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Hickman R, D’Oliveira TC, Davies A, Shergill S. Monitoring Daily Sleep, Mood, and Affect Using Digital Technologies and Wearables: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2024; 24:4701. [PMID: 39066098 PMCID: PMC11280943 DOI: 10.3390/s24144701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Revised: 07/05/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024]
Abstract
Background: Sleep and affective states are closely intertwined. Nevertheless, previous methods to evaluate sleep-affect associations have been limited by poor ecological validity, with a few studies examining temporal or dynamic interactions in naturalistic settings. Objectives: First, to update and integrate evidence from studies investigating the reciprocal relationship between daily sleep and affective phenomena (mood, affect, and emotions) through ambulatory and prospective monitoring. Second, to evaluate differential patterns based on age, affective disorder diagnosis (bipolar, depression, and anxiety), and shift work patterns on day-to-day sleep-emotion dyads. Third, to summarise the use of wearables, actigraphy, and digital tools in assessing longitudinal sleep-affect associations. Method: A comprehensive PRISMA-compliant systematic review was conducted through the EMBASE, Ovid MEDLINE(R), PsycINFO, and Scopus databases. Results: Of the 3024 records screened, 121 studies were included. Bidirectionality of sleep-affect associations was found (in general) across affective disorders (bipolar, depression, and anxiety), shift workers, and healthy participants representing a range of age groups. However, findings were influenced by the sleep indices and affective dimensions operationalised, sampling resolution, time of day effects, and diagnostic status. Conclusions: Sleep disturbances, especially poorer sleep quality and truncated sleep duration, were consistently found to influence positive and negative affective experiences. Sleep was more often a stronger predictor of subsequent daytime affect than vice versa. The strength and magnitude of sleep-affect associations were more robust for subjective (self-reported) sleep parameters compared to objective (actigraphic) sleep parameters.
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Affiliation(s)
- Robert Hickman
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, 16 De Crespigny Park, London SE5 8AF, UK;
- National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley National Health Service Foundation Trust, London SE5 8AF, UK
| | - Teresa C. D’Oliveira
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, 16 De Crespigny Park, London SE5 8AF, UK;
- School of Psychology and Life Sciences, Canterbury Christ Church University, North Holmes Road, Canterbury CT1 1QU, UK
- Kent and Medway Medical School, Canterbury Christ Church University and the University of Kent, Canterbury CT2 7NZ, UK;
| | - Ashleigh Davies
- Kent and Medway Medical School, Canterbury Christ Church University and the University of Kent, Canterbury CT2 7NZ, UK;
| | - Sukhi Shergill
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, 16 De Crespigny Park, London SE5 8AF, UK;
- Kent and Medway Medical School, Canterbury Christ Church University and the University of Kent, Canterbury CT2 7NZ, UK;
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2
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Anderson AR, Holliday D. Mapping the associations of daily pain, sleep, and psychological distress in a U.S. sample. J Behav Med 2023; 46:973-985. [PMID: 37382795 DOI: 10.1007/s10865-023-00432-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 06/19/2023] [Indexed: 06/30/2023]
Abstract
Chronic pain, sleep problems, and psychological distress (PD) can be disabling conditions and previous research has shown that they are associated. The nuances of the comorbid nature of these conditions may be important to understand for those who treat these conditions. This study examined the bidirectional associations of these health factors concurrently and over time in a sample of U.S. adults (N = 1,008, Mage = 57.68) from the Midlife in the United States (MIDUS) study. Participants reported on their daily pain, sleep quantity, and psychological distress over eight days. A modified Random Intercept Cross-lagged Panel Model was used to analyze the relations, starting with the whole sample and then a comparison of those with and without chronic pain. Results indicated that nightly variation in sleep quantity predicted next day psychological distress for both groups. Sleep quantity also predicted next-day pain, but only for individuals with chronic pain. Associations between pain and psychological distress were found both at the daily level and individual (between-person) level. This between-person association was stronger for those with chronic pain. The lagged associations between sleep, and both pain and psychological distress for the chronic pain group indicate that, increased quantity of sleep predicts decreased next-day pain and psychological distress. Providers could consider this unidirectional lagged relationship when prioritizing treatment for patients with these comorbid conditions. Future research may examine whether responsive, just-in-time treatments might intervene after participants wake from a poor night's sleep to counteract the negative effects of reduced sleep on PD and pain.
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Affiliation(s)
- Austen R Anderson
- School of Psychology, University of Southern Mississippi, 118 College Dr. #5025, Hattiesburg, MS, 39406, USA.
| | - Danielle Holliday
- School of Psychology, University of Southern Mississippi, 118 College Dr. #5025, Hattiesburg, MS, 39406, USA
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3
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Sommerhoff A, Ehring T, Takano K. Effects of Induced Mindfulness at Night on Repetitive Negative Thinking: Ecological Momentary Assessment Study. JMIR Ment Health 2023; 10:e44365. [PMID: 37467038 PMCID: PMC10398553 DOI: 10.2196/44365] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 05/26/2023] [Accepted: 05/31/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Repetitive negative thinking (RNT) is a cognitive risk factor for various disorders. Although brief mindfulness-based interventions (MBIs; lasting 20-30 minutes or shorter) are effective tools to reduce RNT, the effect of a minimal (5-minute) MBI remains largely unknown. OBJECTIVE We investigated the acute changes in RNT induced by a 10-day minimal MBI (body scan before sleeping) using an ecological momentary assessment (EMA) administered during the MBI training phase. In addition, we examined longer-term effects on the postintervention and 2-month follow-up assessments for questionnaire-based RNT and psychological distress. METHODS A total of 68 participants (community sample, aged 18-55 years; n=58, 85% women) were randomly allocated to either the intervention group (n=35, 51%) or the no-training control group (n=33, 49%). Both groups completed a 10-day EMA phase of RNT, during which only the intervention group performed a daily 5-minute body scan before sleeping. RESULTS The intervention group showed a significantly larger reduction in questionnaire-based RNT than the control group at the follow-up assessment (for growth-curve modeling analysis [GMA], dGMA=-0.91; P<.001), but this effect was not observed during the EMA phase or at the postintervention assessment. Furthermore, the intervention group showed significantly larger decreases in stress both at the postintervention (dGMA=-0.78; P<.001) and follow-up (dGMA=-0.60; P<.001) assessments than the control group. We found no intervention effects on depressive and anxiety symptoms. CONCLUSIONS A 5-minute body scan before sleeping reduces RNT and stress when continued for at least 10 days; however, the results suggest that this effect only appears with some time lag because no acute changes during and immediately after the intervention emerged for RNT.
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Affiliation(s)
- Amanda Sommerhoff
- Department of Psychology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Thomas Ehring
- Department of Psychology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Keisuke Takano
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, Japan
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4
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Almeida F, Marques DR, Gomes AA. A preliminary study on the association between social media at night and sleep quality: The relevance of FOMO, cognitive pre-sleep arousal, and maladaptive cognitive emotion regulation. Scand J Psychol 2023; 64:123-132. [PMID: 36256468 DOI: 10.1111/sjop.12880] [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: 12/27/2021] [Revised: 07/14/2022] [Accepted: 09/22/2022] [Indexed: 12/01/2022]
Abstract
Research shows that nighttime social media is negatively associated with sleep quality and that it might be utilized to cope with aversive psychological states related to cognitive pre-sleep arousal (i.e., transdiagnostic psychopathology variables, referring to maladaptive repetitive thought), namely Fear of Missing Out (FoMO). The use of nighttime social media to cope with other aversive cognitive states (i.e., worry/rumination), their relationship with FoMO, and these variables' association with sleep are not fully understood. This study explored the relationships between nighttime social media, sleep quality, FoMO, cognitive pre-sleep arousal, and maladaptive cognitive emotion regulation (i.e., worry/rumination). The present correlational study followed a cross-sectional design. Participants were 525 university students, ranging in age from 18 to 64 (M = 22.39, SD = 5.62). Measures of sleep quality, morningness/eveningness, cognitive pre-sleep arousal, worry, rumination, FoMO, nighttime screen, and social media use were collected online or in pencil-paper format. Multiple linear regression analyses were performed. Nighttime social media and FoMO were associated with rumination, worry (H1) and cognitive pre-sleep arousal. Both FoMO and worry predicted higher levels of cognitive pre-sleep arousal (H2) and nighttime social media use (H3). Nighttime social media use independently predicted poor sleep quality (H4). These results suggest that worry and FoMO may potentially affect sleep quality by increasing cognitive pre-sleep arousal and nighttime social media. A possible explanation for these findings is that nighttime social media might be used as a strategy to cope with aversive cognitive states. These conclusions may contribute to improving sleep intervention in this population.
