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Tibubos AN, Zenger M, Schmalbach B, Beutel ME, Brähler E. Measurement invariance, validation and normative data of the Jenkins Sleep Scale-4 (JSS-4) in the German general population across the life span. J Psychosom Res 2020; 130:109933. [PMID: 31951963 DOI: 10.1016/j.jpsychores.2020.109933] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 01/09/2020] [Accepted: 01/11/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVE As sleep disorders have become a major concern in public health, there is strong need for a brief and sound measure for sleep problems. The purposes of the study were to 1) evaluate factor structure and measurement invariance, 2) validate the scale based on sociodemographic data and distress, and 3) provide norm values for the general population. METHODS In a representative survey of the German population N = 2515 participants (14 to 95 years) filled in the 4-item Jenkins Sleep Scale (JSS-4), sociodemographic questions and the Brief Symptom Inventory-18 (anxiety, depression, somatic symptom load). The JSS-4 was analyzed by principal component analysis, confirmatory and multi-group confirmatory factor analyses. A multiple-indicator-multiple-cause model was tested to investigate the relationship of the JSS-4 to distress and sociodemographic variables. RESULTS The one-factor structure of JSS-4 was confirmed. Given the heterogeneity of facets of sleep problems captured in the four items, internal consistency of the JSS-4 was remarkably high. The JSS-4 was strictly invariant across both sexes, and partially strictly invariant across income groups and individuals living with or without a partner. With regard to the full age range, it showed partial scalar invariance. CONCLUSION Female sex, higher age, living without a partner, lower education, lower income and increased distress were associated with more sleep problems. Calculated normative data of sleep problems allow comparisons of JSS-4 scores stratified by sex and age.
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Affiliation(s)
- A N Tibubos
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
| | - M Zenger
- Faculty of Applied Human Studies, University of Applied Sciences Magdeburg and Stendal, Stendal, Germany; Integrated Research and Treatment Center (IFB) Adiposity Diseases - Behavioral Medicine, Medical Psychology and Medical Sociology, University of Leipzig Medical Center, Leipzig, Germany.
| | - B Schmalbach
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
| | - M E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
| | - E Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
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152
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Hyperarousal Scale: Italian Cultural Validation, Age and Gender Differences in a Nonclinical Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041176. [PMID: 32059606 PMCID: PMC7068573 DOI: 10.3390/ijerph17041176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 02/07/2020] [Accepted: 02/10/2020] [Indexed: 12/01/2022]
Abstract
Objectives. Studies on hyperarousal have increasingly developed in the last decade. Nevertheless, there are still very few valid measures of hyperarousal. The aim of the study is to verify the psychometric properties of the Italian version of the Hyperarousal Scale (H-Scale), in order to provide researchers with a valid measure for the target population. Method. The questionnaire was translated, back-translated, pre-tested, and cross-culturally adapted. Subsequently, the Italian version of the H-Scale, the Anxiety Sensitivity Index (ASI-3) and the Health Survey Questionnaire (SF-36) were administered to 982 adults, 456 males and 526 females, aged from 18 to 80 years (M = 35.61 ± 12.47). Results. Cronbach’s alpha of the translated H-Scale was 0.81. Furthermore, positive correlations with the ASI-3 and negative correlations with the SF-36 emerged. The H-Scale is also sensitive to catch age and gender differences. Conclusions. The Italian version of the H-Scale demonstrated good reliability and validity. Its sufficient discriminative and evaluative psychometric properties provide the theoretical evidence for further application in evidence-based research studies.
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153
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Crowley SK, Rebellon J, Huber C, Leonard AJ, Henderson D, Magal M. Cardiorespiratory fitness, sleep, and physiological responses to stress in women. Eur J Sport Sci 2020; 20:1368-1377. [PMID: 31939334 DOI: 10.1080/17461391.2020.1716855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Epidemiological studies suggest that cardiorespiratory fitness (CRfitness) is associated with reduced risk of depression and anxiety in women, however, the mechanisms by which CRfitness may be protective against the development of these disorders are less clear. Because sleep problems are associated with both a higher risk for mental illness and altered physiological responses to stress, this study investigated whether sleep quality might influence the relationship between CRfitness and physiological stress responses in women. Thirty healthy women (18-45 y) who were medication-free, with regular menstrual cycles completed: (1) enrolment visit [including the assessment of CRfitness via maximal oxygen consumption during exercise]; (2) one-week sleep monitoring period including subjective (daily sleep diaries) and objective (wrist actigraphy) sleep measures; and (3) psychosocial stressor protocol (the Trier Social Stress Test; TSST) for the collection of heart rate (HR), blood pressure (BP), and salivary cortisol stress responses. Higher CRfitness was associated with reduced wake after sleep onset (WASO) duration (r = -.38, p = 0.04), higher self-reported sleep quality (higher scores reflect poorer sleep quality; r = -.37, p = 0.05), and lower HR (r = -.43, p = 0.02) during the stressor. Higher sleep quality was associated with a lower HR during the stressor (r = .44, p = 0.01). Increased WASO duration and WASO number were associated with blunted cortisol output during the stressor (r = -.44, p = 0.02, and r = -.46, p = 0.02, respectively). Results suggest that, in women, CRfitness may be protective against the deleterious effects of stress via improved sleep quality.
