689 Objective Assessment of Inpatient Sleep Patterns and Quality: A Pilot Study

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A269-A269
Author(s):  
Sarah Sussman ◽  
Ashwin Ananth ◽  
Elie Fares ◽  
Maurits Boon ◽  
Colin Huntley ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Slow Wave Sleep ◽  
Total Sleep Time ◽  
Objective Assessment ◽  
General Medicine ◽  
Sleep Time ◽  
Sleep Medicine ◽  
Inpatient Setting ◽  
Wrist Actigraphy ◽  
Patient Reported

Abstract Introduction Sleep disruption is common among hospitalized patients due to psychological, physiological, and environmental reasons including illness, pain, anxiety, invasive interventions, frequent monitoring, and stimuli, especially noise and light. The AASM has published guidelines for the use of actigraphy in the outpatient setting, but there is a paucity of literature evaluating the validity of actigraphy in inpatients. The aim of this study is to evaluate sleep in hospitalized general medicine patients undergoing sleep medicine consultation using actigraphy and qualitative surveys. Methods A single-site prospective study in hospitalized medicine patients. Patients were observed with a Fitbit® Charge3 wrist actigraphy device overnight, then administered 7 surveys: Richards-Campbell Sleep Questionnaire (RCSQ), qualitative questionnaires assessing sleep history, sleep hygiene, barriers to sleep, STOP-BANG, Epworth Sleepiness Scale (ESS), and Patient-Health Questionniare-2 (PHQ-2). Actigraphy data including total sleep time, slow wave sleep time, and number of awakenings was compared with patient-reported data. Results In preliminary analysis, six patients met inclusion criteria and underwent sleep medicine consultation, overnight actigraphy, and completed 7 surveys. Based on subjective sleep history questionnaires, average total sleep time was 437 + 215 minutes. Actigraphy revealed average total sleep time was 228 + 80 minutes with an average of 3.6 nocturnal awakenings. Increased number of awakenings on actigraphy was not correlated with increased number of awakenings by survey. The most frequently reported barriers to sleep on patient surveys were pain and being woken up for labs or vital signs. The average STOP-BANG score was 6 out of 8 and average ESS was 14 out of 24. Conclusion Restorative sleep warrants consideration alongside complex medical care during hospitalization. Patients experience decreased total sleep time and increased number of awakenings while in the hospital compared with their subjective estimates of sleep at home. Actigraphy provides a non-invasive and reliable way to monitor some sleep parameters in the inpatient setting. An elevated STOP-BANG score could represent sleep disordered breathing and impact perceptions of sleep quality. Patient-identified barriers to sleep are targets for quality improvement. Future studies should compare inpatient actigraphy data to polysomnographic data and the effect of sleep-directed interventions on sleep quality in the hospital. Support (if any):

scholarly journals Hospitalized COVID-19 Patients Were Five Times More Likely to Suffer From Total Sleep Deprivation Compared to Non-COVID-19 Patients; an Observational Comparative Study

2021 ◽  
Vol 15 ◽  
Author(s):  
Eva S. van den Ende ◽  
Kim D. I. van Veldhuizen ◽  
Belle Toussaint ◽  
Hanneke Merten ◽  
Peter M. van de Ven ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Comparative Study ◽  
Sleep Deprivation ◽  
Total Sleep Time ◽  
Short Form ◽  
Sleep Time ◽  
Hospital Environment ◽  
Poor Sleep ◽  
Total Sleep Deprivation ◽  
Patient Reported

