Pub Date : 2023-10-01DOI: 10.1093/sleepadvances/zpad035.142
M Basheti, R Grunstein, C Gordon, B Saini
Abstract Background Insomnia is a highly burdensome sleep disorder, with a global prevalence of approximately thirty percent in adults. Given its impact on daily functioning and the role it plays in the development/progression of comorbid mental/physical disease, appropriate and timely management is essential. Pharmacists are at the forefront of the primary care workforce and given their expanding roles in healthcare, could aid in alleviating the burden of insomnia in the community by delivering adequate care. Objectives To describe the current and potential roles of pharmacists in insomnia care. Methods An extensive search of five databases (MEDLINE, EMBASE, SCOPUS, IPA, CINAHL) was conducted. Titles, abstracts, and full text articles were screened to identify relevant studies for review inclusion. Articles were reviewed and data extracted, analysed, and grouped categorically based on nature of care provided. Results Thirty studies met inclusion criteria. Insomnia management provision across these studies was divided categorically into 1) Screening/Assessment, 2) Pharmacological and non-pharmacological management provision, and 3) Deprescribing services. Regarding treatment provision, it was evident that pharmacological approaches remain the most common treatment modality adopted despite guidelines recommending behavioural therapy as first line. Overall, the results highlighted that provided with the adequate training and education, pharmacists have the potential to engage in insomnia screening, behavioural therapy and deprescribing services, improving overall insomnia management in primary care. Conclusion The outcomes of this review highlight a current gap in insomnia management practices carried out by pharmacists and provide evidence for improved roles when pharmacists are upskilled with specialised insomnia management education/training.
{"title":"P057 Exploring the ‘Pharmacist Role’ in Insomnia Management and Care Provision: A Scoping Review","authors":"M Basheti, R Grunstein, C Gordon, B Saini","doi":"10.1093/sleepadvances/zpad035.142","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpad035.142","url":null,"abstract":"Abstract Background Insomnia is a highly burdensome sleep disorder, with a global prevalence of approximately thirty percent in adults. Given its impact on daily functioning and the role it plays in the development/progression of comorbid mental/physical disease, appropriate and timely management is essential. Pharmacists are at the forefront of the primary care workforce and given their expanding roles in healthcare, could aid in alleviating the burden of insomnia in the community by delivering adequate care. Objectives To describe the current and potential roles of pharmacists in insomnia care. Methods An extensive search of five databases (MEDLINE, EMBASE, SCOPUS, IPA, CINAHL) was conducted. Titles, abstracts, and full text articles were screened to identify relevant studies for review inclusion. Articles were reviewed and data extracted, analysed, and grouped categorically based on nature of care provided. Results Thirty studies met inclusion criteria. Insomnia management provision across these studies was divided categorically into 1) Screening/Assessment, 2) Pharmacological and non-pharmacological management provision, and 3) Deprescribing services. Regarding treatment provision, it was evident that pharmacological approaches remain the most common treatment modality adopted despite guidelines recommending behavioural therapy as first line. Overall, the results highlighted that provided with the adequate training and education, pharmacists have the potential to engage in insomnia screening, behavioural therapy and deprescribing services, improving overall insomnia management in primary care. Conclusion The outcomes of this review highlight a current gap in insomnia management practices carried out by pharmacists and provide evidence for improved roles when pharmacists are upskilled with specialised insomnia management education/training.","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136054065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.1093/sleepadvances/zpad035.182
H Jang, J Lee, U Ryu, D Park, S Mun
Abstract Objective This study aims to investigate the relationships of the severity of OSA and the long-term results of OSA in untreated patients and to compare them with the results of OSA patients who were operated. Materials and Methods The study retrospectively analyzed medical records of 79 individuals who were diagnosed with OSA, who either underwent surgical treatment or received no treatment from 2009 to 2022. Among the patients who underwent polysomnography (PSG) twice, the patients were subdivided by mild, moderate, severe groups according to apnea-hypopnea index (AHI) and the changes in OSA severity over time were compared. Results This study included 43 patients (54%) who received no treatment and 36 patients (46%) who had undergone surgery including tonsillectomy with or without uvula or palatopharyngeal procedures. Among the untreated patients, there was no significant changes in AHI values over time for the overall group, the mild and severe subgroups, but the moderate group showed a significant increase in AHI values (p=0.017). Surgical treatment, specifically tonsillectomy, resulted in a significant decrease in AHI values compared to untreated patients, particularly within 36 months after the procedure (p=0.000). However, for patients with a follow-up period of more than 36 months, the difference in AHI values was not statistically significant between those who underwent tonsillectomy and those who did not. Conclusions Untreated moderate OSA patients show worsening of AHI values over time, highlighting the need for proactive treatment. Surgical intervention can reduce AHI values within 36 months but may lead to worsening of symptoms afterwards.
