Tue T Te, Mary Regina Boland, Sara Ghadimi, Joseph M Dzierzewski, Cathy Alessi, Jennifer L Martin, Sarah Kremen, Alex A T Bui, Arash Naeim, Constance H Fung
{"title":"Predicting subjective sleepiness during auditory cognitive testing using voice signaling analysis.","authors":"Tue T Te, Mary Regina Boland, Sara Ghadimi, Joseph M Dzierzewski, Cathy Alessi, Jennifer L Martin, Sarah Kremen, Alex A T Bui, Arash Naeim, Constance H Fung","doi":"10.1186/s41606-025-00141-y","DOIUrl":"10.1186/s41606-025-00141-y","url":null,"abstract":"<p><strong>Background: </strong>To determine whether objective markers of sleepiness can be collected passively using voice data to detect sleepiness in individuals undergoing testing in situations where sleepiness is not the focal point of assessment. We assessed verbal reaction time (VRT) as a vocalic marker of subjective sleepiness in middle aged and older adults with history of insomnia and benzodiazepine-receptor-agonist (BZRA) use.</p><p><strong>Methods: </strong>Adults aged ≥55 without a diagnosis of dementia were recruited from a BZRA deprescribing clinical trial and enrolled in the present study that tested the feasibility of cognitive testing using out-of-office, self-directed mobile apps. Participants' working/episodic memory were assessed through recorded verbal responses to Verbal Paired Associates (VPA) tests, and ecological momentary assessments (EMA) of self-reported sleepiness (1[not at all] to 4[more prominent]). Using a generalized additive model, we examined the association between VRT during VPA testing and self-reported sleepiness, adjusting for demographic, test parameters, caffeine intake, cognition, mood, and BZRA-use (<i>p</i>≤0.05 was considered significant). A stratified k-fold cross-validation/random forest (SKCV/RF) was performed to classify sleepiness levels, adjusting for other variables.</p><p><strong>Results: </strong>We analyzed 1,513 observations from 16 patients. VRT was operationalized as the time duration between recording start time and first speech epoch. Longer VRTs were positively associated with greater EMA sleepiness (<i>p</i>≤0.05). The SKCV/RF model yielded a mean F1-score of 0.80 ± 0.08 across folds.</p><p><strong>Conclusions: </strong>Longer VRTs correlated with greater self-reported sleepiness, indicating that voice data can be used as a marker of sleepiness in patients undergoing cognitive testing in out-of-office settings.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1186/s41606-025-00141-y.</p>","PeriodicalId":520302,"journal":{"name":"Sleep science and practice","volume":"9 1","pages":"19"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Krista M Greeley, Rachel M Lee, Joshua Tulk, Scott V Harding, Yanqing Yi, Kris Aubrey-Bassler, Sheila N Garland
{"title":"Recording and reporting of adverse events during a randomized controlled trial of cognitive behavioural therapy for insomnia (CBT-I) among cancer survivors.","authors":"Krista M Greeley, Rachel M Lee, Joshua Tulk, Scott V Harding, Yanqing Yi, Kris Aubrey-Bassler, Sheila N Garland","doi":"10.1186/s41606-025-00129-8","DOIUrl":"https://doi.org/10.1186/s41606-025-00129-8","url":null,"abstract":"<p><strong>Background/aims: </strong>Sleep disturbances are one of the biggest barriers to resuming normal functioning following cancer treatment. Cognitive behavioral therapy for insomnia (CBT-I) has demonstrated efficacy in cancer survivors but few studies have recorded adverse events (AEs) that occur during treatment. The purpose of this study was to report the prevalence, severity, and attribution of AEs during CBT-I with cancer survivors.</p><p><strong>Methods: </strong>Cancer survivors from Atlantic Canada with insomnia and comorbid cognitive impairment were recruited to participate in a randomized controlled trial of CBT-I. Participants reported the prevalence, severity, and attribution of AEs at mid-treatment (4 weeks) and post-treatment (8 weeks). The likeliness of AEs being related to treatment was also rated by an independent clinician.