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Affiliation(s)
- Shannon K Crowley
- Department of Exercise Science, North Carolina Wesleyan College, Rocky Mount, NC, USA.,Department of Health Promotion, North Carolina Wesleyan College, Rocky Mount, NC, USA
| | - Julia Rebellon
- Department of Exercise Science, North Carolina Wesleyan College, Rocky Mount, NC, USA
| | - Christina Huber
- Department of Exercise Science, North Carolina Wesleyan College, Rocky Mount, NC, USA
| | - Abigail J Leonard
- Department of Exercise Science, North Carolina Wesleyan College, Rocky Mount, NC, USA
| | - Daniel Henderson
- Department of Exercise Science, North Carolina Wesleyan College, Rocky Mount, NC, USA
| | - Meir Magal
- Department of Exercise Science, North Carolina Wesleyan College, Rocky Mount, NC, USA
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154
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Mayer P, Herrero Babiloni A, Beetz G, Marshansky S, Kaddaha Z, Rompré PH, Jobin V, Lavigne GJ. The Evaluation of Autonomic Arousals in Scoring Sleep Respiratory Disturbances with Polysomnography and Portable Monitor Devices: A Proof of Concept Study. Nat Sci Sleep 2020; 12:443-451. [PMID: 32765141 PMCID: PMC7371436 DOI: 10.2147/nss.s258276] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/30/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Autonomic arousals can be considered as surrogates of electroencephalography (EEG) arousals when calculating respiratory disturbance index (RDI). The main objective of this proof of concept study was to evaluate the use of heart rate acceleration (HRa) arousals associated with sleep respiratory events in a population undergoing full polysomnography (type 1) and in another undergoing portable monitor study (type 3). Our hypothesis is that when compared to other commonly used indexes, RDI based on HRa will capture more events in both types of recording. MATERIALS AND METHODS A retrospective analysis was performed in two different populations of patients with suspected OSA: a) 72 patients undergoing one night of type 1 recording and b) 79 patients undergoing one night of type 3 recording. Variables for type 1 were 4% oxygen desaturation index (ODI), apnea/hypopnea index (AHI), RDI based on EEG arousals (RDIe), and RDI based on HRa with threshold of 5bpm (RDIa5). For type 3, variables were 4% ODI, AHI, and RDIa5 (it is not possible to calculate RDIe due to the absence of EEG). Calculated data were 1) Mean values for each sleep disturbance index in type 1 and 3 recordings; 2) Frequency of migration from lower to higher OSA severity categories using RDIa5 in comparison to AHI (thresholds: ≥5/h mild, ≥15/h moderate, ≥30/h severe); and 3) Bland-Altman plots to assess agreement between AHI vs RDIe and RDIa5 in type 1 population, and AHI vs RDIa5 in type 3 populations. RESULTS More respiratory disturbance events were captured with RDIa5 index in both type 1 and type 3 recordings when compared to the other indexes. In type 1 recording, when using RDIa5 37% of patients classified as not having OSA with AHI were now identified as having OSA, and a total of 59% migrated to higher severity categories. In type 3 recording, similar results were obtained, as 37% of patients classified as not having OSA with AHI were now identified as having OSA using RDIa5, and a total of 55% patients migrated to higher severity categories. Mean differences for RDIa5 and AHI in type 1 and 3 populations were similar. CONCLUSION The use of autonomic arousals such as HRa can help to detect more respiratory disturbance events when compared to other indexes, being a variable that may help to capture borderline mild cases. This becomes especially relevant in type 3 recordings. Future research is needed to determine its validity, optimization, and its clinical significance.
