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Walker D, Zhang N, Natbony LR. Insomnia and Migraine: A Review of Evidence-Based, Biobehavioral Interventions. Curr Pain Headache Rep 2023; 27:19-25. [PMID: 36701076 DOI: 10.1007/s11916-023-01100-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2023] [Indexed: 01/27/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review is to discuss the current evidence for Cognitive Behavioral Therapy for Insomnia (CBT-I) for patients with migraine and comorbid insomnia. In this article, we provide a narrative review of the literature on CBT-I and migraine, highlighting recent advances in research into this topic. Finally, we propose a way for clinicians to integrate CBT-I into clinical practice. RECENT FINDINGS Multiple studies support CBT-I as a validated modality for the treatment of insomnia in migraine. CBT-I is used to treat insomnia and should be offered as first line therapy. Clinicians should screen for insomnia in all patients with headache, especially in those with migraine, to best manage this condition through the implementation of specific insomnia treatment.
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Affiliation(s)
- David Walker
- Department of Neurology, Stanford School of Medicine, Palo Alto, CA, USA
| | - Niushen Zhang
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Neurology, Stanford School of Medicine, Palo Alto, CA, USA
| | - Lauren R Natbony
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Early-Onset Insomnia among Patients with Hemifacial Spasm in South Korea: A Nationwide Cohort Study. J Pers Med 2023; 13:jpm13020197. [PMID: 36836430 PMCID: PMC9964016 DOI: 10.3390/jpm13020197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/17/2023] [Accepted: 01/19/2023] [Indexed: 01/24/2023] Open
Abstract
This study aimed to investigate mental illnesses among patients with hemifacial spasms (HFS) based on nationwide claims data from the South Korea Health Insurance Review and Assessment Service. In this retrospective study, we defined the HFS group as subjects aged between 20 and 79 years with newly diagnosed HFS between January 2011 and December 2019 and set the date of diagnosis of HFS as the index date. Mental illnesses were defined through the International Classification of Diseases, the tenth revision from 90 days before to after the index date. Of these patients, we enrolled the participants who had visited a psychiatric outpatient clinic more than twice or had been admitted to a psychiatric department more than once diagnosed with psychiatric diseases. To select the control group, which was four times larger than the HFS group, propensity scores were used among those not diagnosed with HFS. The patients with HFS were more likely to have a mental illness than the control group (8.5% and 6.5%, respectively, p < 0.001) within 90 days before and after diagnosis. Among mental illnesses, insomnia (46.2% vs. 13.0%, p < 0.001) was significantly more prevalent in the HFS group. Other mental illnesses were significantly more prevalent in the control group or were not statistically significant. The results of this study suggest that patients diagnosed with HFS were significantly more likely to develop insomnia within a relatively short period than the controls.
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Charlton RA, McQuaid GA, Bishop L, Lee NR, Wallace GL. Predictors of sleep quality for autistic people across adulthood. Autism Res 2023; 16:757-771. [PMID: 36639914 DOI: 10.1002/aur.2891] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 12/28/2022] [Indexed: 01/15/2023]
Abstract
Poor sleep can have a significant impact on physical health and well-being. Sleep problems are common among autistic children, but less is known about sleep across the autistic adult lifespan. Autistic adults (n = 730, aged 18-78 years) were recruited via Simons Powering Autism Research for Knowledge Research Match. Participants completed online surveys asking about demographics, health problems, social support, symptoms of anxiety and depression, and overall and specific aspects of sleep quality. Regression analyses explored the variables associated with sleep quality. Physical health, assigned female sex at birth and self-reported anxiety symptoms significantly contributed to models for all aspects of sleep. Perceived stress contributed to models of overall and subjective sleep quality, and daytime dysfunction. Depression symptoms did not contribute significantly to any of the models of sleep quality. However, utilizing government support mechanisms (such as social security) contributed to the model of sleep efficiency. Age contributed little to models of sleep quality, whereas perceived stress and psychotropic medication use contributed to some but not all aspects of sleep. Sleep quality is poor for autistic people across the adult lifespan. Given known impacts of poor sleep on health, cognition and quality of life, attention should be paid to sleep and its possible everyday effects for autistic people of all ages.
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Affiliation(s)
| | - Goldie A McQuaid
- Department of Psychology, George Mason University, Fairfax, Virginia, USA
| | - Lauren Bishop
- Sandra Rosenbaum School of Social Work and Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Nancy Raitano Lee
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania, USA
| | - Gregory L Wallace
- Department of Speech, Language, and Hearing Sciences, The George Washington University, Washington, District of Columbia, USA
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104
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Wan Q, Liu K, Wang X, Luo S, Yuan X, Wang C, Jiang J, Wu W. The top 100 most cited papers in insomnia: A bibliometric analysis. Front Psychiatry 2023; 13:1040807. [PMID: 36683985 PMCID: PMC9845786 DOI: 10.3389/fpsyt.2022.1040807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 12/08/2022] [Indexed: 01/06/2023] Open
Abstract
Objective The number of citations to a paper represents the weight of that work in a particular area of interest. Several highly cited papers are listed in the bibliometric analysis. This study aimed to identify and analyze the 100 most cited papers in insomnia research that might appeal to researchers and clinicians. Methods We reviewed the Web of Science (WOS) Core Collection database to identify articles from 1985 to 24 March 2022. The R bibliometric package was used to further analyze citation counts, authors, year of publication, source journal, geographical origin, subject, article type, and level of evidence. Word co-occurrence in 100 articles was visualized using VOS viewer software. Results A total of 44,654 manuscripts were searched on the Web of Science. Between 2001 and 2021, the top 100 influential manuscripts were published, with a total citation frequency of 38,463. The top countries and institutions contributing to the field were the U.S. and Duke University. Morin C.M. was the most productive author, ranking first in citations. Sleep had the highest number of manuscripts published in the top 100 (n = 31), followed by Sleep Medicine Reviews (n = 9). The most cited manuscript (Bastien et al., Sleep Medicine, 2001; 3,384 citations) reported clinical validation of the Insomnia Severity Index (ISI) as a brief screening indicator for insomnia and as an outcome indicator for treatment studies. Co-occurrence analyses suggest that psychiatric disorders combined with insomnia and cognitive behavioral therapy remain future research trends. Conclusion This study provides a detailed list of the most cited articles on insomnia. The analysis provides researchers and clinicians with a detailed overview of the most cited papers on insomnia over the past two decades. Notably, COVID-19, anxiety, depression, CBT, and sleep microstructure are potential areas of focus for future research.
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Affiliation(s)
| | | | | | | | | | | | | | - Wenzhong Wu
- Department of Acupuncture and Rehabilitation, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
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105
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Borges C, Ellis JG, Ruivo Marques D. The Role of Sleep Effort as a Mediator Between Anxiety and Depression. Psychol Rep 2023:332941221149181. [PMID: 36595381 DOI: 10.1177/00332941221149181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Depression, anxiety, and insomnia are all conditions that share a complex bidirectional relationship. Sleep effort is a construct with cognitive and behavioral components that perpetuates insomnia. Although many studies have examined the associations between these three variables, no studies have yet examined sleep effort as a mediating variable between anxiety and depression and vice versa. Online versions of the Hospital Anxiety and Depression Scale and the Glasgow Sleep Effort Scale were administered to a sample of 1927 higher education students aged 18-40 years (75.9% women and 76% from 18 to 23 years old). As part of the survey, participants also completed a sociodemographic questionnaire. Mediation analysis indicated that sleep effort mediates the relationship between depression and anxiety, when the former was the predictor and the latter was the criterion. Moreover, sleep effort also mediated the relationship between anxiety and depression when the former was the predictor and the latter was the criterion, albeit in a lesser extent. Sleep effort appears to play a bidirectional mediational role between depression and anxiety, being a potential target for intervention.
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Affiliation(s)
- Cristina Borges
- Department of Education and Psychology, 56062University of Aveiro, Aveiro, Portugal
| | - Jason G Ellis
- Northumbria Sleep Research Laboratory, Faculty of Health and Life Sciences, 5995Northumbria University, Newcastle, UK
| | - Daniel Ruivo Marques
- Department of Education and Psychology, 56062University of Aveiro, Aveiro, Portugal; CINEICC - Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal
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106
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Kater MJ, Werner A, Schlarb AA, Lohaus A. Sleep Reactivity and Related Factors in Adolescence: An Increased Risk for Insomnia? A Longitudinal Assessment. Nat Sci Sleep 2023; 15:207-216. [PMID: 37069845 PMCID: PMC10105585 DOI: 10.2147/nss.s401452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 03/25/2023] [Indexed: 04/19/2023] Open
Abstract
Purpose The individual vulnerability for stress-related sleep difficulties (eg, sleep reactivity) is known as a predisposing factor of insomnia in adults, yet relatively little is known about sleep reactivity in adolescence. The study goal is to determine factors related to sleep reactivity and to investigate whether sleep reactivity and related factors predict current and new incidents of insomnia in adolescents. Patients and Methods At baseline, 11-to-17-year-olds (N = 185, Mage = 14.3 years, SD = 1.8, 54% female) answered an age-appropriate version of the Ford Insomnia Response to Stress Test, questionnaires about sleep, stress, psychological symptoms, and resources, filled out a sleep diary and used actigraphy. Insomnia diagnoses according to ISCD-3 criteria were assessed at baseline, after 9 months and after one and a half years. Results Adolescents with high compared to low sleep reactivity had increased pre-sleep arousal, negative sleep-related cognitions, pre-sleep mobile phone use, stress experience, stress vulnerability, internalizing and externalizing symptoms, less social resources, and a later midpoint of bedtime. High sleep reactivity increased the likelihood for currently having insomnia, but not for the development of insomnia at subsequent assessments. Conclusion The findings suggest that high sleep reactivity is related to poor sleep health and mental health but cast doubt on sleep reactivity as a pivotal predisposing factor for the development of insomnia in adolescence.
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Affiliation(s)
- Maren-Jo Kater
- Faculty of Psychology and Sports Science, Department of Developmental Psychology and Developmental Psychopathology, Bielefeld University, Bielefeld, North Rhine Westphalia, Germany
- Correspondence: Maren-Jo Kater, Bielefeld University, Faculty of Psychology and Sports Science, Developmental Psychology and Developmental Psychopathology, P.O. Box 10 01 31, Bielefeld, 33501, Germany, Tel +49 0521 - 106 4461, Email
| | - Anika Werner
- Faculty of Psychology and Sports Science, Department of Developmental Psychology and Developmental Psychopathology, Bielefeld University, Bielefeld, North Rhine Westphalia, Germany
| | - Angelika Anita Schlarb
- Faculty of Psychology and Sports Science Clinical, Department of Psychology and Psychotherapy of Children and Adolescents, Bielefeld University, Bielefeld, North Rhine Westphalia, Germany
| | - Arnold Lohaus
- Faculty of Psychology and Sports Science, Department of Developmental Psychology and Developmental Psychopathology, Bielefeld University, Bielefeld, North Rhine Westphalia, Germany
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107
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Kay DB, Simmons Z, Nielson SA, Braithwaite SR, Esplin C. A First Glimpse at the Latent Structure of Sleep Valuation Using a Sleep Valuation Item Bank. Nat Sci Sleep 2023; 15:127-137. [PMID: 36974200 PMCID: PMC10039622 DOI: 10.2147/nss.s386838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 01/30/2023] [Indexed: 03/29/2023] Open
Abstract
Introduction Sleep valuation is the relative worth individuals place on sleep. Our prior study using a Sleep Valuation Item Bank (SVIB) showed that sleep valuation relates to age, gender, and health status. In this study, the psychometric properties of the SVIB and its latent factor structure were explored. We also investigated how sleep valuation factors relate to demographic, psychological, and sleep features. Methods Participants (N = 854) were recruited through TurkPRIME and completed a survey consisting of demographic, psychological, and sleep-related questions. The distributional properties of the SVIB items were quantified. Cronbach's alpha and correlation analyses were used to assess the internal consistency and test-retest reliability of SVIB items. Iterated principal factoring with a Promax rotation was used on the SVIB to explore its latent factor structure. Multiple regression analyses were used to investigate the variables associated with each factor. Results The factor analysis identified 29 items with factor loadings ≥0.4 on four major factors, tentatively called (1) sleep wanting, (2) sleep prioritizing, (3) sleep onset preference, and (4) sleep devaluation. While women had higher sleep wanting and lower sleep devaluation scores than men, they had lower sleep prioritizing. Older individuals tended to value sleep less but also devalued it less than younger participants. Finally, although both individuals with insomnia and depression devalued sleep, depressed individuals prioritized it more than those who were less depressed, while individuals with insomnia symptoms wanted sleep and preferred sleep onset more than those with less insomnia symptoms. Discussion The current SVIB captures broad dimensions of sleep valuation (wanting, prioritizing, preferring) and sleep devaluation. These broad dimensions had distinct patterns across person-level factors. Recognition of individual differences in sleep valuation may help target sleep health advocacy efforts and individualized treatment approaches, including for those with depression or insomnia.