Objectives: Sleeping disorders are a common complaint in patients who suffer from an acute COVID-19 infection. Nonetheless, little is known about the severity of sleep disturbances in hospitalized COVID-19 patients, and whether these are caused by disease related symptoms, hospitalization, or the SARS-CoV-2 virus itself. Therefore, the aim of this study was to compare the quality and quantity of sleep in hospitalized patients with and without COVID-19, and to determine the main reasons for sleep disruption.Methods: This was an observational comparative study conducted between October 1, 2020 and February 1, 2021 at the pulmonary ward of an academic hospital in the Netherlands. This ward contained both COVID-19-positive and -negative tested patients. The sleep quality was assessed using the PROMIS-Sleep Disturbance Short Form and sleep quantity using the Consensus Sleep Diary. Patient-reported sleep disturbing factors were summarized.Results: A total of 79 COVID-19 patients (mean age 63.0, male 59.5%) and 50 non-COVID-19 patients (mean age 59.5, male 54.0%) participated in this study. A significantly larger proportion of patients with COVID-19 reported not to have slept at all (19% vs. 4% of non-COVID-19 patients, p = 0.011). The Sleep quality (PROMIS total score) and quantity (Total Sleep Time) did not significantly differ between both groups ((median PROMIS total score COVID-19; 26 [IQR 17-35], non-COVID-19; 23 [IQR 18-29], p = 0.104), (Mean Total Sleep Time COVID-19; 5 h 5 min, non-COVID-19 mean; 5 h 32 min, p = 0.405)). The most frequently reported disturbing factors by COVID-19 patients were; ‘dyspnea’, ‘concerns about the disease’, ‘anxiety’ and ‘noises of other patients, medical staff and medical devices’.Conclusion: This study showed that both patients with and without an acute COVID-19 infection experienced poor quality and quantity of sleep at the hospital. Although the mean scores did not significantly differ between groups, total sleep deprivation was reported five times more often by COVID-19 patients. With one in five COVID-19 patients reporting a complete absence of night sleep, poor sleep seems to be a serious problem. Sleep improving interventions should focus on physical and psychological comfort and noise reduction in the hospital environment.

scholarly journals Effects of melatonin on sleep disturbances in multiple sclerosis: A randomized, controlled pilot study

2021 ◽  
Vol 7 (4) ◽  
pp. 205521732110487
Author(s):  
Wan-Yu Hsu ◽  
Annika Anderson ◽  
William Rowles ◽  
Katherine E. Peters ◽  
Vicki Li ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Sleep Quality ◽  
Sleep Disturbances ◽  
Total Sleep Time ◽  
Low Cost ◽  
Sleep Time ◽  
Sleep Efficiency ◽  
Double Blind ◽  
Randomized Controlled ◽  
Patient Reported

Background Sleep disturbances are commonly reported by people with multiple sclerosis (PwMS). However, optimal management of sleep disturbances is uncertain, and objective studies of sleep quality in PwMS are scarce. Objectives To determine the effect of exogenous melatonin on sleep quality and sleep disturbances in PwMS. Methods Thirty adult PwMS reporting sleep difficulties were recruited in a randomized, controlled, double-blind cross-over study. They took either melatonin or placebo for 2 weeks, and the opposite for the following 2 weeks. During weeks 2 and 4, an actigraph was used to capture mean total sleep time and sleep efficiency. Patient-reported outcomes (PROs) were collected at weeks 0, 2 and 4. Results Melatonin use significantly improved mean total sleep time ( p = 0.03), with a trend towards higher sleep efficiency ( p = 0.06). No PROs were significantly different; there was a trend for melatonin use to decrease mean Insomnia Severity Index score ( p = 0.07), improve Pittsburgh Sleep Quality Index sleep quality component ( p = 0.07), and improve NeuroQoL-Fatigue ( p = 0.06). No other PROs showed differences between melatonin and placebo; nor did step count measured by actigraphy (all p > 0.45). Conclusion These results provide preliminary evidence that melatonin, a low-cost, over-the-counter supplement, could improve objective measures of sleep quality in PwMS.

scholarly journals Tasimelteon safely and effectively improves sleep in Smith–Magenis syndrome: a double-blind randomized trial followed by an open-label extension

2021 ◽  
Author(s):  
Christos M. Polymeropoulos ◽  
Justin Brooks ◽  
Emily L. Czeisler ◽  
Michaela A. Fisher ◽  
Mary M. Gibson ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Crossover Study ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Open Label ◽  
Double Blind ◽  
Open Label Study ◽  
Label Study ◽  
Sleep Complaints ◽  
Open Label Extension

