Sleep Organization Research Articles

Predicting emotional consequences of disorganization among adults with neurodevelopmental disorders: a structural equation model

Purpose Previous studies exhibited differences in sensory processing, motor coordination, metacognitive executive functions (EF-MI), and sleep quality among adults with neurodevelopmental disorders (NDD). This study aims to find relationships between those abilities and organization-in-time, focusing on emotional responses after decreased organization abilities. Materials and methods This is a secondary data analysis of a larger sample from three previous studies conducted in one laboratory. Data were collected from 290 adults; 149 with NDD and 141 sex- and age- (20–50 years) matched controls completed the Adolescent/Adult Sensory Profile, Adult Developmental Coordination Disorder, Adults Behavioral Rating Inventory of Executive Functions, Mini Sleep, and Time Organization and Participation questionnaires. Structural equation model (SEM) analysed relationships and variable prediction. Results Significant between-group differences were found for all variables; SEM indicated similar paths in both groups. Sensory processing affected EF-MI and sleep quality and significantly correlated with motor coordination, affecting EF-MI; EF-MI affected organization-in-time. Sleep quality significantly affected organization-in-time, affecting emotional responses. Conclusions Sensory, motor, EF, and sleep differences were associated with decreased organization-in-time abilities of adults with NDD, adversely affecting their emotional well-being. Early detection of such differences and targeted interventions may improve daily functioning and life quality and prevent negative emotional implications.

A versatile recording device for the analysis of continuous daily external activity in colonies of highly eusocial bees.

As pollinators, bees are key to maintaining the biodiversity of angiosperm plants, and for agriculture they provide a billion-dollar ecosystem service. But they also compete for resources (primarily nectar and pollen), especially the highly social bees that live in perennial colonies. So, how do they organize their daily temporal activities? Here, we present a versatile, low-cost device for the continuous, automatic recording and data analysis of the locomotor activity in the colony-entrance tube of highly eusocial bees. Consisting of an in-house built block containing an infrared detector, the passage of bees in the colony entrance tunnel is registered and automatically recorded in an Arduino environment, together with concomitant recordings of temperature and relative humidity. With a focus on the highly diverse Neotropical stingless bees (Meliponini), we obtained 10-day consecutive recordings for two colonies each of the species Melipona quadrifasciata and Frieseomelitta varia, and also for the honey bee. The Lomb-Scargle periodogram analysis identified a predominant circadian rhythmicity for all three species, but also indications of ultradian rhythms. For M. quadrifasciata, which is comparable in size to the honey bee, we found evidence for a possibly anticipatory activity already before sunrise. As all three species also presented activity at night in the colony entrance tube, this also raises questions about sleep organization in social insects. The cost and versatility of the device and the open-source options for data analysis make this an attractive system for conducting studies on circadian rhythms in social bees under natural conditions, complementing studies on flower visits by these important pollinators.

Puberty interacts with sleep and brain network organization to predict mental health.

Along with pubertal development, the transition to adolescence brings about increased risk for sleep disturbances and mental health problems. Functional connectivity of overlapping large-scale brain networks, such as increased connectivity between the default mode and dorsal attention networks, has been reported to relate to both sleep and mental health problems. Clarifying whether pubertal development interacts with sleep disturbances and functional brain networks to predict mental health may provide information to improve the timing and design of interventions targeting sleep disturbances in adolescents. To examine how pubertal status and tempo relate to sleep disturbances and shape the relationship between sleep disturbances and mental health problems, we harnessed a large sample of children aged 10-14 years from the Adolescent Brain and Cognitive Development (ABCD) Study (N ~ 3,000-10,000). We used graph theoretical tools to probe how pubertal development concurrently interacts with sleep disturbances and brain network organization to predict mental health problems. We found that advanced pubertal status, but not pubertal tempo, predicted sleep disturbances; however, both pubertal status and tempo interact with sleep disturbances to predict mental health problems and engage in three-way interactions with sleep and brain network organization to predict mental health problems. Overall, this work suggests that less advanced pubertal status and slower tempo are risk factors for the strongest links between sleep disturbances, brain organization, and mental health problems. Further, our findings speak to the importance of accounting for interactions in the constellation of factors that surround complex behavioral and clinical syndromes, here internalizing and externalizing disorders, and provide new context to consider for targeted interventions.