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Affiliation(s)
- Daniel B Kay
- Department of Psychology, Brigham Young University, Provo, UT, USA
- Correspondence: Daniel B Kay, Department of Psychology, Brigham Young University, UT 1090 KMBL, Provo, UT, 84602, USA, Tel +1 801 422-7949, Email
| | - Zach Simmons
- Department of Psychology, Brigham Young University, Provo, UT, USA
| | - Spencer A Nielson
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | | | - Charlotte Esplin
- Department of Psychology, Brigham Young University, Provo, UT, USA
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108
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Psychometric Properties of the Sleep Locus of Control (SLOC) Scale in a Portuguese Sample. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2023; 41:193-208. [PMID: 35694129 PMCID: PMC9171082 DOI: 10.1007/s10942-022-00462-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2022] [Indexed: 11/18/2022]
Abstract
Over the past few decades, research has suggested that cognitive variables play a key role in sleep disorders, particularly, in insomnia. The SLOC (Sleep Locus of Control Scale) evaluates the sleep locus of control, which is associated with the degree to which an individual attributes her/his experiences of sleep to chance or internal causes. The aim of this study was to develop the first translation and adaptation of the SLOC into the European Portuguese, as well as to analyze its psychometric properties. In this study, it was recruited a sample of 2029 Portuguese Higher Education students, aged ≥ 18 years, where approximately 75% of the sample were women and 25% men. The results showed that the SLOC had acceptable internal consistency value (α = .64), considering that it is a measure with a reduced number of items. As in the original study, a principal component analysis with varimax rotation identified two components. A parallel analysis was also conducted, identifying two factors. The correlation between the two subscales "internal sleep locus of control" and "chance sleep locus of control" was positive albeit of low magnitude (r = .15). Through the analysis carried out, it was also observed that individuals with "insomnia", relative to those without, had a more chance sleep locus of control. Overall, these findings show similarities with the original study. The SLOC seems to be a useful psychological assessment measure to be used in clinical and research settings.
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109
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Uygur OF, Ahmed O, Uygur H, Bahar A, Hursitoglu O, Chung S, Drake CL. Type D personality to insomnia: Sleep reactivity, sleep effort, and sleep hygiene as mediators. Front Psychiatry 2023; 14:1160772. [PMID: 37113537 PMCID: PMC10128995 DOI: 10.3389/fpsyt.2023.1160772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 03/23/2023] [Indexed: 04/29/2023] Open
Abstract
Background Insomniacs are heterogenous group with very diverse personalities. We aimed to investigate the mediating role of sleep reactivity (SR), sleep hygiene (SH), and sleep effort (SE) in the relationship between Type D personality and insomnia. Materials and methods We conducted a cross-sectional survey among 474 participants. The survey comprised the sociodemographic data form, Insomnia Severity Index (ISI), D Type Personality Scale (DS-14), Ford Insomnia Response to Stress Test (FIRST), Glasgow Sleep Effort Scale (GSES), and Sleep Hygiene Index (SHI). We conducted hierarchical multiple regression analysis to identify the associations between age, sex, SR, Type D personality traits, SE, SH, and insomnia severity. We subsequently conducted mediation analyses to examine whether SR, SH, and SE mediated the relationship between Type D personality and insomnia. Results ISI, DS-14, FIRST, SHI, and GSES scores were significantly higher in individuals with Type D personality. Female sex, SR, Type D personality traits, SE, and SH explained 45% of the variance in insomnia severity. When age, sex, insomnia response to stress, and Type D personality traits were controlled, SE and SH significantly explained 25% of the variance in insomnia severity (R 2 = 0.45, R 2 change = 0.25, F (6.474) = 65.58, p < 0.001). SR, SE, and SH each played a partial mediating role between Type D personality and insomnia. Conclusion The findings showed that individuals with Type D personality had high SR and that individuals with a higher number of these personality traits exhibited more severe insomnia symptoms through high SR, greater SE, and worse SH.
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Affiliation(s)
- Omer Faruk Uygur
- Department of Psychiatry, Ataturk University School of Medicine, Erzurum, Türkiye
- *Correspondence: Omer Faruk Uygur,
| | - Oli Ahmed
- Department of Psychology, University of Chittagong, Chattogram, Bangladesh
| | - Hilal Uygur
- Department of Psychiatry, Erzurum Training and Research Hospital, Erzurum, Türkiye
| | - Aynur Bahar
- Department of Psychiatric Nursing, Gaziantep University Faculty of Health Sciences, Gaziantep, Türkiye
| | - Onur Hursitoglu
- Department of Psychiatry, Sular Academy Hospital, Kahramanmaras, Türkiye
| | - Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Christopher L. Drake
- Henry Ford Hospital Sleep Disorders and Research Center, Detroit, MI, United States
- Department of Psychiatry and Behavioral Neurosciences, Wayne State College of Medicine, Detroit, MI, United States
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Bei B, Pinnington DM, Quin N, Shen L, Blumfield M, Wiley JF, Drummond SPA, Newman LK, Manber R. Improving perinatal sleep via a scalable cognitive behavioural intervention: findings from a randomised controlled trial from pregnancy to 2 years postpartum. Psychol Med 2023; 53:513-523. [PMID: 34231450 PMCID: PMC8738775 DOI: 10.1017/s0033291721001860] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Sleep disturbance is common in gestational parents during pregnancy and postpartum periods. This study evaluated the feasibility and efficacy of a scalable cognitive behavioural therapy (CBT) sleep intervention tailored for these periods. METHODS This is a two-arm, parallel-group, single-blind, superiority randomised controlled trial. Nulliparous females without severe medical/psychiatric conditions were randomised 1:1 to CBT or attention- and time-matched control. All participants received a 1 h telephone session and automated multimedia emails from the third trimester until 6 months postpartum. Outcomes were assessed with validated instruments at gestation weeks 30 (baseline) and 35 (pregnancy endpoint), and postpartum months 1.5, 3, 6 (postpartum endpoint), 12 and 24. RESULTS In total, 163 eligible participants (age M ± s.d. = 33.35 ± 3.42) were randomised. The CBT intervention was well accepted, with no reported adverse effect. Intention-to-treat analyses showed that compared to control, receiving CBT was associated with lower insomnia severity and sleep disturbance (two primary outcomes), and lower sleep-related impairment at the pregnancy endpoint (p values ⩽ 0.001), as well as at 24 months postpartum (p ranges 0.012-0.052). Group differences across the first postpartum year were non-significant. Participants with elevated insomnia symptoms at baseline benefitted substantially more from CBT (v. control), including having significantly lower insomnia symptoms throughout the first postpartum year. Group differences in symptoms of depression or anxiety were non-significant. CONCLUSIONS A scalable CBT sleep intervention is efficacious in buffering against sleep disturbance during pregnancy and benefitted sleep at 2-year postpartum, especially for individuals with insomnia symptoms during pregnancy. The intervention holds promise for implementation into routine perinatal care.
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Affiliation(s)
- Bei Bei
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
- Centre for Women’s Mental Health, Royal Women’s Hospital, Victoria, Australia
- Department of Psychiatry, University of Melbourne, Victoria, Australia
| | - Donna M. Pinnington
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
- Centre for Women’s Mental Health, Royal Women’s Hospital, Victoria, Australia
- Department of Psychiatry, University of Melbourne, Victoria, Australia
| | - Nina Quin
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
- Centre for Women’s Mental Health, Royal Women’s Hospital, Victoria, Australia
- Department of Psychiatry, University of Melbourne, Victoria, Australia
| | - Lin Shen
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| | - Michelle Blumfield
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Victoria, Australia
| | - Joshua F. Wiley
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| | - Sean P. A. Drummond
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| | - Louise K. Newman
- Department of Psychiatry, University of Melbourne, Victoria, Australia
| | - Rachel Manber
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA
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Lai MYC, Mong MSA, Cheng LJ, Lau Y. The effect of wearable-delivered sleep interventions on sleep outcomes among adults: A systematic review and meta-analysis of randomized controlled trials. Nurs Health Sci 2022; 25:44-62. [PMID: 36572659 DOI: 10.1111/nhs.13011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/01/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022]
Abstract
The aims of the review were to (i) evaluate the effectiveness of wearable-delivered sleep interventions on sleep outcomes among adults, and (ii) explore the effect of factors affecting total sleep time. Eight databases were searched to identify relevant studies in English from inception until December 23, 2021. The Cochrane Risk of Bias tool version 2.0 and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) criteria were used to assess the risk of bias and certainty of the evidence, respectively. Twenty randomized controlled trials (RCTs) were included, involving 1608 adults across nine countries. Wearable-delivered sleep interventions elicited significant improvement of 1.96 events/h for the oxygen desaturation index and 3.13 events/h for the respiratory distress index. Meta-analyses found that wearable-delivered sleep interventions significantly decreased sleep disturbance (Hedges' g [g] = -0.37, 95% confidence interval [CI]: -0.59, -0.15) and sleep-related impairment (g = -1.06, 95% CI: -1.99, -0.13) versus the comparators. The wearable-delivered sleep interventions may complement usual care to improve sleep outcomes. More rigorous RCTs with a long-term assessment in a wide range of populations are warranted.
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Affiliation(s)
- Min Yi Calida Lai
- Division of Nursing, KK Women's and Children's Hospital, Singapore Health Services, Singapore, Singapore
| | - Mei Siew Andrea Mong
- Nursing Division, Singapore General Hospital, Singapore Health Services, Singapore, Singapore
| | - Ling Jie Cheng
- Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Ying Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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112
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Chan WS, McCrae CS, Ng ASY. Is Cognitive Behavioral Therapy for Insomnia Effective for Improving Sleep Duration in Individuals with Insomnia? A Meta-Analysis of Randomized Controlled Trials. Ann Behav Med 2022; 57:428-441. [DOI: 10.1093/abm/kaac061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Abstract
Background
Accumulating evidence suggests that sleep duration is a critical determinant of physical and mental health. Half of the individuals with chronic insomnia report less than optimal sleep duration. Cognitive behavioral therapy for insomnia (CBT-I) is an effective treatment for reducing sleep difficulties in individuals with chronic insomnia. However, its effectiveness for increasing sleep duration is less well-established and a synthesis of these findings is lacking.
Purpose
To provide a synthesis of findings from randomized controlled trials (RCTs) on the effect of CBT-I on subjective and objective total sleep time (TST).
Methods
A systematic search was performed on articles published from 2004 to 05/30/2021. A total of 43 RCTs were included in the meta-analysis. Publication biases were examined. Meta-regressions were conducted to examine if any sample or treatment characteristics moderated the effect sizes across trials.
Results
We found a small average effect of CBT-I on diary-assessed TST at post-treatment, equivalent to an approximately 30-min increase. Age significantly moderated the effects of CBT-I on diary-measured and polysomnography-measured TST; older ages were associated with smaller effect sizes. Contrarily, a negative, medium effect size was found for actigraphy-assessed TST, equivalent to an approximately 30-min decrease. Publication biases were found for diary data at follow-up assessments suggesting that positive findings were favored.
Conclusions
CBT-I resulted in improvements in TST measured by sleep diaries and polysomnography (in adults). These improvements were not corroborated by actigraphy findings. Theoretical and clinical implications were discussed.