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Affiliation(s)
- Pierre Mayer
- Faculté de Médecine, Hôpital Hôtel-Dieu du Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montréal, Québec, Canada
| | - Alberto Herrero Babiloni
- Faculté de Médecine, Hôpital Hôtel-Dieu du Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montréal, Québec, Canada.,Research Center, Hôpital du Sacré-Coeur de Montréal, CIUSSS du Nord-de-l'île-de-Montréal, Université de Montréal, Montréal, Québec, Canada.,Department of Oral Health, Faculté de Médecine Dentaire, Université de Montréal, Montréal, Québec, Canada.,Division of Experimental Medicine, McGill University, Montréal, Québec, Canada
| | - Gabrielle Beetz
- Research Center, Hôpital du Sacré-Coeur de Montréal, CIUSSS du Nord-de-l'île-de-Montréal, Université de Montréal, Montréal, Québec, Canada
| | - Serguei Marshansky
- Faculté de Médecine, Hôpital Hôtel-Dieu du Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montréal, Québec, Canada
| | - Zeina Kaddaha
- Faculté de Médecine, Hôpital Hôtel-Dieu du Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montréal, Québec, Canada
| | - Pierre H Rompré
- Department of Oral Health, Faculté de Médecine Dentaire, Université de Montréal, Montréal, Québec, Canada
| | - Vincent Jobin
- Faculté de Médecine, Hôpital Hôtel-Dieu du Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montréal, Québec, Canada
| | - Gilles J Lavigne
- Faculté de Médecine, Hôpital Hôtel-Dieu du Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montréal, Québec, Canada.,Research Center, Hôpital du Sacré-Coeur de Montréal, CIUSSS du Nord-de-l'île-de-Montréal, Université de Montréal, Montréal, Québec, Canada.,Department of Oral Health, Faculté de Médecine Dentaire, Université de Montréal, Montréal, Québec, Canada
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155
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McCrae CS, Curtis AF, Williams JM, Dautovich ND, McNamara JPH, Stripling A, Dzierzewski JM, Berry RB, McCoy KM, Marsiske M. Effects of Brief Behavioral Treatment for Insomnia on Daily Associations between Self-Reported Sleep and Objective Cognitive Performance in Older Adults. Behav Sleep Med 2020; 18:577-588. [PMID: 31203649 PMCID: PMC7981847 DOI: 10.1080/15402002.2019.1632201] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Behavioral treatments for insomnia improve sleep in older adults, but research documenting their effects on cognitive performance is mixed. We explored whether a brief behavioral treatment for insomnia (BBTi) impacts daily associations between sleep parameters and next day cognition. METHODS Sixty-two older adults (Mage = 69.45 years, SD = 7.71) with insomnia completed either 4 weeks of BBTi or self-monitoring control (SMC). At baseline, post-treatment, and 3 month follow-up, participants completed 14 days of diaries measuring sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST), and sleep efficiency (SE), as well as daily cognitive tests measuring processing speed (i.e., symbol digit modalities test, SDMT), and reasoning (i.e., letter series). At each time period, associations between sleep parameters and daily cognition, controlling for age, education, insomnia duration, use of sleep medications, and depression (i.e., Beck Depression Inventory-2nd Edition scores), were examined through multilevel modeling. RESULTS At post-treatment, we observed an interactive fixed effect of treatment condition (i.e., BBTi/SMC) and TST on daily SDMT and letter series performance. For BBTi, longer TST was associated with better letter series performance, and did not predict SDMT performance. For SMC, longer TST was associated with worse SDMT, and was not associated with letter series performance. Greater WASO (regardless of group) was associated with better SDMT performance at post-treatment. Associations were not maintained at follow-up. CONCLUSIONS Sleep duration may play an important role in BBTi-related improvements in daily higher order cognition. Maintenance of these associations may be facilitated by booster sessions following post-treatment. CLINICAL TRIAL IDENTIFIER NCT02967185.