Abstract Purpose To assess the efficacy of tasimelteon to improve sleep in Smith–Magenis syndrome (SMS). Methods A 9-week, double-blind, randomized, two-period crossover study was conducted at four US clinical centers. Genetically confirmed patients with SMS, aged 3 to 39, with sleep complaints participated in the study. Patients were assigned to treatment with tasimelteon or placebo in a 4-week crossover study with a 1-week washout between treatments. Eligible patients participated in an open-label study and were followed for >3 months. Results Improvement of sleep quality (DDSQ50) and total sleep time (DDTST50) on the worst 50% of nights were primary endpoints. Secondary measures included actigraphy and behavioral parameters. Over three years, 52 patients were screened, and 25 patients completed the randomized portion of the study. DDSQ50 significantly improved over placebo (0.4, p = 0.0139), and DDTST50 also improved (18.5 minutes, p = 0.0556). Average sleep quality (0.3, p = 0.0155) and actigraphy-based total sleep time (21.1 minutes, p = 0.0134) improved significantly, consistent with the primary outcomes. Patients treated for ≥90 days in the open-label study showed persistent efficacy. Adverse events were similar between placebo and tasimelteon. Conclusion Tasimelteon safely and effectively improved sleep in SMS.

scholarly journals Gender differences in BaYaka forager sleep-wake patterns in forest and village contexts

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Erica Kilius ◽  
David R. Samson ◽  
Sheina Lew-Levy ◽  
Mallika S. Sarma ◽  
Ujas A. Patel ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Small Scale ◽  
Cultural Variation ◽  
Sleep Patterns ◽  
Economic Activities ◽  
Mixed Effect ◽  
Wake Patterns ◽  
The Republic

AbstractSleep studies in small-scale subsistence societies have broadened our understanding of cross-cultural sleep patterns, revealing the flexibility of human sleep. We examined sleep biology among BaYaka foragers from the Republic of Congo who move between environmentally similar but socio-ecologically distinct locations to access seasonal resources. We analyzed the sleep–wake patterns of 51 individuals as they resided in a village location (n = 39) and a forest camp (n = 23) (362 nights total). Overall, BaYaka exhibited high sleep fragmentation (50.5) and short total sleep time (5.94 h), suggestive of segmented sleep patterns. Sleep duration did not differ between locations, although poorer sleep quality was exhibited in the village. Linear mixed effect models demonstrated that women’s sleep differed significantly from men’s in the forest, with longer total sleep time (β ± SE =  − 0.22 ± 0.09, confidence interval (CI) = [− 0.4, − 0.03]), and higher sleep quality (efficiency; β ± SE =  − 0.24 ± 0.09, CI = [− 0.42, − 0.05]). These findings may be due to gender-specific social and economic activities. Circadian rhythms were consistent between locations, with women exhibiting stronger circadian stability. We highlight the importance of considering intra-cultural variation in sleep–wake patterns when taking sleep research into the field.

scholarly journals A Validation Study of a Commercial Wearable Device to Automatically Detect and Estimate Sleep

Biosensors ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 185
Author(s):  
Dean J. Miller ◽  
Gregory D. Roach ◽  
Michele Lastella ◽  
Aaron T. Scanlan ◽  
Clint R. Bellenger ◽  
...  
Keyword(s):  
Eye Movement ◽  
Sensitivity And Specificity ◽  
Validation Study ◽  
Slow Wave Sleep ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Rapid Eye Movement Sleep ◽  
Two Stage ◽  
Manual Adjustment ◽  
Light Sleep

