depression is encouraged, and the importance of investigating severity of fatigue in this population is emphasized.

0758 Initial Efficacy of a Brief, Trauma-Informed Sleep Intervention for Children in Foster Care

Abstract Introduction Children in foster care experience impairing sleep problems that contribute to greater attachment, emotional and behavioral problems concurrently and over time. Sleep nonetheless remains a critically neglected aspect of health among this vulnerable group. To address the unique sleep needed of this population, we developed a brief, telehealth-delivered behavioral sleep intervention for caregivers of young children currently or formerly in foster care, called Sleep and Adjustment in Foster Environments for Toddlers and Preschoolers (SAFE-T). The current study examined the initial efficacy of SAFE-T. Methods N = 25 foster or adoptive foster parents with a 2- to 5-year-old child (M = 3.9; SD = 1.7) were recruited from the state of Texas. After a baseline assessment including the Children’s Sleep Habits Questionnaire (CSHQ) and Parenting Stress Index (PSI), families were randomized to SAFE-T or an active control group. SAFE-T families (n = 14) received 3 telehealth-delivered sessions with a therapist who provided information about healthy sleep and trauma-informed suggestions for reducing child sleep problems. Control families (n = 11) were sent an informational booklet about sleep to keep. A post-treatment assessment was completed approximately one month after he initial assessment. Results Compared to the control group, the SAFE-T group evidenced greater reductions in total CSHQ sleep problem scores (η2 = .14), including Sleep Anxiety (partial eta squatted = .16), Sleep Onset Delay (η2 = .08), Bedtime Resistance (η2 = .09) and Daytime Sleepiness (η2 = .07) scores at post treatment. Based on the PSI, caregivers in the SAFE-T group reported greater reductions in Difficult Child scores (η2 = .35), Parent-Child Dysfunctional Interactions (η2 = .31) and Parenting Stress (η2 = .16) compared to the control group. Conclusion Medium to very large effects were found for reductions in caregiver-reported child sleep problems as well as parenting stress following intervention with SAFE-T. These promising results suggest that a brief, trauma-informed sleep intervention may be effective in improving child sleep health and caregiver well-being in foster families. Support (if any) This study was funded by the Grant to Enhance and Advance Research (GEAR) from the University of Houston.

Ulotaront, a Trace Amine-Associated Receptor 1/Serotonin 5-HT1A Agonist, in Patients With Parkinson Disease Psychosis: A Pilot Study.

Ulotaront (SEP-363856) is a trace amine-associated receptor 1 agonist with 5-HT1A receptor agonist activity currently in phase 3 clinical development for the treatment of schizophrenia. In this exploratory, flexibly dosed study, ulotaront was evaluated for the treatment of Parkinson disease psychosis (PDP). Patients with PDP requiring antipsychotic therapy were randomized, double-blind to ulotaront (25, 50, or 75 mg/d) or placebo. Mixed Model for Repeated Measures was used to assess change from baseline in the Scale for the Assessment of Positive Symptoms for Parkinson Disease (SAPS-PD) at 6 weeks (primary end point). The efficacy analysis sample comprised 38 patients (ulotaront, n = 24; placebo, n = 14). SAPS-PD total scores were numerically reduced in ulotaront-treated vs placebo-treated patients from week 1 to week 6: Least squares mean (95% confidence interval) difference in change from baseline at week 6 was -1.1 (-6.5, 4.3, p = 0.681). PDP symptom complete remission (≥100% improvement [reduction] from baseline in SAPS-PD total score) was observed in 25% of ulotaront-treated vs 0% of placebo-treated patients. SAPS-PD and Neuropsychiatric Inventory hallucinations subscales were numerically reduced vs placebo, and SAPS-PD total scores were reduced in patients with greater cognitive impairment (baseline Mini-Mental State Examination [MMSE] scores ≤24). Ulotaront improved Scales for Outcomes in Parkinson Disease Sleep Scale - Daytime Sleepiness scores (p = 0.022). There was no worsening of Unified Parkinson Disease Rating Scale Part III motor score, MMSE, or vital signs. Adverse events (≥10%) with ulotaront vs placebo included hallucinations (24% vs 14%), confusional state (20% vs 14%), dizziness (16% vs 7%), nausea (12% vs 7%), and falls (12% vs 21%). In this exploratory pilot study, ulotaront may decrease PDP symptoms without worsening motor function, particularly in patients with cognitive impairment. ClinicalTrials.gov identifier: NCT02969369; submitted: November 17, 2016; study start date: December 31, 2016. This Class II study was an exploratory pilot study that was underpowered to detect a statistically significant difference between ulotaront and placebo in the treatment of patients with Parkinson disease psychosis without worsening motor function.