Healthy Lifestyles and Psychological Well-Being in Students Based on Communication Factors

The objective of the study was to determine the relationship between healthy lifestyles and the psychological well-being of students from public educational institutions in the City of Huánuco, in 2022. The research was quantitative, analytical, observational, cross-sectional, prospective and correlational, with a sample of 350. The hypotheses were verified using Pearson's Chi-square test with 95% confidence and p≤0.05. The results indicate that there was a significant relationship between the dimensions of lifestyles: eating habits, physical activity, organization of sleep and free time, and habit of consumption of harmful substances with psychological well-being..

Sleep from Infancy Through Adolescence.

This article describes the changes in normal sleep regulation, structure, and organization and sleep-related changes in respiration from infancy to adolescence. The first 2years of age are striking, with more time asleep than awake. With development, the electroencephalogram architecture has a marked reduction in rapid eye movement sleep and the acquisition of K-complexes, sleep spindles, and slow-wave sleep. During adolescence there is a reduction in slow-wave sleep and a delay in the circadian phase. Infants have a more collapsible upper airway and lower lung volumes than older children, which predisposes them to obstructive sleep apnea and sleep-related hypoxemia.

Multi-channel recordings reveal age-related differences in the sleep of juvenile and adult zebra finches

Despite their phylogenetic differences and distinct pallial structures, mammals and birds show similar electroencephalography (EEG) traces during sleep, consisting of distinct rapid eye movement (REM) sleep and slow wave sleep (SWS) stages. Studies in human and a limited number of other mammalian species show that this organization of sleep into interleaving stages undergoes radical changes during lifetime. Do these age-dependent variations in sleep patterns also occur in the avian brain? Does vocal learning have an effect on sleep patterns in birds? To answer these questions, we recorded multi-channel sleep EEG from juvenile and adult zebra finches for several nights. Whereas adults spent more time in SWS and REM sleep, juveniles spent more time in intermediate sleep (IS). The amount of IS was significantly larger in male juveniles engaged in vocal learning compared to female juveniles, which suggests that IS could be important for vocal learning. In addition, we observed that functional connectivity increased rapidly during maturation of young juveniles, and was stable or declined at older ages. Synchronous activity during sleep was larger for recording sites in the left hemisphere for both juveniles and adults, and generally intra-hemispheric synchrony was larger than inter-hemispheric synchrony during sleep. A graph theory analysis revealed that in adults, highly correlated EEG activity tended to be distributed across fewer networks that were spread across a wider area of the brain, whereas in juveniles, highly correlated EEG activity was distributed across more numerous, albeit smaller, networks in the brain. Overall, our results reveal that significant changes occur in the neural signatures of sleep during maturation in an avian brain.

ГИГИЕНИЧЕСКОЕ ВОСПИТАНИЕ ШКОЛЬНИКОВ КАК СРЕДСТВО ПРОФИЛАКТИКИ НЕБЛАГОПРИЯТНОГО ВОЗДЕЙСТВИЯ ВНЕШКОЛЬНЫХ ФАКТОРОВ

Preservation and strengthening of children and adolescents' health is one of the most important direc-tions of the state policy of the Russian Federation. Purpose of the study: to assess the effectiveness of hygiene education techniques to prevent adverse effects of out-of-school factors on the health of schoolchildren. Materials and methods: In the dynamics from 2017 to 2019 in three educational or-ganizations of Astrakhan the hygienic education of schoolchildren and their parents was carried out. The influence of extracurricular factors on schoolchildren's health was assessed on the basis of a risk-based model. A total of 1940 Astrakhan schoolchildren aged 7–17 (878 boys and 1062 girls) partici-pated in the questionnaire-based survey. The data was statistically processed using Microsoft Office Excel 2007. Results: A cause-effect relationship was found to be 95,0 %, RR = 6,40, CI = 4,92–8.33, the etiological component was 67,5 %, sensitivity was 0,889, specificity was 0,778. There was a caus-al relationship between occurrence of myopia and failure to perform eye exercises by school children at home, 95,0 %, RR = 1,80, CI = 1,52–2,15, etiological component 26,7 %, sensitivity 0,750, speci-ficity 0,500. A causal relationship was found between the occurrence of musculoskeletal disorders and the use of shoes that did not meet hygienic recommendations, including those outside educational institutions – 95,0 %, RR = 1,75, CI = 1,50–2,00, etiological component 25,0 %, sensitivity – 0,700, specificity – 0,500. Within the framework of the conducted activities short recommendations – check-lists on the rational organization of the day and nutrition, motor activity, night sleep and leisure time organization were formulated. The information was also presented to the parents of the schoolchil-dren. Conclusion. Identification of intra-school and extra-school factors, establishment of cause-effect relationships and evaluation of possible adverse effects, will make it possible to develop relevant techniques of hygiene education, which will contribute to preservation