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Affiliation(s)
- Wai Sze Chan
- Department of Psychology, The University of Hong Kong , Hong Kong , China
| | | | - Albe Sin-Ying Ng
- Department of Psychology, The University of Hong Kong , Hong Kong , China
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113
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Scarpelli S, De Santis A, Alfonsi V, Gorgoni M, Morin CM, Espie C, Merikanto I, Chung F, Penzel T, Bjorvatn B, Dauvilliers Y, Holzinger B, Wing YK, Partinen M, Plazzi G, De Gennaro L. The role of sleep and dreams in long‐
COVID. J Sleep Res 2022; 32:e13789. [PMID: 36398720 DOI: 10.1111/jsr.13789] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/24/2022] [Accepted: 11/04/2022] [Indexed: 11/19/2022]
Abstract
Recent investigations show that many people affected by SARS-CoV2 (COVID-19) report persistent symptoms 2-3 months from the onset of the infection. Here, we report the Italian findings from the second International COVID-19 Sleep Study survey, aiming to investigate sleep and dream alterations in participants with post-acute symptoms, and identify the best determinants of these alterations among patients with long-COVID. Data from 383 participants who have had COVID-19 were collected through a web-survey (May-November 2021). Descriptive analyses were performed to outline the sociodemographic characteristics of long-COVID (N = 270, with at least two long-lasting symptoms) and short-COVID (N = 113, with none or one long-lasting symptom) participants. They were then compared concerning sleep and dream measures. We performed multiple linear regressions considering as dependent variables sleep and dream parameters discriminating the long-COVID group. Age, gender, work status, financial burden, COVID-19 severity and the level of care were significantly different between long-COVID and short-COVID subjects. The long-COVID group showed greater sleep alterations (sleep quality, daytime sleepiness, sleep inertia, naps, insomnia, sleep apnea, nightmares) compared with the short-COVID group. We also found that the number of long-COVID symptoms, psychological factors and age were the best explanatory variables of sleep and oneiric alterations. Our findings highlight that sleep alterations are part of the clinical presentation of the long-COVID syndrome. Moreover, psychological status and the number of post-acute symptoms should be considered as state-like variables modulating the sleep problems in long-COVID individuals. Finally, according to previous investigations, oneiric alterations are confirmed as a reliable mental health index.
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Affiliation(s)
| | | | | | - Maurizio Gorgoni
- Department of Psychology Sapienza University of Rome Rome Italy
- IRCCS Fondazione Santa Lucia Rome Italy
| | - Charles M. Morin
- Centre d'étude des troubles du sommeil, École de psychologie, Institut universitaire en santé mentale, Centre de recherche CERVO, Université Laval Quebec QC Canada
| | - Colin Espie
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences University of Oxford Oxford UK
| | - Ilona Merikanto
- SleepWell Research Program, Faculty of Medicine University of Helsinki Helsinki Finland
- Department of Public Health Solutions Finnish Institute for Health and Welfare Helsinki Finland
| | - Frances Chung
- Department of Anesthesiology and Pain Medicine University Health Network, University of Toronto Toronto ON Canada
| | - Thomas Penzel
- Interdisciplinary Sleep Medicine Center Charité—Universitätsmedizin Berlin Berlin Germany
| | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Care University of Bergen Bergen Norway
- Norwegian Competence Center for Sleep Disorders Haukeland University Hospital Bergen Norway
| | - Yves Dauvilliers
- Sleep‐Wake Disorders Unit, Department of Neurology, Gui‐de‐Chauliac Hospital CHU Montpellier, INM, Univ Montpellier, INSERM Montpellier France
| | - Brigitte Holzinger
- Institute for Consciousness and Dream Research Vienna Austria
- Medical University Vienna Vienna Austria
| | - Yun K. Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine The Chinese University of Hong Kong Hong Kong SAR China
| | - Markku Partinen
- Helsinki Sleep Clinic, Terveystalo Healthcare Helsinki Finland
- Department of Neurosciences, Clinicum University of Helsinki Helsinki Finland
| | - Giuseppe Plazzi
- Department of Biomedical and Neuromotor Sciences (DIBINEM) University of Bologna Bologna Italy
- IRCCS, Istituto delle Scienze Neurologiche Bologna Italy
| | - Luigi De Gennaro
- Department of Psychology Sapienza University of Rome Rome Italy
- IRCCS Fondazione Santa Lucia Rome Italy
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Koshmanova E, Muto V, Chylinski D, Mouraux C, Reyt M, Grinard M, Talwar P, Lambot E, Berthomier C, Brandewinder M, Mortazavi N, Degueldre C, Luxen A, Salmon E, Georges M, Collette F, Maquet P, Van Someren E, Vandewalle G. Genetic risk for insomnia is associated with objective sleep measures in young and healthy good sleepers. Neurobiol Dis 2022; 175:105924. [DOI: 10.1016/j.nbd.2022.105924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 11/01/2022] [Accepted: 11/08/2022] [Indexed: 11/11/2022] Open
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Kwon M, Dickerson SS, Wilding GE, Aquilina AT, Reid M, Dean GE. A nurse-delivered intervention to reduce insomnia in cancer survivors: Study protocol for a randomized-controlled trial. Contemp Clin Trials 2022; 122:106939. [PMID: 36182027 PMCID: PMC10380006 DOI: 10.1016/j.cct.2022.106939] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 01/27/2023]
Abstract
Insomnia has been frequently reported as one of the most burdensome symptoms among cancer survivors. To date, little research exists on strategies to effectively reduce insomnia in cancer survivors, especially in the application of cognitive behavioral therapy for insomnia (CBTI) at the bedside by nurses. The current objective is to determine efficacy and durability of a streamlined, individually delivered version of CBTI, specifically Brief Behavioral Therapy for Insomnia (BBTI) versus a healthy eating attention control, using a large heterogeneous sample of 158 cancer survivors. Study participants will be adults ≥18 years of age; ≥1 month from treatment (except hormones and targeted therapies are acceptable) for stages I through III breast, colorectal, lung or prostate cancers; meet criteria for insomnia defined by Insomnia Severity Index (ISI) >7; screen negative for obstructive sleep apnea <15 events/h; and ability to complete data collection instruments in English. Baseline, and then 1-, 3-, and 12-month objective (i.e., actigraphy) and subjective sleep, mood, and quality of life assessments after the interventions are planned. The primary outcome will be measured with the ISI, a psychometrically-sound instrument used to measure perceived insomnia severity. The results of this trial will demonstrate the application of BBTI in a larger heterogenous sample of cancer survivors for the first time and may lead to implementation strategies that will promote the dissemination and sustainability of this intervention. Clinical trials identifier: http://ClinicalTrials.gov, NCT03810365.
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Affiliation(s)
- Misol Kwon
- School of Nursing, University at Buffalo, The State University of New York, NY 14214, USA.
| | - Suzanne S Dickerson
- School of Nursing, University at Buffalo, The State University of New York, NY 14214, USA.
| | - Gregory E Wilding
- Department of Biostatistics, School of Public Health and Health Professions, University at Buffalo, The State University of New York, NY 14214, USA.
| | - Alan T Aquilina
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, NY 14214, USA.
| | - Mary Reid
- Cancer Screening, Survivorship and Mentorship, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA; Department of Epidemiology and Environmental Health, University at Buffalo, The State University of New York, NY 14214, USA.
| | - Grace E Dean
- School of Nursing, University at Buffalo, The State University of New York, NY 14214, USA.
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116
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Senel GB. Insomnia – Is it a Symptom or a Disorder? Open Neurol J 2022. [DOI: 10.2174/1874205x-v16-e2208150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Insomnia disorder is a common public health problem with a prevalence of approximately 2-5% of the population. It is of major importance to differentiate the insomnia disorder from the isolated symptoms and normal variants, and to define the secondary or associated conditions. Insomnia was mainly classified as acute and chronic insomnia disorder based on the 3rd edition of the International Classification of Sleep Disorders. Many models have been developed to explain the underlying mechanisms of insomnia, such as the Drosophila model, the cognitive model, the psychobiological inhibition model, the neurocognitive model, stimulus control model, hyperarousal model and the “3P model” (Spielman model). Optimizing the environmental conditions, lifestyle changes and elaborating the triggering factors are the first step in the management of insomnia disorders.
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117
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Is a blunted cortisol response to stress a premorbid risk for insomnia? Psychoneuroendocrinology 2022; 144:105873. [PMID: 35905512 DOI: 10.1016/j.psyneuen.2022.105873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/08/2022] [Accepted: 07/19/2022] [Indexed: 11/22/2022]
Abstract
STUDY OBJECTIVES Vulnerability to stress-related sleep disturbances (sleep reactivity) is an established heritable risk factor for insomnia disorder with unclear biological underpinnings. Preliminary research points to a blunted cortisol response to stress as a biological predisposition to familial risk for insomnia, but the role of cortisol response in sleep reactivity is unknown. Therefore, the current studies examined whether sleep reactivity is associated with a blunted cortisol response to two laboratory stressors among participants without insomnia. METHODS Two community samples of adults with no lifetime history of insomnia completed the Trier Social Stress Test (N = 35) or the Cold Pressor Task (N = 34). Participants were grouped by insomnia-risk using sleep reactivity scores from the Ford Insomnia Response to Stress Test (FIRST). Physiological responses were measured via markers of the hypothalamic-pituitary-adrenal (HPA) axis (salivary cortisol) and autonomic nervous system (ANS; heart rate, mean arterial pressure, and salivary alpha amylase). RESULTS Participants with high insomnia-risk (FIRST score > 18) exhibited blunted cortisol responses to both stressors. There were no group differences in ANS responses across stressors. CONCLUSIONS Insomnia-risk as indicated by sleep reactivity is associated with blunted cortisol responses to psychosocial and physical laboratory stressors among premorbid adults without insomnia disorder. This study replicates previous research and supports a blunted cortisol response to stress as a biomarker for insomnia vulnerability that may be detected using the FIRST. Prospective research is needed to elucidate whether a blunted cortisol response to stress is one mechanism by which sleep reactive individuals may be at risk of developing insomnia.
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118
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Porosnicu Rodriguez KA, Salas RME, Schneider L. Insomnia. Neurol Clin 2022; 41:1-19. [DOI: 10.1016/j.ncl.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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119
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Perlis ML, Posner D, Riemann D, Bastien CH, Teel J, Thase M. Insomnia. Lancet 2022; 400:1047-1060. [PMID: 36115372 DOI: 10.1016/s0140-6736(22)00879-0] [Citation(s) in RCA: 88] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 02/03/2022] [Accepted: 05/05/2022] [Indexed: 12/30/2022]
Abstract
Insomnia is highly prevalent in clinical practice, occurring in up to 50% of primary care patients. Insomnia can present independently or alongside other medical conditions or mental health disorders and is a risk factor for the development and exacerbation of these other disorders if not treated. In 2016, the American College of Physicians recommended that insomnia be specifically targeted for treatment. The recommended first-line treatment for insomnia, whether the underlying cause has been identified or not, is cognitive behavioural therapy for insomnia (CBT-I). Currently, there is no global consensus regarding which pharmacological treatment has the best efficacy or risk-benefit ratio. Both CBT-I and pharmacological intervention are thought to have similar acute effects, but only CBT-I has shown durable long-term effects after treatment discontinuation. Administering a combined treatment of CBT-I and medication could decrease the latency to treatment response, but might diminish the durability of the positive treatment effects of CBT-I.
