Sleep Medicine Commons^™

Fatigue And Circadian Disruption In Long-Haul Ferry Pilots: Human Factors Challenges And Mitigation Strategies, Parneet Makkar

Discovery Day - Daytona Beach

Fatigue and circadian rhythm disruption present significant human factors challenges in long-haul aviation operations, particularly for ferry pilots (pilots responsible for transporting aircraft long distances between locations) who often travel across multiple time zones before beginning flight duties. Circadian rhythms regulate the human sleep-wake cycle and are closely tied to cognitive performance, alertness, and coordination. Rapid travel across time zones can disrupt these rhythms, producing symptoms commonly associated with jet lag such as sleep disturbances, fatigue, and reduced cognitive functioning. For ferry pilots, long travel periods and irregular schedules may increase the likelihood of fatigue before flight operations even begin. …

Relaxation Activities And The Effects Of Sleep Quality On High-Achieving Females, Kaitlynn Cusipag

InnovateHER Meeting 2026

The overall goal of this study was to help improve the sleep quality of high-achieving female high school students. This study’s goal was to determine whether the difficulty of crossword puzzles and coloring pages had an impact on sleep quality and stress levels. Sleep is crucial for the well-being and daily performance of teenagers

Restless Legs Syndrome And Neurological Comorbidities: A Narrative Review, Kyrillos Ghattas, Helen Hernandez, Yongwoon Huh, Zhanna Fast, Zhikui Wei

Department of Sleep Medicine Faculty Papers

Restless legs syndrome (RLS) is a common yet underrecognized neurological disorder characterized by uncomfortable sensations and an irresistible urge to move he legs, typically following a circadian pattern. RLS frequently co-occurs with various other neurological diseases, raising questions about shared mechanisms and clinical consequences. This review synthesizes evidence on the prevalence, outcomes, and pathophysiology of RLS in various neurological disorders, including Parkinson's disease, multiple sclerosis, migraine, dementia, stroke, epilepsy, and peripheral neuropathy. In Parkinson's disease, RLS is linked to disease progression and dopaminergic therapy. In stroke and multiple sclerosis, RLS is associated with structural lesions at specific locations, such as …

Neuroplasticity And Hippocampal Impacts Associated With Obstructive Sleep Apnea, Rumaysa Aliniazee

COD Library Student Research and Award Symposium

A review on the implications of Obstructive Sleep Apnea (OSA) and Hippocampal Brain Health. It explores the role of sleep medicine, its effect on the hippocampus, its influence on cognitive function, and emphasizes the need for continued research and intervention to preserve cognitive health.

Faculty Sponsor:  Professor Felipe Armas

What Is Screen Apnea And How Does It Affect You?, Kristi M. Soileau

New Orleans Dental Association News

Screen apnea is a modern epidemic of significant proportions. Research suggests that nearly 80% of people unconsciously alter their breathing, often holding their breath or breathing shallowly, while working on digital devices. This subtle shift in respiration, sometimes called “email apnea,” can place the body into a low-grade stress response without being noticed by the individual at the screen. When breathing becomes restricted from poor posting or content anxiety, the nervous system enters into a sympathetic response, much as it interprets signs of threats to that person. The resultant physiological response may be exhibited by muscle tension, mental fog, increased …

Comparison Of Ecg Features, Cardiac Biomarkers, And Clinical Outcomes In Three Waves Of Hospitalized Covid-19 Pneumonia Patients With Cardiovascular Events, Yuchen Han, Jahnavi Sunkara, Tshura S Ali, Harideep Samanapally, Vidyulata Salunkhe, Fnu Deepti, Emma C. Huang, Justin J. Huang, Maiying Kong, Jiapeng Huang

The University of Louisville Journal of Respiratory Infections

Background

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a rapidly evolving virus that can severely impact the cardiovascular system. With new variants, it is important to characterize wave-specific (defined by dominant circulating variants) clinical changes.

Methods

A multi-center retrospective cohort study of patients hospitalized with SARS-CoV-2 community acquired pneumonia at eight adult acute-care hospitals in the city of Louisville, KY was conducted. Patients hospitalized with Coronavirus Disease 2019 (COVID-19) community acquired pneumonia who experienced a cardiovascular event between March 2020 and July 2022 were included in this analysis. Variant assignment was based on temporal prevalence rather than genomic confirmation, and …

Sleep In Children In Foster Care: A Scoping Review, Juan Castellanos, Anna Wani, Jill Mcleigh

Health Status, Outcomes, and Literacy and Healthcare Utilization

Although the focus on sleep disturbances in children who have experienced adversity has increased, little is known about sleep among children in foster care (CFC). This study aimed to review what research tells us about the relationship between foster care experience and sleep disturbances and to identify knowledge gaps.