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Affiliation(s)
- Filipa Almeida
- University of Coimbra, Faculty of Psychology and Educational Sciences, Coimbra, Portugal
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Coimbra, Portugal
| | - Daniel R Marques
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Coimbra, Portugal
- University of Aveiro, Department of Education and Psychology, Aveiro, Portugal
| | - Ana A Gomes
- University of Coimbra, Faculty of Psychology and Educational Sciences, Coimbra, Portugal
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Coimbra, Portugal
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Baselgia S, Combertaldi SL, Fahr A, Wirz DS, Ort A, Rasch B. Pre-sleep arousal induced by suspenseful series and cliffhangers have only minor effects on sleep: A sleep laboratory study. Sleep Med 2023; 102:186-198. [PMID: 36701833 DOI: 10.1016/j.sleep.2023.01.005] [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: 09/09/2022] [Revised: 12/22/2022] [Accepted: 01/06/2023] [Indexed: 01/13/2023]
Abstract
Pre-sleep arousal impairs sleep. Therefore, watching suspenseful TV series before sleep is not recommended as they increase arousal. In particular, the consumption of multiple episodes of the same suspenseful TV series in one sitting - termed binge-watching - could lead to large increases in physiological arousal delaying sleep onset. Furthermore, abrupt endings during critical scenes - termed cliffhangers - result in unfinished story lines, which further increase cognitive arousal and could negatively impact sleep architecture and the number of awakenings. However, the effects of binge-watching and cliffhangers on objective sleep parameters are still unknown. Here we tested in a controlled sleep-laboratory setting whether pre-sleep arousal induced by watching 3-4 episodes of a suspenseful TV series has negative effects on sleep in 50 healthy young participants (39 females, mean age = 22.62 ± 2.60 (SD)). Watching a neutral TV series served as a control condition, according to a within-subject design. In one group of participants, the suspenseful TV series ended with a cliffhanger. In the other group, the same TV series ended where no ongoing action was interrupted. Pre-sleep arousal was measured both subjectively with the self-reported level of stress and objectively with the mean heart rate and cortisol level. As expected, suspenseful TV series induced higher cognitive and physiological pre-sleep arousal than neutral control TV series, with highest values for TV series with cliffhangers. In spite of the high pre-sleep arousal, participants fell asleep faster after watching the suspenseful compared with the neutral TV series (F(1,48) = 4.89, p = 0.032, η2 = 0.09). Sleep architecture and the number of awakenings remained unaffected. However, in the first two sleep cycles, heart rate was still higher after watching suspenseful TV series (F(1,48) = 6.76, p = 0.012, η2 = 0.12). And only after cliffhangers, objective sleep quality - measured as the ratio between slow-wave and beta activity during sleep - was lower than in the other conditions (interaction effect, F(1,48) = 5.05, p = 0.029, η2 = 0.10). Our results speak against large impairments of pre-sleep watching of multiple episodes of suspenseful TV series and cliffhangers on sleep quality and architecture. However, unfinished narratives might induce more subtle changes in oscillatory power during sleep, possibly reflecting ongoing cognitive processing during sleep.
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Affiliation(s)
- Sandrine Baselgia
- Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | | | - Andreas Fahr
- Department of Communication and Media Research, University of Fribourg, Fribourg, Switzerland
| | - Dominique Stefanie Wirz
- Department of Communication and Media Research, University of Fribourg, Fribourg, Switzerland
| | - Alexander Ort
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Björn Rasch
- Department of Psychology, University of Fribourg, Fribourg, Switzerland.
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Ten Brink M, Dietch JR, Tutek J, Suh SA, Gross JJ, Manber R. Sleep and affect: A conceptual review. Sleep Med Rev 2022; 65:101670. [PMID: 36088755 PMCID: PMC10228665 DOI: 10.1016/j.smrv.2022.101670] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 06/15/2022] [Accepted: 07/08/2022] [Indexed: 10/15/2022]
Abstract
Everyday experience suggests that sleep and affect are closely linked, with daytime affect influencing how we sleep, and sleep influencing subsequent affect. Yet empirical evidence for this bidirectional relationship between sleep and affect in non-clinical adult samples remains mixed, which may be due to heterogeneity in both construct definitions and measurement. This conceptual review proposes a granular framework that deconstructs sleep and affect findings according to three subordinate dimensions, namely domains (which are distinct for sleep and affect), methods (i.e., self-report vs. behavioral/physiological measures), and timescale (i.e., shorter vs. longer). We illustrate the value of our granular framework through a systematic review of empirical studies published in PubMed (N = 80 articles). We found that in some cases, particularly for sleep disturbances and sleep duration, our framework identified robust evidence for associations with affect that are separable by domain, method, and timescale. However, in most other cases, evidence was either inconclusive or too sparse, resulting in no clear patterns. Our review did not find support for granular bidirectionality between sleep and affect. We suggest a roadmap for future studies based on gaps identified by our review and discuss advantages and disadvantages of our granular dimensional framework.
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Affiliation(s)
- Maia Ten Brink
- Department of Psychology, Stanford University, Stanford, CA, USA.
| | - Jessica R Dietch
- School of Psychological Science, Oregon State University, Corvallis, OR, USA
| | - Joshua Tutek
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Sooyeon A Suh
- Department of Psychology, Sungshin University, Seoul, South Korea
| | - James J Gross
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Rachel Manber
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
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7
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Akbar SA, Mattfeld AT, Laird AR, McMakin DL. Sleep to Internalizing Pathway in Young Adolescents (SIPYA): A proposed neurodevelopmental model. Neurosci Biobehav Rev 2022; 140:104780. [PMID: 35843345 PMCID: PMC10750488 DOI: 10.1016/j.neubiorev.2022.104780] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/28/2022] [Accepted: 07/12/2022] [Indexed: 01/28/2023]
Abstract
The prevalence of internalizing disorders, i.e., anxiety and depressive disorders, spikes in adolescence and has been increasing amongst adolescents despite the existence of evidence-based treatments, highlighting the need for advancing theories on how internalizing disorders emerge. The current review presents a theoretical model, called the Sleep to Internalizing Pathway in Young Adolescents (SIPYA) Model, to explain how risk factors, namely sleep-related problems (SRPs), are prospectively associated with internalizing disorders in adolescence. Specifically, SRPs during late childhood and early adolescence, around the initiation of pubertal development, contribute to the interruption of intrinsic brain networks dynamics, both within the default mode network and between the default mode network and other networks in the brain. This interruption leaves adolescents vulnerable to repetitive negative thought, such as worry or rumination, which then increases vulnerability to internalizing symptoms and disorders later in adolescence. Sleep-related behaviors are observable, modifiable, low-stigma, and beneficial beyond treating internalizing psychopathology, highlighting the intervention potential associated with understanding the neurodevelopmental impact of SRPs around the transition to adolescence. This review details support for the SIPYA Model, as well as gaps in the literature and future directions.