{"title":"P097 The Fate of Obstructive Sleep Apnea in Long-term","authors":"H Jang, J Lee, U Ryu, D Park, S Mun","doi":"10.1093/sleepadvances/zpad035.182","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpad035.182","url":null,"abstract":"Abstract Objective This study aims to investigate the relationships of the severity of OSA and the long-term results of OSA in untreated patients and to compare them with the results of OSA patients who were operated. Materials and Methods The study retrospectively analyzed medical records of 79 individuals who were diagnosed with OSA, who either underwent surgical treatment or received no treatment from 2009 to 2022. Among the patients who underwent polysomnography (PSG) twice, the patients were subdivided by mild, moderate, severe groups according to apnea-hypopnea index (AHI) and the changes in OSA severity over time were compared. Results This study included 43 patients (54%) who received no treatment and 36 patients (46%) who had undergone surgery including tonsillectomy with or without uvula or palatopharyngeal procedures. Among the untreated patients, there was no significant changes in AHI values over time for the overall group, the mild and severe subgroups, but the moderate group showed a significant increase in AHI values (p=0.017). Surgical treatment, specifically tonsillectomy, resulted in a significant decrease in AHI values compared to untreated patients, particularly within 36 months after the procedure (p=0.000). However, for patients with a follow-up period of more than 36 months, the difference in AHI values was not statistically significant between those who underwent tonsillectomy and those who did not. Conclusions Untreated moderate OSA patients show worsening of AHI values over time, highlighting the need for proactive treatment. Surgical intervention can reduce AHI values within 36 months but may lead to worsening of symptoms afterwards.","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136054068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.1093/sleepadvances/zpad035.016
K Sclip, A Collaro, J Chawla
Abstract Introduction Children with Down syndrome (DS) frequently require repeated polysomnography (PSG) to diagnose and monitor sleep disordered breathing (SDB). PSG set-up can be distressing for this population, who may struggle with sensor and lead application. The Sonomat, a non-invasive mattress overlay, has now been shown to accurately detect and profile SDB in this population. The aim of this study was to evaluate caregiver experiences of undertaking home Sonomat monitoring in their child with DS, compared to conventional lab PSG. Method Children with DS aged 2-17yrs undergoing a diagnostic PSG at the Queensland Children’s Hospital completed a PSG questionnaire about their child’s experience of this test. Those that also undertook home Sonomat monitoring completed a questionnaire about their experience of using the Sonomat in the home. Results Caregivers of fifty-one children with DS (median age 7yrs, 52% male) completed the PSG questionnaire and twenty-five completed the Sonomat questionnaire. 45% (n=51) of caregivers reported that in-lab PSG was ‘hard’ or ‘very hard’ for their child. 100% (n=25) of the caregivers rated their experience of using the Sonomat at home as good, very good or excellent. 88% (n=25) of caregivers felt that the Sonomat was their preferred option for monitoring in children with DS, as opposed to a traditional in-lab PSG. Conclusion In this study, the Sonomat was viewed favourably by caregivers of children with DS, and in the majority of instances was preferred to in-hospital PSG.