Fatigue, Somnolence and Depression Persist After Six Month In Recovered Individual After The Acute Covid-19 (P14-4.003)

<h3>Objective:</h3> To assess depression/anxiety symptoms, fatigue and daytime sleepiness in individuals previously affected by the COVID-19 infection. <h3>Background:</h3> Neuropsychiatric symptoms may persist after the COVID-19 infection. <h3>Design/Methods:</h3> We included 1183 cases of post-Covid infection (79% women; median age 41 [12–77]) who answered an interview of our online survey (median interval 191 days [50–503] after the infection). We used the Hamilton Anxiety and Depression Scale to evaluate anxiety (HADS-A) and depression symptoms (HADS-D), the Chalder Fatigue Scale to measure the fatigue severity and the Epworth Sleepiness Scale to assess daytime sleepiness. Individuals also answered the PHQ-9 (Patient Health Questionnaire-9). Patients were separated according to the treatment type (home [1046, median 41 years], ward [87, median 45.5 years] or ICU [50, median 48.5 years]). We performed Mann-Whitney tests to compare continuous variables among groups and Spearman tests for correlations. <h3>Results:</h3> Anxiety symptoms were more severe in ICU patients (median score 12 [0–19]) compared to the home group (median score 9 [0–21]; p=0.012). Similarly, the severity of physical fatigue was higher in the patients treated in ICU (median score 16 [2–21]) compared to home treatment (median score 13 [0–21]; p=0.004). However, the depression severity (p=0.1), PHQ-9 scores (p=0.06), mental fatigue (p=0.06) and daytime sleepiness scores (p=0.6) were similar among the three groups. Overall, there were positive correlations between sleepiness and both mental (r=0.33, p&lt;0.001) and physical fatigue (r=0.44, p&lt;0.001). The PHQ-9 scores positively correlated with sleepiness (r=0.36, p&lt;0.001), mental fatigue (r=0.63, p&lt;0.001) and physical fatigue (r=0.73, p&lt;0.001). Interestingly, these correlations were present for the three groups, even after splitting according to treatment. <h3>Conclusions:</h3> We confirmed persistent symptoms of fatigue, daytime sleepiness, anxiety and depression in a large group of recovered individuals after six months from the acute infection. Surprisingly, patients with mild infection presented equivalent intensity of mental fatigue, somnolence and depression, compared to those who required hospitalization. <b>Disclosure:</b> Prof. João has received research support from FAPESP. Lucas Silva has nothing to disclose. Mr. Carvalho has nothing to disclose. Dr. Karmann Aventurato has received research support from Coordenadoria de Aperfeiçoamento de Pessoal de Ensino Superior (CAPES). Miss Costa has nothing to disclose. Mariana Brito has nothing to disclose. Mateus Nogueira has nothing to disclose. Dr. Alvim has nothing to disclose. Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB Pharma. Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for UCB Biopharma. Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for United Medical – Brazil. Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Zodiac Pharma . Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Eurofarma – Brazil . Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Epilepsia. Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Frontiers in Neurology - Epilepsy. The institution of Dr. Cendes has received research support from São Paulo Research Foundation - FAPESP. The institution of Dr. Cendes has received research support from Conselho Nacional de Desenvolvimento Científico e Tecnológico - Brazil . The institution of Dr. Cendes has received research support from NIH. Clarissa Yasuda has nothing to disclose.