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Affiliation(s)
- Saima A Akbar
- Department of Psychology, Florida International University, Miami, FL, USA.
| | - Aaron T Mattfeld
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Angela R Laird
- Department of Physics, Florida International University, Miami, FL, USA
| | - Dana L McMakin
- Department of Psychology, Florida International University, Miami, FL, USA
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8
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Ran-Peled D, Bar-Shachar Y, Horwitz A, Finkelstein O, Bar-Kalifa E, Meiri G, Tikotzky L. Objective and subjective sleep and caregiving feelings in mothers of infants: a longitudinal daily diary study. Sleep 2022; 45:6569230. [DOI: 10.1093/sleep/zsac090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 03/28/2022] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study Objectives
This study explored the links between mothers’ objective and subjective sleep and their caregiving feelings toward their infant (i.e. patience for the infant, desire to be with the infant, and anger toward the infant), using a diary study design. We were particularly interested in examining whether nights of lower sleep quality within individual mothers predict more negative maternal caregiving feelings the following day.
Methods
The sample included 151 women, who were recruited during pregnancy. Data were collected at 4 and 8 months after delivery. Maternal sleep was monitored at home for seven nights using actigraphy and sleep diaries. Mothers rated their caregiving feelings each evening.
Results
Multilevel modeling (controlling for depressive symptoms, feeding method, and background variables) revealed that actigraphic and subjective sleep variables were associated with maternal caregiving feeling, both at the between- and within-person levels. For example, lower sleep percent predicted reduced levels of maternal patience for the infant at 4 and 8 months (between-person effect). Moreover, when a mother had a lower sleep percent on a given night (compared to her average), she reported lower levels of patience for her infant the following day (within-person prospective effect).
Conclusions
The findings demonstrate, for the first time, that maternal nightly variations in objective and subjective sleep quality predict daily changes in maternal feelings toward her infant at two different assessment points. Improving maternal sleep quality might be an important target for future interventions which may help mothers to feel more positively toward their infants.
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Affiliation(s)
- Dar Ran-Peled
- Department of Psychology, Ben-Gurion University of the Negev , Beer-Sheva , Israel
| | - Yael Bar-Shachar
- Department of Psychology, Ben-Gurion University of the Negev , Beer-Sheva , Israel
| | - Avel Horwitz
- Department of Psychology, Ben-Gurion University of the Negev , Beer-Sheva , Israel
| | - Omer Finkelstein
- Department of Psychology, Ben-Gurion University of the Negev , Beer-Sheva , Israel
| | - Eran Bar-Kalifa
- Department of Psychology, Ben-Gurion University of the Negev , Beer-Sheva , Israel
| | - Gal Meiri
- Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer-Sheva , Israel
| | - Liat Tikotzky
- Department of Psychology, Ben-Gurion University of the Negev , Beer-Sheva , Israel
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9
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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: 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 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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10
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Bodys-Cupak I, Czubek K, Grochowska A. Stress and Sleep Disorders in Polish Nursing Students During the SARS-CoV-2 Pandemic—Cross Sectional Study. Front Psychol 2022; 12:814176. [PMID: 35250696 PMCID: PMC8895395 DOI: 10.3389/fpsyg.2021.814176] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 12/29/2021] [Indexed: 12/19/2022] Open
Abstract
Introduction The world pandemic of the virus SARS-CoV-2 , which causes COVID-19 infection was announced by the World Health Organization (WHO) on March 11, 2020. Due to the restrictions that were introduced in order to minimize the spread of the virus, people more often suffer from stress, depression, anxiety, and sleep disorders. The aim of this study was evaluation of the stress levels and sleep disorders among nursing students during the pandemic SARS-CoV-2 . Materials and Study Methods This is a cross-sectional study conducted among 397 nursing students on March 2020. The research tools used were original questionnaires, Perceived Stress Scale (PSS10), and the Athenian Insomnia Scale (AIS), as well as Coping with Stress Inventory (MiniCOPE). Results Respondents felt a high level of stress, which occurred in 68.8% of interviewees regarding whether there was a danger of contracting COVID-19. Respondents experienced 84% stress levels when a family member suffered from COVID-19. Sleep disorders were determined mainly by the fear of infection and contact with someone who might be infected with the virus. Nursing students who felt a high level of stress often suffered from sleep disorders (70.2%) more frequently than students who felt a low or average stress level (30.4%). The respondents decided to cope with stress by denial, taking psychoactive substances, ceasing action, or blaming themselves. The greater the intensity of stress experienced by students, the more often they undertook avoidance behaviors or showed helplessness. Conclusion During the pandemic, students experienced severe stress, which resulted in sleep disorders and avoidance behaviors.
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Affiliation(s)
- Iwona Bodys-Cupak
- Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland
- *Correspondence: Iwona Bodys-Cupak
| | - Kamila Czubek
- Faculty of Health Sciences, University of Applied Sciences in Tarnow, Tarnow, Poland
| | - Aneta Grochowska
- Faculty of Health Sciences, University of Applied Sciences in Tarnow, Tarnow, Poland
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11
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De Angel V, Lewis S, White K, Oetzmann C, Leightley D, Oprea E, Lavelle G, Matcham F, Pace A, Mohr DC, Dobson R, Hotopf M. Digital health tools for the passive monitoring of depression: a systematic review of methods. NPJ Digit Med 2022; 5:3. [PMID: 35017634 PMCID: PMC8752685 DOI: 10.1038/s41746-021-00548-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 11/28/2021] [Indexed: 12/27/2022] Open
Abstract
The use of digital tools to measure physiological and behavioural variables of potential relevance to mental health is a growing field sitting at the intersection between computer science, engineering, and clinical science. We summarised the literature on remote measuring technologies, mapping methodological challenges and threats to reproducibility, and identified leading digital signals for depression. Medical and computer science databases were searched between January 2007 and November 2019. Published studies linking depression and objective behavioural data obtained from smartphone and wearable device sensors in adults with unipolar depression and healthy subjects were included. A descriptive approach was taken to synthesise study methodologies. We included 51 studies and found threats to reproducibility and transparency arising from failure to provide comprehensive descriptions of recruitment strategies, sample information, feature construction and the determination and handling of missing data. The literature is characterised by small sample sizes, short follow-up duration and great variability in the quality of reporting, limiting the interpretability of pooled results. Bivariate analyses show consistency in statistically significant associations between depression and digital features from sleep, physical activity, location, and phone use data. Machine learning models found the predictive value of aggregated features. Given the pitfalls in the combined literature, these results should be taken purely as a starting point for hypothesis generation. Since this research is ultimately aimed at informing clinical practice, we recommend improvements in reporting standards including consideration of generalisability and reproducibility, such as wider diversity of samples, thorough reporting methodology and the reporting of potential bias in studies with numerous features.
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Affiliation(s)
- Valeria De Angel
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
- NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK.
| | - Serena Lewis
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Psychology, University of Bath, Bath, UK
| | - Katie White
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Carolin Oetzmann
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Daniel Leightley
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Emanuela Oprea
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Grace Lavelle
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Faith Matcham
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Alice Pace
- Chelsea And Westminster Hospital NHS Foundation Trust, London, UK
| | - David C Mohr
- Center for Behavioral Intervention Technologies, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
- Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Richard Dobson
- NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Matthew Hotopf
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
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Benham G. Bedtime repetitive negative thinking moderates the relationship between psychological stress and insomnia. Stress Health 2021; 37:949-961. [PMID: 33904245 DOI: 10.1002/smi.3055] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 04/14/2021] [Accepted: 04/21/2021] [Indexed: 11/09/2022]
Abstract
Research suggests that psychological stress is associated with insomnia, but there is limited research on vulnerabilities that might amplify this association, particularly in college students. Based on a sample of 507 undergraduates, the current study demonstrates that the observed positive correlation between self-perceived stress and insomnia severity is moderated by the tendency to engage in repetitive negative thinking (RNT) at bedtime. Additionally, separate analyses of those who scored below/above the threshold for insomnia (non-insomniacs vs. insomniacs) revealed that the interaction between stress and these negative bedtime cognitions differed qualitatively between the two groups. In insomniacs, the stress-insomnia relationship was dampened for those with lower levels of bedtime RNT, but amplified for those with higher levels. For non-insomniacs, the stress-insomnia relationship was stronger for those with minimal bedtime RNT, while higher levels of bedtime RNT appeared to overshadow this association. To develop a better understanding of the contribution of stress and RNT to clinically relevant levels of insomnia, future studies should take into account the dissimilar patterns of moderation seen in non-insomniacs and insomniacs, either through prospective screening or separate analyses. Findings from the current study suggest that insomnia treatments that can simultaneously reduce stress and address bedtime RNT may be optimal.