For questions about this study or others, please email [email protected]

childrens.com/fostercare

Quantifying Sleep Wake Rhythms In The Hospital Environment With Digital Technologies, Carsten Skarke, Nadim El Jamal, Michael V. Genuardi, Thomas G. Brooks, Antonijo Mrčela, Nicholas F. Lahens, Makayla Cordoza, Sean Sarles, Amarachi Mbadugha, Dineth R. Karunamuni, Shikhar Gupta, Charles J. Bae, Amita Sehgal, Thomas P. Cappola, Jacob T. Gutsche, Pavan Atluri, Nimesh D. Desai, Michael A. Acker, Gregory R. Grant, Richard J. Schwab, Ilene M. Rosen, Garret A. Fitzgerald

Division of Cardiology Faculty Papers

Postoperative clinical care is prone to circadian desynchronization that may influence health outcomes. In an exploratory, feasibility-oriented and signal-exploration effort, we collected 1.8 million data points using 11 remote sensors during preoperative, in-hospital and post-discharge settings in 13 elective cardiac surgery patients (5.2% enrolled from 252 screened). We found that room traffic continued during nighttime with ≥1 visit/h. Sound levels exceeded the recommended 45 dBA threshold (51.9 ± 3.3 vs. 48.3 ± 4.2 dBA during nighttime). Brightness dropped at night (89.9 ± 87.7 to 3.7 ± 9.8 lux), but bright light exposures occurred. Ambient room temperature lacked sleep-inducing diurnal variability. …

Examining The Relationship Between A Positive Obstructive Sleep Apnea Diagnosis And Referring Symptoms Of The Pregnant Patient, Christina Emerson, Beth Tremblay

Knowledge and Creativity Expo

PROBLEM: Many healthcare providers do not routinely screen pregnant individuals for obstructive sleep apnea (OSA), contributing to its underdiagnosis and potentially leading to various pregnancy-related health issues. Currently used OSA screening tools, such as the Berlin Questionnaire, STOP-BANG Questionnaire, and Epworth Sleepiness Scale, often demonstrate poor predictive value in pregnant women due to the dynamic physiological changes of pregnancy and the differing presentation of OSA in this population.

PURPOSE: To examine the relationships between a positive OSA diagnosis, patient characteristics, and the symptoms among pregnant patients referred for sleep studies.

EBP QUESTIONS: 1) Is there a relationship between certain referring …

Craniofacial Differences And Safe Sleep Practices: Findings From A Caregiver Survey At A Children’S Hospital, Cait Vuturo-Brady, Aracelia S. Aldrete, Jesus Gil Inciong, Miccah Seaman, Rianna Leazer

Knowledge and Creativity Expo

Purpose

Many infants with cleft lip and/or palate (CL/P) have airway issues that make supine, flat-surface sleep challenging.¹ Prior studies indicate that alternative positioning may reduce obstructive events,² and early sleep-disordered breathing can affect later development.³  Despite this, caregivers of infants with craniofacial differences rarely receive tailored sleep guidance, and no evidence-based, condition-specific recommendations currently exist.^4,5

Methods

This single-site, cross-sectional study evaluated sleep practices, caregiver education, and barriers to adherence among parents of children (< 3 years) with CL/P treated at CHKD’s Craniofacial Program. Eligible caregivers (n=117) were identified via query of the electronic medical record by CHKD Data Governance and invited to complete an anonymous REDCap survey assessing demographics, sleep environment, counseling, and understanding of safe-sleep recommendations.

Results & Conclusions

Of the 11 caregivers who completed the survey, 91% reported crib sleep, though several also used beds, couches, …

Feasibility And Form Factor Validation Of Reflective Shoulder-Mounted Pulse Oximeter In Patients With Suspected Sleep Apnea, Katie N. Kanter, Aaron Wang, David Gordon, Adina Singer, Jacob S. Brenner, Indira Gurubhagavatula, Anush Lingamoorthy, Olumuyiwa Oni, Cameron M. Baston

SKMC Student Presentations and Publications

The shoulder may be an effective central site for continuous oxygen saturation (SpO2) monitoring but studies of shoulder-mounted pulse oximetry technology are limited. We hypothesized that an alternative location would be similar in function and user acceptance to a standard FDA-cleared finger-based pulse oximeter. We conducted a quantitative and descriptive pilot study of two prototype biosensor designs in patients with clinical suspicion of hypoxic episodes at an outpatient sleep center. Participants wore two prototype biosensors-the primary a shoulder-mounted adhesive and the secondary a combination ring-bracelet-in addition to a control FDA-approved finger-based pulse oximeter. We assessed the comfort of the devices …