Features of sleep organization in students of Perm higher educational institutions

Objective. To assess the quality of sleep in students of higher educational institutions of Perm taking into account the profile, anxiety level and social employment.
 Materials and methods. The study enclosed 300 students of three higher educational institutions of Perm. The features of sleep were analyzed on the basis of questioning followed by statistical treatment of the obtained data.
 Results. For all the students, the prevalence of the borderline parameters with subjective assessment of the quality of sleep was a general feature. The students of medical university with a high subjective assessment of the quality of sleep had an excessive daytime sleepiness (50 % of respondents). Medical students were characterized by a night and twenty-four-hour operating schedule and a more expressed situational anxiety. For the students of humanitarian and pedagogical institutions, combination of a high level of personal anxiety with low parameters of the quality of sleep were typical. Sleep was characterized by a long falling asleep with frequent awakening during the night, plenty of dreams often anxious by their content. At the same time, most students preferred work in the daytime. This group of students had a maximum risk for the development of sleep apnea. The students of polytechnic university appeared to be less vulnerable. However, the analyzed subjective characteristics of sleep among most of them demonstrated the borderline disorders, less than 1/3 of them had optimal parameters.
 Conclusions. The obtained results put the question of optimizing organization of sleep and wakefulness among students of higher educational institutions, prevention of disorders of circadian rhythms and their consequences, elevation of students information awareness on reciprocal influence of sleep and wakefulness. If necessary, there should be a possibility of correction by a somnologist and/or psychotherapist.

Functional age estimation through neonatal motion characterization using continuous video recordings.

The follow-up of the development of the premature baby is a major component of its clinical care since it has been shown that it can reveal a pathology. However, no method allowing an automated and continuous monitoring of this development has been proposed. Within the framework of the Digi-NewB European project, our team wishes to offer new clinical indices qualifying the maturation of newborns. In this study, we propose a new method to characterize motor activity from video recordings. For this purpose, we have chosen to characterize the motion temporal organization by drawing inspiration from sleep organization. Thus, we propose a fully automatic process allowing to extract motion features and to combine them to estimate a functional age. By investigating two datasets, one of 28.5 hours (manually annotated) from 33 newborns and one of 4,920 hours from 46 newborns, we show that the proposed approach is relevant for monitoring in clinical routine and that the extracted features reflect the maturation of preterm newborns. Indeed, a compact and interpretable model using gestational age and three motion features (mean duration of intervals with motion, total percentage of time spent in motion and number of intervals without motion) was designed to predict post-menstrual age of newborns and showed an admissible mean absolute error of 1.3 weeks. While the temporal organization of motion was not studied clinically due to a lack of technological means, these results open the door to new developments, new investigations and new knowledge on the evolution of motion in newborns.

Serotonin and cyclic sleep organization in full-term newborn infants with intrauterine growth retardation

BACKGROUND: The high frequency of neurological and mental diseases in children who had intrauterine retardatiojn development indicates the need to study specific markers of disorders of fetal brain functional development, in particular, the state of the serotonergic system, which plays a key role in the morpho-functional development of the brain in early ontogenesis.
 AIM: To study the content of serotonin in full-term newborns with intrauterine development delay in comparison with quantitative and qualitative characteristics of sleep.
 MATERIALS AND MЕTHODS: The main group consisted of 26 newborns, whose intrauterine development took place in conditions of chronic placental insufficiency, which led to the formation of an asymmetric form of intrauterine retardatiojn development. The control group consisted of 72 healthy newborns from healthy mothers without pregnancy complications. Children of each group are divided into three subgroups depending on gestational age: I 37, II 38, III 3940 weeks. In all children, 712 hours after birth, an electropoligram of sleep was recorded (an electroencephalograph of the company Mizar, Russia) and its quantitative and qualitative analyses were carried out, highlighting the orthodox, paradoxical phase and undifferentiated state. The serotonin content was determined in platelet-rich plasma of blood from the umbilical cord vein after birth, as well as in a platelet suspension prepared from venous blood taken on the first day of life. The content of serotonin in platelets was judged by the indicator obtained by dividing the amount of serotonin in the platelet suspension by the platelet level. The amount of serotonin was determined by high-performance liquid chromatography with electrochemical detection. Statistical analysis was performed using the Statistica 6 program (Statsoft Inc, USA).
 RESULTS: We report here a low content of serotonin in platelet-rich plasma and platelets of newborns with intrauterine growth retardation and the absence of its normal increase in weeks 3739 of intrauterine development, as well as a violation of the genetic programming for the sleep-wake cycle organization.
 CONCLUSIONS: Assessment of the serotonin-producing system of the brain in comparison with the newborn sleep pattern can serve as a diagnostic marker of brain damage and substantiate the need for timely application of neuroprotection.