{"title":"O016 Caregivers’ Perspectives on the Sonomat as a Polysomnography Alternative in Children with Down syndrome","authors":"K Sclip, A Collaro, J Chawla","doi":"10.1093/sleepadvances/zpad035.016","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpad035.016","url":null,"abstract":"Abstract Introduction Children with Down syndrome (DS) frequently require repeated polysomnography (PSG) to diagnose and monitor sleep disordered breathing (SDB). PSG set-up can be distressing for this population, who may struggle with sensor and lead application. The Sonomat, a non-invasive mattress overlay, has now been shown to accurately detect and profile SDB in this population. The aim of this study was to evaluate caregiver experiences of undertaking home Sonomat monitoring in their child with DS, compared to conventional lab PSG. Method Children with DS aged 2-17yrs undergoing a diagnostic PSG at the Queensland Children’s Hospital completed a PSG questionnaire about their child’s experience of this test. Those that also undertook home Sonomat monitoring completed a questionnaire about their experience of using the Sonomat in the home. Results Caregivers of fifty-one children with DS (median age 7yrs, 52% male) completed the PSG questionnaire and twenty-five completed the Sonomat questionnaire. 45% (n=51) of caregivers reported that in-lab PSG was ‘hard’ or ‘very hard’ for their child. 100% (n=25) of the caregivers rated their experience of using the Sonomat at home as good, very good or excellent. 88% (n=25) of caregivers felt that the Sonomat was their preferred option for monitoring in children with DS, as opposed to a traditional in-lab PSG. Conclusion In this study, the Sonomat was viewed favourably by caregivers of children with DS, and in the majority of instances was preferred to in-hospital PSG.","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136054070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.1093/sleepadvances/zpad035.017
C Hartnett, A Wilson, D Kilner, K Davies, N Slee, J Chawla, K Iyer, A Kevat
Abstract Obstructive sleep apnoea (OSA) is a common problem in children, and can result in developmental and cognitive complications if untreated. The gold-standard tool for diagnosis is polysomnography (PSG); however, it is an expensive and time-consuming test to undertake. Overnight oximetry has been suggested as a faster and cheaper alternative to PSG as it can be performed at home using limited, reusable equipment. This study aims to evaluate the effectiveness of a home oximetry service (implemented in response to extended waiting times for routine PSG) in reducing the time between patient referral and treatment. All patients who utilised the Queensland Children’s Hospital home oximetry service since its inception in 2021 (n=165) were compared to a historic group of patients who underwent PSG in 2018 (n=313). The time from request of the sleep-related study to definitive treatment (ENT surgery or continuous positive airway pressure trial) was significantly reduced (161 days for the HITH oximetry group vs 348 days for the comparable PSG group; p-value <0.02), and time from sleep study request to the report of results was significantly lower for patients in the oximetry group compared to those in the PSG group (12 days vs 86 days p-value <0.01). These results suggest that a home oximetry service can be effective in reducing the waiting time for patients diagnosed with OSA to receive treatment. Further research should examine larger sample sizes to confirm the study findings, investigate the health economic impacts of the service and explore patient/family perspectives.
{"title":"O017 Real-World Utility of Overnight Oximetry for the Screening of Obstructive Sleep Apnoea in Children","authors":"C Hartnett, A Wilson, D Kilner, K Davies, N Slee, J Chawla, K Iyer, A Kevat","doi":"10.1093/sleepadvances/zpad035.017","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpad035.017","url":null,"abstract":"Abstract Obstructive sleep apnoea (OSA) is a common problem in children, and can result in developmental and cognitive complications if untreated. The gold-standard tool for diagnosis is polysomnography (PSG); however, it is an expensive and time-consuming test to undertake. Overnight oximetry has been suggested as a faster and cheaper alternative to PSG as it can be performed at home using limited, reusable equipment. This study aims to evaluate the effectiveness of a home oximetry service (implemented in response to extended waiting times for routine PSG) in reducing the time between patient referral and treatment. All patients who utilised the Queensland Children’s Hospital home oximetry service since its inception in 2021 (n=165) were compared to a historic group of patients who underwent PSG in 2018 (n=313). The time from request of the sleep-related study to definitive treatment (ENT surgery or continuous positive airway pressure trial) was significantly reduced (161 days for the HITH oximetry group vs 348 days for the comparable PSG group; p-value &lt;0.02), and time from sleep study request to the report of results was significantly lower for patients in the oximetry group compared to those in the PSG group (12 days vs 86 days p-value &lt;0.01). These results suggest that a home oximetry service can be effective in reducing the waiting time for patients diagnosed with OSA to receive treatment. Further research should examine larger sample sizes to confirm the study findings, investigate the health economic impacts of the service and explore patient/family perspectives.","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136054072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.1093/sleepadvances/zpad035.181
M Morrison, J Weakley, G Roach, C Sargent, D Miller, C Gardiner, S Halson
Abstract Introduction Acute exercise may have the ability to disrupt sleep in healthy adults. Given the popularity of afternoon exercise, it is important to determine how this affects sleep. Therefore, the aim of this study was to investigate the effect of afternoon moderate-intensity cycling exercise on objective and subjective sleep in healthy adult males. Methods To assess the effect of moderate-intensity afternoon exercise on sleep quality and quantity, 12 healthy adult males who were identified as good sleepers completed a repeated-measures, counter-balanced, crossover study design with two conditions (moderate-intensity aerobic exercise or no exercise). The exercise task involved cycling for 40 minutes at 70%HRmax and was completed ~15:30h. Polysomnography was used to measure sleep during a 9-h sleep opportunity (23:00h to 08:00h). Results There were no statistically significant differences in objective or subjective sleep between conditions. Exercise had a medium-sized effect on reducing total sleep time (mean ± SD; control 493.71 ± 12.59 mins vs exercise: 471.46 ± 55.19 mins; Cohen’s d: 0.56), sleep efficiency (mean ± SD; control 91.43 ± 2.33 % vs exercise: 87.31 ± 10.22 %; Cohen’s d: 0.56), and increasing REM onset latency (mean ± SD; control: 76.13 ± 45.10 mins vs exercise: 102.75 ± 46.85 mins; r: -0.33) (all p > 0.05). Discussion Healthy adult males can complete afternoon moderate-intensity exercise without compromising subsequent sleep. Individual responses in objective sleep outcomes may vary after exercise.