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Affiliation(s)
- Grant Benham
- Department of Psychological Science, The University of Texas Rio Grande Valley, Edinburg, Texas, USA
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Repetitive negative thinking about suicide: Associations with lifetime suicide attempts. CLINICAL PSYCHOLOGY IN EUROPE 2021; 3:e5579. [PMID: 36398103 PMCID: PMC9667229 DOI: 10.32872/cpe.5579] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 06/28/2021] [Indexed: 11/25/2022] Open
Abstract
Background Repetitive negative thinking has been identified as an important predictor of suicide ideation and suicidal behavior. Yet, only few studies have investigated the effect of suicide-specific rumination, i.e., repetitive thinking about death and/or suicide on suicide attempt history. On this background, the present study investigated, whether suicide-specific rumination differentiates between suicide attempters and suicide ideators, is predictive of suicide attempt history and mediates the association between suicide ideation and suicide attempts. Method A total of 257 participants with a history of suicide ideation (55.6% female; Age M = 30.56, Age SD = 11.23, range: 18–73 years) completed online measures on suicidality, general and suicide-specific rumination. Results Suicide-specific rumination differentiated suicide attempters from suicide ideators, predicted suicide attempt status (above age, gender, suicide ideation, general rumination) and fully mediated the association between suicide ideation and lifetime suicide attempts. Conclusion Overall, though limited by the use of a non-clinical sample and a cross-sectional study design, the present results suggest that suicide-specific rumination might be a factor of central relevance in understanding transitions to suicidal behavior. Suicide-specific rumination was investigated in participants with a history of suicide ideation. Suicide-specific rumination differentiated suicide attempters from suicide ideators. Suicide-specific rumination predicted suicide attempt status. Suicide-specific rumination mediated the association between suicide ideation and lifetime suicide attempts. Suicide-specific rumination might be a factor of central relevance in understanding transitions to suicidal behavior.
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Sleep disturbance is associated with less emotional reactivity in individuals with heightened repetitive negative thinking. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02083-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Messman BA, Slavish DC, Dietch JR, Jenkins BN, Ten Brink M, Taylor DJ. Associations between daily affect and sleep vary by sleep assessment type: What can ambulatory EEG add to the picture? Sleep Health 2021; 7:219-228. [PMID: 33454245 DOI: 10.1016/j.sleh.2020.11.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 11/12/2020] [Accepted: 11/16/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE/BACKGROUND Disrupted sleep can be a cause and a consequence of affective experiences. However, daily longitudinal studies show sleep assessed via sleep diaries is more consistently associated with positive and negative affect than sleep assessed via actigraphy. The objective of the study was to test whether sleep parameters derived from ambulatory electroencephalography (EEG) in a naturalistic setting were associated with day-to-day changes in affect. PARTICIPANTS/METHOD Eighty adults (mean age = 32.65 years, 63% female) completed 7 days of affect and sleep assessments. We examined bidirectional associations between morning positive affect and negative affect with sleep assessed via diary, actigraphy, and ambulatory EEG. RESULTS Mornings with lower positive affect than average were associated with higher diary- and actigraphy-determined sleep efficiency that night. Mornings with higher negative affect than average were associated with longer actigraphy-determined total sleep time that night. Nights with longer diary-determined total sleep time, greater sleep efficiency, and shorter sleep onset latency than average were associated with higher next-morning positive affect, and nights with lower diary-determined wake-after-sleep-onset were associated with lower next-morning negative affect. EEG-determined sleep and affect results were generally null in both directions: only higher morning negative affect was associated with longer rapid eye movement (REM) sleep that night. CONCLUSIONS Self-reported sleep and affect may occur in a bidirectional fashion for some sleep parameters. EEG-determined sleep and affect associations were inconsistent but may still be important to assess in future studies to holistically capture sleep. Single-channel EEG represents a novel, ecologically valid tool that may provide information beyond diaries and actigraphy.
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Affiliation(s)
- Brett A Messman
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX 76203, USA
| | - Danica C Slavish
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX 76203, USA.
| | - Jessica R Dietch
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX 76203, USA
| | - Brooke N Jenkins
- Department of Psychology, Chapman University, One University Drive, Orange, CA 92866 USA
| | - Maia Ten Brink
- Department of Psychology, Stanford University, 450 Jane Stanford Way, Building 420, Stanford, CA 94305 USA
| | - Daniel J Taylor
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX 76203, USA
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Ballesio A, Ghezzi V, Vacca M, Ottaviani C, Lombardo C. Effects of Presleep Cognitive Intrusions on Subjective Sleep and Next-Day Cognitive Performance in Insomnia. Behav Ther 2020; 51:688-699. [PMID: 32800298 DOI: 10.1016/j.beth.2019.09.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 09/04/2019] [Accepted: 09/05/2019] [Indexed: 01/30/2023]
Abstract
Presleep cognitive intrusions about next-day activities, or proprioceptive and environmental stimuli, are thought to trigger insomnia in neurocognitive models. Recent research showed that intrusive cognitions at bedtime may interact with sleep in influencing next-day emotional functioning; their effects on cognitive functioning, however, is largely unknown. We tested the effects of presleep cognitive intrusions on subjective sleep and next-day cognitive performance in 80 participants, either with chronic insomnia or good sleepers. Presleep intrusions were inspected using a validated questionnaire and sleep was assessed with a sleep diary. Cognitive functioning the following morning was measured using a task-switching paradigm assessing executive functions. Structural equation modeling with manifest variables (i.e., path analysis) shows that presleep cognitive intrusions predicted increased sleep onset latency and wake after sleep onset, and lowered sleep efficiency. Moreover, task-switching accuracy was independently predicted by presleep cognitive intrusions in the previous night in those with insomnia but not in controls, beyond the effects of trait anxiety, task-switching components, and previous night's sleep. Findings confirm detrimental effects of presleep intrusions on sleep continuity and suggest the presence of links between presleep conscious activity and next-day executive performance in patients with insomnia, with the need to better elucidate potential mediators.
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Clancy F, O'Connor DB, Prestwich A. Do Worry and Brooding Predict Health Behaviors? A Daily Diary Investigation. Int J Behav Med 2020; 27:591-601. [PMID: 32424781 PMCID: PMC7497422 DOI: 10.1007/s12529-020-09898-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Meta-analyses have reported associations between perseverative cognition (both worry and brooding) and increased engagement in health-risk behaviors, poorer sleep, and poorer physiological health outcomes. METHOD Using a daily diary design, this study investigated the within- and between-person relationships between state and trait perseverative cognition and health behaviors (eating behavior, physical activity, alcohol consumption, and sleep) both cross-sectionally and prospectively. Participants (n = 273, 93% students, Mage = 20.2, SD = 4.11, 93% female) completed morning and evening diaries across 7 consecutive days. RESULTS Multilevel modeling analyses revealed that, cross-sectionally, higher levels of state worry were associated with more time spent sitting and higher levels of state brooding predicted less daily walking. CONCLUSION Worry and brooding may represent useful intervention targets for improving inactivity and walking levels, respectively.