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Affiliation(s)
- Michael L Perlis
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
| | - Donn Posner
- Department of Psychiatry and Behavioral Science, Stanford University, Stanford, CA, USA
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, Germany
| | | | - Joseph Teel
- Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA, USA
| | - Michael Thase
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
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120
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Liao YG, Huang FZ, Ni XH, Ke HY, Tian Y, Yu M, Jin G, Chen GH. Effects of schedule exercise therapy on chronic insomnia. Medicine (Baltimore) 2022; 101:e30792. [PMID: 36197264 PMCID: PMC9509080 DOI: 10.1097/md.0000000000030792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Schedule exercise therapy (SET) is a novel nonpharmacological intervention for the treatment of chronic insomnia disorder (CID). The aim of this study was to explore the effects of SET on CID. Methods: One hundred and eighteen CID were recruited and randomized into medication (MED) or medication combined with SET (MSET) groups. Over 12 observational weeks, sleep and mood status were evaluated using the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), Self-rating Depression Scale (SDS), and Self-rating Anxiety Scale (SAS). At the end of the observational period, the rates of clinically effective hypnotic use were calculated. At 12 weeks, the PSQI progressively decreased for all subjects combined (P < .001) as well as ISI (P < .001), ESS (P < .001), SDS (P < .001), and SAS (P < .001). The decreases in PSQI (P < .05), ISI (P < .05), SDS (P < .01), and SAS (P < .05) in the MSET group were significantly larger than those in the MED group, but not the same as those in the ESS group (P > .05). At the trial endpoint, the clinically effective rate was significantly higher (P < .05) and the hypnotic usage rate was lower (P < .05) in the MSET group than in the MED group. SET may be an effective treatment for insomnia in patients with CID.
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Affiliation(s)
- Yuan-Gao Liao
- Sleep Medical Center and Department of Neurology, Huanggang Central Hospital, Huanggang, China
| | - Feng-Zhen Huang
- Institute of Transitional Medicine at University of South China, Chenzhou, China
- Department of Neurology, the First People’s Hospital of Chenzhou, Chenzhou, China
| | - Xiao-Hong Ni
- Sleep Medical Center and Department of Neurology, Huanggang Central Hospital, Huanggang, China
| | - Hong-Yan Ke
- Sleep Medical Center and Department of Neurology, Huanggang Central Hospital, Huanggang, China
| | - Yu Tian
- Sleep Medical Center and Department of Neurology, Huanggang Central Hospital, Huanggang, China
| | - Mei Yu
- Sleep Medical Center and Department of Neurology, Huanggang Central Hospital, Huanggang, China
| | - Guo Jin
- Sleep Medical Center and Department of Neurology, Huanggang Central Hospital, Huanggang, China
| | - Gui-Hai Chen
- Department of Neurology (Sleep Disorders), the Affliated Chaohu Hospital of Anhui Medical University, Hefei (Chaohu), China
- *Correspondence: Gui-Hai Chen, Department of Neurology (Sleep Disorders), the Affliated Chaohu Hospital of Anhui Medical University, Hefei (Chaohu), 238000, China (e-mail: )
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121
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Lau PH, Marway OS, Carmona NE, Carney CE. Examining whether Changes in Sleep Habits Predict Long-Term Sustainment of Treatment Gains in Individual Remitted from Insomnia after CBT-I. Behav Sleep Med 2022:1-12. [PMID: 36111681 DOI: 10.1080/15402002.2022.2124993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVES Providers of Cognitive-Behavioral Therapy for Insomnia (CBT-I) are often asked whether the behavioral recommendations (e.g., stimulus control, sleep restriction) must be adhered to ad infinitum. We examined whether changes in sleep habits/behaviors are a life sentence, or whether patients who remit can relax their adherence while maintaining their treatment gains at 1-year follow-up (FU). METHODS Participants (N = 179) completed 2 weeks of sleep diaries and measures of insomnia severity and safety behaviors at baseline and following four sessions of CBT-I. Of the 137 patients that achieved remission, 77 completed these measures at 1-year FU. RESULTS Improvements in insomnia severity and total wake time (TWT) at post-treatment were maintained at FU (ps ≥ .52). Similarly, reductions in safety behaviors were maintained at FU (p - 1.00), whereas lingering in bed reduced during treatment (p < .001) but increased at FU (p < .001). Changes in sleep habits after treatment did not predict insomnia severity at FU. However, increases in time in bed positively predicted TWT at FU (p = .001). CONCLUSIONS Those who remit after CBT-I may generally relax their adherence to behavioral recommendations without significantly impacting their perceived insomnia symptoms 1 year after treatment despite some increases in TWT. Results increase our confidence in CBT-I as a brief and durable intervention.
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Affiliation(s)
- Parky H Lau
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Onkar S Marway
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Nicole E Carmona
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Colleen E Carney
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
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122
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Tracy EL, Zhang J, Wilckens K, Krafty RT, Hasler BP, Hall MH, Buysse DJ. Homeostatic response to sleep deprivation and circadian rhythmicity are intact in older adults with insomnia. Sleep 2022; 45:zsac162. [PMID: 35878753 PMCID: PMC9453614 DOI: 10.1093/sleep/zsac162] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 03/20/2022] [Indexed: 07/27/2023] Open
Abstract
STUDY OBJECTIVES We examined whether homeostatic sleep drive and circadian rhythmicity differ in older adults with insomnia (OAI) compared to older good sleepers (GS). METHODS OAI (n = 37) and GS (n = 30) participated in a 60-h in-lab study with sleep deprivation and constant routine paradigms. Homeostatic sleep drive was assessed by examining the effect of sleep deprivation on delta EEG power and theta EEG power, and repeated sleep latency tests. Circadian rhythm was assessed with salivary melatonin (phase and amplitude), core body temperature (phase, amplitude, and mesor), and sleep latency during a constant routine paradigm. Mixed models were used to assess interactions of group (OAS vs GS) with homeostatic sleep and circadian effects. RESULTS Compared to GS, OAI showed a greater linear increase in waking theta power during sleep deprivation, but the two groups did not show differential responses to sleep deprivation in delta EEG, or in repeated sleep latency tests. The two groups did not differ in circadian phase or amplitude of melatonin or core body temperature rhythms. OAI had a significantly elevated core body temperature mesor compared to GS. CONCLUSIONS Homeostatic response to sleep deprivation was intact in OAI compared to GS; theta EEG power suggested a greater homeostatic response in OAI. Circadian rhythm amplitude and phase were similar in OAI compared to GS. Elevated body temperature mesor in OAI may indicate elevated physiological arousal. These findings suggest that effective treatments for insomnia in older adults may leverage intact sleep and circadian regulatory mechanisms, rather than repair defective sleep and circadian regulation.
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Affiliation(s)
| | | | - Kristine Wilckens
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Robert T Krafty
- Department of Biostatics and Bioinformatics, Emory University, Atlanta, GA, USA
| | - Brant P Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Martica H Hall
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Daniel J Buysse
- Corresponding author. Daniel J. Buysse, Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O’Hara St. Pittsburgh, PA, 15213, USA.
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123
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Mansfield DR. Sleep medicine is more than just obstructive sleep apnoea. Respirology 2022; 27:812-814. [PMID: 36068023 DOI: 10.1111/resp.14364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 08/26/2022] [Indexed: 11/28/2022]
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124
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Fabbri M, Beracci A, Martoni M. Insomnia, Time Perspective, and Personality Traits: A Cross-Sectional Study in a Non-Clinical Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11018. [PMID: 36078734 PMCID: PMC9517905 DOI: 10.3390/ijerph191711018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/22/2022] [Accepted: 08/31/2022] [Indexed: 06/15/2023]
Abstract
Insomnia disorder is considered a public health problem and additional studies should investigate predisposing and perpetuating factors. This study examined the relationship between Big Five personality traits, time perspective, and insomnia. In a cross-sectional study, 400 participants (227 women; age range 18-74 years) were administered the Big Five Inventory-10 items, the Zimbardo Time Perspective Inventory, and the Insomnia Severity Index (ISI). A measure of chronotype was also included for control purposes. The results show that insomniacs reported lower scores for conscientiousness and extraversion, and for past-positive (PP) and future (F) perspectives, whereas they obtained higher scores for past-negative (PN) perspectives and deviation from a balanced time perspective. The correlations confirmed these findings, but negative correlations between present-hedonistic (PH) perspective and ISI score, and between emotional stability and ISI score, were also found. The mediation analyses showed that F played an indirect role in the relationship between consciousness and ISI score, PN had an indirect effect on the relationship between emotional stability and ISI or between extraversion and insomnia, and PH had an indirect effect on the relationship between extraversion and ISI score. The current outcomes shed light on the mechanisms which serve to mediate the relationship between insomnia and personality traits.
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Affiliation(s)
- Marco Fabbri
- Department of Psychology, University of Campania “Luigi Vanvitelli”, 81100 Caserta, Italy
| | - Alessia Beracci
- Department of Psychology, University of Granada, 18011 Granada, Spain
| | - Monica Martoni
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
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125
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Robinson CL, Supra R, Downs E, Kataria S, Parker K, Kaye A, Viswanath O, Urits I. Daridorexant for the Treatment of Insomnia. Health Psychol Res 2022; 10:37400. [PMID: 36045942 DOI: 10.52965/001c.37400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 07/19/2022] [Indexed: 11/06/2022] Open
Abstract
Purpose of Review Insomnia is a complex sleeping disorder that affects the lives of many individuals worldwide. Insomnia often occurs in the presence of coexisting comorbidities making it a complex disorder that requires a multifactorial approach to therapy. First-line therapy is cognitive-behavioral therapy for insomnia (CBT-I). Pharmacotherapy for insomnia falls into four classes based on mechanism of action: benzodiazepine receptor agonists (BZRAs), histamine receptor antagonists, melatonin receptor agonists, and dual orexin receptor antagonists (DORAs). Recent Findings Daridorexant is a dual orexin type 1 and types 2 (OX1 and OX2) receptor antagonist that was recently approved by the US FDA for the treatment of adults suffering from insomnia. It was shown to be effective in reducing insomnia symptoms, increasing daytime functioning, and improving the overall quality of sleep. Daridorexant offers patients relief from insomnia while avoiding the severe side effects and dependency issues of traditional treatments like benzodiazepines and sedatives. Summary In this article, we review the most recent data on insomnia treatments and summarize the safety and efficacy of daridorexant in treating insomnia.
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Affiliation(s)
| | | | - Evan Downs
- Louisiana State University Health New Orleans School of Medicine
| | - Saurabh Kataria
- Department of Neurology, Louisiana State University Health Science Center at Shreveport
| | - Katelyn Parker
- Louisiana State University Health New Orleans School of Medicine
| | - Alan Kaye
- Department of Anesthesia, Louisiana State University Health New Orleans School of Medicine
| | - Omar Viswanath
- Envision Physician Services, Valley Anesthesiology and Pain Consultants
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126
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The platform development, adherence and efficacy to a digital Brief therapy for insomnia (dBTI) during the COVID-19 pandemic. Methods 2022; 205:39-45. [PMID: 35526723 PMCID: PMC9070004 DOI: 10.1016/j.ymeth.2022.04.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/10/2022] [Accepted: 04/29/2022] [Indexed: 01/04/2023] Open
Abstract
Brief therapy for insomnia (BTI) is a short-term cognitive behavioral therapy for insomnia. At present, there is no study combining BTI with digital technology. However, in the context of the outbreak of coronavirus disease 2019 (COVID-19), patients with acute insomnia may need an online treatment which can quickly improve insomnia symptoms. Our team built a digital BTI (dBTI) platform based on the WeChat mini program. This research provides a framework design and a course design of dBTI, and evaluates the system via recruiting participants suffering from acute insomnia in pandemic. What's more, it explores patients' adherence, the efficiency of the system and their relationship. As the result demonstrates, 68% of participants have completed more than half of the course with medium to high adherence. Gender, pre-sleep arousal scale (PSAS) somatic score and insomnia severity index (ISI) score have affected participants' adherence, and higher adherence has led to better improvement in the severity of insomnia and somatic pre-sleep arousal. It is proved that the platform we built is effective, which not only offers an entry point for the study of how to set up a dBTI platform, but also provides theoretical basis for its clinical application.
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127
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A Meta-Analysis of Mindfulness-Based Therapies for Insomnia and Sleep Disturbance Moving Toward Processes of Change. Sleep Med Clin 2022; 17:329-353. [PMID: 36150798 DOI: 10.1016/j.jsmc.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
MBTs are increasingly being investigated as a viable treatment of insomnia or sleep disturbance. To date, 13 trials published since 2010 suggest that MBTs are efficacious for improving symptoms of insomnia and sleep quality relative to psychological placebos and inactive control conditions with medium to large effects. Limited evidence suggests that these effects are sustained at 3-month follow-up. Despite this, limited data were collected evaluating the empirically supported mechanisms or processes of change. The authors propose a testable model in the psychological process model of sleep that they hope will advance the next generation of research into MBTs for insomnia.