{"title":"P096 The Effect of Moderate-Intensity Exercise on Sleep Quality and Quantity in Healthy Adult Males","authors":"M Morrison, J Weakley, G Roach, C Sargent, D Miller, C Gardiner, S Halson","doi":"10.1093/sleepadvances/zpad035.181","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpad035.181","url":null,"abstract":"Abstract Introduction Acute exercise may have the ability to disrupt sleep in healthy adults. Given the popularity of afternoon exercise, it is important to determine how this affects sleep. Therefore, the aim of this study was to investigate the effect of afternoon moderate-intensity cycling exercise on objective and subjective sleep in healthy adult males. Methods To assess the effect of moderate-intensity afternoon exercise on sleep quality and quantity, 12 healthy adult males who were identified as good sleepers completed a repeated-measures, counter-balanced, crossover study design with two conditions (moderate-intensity aerobic exercise or no exercise). The exercise task involved cycling for 40 minutes at 70%HRmax and was completed ~15:30h. Polysomnography was used to measure sleep during a 9-h sleep opportunity (23:00h to 08:00h). Results There were no statistically significant differences in objective or subjective sleep between conditions. Exercise had a medium-sized effect on reducing total sleep time (mean ± SD; control 493.71 ± 12.59 mins vs exercise: 471.46 ± 55.19 mins; Cohen’s d: 0.56), sleep efficiency (mean ± SD; control 91.43 ± 2.33 % vs exercise: 87.31 ± 10.22 %; Cohen’s d: 0.56), and increasing REM onset latency (mean ± SD; control: 76.13 ± 45.10 mins vs exercise: 102.75 ± 46.85 mins; r: -0.33) (all p &gt; 0.05). Discussion Healthy adult males can complete afternoon moderate-intensity exercise without compromising subsequent sleep. Individual responses in objective sleep outcomes may vary after exercise.","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136054282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.1093/sleepadvances/zpad035.156
C Dunbar, P Nguyen, A Guyett, K Nguyen, K Bickley, A Reynolds, M Hughes, H Scott, R Adams, L Lack, P Catcheside, J Cori, M Howard, C Anderson, N Lovato, A Vakulin
Abstract Introduction Driver fatigue is a significant contributor to road crashes, but identifying individuals at driving risk is challenging. We examined the potential of simple baseline vestibular ocular motor system (VOMS) assessment via virtual reality goggles to predict subsequent vulnerability to driving simulator impairment following extended wakefulness. Methods 49 individuals (Mean±SD Age 32.6±12.9, 45% Males) underwent 9hr baseline sleep opportunity followed by approximately ~29hrs extended wakefulness with five 60min driving assessments. Cluster analysis classified drivers into vulnerable (n=17) or resistant (n=32) groups based on their worst steering deviation and number of crashes from driving tests. Baseline VOMS were performed ~10mins prior to the first three drives (1, 7 and 13hrs of wakefulness). XGBoost machine learning model was trained using baseline VOMs features to predict vulnerable vs resistant groups from driving tests 4 and 5 (19 and 25hrs of wakefulness) Model performance was evaluated using 5-fold cross-validation approach using ROC analysis. Results XGBoost machine learning ranked all 70 VOMS metrics on their importance in predicting vulnerable vs resistant groups. Top 10 VOMs metrics assessed during baseline non-sleep deprived tests demonstrated a strong ability to predict the driver's performance following extended wakefulness, differentiating between the vulnerable vs resistant groups (AUC 0.73 [95%CI 0.61-0.83, p<0.001]). Conclusion VOMs tests conducted at baseline holds promise for predicting future driving impairment. This approach has the potential to be highly valuable in determining an individual's fitness to drive. Future validation in independent samples, sleep disordered population and in-field on-road testing are needed to confirm these promising findings.
