SLEEP 2011 Abstract Supplement

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B. Clinical Sleep Science XIII. Sleep and Gender Methods: This was a retrospective cohort study. Using ICD-9 codes, we queried our medical records database to find women who had a delivery as well as an in-laboratory polysomnogram (PSG) done at our institution between January 2000 and June 2009. Charts of identified patients were reviewed and data regarding patient demographics, sleep study results, and pregnancy outcomes were abstracted. The first pregnancy with outcome information was selected for those with more than one pregnancy. The primary outcome was an APO composite compromised of: pregnancy induced hypertension (PIH), gestational diabetes (GDM), and early preterm birth (ePTB, ≤34 week). Absence of SBD was defined as an apnea hypopnea index (AHI) of
B. Clinical Sleep Science XIV. Instrumentation and Methodology 0942 THE IMPACT OF BLUE LIGHT ON ACUTE MELATONIN SUPPRESSION: IRRADIANCE AND DURATION RELATIONSHIP Rea MS, Figueiro M Lighting Research Center, Rensselaer Polytechnic Institute, Troy, NY, USA Introduction: The spectral sensitivity of melatonin suppression peaks close to 450 nm. A model of human circadian phototransduction was developed based on the neuroanatomy and neurophysiology of the human retina. This model has been used to successfully predict acute melatonin suppression of polychromatic light sources. The present study is aimed at providing a further, a priori test of the model using a previously described personal light delivery device. In addition, a more accurate estimate of threshold for human circadian phototransduction is provided. Methods: Each of 11 healthy adults (age 50 or older) experienced seven lighting conditions (dark, 0.7, 2, 7, 11, 20 and 65 microwatts/cm2) of 470-nm light. Blood and saliva samples were collected for 110 minutes. The first two samples were collected 10 minutes apart while subjects remained in the dark, after which the 470-nm light goggles were energized. During the first 30 minutes after lights were turned on, blood samples were collected every 10 minutes and saliva sample collection was interleafed five minutes after each blood sample collection. Results: Melatonin concentrations from both fluids were normalized and a 2 x 2 ANOVA (7 lighting conditions x 14 sample times) were performed. Results were consistent with model predictions. Threshold for melatonin suppression was between 0.7 and 2 microwatts/cm2 and significant suppression was observed only after 15 minutes of exposure to the highest irradiance. Conclusion: A priori predictions of acute melatonin suppression can be made using the model of human circadian phototransduction. Much lower levels of 470-nm light can suppress nocturnal melatonin. Implications for clinical applications include more confortable, less bright, and flexible light treatment delivery device. Support (If Any): NSF-EEC-0812056 and NYSTAR-C090145 0943 NEW TOOLS TO MEASURE LIGHT EXPOSURE, ACTIVITY AND CIRCADIAN DISRUPTION IN OLDER ADULTS Figueiro M, Rea MS Lighting Research Center, Rensselaer Polytechnic Institute, Troy, NY, USA Introduction: Sleep disturbances in older adults may result from lack of entrainment to the 24-hr day-night cycle due to low circadian light stimulus experienced by older adults. Clinicians will not embrace light treatment, such as blue light, until the relationships between sleep disturbances, circadian disruption and light exposures are established in the field. Several practical measurement problems exist for obtaining human circadian light-exposure data as they might relate to quantifying circadian disruption in older adults. Methods: Each of 18 healthy older adults (age 65 or older) wore a Daysimeter, three Dime-simeters and a commercially available wrist actigraph for seven consecutive days; all devices measured activity as well as light. Saliva samples were collected every 4 hrs. The Daysimeter is a head-worn device that places a calibrated red-green-blue (RGB) sensor package near the plane of the person’s cornea. The Dime-simeter also contains