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Affiliation(s)
- F Clancy
- Faculty of Medicine and Health, School of Psychology, The University of Leeds, Leeds, UK.
| | - D B O'Connor
- Faculty of Medicine and Health, School of Psychology, The University of Leeds, Leeds, UK
| | - A Prestwich
- Faculty of Medicine and Health, School of Psychology, The University of Leeds, Leeds, UK
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Rosenkranz T, Takano K, Watkins ER, Ehring T. Assessing repetitive negative thinking in daily life: Development of an ecological momentary assessment paradigm. PLoS One 2020; 15:e0231783. [PMID: 32310979 PMCID: PMC7170251 DOI: 10.1371/journal.pone.0231783] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 03/31/2020] [Indexed: 12/24/2022] Open
Abstract
Repetitive negative thinking (RNT) is a transdiagnostic process and a promising target for prevention and treatment of mental disorders. RNT is typically assessed via self-report questionnaires with most studies focusing on one type of RNT (i.e., worry or rumination) and one specific disorder (i.e., anxiety or depression). However, responses to such questionnaires may be biased by memory and metacognitive beliefs. Recently, Ecological Momentary Assessment (EMA) has been employed to minimize these biases. This study aims to develop an EMA paradigm to measure RNT as a transdiagnostic process in natural settings. Based on empirical and theoretical considerations, an item pool was created encompassing RNT content and processes. We then (1) tested model fit of a content-related and a process-related model for assessing RNT as an individual difference variable, (2) investigated the reliability and construct validity of the proposed scale(s), and (3) determined the optimal sampling design. One hundred fifty healthy participants aged 18 to 40 years filled out baseline questionnaires on rumination, worry, RNT, symptoms of depression, anxiety, and stress. Participants received 8 semi-random daily prompts assessing RNT over 14 days. After the EMA phase, participants answered questionnaires on depression, anxiety, and stress again. Multilevel confirmatory factor analysis revealed excellent model fit for the process-related model but unsatisfactory fit for the content-related model. Different hybrid models were additionally explored, yielding one model with satisfactory fit. Both the process-related and the hybrid scale showed good reliability and good convergent validity and were significantly associated with symptoms of depression, anxiety, and stress after the EMA phase when controlling for baseline scores. Further analyses found that a sampling design of 5 daily assessments across 10 days yielded the best tradeoff between participant burden and information retained by EMA. In sum, this paper presents a promising paradigm for assessing RNT in daily life.
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Affiliation(s)
| | | | - Edward R. Watkins
- Mood Disorders Centre, School of Psychology, University of Exeter, Exeter, United Kingdom
| | - Thomas Ehring
- Department of Psychology, LMU Munich, Munich, Germany
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Reflecting on rumination: Consequences, causes, mechanisms and treatment of rumination. Behav Res Ther 2020; 127:103573. [DOI: 10.1016/j.brat.2020.103573] [Citation(s) in RCA: 129] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 11/23/2019] [Accepted: 01/24/2020] [Indexed: 12/11/2022]
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Koch T, Liedl A, Takano K, Ehring T. Daily Worry in Trauma-Exposed Afghan Refugees: Relationship with Affect and Sleep in a Study Using Ecological Momentary Assessment. COGNITIVE THERAPY AND RESEARCH 2020. [DOI: 10.1007/s10608-020-10091-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Abstract
Background
Repetitive negative thinking—and worry as a common variant—have been suggested to be transdiagnostic maintaining factors of psychopathology in refugees. Using an ecological momentary assessment (EMA) approach, this study tested the feasibility of EMA and the hypothesis of a self-reinforcing relationship (a) between worry and affect and (b) between worry and sleep in refugees. Additionally, we examined whether worry interacts with postmigration stress to impact on affect and sleep.
Methods
For 1 week, 45 trauma-exposed Afghan refugees received five prompts per day asking them to report on momentary levels of worrying and negative as well as positive affect. In addition, sleep quality was assessed in the morning and the occurrence of postmigration stress at night.
Results
Our findings did not indicate a bidirectional relationships (a) between worry and affective experiences and (b) between worry and poor sleep quality. However, worry experienced on a given day predicted increased negative affect on the next day; in turn, positive affect predicted decreased worrying on the next day. Hypotheses on the interaction between worry and stress in predicting affect and sleep were not supported.
Conclusion
These preliminary findings suggest unidirectional effects of daily worry on negative affect and positive affect on daily worry. However, the low compliance rate and the small sample size precludes drawing firm conclusions. Implications for further EMA research among refugees are discussed.
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Clancy F, Prestwich A, Caperon L, Tsipa A, O’Connor DB. The association between worry and rumination with sleep in non-clinical populations: a systematic review and meta-analysis. Health Psychol Rev 2020; 14:427-448. [DOI: 10.1080/17437199.2019.1700819] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- F. Clancy
- School of Psychology, Faculty of Medicine and Health, The University of Leeds, Leeds, UK
| | - A. Prestwich
- School of Psychology, Faculty of Medicine and Health, The University of Leeds, Leeds, UK
| | - L. Caperon
- Leeds Institute of Health Sciences, Faculty of Medicine and Health, The University of Leeds, Leeds, UK
| | - A. Tsipa
- School of Psychology, Faculty of Medicine, The University of Leeds, Leeds, UK
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Camden and Islington Foundation Trust, London, UK
| | - D. B. O’Connor
- School of Psychology, Faculty of Medicine and Health, The University of Leeds, Leeds, UK
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22
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Barry TJ, Takano K, Boddez Y, Raes F. Lower Sleep Duration Is Associated With Reduced Autobiographical Memory Specificity. Behav Sleep Med 2019; 17:586-594. [PMID: 29424553 DOI: 10.1080/15402002.2018.1435542] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Objective/Background: Sleep can have an important influence on memory. However, it is unclear whether there is any relation between sleep quality and the specificity with which autobiographical memories are retrieved, a key factor associated with vulnerability for, and the presence of, depression and other psychiatric diagnoses. The present study provides the first investigation of the association between sleep quality and autobiographical memory specificity. Participants and Method: Fifty-four unselected community participants completed the Autobiographical Memory Test (AMT) to assess memory specificity, while subjective and objective measures of total sleep time and sleep onset latency were provided through a daily diary and an actigraphy wristwatch worn for a week. Participants also completed questionnaires that measure known correlates of AMT specificity: the Ruminative Response Scale (RRS) and Beck Depression Inventory (BDI-II). Results: Shorter sleep duration, measured using actigraphy, was associated with reduced autobiographical memory specificity. There was no evidence of an association between total sleep time recorded by self-report diaries, or of sleep onset latency recorded using actigraphy or diaries and memory specificity. The relation between actigraphy-assessed total sleep time and memory specificity was independent of the effects of rumination or depressive symptoms on these variables. Conclusions: Shorter sleep duration is associated with reduced memory specificity. Future research examining memory specificity and its association with psychopathology should consider the role of sleep quality around the time of memory recall in specificity.