{"title":"P071 Simple Vestibular-Occular Motor Assessment as a Predictor of Driving Performance Vulnerability following extended Wakefulness","authors":"C Dunbar, P Nguyen, A Guyett, K Nguyen, K Bickley, A Reynolds, M Hughes, H Scott, R Adams, L Lack, P Catcheside, J Cori, M Howard, C Anderson, N Lovato, A Vakulin","doi":"10.1093/sleepadvances/zpad035.156","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpad035.156","url":null,"abstract":"Abstract Introduction Driver fatigue is a significant contributor to road crashes, but identifying individuals at driving risk is challenging. We examined the potential of simple baseline vestibular ocular motor system (VOMS) assessment via virtual reality goggles to predict subsequent vulnerability to driving simulator impairment following extended wakefulness. Methods 49 individuals (Mean±SD Age 32.6±12.9, 45% Males) underwent 9hr baseline sleep opportunity followed by approximately ~29hrs extended wakefulness with five 60min driving assessments. Cluster analysis classified drivers into vulnerable (n=17) or resistant (n=32) groups based on their worst steering deviation and number of crashes from driving tests. Baseline VOMS were performed ~10mins prior to the first three drives (1, 7 and 13hrs of wakefulness). XGBoost machine learning model was trained using baseline VOMs features to predict vulnerable vs resistant groups from driving tests 4 and 5 (19 and 25hrs of wakefulness) Model performance was evaluated using 5-fold cross-validation approach using ROC analysis. Results XGBoost machine learning ranked all 70 VOMS metrics on their importance in predicting vulnerable vs resistant groups. Top 10 VOMs metrics assessed during baseline non-sleep deprived tests demonstrated a strong ability to predict the driver's performance following extended wakefulness, differentiating between the vulnerable vs resistant groups (AUC 0.73 [95%CI 0.61-0.83, p&lt;0.001]). Conclusion VOMs tests conducted at baseline holds promise for predicting future driving impairment. This approach has the potential to be highly valuable in determining an individual's fitness to drive. Future validation in independent samples, sleep disordered population and in-field on-road testing are needed to confirm these promising findings.","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136054287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.1093/sleepadvances/zpad035.061
L Booker, D Wilson, J Spong, M Deacon-Crouch, K Lenz, T Skinner
Abstract Introduction Infants are not born with a circadian rhythm. Research shows that breast milk clearly exhibits a 24-hour pattern, with melatonin concentrations high during the evening and night but barely detectable in daytime milk. The presence and timing of melatonin in breast milk suggests that this hormone may help provide sleep timing information to infants, thereby supporting the development of their own circadian cycle. Currently, it is not known if disturbances of maternal circadian rhythm, such as shift work, impact the circadian rhythmicity of breastmilk. The aim of this study was to investigate whether maternal circadian disruption, from working night shift has an impact on melatonin timing in breastmilk. Methods A prospective repeated measures study design was undertaken to compare melatonin levels in breastmilk across shift types (day shift/non-workdays and night shifts). Four 10ml breastmilk samples were collected by participants the same time of the day, across five consecutive days. Results. A total of 11 mothers completed the study. Analysis is still ongoing but preliminary results show a potential difference in breastmilk melatonin between pre-night shift, night shift and post night shift, indicating a change in the circadian timing of the breastmilk. Discussion The findings from this study suggest that there is a potential effect from maternal circadian disruption from shift work on breast milk melatonin. This is an important first step in exploring the impact of maternal circadian misalignment disorders on breastmilk hormones and provides preliminary evidence that future research is needed in this area.