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Affiliation(s)
| | - Ashley F. Curtis
- Department of Psychiatry, University of Missouri-Columbia,
Columbia, MO
| | | | | | | | - Ashley Stripling
- College of Psychology, Nova Southeastern University, Fort
Lauderdale, Florida,Department of Psychiatry, Geisel School of Medicine,
Dartmouth College, Hanover, NH
| | | | | | - Karin M. McCoy
- Neuropsychology Service, South Texas Veterans Health Care
System, San Antonio, TX
| | - Michael Marsiske
- Department of Clinical and Health Psychology, University of
Florida, Gainesville, FL
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156
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Magnavita N, Di Stasio E, Capitanelli I, Lops EA, Chirico F, Garbarino S. Sleep Problems and Workplace Violence: A Systematic Review and Meta-Analysis. Front Neurosci 2019; 13:997. [PMID: 31632231 PMCID: PMC6779772 DOI: 10.3389/fnins.2019.00997] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Accepted: 09/03/2019] [Indexed: 12/19/2022] Open
Abstract
Background: This systematic review with meta-analysis was carried out to study the relationship between workplace violence and sleep problems. Methods: The PRISMA statement was used to conduct a systematic search of the literature on PubMed/MEDLINE, Scopus, Sociological abstract, DOAJ, Web of Science, and Google Scholar databases. Of the original number of 749 studies, 34 were included in the systematic review, and 7 in the meta-analysis. Results: A total of 119,361 participants from 15 different countries took part in these studies which were published between 1999 and 2019. Significant heterogeneity was observed among the studies (I2 = 96%). In a random-effects meta-analysis model, pooled odds ratio (OR) analysis revealed that there was a direct relationship between occupational exposure to violence and sleep problems (OR = 2.55; 95% CI = 1.77–3.66). According to the GRADE guidelines, the quality of evidence of the association was low. Conclusions: The findings of this study demonstrate that occupational exposure to physical, verbal, or sexual violence is associated with sleep problems. Further research on the relationship between violence and sleep is needed so that appropriate measures can be taken to prevent violence and improve sleep hygiene in the workplace. Trial Registration Number: PROSPERO International prospective register of systematic reviews (CRD42019124903) February 9, 2019.
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Affiliation(s)
- Nicola Magnavita
- Post-graduate School in Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy.,Department of Women/Child & Public Health, Gemelli General Hospital Foundation IRCCS, Rome, Italy
| | - Enrico Di Stasio
- Post-graduate School in Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy.,Department of Women/Child & Public Health, Gemelli General Hospital Foundation IRCCS, Rome, Italy
| | - Ilaria Capitanelli
- Post-graduate School in Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Erika Alessandra Lops
- Post-graduate School in Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Chirico
- Post-graduate School in Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Sergio Garbarino
- Post-graduate School in Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy.,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Mother and Child Health (DINOGMI), University of Genoa, Genoa, Italy
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157
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Veeramachaneni K, Slavish DC, Dietch JR, Kelly K, Taylor DJ. Intraindividual variability in sleep and perceived stress in young adults. Sleep Health 2019; 5:572-579. [PMID: 31575485 DOI: 10.1016/j.sleh.2019.07.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 06/25/2019] [Accepted: 07/25/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Research suggests strong associations between habitual sleep parameters (eg, mean duration, timing, efficiency), perceived stress, and insomnia symptoms. The associations between intraindividual variability (IIV; night-to-night within-person variation) in sleep, perceived stress, and insomnia have not been explored. This study examined associations between IIV in subjectively and objectively determined sleep parameters and to perceived stress in young adults with and without insomnia. DESIGN Prospective longitudinal. SETTING AND PARTICIPANTS Participants were 149 college students (mean age = 20.2 [SD = 2.4], 59% female) either with insomnia (n = 81; 54%) or without insomnia (n = 68; 46%). MEASUREMENTS Participants completed 1 week of daily sleep diaries and actigraphy (to assess total sleep time [TST], sleep efficiency [SE], and circadian midpoint [CM]), the Perceived Stress Scale, and a diagnostic interview for determination of insomnia as part of a parent study. RESULTS Greater IIV in actigraphy-determined TST (but not SE or CM) was independently associated with greater perceived stress, regardless of insomnia status. Greater IIV in sleep diary-determined TST, SE, or CM was not associated with perceived stress. Insomnia status was the most robust predictor of elevated perceived stress. There was a significant interaction between IIV in sleep diary-determined TST and insomnia status on perceived stress: Only in those without insomnia was greater IIV in sleep diary-determined TST associated with higher perceived stress. CONCLUSION Maintaining a more consistent sleep duration may be associated with lower stress in college students. Future research is needed to clarify the directionality and implications of this association for treatment.
