SLEEP 2011 Abstract Supplement

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B. Clinical Sleep Science IX. Psychiatric and Behavioral Disorders and Sleep NART-R, WTAR, Symbol Digit Modalities Test, Trail Making Test parts A & B, Seashore Rhythm Test, Speech Sounds Perception Test and the PASAT. Results: Preliminary results revealed a significant interaction between the self-reported symptom of being tired with type of ADD diagnosed (i.e.ADD vs.ADD Plus) on PASAT trial 1 scores F(1,1106)=6.10, p=.014 and on PASAT trial 2 scores F(1,1095)=6.35, p=.012. Post hoc tests revealed an opposing effect of being tired for diagnosis of ADD vs. ADD plus on performance scores for both trials. A significant main effect for the self-reported symptom of finding it difficult to complete tasks was found to influence performance on PASAT trial 3 scores F(3,873)=3.45, p=.016. Conclusion: Findings indicate that tiredness and attention symptoms affect performance differentially in the two groups ADD and ADD plus. 0726 SLEEP INFLUENCE ON CARDIAC ACTIVITY IN ADULTS WITH AUTISM Pelletier M 1,4 , D’Antono B 2,5 , Chevrette T 1,4 , Mottron L 3,4,5 , Godbout R 1,4,5 1 Sleep Laboratory & Clinic, Hôpital Rivière-des-Prairies, Montreal, QC, Canada, 2 Research Center, Montreal Heart Institute, Montreal, QC, Canada, 3 Centre d’Excellence en Troubles Envahissants du Développement de l’Université de Montréal, University of Montreal, Montreal, QC, Canada, 4 Centre de Recherche Fernand-Seguin, Hôpital Rivière-des-Prairies, Montreal, QC, Canada, 5 Department of Psychiatry, University of Montreal, Montreal, QC, Canada Introduction: Poor sleep is a frequent finding in autism and it has been shown to interfere with daytime functioning, using either behavioral (Limoges et al., 2005) or EEG measures (Daoust et al., 2004). Literature in typically developing individuals (TD) shows that sleep also influences the regulation of the autonomic nervous system so that the sympathovagal tone is normally higher in the morning compared to evening values. Studies of electrocardiographic (ECG) recordings suggest that there might be disequilibrium between sympathetic and parasympathetic activity in autism (Ming et al., 2005) but it is not known whether this observation is related to sleep or not. Methods: Fifteen men with ASD (22.3 ± 3.5 years) and 18 typically developing individuals (TD: 21.0 ± 4.2 years) were evaluated over two consecutive nights in a sleep laboratory. ECG samples were taken for 5 minutes at bedtime and just before final rise time in the morning. Spectral analysis of the ECG signal was performed using a commercial software and the following four variables were extracted: total spectral power, low frequency power (LF: sympathetic tone), high frequency spectral power (HFabs: parasympathetic tone), normalized values of high frequency spectral power (HFnu). Groups were compared with Student’s t-tests. Results: Significant differences between evening and morning values were found only in the TD group, with lower evening values for total spectral power (p=0.008), LF (p=0.007) and HFabs (p=0.040) were all lower in the evening compared to morning. In the morning, significantly lower HFabs (p=0.043) and HFnu (p=0.027) values were found in ASD vs. TD groups. Conclusion: These results suggest that the effect of nocturnal sleep differs in TD and ASD individuals and that the parasympathetic tone is lower in ASD at rise time. Further analyses will focus on ECG activity during sleep, for each of the sleep stages. Support (If Any): Supported by the Canadian Institutes of Health Research and the “Fonds de la recherche en santé du Québec”. 0727 POOR SUBJECTIVE SLEEP WITH NORMAL OBJECTIVE SLEEP DURATION INCREASES RISK OF SUICIDAL IDEATION AND/OR ATTEMPTS Singareddy R 1 , Vgontzas AN 1 , Fernandez-Mendoza J 1 , Calhoun S 1 , Shaffer M 2 , Bixler EO 1 1 Sleep Research & Treatment Center, Penn State College of Medicine, Hershey, PA, USA, 2 Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA Introduction: Subjective sleep disturbances are associated with suicidal ideation and/or attempts (suicidal behavior =SB). Similarly, objective sleep disturbances were found to be associated with SB in clinical samples. One actigraphic study in non-clinical sample (n=49; ages 19-24) found sleep variability to be associated with SB, but was limited by lack of polysomnographic data. In this study we examined the association of polysomnographic (PSG) and subjective sleep with SB in general population. Methods: A subsample of 1741 (age >20) out of 16,583 randomly selected adults from general population underwent comprehensive assessment (history, physical examination) including suicidal ideation/attempts (SB) and PSG. Results: The prevalence of lifetime SB was 5.7%. Females (p=.011) and subjects with poor subjective sleep (p/=6hr of PSGsleep in comparison to poor subjective sleep and /=6hr of PSGsleep was 2.52 (CI:1.22-5.19). Conclusion: Subjective poor sleep with normal PSG sleep duration (>/=6hr) is associated with increased risk of suicidal behavior. It is possible that individuals with poor subjective sleep but normal objective sleep may have underlying poorer coping resources and more anxiety/ rumination which may increase the risk of suicide. Support (If Any): National Institutes of Health grants RO1 51931 & RO1 40916 0728 SHARED METACOGNITIVE PROCESSES IN INSOMNIA AND ALCOHOL DEPENDENCE Hairston IS 1 , Conroy DA 1 , Arnedt J 2 , Armitage R 2 , Brower K 1 1 Substance Abuse Section, Psychiatry, University of Michigan, Ann Arbor, MI, USA, 2 Psychiatry, University of Michigan, Ann Arbor, MI, USA Introduction: Alcohol-dependent (AD) individuals typically report sleeping poorly. Investigations of the relationship between AD and insomnia largely focus on the impact of alcohol on brain function and on self-medication. However, a feature common to insomnia and addiction is ruminative preoccupation with sleep or alcohol, respectively. Such intrusive thought processes can be interpreted as metacognitions similar to depressive rumination. This investigation assessed whether abstaining alcoholics with insomnia (AD-INS) differed from alcoholics without insomnia (AD-NINS) and healthy controls (HCs), in their preoccupation with sleep quality. Methods: All subjects were recruited from the community. HCs (N=11) had no Axis I disorders. The AD-INS group (N=16) met research diagnostic criteria for insomnia, and the AD-NINS (N=15) did not. Both AD groups stopped drinking 3-12 weeks before the study; all participants adhered to an 11p-6a sleep schedule and completed daily sleep diaries at home for 1 week. Instruments included 3 ruminative scales—the Anxiety and Preoccupation about Sleep Questionnaire (APSQ), Response SLEEP, Volume 34, Abstract Supplement, 2011 A250
B. Clinical Sleep Science IX. Psychiatric and Behavioral Disorders and Sleep Styles Questionnaire (RSQ), and Obsessive-Compulsive Drinking Scale (OCDS), and the Insomnia Severity Index (ISI) for insomnia. Results: Independent of insomnia diagnosis, alcoholics scored higher on the ISI (p=.001) and OCDS (p=.002), but only the AD-INS group rated higher than controls on the APSQ (p=.008) and the RSQ (p=.003). In ADs only, and controlling for insomnia diagnosis, APSQ was significantly correlated with ISI (R2=.693), RSQ (R2=.525), and with the ‘obsessive thoughts’ OCDS subscale (R2=.488). RSQ was not correlated with the ISI or OCDS. Conclusion: These findings suggest that subjects with AD-INS have global ruminative thought processes that encompass self-focused depressive thoughts (RSQ), preoccupation with sleep (APSQ), and preoccupation with alcohol (OCDS). Conversely, depressive rumination was not associated with thinking about drinking. Combined, these observations can be interpreted to indicate that primary insomnia and alcohol dependence share common cognitive processes that play a role in maintaining the disorders. Support (If Any): R37 AA007065-22S1, NIH-NIAAA R01 AA016117, NIH-NIAAA 0729 SLEEP DISTURBANCES AMONG FORMER HEROIN ADDICTS WITH AND WITHOUT METHADONE MAINTENANCE TREATMENT: A CASE-CONTROL STUDY Lee H 1,2,3 , Chen C 1,2 , Wang S 4 1 Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, 2 Department of Psychiatry, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan, 3 Sleep Center, Taipei Medical University Hospital, Taipei, Taiwan, 4 Division of Mental Health and Substance Abuse Research, National Health Research Institute, Miaoli County, Taiwan Introduction: Poor sleep quality has been reported to be commonly seen among heroin addicts. Although methadone maintenance treatment (MMT) could help patients in recovery from heroin dependence, the majority of MMT patients remained suffering from sleep disturbances. However, studies in this field have received little attention. Thus, this study aims to investigate the distributions of sleep disturbances and their associations with psychological distresses and quality of life among MMT patients, compared with former heroin addicts without MMT. Methods: The study cohort included 82 MMT patients. Besides, 88 previous heroin addicts not receiving MMT were collected for comparison. All subjects received overnight ECG monitoring at home for the assessment of cardiopulmonary coupling during sleep. Patients filled out valid questionnaires including the Chinese Pittsburgh Sleep Quality Index (CPSQI), the Epworth Sleepiness Scale (ESS), the Insomnia Severity Index (ISI) and WHO Quality of Life-Brief version (WHOQOL-BREF) at next morning. Specific sleep disorders and comorbid psychiatric disorders