DELAYED SLEEP PHASE SYNDROME CHARACTERIZES CIRCADIAN DISORDER IN PATIENTS WITH ACTIVE SLE
Bibliographic record
Abstract
PV053 / #179 Poster Topic: AS06 - Comorbidities Background/Purpose Poor sleep quality is a common complaint of patients with SLE. Although chronic sleep disruption is known to drive circadian rhythm disorders, the effects of poor sleep quality have not yet been elucidated in SLE. Actigraphy is a validated approach to objectively assess 21 sleep variables and motor activity using a noninvasive accelerometer. In addition, actigraphy can characterize circadian dysfunction by assessments of activity. We examine the relationship of actigraphy data from patients with SLE with 1) disease activity and 2) subjective patient-reported outcome measures of sleep quality. Methods Seventy-six consented subjects from the Washington University Lupus Center with classified SLE were enrolled. Participants wore a wrist-mounted actigraph (Micro Motionlogger, Ambulatory Monitoring Inc, Ardsley, NY) for 1 week. Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Patient Reported Outcomes Measurement Instrument System (PROMIS)-Sleep Related Impairment (SRI), and PROMIS-Sleep Disturbance (SD) survey instruments were administered to measure subjective sleep quality. SLEDAI-2000 Responder Index-50 (S2K RI-50) assessed disease activity (>4, active SLE). Actigraphy data were analyzed using Action W (Ambulatory Monitoring Inc), and circadian variables were derived using ClockLab (Actimetrics, Wilmette, IL). Unpaired Student t tests (2-sided, α < 0.05) were used to compare sleep quality and circadian dysfunction in patients with active vs inactive disease. Pearson correlation coefficient was used to assess correlation of actigraphy and circadian variables with subjective sleep quality. Statistical analyses were performed using SPSS Statistics (IBM, Armonk, NY). Results No differences in actigraphic measures of sleep quality (eg, total sleep duration, percent sleep, wake after sleep onset, etc.) were observed in active vs inactive disease. Active SLE was associated with phase-dependent circadian variables including bedtime, acrophase (peak of circadian activity), M start (beginning of most active hours), and M start – waketime (p=0.01, discrepancy between natural circadian rhythm and actual activity pattern) (Table 1). Table 1. PROMIS-SRI and PROMIS-SD showed no correlation with actigraphy or circadian measures, while PSQI and ESS correlated moderately with % sleep and rho counts (activity during sleep period), and ESS additionally showed modest correlation with measures such as sleep efficiency, sleep and wake episodes, and MESOR (measure of mean activity level) (Table 2). Table 2. Conclusions Changes in circadian phase, but not sleep quality, is associated with SLE disease activity, with a phase delay in those with active disease. The ESS was the PRO that most highly associated with several actigraphy-assessed sleep parameters, including sleep efficiency and fragmentation. Circadian dysfunction may be an underlying cause for other widely experienced symptoms of SLE including cognitive dysfunction and fatigue. Future work will focus on examining this relationship.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".