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Affiliation(s)
- Kirti Veeramachaneni
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX, 76203; College for Public Health and Social Justice, St Louis University, 3545 Lafayette Ave, St Louis, MO 63104
| | - Danica C Slavish
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX, 76203.
| | - Jessica R Dietch
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX, 76203
| | - Kimberly Kelly
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX, 76203
| | - Daniel J Taylor
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX, 76203; Department of Psychology, University of Arizona, 1503 E University Blvd Bldg 68, Tucson, AZ 85721
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158
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Kalmbach DA, Kingsberg SA, Roth T, Cheng P, Fellman-Couture C, Drake CL. Sexual function and distress in postmenopausal women with chronic insomnia: exploring the role of stress dysregulation. Nat Sci Sleep 2019; 11:141-153. [PMID: 31686931 PMCID: PMC6709826 DOI: 10.2147/nss.s213941] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 06/24/2019] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Menopause triggers changes in sexual function and many women develop sexual problems. Insomnia is common in postmenopausal women, and disturbed sleep has been linked to poor sexual health. Thus, postmenopausal women with insomnia may be especially vulnerable to developing sexual difficulties. This study estimated rates of sexual distress in postmenopausal women with chronic insomnia and explored associations between various facets of sexual health, insomnia symptoms, and insomnia-related stress dysregulation. DESIGN Cross-sectional. SETTING Large multi-site health system in the US. PARTICIPANTS 150 postmenopausal women diagnosed with DSM-5 chronic insomnia disorder (56.44±5.64 years) completed measures of sexual distress, sexual function, hot flashes, insomnia symptoms, depression, and stress dysregulation in the forms of cognitive-emotional arousal (worry, rumination), sleep reactivity, and somatic hyperarousal. RESULTS Nearly half of the sample endorsed clinically significant sexual distress (46.9%). Insomnia symptoms were largely associated with poor sexual arousal, orgasmic dysfunction, sexual distress, and sexual dissatisfaction. Insomnia-related stress dysregulation was similarly associated with these facets of sexual health but was also linked to problems with low desire and greater vaginal pain during sex. Hot flashes and depression were negatively associated with sexual health. CONCLUSION Postmenopausal women with chronic insomnia endorse high rates of sexual distress. Although compromised sexual function appears directly related to poor sleep itself, our data suggest that stress dysregulation may play vital role in sexual problems endorsed by postmenopausal insomniacs, particularly regarding low desire and vaginal pain. Prospective research is needed to characterize the evolution of these co-occurring symptoms.
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Affiliation(s)
- David A Kalmbach
- Division of Sleep Medicine, Thomas Roth Sleep Disorders & Research Center, Henry Ford Health System, Detroit, MI, USA
| | - Sheryl A Kingsberg
- Departments of Reproductive Biology and Psychiatry, Case Western Reserve University, Cleveland, OH, USA
| | - Thomas Roth
- Division of Sleep Medicine, Thomas Roth Sleep Disorders & Research Center, Henry Ford Health System, Detroit, MI, USA
| | - Philip Cheng
- Division of Sleep Medicine, Thomas Roth Sleep Disorders & Research Center, Henry Ford Health System, Detroit, MI, USA
| | - Cynthia Fellman-Couture
- Division of Sleep Medicine, Thomas Roth Sleep Disorders & Research Center, Henry Ford Health System, Detroit, MI, USA
| | - Christopher L Drake
- Division of Sleep Medicine, Thomas Roth Sleep Disorders & Research Center, Henry Ford Health System, Detroit, MI, USA
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159
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Wilson S, Anderson K, Baldwin D, Dijk DJ, Espie A, Espie C, Gringras P, Krystal A, Nutt D, Selsick H, Sharpley A. British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders: An update. J Psychopharmacol 2019; 33:923-947. [PMID: 31271339 DOI: 10.1177/0269881119855343] [Citation(s) in RCA: 137] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This British Association for Psychopharmacology guideline replaces the original version published in 2010, and contains updated information and recommendations. A consensus meeting was held in London in October 2017 attended by recognised experts and advocates in the field. They were asked to provide a review of the literature and identification of the standard of evidence in their area, with an emphasis on meta-analyses, systematic reviews and randomised controlled trials where available, plus updates on current clinical practice. Each presentation was followed by discussion, aiming to reach consensus where the evidence and/or clinical experience was considered adequate, or otherwise to flag the area as a direction for future research. A draft of the proceedings was circulated to all speakers for comments, which were incorporated into the final statement.