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Affiliation(s)
- Tom J Barry
- a Experimental Psychopathology Lab, Department of Psychology, The University of Hong Kong , Hong Kong.,b Department of Psychology, The Institute of Psychiatry, Psychology & Neuroscience, King's College London , London , United Kingdom
| | - Keisuke Takano
- c Division of Clinical Psychology and Psychotherapy, Department of Psychology, Ludwig-Maximilians-University Munich , Munich , Germany
| | - Yannick Boddez
- d Centre for Learning Psychology and Experimental Psychopathology, University of Leuven , Leuven , Belgium
| | - Filip Raes
- d Centre for Learning Psychology and Experimental Psychopathology, University of Leuven , Leuven , Belgium
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Executive Dysfunction and Emotion Dysregulation Explain the Effects of Insomnia Symptoms on Repetitive Negative Thinking. COGNITIVE THERAPY AND RESEARCH 2019. [DOI: 10.1007/s10608-019-10033-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Križan Z, Hisler G. Personality and Sleep: Neuroticism and Conscientiousness Predict Behaviourally Recorded Sleep Years Later. EUROPEAN JOURNAL OF PERSONALITY 2019. [DOI: 10.1002/per.2191] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Sleep is one key feature of people's lives that defines their daily routine and reflects overall health and well–being. To test the relevance of personality for core aspects of sleep, we examined if personality traits across the five broad personality domains predicted behaviourally recorded, week–long sleep characteristics up to five years later (alongside subjective sleep quality). Data from 382 participants (63% female, aged 34–82 years) were drawn from the longitudinal study on Midlife in the United States Study—Biomarker project. In terms of mean tendencies, both neuroticism and conscientiousness signalled more sleep continuity (fewer interruptions) alongside better subjective quality. In terms of intra–individual sleep variability, neuroticism predicted more variability in sleep duration, continuity, and subjective sleep quality, while conscientiousness predicted less variability in sleep duration and sleep continuity. Extraversion, agreeableness, and openness traits did not generally foreshadow behaviourally recoded sleep, only higher ratings of subjective quality. These links were robust to the impact of demographic factors and were not moderated by the duration of time between personality and sleep assessments. The findings distinguish which personality traits foreshadow core aspects of sleep and also implicate multiple traits as predictors of variability, not just mean tendencies, in behaviourally recorded sleep. © 2019 European Association of Personality Psychology
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Affiliation(s)
- Zlatan Križan
- Department of Psychology, Iowa State University, Ames, IA USA
| | - Garrett Hisler
- Department of Psychology, Iowa State University, Ames, IA USA
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Konjarski M, Murray G, Lee VV, Jackson ML. Reciprocal relationships between daily sleep and mood: A systematic review of naturalistic prospective studies. Sleep Med Rev 2018; 42:47-58. [DOI: 10.1016/j.smrv.2018.05.005] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 05/01/2018] [Accepted: 05/29/2018] [Indexed: 11/16/2022]
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Takano K, Poel LV, Raes F. Pre-sleep arousal can be associated with efficient processing of sleep-related information. J Behav Ther Exp Psychiatry 2018; 60:13-21. [PMID: 29486370 DOI: 10.1016/j.jbtep.2018.02.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 01/04/2018] [Accepted: 02/13/2018] [Indexed: 10/18/2022]
Abstract
BACKGROUND AND OBJECTIVES Cognitive bias to sleep-related information is thought to be a core feature of sleep disturbances. The bias may enhance pre-sleep arousal, such as excessive worry about sleeplessness, which prevents people from initiating normal sleep onset. The present study focused on (a) attention bias toward sleep-related stimuli and (b) difficulty in updating working memory for sleep-related stimuli as two possible mechanisms underlying pre-sleep cognitive arousal. METHOD Participants (n = 61, a community sample) completed a dot-probe task (with sleep-related and matched control word stimuli) and a 1-back and 2-back task (with sleep-related and non-sleep-related pictorial stimuli). RESULTS For the dot-probe task, the results showed no significant association between pre-sleep cognitive arousal and sleep-related attention bias. However, the results of the 2-back task suggest that pre-sleep arousal is associated with decreased interference by sleep-related stimuli in maintaining non-sleep-related information. That is, individuals with higher levels of pre-sleep arousal are more efficient at processing sleep-related materials. LIMITATIONS The non-clinical nature of the sample may limit the clinical implications of the findings. CONCLUSIONS Although the current results cannot be explained by the extant cognitive theories of insomnia, we offer an alternative explanation based on the idea of worry as mental habit: mental processes that occur frequently (e.g., repetitive thoughts about sleep) require less cognitive resource. Therefore, sleep-related information may be processed easily without consuming much cognitive effort.
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Affiliation(s)
- Keisuke Takano
- Department of Psychology, Clinical Psychology and Psychotherapy, Ludwig-Maximilians-University Munich, Germany.
| | - Louise Vanden Poel
- Center for the Psychology of Learning and Experimental Psychopathology, University of Leuven, Belgium
| | - Filip Raes
- Center for the Psychology of Learning and Experimental Psychopathology, University of Leuven, Belgium
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Nota JA, Coles ME. Shorter sleep duration and longer sleep onset latency are related to difficulty disengaging attention from negative emotional images in individuals with elevated transdiagnostic repetitive negative thinking. J Behav Ther Exp Psychiatry 2018; 58:114-122. [PMID: 29111422 DOI: 10.1016/j.jbtep.2017.10.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 10/06/2017] [Accepted: 10/09/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND OBJECTIVES Repetitive negative thinking (RNT) is often associated with disruptions in sleep and circadian rhythms. Disruptions in sleep and circadian rhythms may deal a "second hit" to attentional control deficits. This study evaluated whether sleep and circadian rhythm disruptions are related to the top-down control of attention to negative stimuli in individuals with heightened repetitive negative thinking. METHODS Fifty-two community adults with high levels of transdiagnostic RNT and varying habitual sleep durations and bedtimes participated in a hybrid free-viewing and directed attention task using pairs of emotionally-evocative and neutral images while eye-tracking data were collected. Self-report and clinician-administered interviews regarding sleep were also collected. RESULTS Shorter habitual sleep duration was associated with more time looking at emotionally negative compared to neutral images during a free-viewing attention task and more difficulty disengaging attention from negative compared to neutral images during a directed attention task. In addition, longer sleep onset latencies were also associated with difficulty disengaging attention from negative stimuli. The relations between sleep and attention for positive images were not statistically significant. LIMITATIONS A causal link between sleep and attentional control cannot be inferred from these cross-sectional data. The lack of a healthy control sample means that the relations between sleep disruption, attention, and emotional reactivity may not be unique to individuals with RNT. CONCLUSIONS These findings suggest that sleep disruption may be associated with a specific impact on cognitive resources that are necessary for the top-down inhibitory control of attention to emotionally negative information.
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Affiliation(s)
- Jacob A Nota
- Binghamton University, Department of Psychology, United States.
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Amaral AP, Soares MJ, Pinto AM, Pereira AT, Madeira N, Bos SC, Marques M, Roque C, Macedo A. Sleep difficulties in college students: The role of stress, affect and cognitive processes. Psychiatry Res 2018; 260:331-337. [PMID: 29227897 DOI: 10.1016/j.psychres.2017.11.072] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 11/25/2017] [Accepted: 11/25/2017] [Indexed: 10/18/2022]
Abstract
Previous research indicates that sleep difficulties and stress are prevalent in college students. The main aim of the current study was to investigate the role of repetitive negative thinking (RNT), cognitive emotion regulation, and negative affect as mediators of the relationship between stress and sleep difficulties. We also intended to analyse the associations between all these variables and the gender differences. A sample of 549 college students completed self-report measures assessing the mentioned variables. Descriptive and correlational analyses showed significant differences between genders. In total sample, sleep difficulties were positively associated with perceived stress, negative affect, RNT and cognitive emotional strategies (rumination, self-blaming, catastrophizing, and acceptance). Mediation analyses suggested that in addition to the direct effect of stress on sleep difficulties, rumination and negative affect were important mediators in this relationship (after controlling gender). RNT did not mediate this association; however it was significantly associated to rumination and/or negative affect. These findings suggest that the effect of stress on sleep difficulties is strengthened by rumination and/or negative affect. The negative impact of RNT (content free) only occurs if associated to rumination and/or negative affect.