a calibrated RGB sensor package, but is dime-sized and can be worn as a pin, a pendant, attached to glasses, and on the wrist. Results: Phasor analysis was applied to the light and activity data from each device to quantify circadian entrainment. Like healthy young adults, but in contrast to persons with Alzheimer’s disease, healthy older adults have high phasor magnitudes, suggesting a good circadian entrainment. The phasors obtained with the different devices were correlated despite the significant differences in the absolute levels of light recorded by the different devices. Conclusion: The Daysimeter and Dime-simeter are tools that can be used to accurately measure light exposures as they affect the circadian system and can quantify circadian entrainment in older adults. The next step will be to deploy these devices among people with and without sleep disorders to determine if measured circadian disruption is related to sleep disturbances in older adults. Support (If Any): U01DA023822 and R01AG034157 0944 COMPARISON OF AN AMBULATORY SLEEP-STAGE RECORDER WITH OUTPATIENT ACTIGRAPHY AND SLEEP LOGS ACROSS A WIDE RANGE OF SLEEP PHENOTYPES Curtis BJ, Walker KA, Jones CR Neurology Department and Sleep-Wake Center, University of Utah, Salt Lake City, UT, USA Introduction: Wrist actigraphy (ACT) and sleep logs (SL) are validated techniques for estimating habitual sleep timing outside the laboratory. In 2009, Fabregas et al demonstrated reasonable agreement between a commercially available wireless sleep-stage recorder (“Zeo”) and both inpatient polysomnography and inpatient ACT in 10 healthy participants. Here we report the results of a 10-day outpatient protocol using this wireless system (WS), ACT, and SL in participants with a wide range of sleep phenotypes. Methods: Seventeen participants (11 female; ages 25-75; mean=51) completed the protocol. Sleep phenotypes were determined by CRJ using questionnaires and structured telephone interviews: Delayed Sleep Phase Syndrome (n=1); Sighted Non-24-Hour Sleep-Wake Syndrome (n=1); Narcolepsy (n=1); Advanced Sleep Phase Syndrome (n=2); Conventional Sleepers (n=5); Short Sleeper Syndrome (n=7). ACT data were collected using the Phillips Respironics Actiwatch-L (n=10) and Ambulatory Monitoring Inc. MicroMini-Motionlogger. Total sleep time (TST), initial sleep onset (ISON) and final sleep offset (FSOFF) were scored automatically using Actiware-Sleep 3.4 and Action-W 2.0 software. TST, ISON and FSOFF were scored automatically by the WS using an artificial neural network. Participants estimated daily ISON and FSOFF by SL. Correlation coefficients (r) between the WS and both ACT and SL for TST, ISON, and FSOFF were calculated across all 134 participant-nights. Results: There was a wide range of average TST, ISON, and FSOFF across all six sleep phenotypes by conventional, well-validated ACT: TST=287-484 min; ISON=15:26-03:58; FSOFF=04:32-18:44. The WS correlated well with ACT and SL: WS/ACT TST r=0.75; WS/SL TST r=0.74; WS/ACT ISON r=0.99; WS/SL ISON r=0.92; WS/ACT FSOFF r=1.00; WS/SL FSOFF r=0.93. Over all 134 participant-nights, WS estimated a lower TST relative to both ACT and SL: WS average TST=369 min; ACT average TST=396 min; SL average TST=425 min. Conclusion: Ambulatory WS TST was moderately correlated with TST from conventional, well-validated ACT and SL measures across both genders and a wide range of ages and sleep phenotypes. Further research is needed to determine whether the lower WS TST relative to ACT and SL is a measure of its ability to detect wakefulness during sleep. Support (If Any): NIH R01HL059596: Principle Investigator Louis J. Ptacek; Co-Investigator Ying-Hui Fu, University of California, San Francisco, CA, USA. NIH R01HL080978: Jeanne F. Duffy, Harvard Medical School, Division of Sleep Medicine, Boston, MA, USA A323 SLEEP, Volume 34, Abstract Supplement, 2011
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JOURNAL OF SLEEP AND SLEEP DISORDER
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EDITORIAL In June of 1986, roughly
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