{"title":"O061 Maternal Circadian Disruption from Shift Work and the Impact on the timing of Melatonin in their Breast Milk","authors":"L Booker, D Wilson, J Spong, M Deacon-Crouch, K Lenz, T Skinner","doi":"10.1093/sleepadvances/zpad035.061","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpad035.061","url":null,"abstract":"Abstract Introduction Infants are not born with a circadian rhythm. Research shows that breast milk clearly exhibits a 24-hour pattern, with melatonin concentrations high during the evening and night but barely detectable in daytime milk. The presence and timing of melatonin in breast milk suggests that this hormone may help provide sleep timing information to infants, thereby supporting the development of their own circadian cycle. Currently, it is not known if disturbances of maternal circadian rhythm, such as shift work, impact the circadian rhythmicity of breastmilk. The aim of this study was to investigate whether maternal circadian disruption, from working night shift has an impact on melatonin timing in breastmilk. Methods A prospective repeated measures study design was undertaken to compare melatonin levels in breastmilk across shift types (day shift/non-workdays and night shifts). Four 10ml breastmilk samples were collected by participants the same time of the day, across five consecutive days. Results. A total of 11 mothers completed the study. Analysis is still ongoing but preliminary results show a potential difference in breastmilk melatonin between pre-night shift, night shift and post night shift, indicating a change in the circadian timing of the breastmilk. Discussion The findings from this study suggest that there is a potential effect from maternal circadian disruption from shift work on breast milk melatonin. This is an important first step in exploring the impact of maternal circadian misalignment disorders on breastmilk hormones and provides preliminary evidence that future research is needed in this area.","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136054378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.1093/sleepadvances/zpad035.114
G Vincent, E Craige, D Belavy, J Ford, C Miller, L Main, A Hahne, S Ferguson, P Owen
Abstract Introduction There is strong evidence indicating interactions between sleep and chronic low back pain (CLBP). However, evidence on the effect of exercise training (first-line treatment for CLBP), especially of specific modes of exercise training, on sleep is limited. This study aimed to investigate the effect of two exercise-based interventions (general strength and conditioning [GSC] and motor control and manual therapy [MCMT]) on sleep quality in adults with CLBP. Methods We conducted a two-group parallel (1:1), randomised controlled trial. Forty adults (mean age [SD]: 34.7 [6.1] years) with CLBP were randomised to receive either GSC (n=20) or MCMT (n=20) for 6 months. Sleep quality and its sub-components (e.g., sleep disturbance, sleep duration) were measured by the Pittsburgh Sleep Quality Index (PSQI). Analysis employed an intention-to-treat approach and group-by-time effects were assessed with mixed linear effect models. Results Both GSC (PSQI mean change [95%CI]: -1.58 [-2.70, -0.46] points) and MCMT (-1.61 [ 2.79, -0.43]) improved sleep quality at 6 months, but no group-by-time effect was detected (β [95%CI]: 0.03 [-1.60, 1.65]). For sleep quality sub-components, GSC improved daytime dysfunction (-0.33 [-0.65, -.0.01]), but led to a small decline in sleep efficiency (0.06 [0.01, 0.10]). MCMT improved sleep disturbance ( 0.31 [-0.55, -0.07]). Conclusion Both GSC and MCMT improved sleep quality, although neither intervention appeared superior. Sleep disturbance was improved in the MCMT group and daytime dysfunction was improved in the GSC group. Future studies would benefit from including a true control, objective sleep measures, and investigation of potential mediators.