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Affiliation(s)
- Ana Paula Amaral
- ESTESC -Coimbra Health School, Polytechnic Institute of Coimbra, Coimbra, Portugal; Department of Psychological Medicine, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
| | - Maria João Soares
- Department of Psychological Medicine, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Ana Margarida Pinto
- Department of Psychological Medicine, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Ana Telma Pereira
- Department of Psychological Medicine, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Nuno Madeira
- Department of Psychological Medicine, Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Coimbra Hospital and University Centre, Coimbra, Portugal
| | - Sandra Carvalho Bos
- Department of Psychological Medicine, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Mariana Marques
- Department of Psychological Medicine, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Carolina Roque
- Department of Psychological Medicine, Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Coimbra Hospital and University Centre, Coimbra, Portugal
| | - António Macedo
- Department of Psychological Medicine, Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Coimbra Hospital and University Centre, Coimbra, Portugal
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Kaplan DM, Palitsky R, Carey AL, Crane TE, Havens CM, Medrano MR, Reznik SJ, Sbarra DA, O'Connor MF. Maladaptive repetitive thought as a transdiagnostic phenomenon and treatment target: An integrative review. J Clin Psychol 2018; 74:1126-1136. [DOI: 10.1002/jclp.22585] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 11/13/2017] [Accepted: 11/20/2017] [Indexed: 01/15/2023]
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Hoggard LS, Hill LK. Examining How Racial Discrimination Impacts Sleep Quality in African Americans: Is Perseveration the Answer? Behav Sleep Med 2018; 16:471-481. [PMID: 27690630 PMCID: PMC5378656 DOI: 10.1080/15402002.2016.1228648] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND African Americans experience more problematic and disordered sleep than White Americans. Racial discrimination has been implicated in this disparity. However, the mechanisms by which discrimination disrupts sleep are unclear. It has been theorized that Perseverative Cognition (PC), characterized by recurrent patterns of reflective (i.e., rumination) and anticipatory (i.e., worry) negative thinking about personally relevant stressors, may reflect the functional mechanism linking discrimination to sleep. The present study is the first to empirically examine the dual components of PC as a candidate functional mechanism in the association between racial discrimination and subjective sleep quality. PARTICIPANTS Sixty-eight self-identified African American college students (55.9% female; Mage = 20.18, SD = 2.93) were recruited at a large predominantly white public university in the Midwest. METHODS The participants completed the Perceived Ethnic Discrimination Questionnaire (PEDQ), Pittsburgh Sleep Quality Index (PSQI), Penn State Worry Questionnaire (PSWQ), and Ruminative Responses Scale (RRS). RESULTS After adjusting for age, gender, and social class, results revealed a significant indirect effect of racial discrimination (RD) on subjective sleep quality through rumination, 95% CI [.008, .125], but not worry. RD was positively associated with rumination, b =.50, SE =.16, p = .003, and rumination, in turn, was positively associated with poorer sleep quality, b = .09, SE = .04, p = .012. CONCLUSIONS As both RD and poor sleep quality have been directly linked to heart disease, diabetes, depression, and a number of other maladies, our findings suggest that RD, sleep, and coping strategies (e.g., rumination) employed to manage RD experiences may be important targets for addressing racial disparities in health.
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Affiliation(s)
- Lori S. Hoggard
- Center for Health Equity Research, Department of Social Medicine and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina,Institute of African American Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - LaBarron K Hill
- c Department of Psychiatry and Behavioral Sciences , Duke University Medical Center , Durham , North Carolina.,d Center for Biobehavioral Health Disparities Research , Duke University , Durham , North Carolina.,e Center for the Study of Aging and Human Development , Duke University Medical Center , Durham , North Carolina
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31
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Positive affect and sleep: A systematic review. Sleep Med Rev 2017; 35:21-32. [DOI: 10.1016/j.smrv.2016.07.006] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 07/13/2016] [Accepted: 07/18/2016] [Indexed: 01/19/2023]
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32
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Fergus TA, Scullin MK. The Cognitive Attentional Syndrome is Associated With Sleep Difficulties in a Community Sample. Behav Sleep Med 2017; 15:410-420. [PMID: 27115050 DOI: 10.1080/15402002.2016.1141771] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We examined whether a process common to anxiety, labeled the cognitive attentional syndrome (CAS), is also associated with sleep disturbances. The CAS represents the sustained use of self-regulating strategies, such as rumination and worry, and beliefs individuals hold about such strategies. Using a sample of community adults located in the United States (N = 226), we found that the CAS was positively associated with sleep difficulties. The association remained intact after controlling for demographic variables, physical health, and negative affect. We further found that self-regulating strategies may be the component of the CAS that is most important to sleep disturbances. Future experimental studies are needed to elucidate whether there exists a causal, and potentially bidirectional, link between the CAS and sleep difficulties.
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Affiliation(s)
- Thomas A Fergus
- a Department of Psychology and Neuroscience , Baylor University , Waco , Texas
| | - Michael K Scullin
- a Department of Psychology and Neuroscience , Baylor University , Waco , Texas
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Grove JL, Smith TW, Crowell SE, Ellis JH. Preliminary Evidence for Emotion Dysregulation as a Mechanism Underlying Poor Sleep Quality in Borderline Personality Disorder. J Pers Disord 2017; 31:542-552. [PMID: 27617649 DOI: 10.1521/pedi_2016_30_261] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Sleep disturbance is common in borderline personality disorder (BPD), yet the reasons for this association are not clear. The present study sought to extend prior studies by testing emotion dysregulation as a mechanism underlying this association. We administered self-report measures of sleep quality (SQ), emotion dysregulation, and borderline features to two cross-sectional samples of undergraduates (sample 1: N = 293; sample 2: N = 188). In addition to replicating prior studies linking BPD features to poor SQ, analyses indicated that BPD features related to emotion dysregulation were most strongly correlated with poorer global SQ across both samples. Further, bootstrapping techniques revealed indirect associations by total score on the Difficulties in Emotion Regulation Scale (DERS), as well as for several of its facets (lack of strategies, lack of emotional clarity, lack of awareness). We discuss the potential clinical relevance of emotion dysregulation in the treatment of co-occurring sleep problems in BPD.
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Chiu VW, Ree M, Janca A, Waters F. Sleep in Schizophrenia: Exploring Subjective Experiences of Sleep Problems, and Implications for Treatment. Psychiatr Q 2016; 87:633-648. [PMID: 26687510 DOI: 10.1007/s11126-015-9415-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Sleep dysfunction is a pervasive issue in schizophrenia and psychosis. Current knowledge is drawn almost exclusively from studies using quantitative research methodologies that include measures and tools developed in healthy population groups. Qualitative studies investigating the first-person perspectives of sleep problems are therefore important for designing better assessment and treatment tools to meet consumer needs. Focus groups were conducted to elicit detailed information regarding the personal experience of sleep problems, their antecedents and impact, in 14 individuals with schizophrenia-spectrum disorder who experienced insomnia during their illness. Thematic analysis was applied to examine the data and draw treatment implications for sleep management. Insomnia was ubiquitous and frequently co-occurred with other sleep difficulties (nightmares, sleep walking, acting out dreams, etc.) in this group. Discussions revealed themes common across insomnia populations (role of negative mood states and cognitive intrusions) and also new themes on factors contributing to sleep problems in schizophrenia: (1) beliefs that sleep problems cannot be changed; (2) trauma and adversity; (3) lifestyle choices and lack of motivation; and (4) medication side effects. Sleep problems also had profound impact on daytime dysfunctions and disability. The findings point to novel issues that may benefit from consideration in the treatment of sleep problems in schizophrenia. Unhelpful cognitions and behaviours about sleep can be addressed with psychological interventions, activity scheduling and motivational interviewing techniques. Seeking a first-person perspective is vital for identifying issues that will impact on treatment success and recovery.