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Affiliation(s)
- Sue Wilson
- 1 Centre for Psychiatry, Imperial College London, London, UK
| | - Kirstie Anderson
- 2 Regional Sleep Service, Freeman Hospital, Newcastle Upon Tyne, UK
| | - David Baldwin
- 3 Clinical and Experimental Sciences, University of Southampton, Southampton, UK
| | - Derk-Jan Dijk
- 4 Sleep Research Centre, University of Surrey, Guildford, UK
| | - Audrey Espie
- 5 Psychology Department, NHS Fife, Dunfermline, UK
| | - Colin Espie
- 6 Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Paul Gringras
- 7 Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Andrew Krystal
- 8 Psychiatry and Behavioral Science, University of California, San Francisco, CA, USA
| | - David Nutt
- 1 Centre for Psychiatry, Imperial College London, London, UK
| | - Hugh Selsick
- 9 Royal London Hospital for Integrated Medicine, London, UK
| | - Ann Sharpley
- 10 Department of Psychiatry, University of Oxford, Oxford, UK
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160
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Warth J, Puth MT, Tillmann J, Porz J, Zier U, Weckbecker K, Münster E. Over-indebtedness and its association with sleep and sleep medication use. BMC Public Health 2019; 19:957. [PMID: 31315596 PMCID: PMC6637586 DOI: 10.1186/s12889-019-7231-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 06/24/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Over-indebtedness is currently rising in high-income countries. Millions of citizens are confronted with the persistent situation when household income and assets are insufficient to cover payment obligations and living expenses. Previous research shows that over-indebtedness increases the risk of various adverse health effects. However, its association with sleep problems has not yet been examined. The objective of this study was to investigate the association between over-indebtedness and sleep problems and sleep medication use. METHODS A cross-sectional study on over-indebtedness (OID survey) was conducted in 70 debt advisory centres in Germany in 2017 that included 699 over-indebted respondents. The survey data were combined with the nationally representative German Health Interview and Examination Survey for Adults (DEGS1; n = 7987). We limited analyses to participants with complete data on all sleep variables (OID: n = 538, DEGS1: n = 7447). Descriptive analyses and logistic regression analyses were used to examine the association between over-indebtedness and difficulty initiating and maintaining sleep, and sleep medication use. RESULTS A higher prevalence of sleep problems and sleep medication use was observed among over-indebted individuals compared to the general population. After adjustment for socio-economic and health factors (age, sex, education, marital status, employment status, subjective health status and mental illness), over-indebtedness significantly increased the risk of difficulties with sleep onset (adjusted odds ratio (aOR) 1.79, 95%-confidence interval (CI) 1.45-2.21), sleep maintenance (aOR 1.45, 95%-CI 1.17-1.80) and sleep medication use (aOR 3.94, 95%-CI 2.96-5.24). CONCLUSIONS Evidence suggests a strong association between over-indebtedness and poor sleep and sleep medication use independent of conventional socioeconomic measures. Considering over-indebtedness in both research and health care practice will help to advance the understanding of sleep disparities, and facilitate interventions for those at risk. TRIAL REGISTRATION German Clinical Trials Register: DRKS00013100 (OID survey, ArSemü); Date of registration: 23.10.2017; Date of enrolment of the first participant: 18.07.2017, retrospectively registered.
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Affiliation(s)
- Jacqueline Warth
- Institute of General Practice and Family Medicine, University of Bonn, Universitätsklinikum Bonn AöR, Sigmund-Freud-Str. 25, 53127, Bonn, Germany.
