P113 An Exploration of Factors that Affect Perceived Onset Latency during the MSLT Test

It is assumed that during the MSLT test, the sleep laboratory environment will be appropriately resourced to facilitate sleep. However, anecdotal evidence suggests that a variety of factors may actually hinder sleep onset, although this possibility has not been formally investigated in the literature. Thirty-four MSLT participants, who attended the sleep unit between 2018 and 2019, completed a questionnaire that was designed to test perception of sleep onset latency by asking them how easy/difficult it was for them to fall asleep on 17 items that came from four categories. The four categories were the 1. sleep unit environment, e.g. noise/ room temperature; 2. the MSLT procedure, e.g. wires/fixed nap times; 3. the MSLT staff e.g. manner/ clarity of explanations and 4. pain/distress unrelated to the test. All items were rated on a five-point Likert scale. Space was provided for written comments for each category. Overall, the relationship with staff had the greatest impact on perceived sleep onset latency. Forty-one percent of participants reported that the provision of a thorough explanation of the day’s procedure helped them fall asleep in naps. Thirty-five percent reported that their own pain and discomfort affected their ability to sleep. Light and noise had little impact. This research indicates that the staff-patient relationship plays a significant role in patient’s experience of the MSLT and may potentially affect test outcomes.

P121 Comparison of Actigraphy versus PSG and Perception of Sleep in Patients with Excessive Daytime Sleepiness

Actigraphy is used as a validated measure of rest and sleep, however, there are reported differences in WASO in healthy individuals (Chinoy, 2021). Methods This study compares the sleep parameters from PSG with simultaneous overnight actigraphy on patients the night prior to MSLT. We also compare the actigraphy data collected on the week prior to the PSG with the patient’s sleep diary. 22 subjects, age 38.7 ± 3.1 years, BMI 23.5 ± 1.4 kg/m2, 40.1% male, 4 participants were treated with CPAP. Results WASO was found to be under estimated by actigraphy versus PSG (y=-0.957x+18.014, R2=0.51), there is an increase in underestimation beyond 18minutes. Our data also show on overestimation of sleep onset latency by actigraphy versus PSG when sleep latency is longer than 12 minutes (y=0.27x-12.04, R2=0.08). Total sleep time was perceived to be longer on the PSG night than the PSG data shows (y=0.68x-4.65, R2=0.21). Data demonstrated participants to overestimate their sleep period in their sleep diary compared to the actigraphy data (y=-0.87x+6.58, R2=0.21). T-tests showed a significant difference between WASO (minutes) detected by PSG and the actigraphy data (67.4 ± 8.9 vs 33.3 ± 3.9 p=0.0007). There were no other significant differences in the datasets. Conclusion Actigraphy uses activity data and light detection to estimate rest and sleep periods in wearers. Our data reflects expected differences reported in the literature of actigraphy data versus PSG due to the limitation of actigraphy being able to differentiate between sleep and motionless wakefulness.

Comparing Infant and Toddler Sleep Patterns Prior To and During The First Wave of Home Confinement Due To COVID-19 in Spain

Introduction: Recent literature has shown that sleep patterns are shaped during the first years of life, playing a relevant role in children’s functioning. We focused on comparing sleep patterns in infants and toddlers in Spain before and during COVID-19 home confinement to assess the immediate impact on sleep patterns. Methods We compared data from two cross-sectional surveys from parents of 1,658 children three to 36 months of age from Spain. One conducted before COVID-19 (2017–2018, n = 1,380) and another during COVID-19 pandemic (March-May of 2020, n = 254). We used an internet self-administrated questionnaire using the Brief Infant Sleep Questionnaire (BISQ) criteria in both surveys. Results During confinement infants and toddlers went to sleep later (median bedtime 21:30 before confinement vs. 21.36 during confinement (p = 0.004)). More infants and toddlers showed longer sleep latencies (> 30 minutes) during confinement median 33.9% versus 12.3% (p < 0.001). Based on the recommended BISQ criteria, we observed an increase in poor sleepers meeting at least one criterion of inadequate patterns during confinement (p < 0.001). Parental perception of a child’s sleep as problematics were 39.4% and 44.1% (adjusted p = 0.363) before and under lockdown, respectively. Conclusions Home confinement generally affected infant’s and toddler’s sleep patterns negatively, however parents didn’t report worse perception of sleep quality of their children. Follow-up studies can help understand the potential long-term effects of the COVID-19 pandemic on sleep patterns.