</p><p><strong>Results: </strong>Of the 122 cancer survivors who completed treatment (<i>M</i> <sub><i>age</i></sub> = 60.3, 77.9% women), 72 reported a total of 197 AEs. At mid-treatment, participants reported 113 AEs, but only 11 were rated as being attributed to the intervention. At post-treatment, participants did not report any AEs attributed to the intervention. An independent rater attributed more AEs to the treatment than the participants at both time points (4 weeks: 16 vs. 11, 8 weeks: 1 vs. 0). Gender (<i>p</i> = .014) and pre-treatment anxiety (<i>p</i> < .001) were associated with reporting an AE.</p><p><strong>Discussion: </strong>CBT-I is a safe treatment that is well-tolerated by cancer survivors. The majority of participants did not experience AEs that could be attributed to the treatment. Clinicians should continue to recommend CBT-I as the first-line treatment for cancer survivors experiencing insomnia symptoms.</p><p><strong>Trial registration: </strong>This study is a secondary analysis of a randomized controlled trial titled 'Addressing Cancer Treatment-Related Insomnia Online in Atlantic Canada (ACTION) study' (https://www.clinicaltrials.gov/search?cond=NCT04026048 identifier: NCT04026048).</p>","PeriodicalId":520302,"journal":{"name":"Sleep science and practice","volume":"9 1","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Orsolya Kiss, Anne Arnold, Helen A Weiss, Fiona C Baker
{"title":"The relationship between sleep and menstrual problems in early adolescent girls.","authors":"Orsolya Kiss, Anne Arnold, Helen A Weiss, Fiona C Baker","doi":"10.1186/s41606-024-00111-w","DOIUrl":"10.1186/s41606-024-00111-w","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescence is marked by hormonal, physical, neural, and behavioral changes, including in sleep patterns and, in females, the onset of menarche. Menstrual problems, such as painful menses, are common and contribute to school absences, and could indicate gynecological conditions impacting reproductive health. While studies in adults have shown associations between sleep disturbances and menstrual problems, this relationship is less understood in adolescents. Our study explores the association between sleep, menstrual problems, and menarche in a diverse sample of early adolescent girls in the U.S.</p><p><strong>Methods: </strong>We used linear mixed-effect models to analyze associations between sleep behavior (self- and caregiver-reported) and menstrual problems (self-reported cycle irregularity, premenstrual symptom and menstrual pain severity and their impact on daily life) and menstrual characteristics (menstrual flow) in 3,037 post-menarcheal adolescent girls (Mean age:13.03 years) from the ABCD Study®. Covariates included years since menarche, race, ethnicity, parental education, and body mass index. We also used longitudinal data to explore changes in sleep behavior as a function of menarche.</p><p><strong>Results: </strong>Of the sample, 26.2% reported moderate-severe premenstrual symptoms and 20.8% reported moderate-severe menstrual pain. 23.3% reported irregular menstrual cycles, 15.9% reported heavy menstrual flow. Shorter sleep duration was associated with greater menstrual pain intensity (β =-0.19) and impact on daily activities (β = -0.15), irregular cycles (β = -0.17), and severe premenstrual symptoms (β = -0.04). Higher sleep disturbance scores correlated with greater menstrual pain (β = 0.18) and premenstrual symptom severity (β = 0.03). Later wake-up times were linked to greater menstrual pain intensity (β = 0.14). Shorter time since menarche was associated with lower menstrual flow (β = 0.07) and pain intensity (β = 0.51) and less severe premenstrual symptoms (β = 0.07). Being post-menarche was associated with later bedtimes and shorter sleep duration.</p><p><strong>Conclusion: </strong>Findings of links between sleep behavior and menstrual problems in early adolescence underscore the importance of addressing sleep and menstrual issues in healthcare screenings and educational initiatives for adolescents. Future research should focus on longitudinal and intervention studies to clarify these relationships.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1186/s41606-024-00111-w.</p>","PeriodicalId":520302,"journal":{"name":"Sleep science and practice","volume":"8 1","pages":"20"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142735510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}