A Prospective Observational Study Examining the Real-World Clinical and Treatment Outcomes of Parkinson’s Disease Psychosis in the United States

AbstractIntroductionPsychosis is a common feature of Parkinson’s Disease (PD), affecting approximately 50% of PD patients during their disease course. The INSYTE study was the first prospective, real-world, observational study examining the outcomes of both treated and untreated patients with PD Psychosis (PDP).MethodsPDP patients were enrolled from 76 US academic centers and community sites from 03/21/2017 to 03/08/2021. Patients were included in the final analytical cohort if they had a baseline visit and at least 1 follow-up visit within 3 years; due to the variability of follow-up for each patient within the 3-year period, all study outcomes were assessed in patients with at least one baseline and two follow-up visits within 1 year. No specific visit schedule was imposed; all interactions were established by the investigators. Questionnaires were completed at follow-up visits and assessments focused on PDP treatment utilization, treatment patterns, clinical outcomes, caregiver burden, quality of life, and resource utilization.Results760 patients were initially enrolled; 635 patients (84%) were included in the final study group, and 441 patients (69%) were included in the analysis. 281 patients (64%) had no antipsychotic treatment at enrollment (untreated group) vs 160 (36%) who had received an antipsychotic at enrollment (treated group). At enrollment, patients in the untreated vs treated group, respectively, had a mean PD duration of 8.05 vs 10.23 years, mean duration of PDP features of 2.20 vs 3.10 yrs, and had a PDP diagnosis for a mean of 1.42 vs 2.16 yrs. Most patients in the untreated group (n=221, 77%) received no antipsychotics through follow-up. The groups were balanced in terms of age (mean 73.9 vs 73.4 yrs) and sex (65.1% vs 63.1% male). The untreated group had higher rates of hypertension (44.5% vs 36.8%) and diabetes (12.8% vs 8.8%); however, the treated group had higher rates of depression (25.6% vs 41.3%) and anxiety (22.8% vs 26.9%). The percent change from baseline at 12 months in total psychosis, hallucination, and delusion scores for the untreated group showed greater worsening than the treated group: 32.3% vs 29.3%; 29.3 % vs 25.0%; and 29.3 % vs 25.0%, respectively, as did daytime sleepiness scores (51.6% vs 40.8%). Measures of PD severity (non-motor and motor MDS-UPDRS scores) and health-related quality of life showed less worsening for the untreated group vs treated group at 12 months. Caregiver burden (per the ZBI) was lower in the untreated group vs the treated group (81.5% vs 90.0%).ConclusionsIn this descriptive analysis, untreated patients had shorter duration of PD, fewer PDP symptoms at baseline, and lower rates of mental health comorbidities vs treated patients. The untreated PDP patients had greater worsening in their psychosis and sleepiness scores at 12 months versus the treated group, yet remained untreated. Future studies are needed to better understand clinicians’ rationale for withholding PDP treatment.FundingAcadia Pharmaceuticals, Inc

Sleep Habits of Turkish Preschool Children

Purpose: This study aims to a) provide a detailed description of sleep habits and problems, b) to compare sleep habits and problems among 4-6-year-old typically developing Turkish children, c) to find out parental views on problem sleep behavior. Methods: Participants consisted of 702 parents. Children’s age ranged from 4 to 6 years. Demographics Information Survey and the Children’s Sleep Habits Questionnaire (CSHQ) were administered to parents. Results: Across different age groups bedtime was not different for weekdays. Bedtime during weekends, however, differed across different age groups. Older children were going to bed later. Wake-up time and bedtime for weekdays differed for children who attend preschool. Children attending preschool woke up earlier and went to bed earlier. Sleep duration did not differ for both weekdays and weekends. There was no gender difference in terms of bedtime, wake-up time, and sleep duration for both weekdays and weekends. However, girls’ daytime sleepiness scores and sleep onset delay scores were higher. Conclusions: Sleep problems are prevalent among young Turkish children. Comparing the CSHQ overall and subscale scores of this study with other studies, the most important differences were seen in the bedtime resistance and the sleep anxiety subscales. These discrepancies indicate a cultural difference in bedtime resistance and sleep anxiety of Turkish preschool children. Future research should investigate the effects of parenting and discipline on sleep behavior and problems. Effective intervention programs are needed in order to reduce problems related to bedtime resistance and sleep anxiety of Turkish preschoolers.