Women's mood at high altitude. sexual dimorphism in hypoxic stress modulation by the tryptophan-melatonin axis.

Sexual (and gender)-dimorphism in tolerance to hypobaric hypoxia increasingly matters for a differential surveillance of human activities at high altitude (HA). At low altitudes, the prevalence of anxiety and depression in women has already been found to double when compared with men; it could be expected to even increase on exposure to HA. In purposefully caring for the health of women at HA, the present work explores the potential involvement of the tryptophan (Trp)-melatonin axis in mood changes on exposure to hypobaric hypoxia. The present work highlights some already known anxiogenic effects of HA exposure. Hypoxia and insomnia reduce serotonin (5-HT) availability; the latter defect being expressed as failure of brown adipose tissue (BAT) activation and mood disorders. Rapid eye movement (REM) sleep organization and synapsis restoration that are additionally affected by hypoxia impair memory consolidation. Affective complaints may thus surge, evolving into anxiety and depression. Sex-related differences in neural network organization and hormonal changes during the menstrual cycle, and certainly also during the life cycle, underscore the possibility of 5-HT-related mood alterations, particularly in women on HA exposure. The mean brain rate of 5-HT synthesis at sea level is already 1.5-fold higher in males than in females. sexual dimorphism also evidences the overexpression effects of SERT, a 5-HT transporter protein. Gonadal and thyroid hormones, as influenced by HA exposure, further modulate 5-HT availability and its effects in women. Besides caring for adequate oxygenation and maintenance of one's body core temperature, special precautions concerning women sojourning at HA should include close observations of hormonal cycles and, perhaps, also trials with targeted antidepressants.

Sleep Continuity, Stability and Cyclic Organization Are Impaired in Insomniacs: A Case-Control Study.

The possibility of distinguishing insomniacs from good sleepers based on polysomnography (PSG) remains an open question. While these groups show modest differences in traditional PSG parameters, some studies suggest that finer measures may be more useful. Here we assess differences between good sleepers (GS), poor sleepers (PS) and insomniacs (IN) in classical PSG measures as well as in sleep continuity, stability and cyclic organization. PSG-monitored sleep (two nights) of 17 IN (diagnosed through a standard clinical interview; Pittsburgh Sleep Quality Index (PSQI) ≥ 5, Insomnia Severity Index (ISI) > 14) was compared to that of 33 GS (PSQI < 5) and 20 PS (PSQI ≥ 5, ISI ≤ 14). Compared to GS, IN were impaired in sleep macrostructure (sleep latency, sleep efficiency, WASO%) and in continuity, stability and organization, whereas PS only showed disrupted continuity and stability. Spindle parameters were comparable between IN and GS, but the former displayed enhanced power in fast frequency bands. Our findings support the hypothesis of a continuum between individuals with self-reported poor sleep and insomniacs. Further, they add to extant data on impaired sleep continuity, stability and organization in poor sleepers and elderly individuals, underlining the utility of including these measures in standard sleep assessments.