The aims of this study were to: (1) compare actigraphy (ACTICAL) and a commercially available sleep wearable (i.e., WHOOP) under two functionalities (i.e., sleep auto-detection (WHOOP-AUTO) and manual adjustment of sleep (WHOOP-MANUAL)) for two-stage categorisation of sleep (sleep or wake) against polysomnography, and; (2) compare WHOOP-AUTO and WHOOP-MANUAL for four-stage categorisation of sleep (wake, light sleep, slow wave sleep (SWS), or rapid eye movement sleep (REM)) against polysomnography. Six healthy adults (male: n = 3; female: n = 3; age: 23.0 ± 2.2 yr) participated in the nine-night protocol. Fifty-four sleeps assessed by ACTICAL, WHOOP-AUTO and WHOOP-MANUAL were compared to polysomnography using difference testing, Bland–Altman comparisons, and 30-s epoch-by-epoch comparisons. Compared to polysomnography, ACTICAL overestimated total sleep time (37.6 min) and underestimated wake (−37.6 min); WHOOP-AUTO underestimated SWS (−15.5 min); and WHOOP-MANUAL underestimated wake (−16.7 min). For ACTICAL, sensitivity for sleep, specificity for wake and overall agreement were 98%, 60% and 89%, respectively. For WHOOP-AUTO, sensitivity for sleep, wake, and agreement for two-stage and four-stage categorisation of sleep were 90%, 60%, 86% and 63%, respectively. For WHOOP-MANUAL, sensitivity for sleep, wake, and agreement for two-stage and four-stage categorisation of sleep were 97%, 45%, 90% and 62%, respectively. WHOOP-AUTO and WHOOP-MANUAL have a similar sensitivity and specificity to actigraphy for two-stage categorisation of sleep and can be used as a practical alternative to polysomnography for two-stage categorisation of sleep and four-stage categorisation of sleep.

Influence of hypothalamic and ambient temperatures on sleep in kangaroo rats

1979 ◽  
Vol 237 (1) ◽  
pp. R80-R88 ◽  
Author(s):  
S. Sakaguchi ◽  
S. F. Glotzbach ◽  
H. C. Heller
Keyword(s):  
Slow Wave Sleep ◽  
Total Sleep Time ◽  
Paradoxical Sleep ◽  
Sleep Time ◽  
Peripheral Stimulus ◽  
Kangaroo Rats ◽  
Hypothalamic Temperature ◽  
Ambient Temperatures ◽  
Thermoregulatory System

Unanesthetized, unrestrained kangaroo rats (Dipodomys) were studied to examine the changes in the frequency and duration of sleep states caused by long-term manipulations of hypothalamic temperature (Thy) at a thermoneutral (30 degrees C) and a low (20 degrees C) ambient temperature (Ta). A cold stimulus present in either the hypothalamus or the skin decreased both the total sleep time (TST) and the ratio of paradoxical sleep (PS) to TST. At a low Ta, TST, but not the PS-to-TST ratio, was increased by raising Thy, indicating that a cold peripheral stimulus could differentially inhibit PS. At a thermoneutral Ta, cooling Thy decreased both TST and the PS/TST. Changes in the amount of PS were due largely to changes in the frequency, but not the duration, of individual episodes of PS, suggesting that the transition to PS is partially dependent on the thermoregulatory conditions existing during slow-wave sleep (SWS). These results are consistent with the recent findings that the thermoregulatory system is functional during SWS but is inhibited or inactivated during PS.

scholarly journals Personality Traits and Insomnia Symptoms in Shift Workers

2021 ◽  
Vol 12 ◽  
Author(s):  
Brigitte Holzinger ◽  
Lucille Mayer ◽  
Gerhard Klösch
Keyword(s):  
Sleep Quality ◽  
Personality Traits ◽  
Sleep Duration ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Work Schedule ◽  
Shift Workers ◽  
Time In Bed ◽  
Shift Schedules ◽  
Insomnia Symptoms

The discrepancy between natural sleep-wake rhythm and actual sleep times in shift workers can cause sleep loss and negative daytime consequences. Irregular shift schedules do not follow a fixed structure and change frequently, which makes them particularly harmful and makes affected individuals more susceptible to insomnia. The present study compares insomnia symptoms of non-shift workers, regular shift workers, and irregular shift workers and takes into account the moderating role of the Big Five personality traits and levels of perfectionism. Employees of an Austrian railway company completed an online survey assessing shift schedules, sleep quality and duration, daytime sleepiness, and personality traits. A total of 305 participants, of whom 111 were non-shift workers, 60 regular shift workers, and 134 irregular shift workers, made up the final sample. Irregular shift workers achieved significantly worse scores than one or both of the other groups in time in bed, total sleep time, sleep efficiency, sleep duration, sleep quality, sleep latency, and the number of awakenings. However, the values of the irregular shifts workers are still in the average range and do not indicate clinical insomnia. Participants working regular shifts reported the best sleep quality and longest sleep duration and showed the least nocturnal awakenings, possibly due to higher conscientiousness- and lower neuroticism scores in this group. Agreeableness increased the effect of work schedule on total sleep time while decreasing its effect on the amount of sleep medication taken. Perfectionism increased the effect of work schedule on time in bed and total sleep time. Generalization of results is limited due to the high percentage of males in the sample and using self-report measures only.