{"title":"P029 Comparing the Impact of General Strength Conditioning and Motor Control Manual Therapy on Sleep Quality in Adults with Chronic Low Back Pain: A Randomised Controlled Trial","authors":"G Vincent, E Craige, D Belavy, J Ford, C Miller, L Main, A Hahne, S Ferguson, P Owen","doi":"10.1093/sleepadvances/zpad035.114","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpad035.114","url":null,"abstract":"Abstract Introduction There is strong evidence indicating interactions between sleep and chronic low back pain (CLBP). However, evidence on the effect of exercise training (first-line treatment for CLBP), especially of specific modes of exercise training, on sleep is limited. This study aimed to investigate the effect of two exercise-based interventions (general strength and conditioning [GSC] and motor control and manual therapy [MCMT]) on sleep quality in adults with CLBP. Methods We conducted a two-group parallel (1:1), randomised controlled trial. Forty adults (mean age [SD]: 34.7 [6.1] years) with CLBP were randomised to receive either GSC (n=20) or MCMT (n=20) for 6 months. Sleep quality and its sub-components (e.g., sleep disturbance, sleep duration) were measured by the Pittsburgh Sleep Quality Index (PSQI). Analysis employed an intention-to-treat approach and group-by-time effects were assessed with mixed linear effect models. Results Both GSC (PSQI mean change [95%CI]: -1.58 [-2.70, -0.46] points) and MCMT (-1.61 [ 2.79, -0.43]) improved sleep quality at 6 months, but no group-by-time effect was detected (β [95%CI]: 0.03 [-1.60, 1.65]). For sleep quality sub-components, GSC improved daytime dysfunction (-0.33 [-0.65, -.0.01]), but led to a small decline in sleep efficiency (0.06 [0.01, 0.10]). MCMT improved sleep disturbance ( 0.31 [-0.55, -0.07]). Conclusion Both GSC and MCMT improved sleep quality, although neither intervention appeared superior. Sleep disturbance was improved in the MCMT group and daytime dysfunction was improved in the GSC group. Future studies would benefit from including a true control, objective sleep measures, and investigation of potential mediators.","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136054384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.1093/sleepadvances/zpad035.119
S Huddle, A Young, M Bonham, T Choi, D O'Driscoll
Abstract Introduction Late night eating is associated with obstructive sleep apnoea (OSA) and may increase obesity risk. Time Restricted Eating (TRE) involves shifting the eating window to 8-12 continuous hours per day, prompting energy intake to earlier in the day without any complex dietary prescription, and has metabolic benefits. We aimed to investigate timing of food intake in patients with OSA and assess their openness to trial TRE. Methods Adults undergoing in-laboratory diagnostic polysomnography (PSG, n=138, 67 male) completed a dietary questionnaire outlining typical eating habits, including timing of meals, frequency of getting up overnight, and frequency of eating/drinking overnight. Questionnaire responses were reviewed with demographics and PSG variables. Proportions of responses were compared across categories of OSA severity using z-tests. Results Patients with moderate/severe OSA (AHI>15events/h, n=77) were more likely to report getting up at night “often” or “always” compared to patients with no/mild OSA (n=61) (63.6% v 47.5%, p=0.08), more likely to report getting up multiple times (66.2% v 47.5%, p=0.04), and more likely to report eating/drinking overnight (42.9% v 18.0%, p=0.003). 71.0% of all patients indicated they would consider trying a TRE diet, and 71.7% could incorporate a TRE diet into their lifestyle. Conclusion Moderate/severe OSA is associated with an increased likelihood of getting up multiple times overnight, and getting up to eat and drink. Patients in this clinical cohort reported a willingness to trial TRE. Future research should investigate the efficacy of implementing TRE in OSA and evaluating its effect on weight loss and sleep quality.
摘要:深夜进食与阻塞性睡眠呼吸暂停(OSA)有关，并可能增加肥胖风险。限时饮食法(TRE)包括将每天的进食时间改为连续8-12小时，在没有任何复杂的饮食处方的情况下，将能量摄入提前，并对代谢有益。我们的目的是调查OSA患者的食物摄入时间，并评估他们对试验TRE的开放程度。方法接受实验室诊断性多导睡眠图(PSG, n= 138,67名男性)的成年人完成了一份饮食问卷，概述了典型的饮食习惯，包括用餐时间、夜间起床频率和夜间进食/饮酒频率。问卷调查结果与人口统计学和PSG变量进行了回顾。采用z检验比较不同OSA严重程度类别的反应比例。结果与无/轻度OSA患者(n=61)相比，中度/重度OSA患者(AHI>15事件/小时，n=77)报告“经常”或“总是”夜间起床的比例(63.6% vs 47.5%， p=0.08)，报告多次起床的比例(66.2% vs 47.5%， p=0.04)，报告夜间进食/饮酒的比例(42.9% vs 18.0%， p=0.003)。71.0%的患者表示他们会考虑尝试TRE饮食，71.7%的患者可以将TRE饮食纳入他们的生活方式。结论中重度OSA与夜间多次起床、起床进食和饮水的可能性增加有关。该临床队列中的患者报告愿意试验TRE。未来的研究应探讨在OSA中实施TRE的疗效，并评估其对减肥和睡眠质量的影响。