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128
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Traupman EK, Dixon MA. Cognitive-behavioral therapy for insomnia for primary care: Review of components and application for residents in primary care. Int J Psychiatry Med 2022; 57:423-433. [PMID: 35786039 DOI: 10.1177/00912174221112466] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Healthy sleep patterns are a significant component of good physical and mental health. Quality sleep can be affected by such things as stress, age, pregnancy, physical health problems, and shift work. Behaviors related to sleep problems can be one of three types: predisposing, precipitating, and perpetuating. Additionally, cognitive processes related to sleep quality tend to be predominated by sleep thinking or insomnia thinking. Multiple medical organizations promote Cognitive Behavioral Therapy for Insomnia as a best practice for clinical management of sleep problems and disorders. Cognitive Behavioral Therapy for Insomnia consists of five components aimed at addressing both the behavioral and cognitive impediments to high quality sleep. These components are sleep hygiene, relaxation, sleep restriction, stimulus control, and cognitive therapy. This paper will address each component, as well as provide a patient education pattern well suited for primary care settings.
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Affiliation(s)
- Emily K Traupman
- 12353University of Washington School of Medicine, Tacoma, WA, USA
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Jahrami H, Haji EA, Saif ZQ, Aljeeran NO, Aljawder AI, Shehabdin FN, Fekih-Romdhane F, Trabelsi K, BaHammam AS, Vitiello MV. Sleep Quality Worsens While Perceived Stress Improves in Healthcare Workers over Two Years during the COVID-19 Pandemic: Results of a Longitudinal Study. Healthcare (Basel) 2022; 10:1588. [PMID: 36011245 PMCID: PMC9408655 DOI: 10.3390/healthcare10081588] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/09/2022] [Accepted: 08/19/2022] [Indexed: 11/25/2022] Open
Abstract
The purpose of the study was to measure changes in sleep quality and perceived stress and their interrelationships in a sample of healthcare workers two years post the COVID-19 pandemic. Using a cohort design, data were collected from frontline healthcare workers (FLHCW, n = 70) and non-frontline healthcare workers (NFLHCW, n = 74) in April 2020 (T1) and in February 2022 (T2). The Pittsburgh Sleep Quality Index (PSQI) and the Perceived Stress Scale (PSS-10) were administered at both time points. There were no differences in sleep quality or perceived stress between FLHCW and NFLHCW at either timepoint. For the entire sample, the PSQI scores at T2 were significantly higher than at T1 (7.56 ± 3.26 and 7.25 ± 3.29, respectively) (p = 0.03, Cohen's d = 0.18). PSS-10 scores at T2 were significantly lower than at T1 (19.85 ± 7.73 and 21.13 ± 7.41, respectively) (p = 0.001, Cohen's d = 0.78). Baseline sleep quality PSQI (T1) was a significant predictor for changes in sleep quality. During the initial months of the outbreak of the COVID-19 pandemic, poor sleep quality and perceived stress were common for healthcare workers. Two years into the pandemic, the perceived stress was reduced, but sleep quality worsened.
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Affiliation(s)
- Haitham Jahrami
- Department of Psychiatry, Ministry of Health, Manama 410, Bahrain
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama 323, Bahrain
| | - Eman A. Haji
- Department of Psychiatry, Ministry of Health, Manama 410, Bahrain
| | - Zahra Q. Saif
- Department of Psychiatry, Ministry of Health, Manama 410, Bahrain
| | - Noora O. Aljeeran
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama 323, Bahrain
| | - Aysha I. Aljawder
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama 323, Bahrain
| | - Faisal N. Shehabdin
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama 323, Bahrain
| | - Feten Fekih-Romdhane
- Department of Psychiatry, The Tunisian Center of Early Intervention in Psychosis, Psychiatry Department “Ibn Omrane”, Tunis 2010, Tunisia
- Department of Psychiatry, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis 1068, Tunisia
| | - Khaled Trabelsi
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia
| | - Ahmed S. BaHammam
- Department of Medicine, College of Medicine, University Sleep Disorders Center, King Saud University, Riyadh 11324, Saudi Arabia
- The Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia, Riyadh 11324, Saudi Arabia
| | - Michael V. Vitiello
- Department of Psychiatry & Behavioral Sciences, Gerontology & Geriatric Medicine, and Biobehavioral Nursing, University of Washington, Seattle, WA 98195-6560, USA
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Ramón-Arbués E, Granada-López JM, Martínez-Abadía B, Echániz-Serrano E, Antón-Solanas I, Jerue BA. The Association between Diet and Sleep Quality among Spanish University Students. Nutrients 2022; 14:3291. [PMID: 36014796 PMCID: PMC9415359 DOI: 10.3390/nu14163291] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/07/2022] [Accepted: 08/10/2022] [Indexed: 01/10/2023] Open
Abstract
While it has long been recognized that diet is a leading behavioral risk factor for human health, recent scientific findings have also suggested that diet and sleep quality may be connected. The purpose of the present study is to evaluate the association between diet and sleep quality among a group of Spanish university students. To do so, a cross-sectional study of 868 students was carried out. Sleep quality was assessed using the Spanish version of the Pittsburgh Sleep Quality Index (PSQI), while diet was assessed using the Spanish Healthy Eating Index (SHEI). The study revealed a noteworthy rate of bad sleepers (51.6%) and students whose diet needed modifications (82.2%). Unhealthy eaters were more likely to have poor sleep quality (aOR = 4.20; CI 95%: 2.07-8.52). The unbalanced intake of vegetables (aOR = 1.63; CI 95%: 1.14-2.34), fruits (aOR = 4.08; CI 95%: 2.90-5.74), dairy products (aOR = 1.96; CI 95%: 1.41-2.72), lean meats (aOR = 1.82; CI 95%: 1.19-2.78), legumes (aOR = 1.43; CI 95%: 1.00-2.02), sweets (aOR = 1.60; CI 95%: 1.13-2.25) and sugary soft drinks (aOR = 1.46; CI 95%: 1.07-1.99) was associated with lower sleep quality.
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Affiliation(s)
- Enrique Ramón-Arbués
- Faculty of Health Sciences, Campus Universitario Villanueva de Gállego, Universidad San Jorge, Villanueva de Gállego, 50830 Zaragoza, Spain
- Research Group Cultural Transferences and International Projection of Aragonese Culture (H27_20D-TRANSFERCULT), 50009 Zaragoza, Spain
| | - José-Manuel Granada-López
- Research Group Cultural Transferences and International Projection of Aragonese Culture (H27_20D-TRANSFERCULT), 50009 Zaragoza, Spain
- Faculty of Health Sciences, Department of Physiatry and Nursing, Universidad de Zaragoza, 50009 Zaragoza, Spain
- GIISA021—Seguridad y Cuidados Research Group, 50018 Zaragoza, Spain
| | - Blanca Martínez-Abadía
- Occupational Health and Prevention Service of the Zaragoza City Council, 50001 Zaragoza, Spain
| | - Emmanuel Echániz-Serrano
- Research Group Cultural Transferences and International Projection of Aragonese Culture (H27_20D-TRANSFERCULT), 50009 Zaragoza, Spain
- Faculty of Health Sciences, Department of Physiatry and Nursing, Universidad de Zaragoza, 50009 Zaragoza, Spain
| | - Isabel Antón-Solanas
- Faculty of Health Sciences, Department of Physiatry and Nursing, Universidad de Zaragoza, 50009 Zaragoza, Spain
- GIIS094—Grupo Enfermero de Investigación en Atención Primaria de Aragón (GENIAPA), 50009 Zaragoza, Spain
| | - Benjamin Adam Jerue
- Faculty of Communication and Social Sciences, Campus Universitario Villanueva de Gállego, Universidad San Jorge, Villanueva de Gállego, 50830 Zaragoza, Spain
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O’Connell M, Jeon S, Conley S, Linsky S, Redeker NS. Coping, Symptoms, and Insomnia among People with Heart Failure during the Covid-19 Pandemic. Eur J Cardiovasc Nurs 2022; 22:291-298. [PMID: 35938348 PMCID: PMC9384676 DOI: 10.1093/eurjcn/zvac072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 08/02/2022] [Accepted: 08/04/2022] [Indexed: 01/25/2023]
Abstract
AIM Increases in stress, symptoms of anxiety and depression and sleep problems have been reported during the Covid-19 pandemic, and people with chronic medical conditions such as heart failure (HF) are especially vulnerable. The purpose of this study was to examine the extent to which sleep characteristics, sleep-related cognitions, anxiety, depression, perceived stress, and changes in these phenomena over time predict ways of coping with pandemic-related stress among participants in the HeartSleep study, a randomized controlled trial of the effects of cognitive behavioral therapy for insomnia (CBT-I) in people with HF. METHODS Participants completed questionnaires to elicit sleep characteristics, daytime symptoms, mood and stress at baseline, six-months after the intervention and during the Covid-19 pandemic. We added measures of coping during the pandemic (June-August 2020). RESULTS The sample included 112 participants (M age = 63 ± 12.9 years; 47% women; 13% Black; 68% NY Heart Class II or III). Participants (43%) reported pandemic-related stressors and most often used secondary control coping. Insomnia severity, anxiety, depression, perceived stress, and sleep-related cognitions predicted secondary control coping (positive thinking, cognitive restructuring, acceptance, distraction), involuntary engagement (physiological arousal, rumination) and involuntary disengagement (emotional numbing). CONCLUSIONS Insomnia and mood disturbance are important determinants of coping and responses to stress. Improving sleep and symptoms among people with HF may improve coping during stressful events, and CBT-I may have protective effects.
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Affiliation(s)
- Meghan O’Connell
- Yale School of Nursing, , 300 Heffernan Drive, West Haven, CT 06516, United States
| | - Sangchoon Jeon
- Yale School of Nursing, , 300 Heffernan Drive, West Haven, CT 06516, United States
| | - Samantha Conley
- Yale School of Nursing, , 300 Heffernan Drive, West Haven, CT 06516, United States
| | - Sarah Linsky
- Yale School of Nursing, , 300 Heffernan Drive, West Haven, CT 06516, United States
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Knight JM, Taylor MR, Rentscher KE, Henley EC, Uttley HA, Nelson AM, Turcotte LM, McAndrew NS, Amonoo HL, Mohanraj L, Kelly DL, Costanzo ES. Biobehavioral Implications of Covid-19 for Transplantation and Cellular Therapy Recipients. Front Immunol 2022; 13:877558. [PMID: 35865530 PMCID: PMC9295749 DOI: 10.3389/fimmu.2022.877558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 06/01/2022] [Indexed: 01/13/2023] Open
Abstract
A growing body of literature has emphasized the importance of biobehavioral processes - defined as the interaction of behavior, psychology, socioenvironmental factors, and biological processes - for clinical outcomes among transplantation and cellular therapy (TCT) patients. TCT recipients are especially vulnerable to distress associated with pandemic conditions and represent a notably immunocompromised group at greater risk for SARS-CoV-2 infection with substantially worse outcomes. The summation of both the immunologic and psychologic vulnerability of TCT patients renders them particularly susceptible to adverse biobehavioral sequelae associated with the Covid-19 pandemic. Stress and adverse psychosocial factors alter neural and endocrine pathways through sympathetic nervous system and hypothalamic-pituitary-adrenal axis signaling that ultimately affect gene regulation in immune cells. Reciprocally, global inflammation and immune dysregulation related to TCT contribute to dysregulation of neuroendocrine and central nervous system function, resulting in the symptom profile of depression, fatigue, sleep disturbance, and cognitive dysfunction. In this article, we draw upon literature on immunology, psychology, neuroscience, hematology and oncology, Covid-19 pathophysiology, and TCT processes to discuss how they may intersect to influence TCT outcomes, with the goal of providing an overview of the significance of biobehavioral factors in understanding the relationship between Covid-19 and TCT, now and for the future. We discuss the roles of depression, anxiety, fatigue, sleep, social isolation and loneliness, and neurocognitive impairment, as well as specific implications for sub-populations of interest, including pediatrics, caregivers, and TCT donors. Finally, we address protective psychological processes that may optimize biobehavioral outcomes affected by Covid-19.