A single night of moderate at-home sleep restriction increases hunger and food intake in overweight young adults

ObjectivesExperimental studies under laboratory conditions have shown a close link between acute sleep restriction and metabolic disorders. The aim of this study was to assess the effect of a single night of moderate sleep restriction implemented under ambulatory settings on sleep organization, food intake, blood pressure, and heart rate in overweight young adults. MethodsIn a non-randomized experimental study, we evaluated 15 young, overweight adults (mean age [± SEM] 20.8 ± 0.6 y) with a mean body mass index (BMI) 27.5 ± 6.2 kg/m2 (BMI range 18.9–36.6 kg/m2). Each participant was recorded at home during two successive nights under:1) Regular sleep routine (from 2330 to 0730 h, ‘night1’) and2) Restricted sleep (6 h in bed, from 0300 to 0900 h, "night2").Sleep was assessed by a non-invasive mobile system (Watch-PAT200) placed on the non-dominant wrist, measuring peripheral arterial tonometry. We measured sleep duration, rapid eye movement sleep (REM), light sleep (LS), deep sleep (DS), and waking. Starting 2 d before night1, four consecutive food records assessed daily food intake. Preceding and succeeding each night, hunger/satiety feelings (measured by self-reported visual analog scales), blood pressure, and heart rate were also evaluated. ResultsTotal sleep time was reduced in night2 (P = 0.007), with higher DS percentage (P = 0.03). Sleep onset and REM sleep latencies, LS time, and the number of wake episodes did not differ between nights. Energy intake was increased the day after night2 (P = 0.007), with increased fat and protein intakes (both P < 0.01) and feelings of hunger (P = 0.002). Systolic blood pressure was higher and heart rate faster in the morning after night2 (both P < 0.05). ConclusionsAn acute moderate at-home sleep restriction exacerbated food intake and feelings of hunger, and impaired blood pressure and heart rate regulation in young, overweight adults.

Sleep state organisation of moderate to late preterm infants in the neonatal unit

BackgroundSleep supports neurodevelopment and sleep architecture reflects brain maturation. This prospective observational study describes the nocturnal sleep architecture of healthy moderate to late preterm (MLP) infants in the neonatal unit at 36 weeks post menstrual age (PMA).MethodsMLP infants, in the neonatal unit of a tertiary hospital in Ireland from 2017 to 2018, had overnight continuous electroencephalography (cEEG) with video for a minimum 12 h at 36 weeks PMA. The total sleep time (TST) including periods of active sleep (AS), quiet sleep (QS), indeterminate sleep (IS), wakefulness and feeding were identified, annotated and quantified.ResultsA total of 98 infants had cEEG with video monitoring suitable for analysis. The median (IQR) of TST in the 12 h period was 7.09 h (IQR 6.61–7.76 h), 4.58 h (3.69–5.09 h) in AS, 2.02 h (1.76–2.36 h) in QS and 0.65 h (0.48–0.89 h) in IS. The total duration of AS was significantly lower in infants born at lower GA (p = 0.007) whilst the duration of individual QS periods was significantly higher (p = 0.001).ConclusionOvernight cEEG with video at 36 weeks PMA showed that sleep state architecture is dependent on birth GA. Infants with a lower birth GA have less AS and more QS that may have implications for later neurodevelopment.ImpactEEG provides objective information about the sleep organisation of the moderate to late preterm (MLP) infant.Quantitative changes in sleep states occur with each week of advancing gestational age (GA).Active sleep (AS) is the dominant sleep state that was significantly lower in infants born at lower GA.MLP infants who were exclusively fed orally had a shorter total sleep time and less AS compared to infants who were fed via nasogastric tube.

INTEGRATION OF PHYSICAL, MENTAL, SOCIAL AND SPIRITUAL COMPONENTS IN THE IMPLEMENTATION OF A HEALTHY LIFESTYLE OF MODERN HIGH SCHOOLCHILDREN