Substitution Of Cannabis For Prescribed Medications In The Management Of Anxiety And Depression Among Midlife Women: A Cross-Sectional Study, Jocelyn Mueller, Jamia Sapp, Jennifer Attonito, Aditya Chakraborty, Karina Villalba

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background and Aims

Given the rising prevalence of cannabis use as an alternative strategy for managing mental health symptoms, there is a crucial need to understand the determinants of substitution behavior, particularly among midlife women who may experience distinct psychosocial and clinical profiles. This study examined the predictors of cannabis substitution among midlife women by comparing profiles of women who substituted cannabis for antidepressant medications versus those who substituted for anxiolytic medications.

Methods

A cross-sectional survey of 172 women who reported substituting cannabis for either anxiety or depression medications was conducted. Measures included the PHQ-8, OASIS, AUDIT, and ACEs. Logistic …

The Effects Of Antidepressant Medications On Sleep Quality In Dominican University Of California Students, Natalie L. Davis, Kenna Wohlford, Stephanie Lee

Physician Assistant Studies | Graduate Research Papers

We spend approximately one third of our life time sleeping or attempting to sleep. The quality of our sleep is equally, if not more important than the amount of sleep we get. This study assesses the effects that medications, specifically antidepressants, can have on sleep quality in Dominican University of California students. 118 participants completed a Qualtrics survey including questions regarding stress, sleep quality, medication lists, and demographics. This study utilized the Pittsburgh Sleep Quality Index (PSQI) to quantify participants’ sleep quality as the outcome. Participant stress levels were assessed with a Likert scale question asking for stress levels on …

Persistent Hypoxemia On Home Sleep Apnea Testing Prompting Further Evaluation For Pulmonary Embolism: A Case Report, Kyle Admire, Andrew Githaiga

Department of Medicine Faculty Publications

Obstructive sleep apnea is a condition characterized by recurrent upper airway collapse during sleep, which may be associated with sleep disruption and repetitive oxygen desaturations. It is diagnosed by nocturnal in-lab polysomnography or home sleep apnea testing. We present a case of an otherwise healthy individual who had home sleep apnea testing that revealed persistent, unexplained hypoxemia which, on further investigation, was found to be due to a saddle pulmonary embolism.

Feeding Mode Is Associated With Infant Night Sleep Trajectories During The First Postnatal Year, Magdalena Olson, Li Liu, Elizabeth Reifsnider, Dean V. Coonrod, Sarada S. Panchanathan, Megan E. Petrov, Corrie M. Whisner

Ellmer School of Nursing Faculty Publications

Background: Short sleep and formula feeding during infancy are associated with increased risk of childhood obesity. Feeding practices and sleep arrangements vary during infancy and may also be dynamic, yet their impact on infant night sleep duration remains unclear. Understanding these relationships is crucial for formulating recommendations to support breastfeeding and address sleep concerns. Objective: We examined the association between feeding mode and parent-reported infant night sleep duration during the first postnatal year, while additionally evaluating night-weaning and bedsharing as contextual sleep-related practices. Methods: Infants in the Phoenix Metropolitan Area (n = 193) were followed up at 3, 8, 13, …

The Relationship Between Physical Activity, Sleep, And Hallucinations In Adults With Charles Bonnet Syndrome, Jarrod Hollis, Rohit Narayan, Eldre W. Beukes, Rosie Lindsay, Aliyah Bharwani, Umair Mughal, Ikra Yaqoob, Justin A. Haegele, Scott Muriden, Peter M. Allen

Human Movement Studies & Special Education Faculty Publications

Physical activity levels, hallucination experiences, sleep quality, and perceived stress were assessed using a survey administered to 57 adults with a confirmed diagnosis of Charles Bonnet Syndrome (CBS). Physical activity demonstrated a significant negative correlation with hallucination severity (r = –0.335, p = 0.011, two-tailed). A significant negative correlation was also observed between physical activity and perceived stress (r = –0.497, p < 0.001, two-tailed). In contrast, no significant association was identified between hallucination frequency and sleep disruption or insomnia. These findings suggest that engaging in appropriate levels of physical activity may help reduce the severity of hallucinations and mitigate stress among individuals with CBS. The observation that higher levels of physical activity are associated with reduced hallucination burden may help the development of evidence-based management strategies for CBS. Additionally, the finding that physical activity was significantly related to hallucination severity, whereas sleep disruption was not, merits deeper exploration in future research.