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Affiliation(s)
- Jennifer M. Knight
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
- Department of Microbiology & Immunology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Mallory R. Taylor
- Department of Pediatrics, Division of Hematology/Oncology, University of Washington School of Medicine, Seattle, WA, United States
- Palliative Care and Resilience Program, Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, WA, United States
| | - Kelly E. Rentscher
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Elisabeth C. Henley
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Hannah A. Uttley
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Ashley M. Nelson
- Department of Psychiatry, Harvard Medical School/Massachusetts General Hospital, Boston, MA, United States
| | - Lucie M. Turcotte
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Natalie S. McAndrew
- College of Nursing, University of Wisconsin – Milwaukee, Milwaukee, WI, United States
- Froedtert Hospital, Froedtert & The Medical College of Wisconsin, Milwaukee, WI, United States
| | - Hermioni L. Amonoo
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, United States
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Lathika Mohanraj
- Department of Adult Health and Nursing Systems, School of Nursing, Virginia Commonwealth University, Richmond, VA, United States
| | - Debra Lynch Kelly
- Department of Nursing, University of Florida, Gainesville, FL, United States
- Cancer Population Science, University of Florida Health Cancer Center, University of Florida, Gainesville, FL, United States
| | - Erin S. Costanzo
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
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133
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Scott H, Cheung JM, Muench A, Ivers H, Grandner MA, Lack L, Morin CM, Perlis M. Does total sleep time substantially increase after cognitive behavioral therapy for insomnia? J Clin Sleep Med 2022; 18:1823-1829. [PMID: 35404226 PMCID: PMC9243283 DOI: 10.5664/jcsm.10004] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 03/21/2022] [Accepted: 03/22/2022] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES In most standardized approaches to cognitive behavioral therapy for insomnia, it is commonly the case that total wake time is reduced substantially during sleep restriction, but self-reported total sleep time (TST) is minimally affected. By follow-up, however, TST increases by almost 1 hour on average. A secondary analysis was undertaken to assess what percentage of participants meet or appreciably exceed baseline TST after cognitive behavioral therapy for insomnia. METHODS Data were drawn from a randomized controlled trial assessing acute and maintenance therapies for chronic insomnia (n = 80). The present analyses assessed the percentage of participants that 1) reached (≥ 0 minute increase) and 2) appreciably exceeded (≥ 30 minutes increase) baseline TST as assessed via daily sleep diaries at posttreatment and 3, 6, 12, and 24 months following treatment. RESULTS By the end of acute treatment, 45% of participants reached or exceeded baseline TST. By 24 months follow-up, this percentage had increased to 86%. Only 17% of participants achieved a 30-minute increase in TST by the end of acute treatment, and this proportion only increased to 58% over time. CONCLUSIONS These findings suggest that cognitive behavioral therapy for insomnia in its current form does not appreciably increase self-reported TST in a significant proportion of patients with insomnia. Whether participants would benefit from further increases in TST warrants investigation. The further titration of sleep opportunity may be useful to accelerate increases in TST, to extend the effect to a larger subset of patients, and/or to increase the magnitude of the TST gain. CITATION Scott H, Cheung JMY, Muench A, et al. Does total sleep time substantially increase after cognitive behavioral therapy for insomnia? J Clin Sleep Med. 2022;18(7):1823-1829.
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Affiliation(s)
- Hannah Scott
- Adelaide Institute for Sleep Health: A Flinders Centre of Research Excellence, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Janet M.Y. Cheung
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Alexandria Muench
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Hans Ivers
- School of Psychology and BRAIN Research Center, Université Laval, Quebec City, Canada
| | | | - Leon Lack
- Adelaide Institute for Sleep Health: A Flinders Centre of Research Excellence, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Charles M. Morin
- School of Psychology and BRAIN Research Center, Université Laval, Quebec City, Canada
| | - Michael Perlis
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
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134
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Merz EL, Gholizadeh S. Mental and Physical Health Concerns in the Context of COVID-19: Opportunities and Applications for Behavioral Medicine. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2022; 20:292-300. [PMID: 37205014 PMCID: PMC10172526 DOI: 10.1176/appi.focus.20220044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Numerous physical and mental health concerns have been documented in the context of COVID-19, and it is likely that patients, survivors, frontline health care workers, and other affected individuals will present to psychiatry for treatment. Behavioral medicine, an interdisciplinary field that is defined by a behavioral and biomedical conceptualization of clinical care, offers an opportunity for collaboration with psychiatry and other health care providers to meet the myriad needs resulting from the pandemic. This review summarizes a conceptual framework of behavioral medicine and clinical health psychology, COVID-19-related quality of life concerns that may be applicable to behavioral medicine referrals, clinical assessment directions, and intervention opportunities. The review combines both findings specific to COVID-19 and general behavioral medicine principles with an overall goal of providing a basic introduction to behavioral medicine practice, applications, and opportunities for management of medical and psychological symptoms.
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Affiliation(s)
- Erin L Merz
- Department of Psychology, College of Natural and Behavioral Sciences, California State University, Dominguez Hills, Carson (Merz); TheKey Research Group™, San Diego (Gholizadeh)
| | - Shadi Gholizadeh
- Department of Psychology, College of Natural and Behavioral Sciences, California State University, Dominguez Hills, Carson (Merz); TheKey Research Group™, San Diego (Gholizadeh)
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135
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Chung S. Four Useful Concepts When Treating Patients With Insomnia: Possibility of Sleep Index-Based Cognitive Behavioral Therapy for Insomnia. SLEEP MEDICINE RESEARCH 2022. [DOI: 10.17241/smr.2022.01249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Cognitive behavioral therapy for insomnia (CBT-I) is one of the most common treatments for insomnia and is considered as the first-line treatment. People who struggle to fall asleep or stay asleep or those who do not find sleep refreshing can benefit over four to six sessions of CBT-I. Although CBT-I has many benefits, it does have some drawbacks. Therefore, a brief version needs to be developed for use in clinical practice. This study proposes the following concepts that can be readily applied in clinical practice: 1) Concept 1, 17 hours of activity and 7 hours of sleep; 2) Concept 2, discrepancy between desired time in bed and desired total sleep time; 3) Concept 3, time in bed during 24 hours; and 4) Concept 4, taking sleeping pills 7 hours before the waking up time. These concepts based on sleep indices could easily help patients with insomnia and may serve as a foundation for the development of Sleep Index-based CBT-I.
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136
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Mijnster T, Boersma GJ, Meijer E, Lancel M. Effectivity of (Personalized) Cognitive Behavioral Therapy for Insomnia in Mental Health Populations and the Elderly: An Overview. J Pers Med 2022; 12:1070. [PMID: 35887566 PMCID: PMC9319701 DOI: 10.3390/jpm12071070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/27/2022] [Accepted: 06/28/2022] [Indexed: 11/16/2022] Open
Abstract
Insomnia is very prevalent in psychiatry and is considered a transdiagnostic symptom of mental disorders. Yet, it is not only a consequence of a mental condition but may also exert detrimental effects on psychiatric symptom severity and therapeutic response; thus, adequate insomnia treatment is particularly important in psychiatric populations. The first choice of intervention is cognitive behavioral therapy for insomnia (CBT-I) as it is rather effective, also in the long run without side effects. It is offered in various forms, ranging from in-person therapy to internet-delivered applications. CBT-I protocols are typically developed for individuals with insomnia disorder without co-occurring conditions. For an optimal therapeutic outcome of CBT-I in individuals with comorbid mental disorders, adaptations of the protocol to tailor the treatment might be beneficial. Based on a literature search using major search engines (Embase; Medline; APA Psych Info; and Cochrane Reviews), this paper provides an overview of the effectiveness of the different CBT-I applications in individuals with diverse comorbid mental conditions and older adults and describes the functionality of CBT-I protocols that have been personalized to specific psychiatric populations, such as depression, substance abuse, and schizophrenia spectrum disorder. Finally, we discuss urgent needs for insomnia therapy targeted to improve both sleep and psychopathologies.
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Affiliation(s)
- Teus Mijnster
- Centre of Expertise on Sleep and Psychiatry, GGZ Drenthe, Mental Health Institute, 9404 LA Assen, The Netherlands; (T.M.); (G.J.B.); (E.M.)
| | - Gretha J. Boersma
- Centre of Expertise on Sleep and Psychiatry, GGZ Drenthe, Mental Health Institute, 9404 LA Assen, The Netherlands; (T.M.); (G.J.B.); (E.M.)
- Forensic Psychiatric Hospital, GGZ Drenthe, Mental Health Institute, 9404 LA Assen, The Netherlands
| | - Esther Meijer
- Centre of Expertise on Sleep and Psychiatry, GGZ Drenthe, Mental Health Institute, 9404 LA Assen, The Netherlands; (T.M.); (G.J.B.); (E.M.)
| | - Marike Lancel
- Centre of Expertise on Sleep and Psychiatry, GGZ Drenthe, Mental Health Institute, 9404 LA Assen, The Netherlands; (T.M.); (G.J.B.); (E.M.)
- Forensic Psychiatric Hospital, GGZ Drenthe, Mental Health Institute, 9404 LA Assen, The Netherlands
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, 9712 TS Groningen, The Netherlands
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137
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Haycock J, Hoon E, Sweetman A, Lack L, Lovato N. The management of insomnia by Australian psychologists: a qualitative study. AUSTRALIAN PSYCHOLOGIST 2022. [DOI: 10.1080/00050067.2022.2089544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Jenny Haycock
- Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, Australia
- NHMRC Centre of Research Excellence, Flinders UniversityNational Centre for Sleep Health Services Research: A , Adelaide, Australia
| | - Elizabeth Hoon
- NHMRC Centre of Research Excellence, Flinders UniversityNational Centre for Sleep Health Services Research: A , Adelaide, Australia
- Discipline of General Practice, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Alexander Sweetman
- Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, Australia
- NHMRC Centre of Research Excellence, Flinders UniversityNational Centre for Sleep Health Services Research: A , Adelaide, Australia
| | - Leon Lack
- NHMRC Centre of Research Excellence, Flinders UniversityNational Centre for Sleep Health Services Research: A , Adelaide, Australia
- College of Education Psychology and Social Work, Flinders University, Adelaide, Australia
| | - Nicole Lovato
- Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, Australia
- NHMRC Centre of Research Excellence, Flinders UniversityNational Centre for Sleep Health Services Research: A , Adelaide, Australia
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138
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Cain N, Richardson C, Bartel K, Whittall H, Reeks J, Gradisar M. A randomised controlled dismantling trial of sleep restriction therapies for chronic insomnia disorder in middle childhood: effects on sleep and anxiety, and possible contraindications. J Sleep Res 2022; 31:e13658. [PMID: 35712855 DOI: 10.1111/jsr.13658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 11/28/2022]
Abstract
Sleep restriction therapies likely drive improvement in insomnia in middle childhood via increases in homeostatic sleep pressure (e.g., evening sleepiness). Increased evening sleepiness may also dampen comorbid anxiety symptoms; and reduced wakefulness in bed may reduce worry. However, sleep restriction therapies have never been evaluated as a standalone intervention in this population. The mechanism of action needs testing, as do effects on anxiety, and cognitive performance and parasomnias (possible contraindications). This randomised controlled trial evaluated the efficacy of two "doses" of sleep restriction therapy (sleep restriction therapy, bedtime restriction therapy), compared to a control condition (time in bed regularisation). A total of 61 children (mean [SD, range] age 9.1 [2.1, 6-14] years; 54% female) with chronic insomnia disorder received two weekly 60-min treatment sessions with a psychologist. Sleep, sleepiness, anxiety, worry, cognitive performance, and parasomnias were measured pre-treatment, across treatment, and at 4-weeks post-treatment. Both the sleep and bedtime restriction groups experienced reductions in total sleep time (d = 1.38-2.27) and increases in evening sleepiness (d = 1.01-1.47) during the 2-week treatment, and improvements in insomnia (i.e., sleep onset latency; d = 1.10-1.21), relative to the control group. All groups reported improved anxiety and worry, yet there were no differences between the control and restriction groups (all p > 0.658). Time in bed increased at the 1-month follow-up, and benefits to sleep and insomnia were maintained. There were no adverse effects on cognitive functioning (all p > 0.259), nor parasomnia occurrence (all p > 0.740). These results suggest that sleep restriction therapies are brief, yet effective, standalone interventions for insomnia in middle childhood, and improvements are likely due to increased sleepiness, not sleep regularisation.