In the article deals with the theoretical approaches to the formation of positive motivation for a healthy lifestyle of modern schoolchildren in the realities of today. The article shows the significance of the fact that in recent years the attention of scientists to the study of the issues of healthy lifestyle implementation has intensified, its qualified propaganda in the mass media is being carried out. Nevertheless, it has been established that the problem of improving the health of the younger generation remains unsolved. Sociological research has shown that 90 per cent of schoolchildren have health problems, more than 50 per cent have inadequate physical training, and almost 60 per cent have a low level of physical development. It has been established that only 38 per cent of pupils take up regular physical exercise, 55 per cent do it occasionally and over 6 per cent do no physical exercise at all. Topicality of the research is also due to the fact that the number of diseases among high schoolchildren increased, a sharp decline in their physical activity and physical performance. The research and analysis of these negative phenomena have shown that the causes of this condition should be sought in the system of school education, in the identification of those factors of educational activities that lead to overstrain of the pupils’ bodies and do not create the right conditions to meet their needs for a healthy lifestyle. The purpose of the research was to analyze the main structural components of a healthy lifestyle and give proof of their implementation among modern high schoolchildren. The results of the analysis provide strong evidence that a healthy lifestyle is simultaneously a pedagogical, spiritual and social category, it covers different aspects of the life of schoolchildren, ensuring the development of their physiological, social and mental functions in a dynamic unity. It has been clarified that the attitude towards a healthy lifestyle does not emerge by schoolchildren on its own, but develops as a result of pedagogical influence aimed at forming by them a positive attitude towards a healthy lifestyle. The solution of this problem at the comprehensive schools is mainly trusted to the teachers and medical staff. Quite often, however, both doctors and teachers are not fully prepared to promote the benefits of a healthy lifestyle and do not always set a positive example in this regard. It is therefore fair to assume that one of the important points in forming positive motivation to lead a healthy lifestyle is to understand the essence of a healthy lifestyle, which consists in disclosure its main structural elements. It was established that a healthy lifestyle is a value phenomenon that integrates at least four components – physical, psychical (mental), social (public) and spiritual. In real life, all four components – soial, spiritual, physical, physical – are transformed into the organization of motion activity, prevention of bad habits, in the fulfilment of the requirements of sanitation, hygiene and hardening, in the mode of education, work and rest, in the nutrition regime, in the organization of sleep, in the culture of communication, in the culture of sexual behavior, in the psychophysiological regulation of the organism. It has been proved that all the components act simultaneously and their influence determines the general state of human health as a value complex of the phenomenon.

Correction of the wake-sleep cycle by intranasal administration of dopamine in modeling of the preclinical stage of Parkinson's disease in rats

Sleep disorders, which are among the earliest and most sensitive non-motor manifestations of Parkinson's disease (PD), are not diagnosed in 40–50 % of patients and are not subject to the necessary correction. In this regard, the ineffectiveness of a late start of treatment, when more than 50 % of dopamine-producing neurons are already affected, dictates the need to search for and develop approaches to the prevention and slowdown of neurodegenerative pathology at the preclinical stages of its development using adequate experimental models. Taking into account the low bioavailability of dopamine (DA) and data on the advantages of the intranasal route of administration in comparison with oral and parenteral methods of drug delivery to the CNS, the aim of the work was to study the neurophysiological features of the wake-sleep cycle as early manifestations of nigrostriatal insufficiency and the effect of intranasal administration of DA on the quality of sleep during the formation of the preclinical stage of PD in rats. It was shown that under the conditions of modeling PD, the cyclic organization of sleep with a predominance of incomplete cycles against the background of hyperproduction of slow-wave sleep and REM phases are early manifestations of nigrostriatal insufficiency. Course administration of DA at a dose of 3 mg/kg is accompanied by the normalization of sleep quality in the form of reduction (by 76 %) in the number of incomplete cycles. The preventive orientation of the obtained effects may indicate a certain therapeutic potential of intranasal delivery of DA to the brain, aimed at slowing down the processes of neurodegeneration and possibly delaying its clinical manifestation

How and why do human beings sleep?

Why do we sleep? For how many hours should we sleep? These simple questions are difficult to answer with accuracy. The function, biological meaning, and physiological organisation of sleep are still pieces of an unresolved scientific puzzle.1 In a Review for The Lancet Neurology, which is the fourth paper in a Series on sleep,2–4 Jerome Siegel attempts to complete this jigsaw, at least in part, by examining the sleep–wake habits of hunter-gatherer groups from Africa and South America, and by comparing the sleep patterns of different animal species.

0410 Utility of the Urine Drug Screen in Maintenance of Wakefulness Testing Interpretation - A Single-Center, Retrospective Analysis in Pediatric Patients