Brain reactivity using fMRI to insomnia stimuli in insomnia patients with discrepancy between subjective and objective sleep

Subjective–objective discrepancy of sleep (SODS) might be related to the distorted perception of sleep deficit and hypersensitivity to insomnia-related stimuli. We investigated differences in brain activation to insomnia-related stimuli among insomnia patients with SODS (SODS group), insomnia patients without SODS (NOSODS group), and healthy controls (HC). Participants were evaluated for subjective and objective sleep using sleep diary and polysomnography. Functional magnetic resonance imaging was conducted during the presentation of insomnia-related (Ins), general anxiety-inducing (Gen), and neutral (Neu) stimuli. Brain reactivity to the contrast of Ins vs. Neu and Gen vs. Neu was compared among the SODS (n = 13), NOSODS (n = 15), and HC (n = 16) groups. In the SODS group compared to other groups, brain areas including the left fusiform, bilateral precuneus, right superior frontal gyrus, genu of corpus callosum, and bilateral anterior corona radiata showed significantly increased blood oxygen level dependent (BOLD) signal in the contrast of Ins vs. Neu. There was no brain region with significantly increased BOLD signal in the Gen vs. Neu contrast in the group comparisons. Increased brain activity to insomnia-related stimuli in several brain regions of the SODS group is likely due to these individuals being more sensitive to sleep-related threat and negative cognitive distortion toward insomnia.

PHYSICAL ACTIVITY, SCREEN TIME, NUTRITIONAL STATUS AND SLEEP IN ADOLESCENTS IN NORTHEAST BRAZIL

ABSTRACT Objective: To verify the prevalence of sleep quality and duration and its association with the level of physical activity, screen time and nutritional status in adolescents. Methods: This is a cross-sectional study with 1,432 adolescents (53.1%, female), ten to 14 years old (12.0±1.0 year) from public schools in Joao Pessoa, Northeast Brazil. Physical activity (≥300 vs. <300 minutes/week), screen time (≤2 vs. >2 h/day) and duration (<8 vs. ≥8 h/day) and perception of sleep quality (negative vs. positive perception) were measured by questionnaire. Nutritional status was assessed by body mass index (low weight / normal weight vs. overweight / obesity). Binary logistic regression was used to analyze association between variables, considering different aggregation of negative factors. Results: The prevalence of insufficient duration and negative perception of sleep quality was 12.6% (95%CI 10.9-14.4) and 21.0% (95%CI 18.9-23.1), respectively. There was a linear trend in the chance of the adolescents to present insufficient duration of sleep as a result of simultaneous negative factors (physical inactivity, excessive screen time, being overweight) (OR=4.31; 95%CI 1.50-12.48). Conclusions: Adolescents exposed simultaneously to low levels of physical activity, excessive screen time and overweight had a lower sleep duration.

0960 Perception of Sleep Importance in Children With Cystic Fibrosis

Introduction Children with cystic fibrosis (CF) are known to have poor sleep efficiency and increased nighttime awakenings secondary to factors such as nocturnal cough and time spent on therapies for airway clearance. Studies have shown that children with poor lung function have a higher Pediatric Daytime Sleepiness Score (PDSS). An increase in sleep disturbance has been associated with poorer perceived health in children with CF. There have been limited studies to date that report the perception of sleep importance in CF patients. We aim to characterize the perception of sleep importance in children with CF as measured through a self-reported questionnaire and identify barriers to sleep. Methods After IRB approval, subjects with CF aged 3-17 years were prospectively recruited from routine pulmonology clinic visits (n=28, 17 male). A questionnaire was provided consisting of 35 questions regarding sleep practices, perception of sleep importance, and PDSS. Recent pulmonary function tests (PFTs) were also collected. Results The mean PDSS was 11.3, with a range of 4 to 24. The questionnaire responses were as follows: 82% of participants reported sleep as “very important” overall, 92% reported sleep being “very important” for health, and 75% reported sleep being “very important” for lung function. In addition, 39% reported airway clearance as part of their nighttime routine and 89% reported utilizing electronic screens 2 hours prior to bed. The most frequent barriers to sleep identified were technology and bedtime resistance (14% each), and homework, excitability, and vest/airway treatments (11% each). 86% of participants had at least one symptom of disordered sleep. Conclusion Screening for sleep problems in the CF population may be beneficial and may contribute to improved quality of life. Further recruitment is ongoing. Support