The Relationships Between Training Load, Type of Sport, and Sleep Among High-Level Adolescent Athletes

2020 ◽  
pp. 1-10
Author(s):  
Anis Aloulou ◽  
Francois Duforez ◽  
Damien Léger ◽  
Quentin De Larochelambert ◽  
Mathieu Nedelec
Keyword(s):  
Sleep Quality ◽  
Muscle Soreness ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Training Load ◽  
Academic Environment ◽  
Adolescent Athletes ◽  
Daily Training ◽  
High Level ◽  
Age And Sex

Purpose: To evaluate the effects of sporting activities, training loads, and athletes’ characteristics on sleep among high-level adolescent athletes, in a controlled training and academic environment. Methods: A total of 128 high-level adolescent athletes (age = 15.2 [2.0] y), across 9 different sports, completed common sleep questionnaires and were monitored daily (7.3 [2.7] d) during a typical in-season training period. Sleep was analyzed using actigraphy and sleep diaries, whereas training load was evaluated using the session rating of perceived exertion, and muscle soreness and general fatigue were reported with the aid of visual analog scales. Separate linear mixed-effects models were fitted, including the athlete as a random effect and the following variables as fixed effects: the sport practiced (categorical predictor), daily training load, age, and sex. Different models were used to compare sleep variables among sports and to assess the influence of training load, age, and sex. Results: The mean total sleep time was 7.1 (0.7) hours. Swimmers presented increased sleep fragmentation, training loads, perceived muscle soreness, and general fatigue compared with athletes who engaged in other sports. Independent of any sport-specific effects, a higher daily training load induced an earlier bedtime and reduced total sleep time and perceived sleep quality, with higher sleep fragmentation. Moreover, female athletes experienced increased total sleep time and worse sleep quality in response to stress compared with those in males. Conclusion: In a controlled training and academic environment, high-level adolescent athletes did not achieve the recommended sleep duration. Impaired sleep quality and quantity could be partially explained by increased training loads.

scholarly journals 1092 Attention-deficit/hyperactivity Disorder Symptoms And Sleep Characteristics Within A Seasonal Affective Disorder Spectrum

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A415-A416
Author(s):  
K N Kim ◽  
D L Wescott ◽  
P L Franzen ◽  
B P Hasler ◽  
K A Roecklein
Keyword(s):  
Sleep Quality ◽  
Sleep Duration ◽  
Adhd Symptom ◽  
Symptom Severity ◽  
Daytime Sleepiness ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Sleep Onset Latency ◽  
Adhd Symptoms ◽  
Depression Severity

Abstract Introduction Seasonal affective disorder (SAD) increases risk for attention-deficit/hyperactivity disorder (ADHD), although the mechanism linking SAD and ADHD is unknown. Prior research has identified insomnia and delayed sleep phase in both ADHD and SAD. We hypothesized that sleep duration and timing in SAD would be associated with the severity of ADHD symptoms. Methods Adults with SAD (n = 45) and subsyndromal SAD (S-SAD; n = 18) aged 19-66 years from Pittsburgh, PA., were assessed for ADHD symptoms, self-report sleep quality, depression severity, and daytime sleepiness in the Winter. Participants wore an Actiwatch for 4-14 days, from which we calculated sleep-onset latency, total sleep time, sleep midpoint, and sleep efficiency. We conducted a hierarchical multivariate linear regression to determine if sleep characteristics predict ADHD symptom severity in our sample while controlling for depressive symptoms. Age and gender were added in Step 1, seasonal depression severity in Step 2, actigraphy-based total sleep time, sleep onset latency, midpoint, and efficiency in Step 3, and self-reported sleep quality and daytime sleepiness in Step 4. Results Participants mostly scored in the “likely” or “highly likely” ADHD range (87.30%, n=55), higher than the national prevalence rate (4.4%). When controlling for age, gender, and depression severity, only shorter actigraphy-based total sleep time was associated with higher ADHD symptom severity (β=-0.30, p<0.05). However, when self-reported sleep quality and daytime sleepiness were added as predictors, total sleep time was no longer a statistically-significant predictor of ADHD symptom severity and only daytime sleepiness predicted ADHD symptom severity (β=0.31, p<0.05). Conclusion Our results suggest that individuals with SAD who experience daytime sleepiness and/or possibly shorter actigraphy-based sleep duration experience higher ADHD symptom severity. Treatments like Trans-C or CBT-I to improve daytime sleepiness and sleep duration may be indicated for SAD patients who present with comorbid ADHD symptoms. Support NIMH K.A.R. MH103303