CARDIORESPIRATORY MONITORING OF CHILDREN AND ADOLESCENTS WITH METABOLIC SYNDROME AGED 10-17 YEARS: A CROSS-SECTIONAL DESCRIPTIVE STUDY

Study objectives. This study aims to investigate potential differences in sleep parameters between children with metabolic syndrome (MetS) and their healthy counterparts using the portable cardiorespiratory monitoring device SOMNOcheck micro CARDIO. Methods. The study included 71 children and adolescents aged 10 to 17 years, with 39 in the MetS group and 32 in the control group. The main anthropometric parameters were: neck circumference (NC), waist circumference (WC) and waist-to-height ratio (WHtR). All children were assessed using the Friedman tongue position (FTP) scale. Children completed the Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD) and the Montreal Cognitive Assessment (MoCA). Salivary cortisol was collected in the morning immediately after waking up. The sleep study was performed using a portable SOMNOcheck micro CARDIO device with a special cardiaс sensor. Statistical analysis of the data was performed using EZR version 1.61. Results. Significant differences in cardiorespiratory sleep monitoring were observed between between the MetS and non-MetS groups. Patients with MetS had higher daytime sleepiness scores and lower MoCA scores compared to the control group. Cortisol levels in morning saliva showed a marked increase among children with obstructive apnea/hypopnea index ≥ 1. A logistic regression model established a link between FTP stages III and IV and the autonomous arousal index. Conclusions. These findings highlight the differences (p &lt; 0.05) in sleep-related parameters between the MetS and non-MetS groups, which may indicate an increased risk of sleep-disordered breathing and cognitive impairment in such children.

Social Jet Lag, sleep quality and daytime sleepiness in university students: A cross-sectional study

The objective was to verify the difference in sleep quality and daytime sleepiness between university students with and without JLS. This is a field, descriptive, analytical, cross-sectional study carried out with 105 university students, selected by convenience. The JLS was measured by calculating the discrepancy between the times of sleeping and waking up on usual weekdays and weekends, individuals with an average sleep point &gt;1 hour were classified as having JLS. The Pittsburgh Sleep Quality Index (PSQI) was used to analyze sleep quality and the Epworth Sleepiness Scale for daytime sleepiness. The JAMOVI statistical package was used, the comparison between the midpoints was performed using the paired t test, Comparison between sleep quality and daytime sleepiness scores among university students with and without JLS was performed using the independent t test, adopting an alpha of 0.05 in all analyses. The results indicate that JLS exists in about 1/3 of university students (38;36.2%). The data showed a statistically significant difference between the weekly midpoint and the weekend midpoint (p&lt;0.001). Most college students (78; 74.3%) had poor sleep quality and levels of excessive daytime sleepiness (77; 73.3%). Independent t-test shows that college students with JLS have higher scores for poor sleep quality and excessive daytime sleepiness. It is concluded that college students with JLS have worse sleep quality and higher levels of excessive daytime sleepiness.