| | - Marie-Therese Puth
- Institute of General Practice and Family Medicine, University of Bonn, Universitätsklinikum Bonn AöR, Sigmund-Freud-Str. 25, 53127, Bonn, Germany.,Institute for Medical Biometry, Informatics and Epidemiology (IMBIE), University of Bonn, Universitätsklinikum Bonn AöR, Sigmund-Freud-Str. 25, 53127, Bonn, Germany
| | - Judith Tillmann
- Institute of General Practice and Family Medicine, University of Bonn, Universitätsklinikum Bonn AöR, Sigmund-Freud-Str. 25, 53127, Bonn, Germany
| | - Johannes Porz
- Institute of General Practice and Family Medicine, University of Bonn, Universitätsklinikum Bonn AöR, Sigmund-Freud-Str. 25, 53127, Bonn, Germany
| | - Ulrike Zier
- Institute of General Practice and Family Medicine, University of Bonn, Universitätsklinikum Bonn AöR, Sigmund-Freud-Str. 25, 53127, Bonn, Germany
| | - Klaus Weckbecker
- Institute of General Practice and Family Medicine, University of Bonn, Universitätsklinikum Bonn AöR, Sigmund-Freud-Str. 25, 53127, Bonn, Germany
| | - Eva Münster
- Institute of General Practice and Family Medicine, University of Bonn, Universitätsklinikum Bonn AöR, Sigmund-Freud-Str. 25, 53127, Bonn, Germany
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161
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Garfield V, Joshi R, Garcia-Hernandez J, Tillin T, Chaturvedi N. The relationship between sleep quality and all-cause, CVD and cancer mortality: the Southall and Brent REvisited study (SABRE). Sleep Med 2019; 60:230-235. [PMID: 31182326 DOI: 10.1016/j.sleep.2019.03.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/12/2019] [Accepted: 03/18/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Both long and short sleep duration increase risk of mortality. Most previous studies have been performed in Europeans and have focused on sleep duration. Thus, we aimed to investigate the association between sleep quality and mortality across three different ethnic groups. METHODS We used data from the Southall and Brent REvisited Study (SABRE) cohort, which comprises first generation migrant South Asian and African Caribbean men and women, aged 40-69 years, recruited between 1988 and 1991. In sum, 4399 participants provided complete data at baseline and follow-up. Of those, 1656 died by December 2017. Our exposures (eg, difficulty falling asleep, early morning waking and waking up tired in the morning) were self-reported and our primary outcome was mortality. We used Cox proportional hazards models to analyse our data, adjusting for baseline-measured confounders. RESULTS None of the sleep measures were strongly associated with all-cause mortality in Europeans or African Caribbeans, whilst in South Asians difficulty falling asleep was related to an increased risk of all-cause mortality (HR = 1.28, 95%CI = 1.01; 1.61). In Europeans, early morning waking was associated with a moderately increased risk of cardiovascular death (HR = 1.31, 95%CI = 1.05; 1.63); alternately, this association was not as strong in the other groups. CONCLUSION Our findings suggest that the relationship between sleep quality and mortality may differ by ethnic group, but formal heterogeneity tests indicated that the strongest difference in HRs was observed for early morning waking and cardiovascular disease (CVD) mortality across the three groups (Cochran's Q test p = 0.036). As such, these results are novel and provide support for ethnic differences in sleep quality and mortality, and may have implications for precision medicine.
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Affiliation(s)
- Victoria Garfield
- Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK.
| | - Roshni Joshi
- Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK
| | - Jorge Garcia-Hernandez
- Institute of Health Informatics, University College London, 222 Euston Road, London, NW1 2DA, UK
| | - Therese Tillin
- Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK
| | - Nish Chaturvedi
- Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK
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162
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Lee SH, Kim SJ, Bang JW, Lee JH. Relationship of the Duration and Timing of Exercise with Sleep Quality in Community-Dwelling Adults. SLEEP MEDICINE RESEARCH 2018. [DOI: 10.17241/smr.2018.00248] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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163
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Kalmbach DA, Cheng P, Arnedt JT, Anderson JR, Roth T, Fellman-Couture C, Williams RA, Drake CL. Treating insomnia improves depression, maladaptive thinking, and hyperarousal in postmenopausal women: comparing cognitive-behavioral therapy for insomnia (CBTI), sleep restriction therapy, and sleep hygiene education. Sleep Med 2018; 55:124-134. [PMID: 30785053 DOI: 10.1016/j.sleep.2018.11.019] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 10/19/2018] [Accepted: 11/28/2018] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Depression increases during menopause, and subclinical depressive symptoms increase risk for major depression. Insomnia is common among postmenopausal women and increases depression-risk in this already-vulnerable population. Recent evidence supports the efficacy of cognitive-behavioral therapy for insomnia (CBTI) to treat menopausal insomnia, but it remains unclear whether treating insomnia also alleviates co-occurring depressive symptoms and depressogenic features. This trial tested whether CBTI improves depressive symptoms, maladaptive thinking, and somatic hyperarousal in postmenopausal women with insomnia; as well as whether sleep restriction therapy (SRT)-a single component of CBTI-is equally efficacious. MATERIALS AND METHODS Single-site, randomized controlled trial. 117 postmenopausal women (56.34 ± 5.41 years) with peri-or-postmenopausal onset of chronic insomnia were randomized to three treatment conditions: sleep hygiene education control (SHE), SRT, and CBTI. Blinded assessments were performed at baseline, posttreatment, and six-month follow-up. RESULTS CBTI produced moderate-to-large reductions in depressive symptoms, whereas SRT produced moderate reductions but not until six months posttreatment. Treatment effects on maladaptive thinking were mixed. CBTI and SRT both produced large improvements in dysfunctional beliefs about sleep, but weaker influences on presleep cognitive arousal, rumination, and worry. Presleep somatic arousal greatly improved in the CBTI group and moderately improved in the SRT group. Improvements in depression, maladaptive thinking, and hyperarousal were linked to improved sleep. SHE produced no durable treatment effects. CONCLUSIONS CBTI and SRT reduce depressive symptoms, dysfunctional beliefs about sleep, and presleep somatic hyperarousal in postmenopausal women, with CBTI producing superior results. Despite its cognitive emphasis, cognitive arousal did not respond strongly or durably to CBTI. NAME: Behavioral Treatment of Menopausal Insomnia: Sleep and Daytime Outcomes. URL: clinicaltrials.gov. REGISTRATION NCT01933295.