were assessed by clinical interview. Results: More than two thirds (67.9%) of MMT patients suffered from poor sleep quality and one forth (25.6%) of them reported excessive daytime sleepiness. Compared to patients not receiving MMT, MMT patients were more likely to have poor sleep quality indicated by higher mean scores in CPSQI, ESS and ISI. MMT patients reported poorer quality of life. There were no significant differences in the distribution of specific sleep disorders and cardiopulmonary coupling during sleep between former heroin addicts with and without MMT. Conclusion: Our study indicated that MMT patients were more likely to suffer from sleep disturbances than previous heroin addicts not receiving MMT. Furthermore, poor sleep quality among MMT patients could lead to poor quality of life. The associations between sleep disturbances and psychiatric co-morbidities were also demonstrated among this specific population. Support (If Any): This study was supported by a grant from the National Science Counsil in Taiwan (NSC 98-2314-B-038-026-MY2). 0730 SLEEP CONTINUITY IS IMPAIRED AS A FUNCTION OF AVERAGE NUMBER OF DAILY CIGARETTES AND TIME SINCE SMOKING ONSET IN OTHERWISE HEALTHY SMOKERS Soreca I, Conklin C, Richardson A, Mumma J, Wettlaufer B, Curet D Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA Introduction: Cigarette smoking is the most important cause of preventable morbidity and premature death in the United States. In addition to adverse effects on respiratory, cardiovascular and cerebrovascular systems, cigarette smoking may also increase morbidity by impairing sleep. Most of the empirical evidence on the detrimental effects of smoking on sleep is based on population surveys and self-report measures. Moreover, virtually no study to date has investigated the effects of cigarette smoking on sleep by segregating them from the effects of smoking-related medical comorbidities, such as sleep disordered breathing. The aims of this study are 1) to objectively investigate behavioral correlates of sleep by means of wrist actigraphy in otherwise healthy smokers and 2) explore the relationship between sleep characteristics and smoking history. Methods: 10 otherwise healthy smokers, who had been smoking at least 10 cigarettes/day for the past year, wore a wrist actigraph on their nondominant arm to objectively establish habitual sleep patterns for two weeks. Time since onset of smoking, maximum amount of cigarettes per day and current amount of cigarettes per day were derived from the Smoking History Form (SHF II) Results: Current average number of cigarettes per day and time since smoking onset were associated with higher sleep fragmentation index (r-.86, p=.006 and r=.84, p=.008 respectively) after adjusting for age. Conclusion: Cigarettes smoking impairs sleep continuity even in the absence of sleep disordered breathing and other medical comorbidities. The degree of impairment is related to current severity and duration of smoking. Support (If Any): NIDA 1R01DA027508 - 01 0731 EFFECTIVE TRANSLATION OF THE PITTSBURGH SLEEP QUALITY INDEX INTO URDU Surani A 1 , Hesselbacher S 2 , Khaliqdina JS 1 , Subramanian S 2 , Surani S 2,3 1 Dow University of Health Sciences, Karachi, Pakistan, 2 Section of Pulmonary, Critical Care, and Sleep Medicine, Baylor College of Medicine, Houston, TX, USA, 3 Department of Medicine, Texas A&M University, Corpus Christi, TX, USA Introduction: The Pittsburgh Sleep Quality Index (PSQI) is a questionnaire used in English speaking countries for assessment of sleep quality and disturbances in patients with psychiatric disorders. The instrument has been translated into many languages; it has not yet been validated in the Urdu-speaking population. Our purpose was to translate and validate the PSQI for use in Urdu-speaking countries. Methods: The original PSQI was translated into Urdu (PSQI-Ur) in three phases: translation and back-translation, committee-based translation, and testing in bilingual individuals, before final approval of the PSQI-Ur version. Subsequently, a prospective study was performed in healthy bilingual subjects to assess the validity of the PSQI-Ur version compared to the original PSQI in the English version. Results: Both English and Urdu versions of the PSQI were administered to 89 bilingual subjects (67% female, age range 15-70 years) in random order. The mean (± s.d.) global PSQI score was 5.73 ± 2.54 in English language and 5.63 ± 2.59 in the PSQI-Ur (p=1.00). The PSQI-Ur score was highly correlated with the English PSQI (rho=0.944, p
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JOURNAL OF SLEEP AND SLEEP DISORDER
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EDITORIAL In June of 1986, roughly
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