Measurement of bradykinesia and chorea in Huntington's Disease using ambulatory monitoring

ObjectivesThe feasibility of measuring bradykinesia and chorea in Huntington's Disease using a wearable sensor system (Parkinson’s Kinetigraph: PKG) developed for measuring bradykinesia and dyskinesia in Parkinson’s Disease was assessed. MethodsUnified Huntington’s Disease Rating Scales (UHDRS) and a PKG were obtained for 25 people with Huntington's Disease. Bradykinesia and Chorea Score were derived from relevant sub-scores of the UHDRS and compared with the PKG’s bradykinesia and dyskinesia scores. The PKG’s daytime sleepiness score was also used. ResultsThere was good correlation between Chorea Scores and the PKG’s dyskinesia score (Pearson’s ρ = 0.66). Correlation between the Bradykinesia Scores and the PKG’s bradykinesia score was also good (Pearson’s ρ = 0.51) in cases whose PKG scores were in the normal or bradykinetic range. The PKG’s bradykinesia score of 23, which is in the higher range of control subjects, separated participants into those with Independence Score ≥ 80 or < 80 and a Functional Assessment (FAS) score ≥ 18 or < 18. The PKG’s daytime sleep score was high in 44 % of participants, whose average time asleep was 21 % compared to 1.6 % in participants with a normal sleep index. Participants with high sleep scores were significantly more likely to have low Independence and TFC scores. ConclusionsMeasures of bradykinesia and dyskinesia from clinical scales have acceptable correlations with those from the PKG. Continuous monitoring provides information about daytime sleep, which was associated with lower functional status. Further studies and larger sample sizes are required to confirm these findings and the utility of this measure in Huntington's Disease.

The Effect of Smartphone Use and Nomophobia on Sleep Quality and Daytime Sleepiness in Turkey

Abstract Background Smartphones used unconsciously and in an uncontrolled manner make young people experience sleep problems. This study aimed to investigate the effects of university students’ smartphone addiction and nomophobia levels on sleep quality and excessive daytime sleepiness. Methods This study, which had a cross-sectional design, was conducted with 390 people who were first-year and senior students at Inonu University between November and December 2019. The Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Nomophobia Scale, and Smartphone Addiction Scale were used in the present study used. For statistical analysis, the chi-squared test, the Student’s t-test, one-way ANOVA, Spearman’s rank correlation coefficient and binomial logistic regression analysis were used. The research has ethics committee approval.The error level was chosen as p = 0.05. Results The smartphone use time of the students was finded to be 5.4±2.6 years, daily online time was 4.3±2.6 hours, and daily sleep time was 7.4±1.5 hours. The students received 78.3±25.8 points from the Nomophobia Scale, 90.3±29.7 from the Smartphone Addiction Scale, 7.2±2.8 from the Pittsburgh Sleep Quality Index, and 5.9±4.1 points from the Epworth Sleepiness Scale. A total of 54.4% of students had moderate, and 22.8% had severe nomophobic symptoms; 83.6% of the group had poor sleep quality, and 14.6% had excessive daytime sleepiness. A positive, moderate and significant relation was detected between the mean Nomophobia score and the mean Smartphone Addiction Scale score. It was also determined that those with less than 30 minutes of smartphone use before sleeping had low nomophobia, smartphone addiction and daytime sleepiness scores, and better sleep quality. Conclusions Nomophobic symptoms and smartphone addiction were observed to be high in university students. Most students had poor sleep quality. The awareness of students on healthy sleep, and conscious and controlled smartphone use should be increased. Key messages • Smartphone addiction increases the level of nomophobia moderately in university students. • Those who use a smartphone less than 30 minutes before going to sleep have better sleep quality and lower daytime sleepiness.

Association between residential greenness and obstructive sleep apnoea among adults in Southern China