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Affiliation(s)
- David A Kalmbach
- Thomas Roth Sleep Disorders & Research Center, Henry Ford Health System, Detroit, MI, USA
| | - Philip Cheng
- Thomas Roth Sleep Disorders & Research Center, Henry Ford Health System, Detroit, MI, USA
| | - J Todd Arnedt
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Jason R Anderson
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | - Thomas Roth
- Thomas Roth Sleep Disorders & Research Center, Henry Ford Health System, Detroit, MI, USA
| | | | - Reg A Williams
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Christopher L Drake
- Thomas Roth Sleep Disorders & Research Center, Henry Ford Health System, Detroit, MI, USA.
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Wang L, Wang K, Liu JH, Wang YP. Altered Default Mode and Sensorimotor Network Connectivity With Striatal Subregions in Primary Insomnia: A Resting-State Multi-Band fMRI Study. Front Neurosci 2018; 12:917. [PMID: 30574065 PMCID: PMC6291517 DOI: 10.3389/fnins.2018.00917] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 11/22/2018] [Indexed: 11/15/2022] Open
Abstract
Background: Primary insomnia is a high prevalent sleep disorder. Disturbed brain activity during reward, emotional, and cognitive processing have been observed in insomnia patients. Studies have implicated a critical role of the striatum in these dysfunctions. However, there have been no direct investigations on the whole-brain functional connectivity (FC) of the striatum in insomnia. Methods: We analyzed the group differences in the FC images of 6 predefined striatal subregions based on the multi-band resting-state fMRI data of 18 insomnia patients and 16 healthy controls. Results: We found increased positive FC in the bilateral medial frontal gyrus for bilateral dorsal caudate (DC) and left inferior ventral striatum (VS) subregions, but increased negative FC in the bilateral inferior parietal lobe for the left inferior VSi and right dorsal caudal putamen (DCP) subregions, and in the lateral temporal, occipital, and primary sensorimotor areas for the bilateral DC and left superior VS subregions. The FC between the right DCP and right inferior parietal lobe showed significant positive correlation with Pittsburgh Sleep Quality Index (PSQI). Conclusion: The findings indicate disturbed striatal FC with the default mode network (DMN), the visual and somatosensory areas in insomnia, which likely reflects an inappropriate reward or emotional significance attribute to self-reflection, episodic memory, sensory-perception processes. The altered striatal FC might increase the risk of insomnia patients to develop depression and anxiety.
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Affiliation(s)
- Li Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Kun Wang
- Beijing Puren Hospital, Beijing, China
| | - Jiang-Hong Liu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yu-Ping Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
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165
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Pöpel A. [Evidence-Based Treatment of Insomnia]. PRAXIS 2018; 107:1339-1343. [PMID: 30482125 DOI: 10.1024/1661-8157/a003160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Evidence-Based Treatment of Insomnia Abstract. This review article presents current evidence on the diagnosis and efficacy of treatment methods for non-organic insomnia. In diagnostics, it is particularly important to examine differential diagnoses individually and, if available, to treat them. Regarding the actual insomnia treatment, it should be emphasized that drug treatment provides proof of efficacy only in short-term treatments lasting less than four weeks. The most effective treatment for insomnia is disorder-specific cognitive-behavioral psychotherapy (CBT-I). CBT-I should therefore be accessible to every patient with insomnia.
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