Abstract Introduction Accurate assessment of hypersomnia depends upon consideration of several factors, including use of medications that affect alertness and sleep organization. Urine drug screens (UDS) are recommended when assessing hypersomnia, but there is little standardization with respect to screening methods, types of substances detected, and use in maintenance of wakefulness test (MWT) interpretation, in part because there is scant literature relating UDS results to patients’ characteristics, MWT findings and implications. Methods A retrospective analysis was performed in adolescents evaluated at Cincinnati Children's Sleep Center between 2008 and 2021 who underwent MWT with concurrent UDS to determine the adequacy of hypersomnia treatment. UDS in our laboratory were performed by Qualitative Immunoassay/Gas Chromatography-Mass Spectrometry/Liquid Chromatography-Tandem Mass Spectrometry. Results A total of 109 MWTs were accompanied by UDS in 79 patients. Patients were 17.7 [16.6, 18.6] years old (median, [IQ range]), 41.3% female, 68.8% White, 25.7% Black, 5.5% Other, with a BMI of 25.8 [22.1, 31.8] kg/m2. 85.3% had narcolepsy. In addition to prescribed medications, caffeine was positive in 54.1% of UDS, and diphenhydramine was positive in 58.7%. No patients reported use of caffeine or diphenhydramine on the day of MWT. There were no significant demographic differences between those who tested positive and negative for caffeine. The median sleep latency in those with caffeine-positive UDS was longer than those with caffeine-negative UDS, although it did not reach statistical significance (27.3 [14.7, 38.3] vs 19.1 [9.8, 36.1] minutes; P=0.15). Patients with a positive UDS for diphenhydramine all took modafinil/armodafinil. In addition, 80% of patients taking modafinil/armodafinil had diphenhydramine-positive results. Nicotine and cannabinoids were detected in 2 UDS. Conclusion Two unexpected substances (caffeine and diphenhydramine) were found on UDS during MWTs in a significant proportion of our cohort. Caffeine may influence the results of MWTs, although further investigations are warranted. The unexpected presence of diphenhydramine is a false positive for those patients on modafinil/armodafinil (supported by literature and confirmed by our laboratory director). Sleep clinicians should be aware of these findings and the implications of unexpected substances when interpreting MWTs. Support (If Any) Cincinnati Children's Hospital Research Fund

Fentanyl‐Induced Sleep Disruption in C57BL/6J (B6) Mice is not Secondary to Increased Motor Activity or Hypothermia

Studies of mice have enhanced the understanding of opioid‐induced respiratory depression (10.1152/jn.00017.2021) and opioid abuse (10.1016/j.neuropharm.2013.08.028). The potential that mechanistic insights gained from studies of mice may be relevant for humans is consistent with the close genetic homology between these two species. Features of mouse biology, however, may limit the extent to which studies of opioid effects can be generalized. Fentanyl administered to mice can increase motor activity (10.1152/jn.00711.2020), cause hypothermia (10.1124/jpet.102.037655), alter cortical electroencephalogram (EEG) power, and disrupt the temporal organization of sleep (10.1152/jn.00266.2021). Our recent finding that fentanyl causes dose‐dependent sleep disruption in B6 mice (10.1096/fasebj.2021.35.S1.01706) led us to test the hypothesis that fentanyl‐induced increases in wakefulness are not caused by changes in motor activity or body temperature. The FASEB Statement of Principles for the use of Animals in Research and Education was followed. Adult males (n=8) were housed in a temperature‐ and humidity‐controlled room with a 12:12h light:dark cycle. Mice were implanted with electrodes and subcutaneous telemeters (DSI HD‐X02) to record EEG, electromyogram, motor activity, and body temperature. Seven to 10 days after recovery from surgery each mouse received a series of subcutaneous injections (0.3 mL) of saline (vehicle) and increasing half‐log doses of fentanyl (0.001 to 3 mg/kg). All injections were made within 60 min of light onset and mice were recorded for 4 h. Injections in the same mouse were separated by 3 or 4 days. Repeated measures mixed model ANCOVAs were performed to evaluate percent time awake between fentanyl dose while accounting for the effects of motor activity and body temperature. Each ANCOVA model was evaluated to determine if the motor activity and body temperature slopes at each level of fentanyl were equal to zero by including the fentanyl main effect and the fentanyl by motor activity (p = 0.11) or fentanyl by body temperature (p = 0.19) interaction. This established the lack of dependence between fentanyl dose and motor activity or body temperature when explaining differences in percent of time in wakefulness. Subsequent common slope models were performed including the main effects for fentanyl with body temperature and fentanyl with motor activity to confirm no effects of either covariate on percent time awake. Motor activity (p = 0.611) and body temperature (p = 0.614) were not found to be significant predictors of increased wakefulness. This finding supports the interpretation that fentanyl causes sleep disruption that is not secondary to enhanced motor activity or hypothermia.

Features of the Organization of Sleep in Children with Attention Deficit Hyperactivity Disorder

Features of the Organization of Sleep in Children with Attention Deficit Hyperactivity Disorder