scholarly journals Protein and Omega-3 Polyunsaturated Fatty Acid Supplementation for 16 Weeks Improves Sleep and Mood States in Postmenopausal Women

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 9-9
Author(s):  
Jamie Baum ◽  
Aubree Hawley ◽  
Caroline Baughn ◽  
Sam Walker ◽  
Angela Tacinelli ◽  
...  
Keyword(s):  
Body Composition ◽  
Sleep Quality ◽  
Postmenopausal Women ◽  
Dietary Intervention ◽  
Sleep Time ◽  
Protein Isolate ◽  
Mood States ◽  
Current Evidence ◽  
Omega 3 ◽  
Wrist Actigraphy

Abstract Objectives Body composition shifts as we age, resulting in loss of skeletal muscle mass with an increase in fat mass, which is linked to disruptions in sleep-wake rhythms and mood disturbance. Current evidence suggests protein and omega-3 polyunsaturated fatty acids (O3FA) individually augment sleep quality and attenuate depression, but a concomitant effect is yet to be determined. The objective of this study was to determine the effect of protein and O3FA supplementation on regulation of sleep and mood states in postmenopausal women. Methods Overweight, postmenopausal women (60.6 ± 9.0 years; BMI: 28.1 ± 6.9) participated in this randomized, controlled, single-blinded, 16 wk dietary intervention. Participants were allocated to 1 of 5 groups: 1) control, no INT (n = 6); 2) whey protein isolate (PRO; 25 g/d; n = 4); 3) O3FA (DHA/EPA; 4.3 g/d; n = 10); 4) PRO + soy bean oil (4.3 g/d) placebo (n = 6), and 5) PRO + O3FA (n = 8). Sleep (via Pittsburgh Sleep Quality Index Global Sleeping Score; PSQI GSS) and total mood disturbances; (TMD; via Profile of Mood States (POMS)) including six affect states of depression, fatigue, anger, tension, confusion, and vigor subscales were assessed at 0, 4, 8, 12, and 16 wks. Sleep was measured at 0, 8, and 16 wk via wrist Actigraphy. Body composition was measured via DXA at 0 and 16 wk. Data were analyzed using two-way ANOVA to assess the relationship between diet, sleep, and mood states over time. Results Overall, all interventions improved PSQI GSS (P < 0.05) by 16 wks. There was a trend for all interventions to improve sleep efficiency (P = 0.06), with no effect on total sleep time. All interventions improved TMD (P < 0.05) and vigor (P < 0.001), with a trend on depression (P = 0.06). PRO, O3FA, and O3FA + PRO significantly improved vigor at 12-wks (P < 0.01). PRO alone significantly improved vigor at 16 wk (P < 0.001) compared to CON. There was no significant effect of intervention on body composition. However, PRO, O3FA, and PRO + O3FA had a positive (564.7 ± 681.4 g) and the CON had a negative (−171.0 ± 991.6) net change of total lean mass at 16 wks. Conclusions This pilot study suggests that PRO, O3FA, and PRO + O3FA have potential to improve sleep and mood in overweight, postmenopausal women. Additional research is needed to determine the long-term individual and concomitant effect of PRO and O3FA on sleep and mood states. NCT0303041. Funding Sources Arkansas Biosciences Institute.

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