Rude Awakening: An Examination Of The Incivility-Sleep Relationship Via Affect, Mallory A. Mccord, Gargi Sawhney, Nastassia M. Savage, Kristen M. Fisher

Psychology Faculty Publications

Despite the prevalence of incivility at work and the essential nature of sleep, study of this relationship is comparatively sparse in the organizational sciences literature. Further, although impaired sleep could logically impact how one interprets subsequent interpersonal interactions at work, the dominant approach is to study sleep as an outcome of perceived incivility. Therefore, we drew upon affective events theory, the affect-as-information hypothesis, and sleep physiology to argue that state affect, both positive and negative, can explain the relationship between perceived incivility and sleep quality in either direction. The hypotheses were tested using a between-subjects design with one-month time lags …

Associations Between Accelerometer-Measured Physical Activity And Sleep Duration And Health Indicators In Children And Adolescents With Attention-Deficit Hyperactivity Disorder: A Systematic Review And Meta-Analysis, Xiao Liang, Hui Qiu, Justin A. Haegele, Xiao Li, Minghui Li, Jiayue Li, Shirley Xin Li

Human Movement Studies & Special Education Faculty Publications

Objective

This systematic review and meta-analysis synthesized available studies to explore relationships between accelerometer-measured physical activity (PA) levels or sleep duration and health-related outcomes in children and adolescents with attention-deficit hyperactivity disorder (ADHD).

Methods

Following the Preferred Reporting Items for Systematic Review and Meta-analyses guidelines, the six databases APA PsychInfo, CINAHL Ultimate, Embase, MEDLINE, SPORTDiscus with Full Text and Web of Science were searched from inception through July 2024. The correlation coefficient (r) was employed to determine the effect size in the meta-analysis. A random-effects model was utilised to estimate the potentially heterogeneously distributed effect sizes with a 95 % …

The Effects Of Physical Activity Timing And Adherence To Physical Activity Guidelines On Sleep In Children With Adhd, Xiao Liang, Mengping Zhao, Li Su, Justin A. Haegele, Richard H. Xu, Jingjing Li, Andy Choi-Yeung Tse, Shirley X. Li

Human Movement Studies & Special Education Faculty Publications

Regular physical activity (PA) has been shown to benefit sleep. However, the effects of PA timing and adherence to the WHO's recommended 60-min moderate-to-vigorous physical activity (MVPA) guideline on sleep are unclear, especially for children with ADHD who often experience sleep problems. This study examined whether timing of MVPA influenced objectively measured sleep, including sleep latency (SL), sleep efficiency (SE), total sleep time (TST), and wake after sleep onset (WASO), among children with ADHD. This cross-sectional study involved 253 children with ADHD (Mage = 8.60 ± 1.31 years, 81% boys). MVPA timing was categorized as more than 8 h before …

Progression Of Mild Sleep-Disordered Breathing In Children Managed With Watchful Waiting, Erin M. Kirkham, Stacey Ishman, Susan Garetz, Cristina M. Baldassari, Ron B. Mitchell, Christopher Liu, Ignacio E. Tapia, Lisa M. Elden, Fauziya Hassan, Sally Ibrahim, Kristie Ross, Mengqi Cen, Rui Wang, Susan Redline, Ronald D. Chervin

Department of Otolaryngology (ENT) Faculty Publications

Purpose

To identify clinical characteristics that may be associated with persistence or progression of mild sleep-disordered breathing (SDB) in children who are observed without surgery.

Methods

This is a secondary analysis of the control arm of the Pediatric Adenotonsillectomy Trial for Snoring (PATS), which randomized 458 children aged 3.0 to 12.9 years with mild SDB (snoring with obstructive apnea-hypopnea index [oAHI] <  3 events/hour) to early adenotonsillectomy (eAT) versus watchful waiting with supportive care (WWSC). Participants were assessed at baseline and 12 months with the Pediatric Sleep Questionnaire-Sleep-Related Breathing Disorder (PSQ-SRBD) scale and polysomnography (PSG). We tested for factors predictive of either (1) PSG progression defined by a 12-month oAHI ≥ 3 or (2) symptom persistence or progression defined by a 12-month PSQ-SRBD score ≥ 0.33.

Results

A total of 234 participants were observed (mean age 6.2 years, 111 [47%] female, 65 [28%] Black or African American, 37 [16%] Hispanic). Overall, only 13% (n = 20/150) progressed to an oAHI ≥ 3 on repeat PSG, …