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Affiliation(s)
- Vivian W Chiu
- Clinical Research Centre, Graylands Hospital, North Metropolitan Area Health Service Mental Health (NMHS MH), Private Mailbag No 1, Claremont, Perth, WA, 6910, Australia. .,School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, WA, Australia.
| | - Melissa Ree
- The Marian Centre, Subiaco, Perth, WA, Australia
| | - Aleksandar Janca
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, WA, Australia
| | - Flavie Waters
- Clinical Research Centre, Graylands Hospital, North Metropolitan Area Health Service Mental Health (NMHS MH), Private Mailbag No 1, Claremont, Perth, WA, 6910, Australia.,School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, WA, Australia
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I sleep with my Mind's eye open: Cognitive arousal and overgeneralization underpin the misperception of sleep. J Behav Ther Exp Psychiatry 2016; 52:157-165. [PMID: 27136307 DOI: 10.1016/j.jbtep.2016.04.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 04/23/2016] [Accepted: 04/25/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Misperception of sleep (e.g., underestimation of sleep time relative to objective measures) is a common feature of insomnia and other psychopathologies. To elucidate the mechanisms underlying this tendency, we examined the role of pre-sleep cognitive arousal and overgeneralization. METHODS We monitored the sleep of 54 community dwellers (the majority being university students), using actigraphy and a sleep diary for 7 days. Immediately after this period, the participants provided an additional global evaluation of their sleep for the past week. In this global evaluation, participants were asked to estimate their average number of hours of sleep and the duration of time taken to fall asleep (sleep onset latency) across the past seven nights. RESULTS Single-night misperceptions (difference between actigraphy and sleep diary estimations) of sleep time and sleep onset latency were significantly associated with pre-sleep cognitive arousal, but not with overgeneralization. In contrast, global misperception of sleep (difference between sleep diary and global estimations) were associated with overgeneralization, but not with cognitive arousal. LIMITATIONS Our sample mainly consisted of female university students, which limits the generalizability of the results. CONCLUSIONS Misperception of sleep occurs in two cases: (1) in the case of a single night due to excessive arousal, and (2) in the case of multiple nights due to overgeneralization.
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Harbard E, Allen NB, Trinder J, Bei B. What's Keeping Teenagers Up? Prebedtime Behaviors and Actigraphy-Assessed Sleep Over School and Vacation. J Adolesc Health 2016; 58:426-432. [PMID: 26874590 DOI: 10.1016/j.jadohealth.2015.12.011] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 11/17/2015] [Accepted: 12/08/2015] [Indexed: 02/08/2023]
Abstract
PURPOSE Technology-related behaviors (e.g., computer use) before bedtime (BT) have been associated with poorer and shorter sleep in adolescents; however, less is known about other behaviors in relation to sleep. This study characterized a range of behaviors in the hour before bed (i.e., pre-BT behaviors [PBBs]) and examined their relationship with sleep parameters during school and vacation periods (i.e., restricted and extended sleep opportunities, respectively). Mechanistic roles of chronotype and cognitive presleep arousal (PSAcog) were also examined. METHODS During the last week of a school term and throughout a 2-week vacation, 146 adolescents (47.26% male, age M ± standard deviation = 16.2 ± 1.0 years) from the general community completed daily sleep measure using actigraphy, self-report measures on PBBs and PSAcog (Presleep Arousal Scale) for both school and vacation periods, and chronotype (Morningness-Eveningness Questionnaire). RESULTS Adolescents engaged in a variety of behaviors before bed. Notably, playing video games was associated with significantly later school and vacation BT and shorter school sleep duration (controlling for chronotype). During vacation, online social media was associated with significantly longer sleep onset latency, and this relationship was mediated by higher PSAcog. In contrast, on school nights, spending time with family was associated with significantly earlier BT and longer sleep duration. CONCLUSIONS Technology-related PBBs video games and online social media were risk factors for shorter and poorer sleep, whereas time with family was protective of sleep duration. In addressing sleep problems in adolescents, therapeutic procedures that target the potentially addictive nature of technology use and reduce PSAcog were implicated.
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Affiliation(s)
- Emily Harbard
- Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Biomedical and Psychological Sciences, Monash University, Victoria, Australia
| | - Nicholas B Allen
- Melbourne School of Psychological Sciences, University of Melbourne, Victoria, Australia; Department of Psychology, University of Oregon, Eugene, Oregon
| | - John Trinder
- Melbourne School of Psychological Sciences, University of Melbourne, Victoria, Australia
| | - Bei Bei
- Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Biomedical and Psychological Sciences, Monash University, Victoria, Australia; Department of Psychiatry, Centre for Women's Mental Health, Royal Women's Hospital, University of Melbourne, Victoria, Australia.
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Thielsch C, Ehring T, Nestler S, Wolters J, Kopei I, Rist F, Gerlach AL, Andor T. Metacognitions, worry and sleep in everyday life: Studying bidirectional pathways using Ecological Momentary Assessment in GAD patients. J Anxiety Disord 2015; 33:53-61. [PMID: 26005837 DOI: 10.1016/j.janxdis.2015.04.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 04/30/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND The metacognitive model of generalized anxiety disorder proposes that negative metacognitive beliefs are crucial in the maintenance of excessive worry. Furthermore, according to the cognitive model of insomnia, worry leads to problems falling or staying asleep and poor sleep quality. In order to test the assumed causal relationships, the present study examined the time-dependent course of negative metacognition and worry as well as worry and sleep quality, using Ecological Momentary Assessment (EMA). METHOD Negative metacognitions, worry and sleep were assessed by self-report questionnaires as well as EMA in 56 GAD patients who carried a portable device for 1 week and logged sleep quality, negative metacognition and worry processes four times a day. RESULTS Metacognitions, worry and sleep were significantly correlated. Structural equation modeling using multilevel analyses showed a unidirectional relationship of negative metacognitions leading to prolonged worry processes and a bidirectional relationship of worry and sleep quality. CONCLUSIONS These findings support the theoretically derived assumptions on the relationship between negative metacognitions, worry and sleep. Implications for further research as well as clinical implications are discussed.
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Affiliation(s)
| | - Thomas Ehring
- Institute of Psychology, University of Münster, Germany; Department of Psychology, University of Munich, Germany
| | | | | | - Ina Kopei
- Institute of Psychology, University of Münster, Germany
| | - Fred Rist
- Institute of Psychology, University of Münster, Germany
| | | | - Tanja Andor
- Institute of Psychology, University of Münster, Germany
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Takano K, Ueno M, Tanno Y. Self-focused thinking predicts nighttime physiological de-arousal. Biol Psychol 2014; 97:9-14. [PMID: 24444702 DOI: 10.1016/j.biopsycho.2014.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Revised: 12/19/2013] [Accepted: 01/07/2014] [Indexed: 11/29/2022]
Abstract
Excessive focus on the internal self has maladaptive consequences for mental and physical health. Although the emotional functions of self-focus have been well established, no study has examined physiological arousal during the daily experience of self-focused thinking. The present study investigates the association between self-focus and autonomic activity using the experience sampling method with ambulatory monitoring of heart rate variability (HRV). Forty-five students reported the content of their thoughts during their daily activities while their heart rate (HR) was being recorded. Multilevel modeling analyses showed that HRV was lower (and HR was higher) over the sampling day if participants engaged in more self-focus, while HRV increased (and HR decreased) from midday to nighttime if participants did not engage in self-focused thinking. These results suggest that self-focus at night is associated with increased physiological arousal, and leads to inhibition of de-arousal associated with normal sleep processes. Implications for insomnia are discussed.
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Affiliation(s)
- Keisuke Takano
- University of Tokyo, 3-8-1 Komaba, Meguro-ku, Tokyo 153-8902, Japan.
| | - Mayumi Ueno
- National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8553, Japan
| | - Yoshihiko Tanno
- University of Tokyo, 3-8-1 Komaba, Meguro-ku, Tokyo 153-8902, Japan
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