{"title":"P035 Investigating the Relationship Between Dietary Timing and Obstructive Sleep Apnoea.","authors":"S Huddle, A Young, M Bonham, T Choi, D O'Driscoll","doi":"10.1093/sleepadvances/zpad035.119","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpad035.119","url":null,"abstract":"Abstract Introduction Late night eating is associated with obstructive sleep apnoea (OSA) and may increase obesity risk. Time Restricted Eating (TRE) involves shifting the eating window to 8-12 continuous hours per day, prompting energy intake to earlier in the day without any complex dietary prescription, and has metabolic benefits. We aimed to investigate timing of food intake in patients with OSA and assess their openness to trial TRE. Methods Adults undergoing in-laboratory diagnostic polysomnography (PSG, n=138, 67 male) completed a dietary questionnaire outlining typical eating habits, including timing of meals, frequency of getting up overnight, and frequency of eating/drinking overnight. Questionnaire responses were reviewed with demographics and PSG variables. Proportions of responses were compared across categories of OSA severity using z-tests. Results Patients with moderate/severe OSA (AHI&gt;15events/h, n=77) were more likely to report getting up at night “often” or “always” compared to patients with no/mild OSA (n=61) (63.6% v 47.5%, p=0.08), more likely to report getting up multiple times (66.2% v 47.5%, p=0.04), and more likely to report eating/drinking overnight (42.9% v 18.0%, p=0.003). 71.0% of all patients indicated they would consider trying a TRE diet, and 71.7% could incorporate a TRE diet into their lifestyle. Conclusion Moderate/severe OSA is associated with an increased likelihood of getting up multiple times overnight, and getting up to eat and drink. Patients in this clinical cohort reported a willingness to trial TRE. Future research should investigate the efficacy of implementing TRE in OSA and evaluating its effect on weight loss and sleep quality.","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136054493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.1093/sleepadvances/zpad035.120
K Falloon, C Campos, M Nakatsuji, F Moir, A Wearn, H Bhoopatkar
Abstract Aims To explore Year 6 medical students’ perceptions of sleep education during medical school to inform the development of a sleep curriculum. Methods Year 6 medical students on their final general practice (GP) placement in 2020 (71/254 of the Year 6 cohort) were invited to complete an online survey regarding sleep education recalled during the medical programme. Results Sleep education survey responses were received from 51/71 of students in the final GP cohort (72%). Three areas were more frequently recalled - 83% recalled learning about sleep apnoea, 71% about sleep physiology, and 69% about snoring. Only 50% recalled learning about assessing sleep and 42% recalled receiving education about insomnia. More than 80% of students reported they received no education regarding preparing for, coping with, or recovering from night shifts. Students identified common sleep disorders, sleep assessment, and shift work as priority topics. Conclusions Whilst the majority of students recalled receiving education on select topics, most had no awareness of education relating to sleep assessment, insomnia, or shift work. Sleep education in the curriculum needs more emphasis and reinforcement given its relevance across many domains of health and morbidity. We propose that an identifiable sleep curriculum is necessary and useful to ensure medical students have the necessary core education regarding sleep and sleep disorders both for patients and themselves. Further, we believe this is possible to achieve within the constraints of the undergraduate curriculum and propose some creative solutions.
{"title":"P036 A novel approach to nurture sleep education in a crowded curriculum","authors":"K Falloon, C Campos, M Nakatsuji, F Moir, A Wearn, H Bhoopatkar","doi":"10.1093/sleepadvances/zpad035.120","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpad035.120","url":null,"abstract":"Abstract Aims To explore Year 6 medical students’ perceptions of sleep education during medical school to inform the development of a sleep curriculum. Methods Year 6 medical students on their final general practice (GP) placement in 2020 (71/254 of the Year 6 cohort) were invited to complete an online survey regarding sleep education recalled during the medical programme. Results Sleep education survey responses were received from 51/71 of students in the final GP cohort (72%). Three areas were more frequently recalled - 83% recalled learning about sleep apnoea, 71% about sleep physiology, and 69% about snoring. Only 50% recalled learning about assessing sleep and 42% recalled receiving education about insomnia. More than 80% of students reported they received no education regarding preparing for, coping with, or recovering from night shifts. Students identified common sleep disorders, sleep assessment, and shift work as priority topics. Conclusions Whilst the majority of students recalled receiving education on select topics, most had no awareness of education relating to sleep assessment, insomnia, or shift work. Sleep education in the curriculum needs more emphasis and reinforcement given its relevance across many domains of health and morbidity. We propose that an identifiable sleep curriculum is necessary and useful to ensure medical students have the necessary core education regarding sleep and sleep disorders both for patients and themselves. Further, we believe this is possible to achieve within the constraints of the undergraduate curriculum and propose some creative solutions.","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136054496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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