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Affiliation(s)
- Neralie Cain
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, South Australia, Australia
| | - Cele Richardson
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, South Australia, Australia.,Centre for Sleep Science, School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| | - Kate Bartel
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, South Australia, Australia
| | - Hannah Whittall
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, South Australia, Australia
| | - Joseph Reeks
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, South Australia, Australia
| | - Michael Gradisar
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, South Australia, Australia
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139
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Mair A, Scott H, Lack L. Intensive sleep retraining treatment for insomnia administered by smartphone in the home: an uncontrolled pilot study. J Clin Sleep Med 2022; 18:1515-1522. [PMID: 35641889 PMCID: PMC9163610 DOI: 10.5664/jcsm.9892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 01/13/2022] [Accepted: 01/14/2022] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Intensive sleep retraining (ISR) is a behavioral treatment that involves a patient falling asleep repeatedly over 1 treatment session (< 24 hours in duration) to treat sleep-onset insomnia. ISR relies on high homeostatic sleep and circadian rhythm drives to facilitate rapid sleep onsets overnight. The high cost and inaccessibility of laboratory-based ISR is a significant practical barrier to treatment uptake. Smartphone-delivered ISR offers a significantly more affordable, flexible, and efficient method to treat chronic insomnia. The present study is the first trial of ISR administered via smartphone in the home environment. METHODS Smartphone-delivered ISR was investigated with 12 individuals with chronic insomnia (9 women, 3 men, aged 49.75 ± 7.71 years) using a single-group, repeated-measures, case-replication series design. Participants received a single overnight session of home-based ISR treatment administered by smartphone. Sleep onset trials started at 23:00 and concluded after 40 trials or at 11:00 the following morning, whichever occurred first. Sleep diary and psychological variables associated with insomnia were measured at pretreatment, post-treatment, and 4- and 7-week follow-up. RESULTS Significant improvements with moderate to strong effects (d = 0.59-1.94) were indicated for sleep-onset latency, sleep efficiency, insomnia symptom severity, sleep self-efficacy, anticipatory sleep anxiety, dysfunctional beliefs about sleep, and daytime fatigue and functioning compared to baseline. Therapeutic benefits were largely maintained at the 7-week follow up. CONCLUSIONS This pilot study suggests that ISR may be feasibly administered via smartphone in the home. With fewer trials and a shorter treatment session, smartphone-delivered ISR seemed to achieve similar outcomes to the earlier laboratory-based ISR procedure. Randomized controlled trials are warranted to investigate the efficacy of smartphone-administered ISR. CITATION Mair A, Scott H, Lack L. Intensive sleep retraining treatment for insomnia administered by smartphone in the home: an uncontrolled pilot study. J Clin Sleep Med. 2022;18(6):1515-1522.
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Affiliation(s)
- Andrew Mair
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
- NQ Insomnia Clinic, South Townsville, Queensland, Australia
| | - Hannah Scott
- College of Medicine and Public Health, Adelaide Institute for Sleep Health: A Flinders Centre of Research Excellence, Flinders University, Adelaide, Australia
| | - Leon Lack
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
- College of Medicine and Public Health, Adelaide Institute for Sleep Health: A Flinders Centre of Research Excellence, Flinders University, Adelaide, Australia
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140
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Yavuz AY, Uysal E. Treatment method selection for sleep quality due to lumbar DISC herniation: Early surgery or others?; A single center clinical trial. J Clin Neurosci 2022; 101:162-167. [PMID: 35597065 DOI: 10.1016/j.jocn.2022.04.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 03/20/2022] [Accepted: 04/30/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND/AIM Sleep deprivation may lead to individual and social insufficiency associated with many physiological and psychological pathologies. This study is reported to investigate sleep quality and the relationship between treatment modalities of lumbar disc herniation, which is the most common cause of chronic lower back pain and sciatica. MATERIALS AND METHODS This present study was conducted on 249 cases with chronic lower back pain and sciatica caused by a single- level lumbar disc herniation diagnosed after lumbar MRI (Magnetic Resonance Imaging) between June 2017 and September 2019. Cases were divided into three groups according to the treatment modalities: early surgical treatment (n:80), extended conservative treatment (n:142), and medical treatment only (n:27). VAS (Visual Analog Scale) and PSQI (Pittsburgh Sleep Quality Index) data before the treatment and 6 months after the treatment were statistically analyzed. RESULTS It was determined that post-treatment VAS and PSQI scores were significantly reduced in all cases, regardless of the differences in treatment modalities (p < 0.05). In the early surgical treatment group, VAS score was improved by 69% and PSQI score was improved by 63.8%. These values were 28.5% and 38.6% in the extended conservative treatment. However, VAS score was increased by 27% in the patients who received only medical treatment. Statistical analysis of the treatment modalities showed that early surgical treatment was superior to the other treatment modalities (p < 0.05). CONCLUSIONS It was determined that early surgical treatment of lumbar disc herniation was superior to other treatment methods in terms of maintaining the sleep quality impairments associated with deterioration in sleep quality.
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Affiliation(s)
- Ahmed Yasin Yavuz
- Department of Neurosurgery, University of Health Sciences Turkey, Prof. Dr. Cemil Taşçıoğlu City Hospital, Turkey.
| | - Ece Uysal
- Department of Neurosurgery, University of Health Sciences Turkey, Prof. Dr. Cemil Taşçıoğlu City Hospital, Turkey.
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141
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Rogers CJ, Pakdaman S, Forster M, Sussman S, Grigsby TJ, Victoria J, Unger JB. Effects of multiple adverse childhood experiences on substance use in young adults: A review of the literature. Drug Alcohol Depend 2022; 234:109407. [PMID: 35306395 DOI: 10.1016/j.drugalcdep.2022.109407] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 03/06/2022] [Accepted: 03/08/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Adverse childhood experiences (ACE), including maltreatment and household dysfunction, are consistent predictors of health compromising behaviors in adulthood. While most ACE studies have focused on adults, there is an emerging body of research focusing on young adulthood. METHODS This review describes research focused on the relationship between ACE and substance use among young adults. Two databases were searched for studies published from 1998 to 2021 that assess the relationship between ACE and substance use among young adults. Of the 1474 articles identified in the search, 43 met the inclusion criteria. RESULTS Consensus across reviewed studies is that the relationship between ACE and substance use demonstrated in the general adult population is evident in young adults, although effects varied by demographic variables such as gender and ethnic background. CONCLUSIONS The need for standardized measures across studies, racial/ethnic considerations, and the importance of building trauma informed prevention programs targeting this age group are discussed.
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Affiliation(s)
- Christopher J Rogers
- Department of Population and Public Health Science, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA.
| | - Sheila Pakdaman
- Department of Population and Public Health Science, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - Myriam Forster
- Department of Health Sciences, California State University, Northridge, CA, USA
| | - Steve Sussman
- Department of Population and Public Health Science, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - Timothy J Grigsby
- Department of Environmental and Occupational Health University of Nevada, Las Vegas, USA
| | - Jazmine Victoria
- Department of Health Sciences, California State University, Northridge, CA, USA
| | - Jennifer B Unger
- Department of Population and Public Health Science, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
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142
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Riemann D, Benz F, Dressle RJ, Espie CA, Johann AF, Blanken TF, Leerssen J, Wassing R, Henry AL, Kyle SD, Spiegelhalder K, Van Someren EJW. Insomnia disorder: State of the science and challenges for the future. J Sleep Res 2022; 31:e13604. [PMID: 35460140 DOI: 10.1111/jsr.13604] [Citation(s) in RCA: 77] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 03/23/2022] [Accepted: 03/23/2022] [Indexed: 12/25/2022]
Abstract
Insomnia disorder comprises symptoms during night and day that strongly affect quality of life and wellbeing. Prolonged sleep latency, difficulties to maintain sleep and early morning wakening characterize sleep complaints, whereas fatigue, reduced attention, impaired cognitive functioning, irritability, anxiety and low mood are key daytime impairments. Insomnia disorder is well acknowledged in all relevant diagnostic systems: Diagnostic and Statistical Manual of the American Psychiatric Association, 5th revision, International Classification of Sleep Disorders, 3rd version, and International Classification of Diseases, 11th revision. Insomnia disorder as a chronic condition is frequent (up to 10% of the adult population, with a preponderance of females), and signifies an important and independent risk factor for physical and, especially, mental health. Insomnia disorder diagnosis primarily rests on self-report. Objective measures like actigraphy or polysomnography are not (yet) part of the routine diagnostic canon, but play an important role in research. Disease concepts of insomnia range from cognitive-behavioural models to (epi-) genetics and psychoneurobiological approaches. The latter is derived from knowledge about basic sleep-wake regulation and encompass theories like rapid eye movement sleep instability/restless rapid eye movement sleep. Cognitive-behavioural models of insomnia led to the conceptualization of cognitive-behavioural therapy for insomnia, which is now considered as first-line treatment for insomnia worldwide. Future research strategies will include the combination of experimental paradigms with neuroimaging and may benefit from more attention to dysfunctional overnight alleviation of distress in insomnia. With respect to therapy, cognitive-behavioural therapy for insomnia merits widespread implementation, and digital cognitive-behavioural therapy may assist delivery along treatment guidelines. However, given the still considerable proportion of patients responding insufficiently to cognitive-behavioural therapy for insomnia, fundamental studies are highly necessary to better understand the brain and behavioural mechanisms underlying insomnia. Mediators and moderators of treatment response/non-response and the associated development of tailored and novel interventions also require investigation. Recent studies suggest that treatment of insomnia may prove to add significantly as a preventive strategy to combat the global burden of mental disorders.