BackgroundNo previous study has explored the association of residential greenness with obstructive sleep apnoea (OSA) indexes. ObjectiveTo investigate the association of exposure to residential greenness with OSA indexes in adults in Guangdong Province, Southern China. MethodsFrom January 1, 2005 to December 31, 2015, a total of 3925 participants were recruited from the Sleep Center of Guangdong Provincial People's Hospital. Apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) were measured by polysomnography or home sleep test (HST). Participants' daytime sleepiness scores were evaluated using The Epworth Sleeping Scale (ESS). The normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI) were used to assess residential greenness levels. Generalized linear regression models were used to assess the associations of residential greenness with OSA indexes after adjusting for multiple covariates. ResultsThe mean (standard deviation) age of the participants was 63.3 (14.4) years. In adjusted models, an interquartile range (IQR) increase in 3-year average NDVI was significantly associated with 9.8 % (95 % confidence interval [95 % CI]: 17.5 %, 2.1 %); 14.5 % (95 % CI: 24.5 %, 4.4 %) and 6.9 % (95 % CI: 13.7 %, 0.0 %) decreases in AHI, ODI and ESS scores, respectively. Furthermore, an IQR increase in 3-year average EVI was significantly associated with 7.8 % (95 % CI: 13.7 %, 1.9 %); 10.8 % (95 % CI: 18.3 %, 3.2 %) and 7.2 % (95 % CI: 12.5 %, 2.0 %) declines in AHI, ODI and ESS scores, respectively. Significant associations were only observed among males, adults aged ≥65 years old, and in the warm season. ConclusionsOur study indicates that higher residential greenness was significantly associated with lower OSA indexes in adult population in South China, especially in males, in the elderly, and in the warm season.

Associations of Sleep Disorders With Depressive Symptoms in Early and Prodromal Parkinson's Disease.

BackgroundNon-motor symptoms, including sleep disorders and depression, are common in Parkinson’s disease (PD). The purpose of our study is to explore the effect of sleep disorders, including the probable rapid eye movement (REM) sleep behavior disorder (pRBD) and the daytime sleepiness, on depressive symptoms in patients with early and prodromal PD.MethodsA total of 683 participants who obtained from the Parkinson Progression Markers Initiative (PPMI) were included, consisting of 423 individuals with early PD, 64 individuals with prodromal PD, and 196 healthy controls (HCs), who were followed up to 5 years from baseline. Multiple linear regression models and linear mixed-effects models were conducted to explore the relationship between sleep disorders and depression at baseline and longitudinally, respectively. Multiple linear regression models were used to further investigate the association between the change rates of daytime sleepiness score and depression-related score. Mediation analyses were also performed.ResultsAt baseline analysis, individuals with early and prodromal PD, who had higher RBD screening questionnaire (RBDSQ) score, or who were considered as pRBD, or who manifested specific behaviors of RBD (things falling down when sleep or disturbance of sleep), showed significantly the higher score of depression-related questionnaires. Our 5-year follow-up study showed that sleep disorders, including pRBD and daytime sleepiness, were associated with the increased depressive-related score in individuals with early and prodromal PD. Interestingly, we also found that the increased possibilities of daytime sleepiness were associated with depressive-related score. Finally, mediation analysis demonstrated that the relationship between RBD and depressive symptoms was partially mediated by autonomic symptoms, such as postural hypertension, salivation, dysphagia, and constipation.ConclusionOur study shows that sleep disorders, including pRBD and daytime sleepiness, are associated with depression at baseline and longitudinally, which is partially mediated by the autonomic dysfunction in early and prodromal PD, with an implication that sleep management is of great value for disease surveillance.

Sluggish cognitive tempo, eating habits, and daytime sleepiness in obese adolescents.

Rates of obesity have risen steeply in the western world in all age groups. Sluggish Cognitive Tempo (SCT) is characterized by a cluster of symptoms. Daytime sleepiness, commonly seen in obesity, may share a similar origin with sleepiness and daydreaming symptoms of SCT. This study aims to investigate the relationship between obesity, SCT, daytime sleepiness, and eating habits. Adolescents, aged between 10-17years, with a BMI >95th centile, were recruited to the study. Clinical interviews were supplemented with standardized questionnaires. Of the 35 adolescents, more than one quarter (N = 10, 28.6%) had SCT. Emotional overeating and food enjoyment subscale scores showed moderate correlations with the SCT scores, though these associations were not significant when controlling for ADHD symptoms. Daytime sleepiness score in adolescents with SCT was found to be significantly higher than those without. Sluggish Cognitive Tempo is frequently present in adolescents with obesity and associated with higher levels of emotional overeating, food enjoyment, and daytime sleepiness. Targeting aspects of SCT might offer additional avenues to assist in weight management programs for youth.