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Affiliation(s)
- Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany.,Center for Basics in NeuroModulation (NeuroModulBasics), Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Fee Benz
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Raphael J Dressle
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Colin A Espie
- Sir Jules Thorn Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.,Big Health Ltd, London, UK.,Big Health Ltd, San Francisco, California, USA
| | - Anna F Johann
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany.,Institute of Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Tessa F Blanken
- Department of Psychological Methods, University of Amsterdam, Amsterdam, The Netherlands
| | - Jeanne Leerssen
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Rick Wassing
- Centre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research, The Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Alasdair L Henry
- Sir Jules Thorn Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.,Big Health Ltd, London, UK.,Big Health Ltd, San Francisco, California, USA
| | - Simon D Kyle
- Sir Jules Thorn Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Eus J W Van Someren
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
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143
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Drapkina OM, Kontsevaya AV, Kalinina AM, Avdeev SM, Agaltsov MV, Alexandrova LM, Antsiferova AA, Aronov DM, Akhmedzhanov NM, Balanova YA, Balakhonova TV, Berns SA, Bochkarev MV, Bochkareva EV, Bubnova MV, Budnevsky AV, Gambaryan MG, Gorbunov VM, Gorny BE, Gorshkov AY, Gumanova NG, Dadaeva VA, Drozdova LY, Egorov VA, Eliashevich SO, Ershova AI, Ivanova ES, Imaeva AE, Ipatov PV, Kaprin AD, Karamnova NS, Kobalava ZD, Konradi AO, Kopylova OV, Korostovtseva LS, Kotova MB, Kulikova MS, Lavrenova EA, Lischenko OV, Lopatina MV, Lukina YV, Lukyanov MM, Mayev IV, Mamedov MN, Markelova SV, Martsevich SY, Metelskaya VA, Meshkov AN, Milushkina OY, Mukaneeva DK, Myrzamatova AO, Nebieridze DV, Orlov DO, Poddubskaya EA, Popovich MV, Popovkina OE, Potievskaya VI, Prozorova GG, Rakovskaya YS, Rotar OP, Rybakov IA, Sviryaev YV, Skripnikova IA, Skoblina NA, Smirnova MI, Starinsky VV, Tolpygina SN, Usova EV, Khailova ZV, Shalnova SA, Shepel RN, Shishkova VN, Yavelov IS. 2022 Prevention of chronic non-communicable diseases in Of the Russian Federation. National guidelines. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2022. [DOI: 10.15829/1728-8800-2022-3235] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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144
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Sleep reactivity as a potential pathway from childhood abuse to adult insomnia. Sleep Med 2022; 94:70-75. [DOI: 10.1016/j.sleep.2022.03.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/24/2022] [Accepted: 03/27/2022] [Indexed: 11/24/2022]
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145
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Lin WC, Chang WH, Bai YM, Li CT, Chen MH, Su TP. The risk of insomnia after surgical operation: A longitudinal, population-based, case-crossover study. J Chin Med Assoc 2022; 85:519-524. [PMID: 35019868 DOI: 10.1097/jcma.0000000000000688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The acute onset of insomnia following surgical operations has long been neglected, and long-term outcomes are not clear. Our aims were (1) to evaluate the risk of postoperative insomnia, (2) to identify which surgeries are related, and (3) to follow patients with postoperative insomnia for the development of major mental and physical disorders. METHODS We conducted a case-crossover study comprising 9898 participants with new-onset insomnia from the Taiwan National Health Insurance Research Database between 1997 and 2011. We determined the odds of having surgery in the case period (30 days) before the onset of insomnia by logistic regression analysis. Types of surgery that postoperative insomniacs had undergone were compared with age-/gender-/timing-matched controls. Longitudinal follow-up of postoperative and non-postoperative insomniacs was performed. RESULTS The odds ratio of surgical exposure vs. nonexposure within 30 days was 12.05 (p < 0.001) before new-onset insomnia. Surgery of musculoskeletal and nervous systems predisposed to insomnia. The duration of hypnotic drug use (0.83 years) was shorter and with a nearly 2-fold faster remission rate in postoperative than in non-postoperative insomniacs (1.45 years). Approximately 25% of each insomnia group developed persistent sleep disturbance. CONCLUSION Surgery is associated with subsequent insomnia, which has a shorter duration and a faster remission than non-postoperative insomnia. Our data provide a reference for postoperative care, and warrant future studies.
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Affiliation(s)
- Wei-Chen Lin
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Wen-Han Chang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan, ROC
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146
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Deutsch-Lang S, Kuchling M, Valeske I, Hulle-Wegl P, Stepansky R, Lang W. Die primäre und die psychiatrisch-„komorbide“, nichtorganische Insomnie in einem neurologisch geführten Schlaflabor. PSYCHOPRAXIS. NEUROPRAXIS 2022. [PMCID: PMC8886859 DOI: 10.1007/s00739-022-00790-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Patientinnen und Patienten, die in einem neurologischen Schlaflabor die Abschlussdiagnose nichtorganische Insomnie erhalten, leiden zu einem großen Teil (34 von 43 Personen) unter einer psychiatrischen Erkrankung: Persönlichkeitsstörungen, mit und ohne zusätzliche affektive Störung, Depression, Dysthymie, Zyklothymie, bipolare Störung, Angststörungen (generalisierte Angststörung, soziale Phobie), somatoforme (autonome) Funktionsstörung, hypochondrische Störung, Zwangsstörung, Anpassungsstörungen nach dramatischen Lebensereignissen sowie posttraumatische Belastungsstörungen. Sie befinden sich in laufender psychiatrischer und psychotherapeutischer Behandlung, leiden aber anhaltend unter den Symptomen der Insomnie. Allen Patientinnen und Patienten mit nichtorganischer Insomnie wird die kognitive Verhaltenstherapie der Insomnie angeboten.
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147
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Smejka T, Wiggs L. The effects of Autonomous Sensory Meridian Response (ASMR) videos on arousal and mood in adults with and without depression and insomnia. J Affect Disord 2022; 301:60-67. [PMID: 34915083 DOI: 10.1016/j.jad.2021.12.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/03/2021] [Accepted: 12/09/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Autonomous Sensory Meridian Response (ASMR) is a pleasant physiological tingling sensation induced by certain visual and auditory triggers. ASMR has been shown to reduce stress and increase positive mood, but its effects have not yet been studied in populations with clinically severe symptoms. The present study aimed to investigate whether the experience of ASMR improved mood and reduced arousal in people with and without insomnia and depression symptoms. METHODS 1,037 participants (18-66 years) completed online questionnaires assessing insomnia and depression symptom severity followed by questionnaires on current mood and arousal levels before and after watching an ASMR video. The independent variables were the participant's group (insomnia, depression, insomnia and depression combined or control) and whether they experienced ASMR during the video. The dependent variables were the change in mood and arousal levels after watching the video. RESULTS As predicted, all participants showed significantly increased relaxation and improved mood after watching the video with the largest effects for participants who experienced ASMR and for participants in the combined and depression groups. No difference was found between the insomnia and control groups. LIMITATIONS It is not known how many participants were familiar with ASMR videos prior to taking part in the study (nor whether this is important). Also, the categorization of participants into the ASMR group was based on self-report and thus, not verified. CONCLUSIONS Results suggest that ASMR videos have the potential to be used to improve mood and reduce arousal with implications for alleviating symptoms of insomnia and depression.
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Affiliation(s)
- Tom Smejka
- Centre for Psychological Research, Department of Psychology, Health and Professional Development, Oxford Brookes University, Gipsy Lane, Headington, Oxford OX3 0BP, UK
| | - Luci Wiggs
- Centre for Psychological Research, Department of Psychology, Health and Professional Development, Oxford Brookes University, Gipsy Lane, Headington, Oxford OX3 0BP, UK.
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148
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Miller MB, Curtis AF, Hall NA, Freeman LK, Everson AT, Martinez LD, Park CJ, McCrae CS. Daily associations between modifiable sleep behaviors and nighttime sleep among young adult drinkers with insomnia. J Clin Sleep Med 2022; 18:703-712. [PMID: 34605392 PMCID: PMC8883105 DOI: 10.5664/jcsm.9706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Empirical evidence linking individual sleep hygiene practices to subsequent sleep parameters is limited, particularly at the daily level. This study compared the strength of daily, within-person associations between these modifiable sleep behaviors and nighttime sleep in young adult drinkers with insomnia. METHODS Young adults (ages 18-30 years; n = 56) who met diagnostic criteria for insomnia and reported past-month binge drinking wore wrist actigraphy and completed online sleep diaries for 8.5 days (standard deviation = 2.3; 477 reports). Diaries assessed engagement in 11 sleep hygiene recommendations. Multilevel models tested daily associations between sleep behaviors and 3 outcomes: sleep quality, self-reported sleep efficiency, and actigraphy-measured sleep efficiency. RESULTS Participants self-reported better sleep quality/efficiency on days that they slept in a comfortable environment, limited naps to 30 minutes, and maintained a consistent wake time. They self-reported worse sleep quality and efficiency on nights that they avoided alcohol use before bedtime. No sleep behaviors were significantly associated with actigraphy-measured sleep efficiency after correcting for inflation in type I error. CONCLUSIONS The sleep hygiene recommendations most strongly associated with sleep at the daily level were consistent with stimulus control. Creating a comfortable sleep environment also emerged as an important correlate of daily sleep. Heavy drinkers with insomnia may perceive better sleep if they drink before bedtime; however, this finding may be unique to this population. CITATION Miller MB, Curtis AF, Hall NA, et al. Daily associations between modifiable sleep behaviors and nighttime sleep among young adult drinkers with insomnia. J Clin Sleep Med. 2022;18(3):703-712.
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Affiliation(s)
- Mary Beth Miller
- Address correspondence to: Mary Beth Miller, PhD, One Hospital Drive DC067.00, Columbia, MO 65212; Tel: (573) 882-1813; Fax: (573) 884-1070;
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149
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Siengsukon C. Physical Therapists' Role in Addressing Acute Insomnia: Could We Prevent Chronic Insomnia-and Chronic Pain? Phys Ther 2022; 102:6478861. [PMID: 34939102 DOI: 10.1093/ptj/pzab285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/03/2021] [Accepted: 11/09/2021] [Indexed: 11/14/2022]
Affiliation(s)
- Catherine Siengsukon
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, Kansas, USA
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150
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Frøjd LA, Papageorgiou C, Munkhaugen J, Moum T, Sverre E, Nordhus IH, Dammen T. Worry and rumination predict insomnia in patients with coronary heart disease: a cross-sectional study with long-term follow-up. J Clin Sleep Med 2022; 18:779-787. [PMID: 34633284 PMCID: PMC8883089 DOI: 10.5664/jcsm.9712] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Insomnia is highly prevalent and associated with anxiety and depression in patients with coronary heart disease patients. The development of effective psychological interventions is needed. Worry and rumination are potential risk factors for the maintenance of insomnia, anxiety, and depression that may be modified by psychological treatment grounded in the Self-Regulatory Executive Function model. However, the relationships between worry, rumination, anxiety and depression, and insomnia are not known. Therefore, we investigated these relationships both cross-sectionally and longitudinally among patients with coronary heart disease. METHODS A cross-sectional study consecutively included 1,082 patients in 2014-2015, and 686 were followed up after mean of 4.7 years. Data were gathered from hospital records and self-report questionnaires comprising assessment of worry (Penn State Worry Questionnaire), rumination (Ruminative Responses Scale), anxiety and depression (Hospital Anxiety and Depression Scale), and insomnia (Bergen Insomnia Scale). RESULTS Insomnia correlated moderately with all other psychological variables (R 0.18-0.50, all P values < .001). After adjustments for anxiety and depression, odds ratios for insomnia at baseline were 1.27 (95% confidence interval 1.08-1.50) and 1.60 (95% confidence interval 1.31-1.94) per 10 points increase of worry and rumination, respectively. Corresponding odds ratios for insomnia at follow-up were 1.28 (95% confidence interval 1.05-1.55) and 1.38 (95% confidence interval 1.09-1.75). Depression was no longer significantly associated with insomnia after adjustments for worry and rumination, but anxiety remained significant. CONCLUSIONS Worry and rumination predicted insomnia both cross-sectionally and prospectively, even after controlling for anxiety and depression, although anxiety remained significant. Future studies may test psychological interventions targeting these factors in patients with coronary heart disease and insomnia. CITATION Frøjd LA, Papageorgiou C, Munkhaugen J, et al. Worry and rumination predict insomnia in patients with coronary heart disease: a cross-sectional study with long-term follow-up. J Clin Sleep Med. 2022;18(3):779-787.
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Affiliation(s)
- Lars Aastebøl Frøjd
- Department of Behavioural Medicine, University of Oslo, Oslo, Norway,Address correspondence to: Lars Aastebøl Frøjd, StudMed, Department of Behavioural Medicine, Institute of Basic Medical Sciences, Institute of Medicine, University of Oslo. Postal address: Postboks 1111 Blindern 0317 Oslo, Norway;
| | - Costas Papageorgiou
- Priory Hospital Altrincham, Cheshire, United Kingdom,Department of Psychology, University of Oslo, Oslo, Norway
| | - John Munkhaugen
- Department of Behavioural Medicine, University of Oslo, Oslo, Norway,Department of Medicine, Drammen Hospital, Drammen, Norway
| | - Torbjørn Moum
- Department of Behavioural Medicine, University of Oslo, Oslo, Norway
| | - Elise Sverre
- Department of Behavioural Medicine, University of Oslo, Oslo, Norway,Department of Medicine, Drammen Hospital, Drammen, Norway
| | - Inger Hilde Nordhus
- Department of Behavioural Medicine, University of Oslo, Oslo, Norway,Department of Clinical Psychology, University of Bergen, Bergen Norway
| | - Toril Dammen
- Department of Behavioural Medicine, University of Oslo, Oslo, Norway
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