0312 Sleep and fear of falling, is there a relationship? A cross-sectional study in older adults

Abstract Introduction Excessive daytime sleepiness is a common problem in older people. This population is at higher risk of falls that lead to injuries, which explains the high prevalence of fear of falling among them. The relationship between sleep disturbances and concern about falling is unclear. The aim of this study was to identify whether poor sleep quality and excessive daytime sleepiness are associated with fear of falling in older adults. Methods This is a cross-sectional study. Data on age, sex, body mass index, alcohol consumption, mental status, depression, single-leg stance, excessive daytime sleepiness (Epworth Sleepiness Scale), sleep quality, comorbidities, and fear of falling (assessed through the Falls Efficacy Scale), were collected from participants aged 60 years and over. Univariable and multivariable linear regression were performed. Logistic regression evaluated the association between excessive daytime sleepiness and high fear of falling. Results 504 participants were analyzed. The chance of an older person having high concern of falling was 3 times bigger among those with excessive daytime sleepiness when compared to those without excessive daytime sleepiness. The final model, multivariable linear regression showed that excessive daytime sleepiness score was able to predict fall efficacy scale scores (Beta coefficient=0.26; 95%CI: 0.07 to 0.45) adjusted by the following variables: age, single-leg stance, comorbidities, and depression. Our results showed that for each point increase on the Epworth Sleepiness Scale there was an average increase of 0.26 points in the Falls Efficacy Scale, indicating that sleepiness was related to fear of falling. Conclusion Having excessive daytime sleepiness increased the chance of older adults showing a high fear of falling. Healthcare workers should be aware that drowsiness can increase the fear of falling among older patients, and this may influence treatment. Support (If Any) The study was supported by Associação Fundo de Incentivo à Pesquisa (AFIP) and Coordenação de Aperfeiçoamento de Nível Superior (CAPES, Finance Code 001 to GLF). ST, MLA and RZP received fellowships from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq). GLF receives funding from CNPq (#141445/2021-1)

Early To Bed, Early To Rise: LVAD Patients And Sleep Patterns

Early To Bed, Early To Rise: LVAD Patients And Sleep Patterns

Treatment of sleep apnoea with tonsillectomy: a retrospective analysis using long-term follow-up data

PurposeThis single-group, retrospective, pre-test–post-test study was performed to examine clinical outcomes in treating obstructive sleep apnoea (OSA) with tonsillectomy alone and had the longest follow-up periods to date.MethodsWe analysed 151 tonsillectomies in our district between the years 2004 and 2018 that had either sleep apnoea or snoring listed as a diagnosis. Twenty-one patients met our criteria and were included. Patient records were analysed for home sleep apnoea test and Epworth Sleepiness Scale (ESS) scores.ResultsWe defined success as a > 50% reduction of the Apnoea–Hypopnea Index (AHI) and a total AHI of < 20 post-surgery. The averages before surgery were an AHI of 22.3 and an ESS of 7.22. The success rate was 47.6% after tonsillectomy as the sole treatment for obstructive sleep apnoea in our adult population. Eleven patients were non-responders. The average ESS score reduction was 0.69 and did not reach statistical significance. With follow-up times ranging from 1.8 to 171 months, this study had the longest follow-up period compared to other existing studies. No patient with a follow-up longer than one year was a responder.ConclusionOur results support that tonsillectomy is an effective treatment for obstructive sleep apnoea in adults with tonsillar hypertrophy. With less severe OSA than those reported on previously, our patients also had less severe daytime sleepiness before surgery, and daytime sleepiness score reductions did not reach statistical significance. In the future, long-term results should be further analysed.